Table of Contents
NURS FPX 6218 Proposing Evidence-Based Change Paper Example
NURS FPX 6218 Assessment 1 Proposing Evidence-Based Change
NURS FPX 6218 Proposing Evidence-Based Change Paper Assignment Brief
Course: NURS-FPX 6218 Leading the Future of Health Care
Assignment Title: NURS FPX 6218 Assessment 1 Proposing Evidence-Based Change
Assignment Overview
In this assignment, you will propose a change to one aspect of your local or regional healthcare system or program with the aim of improving outcomes. Additionally, you will conduct a comparative analysis of different non-U.S. healthcare systems to gain insights into potential strategies for change. The assignment will culminate in a summary report presenting your proposed change and comparative analysis to executive leaders.
Understanding Assignment Objectives
The primary objective of this assignment is to identify an area within the local or regional healthcare system that requires improvement and propose evidence-based changes to address it. You will analyze various non-U.S. healthcare systems to understand different approaches to similar issues and determine their applicability to the proposed change.
The Student’s Role
As a nursing student, your role is to critically assess the current healthcare system or program within your locality or region. You will evaluate its strengths and weaknesses, identify areas for improvement, and propose evidence-based changes to enhance outcomes. Additionally, you will conduct research on non-U.S. healthcare systems to understand alternative approaches and gather insights for your proposed change.
Competencies Measured
This assignment aims to measure several competencies, including:
- Critical thinking: Assessing the effectiveness of current healthcare practices and proposing evidence-based changes.
- Research skills: Conducting comparative analyses of different healthcare systems to gather insights and inform decision-making.
- Communication: Clearly articulating proposed changes and comparative analysis findings in a summary report format suitable for executive leaders.
You Can Also Check Other Related Assessments for the NURS-FPX 6218 Leading the Future of Health Care Course:
NURS FPX 6218 Assessment 2 Assessing Community Health Care Needs Example
NURS FPX 6218 Assessment 3 Planning for Community and Organizational Change Example
NURS FPX 6218 Assessment 4 Advocating for Lasting Change Example
NURS FPX 6218 Proposing Evidence-Based Change Paper Example
Change Proposal Summary Report
The primary objective of this executive summary report is to advocate for a change in the approach to managing peripheral neuropathy in diabetic patients within healthcare organizations in Colorado. This proposal entails thorough research on peripheral neuropathy followed by a comparative analysis of its management in healthcare systems outside the United States. The aim is to identify effective strategies and measures to enhance the health outcomes of individuals with diabetes by reducing complications associated with peripheral neuropathy.
Executive Summary
Proposed Change
Peripheral neuropathy presents a significant challenge for individuals with diabetes, causing pain, sensory loss, and tingling sensations due to nerve damage. This complication, known as Diabetic Peripheral Neuropathy (DPN), affects about half of all diabetics and increases the risk of foot ulcers and subsequent amputations (Hicks & Selvin, 2019). To address these adverse effects, there is a pressing need for proactive screening and management of diabetes through regular monitoring of HbA1c levels, foot examinations, and effective pain management.
In Colorado, healthcare systems are grappling with the emerging issue of peripheral neuropathy among diabetic patients, leading to symptoms like foot numbness, pain, ulcers, and even amputations. Given the profound impact of diabetic peripheral neuropathy on patients’ quality of life, it is imperative to focus on improving care in this specific area to enhance the health and well-being of individuals with diabetes. By prioritizing regular foot examinations, in line with recommendations from the American Diabetes Association (American Diabetes Association Professional Practice Committee, 2021), and optimizing glycemic control through lifestyle changes and medication, we can mitigate the risk of peripheral neuropathy and its progression. Additionally, patient education on foot care and self-management strategies for controlling blood sugar levels can delay the onset of peripheral neuropathy (Alahakoon et al., 2020).
