Diabetes: Comparative Impacts of Non-Pharmacological Interventions

Benchmark - Evidence-Based Practice Proposal Final Paper
Throughout this course, you have developed a formal, evidence-based practice proposal.
The proposal is the plan for an evidence-based practice project designed to address a problem, issue, or concern in the professional work setting. Although several types of evidence can be used to support a proposed solution, a sufficient and compelling base of support from valid research studies is required as the major component of that evidence. Proposals must be submitted in a format suitable for obtaining formal approval in the work setting. Proposals will vary in length depending upon the problem or issue addressed (3,500 and 5,000 words). The cover sheet, abstract, references pages, and appendices are not included in the word count.
Section headings for each section component are required. Evaluation of the proposal in all sections will be based upon the extent to which the depth of content reflects graduate-level critical thinking skills.
This project contains seven formal sections:
Section A: Organizational Culture and Readiness Assessment
Section B: Proposal/Problem Statement and Literature Review
Section C: Solution Description
Section D: Change Model
Section E: Implementation Plan
Section F: Evaluation of Process
Each section (A-F) will be submitted as a separate assignment in Topics 1-6 so your instructor can provide feedback (refer to applicable topics for complete descriptions of each section).
The final paper submission in Topic 7 will consist of the completed project (with revisions to all sections), title page, abstract, compiled references list, and appendices. Appendices will include a conceptual model for the project, handouts, data and evaluation collection tools, a budget, a timeline, resource lists, and approval forms, as previously assigned in individual section assignments
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is 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.
RUBRIC
Benchmark - Evidence-Based Practice Proposal Final Paper - Rubric
No of Criteria: 12 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
Translation of Research and Knowledge Gained From Practice, While Adhering to Ethical Research Standards, to Improve Patient Outcomes and Clinical Practice (1.1)
15.0
Translation of research and knowledge gained from practice, while adhering to ethical research standards, to improve patient outcomes and clinical practice is not included.
Translation of research and knowledge gained from practice, while adhering to ethical research standards, to improve patient outcomes and clinical practice is present, but it lacks detail or is incomplete.
Translation of research and knowledge gained from practice, while adhering to ethical research standards, to improve patient outcomes and clinical practice is present.
Translation of research and knowledge gained from practice, while adhering to ethical research standards, to improve patient outcomes and clinical practice is clearly provided and well developed.
Translation of research and knowledge gained from practice, while adhering to ethical research standards, to improve patient outcomes and clinical practice is comprehensive and thoroughly developed with supporting details.
Application of Theoretical Frameworks From Nursing and Other Disciplines to Make Decisions Regarding Practice and Health-Related Problems at the Individual and Population Level (1.2)
15.0
Application of theoretical frameworks from nursing and other disciplines to make decisions regarding practice and health-related problems at the individual and population level is not included.
Application of theoretical frameworks from nursing and other disciplines to make decisions regarding practice and health-related problems at the individual and population level is present, but it lacks detail or is incomplete.
Application of theoretical frameworks from nursing and other disciplines to make decisions regarding practice and health-related problems at the individual and population level is present.
Application of theoretical frameworks from nursing and other disciplines to make decisions regarding practice and health-related problems at the individual and population level is clearly provided and well developed.
Application of theoretical frameworks from nursing and other disciplines to make decisions regarding practice and health-related problems at the individual and population level is comprehensive and thoroughly developed with supporting details.
Assessment of Health Care Processes and Systems to Recommend Measures for Improving Quality, Safety, and Cost-Effectiveness Across an Organization (3.1)
10.0
An assessment of health care processes and systems to recommend measures for improving quality, safety, and cost-effectiveness across an organization is not included.
An assessment of health care processes and systems to recommend measures for improving quality, safety, and cost-effectiveness across an organization is present, but it lacks detail or is incomplete.
An assessment of health care processes and systems to recommend measures for improving quality, safety, and cost-effectiveness across an organization is present.
