Diabetes Management Technology: Care Coordination Strategies and Community Resources

NURS-FPX 4900: Capstone Project for Nursing

FlexPath Assessment 3: Assessing the Problem: Technology, Care Coordination, and Community Resources Considerations

Overview

As a culminating activity in your BSN FlexPath journey at Capella University, this assessment builds on your previous work identifying a population health problem. In this 5–7 page written assessment (excluding title page and references), you will analyze how health care technology, care coordination, and community resources can be strategically applied to address a specific patient, family, or population health problem—in this case, type 2 diabetes management among adults aged 45–65 in urban community settings. This problem affects over 34 million Americans and contributes to significant morbidity, including cardiovascular complications and healthcare costs exceeding $327 billion annually (Centers for Disease Control and Prevention, 2024).

Your paper should dedicate approximately 2–3 double-spaced pages to describing the problem and population, followed by 3–4 double-spaced pages analyzing interventions and providing evidence-based recommendations. Use APA 7th edition formatting, including a title page, headings, and a reference list. Support your analysis with at least 4 current (within the last 5 years) peer-reviewed sources.

This assessment evaluates your ability to integrate evidence-based practice with real-world nursing leadership, aligning with BSN program outcomes in population health, informatics, and interprofessional collaboration.

Instructions

Part 1: Describe the Problem and Population (2–3 pages)

• Provide a clear, concise description of type 2 diabetes as the health problem, including its pathophysiology, prevalence, and impact on quality of life (e.g., risks of neuropathy, retinopathy, and reduced life expectancy).
• Discuss the background and significance of the problem within the broader U.S. healthcare system, including social determinants of health such as access barriers in urban low-income populations.
• Identify your target population (adults aged 45–65 in urban communities) and setting (e.g., primary care clinics or community health centers). Explain why this group is particularly vulnerable and how the problem perpetuates health disparities.

Part 2: Analyze the Problem and Make Recommendations (3–4 pages)

• Health Care Technology (1 page): Explain how specific technologies, such as continuous glucose monitoring (CGM) systems or mobile health apps for self-management, can be applied to improve glycemic control and patient adherence. Analyze benefits (e.g., real-time data for personalized interventions) and potential barriers (e.g., digital literacy gaps).
• Nursing Practice Standards, Policies, and Technology Support (0.5 page): Describe relevant standards (e.g., American Diabetes Association guidelines) and policies (e.g., CMS reimbursement for telehealth under the 21st Century Cures Act) that endorse technology integration in nursing practice.
• Care Coordination (1 page): Discuss how interprofessional care coordination—such as team-based case management involving nurses, endocrinologists, and dietitians—can address fragmented care and reduce hospital readmissions. Recommend strategies like shared electronic health records for seamless transitions.
• Nursing Practice Standards, Policies, and Care Coordination Support (0.5 page): Reference organizational policies (e.g., Joint Commission standards on care transitions) and governmental initiatives (e.g., HRSA’s Health Center Controlled Networks) that facilitate coordinated care.
• Community Resources (1 page): Explore how resources like local diabetes support groups, faith-based nutrition programs, or federally qualified health centers (FQHCs) can enhance self-efficacy and long-term outcomes. Propose partnerships to bridge gaps in education and social support.
• Nursing Practice Standards, Policies, and Community Resource Support (0.5 page): Cite standards (e.g., ANA’s Scope and Standards of Practice) and policies (e.g., Affordable Care Act provisions for community health integration) that promote resource utilization.
• Synthesis and Recommendations: Conclude with 2–3 actionable recommendations for nurses, such as piloting a CGM education program in collaboration with community partners, and evaluate potential outcomes using measurable indicators (e.g., A1C reduction by 1%).

Additional Requirements

• Length: 5–7 double-spaced pages (approximately 1,250–1,750 words), using 12-point Times New Roman font, 1-inch margins.
• References: Include at least 4 peer-reviewed sources published 2019–2025. Use in-text citations and a reference list in APA 7th edition.
• Formatting: Include a title page with your name, course code (NURS-FPX 4900), assessment title, and submission date (e.g., October 3, 2025). Use level 1 and level 2 headings for clarity.
• Evidence-Based Approach: Ground recommendations in scholarly evidence; avoid unsubstantiated opinions.
• Submission: Upload to the courseroom as a Word document. Late submissions incur a 10% deduction per day.

Evaluation Rubric

Aim for Distinguished by demonstrating critical thinking and leadership in nursing practice. If you have questions, schedule a 1:1 coaching session via the courseroom. Success in this assessment will prepare you for your capstone proposal in Assessment 4.

 References (APA Format)

Alhaiti, A. (2025). Integrative technologies in nursing-led interventions for diabetes management: A systematic review of efficacy and outcomes. BMC Nursing, 24(1), Article 846. https://doi.org/10.1186/s12912-025-03435-9

American Diabetes Association Professional Practice Committee. (2025). 1. Improving care and promoting health in populations: Standards of Care in Diabetes—2025. Diabetes Care, 48(Suppl. 1), S14–S26. https://doi.org/10.2337/dc25-S001

Edelman, S., Close, K. L., Cosson, W. W., & Nickerson, A. (2024). Patient perspectives on the benefits and challenges of diabetes technology in primary care practices. Clinical Diabetes, 42(2), 243–257. https://doi.org/10.2337/cd23-0087

Klonoff, D. C., Yeung, A. M., Huang, J., Espinoza, J. C., Raymond, J. K., Lee, W. A., Koliwad, S. K., & Kerr, D. (2023). Twenty-first century management of diabetes with shared telemedicine appointments. Journal of Telemedicine and Telecare, 31(3), 446–453. https://doi.org/10.1177/1357633X231184503

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NURS-FPX 4900: Capstone Project for Nursing

FlexPath Assessment 2: Assessing the Problem: Quality, Safety, and Cost Considerations

Overview

This assessment continues your BSN FlexPath capstone progression at Capella University, following Assessment 1 where you identified a population health problem. Here, you will examine the implications of type 2 diabetes management among adults aged 45–65 in urban community settings through the lenses of quality of care, patient safety, and healthcare costs. Type 2 diabetes impacts over 34 million U.S. adults, leading to annual costs surpassing $327 billion and heightened risks for complications like cardiovascular disease (Centers for Disease Control and Prevention, 2024).

