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NURS FPX 4900 Assessment 3  Assessing the Problem Technology Care Coordination and Community Resources Considerations PS

NURS FPX 4900 Assessment 3 Assessing the Problem Technology Care Coordination and Community Resources Considerations PS

Resources For Diabetes Care


The high prevalence of diabetes and its microvascular complication globally require multisectoral strategies. In the United States, 25.8 million people suffer from diabetes and its complications. It is reported that less than half of these diabetic fails to maintain their A1c, blood pressure and cholesterol (Sieverdes et al., 2013). Since the discovery of the mobile phone and the evolution of technology in the health care system its use is increasing and accepted everywhere. The term digital health implemented as a widespread behaviorally design intervention is enhancing the education and self-management measures (Greenwood et al., 2017).  

Diabetes care is necessary for avoiding the later complications of microvascular complications. The blood glucose monitoring related to the increased A1C marker is the most crucial indicator of the diabetics. They need to analyze their glucose concentration first to administer the dose of insulin. The suggested self-management strategy and generating awareness and education among the people can be monitored by the technology use. The self-management of the A1c has been effective by using technology. It enhances the communication between the nurse and the patient. The health care team can analyze the patient-generated data and issue guidelines for management (Greenwood et al., 2017). 

NURS FPX 4900 Assessment 3 Assessing the Problem Technology Care Coordination and Community Resources Considerations PS

Resources Of Diabetes Care

More than 80 to 90% of diabetic patients have access to mobile phone health technology. The health care guidelines in diabetic care related to glycemic control by self-monitoring of glucose can be increased. The health care team can monitor the pharmacological management of diabetes. Diabetics often have fluctuating weight curves which also shows their diabetes condition (Delahanty, 2017). Nurses can monitor the weight from the remote technology. Dietary and lifestyle changes including exercise are a basic part of self-management of diabetes interventions (Alouki et al., 2016). The behavior change in the patient can also be monitored. Medical nutrition therapy and vitals management are also crucial to prevent its worse outcomes. The technology can also monitor hypertension and nutrition plans by nursing staff at the back of the monitoring app (Sieverdes et al., 2013). Sensor augmented Insulin Pumps have helped report the glucose on the insulin pump. The patients can easily get warned in case of raising or decreasing glucose concentration by the use of this Smart Guard feature (Ranjan et al., 2020). The long-term use of insulin pump technology also reduces albuminuria (Gómez et al., 2017).

The screening of the diabetics for the possible complications of diabetic retinopathy and blindness requires community level and national level screening. Telemedicine has been with clinical application validation. It has been globally accepted as the high-level and accurate screening of diabetic retinopathy. It also improves the cost-effectiveness of the patient’s resources (Tozer et al., 2015). The timely diagnosis of the prognosis of diabetes into retinopathy complications has been highly effective in timely measures. Telemedicine use non-mydriatic cameras that are somehow beneficial in identifying the risk of eye disease in diabetics (Mansberger et al., 2013). Telemedicine has also been effective in improved diabetic care in terms of serum glucose, cholesterol, and hypertension. The evidence on the lifestyle and dietary interventions is also supportive in regulating the normal glucose and blood pressure (Rho et al., 2013). 

NURS FPX 4900 Assessment 3 Assessing the Problem Technology Care Coordination and Community Resources Considerations PS

These applications of patient-centered safe, efficient, and quality health care provide an acceptance as a clinical method. The team-based efforts of diabetes management, glycemic control medication uses accepted over time and also improves effectiveness the of diabetic care (Izquierdo et al., 2015). Long-term diabetes management care in hospital settings requires a comprehensive care practice by skilled staff. Diabetics tend to have a high rate of rehospitalization in case of progression of diabetes to microvascular complications. The knowledge and skill of nurses are also crucial; at this point. Diabetics require individual care plans, the nurses must adhere to the guidelines of the American Dietetic Association (ADA) (Munshi et al., 2016). 

The care coordination at health care centers is an evolving role of registered nurses. Patient-centered health care provisions require a multicentric approach in intervention strategies. The coordination among the nursing staff and with the patient as well. Care coordination functions to ensure the needs of patients related to health service information and practice (Vanderboom et al., 2015). Nurse coordination requires management team, education, skills, knowledge of the policies and guidelines. Professional teamwork provides supportive information and evidence-based therapeutic methods (Martins, F.Z. and Dall’Agnol, 2017). Survival skills and education of the emergency measures provide safe community care. The interdisciplinary communication of the health care system with integrated services ensures high-quality care (Hardee et al., 2015). 

