NRS 490V Capstone Project Topic Selection & Approval

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NRS 490V: Professional Capstone and Practicum

Capstone Project Topic Selection & Approval

Diabetes is a disease characterized by hyperglycemia emanating from improper insulin secretion, defects in insulin actions in the body or both.  In the United States, diabetes is one of the leading causes of death, accounting for more than $250 billion in lost productivity and medical costs annually (Menke et al., 2013). It is critical to create awareness about diabetes and management of symptoms to reduce the possibility of uncontrolled diabetes.

                                                Topic Problem

According to the Department of Health and Human Services, at least 29 million Americans have the diabetes while another 89 million at a high risk of developing the disease (Menke et al., 2013). It is estimated one out of every three adults in the United States could have diabetes by the year 2050.  Most deaths caused by diabetes can be avoided by ensuring it does not hit chronic levels. Eighty percent of diabetes related deaths are caused by improper management of glucose levels in the blood, which is also known uncontrolled diabetes (Menke et al., 2013). Worse, diabetic patients whom do not take medication as instructed and follow diabetic diet, physical exercise, and lifestyle guidelines provided by caregivers are at a risk of suffering uncontrolled diabetes. 

Topic Setting or Context

 Uncontrolled diabetes mellitus is common among people between the ages of 50 and 60 and are less likely to manage their diabetes as compared to many younger people. It usually exists simultaneously with conditions such as obesity, hyperlipidemia, depression, and nephropathy (Yang et al, 2016). It is also common among low-income earners who cannot afford proper care to manage the disease.  In fact, uncontrolled diabetes is more prevalent in middle and low-income families. Furthermore, long-standing DM2, total hypercholesterolemia, and cigarette smoking are factors leading to poor control of blood glucose (Kitabchi, 2009).  Finally, uncontrolled diabetes is prevalent among people with busy working schedules, which make things hard for them to exercise, eat healthy meals, or take medications. 

Description of Topic Problem

Uncontrolled diabetes happens as blood sugar levels rise beyond the recommended targets including an A1C above 7.0 percent.  Studies indicate that 54.5 percent of people with diabetes mellitus are not able to control their blood glucose levels (Rother, 2017).  Inability to control glucose levels leads to deterioration of the condition to untreatable levels. When diabetes is not properly managed, it develops into uncontrolled diabetes whose dangerously high levels of blood glucose leads to several conditions which include, eye complications, kidney disease or even organ damage (Grams & Garvey, 2015). When caring for patients with uncontrolled diabetes mellitus, the goals are the elimination of symptoms and prevention of development of complications or slow down their development if they have already started.

Impact of Problem

The consequences of failure to control blood sugar level can be fatal. They include cardiovascular complications, high risk of stroke or heart attack, visual problems, kidney failure, nerve damages, dental problems, and possible amputations due to infections in the feet.  One impact of uncontrolled diabetes in the workplace is using non-traditional approaches to healthcare (Haw & Galaviz, 2017).  Healthcare facilities must build enough team care practices such as shared medical appointments and telehealthcare. For example, telehealth programs directed by pharmacists can improve blood pressure outcomes and medication management among diabetics. In short, health care settings must be ready to use non-traditional approaches to manage patients with uncontrolled diabetes to reduce their fatality risks.

Significance of Problem

 The prevalence of uncontrolled diabetes is expected to double by 2030. Already, many health care organizations are under significant pressure to create cost-effective interventions to care for the diabetics. One of the implications of this reality is nursing practitioners need to be integrated into primary care teams. They can provide innovative support methods which will improve diabetes type 2 patient metrics (Polonsky, 2012). This is a cost-effective method of providing care. Nurse practitioners in primary settings are effective in the improvement of clinical values among patients with uncontrolled diabetes. Improved clinical values such as LDC-L, BP and HbA_1c reduce micro and macro-vascular complications associated with uncontrolled diabetes. These clinical values can be further improved through e-visits, which give convenient care to patients and reduce the financial cost of visiting healthcare facilities for managed care. E-visits and telehealth services can also improve patient’s adherence to medication and treatment plans.

Proposed Solution to the Problem

The best solution to the problem is education and nursing management. Nurses should provide up-to-date and accurate information about the condition of the diabetic patient, so the healthcare team can craft intervention and management strategies. Nursing priorities in the management of uncontrolled diabetes should include restoration of electrolyte or fluid balance, reversal of metabolic abnormalities, prevention of complications, identification of underlying causes, and provision of information about patient treatment needs (Umpierrez & Pasquel, 2017).

There are several nursing interventions providing solutions to uncontrolled diabetes. Education is key in regarding glucose monitoring to help patients identify and manage variations in glucose levels (Brunström & Carlberg, 2016). A review of factors is necessary which cause glucose instability and address them. Furthermore, nurses should encourage patients with diabetes to read labels and teach a diet of low-fat, high-fiber, and low glycemic index foods.  Nurses should also help patients in checking the viability of insulin, emphasizing on expiration dates and proper storage.

Conclusion

The quality of care given to patients with diabetes mellitus should ensure it does not degenerate into uncontrolled diabetes. Diabetes mellitus is not fatal if managed well. Diabetic patients take their medications as instructed, monitor blood glucose levels, managing healthy diets, exercise regularly, and avoid unhealthy lifestyles choices like smoking and alcohol are at a lower risk of their condition degenerating into uncontrolled diabetes. The fact that 54.5 percent of diabetics have uncontrolled diabetes means nursing practices must use non-traditional approaches to deal with diabetics. The practice needs to create innovative solutions for managing diabetes to ensure that blood glucose levels remain under control.