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Implementation Plan for Capstone Project

Sashane Ellis

Grand Canyon University

NRS-465

Professor Leslie Green

December 15, 2024

Problem Summary

Poor adherence to a management protocol among adult diabetic patients leads to poor control of glycemic levels in patients, increasing their susceptibility to health complications. This challenge is further emphasized in a socio-culturally diverse setting, such as the practicum site, where most patients are from Haiti and Spanish-speaking.

Proposed Solution

Telehealth help will supplement in-person care to address the issues. The main aim is the improvement of patient compliance with protocols in diabetes management for convenience, access, and personalization. Telehealth model will integrate remote consultations, real-time monitoring gadgets, and educational resources to help bridge gaps in care (Shao et al., 2023). Recognizing these sociocultural and linguistic realities, the intervention will incorporate bilingual telehealth capabilities that guarantee linguistically appropriate instruction and counselling to all patients (Ballesta et al., 2023). Moreover, culturally tailored educational materials will emphasize specific dietary practices, health beliefs, and obstacles these groups face. Such culturally competent care will be taught in-service to nurses and telehealth providers with the expectation of engendering trust and respect. This approach supports equitable diabetes treatment, enables patients to manage their health, and follows evidence-based practice to enhance outcomes in marginalized settings.

Implementation Steps

The proposed intervention will follow a structured, phased approach:

Phase 1: Preparation and Training

· Train clinic staff in telehealth technology and culturally sensitive communication, including nurses and administrative personnel.

· Procure bilingual telehealth platforms and ensure compatibility with existing clinic systems.

Phase 2: Patient Enrollment

· Identify eligible patients based on diabetes diagnosis and access to telehealth resources.

· Conduct orientation sessions for patients, emphasizing the benefits of telehealth and providing training on using the platform.

Phase 3: Intervention Delivery

· Schedule biweekly virtual consultations on glycemic monitoring, medication adherence, and lifestyle education.

· Implement asynchronous monitoring tools such as mobile apps to track blood sugar levels and dietary logs.

· Provide resources in Haitian Creole and Spanish to enhance understanding and engagement.

Phase 4: Evaluation and Adjustment

· Collect baseline and ongoing glycemic control, medication adherence, and patient satisfaction data.

· Use feedback to refine the program, addressing barriers like technology access or language comprehension.

Impact on Nursing Practice

The integration of telehealth in nursing practice will broaden the role of nursing in the area of basic skill provision in digital health technology and remotely managing conditions. Nurses will learn to navigate different telehealth platforms, give virtual consultations, and monitor patient progress remotely, which may help in timely and effective care (Bulto, 2024). Moreover, cultural competence in nursing will assist nurses in understanding and meeting the needs of varied groups, creating trust and communication.

Objectives

· Increase compliance with diabetes management protocols among enrolled patients by 20% within six months.

· Improve average HbA1c levels among participants by at least 0.5% over six months.

· Enhance patient satisfaction with diabetes care, achieving a satisfaction rate of 85% in post-intervention surveys.

· Train 100% of clinic staff using the telehealth platform and culturally sensitive communication practices.

· Deliver bilingual education materials to 90% of participating patients to improve diabetes knowledge.

Measurable Outcomes

· Percentage of patients achieving adherence to prescribed diabetes management plans, as measured through self-reported logs and provider assessments.

· The average reduction in HbA1c levels among participants was verified through laboratory tests.

· Patient satisfaction scores were assessed via post-intervention surveys.

· Pre- and post-training evaluations measured the number of nurses trained in telehealth delivery and their self-reported confidence levels.

· Documentation of a telehealth protocol for the clinic, including workflows and best practices

Rationale for Respecting Autonomy and Diversity

This project respects patient autonomy by enabling patients to manage their diabetes through accessible telehealth services. The intervention will give the patients the tools and support to make informed decisions about their care. The patients can participate in telehealth services, and resources shall be accorded for self-management of the disease condition. Linguistic diversity is considered with the availability of English, Spanish, and Haitian Creole services, which helps build trust and effective communication.

The project also considers the sociocultural aspect in designing educational and care approaches appropriate for the patient population's cultural values and health beliefs. For example, dietary recommendations will include culturally appropriate food choices and educational classes will discuss common myths about diabetes in these communities.

The project also fulfils the ethical principles of beneficence, nonmaleficence, and justice. Beneficence is ensured through improved health outcomes and quality of life in diabetic patients. Nonmaleficence is ensured through training and quality control measures that ensure telehealth services' safe and effective delivery. The intervention considers linguistic and cultural barriers to ensure fair opportunities for these underrepresented populations to access health care.

References

Ballesta, S., Chillarón, J., Inglada, Y., Climent, E., Llauradó, G., Pedro‐Botet, J., Francesc Cots, Camell, H., Flores, J. A., & Benaiges, D. (2023). Telehealth model versus in-person standard care for persons with type 1 diabetes treated with multiple daily injections: an open-label randomized controlled trial. Frontiers in Endocrinology, 14. https://doi.org/10.3389/fendo.2023.1176765

Bulto, L. N. (2024). The role of nurse‐led telehealth interventions in bridging healthcare gaps and expanding access. Nursing Open, 11(1). https://doi.org/10.1002/nop2.2092

Shao, Y., Shi, L., Nauman, E., Price‐Haywood, E. G., & Stoecker, C. (2023). Telehealth use and its impact on clinical outcomes in patients with type 2 diabetes during the COVID‐19 pandemic. Diabetes, Obesity and Metabolism. https://doi.org/10.1111/dom.15293