Concept Maps and Evidence Narrative

Assessment 1 Instructions: Concept Map

  • 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.

 

Answer

Concept Maps Narrative

According to Baliga et al. (2021), concept mapping is one of nursing education’s learning and teaching concepts to organize extensive information into understandable bits. A concept map is also used to convey information among care providers to enable them to work together and achieve better patient outcomes. It also shows the relationship between different concepts, thus making the concepts easier to understand. This narrative presents the information illustrated in the two concept maps above. The concept maps were created to visually represent a patient’s health condition and concerns in two different settings to enhance the development of an appropriate care decision and plan for the patient in the two separate incidences. The value justification and the relevance of the evidence used as the basis for the concept maps and the interprofessional strategies that can be applied to the concept maps to enhance the achievement of the desired outcomes will also be discussed.

The concept maps illustrate the connection between the patient’s diagnosis, assessment findings, nursing interventions and the desired outcomes. The patient is Mrs. Smith, a 52-year-old black female who, during the acute phase, was admitted to the ICU with a history of type 2 diabetes mellitus, high blood glucose levels and acute renal failure, which is visualized in the first concept map. During the chronic phase, she had just been discharged and was monitored under home health care. The scenario is visualized in the second concept map. The two concept maps enable the nurses and other stakeholder care professionals to be on the same page based n Mrs. Smith’s health, thus enabling them to work together to achieve better health outcomes.

Patient’s Acute Phase Concept Map

Mrs. Smith was admitted this morning to the ICU with high blood glucose levels and acute renal failure. She also has a history of type 2 diabetes mellitus. The first step was identifying the nursing diagnoses based on the NANDA I diagnosis to develop the appropriate nursing care and management interventions. The most urgent nursing diagnosis for Mrs. Smith is the risk of unstable blood glucose (NANDA International Inc., 2023). According to Nemer et al. (2020), the risk for unstable blood glucose is one of the most vital nursing diagnoses for diabetes patients. Type 2 diabetes patients are at a greater risk of developing macrovascular changes, such as heart disease, and macrovascular abnormalities, such as renal failure. These abnormalities are complications that result from unstable blood glucose levels. Therefore, it is essential to identify the risk as a diagnosis and plan on addressing it. Based on this diagnosis, the nursing interventions that will be conducted for this patient are diabetes management education and administering the drugs as prescribed. The desired outcomes include achieving a blood glucose level of 180 and below, as illustrated above.

The two other diagnoses at this phase are fatigue and fluid volume excess (NANDA International Inc., 2023). The fatigue is related to insufficient metabolism action and is evidenced by the patient’s shortness of breath and feeling weak. The fluid volume excess is related to fluid build-up in the extracellular spaces, evidenced by the swollen feet. The nursing interventions selected for fatigue include encouraging adequate nutritional intake and verbalizing the impact of fatigue. The desired outcome is verbalizing increased energy levels. The interventions selected for fluid volume excess include monitoring vital signs and creating a fluid chart. The outcomes based on these interventions include the patient demonstrating an understanding of fluid balance and maintaining fluid balance.

Patient’s Chronic Phase Concept Map

Mrs. Smith has just been discharged from the ICU, where she was admitted with a history of type 2 diabetes, high blood sugar levels and acute renal failure. She is to be followed for six weeks under home health care, thus crucial to create a concept map to guide the nursing interventions and enable the nurse to make the proper care decision for Mrs. Smith. The most urgent diagnosis at this stage is insufficient knowledge of diabetes (NANDA International Inc., 2023), related to unfamiliarity with information as evidenced by statements of concern and requesting information. Alhaik et al. (2019) note that deficient knowledge of diabetes is a serious issue in diabetic patients since it prevents them from managing the condition effectively to prevent complications and achieve desired patient outcomes. The diagnosis at this stage was the most urgent since the patient needs to manage her condition effectively to avoid complications and hospital emergency visits. The selected nursing intervention for this diagnosis mainly focuses on patient education on diabetes self-management to enhance self-management behavior and confidence,

The other two diagnoses at this phase are imbalanced nutrition, less than the body requirements related to insufficient dietary intake, and risk for fluid volume deficit related to osmotic diuresis and hyperglycemia. The patient states that she does not cook as often as she used to and often takes a sandwich or cereal bowl. Additionally, the patient states that she frequently urinates, which may increase the risk of fluid volume deficit. The interventions for imbalanced nutrition included encouraging the patient to maintain a high-fiber and low-fat diet, promote a diabetic-recommended diet, and include at least three meals and healthy snacks daily. The major outcome is maintaining a healthy/diabetic-recommended diet. The interventions for fluid volume deficit include increased fluid intake and maintaining a fluid chart. The outcome is demonstrating adequate hydration and maintaining an I/O chart.

