1

Assessing the Problem: Leadership, Collaboration, Communication, Change Management and

Policy Consideration

Student’s Name

Course

Instructor

Date
 2

Patient, Family, or Population Health Problem That’s Relevant to My Practice.

As a nurse with a bachelor degree working at Ascension Saint Joseph in Joliet, Illinois,

the systemic health issue of diabetes is extremely important to my profession. A major section of

the general public suffers from the persistent medical illness diabetes, which has repercussions

for the physical and mental well-being of individuals, households, and the wider population at

large. Due of its growing frequency and occurrence, it has garnered popularity on a global scale.

In addition to being persistent, it also poses a grave risk to one's life. Diabetes was always

thought to be one illness, but today's medical specialists have discovered that diabetes really

contains a number of heterogeneity disorders and can cause a wider range of illnesses

(Budreviciute et al., 2020; Choudhury & Devi Rajeswari, 2021).

Diabetes is a metabolism illness marked by high levels of sugar in the blood, and it may

be roughly divided into two categories: both Type 1 and Type 2. The growing incidence of type

2 diabetes, which is frequently linked to behavioral factors including unhealthy eating habits and

inactivity, has made it a significant public health problem (Banday et al., 2020). Nearly 34

million Americans (US) suffer from type 2 diabetes, with stark health inequalities between rural

and urban populations. About 32 of these 34 million persons have type 2 diabetes mellitus

(T2DM). The issue affects all patients, as well as individuals, their households, and the general

public (Dugani et al., 2021).

Communicating with those who have been afflicted with diabetes and their family

members, who are an important source of support, will be a part of my fieldwork at Ascension

Saint Joseph. In order to spread understanding and encourage diabetes control and preventative

measures, I will also interact with the larger community. Several important variables influence

the importance of diabetes as a community health problem in Joliet, Illinois. First, Ascension
 3

Saint Joseph serves a large number of those impaired reflecting the disease's high incidence in

the United States in Joliet (Dugani et al., 2021). Interventions to enhance public health are

required since uncontrolled diabetes causes serious consequences such as heart disease, renal

issues, decreased vision, and nerve damage. Furthermore, diabetes places a huge financial strain

on sufferers as well as the medical sector, requiring an enormous investment of money for its

management (Afaya et al., 2020; Oyando et al., 2020). Additionally, diabetes adversely impacts

specific population segments, especially those from lower socioeconomic strata and racial and

cultural minorities, emphasizing the necessity to treat it in order to eliminate health inequities in

the general population (Haw et al., 2021).

Handling the type 2 diabetes issue is crucial for nurses with baccalaureate preparation for

a number of important reasons. In order to provide patient-centered treatment, I will be

instrumental in teaching those who have diabetes about management, administering medications,

modifications to their lifestyles, and psychological support. My work includes wellness

initiatives, medical examinations, and the promotion of better lifestyles through outreach to the

public and awareness. I also would fight for favorable legislative modifications. In order to

provide complete patient care, my job also requires strong multidisciplinary coordination with

medical specialists including nutritionists, diabetes specialists, and pharmacy technicians. I can

use my expertise and training to promote modifications to policies at the administrative and local

levels in order to increase accessibility to care and the quality of diabetes avoidance and

management interventions.

Analysis of Peer-Reviewed Nursing Evidence for Diabetes

Supporting Evidence in Literature

 4

ElSayed et al. (2022) article focuses on pharmacologic glycemic control and presents

evidence-based recommendations for diabetes management in the ADA's yearly edition. It

provides suggestions for choosing medications while putting an emphasis on customized

treatment. This article can help nurses make pharmaceutical choices for optimal glycemic

management that are in line with their clinical nursing expertise. As a result, the writers include

additional evidence that is in line with what I observe in my job as a nurse.

Dennis et al. (2022) study sought to create and verify a technique for deciding on the best

course of therapy for type 2 diabetes, such as SGLT2 or DPP-4 inhibitors, depending on

variables such as glucose reaction, changes in weight, and tolerance. By offering a data-driven

approach to tailored diabetes care that adheres to the fundamentals of evidence-based healthcare,

the investigation improves the way nurses practice.