An assessment of health care processes and systems to recommend measures for improving quality, safety, and cost-effectiveness across an organization is clearly provided and well developed.
A comprehensive assessment of health care processes and systems to recommend measures for improving quality, safety, and cost-effectiveness across an organization is thoroughly developed with supporting details.
Integration of Appropriate Information and Communication Technologies to Improve Nursing Practice and Care Delivery for Individuals and Populations (3.3)
10.0
An integration of appropriate information and communication technologies to improve nursing practice and care delivery for individuals and populations is not included.
An integration of appropriate information and communication technologies to improve nursing practice and care delivery for individuals and populations is present, but it lacks detail or is incomplete.
An integration of appropriate information and communication technologies to improve nursing practice and care delivery for individuals and populations is present.
An integration of appropriate information and communication technologies to improve nursing practice and care delivery for individuals and populations is clearly provided and well developed.
A comprehensive integration of appropriate information and communication technologies to improve nursing practice and care delivery for individuals and populations is thoroughly developed with supporting details.
Design of Ethically Sound, Evidence-Based Solutions to Complex Health Care Issues Related to Individuals, Populations, and Systems of Care (5.1)
10.0
Design of ethically sound, evidence-based solutions to complex health care issues related to individuals, populations, and systems of care is not included.
Design of ethically sound, evidence-based solutions to complex health care issues related to individuals, populations, and systems of care is present, but it lacks detail or is incomplete.
Design of ethically sound, evidence-based solutions to complex health care issues related to individuals, populations, and systems of care is present.
Design of ethically sound, evidence-based solutions to complex health care issues related to individuals, populations, and systems of care is clearly provided and well developed.
Design of ethically sound, evidence-based solutions to complex health care issues related to individuals, populations, and systems of care is comprehensive and thoroughly developed with supporting details.
Evaluation of Process
5.0
An evaluation of process is not included.
An evaluation of process is present, but it lacks detail or is incomplete.
An evaluation of process is present.
An evaluation of process is clearly provided and well developed.
A comprehensive evaluation of process 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
Section A
The organizational readiness survey tool selected for this study is the Organizational Culture and Readiness for System-Wide Integration of Evidence-Based Practice. The tool will help examine, evaluate, and identify the readiness of the firm to adopt the evidence-based practice.
The findings from the survey tool imply that the organization is ready to engage in the EBP. The nurses have the commitment and desire to adopt the evidence-based practice.
The barrier to evidence-based practice includes corporate and human factors. One barrier relates to the limited amount of time allotted to read literature following heavy workloads. The other barrier is staff involved in the evidence-based practice have little knowledge on what they are about to embark on. There are limited resources to facilitate the procedure of evidence-based practice. The facilitators of evidence-based practice are identified and deemed to help with adopting the new cultures that will enhance the treatment of diabetes and the enhancement of self-management care. The facilitators in the case include improved access to information and role modeling to influence more evidence-based practice in the organization.
Section B
Problem Statement
Diabetes is one of the major chronic diseases that affect millions of people in the United States. Different efforts and initiatives have been put in place to help manage the condition and improve the health outcomes of the patients. Self-management is one of the proposed approaches to help with health outcomes and improve the quality of care. However, various factors have proven a challenge to the self-management of diabetes . There is an aspect of low socioeconomic status of the patient that limits the access to self-management education. It is difficult to have standardized care with limited education on self-management. The education is alsowill be designed to improve the outcomes, quality of care and reduce the health disparities. Self-management is desired to help diabetic patients improve their health as they find the best ways to control their condition and dictate their health outcomes in the best efficient ways .
