19 Jul CAPSTONE: PART II? TOPIC: Poor Glycemic Control in Diabetes Mellitus Type II 1. Review of Literature – Review and discuss literature: Synthesize at least 10 primary research studies and

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CAPSTONE PROJECT PART 1

Student’s name: Alina Leon

Institution: Florida National University

Instructor: Carmen Lazo

Course: MSN Capstone Project-DBX-DL02

Date: July 6, 2023

CAPSTONE PART 1

Poor Glycemic Control in Diabetes Mellitus Type II

Introduction

The practice problem is essential in addressing inadequate glycemic control among individuals aged 65 and above who have been diagnosed with type 2 diabetes and live in a rural community. The primary objective is attaining enhanced glycemic control, reduced incidence of diabetes-related complications, low use of healthcare services, and enhanced quality of life among adult patients with Type 2 diabetes within 12 months (Almutairi et al., 2020). This matter holds significant significance within nursing practice, as nurses play a pivotal role in educating and supporting patients diagnosed with diabetes (Mamo et al., 2019). 

PICOT

Adults with type 2 diabetes are more likely to live in a rural community (P), does implement a community-based diabetes self-management education program (I) compared to standard care (C) lead to improved glycemic control, reduced diabetes-related complications, decreased healthcare utilization, and enhanced quality of life (O) over 12 months (T)?  

Population and Intervention

The practice problem that has been identified is of great importance, as it focuses on the issue of inadequate management of blood sugar levels among individuals aged 65 and above who have been diagnosed with type 2 diabetes in rural areas.

Vulnerable Population

This case examines adult populations above years diagnosed with diabetes two and living in rural areas. This is a vulnerable population due to a combination of risk factors. These individuals often need help with various obstacles, such as the restricted availability of healthcare services, especially in geographically isolated regions where healthcare facilities may be scarce or situated at a significant distance (Almutairi et al., 2020). Lower socioeconomic status is a commonly observed risk factor, as it can hinder individuals' capacity to financially afford crucial medications, routine medical examinations, and essential lifestyle adjustments.

Limited health literacy poses additional challenges, as it impedes individuals' comprehension of strategies for managing diabetes and their capacity to comply with prescribed treatment regimens. Furthermore, the limited accessibility of specialized resources for diabetes care, such as healthcare professionals possessing extensive knowledge in diabetes management, is frequently restricted in rural regions. The combination of these factors collectively contributes to disparities in health within the population, resulting in elevated rates of complications and heightened utilization of healthcare services among this susceptible group.

Research

The research for this capstone project will involve scholarly journals with evidence-based interventions addressing the problem of “poor glycemic control in type 2 diabetes” (Almutairi et al., 2020). The research will use peer-reviewed research articles not older than five years. This will help in supporting the discussion and proposed intervention.

Proposal

The proposed intervention is implementing a community-based diabetes self-management education program in the selected population and setting. This intervention will require educational materials, trained healthcare professionals, community partnerships, and access to appropriate technology. Feasibility for a nurse in an advanced role involves coordinating and leading the program, collaborating with community stakeholders, and providing ongoing support and education to participants. A timeline for the proposed intervention will be outlined to ensure efficient implementation and evaluation. Implementing an education program empowers individuals to take control of their health, equipping them with the necessary knowledge and skills to effectively manage their condition, resulting in improved health outcomes and overall well-being.

Theoretical Framework/Nursing Theory

Health Belief Model will serve as the theoretical framework for this capstone project. This model explains and predicts the health behaviors of people based on their beliefs about various issues. These issues include “susceptibility to a health problem, the severity of the problem, the benefits of taking action, and the barriers to change” (Anuar et al., 2020). By applying this theory, the project aims to address the significance of poor glycemic control, promote self-management behaviors, and increase the uptake of the proposed intervention. The Health Belief Model provides a foundation for understanding the factors influencing health behavior change in the targeted population.

Overall, this capstone project highlights the issue of poor glycemic control in people with diabetes 2, emphasizes the importance of implementing a community-based diabetes self-management education program, and utilizes the Health Belief Model as the guiding theoretical framework (Tefera et al., 2020). The project seeks to positively impact patient outcomes, community health, healthcare costs, and overall quality of life by addressing this practice problem.

References

Almutairi, N., Hosseinzadeh, H., & Gopaldasani, V. (2020). The effectiveness of patient activation intervention on type 2 diabetes mellitus glycemic control and self-management behaviors: a systematic review of RCTs.  Primary care diabetes,  14(1), 12-20.

Anuar, H., Shah, S. A., Gafor, H., Mahmood, M. I., & Ghazi, H. F. (2020). Usage of Health Belief Model (HBM) in health behavior: A systematic review,2636–9346.  Malaysian Journal of Medicine and Health Sciences,  16(11).

Mamo, Y., Bekele, F., Nigussie, T., & Zewudie, A. (2019). Case-control study on the factors contributing to poor glycemic control in adult patients with type 2 diabetes mellitus at Jimma University Medical Center in Jimma Zone, South West Ethiopia. 19, 1-11.  BMC endocrine disorders.

Tefera, Y. G., Gebresillassie, B. M., Emiru, Y. K., Yilma, R., Hafiz, F., Akalu, H., & Ayele, A. A. (2020). Type 2 diabetes mellitus in adult patients in an Ethiopian university hospital's outpatient clinic: diabetic health literacy and its relationship to glycemic management. 15(4) of PLoS One, e0231291.