Organizational Culture and Readiness Assessment

Evidence-Based Practice Proposal - Section A: Organizational Culture and Readiness Assessment and Section B: Proposal/Problem Statement and Literature Review
In order to formulate your evidence-based practice (EBP), you need to assess your organization. In this assignment, you will be responsible for setting the stage for EBP. This assignment is conducted in two parts: an organizational cultural and readiness assessment and the proposal/problem statement and literature review, which you completed in NUR-550.
Section A: Organizational Culture and Readiness Assessment
It is essential to understand the culture of the organization in order to begin assessing its readiness for EBP implementation. Select an appropriate organizational culture survey tool and use this instrument to assess the organization's readiness.
Develop an analysis of 250 words from the results of the survey, addressing your organization's readiness level, possible project barriers and facilitators, and how to integrate clinical inquiry, providing strategies that strengthen the organization's weaker areas.
Make sure to include the rationale for the survey category scores that were significantly high and low, incorporating details or examples. Explain how to integrate clinical inquiry into the organization.
Submit a summary of your results. The actual survey results do not need to be included.
Section B: Proposal/Problem Statement and Literature Review
In NUR-550, you developed a PICOT statement and literature review for a population quality initiative. In 500-750 words, include the following:
Refine your PICOT into a proposal or problem statement.
Provide a summary of the research you conducted to support your PICOT, including subjects, methods, key findings, and limitations.
General Guidelines:
You are required to cite three to five sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.
Note: After submitting the assignment, you will receive feedback from the instructor. Use this feedback to make revisions for your final paper submission. This will be a continuous process throughout the course for each section.
This was Part A for NUR 550 The PICOT statement
P: Low-socioeconomic status (SES) population with Type 2 Diabetes. I: Reducing barriers to diabetes self-management education (DSME). C: Standardized care without diabetes self-management education. O: Improves health outcomes, improved quality care, and reduced health disparities
Demographics and health concerns
In 2020, 34.2 million people were living with diabetes in the U.S., about 10% of the population (CDC, 2021). Additionally, there are 88 million American adults with prediabetes. Non-Hispanic blacks and Hispanic people account for a high increase in new diabetes cases, yet the overall diabetes rates decreased in 2008-2018 (CDC, 2021). Among adults with diabetes, American Indians/Alaska Natives had the percentage of existing cases (CDC, 2021). People living with diabetes were more likely to be overweight as they accounted for 89% of the cases, while 38% were physically inactive (CDC, 2021).
Easy access to unhealthy processed products at very low prices is one of the reasons for the high incidence of diabetes in low-income communities. An unbalanced diet can lead to problems of malnutrition and overweight as is common in urban settings with few food healthy choices. Yet, dieting is one of the risk factors for diabetes in low SES populations.
Various researches have shown that low socioeconomic status and low protein consumption are associated with obesity, diabetes, and other chronic diseases.
Obesity is the result of an imbalance between energy consumption and expenditure in the body. Excessive food consumption and little physical activity are associated with excess caloric intake over expenditure. Physical activity, sex, age, calorie consumption, and genetics affect susceptibility to developing diabetes.
Potential solution
Reducing barriers to diabetes self-management education will improve health outcomes, and individuals will improve their knowledge on diabetes and diabetes management. To deal with diabetes, prevention and treatment are the main issues prioritized to prevent complications and deteriorating health outcomes (Spencer et al., 2018). Thus, the solution is not only to offer treatment to those living with diabetes but also to improve educating diabetes management and dieting and promoting a healthy lifestyle.
Self-care is a critical aspect of diabetes care management, and various studies highlight the need for people with diabetes to actively participate in managing diabetes and reducing the risk of future health complications while improving outcomes (McElfish et al. 2019). Patient participation indicates self-management education programs are mainly influenced by a physician's referral, and improving both patient and physician participation in the programs is necessary to improve health outcomes.
