Posted: September 17th, 2023

Concept map – a patient with renal failure related to diabetes

Scenario
You have already learned about evidence-based practice and quality improvement initiatives in previous courses. You will use this information to guide your assessments, while also implementing new concepts introduced in this course. For this assessment, you will engage in the Vila Health: Using Concept Maps for Diagnosis scenario, develop a concept map, and provide supporting evidence and explanations.
Engage with a Vila Health scenario and then create a concept map that illustrates a plan for achieving high-quality outcomes for a patient.

Introduction
Note: Each assessment in this course builds on the work you completed in the previous assessment. Therefore, you should complete the assessments in this course in the order in which they are presented.

The biopsychosocial (BPS) approach to care is a way to view all aspects of a patient’s life. It encourages medical practitioners to take into account not only the physical and biological health of a patient, but all considerations like mood, personality, and socioeconomic characteristics. This course will also explore aspects of pathophysiology, pharmacology, and physical assessment (the three Ps) as they relate to specific conditions, diseases, or disorders.

The first assessment is one in which you will create a concept map to analyze and organize the treatment of a specific patient with a specific condition, disease, or disorder.

The purpose of a concept map is to visualize connections between ideas, connect new ideas to previous ideas, and to organize ideas logically. Concept maps can be an extremely useful tool to help organize and plan care decisions. This is especially true in the biopsychosocial model of health, which takes into account factors beyond just the biochemical aspects of health. By utilizing a concept map, a nurse can simplify the connection between disease pathways, drug interactions, and symptoms, as well as between emotional, personality, cultural, and socioeconomic considerations that impact health.

Professional Context
The purpose of a concept map is to visualize connections between ideas, connect new ideas to previous ideas, and to organize ideas logically. Concept maps can be an extremely useful tool to help organize and plan care decisions. This is especially true in the context of the biopsychosocial model, which takes into account factors beyond just the biochemical aspects of health. By utilizing a concept map, a nurse can simplify the connection between disease pathways, drug interactions, and symptoms, as well as between the emotional, personality, cultural, and socioeconomic considerations that impact health.

Scenario
You have already learned about evidence-based practice and quality improvement initiatives in previous courses. You will use this information to guide your assessments, while also implementing new concepts introduced in this course. For this assessment, you will engage in the Vila Health: Using Concept Maps for Diagnosis scenario, develop a concept map, and provide supporting evidence and explanations.

Instructions
For this assessment, you will develop a concept map and a short narrative that supports and further explains how the concept map is constructed. The bullet points below correspond to the grading criteria in the scoring guide. Be sure that your evidence-based plan addresses all of the bullet points. You may also want to read the Concept Map scoring guide and Guiding Questions: Concept Map [DOCX] to better understand how each grading criterion will be assessed.

Part 1: Concept Map
Develop an evidence-based concept map that illustrates a plan for achieving high-quality outcomes for acute and chronic stages for a patient with renal failure related to diabetes in both an acute care facility and in the community.
You can achieve this by following the Vila Health scenario.
You will have a total of two concept maps. One will show the acute care facility with three diagnoses, and the other will show a home health community setting with three diagnoses.
Part 2: Additional Evidence (Narrative)
Justify the value and relevance of the evidence you used as the basis for your concept maps.
Analyze how interprofessional strategies applied to the concept map can lead to the achievement of desired outcomes.
Construct the concept maps and linkage to additional evidence in a way that facilitates a reader’s understanding of key information and links. This will be done by adding links in each section of the concept map that will show your value, relevance, and evidence.
Integrate relevant sources to support assertions, correctly formatting citations and references using current APA style.
Submission Requirements
Length of submission: Each concept map should be on a single page, if at all possible. You will add links to each section of your concept map for additional evidence and narratives that support your concept maps.
Number of references: Cite a minimum of 3–5 sources of scholarly or professional evidence that support your concept map, decisions made regarding care, and interprofessional strategies. Resources should be no more than five years old.
APA formatting:
For the concept map portion of this assessment, format resources and citations according to current APA style. Please include references both in-text and in the reference page that follows your narrative.
For the narrative portion of this assessment: An APA Template Tutorial [DOCX] is provided to help you in writing and formatting your analysis. You do not need to include an abstract for this assessment.
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

