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FPX 6021

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FPX 6008

FPX 6210

FPX 6103

FPX 5007

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FPX 6210

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FPX 6610

NURS-FPX 6021 Assessment 2: Change Strategy and Implementation

Capella 6021 Assessment 2

Assessment 2: Change Strategy and Implementation

Student Name

Capella University

School of Nursing and Health Sciences, Capella University

NURS-FPX 6021 Assessment 2:

Biopsychosocial Concepts for Advanced Nursing Practice 1

Prof. Name:


Change Strategy and Implementation

Renal failure, also known as kidney failure, is a severe medical condition that significantly impacts patients’ quality of life. Diabetes is a leading cause of renal failure, making it essential for healthcare practitioners to understand the best practices for managing this condition (Inker et al., 2023). In the United States, around 37 million people have chronic kidney disease (CKD), with approximately 40% of cases attributed to diabetes (Inker et al., 2023). Moreover, diabetes accounts for about 60% of all end-stage renal disease (ESRD) cases (AlSabbah et al., 2019).

Nurses play a vital role in identifying areas of care that require improvement and utilizing evidence-based sources to set goals for advancing safe and effective patient care. This assessment focuses on assessing change strategies and implementing them to improve patient outcomes concerning renal failure due to diabetes. NURS-FPX 6021 Assessment 2: Change Strategy and Implementation. Through this process, nurses learn to locate, evaluate, analyze, and implement change strategies to enhance patient care and outcomes in this critical area of healthcare.

Data Table

The clinical outcome assessment table provided outlines current and desired states of clinical outcomes related to renal failure caused by uncontrolled diabetes. It also includes change strategies that can be implemented to improve these outcomes, potentially reducing the incidence of renal failure due to uncontrolled diabetes.

Table 1. Clinical Outcome Assessment

Current StateDesired StateChange Strategy
High incidence of renal failure due to uncontrolled diabetes (Hassan et al., 2020).Reduced incidence of renal failure due to improved diabetes control (Pugliese et al., 2019).Implement a structured diabetes education program for patients with uncontrolled diabetes (Cowart et al., 2020).
Inadequate monitoring of kidney function in patients with diabetes (Zwart et al., 2022).Improved monitoring of kidney function in patients with diabetes.Implement regular kidney function tests for patients with diabetes, including glomerular filtration rate (GFR) tests and urine protein tests (Stempniewicz et al., 2021).
Poor adherence to medication regimen among patients with diabetes (Hashimoto et al., 2019).Improved adherence to medication.Implement a medication reconciliation program to ensure patients take the correct dose of their medications at the right time (Frament et al., 2020).
Limited access to specialized renal care for patients with diabetes and renal failure (Hull et al., 2020).Improved access to specialized renal care for patients with diabetes and renal failure.Establish partnerships with renal specialists to provide timely referral and treatment for patients with diabetes and renal failure (Greer et al., 2019).

Areas of Ambiguity or Uncertainty

To improve clarity on the effectiveness of structured diabetes education programs or medication reconciliation programs in reducing the incidence of renal failure in patients with diabetes, additional data could be gathered through clinical trials, observational studies, or other research methods. Such data can help healthcare practitioners make informed decisions about improving patient outcomes related to renal failure due to diabetes.

Proposed Change Strategies

The proposed change strategies outlined in Table 1 aim to improve clinical outcomes related to renal failure due to diabetes and are based on current evidence and best practices. Implementing a structured diabetes education program can empower patients with the knowledge and skills needed to effectively manage their condition and reduce the risk of developing renal failure (Cowart et al., 2020). Improving the monitoring of kidney function through regular tests can aid in early detection and prevention of further deterioration (Stempniewicz et al., 2021). Enhancing medication adherence through a reconciliation program can lead to improved overall health and reduced complications (Frament et al., 2020). Moreover, improving access to specialized renal care by partnering with specialists can ensure timely referral and treatment (Greer et al., 2019).

Justification of Change Strategies

The proposed change strategies are supported by research and evidence from reputable sources, including literature, clinical practice guidelines, and professional organization practice alerts. Structured diabetes education programs have been shown to improve patient knowledge and skills in diabetes management, leading to better health outcomes and reduced complications (Cowart et al., 2020). Monitoring kidney function and improving medication adherence are well-established best practices for managing diabetes and reducing the risk of renal failure (Stempniewicz et al., 2021).


The assumptions underlying the proposed change strategies are:

  1.  Structured diabetes education programs improve patients’ knowledge and skills in managing diabetes, reducing the risk of renal failure.
  2. Monitoring kidney function and medication adherence reduce the risk of adverse events and improve health outcomes.
  3. Implementing change strategies leads to better health outcomes, lower costs, and efficient use of healthcare resources.

How Change Strategies Will Utilize Interprofessional Considerations?

The proposed change strategies for managing renal failure due to diabetes will involve interprofessional considerations to ensure successful implementation. NURS-FPX 6021 Assessment 2: Change Strategy and Implementation, A team of healthcare professionals, including nurses, dietitians, endocrinologists, physicians, and pharmacists, will collaborate to provide patients with a comprehensive approach to managing their diabetes (Nuland et al., 2022). This interdisciplinary approach will lead to consistent and coordinated care, allowing for the sharing of best practices and expertise among team members.


An interprofessional team of healthcare professionals will provide a coordinated and comprehensive approach to managing diabetes, resulting in improved patient outcomes and reduced risk of adverse events.


