NURS FPX 9020 Assessment 3 VCI Summary 9020: Mid-Implementation Check Point

NURS FPX 9020 Assessment 3 VCI Summary 9020: Mid-Implementation Check Point Student Name School of Nursing and Health Sciences, Capella University NURS-FPX9020 Doctor of Nursing Practice 3 Professor Name Submission Date   Slide 1 VCI Summary 9020: Mid-Implementation Check Point Hello, I am……. I am here to speak about a quality improvement project that I worked on to adapt the clinical practice guidelines of the American diabetes association to help enhance glycemic control of adult patients with type 2 diabetes at the project site. Slide 2 Introduction Strategies to improve the quality of primary care are central to improving the care of people with chronic conditions and the outcomes of people who use primary care. Type-2 diabetes mellitus is a considerable burden of disease and is associated with cardiovascular diseases, neuropathy, and avoidable hospitalization (Siam et al., 2024). The results of the onsite findings showed that 42% of the adult patients who attended the outpatient primary care clinic had HbA1c readings above 9%, and only 36% had readings below 7%, which is a critical practice gap from national benchmarks (Adjei et al., 2025; APRN, personal communication, November 2025). Based on the American Diabetes Association guidelines (ADA 2024), interventions will include HbA1c testing, medication review, lifestyle counseling, and goal setting. The lack of a standardized and protocoled follow-up system resulted in variability in the delivery of education, medication reviews and glycemic control. The project leader used an evidence-based American Diabetes Association follow-up protocol with structured staff education to enhance glycemic control in adults with type 2 diabetes for 8 weeks. Slide 3: Key Concepts The quality improvement initiative is aimed at implementation of the follow-up protocol for the American Diabetes Association for adult patients with type 2 diabetes at the project site. This intervention, which consists of 8 weeks of structured follow-up with biweekly visits, nurse-led patient education, and telehealth support, provides individualized, evidence-based diabetes care that supports medication adherence, diabetes self-management, and reduces knowledge gaps and lifestyle modifications (Dailah, 2024). The nursing staff will undergo organized training for implementing the ADA guidelines, which includes adding competency to the training plan, incorporating simulation activities and peer mentoring with the training plan, and implementing EHR documentation as part of the training plan. During the intervention period, quality is implemented and continually improved using the plan-do-study-act (PDSA) model; PDSA provides a structured process to test workflow changes that can be assessed at a small scale over and over again (Lighterness et al., 2024). The primary results will include a decrease in the percentage of patients who have HbA1c levels above 9% and an increase in the overall competency and evidence-based diabetes care practices of nursing staff. Slide 4 Project Implementation The implementation will take place over an 8-week systematic process of quality improvement (PDSA model) with a structured weekly plan to guide implementation and achieve all objectives and evidence-based protocols. The intervention will be well established with nursing staff in weeks 1-2, as they will be thoroughly collecting and presenting baseline data, preparing teaching materials and EHR dashboards relating to the Diabetes ADA post-discharge instructions. Weeks 3-4 are spent on formal staff education and beginning weekly patient follow-up visits (every two weeks), and the patient receives assistance with telehealth if they have mobility or access issues. Follow-up protocols with structured and guided instructions and nurse-led education have always shown clinically significant progression in glycemic control and staff competency in outpatient settings with chronic diseases (Yu et al., 2022). Standardized diabetes care pathways have also been demonstrated to tackle persistent care practice gaps through robust medication reviews, self-management education, and team-based follow-up across various patient cohorts (AlHaqwi et al., 2023). Continuous patient visits in weeks 5-6 will be biweekly; continuing diabetes care with telehealth; and each nursing staff member will have a competency evaluation in the middle of weeks 5-6 to assess adherence to the diabetes care protocol, with changes in teaching and learning strategies as needed based on formative assessment results. Week 7–8 will be dedicated to completing all of patient follow-up, checking process fidelity, interim and final outcome measures evaluation, and a comprehensive analysis of baseline and post-intervention data. Slide 5 Barriers There will be several barriers to implementing the diabetes quality improvement project. Patient engagement is important, particularly for low health-literacy patients who haven’t developed positive digital technology habits for engagement. Variance in the competence of the baseline nursing staff leads to inconsistencies in the provision of standardised diabetes education in the interprofessional team. Typical challenges to the implementation of quality improvement in outpatient chronic disease settings include differing technology, staff resistance to changes in protocols, and competing patient needs that compromise adherence to quality improvement interventions (Samal et al., 2021). The mitigation strategies that need to be proactive to overcome the barriers are: Telehealth alternatives, frequent EHR audits, and repeated staff mentoring (Lee et al., 2025). Inadequate or erroneous documentation of EHRs can lead to data quality challenges and the inability to accurately track the outcomes over time. Limited patient numbers due to attrition or nonattendance may affect the power of the study and its ability to detect clinically significant differences in HbA1c results. Building leadership capacity over the long term and investing in the right resources are essential to address implementation challenges. Slide 6 Project Strengths There are several strengths in the quality improvement project in diabetes that establish its viability, rigor, and sustainability. All interventions are in line with the existing guidelines of the American diabetes association, and the proposed project is based on these guidelines. The interprofessional team approach to care, with a nurse practitioner at the outpatient care clinic, is a natural means of follow-up that patients prefer, and does not require an organization to make any significant changes. Multidisciplinary, structured quality improvement efforts that utilize validated follow-up protocols and monitoring systems based on EHRs have consistently demonstrated a positive impact in terms of glycemic outcomes (Kirkland et al., 2023). Another strength of the intervention that is anticipated to help overcome health equity, patient engagement,