Literature Review
The study was conducted through interviews and survey approaches to assist in mining data to direct the findings and conclusions. Semi-structured interviews were conducted with patients with type 2 diabetes from a safety net primary care in a health facility. The study participants were selected from a primary care practice that draws from an ethnically diverse and low-income neighborhood. An international survey was also conducted on adults with type 2 diabetes. The survey inquired about the skills and efficiency in diabetes self-management, while the interviews assessed the barriers to self-management (Adui Adui, Malubu, Aduli, & Bunmi, 2019). Descriptive and inferential statistics were used to analyze the survey results, while the interview results were analyzed using a thematic analysis approach (Adui, et al., 2019).
The findings suggested that many people in the United States live with diabetes. In 2020, it was 10% of the entire population of the country. The reports further noted that 88 million American adults show signs of being prediabetic. The non-Hispanic blacks and Hispanic people are were reported to have a high increase in diabetic cases in the country. This is even though the overall diabetic rate recorded a decline between 2008 and 2018. Most of the adults with diabetes in the country are were American Indian natives .
The people living with diabetes in the country are were more likely to be overweight, while other individuals are physically inactive. The issue is contributed by the easy access to unhealthy processed products at low prices that comes as one reason for the high incidence of diabetes in low-income communities (Bursell, Stephanie, Lewis & Horton, 2018). People also tend to live under unbalanced diets, which resultsed in malnutrition and overweight. This is a common issue in the urban setting with few healthy food choices. Dieting is one of the risk factors for diabetes in low-income. Research shows indicated that low socioeconomic status and low protein consumption are were associated with obesity, diabetes, and other chronic diseases.
The dieting issues tend to lead with the end resultthe result in obesity between energy consumption. Excessive food consumption and little physical exercise elevate the severity of the matter as the high intake of calories is associated with limited exercise and massive effects on the body. Physical exercise, gender, age, calorie consumption, and genetics affect the susceptibility to developing diabetes .
According to Schmitt et al. (2016), self-management education is was introduced as the possible solution to eliminate the problem. Nurses recommended self-management to patients to help counter the condition and help improve their health outcomes. However, aspects such as limited access to self-management education are was a major barrier to fulfilling the recommended practice. The educational barriers to the self-management exercise should allow diabetic patients the opportunity to access knowledge on their condition and how to manage their disease (Hurst, Rakkapao, & Hay, 2020). Priority is placedwas placed on prevention and treatment. As a result, the solution is was mainly to improve the education of the patients on how they can manage their diabetes and how they can promote healthy lifestyles.
Self-care is identified as a critical aspect in the management of diabetes. Various studies have explored the need for people with diabetes to live active lives to manage their condition and reduce the risks for future health complications while enhancing the results (Gunggu, Thon, & Lian, 2016). Patient participation implies that the physicians' referral influences self-management and improving both patient and physician participation programs is necessary to enhance the health results.
Educating the patient on self-management will focus focuses on helping patients improve their diabetic conditions and cope with the disease. It is common for the low socioeconomic communities have limited access to health information. The y have poor knowledge of diabetes management. as a result, they suffer challenges accessing healthy foods and diets (Dehkordi & Abdoli, 2017). Patient-centered education programs, service by improving patient participation.
The existing limitation of the study is was that it enrolled patients at one primary care medical practice. Therefore, there is a need for further studies that incorporate patients across different practice settings to allow high validation of the findings presented in the study .
Conclusion
Evidence-based practice is an exercise that desires an organization with a learning culture and willingness to adopt new practices. The organizational teams are expected to portray the best skills and characters that will embrace and accommodate the new practice and work towards attaining the goals and objectives of the EBP. In self-management of diabetes, the patients are expected to have adequate education about the practice and improve their health outcomes. Aspects such as limited access to self-management education are a major barrier to fulfilling the recommended practice. The educational barriers to the self-management exercise should allow diabetic patients the opportunity to access knowledge on their condition and how to manage their disease. Nurses are major stakeholders in facilitating this exercise and can actively engage the patients through the self-management processes.