Desired Outcomes
This proposal aims to improve the outcomes for diabetes patients with peripheral neuropathy by focusing on adequate foot examination, foot care, and patient education. The desired outcomes we aim to achieve through this proposal for change and improvement are outlined below:
- Prevention of Neuropathy Complications: Timely management of diabetes and peripheral neuropathy can help prevent complications such as infections, delayed healing, foot ulcerations, and leg amputations in advanced cases of peripheral neuropathy (Selvarajah et al., 2019).
- Enhanced Sensation: Peripheral neuropathy damages sensory peripheral nerves, affecting sensation to temperature, pain, and pressure, leading to numbness and tingling. By improving glycemic levels and preventing peripheral neuropathy, diabetic patients can experience enhanced sensation to changes in physical stimuli, which facilitates preventing injuries (Agarwal et al., 2019).
- Improved Mobility and Preservation of Limb Function: Managing and preventing peripheral neuropathy through lifestyle modification and dietary changes to regulate glycemic levels promote mobility in people with diabetes. This helps them balance and coordinate their gait while walking, which can be hindered by lower nerve power. Improved mobility reduces the risk of patient falls and helps people with diabetes stay active throughout their lifetime (Zilliox & Russell, 2019).
Achieving these outcomes requires stakeholders to invest in care and implement necessary changes. Healthcare organizations need adequate resources to provide attentive care to people with diabetes regarding peripheral neuropathy. This includes conducting regular foot examinations and guiding patients to self-care for their feet by regulating their blood glucose levels. Additionally, external resources such as Medicare and Medicaid programs under the Affordable Care Act, which provide health insurance coverage for older people with chronic diseases and promote care delivery in low-income individuals, can also be utilized (Duru et al., 2020).
Several factors may limit the achievement of these outcomes, including the need for more human and financial resources, inadequate inter-professional collaboration, and patient compliance issues. Implementing inter-professional collaboration in delivering patient-centered care to manage diabetes, along with training physicians and nurses on performing foot examinations properly, can help address these limitations. Furthermore, providing effective foot care to avoid long-term complications of peripheral neuropathy is crucial (Aalaa et al., 2022).
Health Care System Comparative Analysis
A comparative analysis was conducted to explore the management and prevention of peripheral neuropathy in two non-U.S. healthcare systems to broaden our understanding and identify effective approaches. The National Health Service (NHS) in the United Kingdom adheres to guidelines set by the National Institute for Health and Care Excellence (NICE) regarding the management of diabetes and associated complications like peripheral neuropathy. NICE recommends regular foot examinations and patient education on self-care for individuals with diabetes to prevent peripheral neuropathy and its complications (NICE, 2019). These guidelines outline the frequency of foot assessments, focusing particularly on adults with diabetes to ensure early detection and intervention when foot problems arise.
Additionally, NICE provides guidance on investigating and treating foot ulcers, infections, and Charcot arthropathy. Another notable healthcare system in Australia follows guidelines from the Australian Diabetes Society (ADS), specifically Diabetes Feet Australia (DFA). DFA offers comprehensive strategies and guidelines for diabetic foot care, including educational webinars and events aimed at preventing peripheral neuropathy. Recently, DFA introduced digital platforms for accessing foot care guidelines and daily foot care checklists, enhancing accessibility for patients with diabetes (Diabetes Feet Australia, n.d.).
These approaches from the UK and Australia offer valuable insights for the U.S. healthcare system, particularly in managing peripheral neuropathy. In Colorado’s local healthcare systems, there is a need for annual foot examinations for diabetic patients, accompanied by physician training on foot disease evaluation and timely care provision. Additionally, educational initiatives on foot care for individuals with diabetes can be developed, drawing inspiration from successful programs in Australian healthcare systems.
Rationale for the Proposed Change
Implementing these specific proposed changes has the potential to enhance outcomes for diabetic patients, particularly concerning peripheral neuropathy. By adopting preventive and management strategies outlined in guidelines from the National Institute for Health and Care Excellence (NICE) and recommendations from Diabetes Feet Australia (DFA), individuals with diabetes can experience prolonged life expectancy and maintain mobility and physical activity as their peripheral nerves remain unaffected. Additionally, the risk of lower limb amputation can be minimized through regular monitoring of glycemic levels, coupled with appropriate foot examinations and care (Selvarajah et al., 2019).
