The Impact of Nursing Informatics on Patient Outcomes and Patient Care Efficiencies – Project Solution

The Impact of Nursing Informatics on Patient Outcomes and Patient Care Efficiencies

In a 4- to 5-page project proposal written to the leadership of your healthcare organization, propose a nursing informatics project for your organization that you advocate to improve patient outcomes or patient-care efficiency. Your project proposal should include the following:

• Describe the project you propose.
• Identify the stakeholders impacted by this project.
• Explain the patient outcome(s) or patient-care efficiencies this project is aimed at improving and explain how this improvement would occur. Be specific and provide examples.
• Identify the technologies required to implement this project and explain why.
• Identify the project team (by roles) and explain how you would incorporate the nurse informaticist in the project team.
• Use APA format and include a title page and reference page.

Some suggested references to use but not limited to same are in the attachment. Peered reviewed journals can also be used as references.

Solution

Nursing Informatics Project Proposal

Nursing Informatics plays an integral role in shaping practice and initiatives for epidemic diseases such as diabetes. The National Diabetes Statistics Report (2020) indicates that about 10.5% of the US population of more than 34 million people have diabetes and 26.8 million of those diagnosed are adults. The same report further notes that more than 7 million individuals are undiagnosed. In the state of Connecticut (CT), America’s Health Rankings (2020) notes that the number of adult females living with diabetes is 8.8 %, while their male counterparts are higher at 10.4%, a figure that was significantly lower than the national average that stood at 10.7% for females and 11.4 % for males. At the level of the individual, diabetes management is straightforward considering that insulin has been available for several decades now, is off-patent, and has a mechanism of action that is well understand. The administration of oral hypoglycemic medications in T2DM patients is cheap and readily available, as do effective treatment of complications arising from this disease. However, the increase in chronic and uncontrolled T2DM, diabetes-related complications like retinopathy and nephropathy, and rising mortality rates require healthcare providers to take a new approach to T2DM patients. Consequently, this paper explores whether adult patients diagnosed with T2DM could use diabetes self-management education DSME by using a smartphone application to lower daily blood sugar levels with a bias towards a rural healthcare organization in an urban county in northern Connecticut.

Description of the Project Proposed

Healthcare providers like clinicians and pharmacists, together with their patients, are increasingly using mHealth (herein defined as mobile and wireless technologies that aim to support the realization of health objectives) to help diabetes self-management. It is important to note that diabetes mHealth applications vary in the functions they provide that include but are not limited to tracking blood glucose measurements, physical activity, and weight tracking. There is also a carbohydrate tracking and nutritional database, sharing of data with peers and providers, and social support. Furthermore, the apps come with functionalities that help the user to receive specific diabetic messages and reminders. Ideally, these apps can significantly help the patients stick to a diabetes-friendly diet, exercise, and pharmacological management plans leading to better diabetes-related patient outcomes. Subsequently, the purpose of the proposed project is to enhance hemoglobin A1c (HbA1c) using a smartphone health application among adults aged 18 years or more. The study participants are required to be adults who have been confirmed to have T2DM for over a year and have an HA1c level that ranges between 7.5% and 12.5%.

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Additionally, the subjects should have a stable diabetes therapy lasting more than six months, own a smartphone, and not use the Blue Star diabetes health application before the proposed study. The intervention group is expected to use Blue Star Diabetes, an m-health diabetes management platform, including a smartphone app for T2DM patients, a Web portal, and a smartphone for the providers (Viazie et al., 2018). The most appropriate theories on behavior modification, like the theory of planned behavior and the health belief model, will be incorporated into this evidence-based platform. The subjects will be catered for with transport fees, laboratory tests, lancets, strips, and free visits. The control group will be educated on managing their diabetes using standard practices during the three months the study will be in progress. They, however, will be free to use the selected health app (Blue Star diabetes) after completion of the study. The primary investigator proposes that the intervention group have access to the Blue Star diabetes smartphone app for 90 days and receive a stipend to offset the cost of their smartphone plan. Relevant data will be collected at baseline, two months, and 3- month visits using a tablet computer. The provider’s data will be collected after the 3month visits. After 90 days, the participant’s mean HbA1c will be taken and compared between the intervention and control groups.