In this 5–7 page written assessment (excluding title page and references), allocate about 2–3 double-spaced pages to describing the problem and its effects, and 3–4 double-spaced pages to analyzing quality, safety, and cost factors with evidence-based recommendations. Format in APA 7th edition, including a title page, headings, and references. Incorporate at least 4 peer-reviewed sources from the last 5 years.

This task assesses your proficiency in applying nursing leadership to enhance care quality, safety, and fiscal responsibility, supporting BSN outcomes in evidence-based practice, safety, and resource management.

Instructions

Part 1: Describe the Problem and Population (2–3 pages)

• Offer a detailed overview of type 2 diabetes, covering its etiology, epidemiology, and effects on daily functioning (e.g., increased hospitalization risks and economic burden).
• Highlight the problem’s relevance in the U.S. healthcare landscape, factoring in determinants like socioeconomic status and urban access challenges.
• Specify the population (adults aged 45–65 in urban areas) and context (e.g., outpatient clinics or community health programs). Discuss vulnerabilities, such as comorbidity prevalence, and how it exacerbates inequities.

Part 2: Analyze the Problem and Make Recommendations (3–4 pages)

• Quality of Care (1 page): Evaluate how quality metrics (e.g., A1C control rates) influence outcomes in diabetes management. Discuss interventions like patient education to improve adherence and reduce disparities.
• Nursing Practice Standards, Policies, and Quality Support (0.5 page): Reference standards (e.g., ADA Standards of Care) and policies (e.g., CMS quality reporting under MACRA) that guide quality enhancement in nursing.
• Patient Safety (1 page): Analyze safety risks, such as hypoglycemia from medication errors or falls due to neuropathy. Recommend protocols like standardized insulin administration to mitigate harms.
• Nursing Practice Standards, Policies, and Safety Support (0.5 page): Cite guidelines (e.g., Institute for Safe Medication Practices) and regulations (e.g., HIPAA for data security in telemonitoring) promoting safety.
• Costs to Patient and System (1 page): Examine direct costs (e.g., medications) and indirect costs (e.g., lost productivity), including system-level burdens like emergency visits. Suggest cost-effective strategies, such as preventive screenings.
• Nursing Practice Standards, Policies, and Cost Support (0.5 page): Discuss policies (e.g., Affordable Care Act incentives for value-based care) and standards (e.g., ANA principles on resource allocation) that address cost efficiency.
• Synthesis and Recommendations: Integrate findings into 2–3 practical recommendations for nurses, like implementing multidisciplinary quality audits, and assess impacts via metrics (e.g., 20% cost reduction in readmissions).

Additional Requirements

• Length: 5–7 double-spaced pages (about 1,250–1,750 words), in 12-point Times New Roman font with 1-inch margins.
• References: At least 4 peer-reviewed sources from 2019–2025, with in-text citations and APA 7th edition reference list.
• Formatting: Title page with name, course (NURS-FPX 4900), assessment title, and date (e.g., October 3, 2025). Use level 1 and 2 headings.
• Evidence-Based Approach: Base analysis on scholarly evidence; steer clear of personal anecdotes.
• Submission: Submit as a Word document via the courseroom. Deductions apply for late work (10% per day).

Evaluation Rubric

Strive for Distinguished by showcasing analytical depth and nursing advocacy. Consult coaching for support; this prepares for Assessment 3 on technology and coordination.

References (APA Format)

American Diabetes Association Professional Practice Committee. (2025). 1. Improving care and promoting health in populations: Standards of Care in Diabetes—2025. Diabetes Care, 48(Suppl. 1), S14–S26. https://doi.org/10.2337/dc25-S001

Clark, J. E., Boehmer, K. R., Breslin, M., Hayes, S., Parker, W., Griffin, D., Shippee, N., Gionfriddo, M., Kasia, J. L., & Montori, V. M. (2021). Quality of life, burden of treatment, safety, and avoidance of future events (QBSAfe) protocol: A pilot study testing an intervention to shift the paradigm of diabetes care. Pilot and Feasibility Studies, 7(1), 196. https://doi.org/10.1186/s40814-021-00935-8

Galindo, R. J., Trujillo, J. M., Low Wang, C. C., & McCoy, R. G. (2023). Advances in the management of type 2 diabetes in adults. BMJ Medicine, 2(1), e000372. https://doi.org/10.1136/bmjmed-2022-000372

Powers, M. A., Bardsley, J. K., Cypress, M., Funnell, M. M., Harms, D., Hess-Fischl, A., Hooks, B., Isaacs, D., Mandel, E. D., Maryniuk, M., Norton, A., Rinker, J., Siminerio, L. M., & Uelmen, S. (2022). Diabetes self-management education and support in adults with type 2 diabetes: A consensus report of the American Diabetes Association, the Association of Diabetes Care & Education Specialists, the Academy of Nutrition and Dietetics, the American Academy of Family Physicians, the American Academy of PAs, the American Association of Nurse Practitioners, and the American Pharmacists Association. Clinical Diabetes, 40(3), 356–369. https://doi.org/10.2337/cd22-0051