The proposed change strategies for managing renal failure due to diabetes aim to enhance patient outcomes by employing interprofessional considerations and implementing evidence-based best practices in diabetes care. The structured diabetes education program, improved monitoring of kidney function, and medication adherence will ensure that patients receive comprehensive and effective care. Successful implementation will require close collaboration among healthcare professionals and a commitment to continuous quality improvement. With the right resources and support, these change strategies can lead to improved patient outcomes and reduced risk of adverse events related to renal failure due to diabetes.


Al-Sabbah, H., Basheer, K. N., Lu, K., & Younis, M. (2019). Major risk factors in the onset of end-stage renal disease. J Diabetes Treat, 1, 1065. 

Bandiera, C., Dotta-Celio, J., Locatelli, I., Nobre, D., Wuerzner, G., Pruijm, M., Lamine, F., Burnier, M., Zanchi, A., & Schneider, M. P. (2021). Interprofessional medication adherence program for patients with diabetic kidney disease: Protocol for a randomized controlled and qualitative study (PANDIA-IRIS). JMIR Research Protocols, 10(3), 25966. 

Cowart, K., Updike, W., & Bullers, K. (2020). A systematic review of randomized controlled trials evaluating glycemic efficacy and patient satisfaction of intermittent-scanned continuous glucose monitoring in patients with diabetes. Diabetes Technology & Therapeutics, 22(5), 337–345. 

Frament, J., Hall, R. K., & Manley, H. J. (2020). Medication reconciliation: The foundation of medication safety for patients requiring dialysis. American Journal of Kidney Diseases. 

Greer, R. C., Liu, Y., Cavanaugh, K., Diamantidis, C. J., Estrella, M. M., Sperati, C. J., Soman, S., Abdel-Kader, K., Agrawal, V., Plantinga, L. C., Schell, J. O., Simon, J. F., Vassalotti, J. A., Jaar, B. G., & Choi, M. J. (2019). Primary care physicians’ perceived barriers to nephrology referral and co-management of patients with CKD: A qualitative study. Journal of General Internal Medicine, 34(7), 1228–1235. 

NURS-FPX 6021 Assessment 2: Change Strategy and Implementation

Hashimoto, K., Urata, K., Yoshida, A., Horiuchi, R., Yamaaki, N., Yagi, K., & Arai, K. (2019). The relationship between patients’ perception of type 2 diabetes and medication adherence: A cross-sectional study in Japan. Journal of Pharmaceutical Health Care and Sciences, 5(1). 

Hassan, N. K., Gillani, S. W., Kaoje, A. A., Fari, F. M., Elashmouny, H. M., Sulayman, N. M., & Mohammadi, N. A. (2020). A clinical review on nutritional requirements and assessment for type 2 diabetes mellitus with chronic renal disease. Current Diabetes Reviews, 16(9), 922–930. 

Hull, S. A., Rajabzadeh, V., Thomas, N., Hoong, S., Dreyer, G., Rainey, H., & Ashman, N. (2020). Do virtual renal clinics improve access to kidney care? A preliminary impact evaluation of a virtual clinic in East London. BMC Nephrology, 21(1). 

Inker, L. A., Ferrè, S., Baliker, M., Barr, A., Bonebrake, L., Chang, A. R., Chaudhari, J., Cooper, K., Diamantidis, C. J., Forfang, D., Gillespie, B., Gregoriou, P., Gwadry-Sridhar, F., Ladin, K., Maxwell, C., Mitchell, K. R., Murphy, K. P., Rakibuz-Zaman, M., Rocco, M. V., & Spry, L. A. (2023). A national registry for people with all stages of kidney disease: The national kidney foundation (NKF) patient network. American Journal of Kidney Diseases, 81(2), 210-221. 

Moriconi, D., Nannipieri, M., Dadson, P., Rosada, J., Tentolouris, N., & Rebelos, E. (2022). The beneficial effects of bariatric-surgery-induced weight loss on renal function. Metabolites, 12(10), 967. 

Nuland, E. V., Dumitrescu, I., Scheepmans, K., Paquay, L., De Wandeler, E., & De Vliegher, K. (2022). The diabetes team dynamics unraveled: A qualitative study. Diabetology, 3(1), 246–257. 

Pugliese, G., Penno, G., Natali, A., Barutta, F., Di Paolo, S., Reboldi, G., Gesualdo, L., & De Nicola, L. (2019). Diabetic kidney disease: New clinical and therapeutic issues. Joint position statement of the Italian diabetes society and the Italian Society of Nephrology on “The natural history of diabetic kidney disease and treatment of hyperglycemia in patients with type 2 diabetes and impaired renal function.” Nutrition, Metabolism and Cardiovascular Diseases, 29(11), 1127–1150. 

Stempniewicz, N., Vassalotti, J. A., Cuddeback, J. K., Ciemins, E., Storfer-Isser, A., Sang, Y., Matsushita, K., Ballew, S. H., Chang, A. R., Levey, A. S., Bailey, R. A., Fishman, J., & Coresh, J. (2021). Chronic kidney disease testing among primary care patients with type 2 diabetes across 24 U.S. health care organizations. Diabetes Care, 202715. 

Zwart, T. C., Metscher, E., van der Boog, P. J. M., Swen, J. J., de Fijter, J. W., Guchelaar, H., de Vries, A. P. J., & Moes, D. J. A. R. (2022). Volumetric microsampling for simultaneous remote immunosuppressant and kidney function monitoring in outpatient kidney transplant recipients. British Journal of Clinical Pharmacology, 88(11), 4854–4869.

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