Competency 1: Design patient-centered, evidence-based, advanced nursing care for achieving high-quality patient outcomes.
Develop an evidence-based concept map that illustrates a plan for achieving high-quality outcomes at the acute and chronic stage for a patient with renal failure related to diabetes in both an acute care facility and in the community.
Justify the value and relevance of the evidence used as the basis for a concept map.
Competency 4: Evaluate the efficiency and effectiveness of interprofessional care systems in achieving desired health care improvement outcomes.
Analyze how interprofessional strategies applied to the concept map can lead to achievement of desired outcomes.
Competency 5: Communicate effectively with diverse audiences, in an appropriate form and style, consistent with organizational, professional, and scholarly standards.
Create links within each section of the concept map for any additional evidence in a way that facilitates understanding of key information.
Integrate relevant sources to support assertions, correctly formatting citations within the concept map and references using current APA style.
You are an ICU nurse (black male) at St. Anthony Medical Center. You have been assigned Mrs. Smith (black female), a 52-year-old with a history of Type II Diabetes Mellitus, who was admitted this morning with high glucose levels and Acute Renal Failure.

Ask her some questions in order to create a concept map.

Mrs. Smith
I see that your HA1C is at 8.5. Can you give me a history of your blood glucose readings over the last 2 weeks?
Hide Response

Mrs. Smith: My fasting blood sugars have been running around 200 with it getting as high as 350+ after each meal. I can tell that I wasn’t feeling very good, and I am swelling in my legs more than usual. I also have some blurred vision and I am very tired.
Are you experiencing any other symptoms?
Hide Response

Mrs. Smith: Yes, I think so but I’m not sure if they are related.
What are some of the other things going on?
Hide Response

Mrs. Smith: I have not voided as often as before, and I feel a little short of breath when I get up to walk to the mailbox. I also feel weak and even a little nauseous.