Furthermore, the proposed change facilitates self-care among individuals with diabetes, empowering them to recognize foot-related symptoms promptly and seek medical attention when necessary. This proactive approach to managing peripheral neuropathy can significantly improve health outcomes for diabetic patients, preventing the progression of complications and enhancing overall quality of life.
Financial and Health Implications
The implementation of proposed changes aimed at preventing and managing peripheral neuropathy in individuals with diabetes can lead to significant financial and health implications. By addressing peripheral neuropathy in its early stages, financial resources that would otherwise be spent on treating advanced complications and long-term rehabilitation can be avoided (Rodríguez-Sánchez et al., 2019). This proactive approach to screening, treatment, and management can result in reduced healthcare costs for both patients and healthcare organizations, as there will be fewer hospitalizations, surgeries, and medical interventions required.
Moreover, timely prevention and management of peripheral neuropathy can have substantial health benefits for individuals with diabetes. It can enhance their quality of life, improve glycemic control, and positively impact their prognosis. By avoiding the progression of peripheral neuropathy, individuals with diabetes can mitigate the risk of developing foot problems and related complications (Rodríguez-Sánchez et al., 2019).
Conversely, failing to implement these proposed changes in a timely manner can have detrimental financial and health consequences. Advanced cases of peripheral neuropathy may necessitate costly surgeries and medical interventions, imposing a significant financial burden on both patients and healthcare organizations (Kiyani et al., 2020). Additionally, individuals may experience a diminished quality of life due to impaired mobility, leading to reduced productivity and compromised overall well-being.
Conclusion
In conclusion, the proposed evidence-based changes outlined in this report offer a comprehensive approach to improving the management and prevention of peripheral neuropathy in individuals with diabetes. By prioritizing regular foot examinations, optimizing glycemic control, and promoting patient education on self-care strategies, healthcare organizations can mitigate the risks associated with diabetic peripheral neuropathy. Moreover, drawing insights from comparative analyses of healthcare systems in the United Kingdom and Australia provides valuable guidance for implementing similar strategies in local healthcare systems, such as those in Colorado. These changes not only promise to enhance the quality of life for individuals with diabetes but also carry significant financial implications by reducing healthcare costs associated with advanced complications. However, addressing the limitations and challenges, such as resource constraints and patient compliance issues, will be crucial in achieving the desired outcomes and realizing the full potential of these evidence-based changes.
References
Aalaa, M., Malazy, O. T., & Sanjari, M. (2022). Effects of nurse-led telephone follow-up on blood glucose levels and neuropathic symptoms in patients with diabetic peripheral neuropathy: A randomized controlled trial. Journal of Diabetes & Metabolic Disorders, 21(1), 205–212.
Agarwal, P., Chandran, S. P., & Rajitha, K. (2019). Prevalence of diabetic peripheral neuropathy among patients with type 2 diabetes mellitus in a tertiary care hospital in Kerala. International Journal of Contemporary Medical Research, 6(8), H5–H8.
American Diabetes Association Professional Practice Committee. (2021). 14. Diabetes care in the hospital: Standards of medical care in diabetes—2021. Diabetes Care, 44(Supplement 1), S211–S220.
Diabetes Feet Australia. (n.d.). Retrieved from https://www.diabetesfeetaustralia.org/
Duru, O. K., Mangione, C. M., Hsu, J., Steers, N. W., & Farmer, M. M. (2020). Effect of eliminating race-based clinical algorithms on quality of care and outcomes among patients with diabetes: A cluster randomized clinical trial. JAMA Network Open, 3(11), e2021055–e2021055.
Hicks, C. W., & Selvin, E. (2019). Epidemiology of peripheral neuropathy and lower extremity disease in diabetes. Current Diabetes Reports, 19(10), 86.
Kiyani, M., Yang, Z., Charalambous, L. T., Adil, S. M., Lee, H.-J., Yang, S., Pagadala, P., Parente, B., Spratt, S. E., & Lad, S. P. (2020). Painful diabetic peripheral neuropathy: Health care costs and complications from 2010 to 2015. Neurology: Clinical Practice, 10(1), 47–57.
