Components of an Intervention Plan for Health Promotion Assignment

Intervention Plan Design

Intervention Plan Components

Following the PICOT question identified in the first part, the target members of the population for the intervention plan are pregnant women in the San Diego area of California who are at a high risk of gestational diabetes. With the objective being to improve the healthcare outcome for this demographic, this second part of the report is a detailed intervention plan design. Key components of the plan include the proposed remote patient monitoring and associated support such as ensuring its use is evidence-based, its performance meets standards of care as envisaged in the health care policy in the United States, and persistent communication to stakeholders such as patients, policymakers, and provider organizations. Throughout, the intervention plan is guided by core nursing theories and principles. Components of an Intervention Plan for Health Promotion Assignment

Major Components of an Intervention Plan for Health Promotion

The intervention plan proposed for pregnant women in the San Diego area of California at risk of gestational diabetes has three main components. The objective of this intervention plan is to improve the health outcomes of the identified population. The first component is the adoption of an evidence-based action which in this case is remote patient monitoring. Remote patient monitoring is defined by Polsky et al. (2020) as a technological telehealth digital tool that reports, collects, and transmits patient data to healthcare providers who then evaluate it and determine interventions required. In this particular case, the proposed remote patient monitoring tools could come in the form of wearables, mobile devices, and smartphone-based applications (Malasinghe, Ramzan & Dahal, 2019). Pregnant women at risk of gestational diabetes will be constantly reminded through notification nudging to check important vital signs such as their weight and blood glucose levels and transfer them to their physicians for analysis. The second component is performance management. Aziz et al. (2020) advised that any intervention plan should be checked for effective performance with minimized negative impacts on patients. Following this, performance management of the proposed intervention is done through rigorous monitoring and evaluations in a bid to ascertain that it is a model that can be relied on and achieve the objective of improving health outcomes for patients. In addition to this, the healthcare provider adopting the proposed plan should be guided by the philosophy of continuous and persistent improvement which in this case implies telehealth program improvement. The third component is for the healthcare provider to make effective and constant communication to stakeholders on the intervention. The healthcare community and decision makers are keenly interested in changes taking place in the industry and they need to be kept abreast of new developments to keep them informed for one and secondly to ensure that the changes are in line with healthcare policy and standards of operation.

ORDER HERE A PLAGIARISM-FREE PAPER 

The Impact of Cultural Needs and Characteristics of a Target Population

The success of healthcare policy and innovations is impacted by culture and its components. In view of this, the use of the proposed telehealth tools, RPM, is expected to be received with a mixed reception by the target population. Su et al. (2020) stated that it must be understood that not everyone is savvy or conversant with the use of digital technology tools such as wearables and smartphone applications. San Diego is a multicultural community and people from different cultural backgrounds reside in the expansive city. Drawing from this, these different cultures have impacts on the way the target population perceives approaches to health promotion which in this case is telehealth. In truth, the collection and sharing of personal data collected using wearable devices and smartphones are not as easy for everyone and this is likely to offer a slight challenge to implementation. The characteristic of the target population that will have an impact on the intervention plan, probably acceptance, and adoption, is that they are at a relatively higher risk of gestational diabetes and would heed calls for using the RPM. Components of an Intervention Plan for Health Promotion Assignment

Theoretical Foundations

The proposed intervention plan is advised or influenced by core nursing models and theories. One such model is the patient-centered model. Uecker and Kinnaman (2021) commented that the patient-centered model is based on the principle that all patients are unique and have different cultural backgrounds. What this means is that healthcare should not be based on a static set of routines but should rather be based on understanding the individual needs of patients. Patient-centered care is manifested through the demonstration of respect for the values needs and preferences of all patients. The implementation of the proposed RPM plan will be guided by the patient-centered theory where opinions and preferences for the type of device will be considered. Components of an Intervention Plan for Health Promotion Assignment

A second theory that offers insights to the proposed intervention model plan is the cultural care model. According to Lee, Greenfield and Pappas (2018), the effectiveness and efficiency of healthcare to patients is best achieved when the providers acknowledge that cultural differences exist in society and among patients and use this diversity to develop a care plan for each patient. What this simply means is that healthcare interventions and approaches to care that providers issue and develop should be congruent with different cultures. As a priority, therefore, the proposed implementation should be guided by the cultural care theory in the sense that the cultural and religious practices of the patients should be highly prioritized.

