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Capella 4900 Assessment 1

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    Capella 4900 Assessment 1

    Capella 4900 Assessment 1 Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations

    Student Name

    Capella University

    NURS-FPX 4900 Capstone Project for Nursing

    Prof. Name


    Diabetes Mellitus: A Patient Health Problem

    In this capstone project, Michael’s case of diabetes mellitus has been addressed which is also relevant to personal and professional practice in healthcare setup. Michael is 67 years-old male patient with type 2 diabetes mellitus for 4 years. He has been readmitted to Southern California Hospital at Hollywood, where I work as a Registered Nurse. The patient got admitted due to poor management of diabetes, as his blood glucose level reached 315mg/dL.

    The patient’s family described that he is unable to maintain his blood glucose levels due to poor dietary habits (use of processed foods) and excessive use of alcohol. Furthermore, his poor socioeconomic status made him inconsistent in taking medication to control his glucose levels. Michael belongs to a lower-middle-class family and worked as a taxi driver before diabetes took over his life. This led to poor circumstances where his family could barely meet the ends. Michael has minimal knowledge about his disease and its management, which made him negligent in his lifestyle habits. Therefore, this capstone project is based on Michael’s disease as diabetes is fairly relevant to my personal and professional practice.

    Substantial Relevance of Diabetes 

    Diabetes mellitus is one of the chronic diseases that commonly occur in elderly people due to various factors such as age, genetics, and poor lifestyle. In hospitals, the majority of cases in endocrinology departments consist of diabetes mellitus. In one study, it is highlighted that the crude prevalence of diabetes in hospitalized patients ranged from 15% to 16% in various studies (Bradley et al., 2021). This shows that diabetes is a relevant health problem to professional practice and requires early detection for better control and prevention of diabetes-associated health problems. As a baccalaureate-prepared nurse, I would try my best to provide care treatment to patients with this health problem as it is relevant to my personal and clinical practice. 

    Peer-Reviewed Literature & Professional Sources on Nursing Actions for Diabetes

    Nurses are great caretakers for patients in all circumstances as their primary responsibility is to cater to the needs of patients and to provide them with the best possible care treatments. In the case of diabetes, nurses have been immense support as they can provide numerous nursing actions to diabetes in treating and managing the disease. Nurses with their insightful knowledge and practical experience in providing care treatment to patients can educate diabetics on self-care practices and monitoring blood glucose levels. Furthermore, they can educate patients on the medication required for diabetes treatment and insulin injections. Patient education on diabetes aware patient of their disease and can be empowered to take care of it by themselves. This can be possible if nurses guide patients through proper education (Świątoniowska et al., 2019). 

    Nurses can also collaborate with dieticians to provide dietary guidance to diabetic patients as hyperglycemia is most commonly caused by unhealthy food intake. The nurses and dieticians together can teach patients about balanced nutrition, portion control, and healthy eating by limiting carbohydrate intake. They can also provide meal planning services with dieticians for diabetic patients who are unable to maintain their healthy habits (Tan et al., 2020). Often diabetic patients experience depression and need psychological and social support. Nurses can play a vital role in providing psychosocial support to patients by actively listening to their concerns, addressing these concerns, and providing practical solutions to them. Moreover, they can connect diabetics to support groups where they can feel motivated by peer support who have tackled diabetes (Nikitara et al., 2019).

    Evaluation of the Evidence 

    These peer-reviewed literature sources described and guided nursing actions for diabetes. One of the criteria which can be used to evaluate these evidence-based resources is CRAAP criteria. It stands for currency, relevance, authority, accuracy, and purpose. All of the aforementioned literature resources that guide nursing actions are published within the last five years and are reliable. The authors are related to the field of medicine and provided accurate information to lower blood glucose levels in diabetics.

    Potential Barriers to Evidence-Based Practice and Guiding Frameworks

    Some of the potential barriers to the implementation of evidence-based practices for diabetes care can be nurses’ lack of knowledge, lack of resources, and lack of time. Nurses may be less expert or lack knowledge in certain areas of diabetes such as knowledge about the timing and administration of insulin, use of metformin in renal impaired patients, etc. Moreover, healthcare organizations may lack resources to provide adequate care treatments based on evidence-based practices and theoretical guiding frameworks such as lack of equipment, lack of space, and lack of IT-based facilities. Due to the overcrowding of patients with multiple disorders, time constraints can be another potential hindrance to implementing evidence-based practices (Nikitara et al., 2019). Thus, it is significant to address these potential barriers to implementing evidence-based practices and guiding frameworks. 

    State Board Nursing Practice Standards/Organizational or Governmental Policies’ Impact on Diabetes

    Considering Michael’s case, several practice standards by Diabetes specific organizations and governmental policies can impact diabetes and help Michael manage his diabetes. The California Board of Registered Nursing has developed the Nursing Practice Act (NPA) which provides nurses with standard guidelines on nursing practices. Some of these nursing practice standards are to provide safe patient care and improve the quality of life of patients. Furthermore, NPA has also provided regulations on nursing education and training programs that can improve nursing practices (California Board of Registered Nursing, 2019). These standard policies by the NPA guide nurses in providing the best care treatment to diabetics which improves their safety and efficacy of life.

    Another policy that can impact Diabetes in Michael’s case is the governmental policy of the Affordable Care Act (ACA). This act covers the health insurance of patients suffering from chronic diseases like diabetes by preventing health insurers to charge diabetics extra and giving them access to insurance coverage. Furthermore, the Medicaid and Medicare expansion by ACA has ensured that diabetes patients access healthcare services easily such as diabetes management and treatment and diabetes self-management training which can help patients with diabetes better manage their condition (American Diabetes Association, n.d.).

