NURS FPX 4045 Assessment 3 Evidence-Based Proposal and Annotated Bibliography on Technology in Nursing

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Capella University

NURS-FPX-4045 A3

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Evidence-Based Proposal and Annotated Bibliography on Technology in Nursing

Insulin pump technology refers to a continuous insulin delivery technology that provides patients with diabetes type 1 and type 2 diabetes with accurate delivery of insulin. It enhances the management of glycemic, reduces acute complications, and patient self-management. The technology promotes safety and quality of care delivery to patients and interdisciplinary teamwork. It can be very useful in clinical practice, both to the patients and to the medical staff.

Rationale for Selecting This Technology Topic

The technology of the insulin pump was selected due to the significant implications in the treatment of chronic diseases, the telehealth nursing practice, and patient-centered care. Insulin pumps provide precise and consistent insulin administration as a way of enhancing glycemic control and strengthening patient autonomy and adherence. Technology can largely be applied in the telehealth nursing sphere, and could be applied to monitor, intervene, and provide effective coordination among patients with type 2 diabetes, hypertension, and obesity.

Insulin pumps constitute a crucial tool for enhancing patient outcomes and reducing complications because of the fast advancement of automated delivery systems of insulin and integration of digital health monitoring (Puckett et al., 2020). Other competences in terms of scope of practice, patient education, virtual visit management, and device alert monitoring also include the technology.

In order to ensure that the literature used was up-to-date and relevant, the systematic review of peer-reviewed literature published within five years (2020-2025) has been used. The databases were PubMed, Elsevier, Journal of Managed Care and Specialty Pharmacy, and Journal of the American Medical Association. The search criteria included insulin pump telehealth diabetes, automated insulin delivery nursing role, remote monitoring diabetes management, and telehealth nurse patient education insulin pump.

The criteria of inclusion focused on those studies that revealed the involvement of nursing, device education, virtual visit introduction, and the outcome of remote monitoring. The selection was informed by the following assumptions, which are that telehealth nursing is at the centre of the management of chronic diseases. Supposes that insulin pump technology is developed to the extent of the level of maturity to be applied in clinical facilities, and that a combination of technology and patient-centred strategies can result in better quality of care and safety

Evidence of the Impact on Patient Safety, Quality of Care, and the Interdisciplinary Team

Rimon, M. T. I., Hasan, M. W., Hassan, M. F., & Cesmeci, S. (2024). Advances in Insulin Pump Technology: A Comprehensive Review of Systems, Innovations, and Future Prospects. Pharmaceutics, 16(7), 944. https://doi.org/10.3390/pharmaceutics16070944

The article has given a comprehensive review of insulin pump system innovation in recent years, how it has improved in terms of hardware, algorithm, continuous glucose monitoring (CGM), and connectedness, and where it is heading. The authors emphasize the advancement of pump technologies to improve patient outcomes by supporting a more advanced basal-insulin delivery and responsive bolus and data connectivity as part of remote monitoring and clinician supervision. The article demonstrated how these systems can be used to increase glycemic control, reduce instances of hypoglycemia, as well as increase the quality of life of patients, hence enhancing the quality of care.

It is important to note that it identified safety problems like device malfunctions, infusion sets, and susceptibility to cybersecurity on the occasion of connection to any network, hence associating technology enhancement with patient safety needs. The review showed an interdisciplinary view of a team in the sense that application of state-of-the-art pump technology requires the integration of the activities of endocrinologists, diabetes educators, nurses, and biomedical device teams to support the selection of the device. The specified source is particularly valuable because the technological and clinical components of insulin pump treatment are centralized in a single location, which makes it possible to form the ideology of nursing practice about patient education, how to operate the device, and adopt telehealth.

Integrating Technology on Patient Safety, Quality of Care, and the Interdisciplinary Team

Piotie, P. N., Wood, P., Muchiri, J. W., Webb, E. M., & Rheeder, P. (2022). Feasibility of a Nurse-Led, Home-Based Telehealth Approach to Optimize Insulin Therapy in Type 2 Diabetes Within Primary CareJournal of Endocrinology, Metabolism and Diabetes of South Africa, 27(3), 108–116. https://doi.org/10.1080/16089677.2022.2074122

The paper presented a home-based, nurse-managed telehealth intervention that can help in managing insulin therapy treatment of adults with type 2 diabetes in primary care. It is preoccupied with feasibility with the view to how feasible a telehealth model is that can be applied to patient education and remote follow-up, which is led by a nurse for insulin users. The article reported the process of helping the patients involved in this intervention at home through telehealth communication channels and how the model addressed adherence, glycemic control, and self-management, where primary care is provided. This text is significant because it introduces an interim between insulin treatment according to their devices and telehealth-based nursing care that illustrates that telehealth and nurse-centered care would manage the complicated diabetes regimes remotely.

The intervention is linked to patient safety in the sense that this intervention allows noticing the issues related to insulin therapy early, remotely monitoring the use of the insulin, and a quick response of the nurse to the potential instances of hypo- or hyperglycemia. Regarding quality of care, the study has highlighted the issue that remote learning and follow-up may be used to enhance patient engagement, adherence, and, potentially, outcomes. Also depicted is the middle position that the nurses will play in the telehealth system, collaborating with the physicians, diabetes educators, and remote monitoring devices. This source is particularly helpful as it puts the technology-driven insulin therapy management in the context of nursing-based care provision.