Since the proposed remote patient monitoring technology requires support resources, it is important to mention that access to digital gadgets, the internet, and computers will be a huge plus. In California metropolitan areas of San Diego, Los Angeles, Santa Barbara, and San Francisco have very high smartphone and personal computer ownership at 86% and 81% respectively. These support technologies will make it more convenient for remote patient monitoring to be rolled out en masse.

One of the major components of the intervention plan is the introduction of remote patient monitoring. While its implementation will involve a lot of capital layout for providers and for patients, its long-term benefits are immense. Commenting on the proliferation of telehealth and telemedicine, Vora et al. (2020) have pointed out two important issues. Basing their findings during the height of the novel Covid-19, the researchers have mentioned that telehealth lessens the risk of disease transmission. When outpatient pregnant mothers adopt the use of RPM, they reduce the risks of being exposed to communicable diseases that are sometimes acquired in health care settings. The second issue that the researchers commented on is the freeing up of hospital resources. With an increase in the use of remote patient monitoring using the technologies mentioned, hospital resources are freed up enabling the providers to serve the neediest patients more and better. According to Malasinghe, Ramzan and Dahal (2019), the use of remote patient monitoring technology helps providers gain faster access to patient data and in effect respond to emerging trends and issues sooner. Components of an Intervention Plan for Health Promotion Assignment

Stakeholders, Policy, and Regulations

The implementation of any health promotion plan is impacted by external and internal elements. These elements are the stakeholders, healthcare policies, and regulations. To this end, there are a handful of stakeholder needs that prevail and the stakeholders that are referred to in the context of this implementation are patients, providers, and policymakers. Su et al. (2020) mentioned that while the patient’s need which in this case is pregnant women is to maintain good health and deliver babies with minimal health complications, care providers have a need to improve health outcomes for all their patient groups. For the policymakers, their interest is that healthcare resources and benefits be equitably distributed. Collectively looking at all these needs, they all point towards health practices that are modeled to address the different groups within the population. In the United States, provider organizations are compensated by third-party payers which in this case are private and public insurance companies. According to Zahmatkeshan et al. (2021), health policy in the country has been pushing towards increased coverage by insurance companies in an effort to provide care to as many people as possible including the less affluent. Drawing from this, regulations have been set for providers on all interventions intended at improving healthcare outcomes in the country. Suffice it to say, the promotion of remote patient monitoring as a component of telehealth will be analyzed from the perspective of meeting key standards of practice and use.

Ethical and Legal Implications

Whenever a change is proposed or considered in healthcare, consideration must be put into the ethical and legal issues. Following this, key ethical and legal issues related to telehealth and specifically the use of remote patient monitoring, are rules and standards. The rationale for this is that such an implementation should at all times guarantee equitability of access, quality of care, and realistic costs. The fact that the RPM is intended at facilitating care means that it should a better alternative than the traditional physical visits to provider institutions. An equally important ethical issue is the privacy of patients (Polsky et al., 2020). Even as providers are called upon to increase the use of remote technological tools, they must at all times be respectful of patient privacy. On this, a legal issue that emerges is data privacy. It is crucial that providers put in place systems that guarantee that patient data breach likelihood is lessened. It is suggested that the transmitted data is fully encrypted to protect it from unauthorized persons. Components of an Intervention Plan for Health Promotion Assignment