    Effect of Policies on Nursing Scope of Practice

    These policies affect the nursing scope of practice as they create more opportunities for nurses to provide better care treatment to patients with diabetes. For example, training on acquiring practice standards for diabetes educators can enable nurses to become certified diabetes educators which opens ways for them to practice and help patients manage diabetes in a significant way by educating them on lifestyle and diet modification, etc. These policies also enable nurses to work according to the standards set so that evidence-based, authentic, and quality care is provided to the patients. 

    Leadership Strategies to Improve Outcomes, Patient-Centered Care, and the Patient Experience in Diabetes 

     Leadership strategies are important in every healthcare department in order to improve treatment outcomes, provide patient-centered care, and enhance patient experience. In the case of Michael’s condition of diabetes, several leadership strategies can be employed which can improve his health outcomes, provide care tailored to his needs and preferences and improve his experience. These leadership strategies are as follows

    • The nurse leader can empower nurses by providing them with autonomy, responsibility, and decision-making authority. With the nurse leader’s insight and wisdom, task delegation can be done on the basis of each nurse’s individual strength and extent of expertise. This will lead to empowered health professionals which can lead to improved health outcomes (Mirhoseiny et al., 2019). For example, if some nurses are more proficient in counseling patients, the head nurse can delegate them to counsel and educate diabetics on their condition and ways to manage it such as self-management education, lifestyle and dietary modification, etc. This will lead to patient-centered care and improve patient experience of diabetes patients like Michael.
    • Setting a vision and goal by health professionals such as physicians and communicating about it with other staff is another leadership strategy that can improve health outcomes (Alrowwad et al., 2020). For example, physicians can act as leaders and propose a clear vision for obtaining achievable goals in the future of lowering and maintaining the blood glucose levels in patients with diabetes. They can collaborate with other healthcare staff of the hospital and discuss ways to achieve those goals. As a result, all healthcare professionals will be actively working towards obtaining improved health outcomes, providing patient-centered care for diabetes, and enhancing their experience of acquiring care treatment from healthcare professionals.

    Need for Leadership, Communication, Collaboration, and Change Management

    It is necessary to implement leadership strategies as leadership roles promote the delegation of tasks and effective working in healthcare. Therefore, it is necessary in achieving positive health outcomes, promoting patient-centered care, and improving the patient experience. Furthermore, leadership requires effective collaboration, communication, and change management to address diabetes in healthcare organizations. As achieving diabetes-related goals requires some change management such as changing the organizational culture of the traditional way of providing care for diabetes. This will require communication and collaboration with hospital administration, policymakers, and authorities to change hospital culture according to evidence-based practices of treating and managing diabetes.

    Documentation of Practicum Hours

    I have spent more than two hours with Michael and his family exploring the case, lifestyle, past medical history, etc. These hours spent with Michael have been documented in the CORE ELMS Volunteer Experience Form where details of the meeting are described.


    In this capstone project assessment, Michael’s case of diabetes has been addressed where he is unable to manage his disease due to personal factors of health and income. Various literature and professional sources provide guiding actions for nurses to treat and manage diabetes such as educational and psychosocial support, and collaboration with other health professionals such as nutritionists or dieticians. Furthermore, various organizational and governmental policies such as practicing standards for diabetes educators by AADE and ACA impact diabetes by improving the nursing scope of practice and diabetics’ access to diabetes care treatment.

    Lastly, leadership strategies such as transformational leadership which empower nurses to make decisions based on their strengths are necessary along with collaboration and communication. This also requires change management in organizational culture in order to obtain improved outcomes, patient-centered care, and enhanced patient satisfaction. The practicum hours spent with Michael and his family have been documented in CORE ELMS Volunteer Form.


     Alrowwad, A., Abualoush, S. H., & Masa’deh, R. (2020). Innovation and intellectual capital as intermediary variables among transformational leadership, transactional leadership, and organizational performance. Journal of Management Development, 39(2), 196–222.

    American Diabetes Association. (n.d.). Preserving the Affordable Care Act is crucial to people with diabetes. 

    Bradley, S. A., Banach, M., Alvarado, N., Smokovski, I., & Bhaskar, S. M. M. (2021). Prevalence and impact of diabetes in hospitalized patients: A systematic review and meta‐analysis. Journal of Diabetes, 14(2), 144–157. 

    Capella 4900 Assessment 1

    California Board of Registered Nursing. (2019). Nursing practice act. 

    Mirhoseiny, S., Geelvink, T., Martin, S., Vollmar, H. C., Stock, S., & Redaelli, M. (2019). Does task delegation to non-physician health professionals improve quality of diabetes care? Results of a scoping review. PLOS ONE, 14(10), e0223159. 

    Nikitara, M., Constantinou, C. S., Andreou, E., & Diomidous, M. (2019). The role of nurses and the facilitators and barriers in diabetes care: A mixed methods systematic literature review. Behavioral Sciences, 9(6), 61. 

    Świątoniowska, N., Sarzyńska, K., Szymańska-Chabowska, A., & Jankowska-Polańska, B. (2019). The role of education in type 2 diabetes treatment. Diabetes Research and Clinical Practice, 151(151), 237–246. 

    Tan, H. Q. M., Chin, Y. H., Ng, C. H., Liow, Y., Devi, M. K., Khoo, C. M., & Goh, L. H. (2020). Multidisciplinary team approach to diabetes. an outlook on providers’ and patients’ perspectives. Primary Care Diabetes, 14(5), 545–551. 

    Capella 4900 Assessment 1