Makam and Nguyen (2017) article intended to use scientifically supported medical

concepts, particularly with reference to glucose management, to reduce excessive therapy and

enhance patient-centered therapy in diabetes. It placed a strong emphasis on fundamental ideas

including choosing absolute advantages over comparative forecasts, taking the treatment's

duration into consideration, weighing prospective advantages and hazards, and integrating

recipients in jointly making choices. By employing these concepts, nurses can improve the

results for patients in the care of diabetes and other conditions by providing a comprehensive

strategy that avoids pointless procedures while taking the needs of patients into account.

Reliability of Data

Identifying the validity and accuracy of the data you are using by evaluating its

dependability is essential. Numerous aspects must be considered while evaluating data

reliability. First, check the source for reliability, giving preference to peer-reviewed publications,
 5

respectable organizations, and governmental organizations. Examine the openness of the data

gathering processes, placing a focus on well-researched, impartial, and consistent procedures

(Tripp & Shortlidge, 2020). Data that have undergone evaluation by others as well as control

procedures are more reliable, and replication helps establish credibility. To guarantee that data

remain trustworthy for study findings, decision-making, or therapeutic treatment, they should

conform to the mainstream of the area, resolve possible collecting prejudices anomalies, and

verification with trustworthy sources (Parsa et al., 2020; Nowell et al., 2017).

Barriers to Implementing Evidence-Based Practice

Setho Hadisuyatmana et al. (2023) study identified important obstacles to using

scientifically supported therapies for type 2 diabetes mellitus-associated erectile dysfunction

(T2DMED) in medical encounters. These obstacles included patient unwillingness brought on by

humiliation and financial limitations, in addition to the contemptuous sentiments of healthcare

personnel. Letta et al. (2021) found there are several obstacles to providing evidence-based

treatment for diabetes, such as: unorganized medical services, a lack of interdisciplinary teams,

restricted practitioner teamwork, and clinicians' lack of skills and experience.

Effectiveness of Nursing Standards and Policies

Tamiru et al. (2023) study discovered that enhancing self-care understanding as well as

conduct in people with type II diabetes requires nurse-led diabetes self-management education

(DSME). This study highlighted the importance of DSME in healthcare settings by indicating

that it can improve managing diabetes and the results for patients. This strategy shows potential

for enabling those with type II diabetes to take control of their health. The ramifications of this

study showed an opportunity for such actions to enhance patient, family, and population results

for diabetics, making them especially relevant to the establishment and application of standards
 6

f and guidelines for nurses. Oba et al. (2020) study main goal was to look at the factors that

contribute to unregulated glucose levels in diabetics and create a plan to improve glycemic

management in a few Thai community hospitals. The study emphasized the need of nursing

principles and guidelines for maintaining glycemic control in diabetic patients. The Nurse-led

Multidisciplinary Based Program established the critical function of nurses in planning and

delivering treatment in the community hospital environment in addition to effectively improving

glycemic control. It served as an example of the possibilities for interdisciplinary, cooperative

initiatives to improve diabetes therapeutic results while tackling the uneven allocation of medical

amenities.

Role of Nurses in Policymaking

According to Hajizadeh et al. (2021), a substantial portion of the medical employees,

nurses are crucial to the improvement of medical facilities. Their engaged involvement in the

formulation of health policies is crucial for enhancing medical results, averting disease, and

lowering readmitted to hospitals rates. Nurses require assistance from both their employers and

the larger system of healthcare to do this. Etowa et al. (2023) study centered on the encounters of

midwives and nurse practitioners in low- and middle-income (LMIC) nations policy formulation.

Although it focused on their participation in LMIC policy formulation, it may be extended to the

wider scope of medical policymaking. In many care environments, enhancing medical results,

avoiding sickness, and lowering hospitalizations are goals that are aligned with the focus on

rebuilding fundamental relationships of power and encouraging collaboration between

disciplines.