Concept Map 1

Concept Map 2

Introduction
In both an acute care facility and the community, the concept maps shown above highlight the evidence-based strategy for a patient with renal failure related to diabetes to achieve high-quality outcomes. Acute renal failure, hypertension, and diabetic foot ulcer are the three diagnoses listed on the concept map for acute care facilities. Chronic kidney disease, diabetic retinopathy, and diabetes self management educatio are the three diagnoses listed on the concept map for the community setting. Both maps include assessment, results, and interventions that are based on the most recent research and recommendations.
Value and Relevance of Evidence
The concept maps’ evidence base is extremely valuable and pertinent to the treatment of diabetic patients with renal failure. Peer-reviewed journals and policies from reputable organizations, including the American Diabetes Association and the National Kidney Foundation, made up the majority of the sources used. These resources are founded on in-depth investigation and are frequently updated to reflect the most recent developments in the field. The concept maps draw on these resources to offer evidence-based recommendations for the treatment of patients with renal failure associated with diabetes (De Boer et al., 2022). Furthermore, the concept maps’ supporting data is extremely pertinent to the state of the healthcare industry today. There is a growing need for evidence-based guidelines to guarantee that patients receive the best care possible due to the rising incidence of diabetes and the rising number of patients with renal failure (De Boer et al., 2022). The concept maps offer a thorough strategy for treating patients with renal failure brought on by diabetes, considering both acute care and community settings (De Boer et al., 2022). The use of evidence-based recommendations also makes sure that patient care is uniform across healthcare settings, which can result in better patient outcomes. Evidence-based recommendations can assist healthcare professionals in ensuring that they are offering the most cutting-edge and efficient care possible, improving patient outcomes and elevating patient satisfaction.
Interprofessional Strategies
In the acute care setting, interprofessional collaboration is crucial for achieving the best patient outcomes. The concept map for Mrs. Smith’s case described interventions involving a range of healthcare specialists, including doctors, nurses, dietitians, and pharmacists. Together, these medical professionals can make sure Mrs. Smith receives prompt, appropriate care that takes into account all facets of her condition.
Effective communication is a key interprofessional strategy. Sharing pertinent patient information, outlining precise expectations for care, and working together to create a thorough care plan are all essential components of effective communication. Effective communication in Mrs. Smith’s case would entail regular communication between the medical staff members handling her care, including the doctor, nurses, dietitian, and pharmacist. These specialists can create a thorough care strategy that meets all of Mrs. Smith’s needs by exchanging knowledge and cooperating.
Care coordination is a crucial interprofessional tactic. Care organization and coordination take place across various healthcare settings and providers. Care coordination in Mrs. Smith’s situation entails coordinating her treatment at the hospital and any additional care she might require in the community. This might entail working with home health organizations or outpatient clinics to make sure Mrs. Smith receives the right care after leaving the hospital.
For the best patient outcomes, interprofessional education and training are crucial. To enable effective collaboration among healthcare professionals from various disciplines, this entails providing them with education and training. For Mrs. Smith, interprofessional education and training may entail educating all medical personnel involved in her care about the management of diabetes and renal failure (De Boer et al., 2022). By doing this, it would be certain that everyone is on the same page and pursuing the same objectives.
For patients with renal failure related to diabetes, interprofessional strategies may be essential for achieving desired results in the community. To achieve desired results, interprofessional strategies can be applied to the concept map in the following ways:
Assessment and monitoring: In the community setting, the patient’s healthcare team may include a primary care physician, a home health nurse, and a pharmacist. The team can work together to assess and monitor the patient’s condition regularly. The nurse can monitor the patient’s blood glucose levels, blood pressure, and fluid balance, and report any changes to the primary care physician (National Kidney Foundation, 2022). The pharmacist can review the patient’s medication list and make recommendations to the physician for any adjustments that may be needed to optimize the patient’s medication regimen (Rahayu et al., 2021).
Patient education is essential in the community environment, since the patient is in charge of independently managing their health. The patient can receive thorough information on how to manage their diabetes and renal failure if the healthcare team collaborates to make sure of it. The nurse can instruct patients on self-blood glucose monitoring, how to take medications, and the warning signs and symptoms of hyper- and hypoglycemia (National Kidney Foundation, 2022). The pharmacist can give guidance on managing medications, emphasizing the value of adherence and possible side effects (Rahayu et al., 2021).
Care coordination: Effective care coordination is essential in the community setting, where patients may have multiple healthcare providers. The healthcare team can work together to ensure that the patient’s care is coordinated and that everyone is on the same page. The nurse can communicate with the physician and pharmacist regularly, providing updates on the patient’s condition and medication regimen (Rahayu et al., 2021). The pharmacist can communicate with the physician and nurse regarding any medication-related issues, such as adverse drug reactions or potential drug interactions.
Multidisciplinary approach: can be beneficial in the community setting, where patients may have complex medical needs. The healthcare team can work together to develop a comprehensive care plan that addresses all of the patient’s needs. For example, the physician may refer the patient to a dietitian or a social worker to address nutritional or psychosocial needs. The nurse, pharmacist, and other healthcare providers can work together to ensure that the patient’s needs are addressed comprehensively (Rahayu et al., 2021).
Conclusion
The concept maps offered present a thorough strategy for the management of diabetic renal failure, both acute and chronic, in acute care and community settings. The concept maps were based on evidence-based practice guidelines, and additional evidence was provided to support the interventions recommended. Interprofessional collaboration was emphasized in both settings, as it is essential to the achievement of desired outcomes. The use of these concept maps can improve patient outcomes and satisfaction while reducing hospital readmissions and healthcare costs. However, knowledge gaps and areas of uncertainty remain, and further research is needed to develop and refine the management of renal failure related to diabetes.

References
De Boer, I. H., Khunti, K., Sadusky, T., Tuttle, K. R., Neumiller, J. J., Rhee, C. M., Rosas, S. E., Rossing, P., & Bakris, G. (2022). Diabetes management in chronic kidney disease: A consensus report by the American Diabetes Association (ADA) and kidney disease: Improving global outcomes (KDIGO). Diabetes Care, 45(12), 3075–3090. https://doi.org/10.2337/dci22-0027
National Kidney Foundation. (2022, May 25). Managing blood sugar for kidney health. National Kidney Foundation. Retrieved April 29, 2023, from https://www.kidney.org/atoz/content/managing-blood-sugar-for-kidney-health
Rahayu, S. A., Widianto, S., Defi, I. R., & Abdullah, R. (2021). Role of pharmacists in the interprofessional care team for patients with chronic diseases. Journal of Multidisciplinary Healthcare, Volume 14, 1701–1710. https://doi.org/10.2147/jmdh.s309938

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