NICE. (2019). Diabetic foot problems: Prevention and management. Retrieved from https://www.nice.org.uk/guidance/ng19
Rodríguez-Sánchez, B., Peña-Longobardo, L. M., & Sinclair, A. J. (2019). Cost-effectiveness analysis of the neuropad device as a screening tool for early diabetic peripheral neuropathy. The European Journal of Health Economics, 21(3), 335–349.
Selvarajah, D., Kar D., Khunti, K., Davies, M. J., & Scott, A. R. (2019). Diabetic peripheral neuropathy: Advances in diagnosis and strategies for screening and early intervention. The Lancet Diabetes & Endocrinology, 7(12), 938–948.
Zilliox, L. A., & Russell, J. W. (2019). Treatment of diabetic sensory polyneuropathy. Current Treatment Options in Neurology, 21(4), 1–16.
Detailed Assessment Instructions for the NURS FPX 6218 Proposing Evidence-Based Change Paper Assignment
Description
Propose a change to one aspect of your local or regional health care system or program that would improve outcomes. Then, conduct a comparative analysis of other, non-U. S. health care systems, focusing on the proposed change. Summarize the proposed change and your comparative analysis in a 4–5-page report.
Preparation
Your organization, in collaboration with the key stakeholders from the community, is funding an initiative to investigate potential improvements in the local or regional health care system. As a nurse leader attuned to the effects of health care policy and finance on the provision of affordable, high-quality care, you have been asked to join the task force conducting the study.
You know that an examination of other countries’ health care systems can provide a solid, evidence-based foundation for evaluating outcomes and identifying benchmarks. Consequently, you have decided to undertake an analysis of selected, non-U.S. health care systems and compare them to each other and to the existing local or regional U.S. system to help inform decision making as the task force considers proposed changes.
In this assessment, you will propose a change to one aspect of your local or regional health care system or program. Conduct a comparative analysis of different health care systems and summarize your proposed change and findings from your analysis in a report to executive leaders. To prepare for your assessment, you are encouraged to begin thinking about the non-U.S. health care systems you might like to examine. In addition, you may wish to:
- Review the assessment requirements and scoring guide to ensure that you understand the work you will be asked to complete.
- Review Guiding Questions: Proposing Evidence-Based Change [DOCX], which includes questions to consider and additional guidance on how to successfully complete the assessment.
- Note: Remember that you can submit all or a portion of your draft report to Smarthinking Tutoring for feedback before you submit the final version for this assessment. If you plan on using this free service, be mindful of the turnaround time of 24–48 hours for receiving feedback.MSN PROGRAM JOURNEY
The following is a useful map that will guide you as you continue your MSN program. This map gives you an overview of all the steps required to prepare for your practicum and to complete your degree. It also outlines the support that will be available to you along the way. - MSN Program Journey.
- TEMPLATES
Use this template for your summary report. - Summary Report Template [DOCX].
Requirements
Complete this assessment in three steps:
- Propose a change to one aspect of your local or regional health care system or program that would improve outcomes.
- Conduct a comparative analysis of different health care systems, focusing on one aspect of the system you are proposing to change.
- Summarize your proposed change and the results of your comparative analysis in a report to executive leaders.
The summary report requirements outlined below, correspond to the grading criteria in the scoring guide for Proposing Evidence-Based Change, so be sure to address each point. Read the performance-level descriptions for each criterion to see how your work will be assessed. The Guiding Questions: Proposing Evidence-Based Change document provides additional considerations that may be helpful in completing your assessment. In addition, be sure to note the requirements below for document format and length and for citing supporting evidence.
- Identify an aspect of a local or regional health care system or program that should be a focus for change.
- Define desirable outcomes, including who will pay for care and factors limiting achievement of those outcomes.
- Analyze two non-U.S. health care systems or programs that offer insight into a proposed change for a health care system or program in the United States.