The solution and health care equity
Diabetes Self-Management Education (DSME) providers are the educators, nurses treating diabetes patients and dietitians, and patients with type 2 diabetes would be involved in the diabetes education programs. The diabetes self-management education intervention focuses on helping patients to improve type 2 diabetes management and coping with the disease. Low SES communities have less access to health information, have poor knowledge on diabetes management and face challenges accessing healthy foods and diets (Spencer et al., 2018). Identifying barriers and facilitators of engagement and non-attendance would provide insights on how best to improve diabetes care. Education programs that are patient-centered and improve are more likely to improve patient participation, especially when there is support among the health care practitioners.
Among the poor, there are also more barriers to compliance and consideration. Patient-specific factors and factors to their environments are necessary to improve diabetes management. Middle-class patients with diabetes have access to healthcare providers and support from family members better than the poor, making it easier to cope. One of the concerns for the poor is making lifestyle changes when they have few resources. Patient educational level is one of the patient-specific factors that tend to affect compliance and outcome. Patients with little motivation to change behaviors tend to have poor compliance with the intervention, and identifying barriers to DSME helps improve outcomes.
The patient-health professional relationship is another important factor that affects patient compliance and the success of the intervention. A healthy relationship is based on patients' trust and physicians' relationship. There is good compliance when physician treating patients focuses on emotional support, trust, and equal treatment. There are different positive outcomes associated with diabetes glycemic control, self-care, diabetes knowledge provider and patient satisfaction.
This was Part B for NUR 550 PICOT Literature Review
There is an urgent need to manage the prevalence of diabetes in American society, hearing the escalating numbers of the condition. The American Diabetes Association (ADA) has recommended large-scale public education and assessment of diabetes. Currently, there is an ongoing debate on viable treatment strategies for individuals diagnosed with type 2 diabetes. While a section would prefer non-pharmacological approaches, another section values the pharmacological inputs. There is a small category of professionals who prefer a combination of both pharmacological and non-pharmacological interventions. To patients, all such debates can be confusing. Also, it is impossible to ascertain the necessary interventions in specific frames of the condition. This literature review assesses pharmacological and non-pharmacological interventions in type 2 diabetes. Understanding the necessary interventions from specific studies should help elevate the debate on what professionals should recommend in particular stages of the condition.
The Clinical Issue
Diabetes is one of the most challenging illnesses in the world currently. In the US, diabetes ranks among the leading causes of death. Data from the CDC have indicated that the number of new diabetes diagnoses keeps increasing for all the population segments except for those whose ages are 20 and below. Currently, more than 34.2 million Americans have been diagnosed with diabetes. That translates to 1 in 10 Americans. In 2018, CDC reported that 38% of the people diagnosed with diabetes were physically inactive, 89% were overweight, and 15% were smokers. Still, 37% of the individuals diagnosed with the condition had chronic kidney disease. One of the biggest challenges that the US is facing in dealing with diabetes is access to screening and eventually treatment. Close to 7.5 million Americans who have diabetes have not been diagnosed. The undiagnosed cases are increasing and posing a bigger challenge to the national initiatives to manage the condition. Still, 37% of those who have been diagnosed find the treatment regimens expensive for their capability. That has led to questions on newer avenues of addressing the condition.
Diabetes patients can be subjected to both pharmacological and non-pharmacological treatment regimens depending on the assessments by their physicians. Non-pharmacological treatment refers to interventions that do not involve medications to manage various conditions and pain. The goals for non-pharmacological interventions are to provide patients with a sense of control, reduce pain, eliminate specific symptoms, such as fatigue, and decrease fear, distress, and anxiety while battling specific conditions. On other occasions, patients and healthcare professionals prefer the inputs of pharmacological interventions. Pharmacological interventions majorly focus on medications geared towards addressing specific illnesses. In this study, emphasis is put on a comparative analysis of pharmacological and non-pharmacological interventions in the management of type 2 diabetes.
Methods
The study employs a systematic review to execute its findings. The GCU library was employed to search for peer-reviewed articles published in the past five years. The search terms included “pharmacological treatment of type 2 diabetes,” “non-pharmacological treatment of type 2 diabetes,” and “treatment of type 2 diabetes.” The searches lead to a wide array of articles from which a systematic review was employed to mark the final choices. In a systematic review, a clearly formulated question that employs reproducible techniques to identify, select, and appraise sources is used. The selection and appraisal of the sources used in this study encompassed assessment of the year of publication, peer-reviewed status, and relevance to the research questions.