References
Schmitt, A., Reimer, A., Hermanns, N., Huber, J., Ehrmann, D., Schall, S., & Kulzer, B. (2016). Assessing diabetes self-management with the diabetes self-management questionnaire (DSMQ) can help analyseanalyze behaviouralbehavioral problems related to reduced glycaemicglycemic control. PLoS One, 11(3) http://dx(dot)doi(dot)org/10.1371/journal.pone.0150774
Hurst, C. P., Rakkapao, N., & Hay, K. (2020). Impact of diabetes self-management, diabetes management self-efficacy and diabetes knowledge on glycemic control in people with type 2 diabetes (T2D): A multi-center study in tThailand. PLoS One, 15(12) http://dx(dot)doi(dot)org/10.1371/journal.pone.0244692
Gunggu, A., Thon, C. C., & Lian, C. W. (2016). Predictors of diabetes self-management among type 2 diabetes patients. Journal of Diabetes Research , 2016 http://dx(dot)doi(dot)org/10.1155/2016/9158943
Dehkordi, L. M., & Abdoli, S. (2017). Diabetes self-management education; experience of people with diabetes. Journal of Caring Sciences, 6(2), 111-118. http://dx(dot)doi(dot)org/10.15171/jcs.2017.011
Mary D. Adu, Usman H. Malabu, Aduli E. O. Malau Aduli, & Bunmi S. Malau- Aduli . Enablers and barriers to effective diabetes self-management: A multi-national investigation.
Bursell , S., Stephanie, J. F., Lewis, D. G., & Horton, M. B. (2018). Prevalence of diabetic
retinopathy and diabetic macular edema in a primary care-based teleophthalmology
program for american indians and alaskan natives. PLoS One, 13(6)
http://dx(dot)doi(dot)org/10.1371/journal.pone.0198551
SECTION C
Interventions
Proposed Intervention
Non-pharmacological interventions have proven vital in the management of diabetes bearing the inputs of prevalent evidence. Non-pharmacological interventions do not include the application of medications to manage or prevent diabetes (Leite, Banzato, & Galendi, 2020). The non-pharmacological interventions constitute inputs. There is a wide range of non-pharmacological interventions that if implemented to prevent diabetes or mitigate its impacts on a patient. Some of the interventions include diabetes self-management education and support (DSMES), multidisciplinary lifestyle interventions, social interventions, psychological interventions, physical therapy, and nutritional therapy (Renata et al., 2020). The choice for intervention should depend on the patient's needs. The level of physical ability of an individual, social or psychological deficiencies, and financial factors all contribute to the intensity of interventions to which diabetes patients are subjected.
Multiple evidence-based practices have proven that non-pharmacological interventions in diabetes are necessary. The American Diabetes Association Standards of Medical Care recommends that every diabetes patient is subjected to ongoing support and education to the national DSME/S standards. Presently, only five to seven percent of patients receive DSME, which has hampered the interventions (Leite et al., 2020). DSME/S has been shown to lower costs, improve quality of life, and improve glycemic control. It is also indicated that people with impaired glucose tolerance subjected to enhanced lifestyle advice significantly lower the incidence of type two diabetes by 50% (Raveendran et al., 2018). To that effect, most cases of type two diabetes can be prevented, or the onset can be delayed at least. Ultimately, metabolic derangements such as hypercoagulability, inflammation, and insulin resistance can be understood as consequences of adipose tissue dysfunctions. Weight loss interventions can influence adipose tissue functioning by affecting the levels of plasma cytokine and adipokine (Leite et al., 2020). Hence, evidence indicates that proper implementation of various non-pharmacological strategies should help to address various aspects of diabetes.
The interventions are realistic in any setting that demands effective management of diabetes. Non-pharmacological interventions, as evidence indicates, are cheaper as opposed to pharmacological interventions. Still, there are community resources that are available and can be employed in addressing various needs (Raveendran et al., 2018). DSME/S, for instance, has proven effective in education and ongoing support. Other resources, including social and support groups and non-governmental organizations, have shown the motivation to steer non-pharmacological diabetes interventions. Remarkably, some interventions such as nutritional, physiological, or psychological therapy may need costly professional interventions. However, if implemented rightly, most non-pharmacological interventions should befit the needs of many communities .