- Choose one of the following options for selecting the two systems or programs:
- Option 1: Select two systems at opposite ends of the scale in terms of desirable outcomes for the issue reflected in your proposed change.
- Option 2: Select two systems that both produce positive outcomes but take unique or innovative approaches to the problem.
- Compare the outcomes in each non-U.S. system with each other and with present outcomes in your local or regional health care system.
- Explain why specific changes will lead to improved outcomes.
- Determine the financial and health implications associated with the proposed changes.
- Address the implications of making the changes.
- Address the implications of not making the changes.
- Write clearly and concisely in a logically coherent and appropriate form and style.
- Support assertions, arguments, propositions, and conclusions with relevant and credible evidence.
United Nations
- United Nations. (n.d.). UN E-government knowledge database. Retrieved from https://publicadministration.un.org/egovkb/Data-Center
- United Nations. (n.d.). Health. Retrieved from http://www.un.org/en/sections/issues-depth/health/index.html
- United Nations. (n.d.). Millennium development goals and beyond 2015. Retrieved from http://www.un.org/millenniumgoals/
World Health Organization
- World Health Organization. (n.d.). Global Health Observatory (GHO) data: Country statistics. Retrieved from http://www.who.int/gho/countries/en/
- World Health Organization. (n.d.). Global Health Observatory (GHO) data. Retrieved from http://www.who.int/gho/en/
- World Health Organization. (n.d.). The Global Health Observatory: Universal health coverage. Retrieved from http://apps.who.int/gho/cabinet/uhc.jsp?lang=en
Improving Care
The following articles provide various perspectives on improving care.
- Gluyas, H. (2015). Patient-centered care: Improving healthcare outcomes. Nursing Standard, 30(4), 50–57.
- Addresses barriers to the provision of care and strategies to overcome them.
- Melnyk, B. M., & Newhouse, R. (2014). Evidence-based practice versus evidence-informed practice: A debate that could stall forward momentum in improving healthcare quality, safety, patient outcomes, and costs. Worldviews on Evidence-Based Nursing, 11(6), 347–349.
- Addresses the debate about changes in terminology and the implications of such a change in the momentum for evidence-based practice.
- Mohammed, K., Nolan, M. B., Rajjo, T., Shah, N. D., Prokop, L. J., Varkey, P., & Murad, M. H. (2016). Creating a patient-centered health care delivery system: A systematic review of health care quality from the patient perspective. American Journal of Medical Quality, 31(1), 12–21.
- Examines a variety of studies on quality from the perspective of the patient.
- Robbins, R. A. (2017). Is quality of healthcare improving in the US? Southwest Journal of Pulmonary & Critical Care, 14(1), 29–36.
- Addresses the issue of meaningful outcomes. Provides data indicating that the rate of improvement is slowing and that many quality gains cited by politicians and administrators are not associated with improved outcomes.
Change Proposal Summary Report
Note: Delete this note and all instructions from the template before submitting your report.Use headings to organize your text, rather than bullets.
Executive Summary
Proposed Change
Identify an aspect of a local or regional health care system or program that should be a focus for change.
Desired Outcomes
Define each desirable outcome you wish to examine, including who will pay for care and factors limiting achievement of those outcomes.
Health Care System Comparative Analysis
Use Table 1, in the appendix, for your comparative analysis of the specific outcomes you wish to examine.
Analyze outcomes in two non-U.S. health care systems that offer insight into your proposed change.
Choose one of the following options for selecting the two systems:
- Option 1: Select two systems at opposite ends of the scale in terms of desirable outcomes for the issue reflected in your proposed change.
- Option 2: Select two systems that both produce positive outcomes but take unique or innovative approaches to the problem.
Compare the outcomes in each non-U.S. system with each other and with present outcomes in your local or regional health care system.
Rationale for the Proposed Change
Explain why specific changes will lead to improved outcomes.
Financial and Health Implications
Determine the financial and health implications associated with the proposed changes.
Address the implications of making the changes.
Address the implications of not making the changes.
Conclusion
Summarize your analysis and provide your rationale for the proposed change.
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