Literature Synthesis
Various articles were identified as relevant in the search for this study. Primary among the articles was published by Raveendran, Chacko, and Pappachan (2018). The study assesses the “non-pharmacological treatment options in the management of diabetes mellitus.” The study employed a systematic review to assess various non-pharmacological treatment interventions for type 2 diabetes. In the findings, Raveendran, Chacko, and Pappachan (2018) noted that strategies that include dietary interventions in the patients, medical nutrition therapy, physical exercises, and bariatric surgery are vital to the treatment and management of type 2 diabetes. This study will be vital in understanding the specific elements of non-pharmacological interventions in the treatment or management of diabetes in the study.
The second study that matched the needs of this review was published by Renata Giacomini Oliveira et al. (2020). The study addresses “the effectiveness of non-pharmacological strategies in the management of type 2 diabetes in primary care.” Renata Giacomini Oliveira et al. (2020) insist on the value of non-pharmacological interventions, especially in primary care. Their inputs stem from the understanding that most professionals overlook the value of non-pharmacological interventions, thereby putting the patients at risk of responding poorly to all the other interventions to which they are subjected. Some of the suggestions in the article include physical therapy, nutritional therapy, and emotional health. This study will be relevant to the PICOT question as it assesses a faction of the diabetes type 2 treatment strategies with the required detail. The article also employs a systematic review and network meta-analyses to mark its findings. With the scope of inputs in this study, a researcher is informed of the extent to which non-pharmacological interventions can affect the management of type 2 diabetes.
McMillan et al. (2018) also conducted a study to ascertain the non-pharmacological interventions when dealing with type 2 diabetes. In the study entitled, “Impact of pharmacological treatment of diabetes mellitus on dementia risk,” emphasis is put on the various inputs that pharmacological interventions can instill in the management of type 2 diabetes. The study, however, extends its inputs to assess the impacts of specific interventions on patients with underlying health conditions, specifically dementia. McMillan et al. (2018) noted that infusing non-pharmacological interventions in the management of diabetes must be accompanied by insights into the underlying conditions. That is, the employment of strategies such as physiological activities must be moderated bearing the underlying conditions. To the PICOT, this paper will help in understanding the extent to which pharmacological interventions must change bearing the underlying conditions showcased by the patients. The research included 37 studies in its systematic review to mark the findings.
Gagnon et al. (2019) assess pharmacological treatments of diabetes in older individuals. Older individuals instill newer challenges when it comes to managing their diabetes. That is, such individuals need support and care to adhere to the regimens. The medication prescribed for older individuals should also match the patients' needs since they often face the challenges of underlying conditions. Gagnon et al. (2019) conducted a population-based study in Canada among diabetes patients aged 55 and above. In their findings, the researchers indicate that healthcare professionals must find age as a defining factor in prescribing pharmacological regimens for diabetes patients. This article will be important in assessing the scope of pharmacological interventions and the impacts of age in any interventions concerning diabetes treatment in the PICOT question.
The last article in this PICOT review was conducted by Chung-Cheng, Yung-Hong, and Kuo, (2020). Chung-Cheng, Yung-Hong, and Kuo, (2020) explored the pharmacological inputs on patients with underlying challenges. Specifically, the study addresses the use of botulinum toxin treatment on patients with over-reactive bladder. This study was completed through a systematic review. The outcomes of this study help the PICOT in assessing various pharmacological intervention limitations when it comes to managing diabetes type 2 patients.
Comparison of the Articles
The articles above showcase some similarities and differences masked in strengths and limitations. The strengths of the studies stem from their assessment of current issues affecting the management of type 2 diabetes. The studies differ in the scope of their approaches. That is, as some of the studies explore the limits of pharmacological or non-pharmacological interventions, other studies extend their inputs to accommodate the underlying factors. It is also worth noting that the researchers relied majorly on qualitative approaches with systematic reviews dominating the methods. Only Gagnon et al. (2019) dared an experimental approach to drive their findings. The limitations of the approaches employed are that they do not reflect current happenings in the management of diabetes. Still, qualitative approaches are limited because they do not offer the reliable statistical requirements of studies of such caliber.