The Organizational Culture
The implementation of non-pharmacological interventions in diabetes befit various elements of organizational culture. The organization has been motivated to steer prevention mechanisms in the prevalence of diabetes. The organization has traditionally used its resource to educate communities on lifestyle attributes that must be changed to mitigate cases of diabetes. This initiative also synchronizes with the efforts that various outlets have put in communities to help in managing or preventing the prevalence of diabetes. Health organizations such as the Academy of Nutrition and Dietetics, American Association of Clinical Endocrinologists (AACE), American Association of Diabetes Educators (AADE), and American Diabetes Association (ADA) have dedicated resources to help communities to overcome the diabetes challenges using non-pharmacological interventions. Using such platforms, the organization can fuel its culture of steering prevention, mitigation, and management measures against diabetes .
Expected Outcomes
The project expects outcomes in two categories. Primarily, it intends to oversee an increase in the number of patients registering for non-pharmacological interventions such as DSME/S, physical, or nutritional therapies. The project will also foster managing the symptoms of patients. That is, it will assess the effectiveness of the interventions in managing the condition .
Method to Achieve Outcomes
The outcomes will be achieved through participant assessment at different stages of the program. The project will explore factors such as symptoms, knowledge of the patients, and affinity to some lifestyle behaviors to ascertain their changes across the project's scope. For instance, data will be collected on alcohol consumption behaviors at the beginning and at the end of the program to ascertain the changes. Knowledge will be assessed through tests to note the differences. The difficulty with this assessment strategy will be according to all the patients' similar conditions. The project will overcome specific patient variations by subjecting them to similar conditions, including nutritional and medical, throughout the program. The primary limitation that should be addressed is time and resource allocation. The project will need a longer period and more inputs on stakeholder collaborations to match the resource needs .
Outcome Impacts
The impacts of the outcomes will be centered on quality care improvement. The project intends to improve the quality of care for diabetes patients by instilling inputs of various non-pharmacological interventions. The end of the project should coincide with advanced knowledge on diabetes management mechanisms and active patient participation in managing the condition.
References
Leite, R., Banzato, L. R., & Galendi, J. (2020). Effectiveness of non-pharmacological strategies in the management of type 2 diabetes in primary care: A protocol for a systematic review and network meta-analysis. BMJ Open 2020;10:e034481. DOI: 10.1136/bmjopen-2019-034481
Raveendran, A. V., Chacko, E. C., & Pappachan, J. M. (2018). Non-pharmacological treatment options in the management of diabetes mellitus. European Endocrinology, 14(2), 31–39. https://doi(dot)org/10.17925/EE.2018.14.2.31
Renata, F. L., Luísa, R. B., Julia Simões Corrêa Galendi, Mendes, A. L., Bolfi, F., Areti, A. V., . . . Vania dos Santos Nunes-Nogueira . (2020). Effectiveness of non-pharmacological strategies in the management of type 2 diabetes in primary care: A protocol for a systematic review and network meta-analysis. BMJ Open, 10(1) doi:http://dx(dot)doi(dot)org/10.1136/bmjopen-2019-034481
SECTION D
Change Implementation
Change can be a daunting prospect even for established organizations bearing the inputs that it demands. A change process may require the elimination or addition of various prospects, including cultural and structural factors within an organization. As such, stakeholders fear changes. If implemented wrongly, changes can lead to more organizational problems as opposed to their prospective solutions. Evidence-based practice (EBP) is among the conspicuous changes healthcare organizations are presently implementing to enhance quality and efficiency. An insightful implementation process, especially to small organizations with few resources, is necessary lest the organization lands in an irredeemable failure. This paper employs Duck’s change curve model to guide the implementation of EBP .