Identification of the Stakeholders Impacted By This Project

For this proposal, stakeholders refer to all those entities involved in a health care system and would therefore be significantly affected by reforms or changes to the system. Suffice it to say that implementing a mobile health application to improve DSME through the use of Bluestar Diabetes would substantially impact T2DM patients, their families, physicians, and nursing staff. This would happen not just at the selected site of the implementation of the project but across healthcare organizations in the US and beyond. Other stakeholders are the healthcare facilities themselves, insurance companies, pharmaceutical companies, and the government, whether local, state, or federal. Most importantly, the interrelationship that exists among the stakeholders is rather complex.

According to Jeffrey et al. (2019), T2DM patients stand to benefit in terms of health and the quality of life that they lead if their condition is successfully brought under control. The reduced incidence of morbidities and comorbidities arising from the complications of poorly managed blood glucose levels would translate to lower healthcare costs and increased household income for those in employment since the patients will be able to continue working. Unlike other stakeholders, physicians and other healthcare providers have fiduciary duties and responsibilities as far as T2DM patients are concerned. Even though they receive remunerations after offering their services, the provider-patient relationship is sacred. It surpasses the financial gains with improved patient outcomes leading to better job satisfaction among these workers.

On the other hand, employers exist to make money even as they offer their employees health insurance benefits. A healthy employee will mean increased performance and, ultimately, productivity for the firm. At the same time, health insurance companies are entities listed in the stock exchange where effective management of T2DM will translate to reduced expenses for reimbursement in the long run. Hospitals will also get reimbursements for improved patient outcomes as the rate of hospital readmissions would also decrease. The last but certainly not the least of the stakeholders affected is the government. It is defined within the quality of health care provided in the evolving American healthcare narrative.

Explanation of the Patient Outcome(S) or Patient-Care Efficiencies This Project Is Aimed At Improving and the Technologies Required For Its Implementation

The proposed DSME through a mobile health application aims to reduce the daily blood glucose levels. It is anticipated that the levels will be significantly lower in the intervention group than those of the control group after using the Bluestar Diabetes application for three months. The proposed PICOT framework question that guides the relevant literature search is ‘In Type 2 Diabetic patients aged 18 years and above(P-Population) does the Implementation of Mobile health application- aided DSME (MHA-DSME) program (I- Intervention) compared to T2DM patients using standard DMSE (C-Comparison) lead to lower daily blood sugar levels (O-outcome) within twelve weeks(T-Time)?

To demonstrate the impact MHA-DSME has on the intervention group, the HbA1c measurements in the intervention group will be taken post- program intervention and compared to the pre-intervention program score. The exact measurements will be taken in the comparison group who received standard DSME and any differences in the scores noted after 12 weeks. It is expected that if the project is successfully implemented, there will be a significant decrease in HbA1c in the post-intervention scores compared to the pre-intervention scores within the group of participants who received MHA-DSME. At the same time, the primary investigator anticipates that there will be no significant variations in the control group’s scores that received the standard DSME. The improvement in patient outcomes within the intervention group is expected to occur as self-care activities, and self-care agency is expected to increase statistically for patients in the intervention group.

The successful implementation of the MHA-DSME project will materialize if the users have Android (tablet and phone) or Apple mobile gadgets (iPhone, iPad, or iPod Touch). This is because these are platforms that Blue Star Diabetes is compatible with besides having no extra cost to install since the application is free to download, although it requires an access code (Desveaux et al., 2018). Once downloaded, the application will help the patient track their blood glucose, HbA1c levels, carbohydrates/ food, prescription/ medication, weight exercises. According to Bene et al. (2019), the use of this mobile health app, just like any other of its kind, calls for improvement in the design and use through an adequate understanding of how the app most effectively influences the self-management of T2DM. Every diabetic specialist and the patient should appreciate the fact that the utilization of mobile health apps is a function of several interacting factors like medication adherence, blood sugar monitoring, healthy eating, and physical activity. Moreover, Specific patient factors include risk reduction skills, healthy coping skills, and good problem-solving skills and competencies.