Nursing Theory or Conceptual Framework

 7

Borji et al. (2017) study remarked that Orem's Self-Care Deficit Theory is a well-known

medical concept that offers a systematic paradigm for comprehending and enhancing the quality

of life (QOL) of individuals with chronic diseases, such as diabetes mellitus. The study focused

on this specific application, it reflects a broader body of literature and research related to Orem's

theory and its implications for nursing practice. A nursing student during practicum, can draw

from this research study to inform nursing practice. Using Orem's Self-Care Model as a guiding

framework, the practitioner can work with patients, especially those with chronic conditions like

diabetes, to develop individualized care plans, provide education, and assess their self-care

abilities. By doing so, you can contribute to improving their QOL and overall health outcomes.

References

Afaya, R. A., Bam, V., Azongo, T. B., & Afaya, A. (2020). Knowledge of chronic complications

of diabetes among persons living with type 2 diabetes mellitus in northern Ghana. PLOS

ONE, 15(10), 1–14. https://doi.org/10.1371/journal.pone.0241424

Banday, M. Z., Sameer, A. S., & Nissar, S. (2020). Pathophysiology of diabetes: An overview.

Avicenna journal of medicine, 10(4), 174–188. https://doi.org/10.4103/ajm.ajm_53_20

Borji, M., sharifi, A., Otaghi, M., & Kazembeigi, S. (2017). The impact of Orem’s Self-Care

Model on the quality of life in patients with Type II Diabetes in Ilam. Biomedical and

Pharmacology Journal, 10(1), 213–220. https://doi.org/10.13005/bpj/1100

Budreviciute, A., Damiati, S., Sabir, D. K., Onder, K., Schuller-Goetzburg, P., Plakys, G.,

Katileviciute, A., Khoja, S., & Kodzius, R. (2020). Management and prevention
 8

strategies for Non-Communicable Diseases (NCDs) and their risk factors. Frontiers in

Public Health, 8(574111), 1–11. https://doi.org/10.3389/fpubh.2020.574111

Choudhury, A. A., & Devi Rajeswari, V. (2021). Gestational diabetes mellitus - A metabolic and

reproductive disorder. Biomedicine & Pharmacotherapy, 143, 1–18.

https://doi.org/10.1016/j.biopha.2021.112183

Dennis, J. M., Young, K. G., McGovern, A. P., Mateen, B. A., Vollmer, S. J., Simpson, M. D.,

Henley, W. E., Holman, R. R., Sattar, N., Pearson, E. R., Hattersley, A. T., Jones, A. G.,

& Shields, B. M. (2022). Development of a treatment selection algorithm for SGLT2 and

DPP-4 inhibitor therapies in people with type 2 diabetes: A retrospective cohort study.

The Lancet Digital Health, 4(12), e873–e883. https://doi.org/10.1016/s2589-

7500(22)00174-1

Dugani, S. B., Mielke, M. M., & Vella, A. (2021). Burden and management of type 2 diabetes in

rural United States. Diabetes/metabolism research and reviews, 37(5), 1-19.

https://doi.org/10.1002/dmrr.3410

ElSayed, N. A., Aleppo, G., Aroda, V. R., Bannuru, R. R., Brown, F. M., Bruemmer, D., Collins,

B. S., Hilliard, M. E., Isaacs, D., Johnson, E. L., Kahan, S., Khunti, K., Leon, J., Lyons,

S. K., Perry, M. L., Prahalad, P., Pratley, R. E., Seley, J. J., Stanton, R. C., & Gabbay, R.

A. (2022). Pharmacologic approaches to glycemic treatment: Standards of care in

diabetes—2023. Diabetes Care, 46(Supplement_1), S140–S157.

https://doi.org/10.2337/dc23-s009

Etowa, J., Vukic, A., Aston, M., Iduye, D., Mckibbon, S., George, A., Nkwocha, C., Thapa, B.,

Abrha, G., & Dol, J. (2023). Experiences of nurses and midwives in policy development

in low- and middle-income countries: Qualitative systematic review.