The Stages of the Model
Duck’s change curve model is a popular change model that focuses on different stages of change within the setting of an organization. The model helps employees to understand the change and support its implementation (Baxley, 2016). The developer of this model, Jeanie Daniel Duck, noted that an effective change process must undergo five stages to reach the needed impacts. The five stages are discussed as follows:
Stagnation
Stagnation is the primary stage of a change process. Stagnation occurs at the end of a period in which stakeholders begin to understand the need for change. In a healthcare organization, stagnation can occur when the organization no longer makes profits (Baxley, 2016). Other factors, including increasing cases of patient injuries or infections or reducing the number of patients who seek help from the organization, can be signs of stagnation. Healthcare organizations assess stagnation from various key point indicator changes. If the indicators stay constant or plummet, the chances are that changes are needed. Some stakeholders understand that things must change right at the stagnation stage.
Preparation
The preparation stage follows stagnation and is characterized by a more insightful avenue towards the change itself. In the preparation, leaders announce the prospect of instilling specific changes in the organization (Baxley, 2016). Every stakeholder who is poised to feel the impacts of the change must be informed to help him/her prepare for the future. The emotions at the preparation stage range from fear, where people wonder if they will keep their jobs after the change, relief in which people find it necessary to implement the change, to excitement in which people cannot wait to participate in the change process.
Implementation
Implementation marks the third stage in which the proposed change is subjected to the revitalization of organizational processes. In the implementation stage, stakeholders accept the inevitability of the change, and leaders assign new processes or responsibilities relevant to the change itself (Rahmayanti et al., 2020). The implementation stage is characterized by confusion as people grapple with the fear of indulging in new processes while also abandoning some of the old activities. The implementation can come with cultural, structural, activity, changes, changes in responsibilities, and prospects for people to adapt. In healthcare, changes can be introduced on seeking evidence before specific interventions, for instance. Variations in feelings also characterize the implementation stage.
Determination
The determination stage implies the reactions shortly after a change is completed. At this stage, people are willing to understand the impacts of the implemented changes. The determination stage can come with a section resenting the changes and insisting that they were unnecessary in the first place (Wan, 2017). The change process here is slow as people are still prone to making mistakes born of torn allegiance between the traditional and new ways of doing things.
Fruition
The fruition stage is where the outcomes of the change take place. In fruition, the organization showcases a swift move from the stagnation that it experienced before opting for the changes (Wan, 2017). The fruition stage in healthcare comes with better patient satisfaction rates, efficient working hours for healthcare professionals, increased patient safety, and enhanced reliance on the evidence to make clinical decisions.
Application of Each Stage
Each stage in the Duck’s change curve model is vital in the implementation of EBP protocols. The stages will help in subdividing the implementation into stages that should define the progress. For instance, the first two stages should be short-term and should encompass the need for change and formulation. The third and fourth stages should be mid-term, in which the processes are implemented, and determinations are made based on impacts. The fifth stage should be long-term, and the organization is guided on the contingency plans alongside evaluation strategies to ensure the effectiveness of the changes.