Identification of the MHA-DSME Project Team

The MHA-DSME project will incorporate effective management practices so the program yields efficient and enhanced results. This means the basics of project management, principles, the requisite skills, and best practices will determine who is on the team and their respective roles. In a nutshell, the project will be headed by the Project manager, whose primary role is to ensure the project proceeds and completes its tasks within the specified time frame and the approved budget. The PM will develop a project plan, and establish a project schedule and determine each phase. The PM will be supported by the project management staff, who comprise the in-house staff located at the healthcare organization, and an external consultant. These members will contribute to overall project objectives, complete individual deliverables, and document the process. The project also has a project sponsor who is the driver and in-house change champion of the project. The role of the project sponsors is to ensure the availability of the resources required and communicate the goals of the project throughout the healthcare facility. Finally, there will also be nurse informaticists whose role will be to provide expert knowledge since they are skilled in information technology, computer skills, and informatics.

Conclusion

In conclusion, this essay has determined that T2DM is a severe chronic disease whose adverse effects on health can effectively be managed to control and prevent unnecessary complications. Incorporating a mobile health application, if incorporated in DSME, has improved patient outcomes by reducing Hb1Ac levels. As such, the proposed project aims at answering the PICOT framework–based question that states ‘In Type 2 Diabetic patients aged 18 years and above (P-Population) does the Implementation of Mobile health application- aided DSME (MHA-DSME) program (I- Intervention) compared to T2DM patients using standard DMSE (C-Comparison) lead to lower daily blood sugar levels (O-outcome) within twelve weeks(T-Time)?

References

America’s Health Rankings(2020) Annual Report Diabetes in Connecticut  URL: https://www.americashealthrankings.org/explore/annual/measure/Diabetes/state/CT

Bene, B. A., O’Connor, S., Mastellos, N., Majeed, A., Fadahunsi, K. P., & O’Donoghue, J. (2019). Impact of mobile health applications on self-management in patients with type 2 diabetes mellitus: a systematic review protocol. BMJ Open, 9(6), e025714. URL https://sci-hub.se/https://bmjopen.bmj.com/content/9/6/e025714.abstract

Desveaux, L., Shaw, J., Saragosa, M., Soobiah, C., Marani, H., Hensel, J., … & Jeffs, L. (2018). A mobile app to improve self-management of individuals with type 2 diabetes: qualitative realist evaluation. Journal of medical Internet research, 20(3), e8712. URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5878364/

Flood, D., Seiglie, J. A., Dunn, M., Tschida, S., Theilmann, M., Marcus, M. E., … & Manne-Goehler, J. (2021). The state of diabetes treatment coverage in 55 low-income and middle-income countries: a cross-sectional study of nationally representative, individual-level data in 680 102 adults. The Lancet Healthy Longevity, 2(6), e340-e351. URL: https://www.thelancet.com/journals/lanhl/article/PIIS2666-7568(21)00089-1/fulltext

Jeffrey, B., Bagala, M., Creighton, A., Leavey, T., Nicholls, S., Wood, C., … & Pit, S. (2019). Mobile phone applications and their use in the self-management of type 2 diabetes mellitus: a qualitative study among app and non-app users. Diabetology & metabolic syndrome, 11(1), 1-17. URL: https://dmsjournal.biomedcentral.com/articles/10.1186/s13098-019-0480-4

The National Diabetes Statistics Report (2020) Estimates of Diabetes and Its Burden in the United States URL: https://www.cdc.gov/diabetes/data/statistics-report/index.html

Veazie, S., Winchell, K., Gilbert, J., Paynter, R., Ivlev, I., Eden, K. B., … & Helfand, M. (2018). Rapid evidence review of mobile applications for self-management of diabetes. Journal of general internal medicine, 33(7), 1167-1176.URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6025680/