Influence of Organizational Factors

Puckett, C., Wong, J. C., Daley, T., & Cossen, K. (2020). How organizations shape medical technology allocation: Insulin pumps and pediatric patients with type 1 diabetes. Social Science & Medicine, 249, 112825. https://doi.org/10.1016/j.socscimed.2020.112825

The qualitative comparative research proposal provided an investigation into the impact of organizational environment on the utilization of insulin pump technology among pediatric patients with type 1 diabetes in two endocrinology clinics. The authors have observed over 400 hours and interviewed 16 providers to find that three key factors in the organization, such as the way eligible patients are made by the clinic, how the technology is framed by the organization, and the structures of the decision-making within the organization, affect allocation.

As a case in point, technology-receptive clinics pioneered the establishment of pumps within the clinic, and the risk-averse clinic restricted the accessibility of pumps using social capital and levels of compliance related to patients. The article has highlighted the adoption and equal access to technology as a decision that is driven by structural, cultural, and historical forces in organizations. It fills the gap between the insulin pump implementation at the individual level, institutional practice, power relations, and the resource policies that may impact safety, quality, and equity of care.

Implementation and Use of Insulin Pumps in a Health Care Setting

Biskupiak, J. E., Carlow, D. L., & Munshi, M. N. (2024). Impact of a tubeless, disposable insulin pump on emergency department visits and inpatient admissions among a Medicare population. Journal of Managed Care & Specialty Pharmacy, 30(10), 1–8. https://doi.org/10.18553/jmcp.2024.23292

It was a retrospective observational study based on Medicare claims data of 811 U.S. beneficiaries who had started the use of a tubeless and disposable insulin pump. The researchers compared the level of diabetes related emergency department visit (DRED), all-cause ED visit (ACED), diabetes related inpatient (DRIP) or hospitalization, and all-cause inpatient (ACIP) hospitalization in the pre- and post-pump set-up. The reduction in the amount of DRIP did not differ considerably across all the subgroups; however, the similar negative movement of changes in all types of events revealed the existence of considerable alterations in the consumption of health care resources.

The paper presented an excellent argument to accept the application of insulin pump technology in the healthcare sector of the United States, with a high percentage of emergency visits and hospitalization reductions among the patients under Medicare coverage. These outcomes prove the vitality of the technology in enhancing patient safety, quality of care, and minimizing the consumption of healthcare. The findings also focus on the cost-effectiveness and value of interdisciplinary coordination in the procedure of attaining better patient outcomes. In total, the source revealed that the introduction of insulin pumps results in actual change in healthcare organizations in the aspects of safety, efficiency, and the performance of the system.

Use of Artificial Intelligence (AI) 

Nayak, A., Vakili, S., Nayak, K., Nikolov, M., Chiu, M., Sosseinheimer, P., Talamantes, S., Testa, S., Palanisamy, S., Giri, V., & Schulman, K. (2023). Use of voice-based conversational artificial intelligence for basal insulin prescription management among patients with type 2 diabetes: A randomized clinical trial. Journal of the American Medical Association Network Open, 6(12), e2340232. https://doi.org/10.1001/jamanetworkopen.2023.40232

It was a randomized clinical trial about employing a voice-based AI system to address the issue of basal insulin prescription in six outpatient diabetic health facilities in the United States. It was a comparison study of basal insulin titration with AI guidance and physician guidance. The findings were successful in proving that the AI application was the most appropriate in demonstrating the fastest insulin dosing, improved adherence, and maintenance of better glycemic regulation without augmenting hypoglycemic incidences in individuals. The results indicated that the implementation of AI could help to induce efficiency, accuracy, and patient engagement in the management of diabetes.

This paper has shown that the application of AI to insulin pumps can streamline the workflow of nurses and enhance patient care. Nurses can use AI-driven data to determine trends, predict complications, and educate with the use of the data, which is customized to the needs of the particular patient, instead of manually adjusting doses. The AI system facilitates interdisciplinary collaboration as nurses, endocrinologists, and diabetes educators can communicate without any problem. The outcome is a reduction in patient safety because of the timely interventions, compliance, and enhancement of the overall quality of care, indicating the realistic impact of the technology on the healthcare facilities within the United States.

Summary of Recommendations

An integration of the concepts provided in these five journals is evidence of the clinical and organizational effectiveness of insulin pump technology to improve patient care, safety, and interdisciplinary workflow. As shown by Biskupiak et al. (2024), tubeless insulin pumps can help to decrease emergency department visits and inpatient hospital visits significantly, and this is related to enhanced patient safety and cost-effectiveness. Nayak et al. (2023) demonstrated that the AI addition in the form of voice integration enhances the productivity of a prescription module and a nursing workflow. In a study conducted by Piotie et al. (2022), it was revealed that the use of telehealth interventions (initiated by nurses) can positively impact insulin therapy adherence and patient engagement in primary care.

It should be stated that the resources are allocated and the choices made in the organization have an impact on the successful implementation of technology, according to Puckett et al. (2020). Rimon et al. (2024) gave a review of the new systems of insulin pump development and indicated the importance of new training and cross-disciplinary interaction. The institutional policies that support innovation, financing, and technical resources are among the organizational factors that are involved in the process of adopting technology. Insulin pump technology must be introduced in the US healthcare setting since this will help in patient safety, glycemic control, patient satisfaction, and interdisciplinary cooperation efficiency. This technology also reduces the number of hospitalizations, efficient utilization of the resources, staff productivity, satisfaction, and retention of the employees.

Conclusion

A better technology that fosters patient safety, adherence, and quality of care is the insulin pump technology. It is shown that tubeless pumps, AI-based management, and nurse-led telehealth interventions decrease the hospitalization rate and support the interdisciplinary working process. Organizational factors, including resources, training, and a culture of innovation, are required for adopting the innovation. Overall, the use of insulin pumps is quite justifiable, as it will maximize patient outcomes, staff performance, and the work of the healthcare system.