Educating Nurses on Early Assessment of Diabetes NURS 499 Capstone Project Progress Report #2
Introduction/overview: Diabetes is the third leading cause of premature death in people 65 years old and younger in Kings County Hospital. Diabetes is a major risk factor for cardiovascular events, microvascular disease, and premature mortality. In 2020, diabetes was the eighth leading cause of death in the U.S. and resulted in >100,000 deaths. Diabetes also imposes a substantial economic burden, costing patients and the health care system. (Fang, M.,2020). Statistics show that African Americans are mostly affected/ diagnosed with type II diabetes. One of the recurring factors I have noticed while completing my clinical in the ambulatory department is that majoring of the patient affected by type II diabetes are African American/Black which is relative to genetic factors along with the subtle influences of economics, access to care, environment, attitude, behavior, lifestyle, social support, quality of life, personal responsibility, and self-care. (REHM, K. B. 2018)
Goal #1 My goal for the past 2 weeks was to work with the ten nurses participating in the Capstone project to finalize the survey questions.
Goal #2 To start utilizing the survey question daily by the nurses participating in the project
Song, Y., Chiu, N., Wadhera, R. K., Shen, C., & Kazi, D. S. (2022). Diabetes Screening by Race and Ethnicity in the United States: Equivalent Body Mass Index and Age Thresholds. Annals of Internal Medicine
Goal#3 To meet with my preceptor and the unit ADN to discuss the project implementation (Fowler, J. (2016). From staff nurse to nurse consultant: Clinical leadership part 1: leadership or management? British Journal of Nursing, 25
The project will utilize Lewin’s change theory which consists of three phases: unfreezing, movement, and refreezing. During unfreezing, individuals become aware of and believe there is a need for change. The movement phase includes the planning and implementation of the change.
The final phase, refreezing, integrates the change into the current work environment. (Cunning, G 2011). I think as the project progressed the participating staff members have gone through all three phases, and we are currently in the refreezing phase with the implementation of the survey.
Challenges: There has been a resurgence of covid which has affected the nursing staff therefore several nurses who are participating in the were out due to being infected with covid. To overcome this, we moved the in-person meeting to conference calls, so we were able to stay on track. Due to short staffing, my preceptor had to work on the unit leaving little to no time to discuss the project, to overcome this I stayed the entire shift until she had completed her assignment and had time to sit and discuss the project.
Utilization of coaching and/or mentoring: I had a meeting with professor Dr. Hauck which help me to focus on my assignment and gather information to incorporate into the assignment. My preceptor facilitated a meeting with the unit ADN so we can get approval on the survey question to start the implementation of the project.
My preceptor also tried to help me recruit more nurses to participate in the project, six nurses agreed to answer next week if they will participate in the project.
Project Progress: My preceptor and I meet with Leadership from this meeting we laid out the project’s goal and received approval. The project is progressing but there were a few sets this week due to the staff coming down sick with the covid vaccine. We were able to complete the survey questions and give them to the nurses to start using to analyze the effectiveness of the survey.
Leadership and Lessons: The past 2 weeks have highlighted the difficulties in leadership, seeing the extra work leaders had to put in during stressful situations such as short staffing. My preceptor had to work the floor as a Staff nurse while expected to also complete her head nurse duties. This week enforced the importance of implementing a nursing leadership style that best suit your unit, my preceptor demonstrated a transformational leadership style. Transformational leadership happens when a leader’s actions influence and encourage subordinates to outperform their perceived abilities, transformational leadership had positive results for patients, professionals, and institutions alike. (Gasparino, R. C. 2022).
Outcomes achieved: My preceptor and I have made several attempts to meet with leadership but were unable to due to scheduling issues, we were able to finally have a sit-down meeting where we discussed in detail the goals for the capstone project and got approval. The survey was discussed in detail with the participant and the nurses implemented the use of the survey with feedback about its effectiveness. Using different research sources, I continue to gather information to incorporate into my project.
Clinical Hours/Activities: In the past 2 weeks I have completed a total of ten clinical hours and 4 hours doing research. My clinical hours spend collaborating with nurses on the floor observing them and meeting with my preceptor to discuss the progression of the project. I used 4 hours doing EBP research.
References
REHM, K. B. (2018). Ethnic, Racial and Hereditary Influences in Diabetes: Is it nature, nurture, or both?
Fang, M., Wang, D., Coresh, J., & Selvin, E. (2022). Undiagnosed Diabetes in U.S. Adults: Prevalence and Trends. Diabetes Care, 45(9), 1994–2002.
