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NURS FPX 6218 Assessment 1 Proposing Evidence-Based Change

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    NURS FPX 6218 Assessment 1 Proposing Evidence-Based Change

    Student Name

    Capella University

    NURS-FPX 6218 Leading the Future of Health Care

    Prof. Name

    Date

    Change Proposal Summary Report

    Executive Summary

    The primary objective of this executive summary report is to recommend a change in the management of peripheral neuropathy in diabetic patients within healthcare organizations in Colorado. To achieve this, comprehensive research on peripheral neuropathy was conducted, followed by a comparative analysis of its management in non-U.S. healthcare systems. The aim is to identify effective measures and strategies for proposing changes that enhance the health quality of individuals with diabetes by reducing complications associated with peripheral neuropathy.

    Proposed Change

    Peripheral neuropathy poses a significant challenge for diabetic patients, impacting peripheral nerves and causing pain, sensory loss, and paraesthesia. Diabetic peripheral neuropathy (DPN) affects 50% of diabetics, resulting in pain and a 25% risk of foot ulcers, potentially leading to leg amputation (Hicks & Selvin, 2019). To address these consequences, proactive efforts are essential to promote aggressive screening and management of diabetes through regular HbA1c monitoring, foot examination, and pain management.

    In Colorado’s local healthcare systems, peripheral neuropathy is emerging as a concern for diabetics, leading to issues such as numbness, pain, foot ulcers, and leg amputations. To improve the quality of life for individuals with diabetes, it is crucial to focus on changing the care approach in this area. Implementing annual foot examinations, as recommended by the American Diabetes Association, and enhancing glycemic control through lifestyle modification and pharmacotherapy can help control peripheral neuropathy (American Diabetes Association Professional Practice Committee, 2021; Alahakoon et al., 2020).

    Desired Outcomes

    The proposed changes aim to achieve several desired outcomes:

    1. Prevention of Neuropathy Complications: Timely management of diabetes and peripheral neuropathy can prevent complications such as infections, delayed healing, foot ulcerations, and leg amputations (Selvarajah et al., 2019).
    2. Enhanced Sensation: Improved glycemic levels and prevention of peripheral neuropathy can enhance sensory perception, preventing numbness and tingling (Agarwal et al., 2019).
    3. Improved Mobility and Preservation of Limb Function: Managing and preventing peripheral neuropathy promotes mobility, balance, and coordination in people with diabetes, reducing the risk of falls and maintaining an active lifestyle (Zilliox & Russell, 2019).

    Achieving these outcomes necessitates stakeholder support and the allocation of resources for care and implementation of desired changes. Resources such as Medicare and Medicaid programs can contribute to providing health insurance coverage and promoting care delivery for individuals with chronic diseases (Duru et al., 2020).

    Health Care System Comparative Analysis

    A comparative analysis of non-U.S. healthcare systems, specifically the National Health Service (NHS) in the United Kingdom and the Australian Diabetes Society (ADS), revealed valuable insights. Both systems emphasize regular foot examinations, patient education, and preventive measures for managing diabetes and associated complications. Implementing similar strategies in Colorado’s healthcare systems, such as mobile apps and peripheral neuropathy clinics, can enhance financial and health outcomes for diabetic patients (NICE, 2019; Diabetes Feet Australia, n.d.).

    The Rationale for the Proposed Change

    The proposed changes, inspired by the NICE guidelines and DFA recommendations, aim to improve outcomes in diabetic patients with peripheral neuropathy. Regular monitoring, foot examination, and glycemic control can lead to a longer life span, intact mobility, and reduced risks of lower limb amputation (Selvarajah et al., 2019).

    Financial and Health Implications

    Implementing changes to prevent and manage peripheral neuropathy can have significant financial and health implications. Timely prevention can reduce costs associated with peripheral neuropathy treatment and long-term rehabilitation. Cost-effective screening, treatment, and management can improve the quality of life, glycemic control, and prognosis, reducing the need for extensive medical interventions (Rodríguez-Sánchez et al., 2019).

    Conclusion

    This summary report emphasizes the emerging issue of peripheral neuropathy in diabetic patients within Colorado’s local healthcare systems. Insights from the comparative analysis of healthcare systems in the United Kingdom and Australia suggest that implementing similar strategies can enhance financial and health outcomes for diabetic patients with peripheral neuropathy.

    References

    Aalaa, M., Amini, M. R., Delavari, S., Mohajeri Tehrani, M. R., Adibi, H., Shahbazi, S., Shayeganmehr, Z., Larijani, B., Mehrdad, N., & Sanjari, M. (2022). Diabetic foot workshop: A strategy for improving the knowledge of diabetic foot care providers. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 16(7), 102543. https://doi.org/10.1016/j.dsx.2022.102543

    Agarwal, P., Sharma, B., & Sharma, D. (2019). Tarsal tunnel release restores sensations in sole for diabetic sensorimotor polyneuropathy. Journal of Clinical Orthopaedics and Trauma, 11(3). https://doi.org/10.1016/j.jcot.2019.08.014

    Alahakoon, C., Fernando, M., Galappaththy, C., Matthews, E. O., Lazzarini, P., Moxon, J. V., & Golledge, J. (2020). Meta‐analyses of randomized controlled trials reporting the effect of home foot temperature monitoring, patient education or offloading footwear on the incidence of diabetes‐related foot ulcers. Diabetic Medicine, 37(8), 1266–1279. https://doi.org/10.1111/dme.14323

    NURS FPX 6218 Assessment 1 Proposing Evidence-Based Change

    Diabetes Feet Australia. (n.d.). Diabetes feet australia. https://www.diabetesfeetaustralia.org/

    Duru, O. K., Harwood, J., Moin, T., Jackson, N. J., Ettner, S. L., Vasilyev, A., Mosley, D. G., O’Shea, D. L., Ho, S., & Mangione, C. M. (2020). Evaluation of a national care coordination program to reduce utilization among high-cost, high-need Medicaid beneficiaries with diabetes. Medical Care, p. 58, S14–S21. https://doi.org/10.1097/mlr.0000000000001315

    Hicks, C. W., & Selvin, E. (2019). Epidemiology of peripheral neuropathy and lower extremity disease in diabetes. Current Diabetes Reports, 19(10). https://doi.org/10.1007/s11892-019-1212-8

    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. https://doi.org/10.1212/CPJ.0000000000000671

    NICE. (2019, October 11). Overview | Diabetic foot problems: prevention and management | Guidance | NICE. 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. https://doi.org/10.1007/s10198-019-01134-2

    NURS FPX 6218 Assessment 1 Proposing Evidence-Based Change

    Selvarajah, D., Kar, D., Khunti, K., Davies, M. J., Scott, A. R., Walker, J., & Tesfaye, S. (2019). Diabetic peripheral neuropathy: Advances in diagnosis and strategies for screening and early intervention. The Lancet Diabetes & Endocrinology, 7(12), 938–948. https://doi.org/10.1016/s2213-8587(19)30081-6

    Zilliox, L. A., & Russell, J. W. (2019). Physical activity and dietary interventions in diabetic neuropathy: A systemic review. Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society, 29(4), 443–455. https://doi.org/10.1007/s10286-019-00607-x