References
Baxley, M. (2016). School nurse’s implementation of evidence -based practice: A mixed-method study (Order No. 10257368). Available from Publicly Available Content Database. (1877998964). Retrieved from https://www(dot)proquest(dot)com/dissertations-theses/school-nurses-implementation-evidence-based/docview/1877998964/se-2?accountid=130654
Rahmayanti, E. I.,M.N.R.N., Kadar, K. S., PhD., & Saleh, A., PhD. (2020). Readiness, barriers, and potential strength of nursing in implementing evidence-based practice. International Journal of Caring Sciences, 13(2), 1203-1211. Retrieved from https://www(dot)proquest(dot)com/scholarly-journals/readiness-barriers-potential-strenght-nursing/docview/2462488094/se-2?accountid=130654
Wan, L. P. A. (2017). Educational intervention effects on nurses’ perceived ability to implement evidence-based practice ( Order No. 10689507). Available from Publicly Available Content Database. (1984940077). Retrieved from https://www(dot)proquest(dot)com/dissertations-theses/educational-intervention-effects-on-nurses/docview/1984940077/se-2?accountid=130654
SECTION E
Implementation Plan
Description of the Setting
This project will be focusing on a healthcare facility whose patients are predominantly of Hispanic origin. The choice for Hispanics in this study is because they stand among the leading ethnic groups in the prevalence of diabetes in the US. Hispanics constitute 12.5% of diabetes patients in the US and are only bettered by Native Americans (Grabowski et al., 2017). The choice of a healthcare facility is strategic because all the stakeholders necessary in the management of diabetes will be easily accessible. Healthcare facilities also have records about their patients that can be assessed to understand the different diabetes management practices to which the patients are subjected and their impacts in managing the conditions. Ultimately, the facility will offer a platform for education considering the number of people seeking services from the professionals .
Project Timeline
The project is poised to take a minimum of six months from its introduction to completion. The project will be subdivided into three portions, with each portion consisting of two months each. In the first two months, the emphasis will be placed on understanding the scope of the project. Some factors to be emphasized in the first two months will include stakeholders, identification of stakeholder roles, assessment of the required resources for the completion of the project, and structuring the other two portions of the project. In the second phase, the project will take two months to collect data. The data collection will accommodate extensive stakeholder interactions. The last phase of the project will emphasize data analysis and assessment of the findings. The project will be evaluated to understand its adherence to the prevalent challenges in managing diabetes in various paradigms.
Resources
The project will require an input of a range of resources to be completed. The primary category of resources will be human resources. Different individuals will be required in a professional capacity to participate in the course of the project. The inclusion of some non-pharmacological diabetes management practices such as patient education, effective dietary behaviors, and physiotherapy requires professional inputs. The project also demands the inputs of financial resources. Part of the activities accommodated in the project demands intense involvements. Prospects such as the acquisition of training centers, data collection, and acquisition of data analysis tools all require finances that the project will need to accommodate .
Methods and Instruments
Reliability and validity must be emphasized in designing data collection for this project. As such, emphasis will be put on employing multiple methods and instruments to seek the necessary data. This project will partially focus on a systematic review. Hence, online libraries such as Google Scholar and ProQuest should help in finding publications that majorly take a comparative analysis of different techniques in the management of diabetes. The study will also conduct interviews from a specific healthcare facility based on different management techniques. At the project’s onset, the participants will be assessed based on their knowledge and the scope of activities they involve in managing their conditions. The assessment will again be conducted at the end of the project to ascertain any changes both in knowledge and the symptoms that the patients manifest. The participants can also answer open-ended questions in a questionnaire to ascertain consistency in the information that they deliver .
Process of Delivering Intervention
Interventions should be delivered following the certainty of the needs of individual participants in the project. The interventions will require professional involvement. In this project, professionals who emphasize both pharmacological and non-pharmacological diabetes interventions will be needed. Nurses involved in patient education, physiotherapists, nutritionists, and physicians will be needed to explore the different interventions. Bearing the resource limitations, the interventions will be mainly educational. The professionals will lead the patients in gaining knowledge on different non-pharmacological techniques necessary in managing diabetes. Training for the participants will be needed to define the scope of interventions that the project will foster .
Outline of Data Collection Plan
The data collection plan will be outlined in different categories. The first category will be the data. In this project, data types will be discrete or continuous. Discrete data are information that can only take specific values (Islam et al., 2018). The number of patients attending the facility or the number of calories an individual takes in a specific meal is discrete data. Conversely, continuous data is data that can take any value. In this project, continuous data will include aspects such as length, temperature, height, and weight. The data plan will also emphasize operational definition, such as the amount of time it takes the patients to understand various non-pharmacological interventions in diabetes management. The last element of the data outline will be responsibilities where the individuals involved in various intervention strategies can be defined based on their specific inputs. The data collection plan will also emphasize reviews and qualitative data. The information collected through interviews can be categorized based on the information and the informant characteristics throughout the project. The project will instill reviews in which comparative analyses will be conducted on different studies with emphasis on the research questions .