References

Aziz, A., Zork, N., Aubey, J. J., Baptiste, C. D., D’alton, M. E., Emeruwa, U. N., … & Friedman, A. M. (2020). Telehealth for High-Risk Pregnancies in the Setting of the COVID-19 Pandemic. Amerfican journal of perinatology, 37(08), 800-808. https://doi.org/10.1055/s-0040-171212

Lee, P. A., Greenfield, G., & Pappas, Y. (2018). The impact of telehealth remote patient monitoring on glycemic control in type 2 diabetes: a systematic review and meta-analysis of systematic reviews of randomised controlled trials. BMC health services research, 18(1), 1-10. https://doi.org/10.1186/s12913-018-3274-8

Malasinghe, L. P., Ramzan, N., & Dahal, K. (2019). Remote patient monitoring: a comprehensive study. Journal of Ambient Intelligence and Humanized Computing, 10(1), 57-76. https://doi.org/10.1007/s12652-017-0598-x

Polsky, S., Garcetti, R., Pyle, L., Joshee, P., Demmitt, J. K., & Snell-Bergeon, J. K. (2020). Continuous glucose monitor use with and without remote monitoring in pregnant women with type 1 diabetes: A pilot study. PloS one, 15(4), e0230476. https://doi.org/10.1371/journal.pone.0230476

Su, D., Michaud, T. L., Estabrooks, P., Schwab, R. J., Eiland, L. A., Hansen, G., … & Siahpush, M. (2019). Diabetes management through remote patient monitoring: the importance of patient activation and engagement with the technology. Telemedicine and e-Health, 25(10), 952-959. https://doi.org/10.1089/tmj.2018.0205

Uecker, M., & Kinnaman, J. (2021). A Comprehensive Analysis of the Importance and Implementation of Telehealth Behavioral Services in Rural Areas & Schools.

Vora, N. L., Hardisty, E., Coviello, E., & Stuebe, A. (2020). Telehealth to provide prenatal genetics services: Feasibility and importance revealed during global pandemic. Prenatal diagnosis, 40(8), 1040. https://doi.org/10.1002/pd.5716

Zahmatkeshan, M., Zakerabasali, S., Farjam, M., Gholampour, Y., Seraji, M., & Yazdani, A. (2021). The use of mobile health interventions for gestational diabetes mellitus: a descriptive literature review. Journal of medicine and life, 14(2), 131. Components of an Intervention Plan for Health Promotion Assignment

Problem Statement

Need Statement

The COVID-19 pandemic has changed how healthcare delivery of outpatient care and telehealth has increased. The PICOT question- In outpatient clinics, how does telehealth visits compared to office visits result in improved patient care outcomes and satisfaction rate within ten months of implementation?. A growing body of evidence shows that telehealth can improve health outcomes. Telehealth can also improve access to care by increasing patients’ ability to see a provider from home or other locations. Telehealth can improve access to care, continuity of care, engagement in care, and self-management of chronic conditions.

Population and Setting

The setting targeted by the current research study is an outpatient clinic in San Diego, California. The target populations are pregnant women with gestational diabetes. The condition occurs among pregnant women and specifically implies high blood sugar levels. This happens because the body fails to produce enough insulin, a hormone that controls the amount of blood sugar. Often, gestational diabetes occurs during the second and third trimesters but disappears shortly after birth. Giannakou et al. (2019) have identified a list of risks of gestational diabetes and the need for appropriate and timely intervention. Some of these risks are a higher-than-normal growth of the fetus, excessive amniotic fluid, and premature birth. Components of an Intervention Plan for Health Promotion Assignment

Intervention

The proposed intervention is telehealth. This is in recognition that while there is a sufficient supply of health care clinics in the San Diego area, not all patients can attend the periodic clinic visits due to their condition and the distance between their residences and the hospital. In addition, telehealth is intended to supplement physical visits because digital tools allow for examinations to take place virtually. The fact that the target population visits the clinics for checkups and treatment implies that the caregivers cannot afford sufficient observation. This means they could miss out on identifying changes in vitals such as blood sugar. Intervention through telehealth enables caregivers to have more time to observe pregnant women and guide them on ways to assess their blood sugar levels. Components of an Intervention Plan for Health Promotion Assignment