WELLS, J., MANUEL, M., & CUNNING, G. (2011). Changing the model of care delivery: nurses’ perceptions of job satisfaction and care effectiveness. Journal of Nursing Management
Fowler, J. (2016). From staff nurse to nurse consultant: Clinical leadership part 1: leadership or management? British Journal of Nursing, 25(7),
Aggarwal, R., Bibbins-Domingo, K., Yeh, R. W., Song, Y., Chiu, N., Wadhera, R. K., Shen, C., & Kazi, D. S. (2022). Diabetes Screening by Race and Ethnicity in the United States: Equivalent Body Mass Index and Age Thresholds. Annals of Internal Medicine
Ferreira, T. D. M., de Mesquita, G. R., de Melo, G. C., de Oliveira, M. S., Bucci, A. F., Porcari, T. A., Teles, M. G., Altafini, J., Dias, F. C. P., & Gasparino, R. C. (2022). The influence of nursing leadership styles on the outcomes of patients, professionals, and institutions
Introduction/overview: Diabetes is the third leading cause of death in people aged 65 and under at Kings County Hospital. Diabetes is a leading cause of cardiovascular events, microvascular disease, and premature death. Diabetes was the eighth leading cause of death in the United States in 2020, accounting for over 100,000 deaths. Diabetes also has a significant economic impact, both on patients and the health-care system. (Fang, M.,2020). According to statistics, African Americans are the most affected/diagnosed with type II diabetes. One of the recurring factors I noticed while completing my clinical in the ambulatory department is that the majority of type II diabetes patients are African American/Black, which is due to genetic factors as well as the subtle influences of economics, access to care, environment, attitude, behavior, lifestyle, social support, quality of life, personal responsibility, and self-care. K. B. REHM (2018)
Goal #1 My goal for the past two weeks has been to finalize the survey questions with the ten nurses participating in the Capstone project.
Goal #2 is for the nurses involved in the project to begin using the survey questions on a daily basis.
Song, Y., Chiu, N., R. K. Wadhera, C. Shen, and D. S. Kazi (2022). Diabetes Screening in the United States by Race and Ethnicity: Equivalent BMI and Age Thresholds Internal Medicine Annals
Goal #3: Meet with my preceptor and the ADN for the unit to discuss project implementation (Fowler, J. (2016). From staff nurse to consultant nurse: Part 1 of clinical leadership: leadership or management? 25th British Journal of Nursing
The project will make use of Lewin’s change theory, which is divided into three stages: unfreezing, movement, and refreezing. Individuals become aware of and believe there is a need for change during the unfreezing process. The planning and implementation of the change are included in the movement phase.
Refreezing, the final phase, integrates the change into the current work environment. Cunning, G. (2011) I believe that as the project progressed, the participating staff members went through all three phases, and we are currently in the refreezing phase with the survey implementation.
Challenges: There has been a resurgence of covid, which has affected the nursing staff; as a result, several nurses participating in the were absent due to covid infection. To get around this, we switched the in-person meeting to conference calls, which allowed us to stay on track. Due to a lack of staffing, my preceptor had to work on the unit, leaving little to no time to discuss the project; to compensate, I stayed the entire shift until she finished her assignment and had time to sit and discuss the project.
Use of coaching and/or mentoring: I met with professor Dr. Hauck, who helped me focus on my assignment and gather information to incorporate into it. My preceptor arranged for a meeting with the unit ADN so that we could get approval on the survey question and begin project implementation.
My preceptor also attempted to Help me in recruiting more nurses to participate in the project; six nurses agreed to respond next week if they will participate.
Project Status: My preceptor and I met with Leadership; during this meeting, we defined the project’s objectives and received approval. The project is moving forward, but there were a few setbacks this week due to staff illness from the covid vaccine. We were able to finish the survey questions and give them to the nurses to begin analyzing the survey’s effectiveness.
Leadership and Learning: The last two weeks have highlighted the challenges of leadership, as leaders have had to put in extra effort during stressful situations such as short staffing. My preceptor had to work the floor as a Staff nurse while also performing head nurse duties. My preceptor demonstrated a transformational leadership style this week, emphasizing the importance of implementing a nursing leadership style that is best suited to your unit. Transformational leadership occurs when a leader’s actions influence and encourage subordinates to outperform their perceived abilities. Transformational leadership resulted in positive outcomes for patients, professionals, and institutions alike. R. C. Gasparino 2022).
Results obtained: My preceptor and I attempted to meet with leadership several times but were unable to due to scheduling conflicts. We were finally able to have a sit-down meeting where we discussed in detail the goals for the capstone project and received approval. The survey was thoroughly discussed with the participant, and the nurses used it with feedback on its effectiveness. I’m still gathering information for my project by using various research sources.
Clinical Activities/Hours: In the last two weeks, I have completed ten clinical hours and four hours of research. My clinical hours are spent working with nurses on the floor, observing them, and meeting with my preceptor to discuss the project’s progress. I spent 4 hours researching EBP.
References
K. B. REHM (2018). Diabetes Ethnic, Racial, and Hereditary Influences: Is it nature, nurture, or both?
M. Fang, D. Wang, J. Coresh, and E. Selvin (2022). Diabetes Undiagnosed in Adults in the United States: Prevalence and Trends Diabetes Care, vol. 45(9), pp. 1994-2002.
J. WELLS, M. MANUEL, and G. CUNNING (2011). Changing the care delivery model: nurses’ perspectives on job satisfaction and care effectiveness Nursing Management Journal
J. Fowler (2016). From staff nurse to nurse consultant: Part 1 of Clinical Leadership: Leadership or Management? 25th British Journal of Nursing (7),
R. Aggarwal, K. Bibbins-Domingo, R. W. Yeh, Y. Song, N. Chiu, R. K. Wadhera, C. Shen, and D. S. Kazi (2022). Diabetes Screening in the United States by Race and Ethnicity: Equivalent BMI and Age Thresholds Internal Medicine Annals
Ferreira, T. D. M., de Mesquita, G. R., de Melo, G. C., de Oliveira, M. S., Bucci, A. F., Porcari, T. A., Teles, M. G., Altafini, J., Dias, F. C. P., & Gasparino, R. C. (2022). The impact of nursing leadership styles on patient, professional, and institutional outcomes