Conclusion and Areas of Further Study
The debate on the choices between pharmacological and non-pharmacological approaches in treating diabetes is poised to continue. Based on some researchers' analyses, patients should engage in different approaches bearing their characteristics, including underlying conditions. For the future, more inputs should be invested in the reactions by patients to different treatment techniques bearing a wide array of underlying conditions and age. That is, more patient factors should be included in further studies to ascertain preferable approaches for specific age groups or those with certain underlying illnesses.
You can change the PICOT or what ever you have to do to meet the requirements of the assignment.
RUBRIC
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Evidence-Based Practice Proposal - Section A: Organizational Culture and Readiness Assessment and Section B: Proposal/Problem Statement and Literature Review - Rubric
No of Criteria: 9 Achievement Levels: 5
Criteria
Achievement Levels
DescriptionPercentage
Unsatisfactory
0.00 %
Less than Satisfactory
80.00 %
Satisfactory
88.00 %
Good
92.00 %
Excellent
100.00 %
Content
70.0
Section A: Organizational Culture and Readiness Assessment
40.0
A discussion of the readiness level or the organization, possible project barriers and facilitators, how to integrate clinical inquiry, and the rationale for survey categories is not included.
A discussion of the readiness level or the organization, possible project barriers and facilitators, how to integrate clinical inquiry, and the rationale for survey categories is present, but it lacks detail or is incomplete.
A discussion of the readiness level or the organization, possible project barriers and facilitators, how to integrate clinical inquiry, and the rationale for survey categories is present.
A discussion of the readiness level or the organization, possible project barriers and facilitators, how to integrate clinical inquiry, and the rationale for survey categories is clearly provided and well developed.
A comprehensive discussion of the readiness level or the organization, possible project barriers and facilitators, how to integrate clinical inquiry, and the rationale for survey categories is thoroughly developed with supporting details.
Section B: Proposal or Problem Statement
10.0
A proposal or problem statement is not included.
A proposal or problem statement is present, but it lacks detail or is incomplete.
A proposal or problem statement is present.
A proposal or problem statement is clearly provided and well developed.
A proposal or problem statement is comprehensive and thoroughly developed with supporting details.
Section B: Literature Review
15.0
A summary of the research you conducted to support your PICOT, including subjects, methods, key findings, and limitations, is not included.
A summary of the research you conducted to support your PICOT, including subjects, methods, key findings, and limitations, is present, but it lacks detail or is incomplete.
A summary of the research you conducted to support your PICOT, including subjects, methods, key findings, and limitations, is present.
A summary of the research you conducted to support your PICOT, including subjects, methods, key findings, and limitations, is clearly provided and well developed.
A comprehensive summary of the research you conducted to support your PICOT, including subjects, methods, key findings, and limitations, is thoroughly developed with supporting details.
Required Sources
5.0
Sources are not included.
Number of required sources is only partially met.
Number of required sources is met, but sources are outdated or inappropriate.
Number of required sources is met. Sources are current, but not all sources are appropriate for the assignment criteria and nursing content.
Number of required resources is met. Sources are current, and appropriate for the assignment criteria and nursing content.
Organization and Effectiveness
20.0
Thesis Development and Purpose
7.0
Paper lacks any discernible overall purpose or organizing claim.
Thesis is insufficiently developed or vague. Purpose is not clear.
Thesis is apparent and appropriate to purpose.
Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.
Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.
Argument Logic and Construction
8.0
Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.
Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.
Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.
Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.
Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.
Mechanics of Writing (includes spelling, punctuation, grammar, language use)
5.0
Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.
Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.
Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.
Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.
Writer is clearly in command of standard, written, academic English.
Format
10.0
Paper Format (Use of appropriate style for the major and assignment)
5.0
Template is not used appropriately or documentation format is rarely followed correctly.
Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.
Template is used, and formatting is correct, although some minor errors may be present.
Template is fully used; There are virtually no errors in formatting style.
All format elements are correct.
Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)
5.0
Sources are not documented.
Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.
Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.
Sources are documented, as appropriate to assignment and style, and format is mostly correct.
Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.
Total Percentage 100