Comparison

Most healthcare organizations commonly use approaches are issuing test kits to at-risk pregnant mothers and having them conduct their tests at home. In addition, they are then required to monitor their diet to ensure that the possibility of an increase in blood sugar is suppressed. While this approach has been helpful, it preempts the one-on-one observation a caregiver takes on their patients virtually through telehealth. The fact is that patients are expected to follow the guidelines as issued during their last visit. With telehealth, day-to-day follow-ups are likely made possible, with it, better patient outcomes. Vora et al. (2020) have stated that high blood sugar levels are reduced and managed with a proper diet and physical exercises. Caregivers are challenged with making these verifications when they are done away from the health care settings, like with outpatients visiting clinics periodically. A benefit that telehealth would be able to create is a daily check and monitoring of the individual patients without having them visit the clinic.

Outcome

The use of telehealth on gestational diabetes patients yields improved patient outcomes at a lesser cost. The patients can access valuable and high-quality care in the comfort of their homes, saving a lot of time and financial resources. Zork (2022) has discussed the issues of convenience for patients and caregivers and addressed the plight of people with mobility challenges. Telehealth increases the provider’s reach to pregnant mothers who are limited in their movement to and from one place to the other, perhaps due to distance from the hospital or other physical challenges. Alleviating patients’ safety by giving them the best quality care, telehealth helps achieve this goal. Many others further justify its importance and adoption in helping address gestation diabetes patients. Components of an Intervention Plan for Health Promotion Assignment

Time

Since gestational diabetes has become a common condition in pregnant women in the San Diego area and California at large, the proposed timeframe for the telehealth intervention is ten months. The rationale for this timeframe is to allow sufficient time for providers to purchase and install the necessary equipment and technology to support the intervention. In addition, the staff members who frequently use these technologies internally and remotely will be trained within this set timeframe.

Literature Review

While there has been an increase in the number of pregnant women experiencing gestational diabetes in recent years, the emergence of Covid-19 perhaps illuminated the degree of unpreparedness of the healthcare system in the country. Commenting on the challenges women with gestational diabetes faced during the pandemic, Aziz et al. (2020) mentioned that the inability of many of them to access health care facilities increased their risks of gestational diabetes. Drawing from this, the researcher has suggested the need for the federal government to liaise with private and public health providers to embrace the use of telehealth and telemedicine. The contemporary common approach and methods used are for pregnant mothers to make physical visits to hospitals where their vitals are checked, and this reveals whether they are at risk of gestational diabetes (May et al., 2021). Since collecting self-monitoring data in the case of gestational diabetes is not complicated, the intervention of telemedicine and telehealth would come in handy for caregivers and patients. As noted by Uecker and Kinnaman (2021), this would mean that the need for frequent physical visits would be unnecessary. Proper training on gathering the much-needed self-monitoring data using the toolkits provided by the healthcare providers and submitting the same virtually through digital forms such as mobile phones has had positive impacts. Döğer et al. (2019) have noted that clinicians follow up with the visiting patients to determine whether treatment is needed. The challenge of the physical visits is that they are time-consuming, cumbersome, and leave out a material proportion of pregnant women who otherwise need similar care. With the emergence and rise in popularity of telehealth and telemedicine, clinicians have found a much-needed intervention for gestational diabetes and other ailments pregnant, and nursing mothers face. Components of an Intervention Plan for Health Promotion Assignment