NURS FPX 4900 Assessment 3 Assessing the Problem Technology Care Coordination and Community Resources Considerations PS

Community-based diabetes prevention and management programs can be effective in reducing the complications of diabetes. The dietary and lifestyle awareness campaigns and education at the education centers, professional works enhance the awareness in the general masses. The Center for Disease Control and Prevention (CDC) has issued the guidelines of the community-based intervention strategies. The American Diabetic Association also provides online and other resources for community integration in self-management. The help on health insurance also provides financial support for the care practices. AD also provides a guideline on the standard nutrition food products in the market. Diabetes care help is also available online for people. The state’s community health workers program can lead to the better implementation of the strategies. It requires the skill and knowledge of the health worker. The knowledge of the subject and all the related guidelines and policies will enhance the effectiveness of the communication and acceptance of the information by the general masses. 

Potential Barriers

The implementation of the technology, community measures, and the health care nurse coordination care face certain issues. The health care strategy and resource care implementation often face multiple barriers at the fronts of availability of resources, cost, and individual preferences. It has been reported that glucose control and monitoring the patient faces issues of education, insurance, and costs invested on the resources. The perceptions of pain and psychological issues of depression and anxiety also affect the proper medication and outcomes on the disease (Pagan and ElAarag, 2018). The implementation of telemedicine in diabetic retinopathy identification faces poor imaging quality. If the imagining method is improved the overall eye health care system will benefit from it. It will also be an effective way of screening exams for retinopathy (Mansberger et al., 2013). However, the administrative costs of telemedicine in screening exams establishes high costs requirements. It requires a sufficient coverage of resources both financial and non-financial to promote the telemedicine-based diabetic eye are (Rachapelle et al., 2013). 

The applications of technology and telemedicine tools in the general masses face some issues. Most of the cases of diabetes have old age, the limitations of the use of technology can sometimes compromise the effective outcomes. At the same time, the majority of people accept it as a cost-effective method. It has also been reported that the factors including performance expectancy, effort expectance, social influence of the patient, behavioral intentions of the patients (Rho et al., 2015).  

Impact Of The Technology, Community-Based, And Coordination Resources 

The implementation of the technology-based measure made it easy to identify and monitor the health care guidelines. The self-management education program provisions can also be assessed by telecommunication. Screening and diagnosis tools of technology made it easy and cost-effective for diabetics. As elaborated by the patient-centered survey the overcoming the barriers of diabetes care will surely manage to provide better care with high-quality life (Engström et al., 2016). The barriers to the implementation of the technology can be prevented by promoting the facilitators. The facilitators can be continuous assistance, service, education of the process, and guidelines regarding the implementation (Rho et al., 2015). 

The research showed that the technology interventions improved diabetes care, A1c marker, cholesterol control, weight management, self-efficacy, self-behavior management, and overall health outcomes (Greenwood et al., 2017).  The coordination care can be improved by the organizational resource availability of the skilled nurses, education training, and accurate monitoring of the care practices. The goal of the care should be patient-centered, safe, quality, and efficient standards based on the guidelines and standards issued by the health organizations.

NURS FPX 4900 Assessment 3 Assessing the Problem Technology Care Coordination and Community Resources Considerations PS

The promotion of self-management strategies is the key to diabetes care. The complex health care condition, limited social support, cultural and language barriers with the patients sometimes pose a coordination issue. Nurses find it difficult to educate the patient with different cultural background about the self-management guidelines (Vanderboom et al., 2015).

Nurse coordination with patients and the staff members provide timely, accurate, and resourceful management care of the diabetics (Goebel et al., 2016).

The Evidence-Based Analysis 

Diabetes self-management education (DSME) program promoted by the Government has been found effective at large scale prevention of the complications of diabetes. This program promotes the patient and his family to adapt to the lifestyle and dietary guidelines with low cholesterol and healthy food. The glycemic control, blood pressure monitoring, and cholesterol control have been found to reduce after the self-management program implementation. The medication dose and administration have been accurate with health-promoting outcomes (Beck et al., 2017). 

The ADA-issued hospital-based Joint Commission Advanced Inpatient Diabetes Certification Program was found effective in delivering the facilitators of the clinical care, supporting the self-management in diabetes care, providing accurate information of the managemental measures, along with the performance measurements (Arnold et al., 2016). The implementation of policies and the regulatory standards could ensure the effectiveness of the health care programs and improve the diabetes care outcomes. 


Greenwood, D.A., Gee, P.M., Fatkin, K.J. and Peeples, M. (2017). A systematic review of reviews evaluating technology-enabled diabetes self-management education and support. Journal of diabetes science and technology11(5), pp.1015-1027.

Sieverdes, J.C., Treiber, F., Jenkins, C. and Hermayer, K. (2013). Improving diabetes management with mobile health technology. The American journal of the medical sciences345(4), pp.289-295.

Delahanty, L.M. (2017). Weight loss in the prevention and treatment of diabetes. Preventive medicine104, pp.120-123.

Martins, F.Z. and Dall’Agnol, C.M. (2017). Surgical center: challenges and strategies for nurses in managerial activities. Revista gaucha de enfermagem37.