Evidence Use Justification

Research evidence shows that effective diabetes self-management behavior and practices help prevent diabetes complications emergency room and improve the quality of life for diabetic patients (Kumar et al., 2021). Additionally, concept mapping can be used together with diabetes self-management education and support to enhance glycemic control through enhanced diabetes self-management behavior and practices. Additionally, desirable patient outcomes result from working together guided by the concept maps. As mentioned earlier, the concept map provides and conveys information to all the stakeholders involved in patient care, thus enabling them to work together. Similarly, in this case, the nurse can work with other care providers, the family and caregivers to provide the patient with the support she needs and strive to achieve the desired patient outcomes. However, one of the conflicting perspectives on using concept mapping in patient care is that different care professionals may not agree on the same interventions or diagnosis, thus leading to adverse patient outcomes.

Application of Interprofessional Strategies

Diabetes care requires the integration of different professionals’ work to be effective. Similarly, Mrs. Smith’s care will require different professionals to work together to achieve desired patient outcomes. Among these professionals are a nutritionist: Endocrinologist, a nurse, and a physician. Therefore, there is a need to identify a collaboration strategy to enhance interprofessionals work together. According to Szafran et al. (2019), a care team can collaborate by openly sharing information among the team and making pertinent information accessible to all team members. Similarly, information will be openly accessible for all team members to ensure better patient outcomes.

Conclusion

Concept mapping in diabetes care enables providers to work together and achieve better care outcomes. The concept map developed above will assist the provision for the patient. It will also act as a reference point and convey information among the other interprofessional team members. The concept maps have helped streamline disease management aspects, thus avoiding missing out on vital aspects.

References

Alhaik, S., Anshasi, H. A., Alkhawaldeh, J. F., Soh, K. L., & Naji, A. M. (2019). An assessment of self-care knowledge among patients with diabetes mellitus. Diabetes & Metabolic Syndrome: Clinical Research & Reviews13(1), 390-394. https://doi.org/10.1016/j.dsx.2018.10.010

Baliga, S. S., Walvekar, P. R., & Mahantshetti, G. J. (2021). Concept map as a teaching and learning tool for medical students. Journal of Education and Health Promotion10, 35. https://doi.org/10.4103/jehp.jehp_146_20

Kumar, D., Joshi, A., Grover, A., Raina, S., Bhardwaj, A. K., Malhotra, B., & Sharma, S. (2021). Effect of personalized human-centred dietary decision support system (PHCDDSS) on dietary knowledge, attitude, practice (KAP), and mean fasting blood sugar (FBS) among participants with type 2 diabetes mellitus (T2DM) in community-based settings of the northern state of India. Journal of Diabetology12(3), 338-343. https://di.org/10.4103/JOD.JOD_21_21

Nanda International, Inc. (2023). NANDA International Nursing diagnosis list. https://nanda.org/

Nemer, A. P. L., Cavalcante, T. F., Moreira, R. P., de Araújo, T. L., Ferreira, J. E. D. S. M., & de Oliveira, L. R. (2020). Nursing Diagnosis Risk for Unstable Blood Glucose Level in Patients with Diabetes Mellitus. International Journal of Nursing Knowledge31(4), 240-245. https://doi.org/10.1111/2047-3095.12282

Szafran, O., Kennett, S. L., Bell, N. R., & Torti, J. M. (2019). Interprofessional collaboration in diabetes care: perceptions of family physicians practising in or not in a primary health care team. BMC Family Practice20(1), 1-10. https://doi.org/10.1186/s12875-019-0932-9

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