ORDER HERE NOW

Appuswamy and Desimone (2020) argue that it makes no logical sense for pregnant women to visit clinics just to check their glucose levels and spend a lot of time and financial resources. Notably, most of them do this as a precaution to safeguard their plight and that of the unborn child. However, using digital technologies such as telehealth has enabled more women who are otherwise limited by the lack of mobility and resources to collect their records and share them using simple applications on their smartphones. The benefit that this has on these women is that their risks of gestational diabetes and related adverse outcomes are reduced. In addition, the healthcare provider can handle more patients at a time as they only advise those who need treatment based on the data collected to visit them. A different view presented by Appuswamy and Desimone (2020) points to the importance of clinics holding large volumes of data. The researchers have discussed the issue of using telehealth from a holistic point of view, where they argue that with larger volumes of data from patients, these providers can engage in more analysis on the prevalence of gestational diabetes and other illnesses and hence determine the various interventions required for the entire population.

While many benefits are discussed by researchers on the use of telemedicine as an important intervention in healthcare, there are a few limitations that emerge, and the key among them is the availability and access to technologies such as the internet and digital equipment needed to facilitate the intervention. In commenting on this, Natamba, Namara, and Nyirenda (2019) have raised the question of whether healthcare providers factor in the possible limitation in accessing and using digital technologies. Moreover, some patients may delay or misinterpret readings on the test kits available to them or mistype them while relaying the information to clinicians (Aziz et al., 2020). Challenges such as these are likely to have a slight negative impact on the use of telehealth in intervening in gestational diabetes in places like San Francisco and others. On their part, Natamba, Namara, and Nyirenda (2019) have considered that while providers profit from the increase in digital data for patients, as mentioned, enables the custodian to leverage the big data for research and analysis, there is one slight issue that needs to be factored in; that with the more significant amount of data, more workloads accrue for the healthcare organization. There need additional resources and staff for managing and handling this accumulation of medical and personal data, which could stretch the provider’s existing resources. Components of an Intervention Plan for Health Promotion Assignment

Despite the identified drawbacks of telehealth, Zork (2022) has argued that the benefits associated with this intervention, in the context of the United States at least, far outweigh the costs. Patient outcomes are improved because of the convenience that the use of telehealth creates. The existing policy on increasing coverage of patients in the country benefits from the use of technology as the providers can attend to more patients from across regions. Moreover, telehealth and its closely linked concept of telemedicine increase the efficiency of intervention over time. This means that as more people get accustomed to digital technology, their use, and the collection of their medical data using specified medical kits, they increase the efficiency in personal and healthcare, further adding to the success of intended interventions. A huge plus that Zork (2022) has discussed in her article on the revolution technology is causing in health care is communication. Today, more than ever before, the communication between clinicians and patients has improved. This has been partially boosted by increased digital communication such as emailing, video calling, texting, and other digital-based applications such as social media and in-house medical applications. Suffice it to say, an increase in communication between these parties harnesses the understanding of the needs of the patients, ultimately leading to better quality healthcare and patient outcomes.

The one crucial lesson that covid-19 perhaps benefited the healthcare system is increasing awareness and illuminating the importance of virtual healthcare. With providers and patients alike forced by the pandemic to seek alternative ways of medical care that required minimal physical interaction, the ideas of telehealth were popularized at this time, and people recognized the value provisions of the technology. That aside, since the pandemic is arguably diminished, telehealth and telemedicine will likely stay longer and will probably be industry standards over time. Rutledge et al. (2021) claim that the sometimes infeasible and difficult in-patient visits are addressed with telehealth. Telehealth ensures that patients receiving or requiring continued medical care and faced with unavoidable challenges still have access to the care. Components of an Intervention Plan for Health Promotion Assignment

The details of the analyzed literature reveal two important issues. One is that the emergence and popularity of telehealth have many positive impacts and are likely to improve gestational diabetes patient outcomes over time. This is because more patients will be reached, and the convenience created. Two is that as providers and patients embrace this disruptive technology in healthcare, they will yield better results in the communication and care for patients. More importantly, disruptive technology should be regarded as an approach or alternative that supplements are existing physical and in-patient visits. Components of an Intervention Plan for Health Promotion Assignment