Hardee, S.G., Osborne, K.C., Njuguna, N., Allis, D., Brewington, D., Patil, S.P., Hofler, L. and Tanenberg, R.J. (2015). Interdisciplinary diabetes care: a new model for inpatient diabetes education. Diabetes Spectrum28(4), pp.276-282.

Beck, J., Greenwood, D.A., Blanton, L., Bollinger, S.T., Butcher, M.K., Condon, J.E., Cypress, M., Faulkner, P., Fischl, A.H., Francis, T. and Kolb, L.E. (2018). 2017 National standards for diabetes self-management education and support. The Diabetes Educator44(1), pp.35-50.

NURS FPX 4900 Assessment 3 Assessing the Problem Technology Care Coordination and Community Resources Considerations PS

Alouki, K., Delisle, H., Bermúdez-Tamayo, C. and Johri, M. (2016). Lifestyle interventions to prevent type 2 diabetes: a systematic review of economic evaluation studies. Journal of diabetes research2016.

Munshi, M.N., Florez, H., Huang, E.S., Kalyani, R.R., Mupanomunda, M., Pandya, N., Swift, C.S., Taveira, T.H. and Haas, L.B. (2016). Management of diabetes in long-term care and skilled nursing facilities: a position statement of the American Diabetes Association. Diabetes care39(2), pp.308-318.

Engström, M.S., Leksell, J., Johansson, U.B. and Gudbjörnsdottir, S. (2016). What is important for you? A qualitative interview study of living with diabetes and experiences of diabetes care to establish a basis for a tailored Patient-Reported Outcome Measure for the Swedish National Diabetes Register. BMJ open, 6(3), p.e010249.

Izquierdo, R.E., Wang, D., Huang, D., Palmas, W. and Weinstock, R.S. (2015). Case management with a diabetes team using home telemedicine: acceptance of treatment recommendations by primary care providers in IDEATel. Telemedicine and e-Health21(12), pp.980-986.

Goebel, J., Valinski, S. and Hershey, D.S. (2016). Improving Coordination of Care Among Healthcare Professionals and Patients With Diabetes and Cancer. Clinical journal of oncology nursing20(6).

Vanderboom, C.E., Thackeray, N.L. and Rhudy, L.M. (2015). Key factors in patient-centered care coordination in ambulatory care: Nurse care coordinators’ perspectives. Applied Nursing Research28(1), pp.18-24.

Gómez, A.M., Marín Carrillo, L.F., Muñoz Velandia, O.M., Rondón Sepúlveda, M.A., Arévalo Correa, C.M., Mora Garzón, E., Cuervo Diaz, M.C. and Henao Carrillo, D.C. (2017). Long-term efficacy and safety of sensor augmented insulin pump therapy with low-glucose suspend feature in patients with type 1 diabetes. Diabetes technology & therapeutics19(2), pp.109-114.

NURS FPX 4900 Assessment 3 Assessing the Problem Technology Care Coordination and Community Resources Considerations PS

Ranjan, A.G., Rosenlund, S.V., Hansen, T.W., Rossing, P., Andersen, S. and Nørgaard, K. (2020). Improved time in range over 1 year is associated with reduced albuminuria in individuals with sensor-augmented insulin pump–treated type 1 diabetes. Diabetes Care43(11), pp.2882-2885.

Pagan, R. and ElAarag, H. (2018). March. Diabetic assistant tool. In Proceedings of the ACMSE 2018 Conference (pp. 1-8).

Rho, M.J., Kim, H.S., Chung, K. and Choi, I.Y. (2015). Factors influencing the acceptance of telemedicine for diabetes management. Cluster Computing18(1), pp.321-331.

Tozer, K., Woodward, M.A. and Newman-Casey, P.A. (2015). Telemedicine and diabetic retinopathy: review of published screening programs. Journal of endocrinology and diabetes2(4).

Rachapelle, S., Legood, R., Alavi, Y., Lindfield, R., Sharma, T., Kuper, H. and Polack, S. (2013). The cost–utility of telemedicine to screen for diabetic retinopathy in India. Ophthalmology120(3), pp.566-573.

Mansberger, S.L., Gleitsmann, K., Gardiner, S., Sheppler, C., Demirel, S., Wooten, K. and Becker, T.M. (2013). Comparing the effectiveness of telemedicine and traditional surveillance in providing diabetic retinopathy screening examinations: a randomized controlled trial. Telemedicine and e-Health19(12), pp.942-948.

Arnold, P., Scheurer, D., Dake, A.W., Hedgpeth, A., Hutto, A., Colquitt, C. and Hermayer, K.L., (2016). Hospital guidelines for diabetes management and the Joint Commission-American Diabetes Association inpatient diabetes certification. The American journal of the medical sciences, 351(4), pp.333-341.

Greenwood, D.A., Gee, P.M., Fatkin, K.J. and Peeples, M. (2017). A systematic review of reviews evaluating technology-enabled diabetes self-management education and support. Journal of diabetes science and technology, 11(5), pp.1015-1027.

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