 9

International Journal of Nursing Studies Advances, 5, 1–14.

https://doi.org/10.1016/j.ijnsa.2022.100116

Hajizadeh, A., Zamanzadeh, V., Kakemam, E., Bahreini, R., & Khodayari-Zarnaq, R. (2021).

Factors influencing nurses participation in the health policy-making process: A

systematic review. BMC Nursing, 20(1), 1–9. https://doi.org/10.1186/s12912-021-00648-

Haw, J. S., Shah, M., Turbow, S., Egeolu, M., & Umpierrez, G. (2021). Diabetes complications

in racial and ethnic minority populations in the USA. Current diabetes reports, 21(1), 2.

https://doi.org/10.1007/s11892-020-01369-x

Letta, S., Aga, F., Yadeta, T. A., Geda, B., & Dessie, Y. (2021). Barriers to diabetes patients’

self-care practices in Eastern Ethiopia: A qualitative study from the health care providers

perspective. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 14, 4335–

4349. https://doi.org/10.2147/dmso.s335731

Makam, A. N., & Nguyen, O. K. (2017). An evidence-based medicine approach to

antihyperglycemic therapy in diabetes to overcome overtreatment. Circulation, 135(2),

180–195. https://doi.org/10.1161/CIRCULATIONAHA.116.022622

Nowell, L. S., Norris, J. M., White, D. E., & Moules, N. J. (2017). Thematic analysis: Striving to

meet the trustworthiness criteria. International journal of qualitative methods, 16(1), 1-

13. https://doi.org/10.1177/1609406917733847

Oba, N., Barry, C. D., Gordon, S. C., & Chutipanyaporn, N. (2020). Development of a nurse-led

multidisciplinary based program to improve glycemic control for people with

uncontrolled diabetes mellitus in a community hospital, Thailand. Pacific Rim

 10

International Journal of Nursing Research, 24(3), 349-362. https://he02.tci-

thaijo.org/index.php/PRIJNR/article/view/206447

Oyando, R., Njoroge, M., Nguhiu, P., Sigilai, A., Kirui, F., Mbui, J., Bukania, Z., Obala, A.,

Munge, K., Etyang, A., & Barasa, E. (2020). Patient costs of diabetes mellitus care in

public health care facilities in Kenya. The International journal of health planning and

management, 35(1), 290–308. https://doi.org/10.1002/hpm.2905

Parsa, N., Zibaeenezhad, M. J., Trevisan, M., Karimi Akhormeh, A., & Sayadi, M. (2020).

Magnitude of the quality assurance, quality control, and testing in the shiraz cohort heart

study. BioMed research international, 2020, 1-7.

https://doi.org/10.1155/2020/8179795

Setho Hadisuyatmana, Malik, G., Ferry Efendi, Reisenhofer, S., & Boyd, J. H. (2023). The

experiences and barriers in addressing type 2 diabetes mellitus-associated erectile

dysfunction: A mixed method systematic review. Systematic Reviews, 12(1), 1–14.

https://doi.org/10.1186/s13643-023-02303-4

Tamiru, S., Dugassa, M., Amsalu, B., Bidira, K., Bacha, L., & Tsegaye, D. (2023). Effects of

Nurse-Led Diabetes Self-Management Education (DSME) on self-care knowledge and

self-care behavior among adult patients with type 2 diabetes mellitus attending diabetes

follow up clinic: A Quasi-Experimental study design. International Journal of Africa

Nursing Sciences, 18, 1–7. https://doi.org/10.1016/j.ijans.2023.100548

Tripp, B., & Shortlidge, E. E. (2020). From theory to practice: Gathering evidence for the

validity of data collected with the Interdisciplinary Science Rubric (IDSR). CBE life

sciences education, 19(3), 1-16. https://doi.org/10.1187/cbe.20-02-0035