Management of Barriers
Multiple challenges face projects of this kind. The first challenge is the identification of the participants. Bearing the sensitivity of the information that the study targets, it can be challenging for individuals to participate voluntarily in a project of this kind (Moore et al., 2016). Some project managers can opt to pay their participants. However, paying all the participants effectively cannot be feasible with limited financial resources. This challenge can be addressed by leveraging the power of networks. People are more connected presently, which eases interactions with more participants in studies. The sampling technique can also be efficient. In this project, the use of snowball sampling helps with easy targeting of a specific demographic segment for the study.
The second challenge is finding the right institutions to participate in the project. Studies that emphasize aspects of healthcare need the inputs of some institutions to succeed. The resources required for effective participation can deter some organizations. On various occasions, project managers can be discouraged, especially with rejections. Addressing the issue requires insisting on the course of the project, seeking as many organizations as possible, and preparing to face the challenges.
The other challenge that the project can encounter is dealing with the data. The data collected during the project should be analyzed and arranged in a manner that instills relevance. Making sense of the data can be challenging, especially when the data is generated from different sources with outcomes projected to emphasize particular trajectories (Tremblay et al., 2018). Dealing with data management problems can be addressed by reverting to the methodologies to understand the details of the data collected. The researcher can also take more time to explore the different elements of the data. Ultimately, it is important to employ the right tools in data analysis to make sense of the collected data.
Feasibility of the Implementation Plan
The implementation plan above is feasible on various grounds. Primarily, it is grounded on the scope of the research methodology. The data collected should reflect the objectives of the study. The feasibility of the implementation plan is also based on resource utilization. Effective utilization of resources should account for effectively concluded studies. The amount and quality of data collected should also mark the scope of the plan. In this implementation plan, considerations are put on data and the possible outcomes of the project .
Budget Plan
The budget plan will outline the expenses that the project will undergo throughout its course. Some expenses that the project is poised to incur include training of participants, recruitment of participants, hiring of training materials, traveling, and hiring of professionals and conference facilities. Some other expenditures will be directed to communication and emergency preparedness. The project will also invest in data collection and data analysis, prospects that require proper resource allocation .
Plan after the Implementation
The implementation plan should go with a project evaluation. Project evaluation factors in the impacts of a particular project. The impacts can be assessed on the grounds of whether the project has achieved its objectives or if it has failed (Harris et al., 2019). Beyond the implementation plan, the project should manifest contingencies that help in addressing emerging issues in the course or after the project .
References
Grabowski, D., Aagaard-Hansen, J., Willaing, I., & Bjarne, B. J. (2017). Principled promotion of health: Implementing five guiding health promotion principles for research-based prevention and management of diabetes. Societies, 7(2), 10. doi:http://dx(dot)doi(dot)org/10.3390/soc7020010
Harris, J., Haltbakk, J., Dunning, T., Austrheim, G., Kirkevold, M., Johnson, M., & Graue, M. (2019). How patient and community involvement in diabetes research influences health outcomes: A realist review. Health Expectations, 22(5), 907-920. doi:http://dx(dot)doi(dot)org/10.1111/hex.12935
Islam, N., Gepts, T., Lief, I., Gore, R., Levy, N., Tanner, M., & Schwartz, M. D. (2018). Protocol for the CHORD project (community health outreach to reduce diabetes): A cluster-randomized community health worker trial to prevent diabetes. BMC Public Health, 18 doi:http://dx(dot)doi(dot)org/10.1186/s12889-018-5419-4
Moore, G., Fitzpatrick, T., Lim-Carter, I., Haynes, A., Flego, A., & Snelgrove, B. (2016). Implementing knowledge translation strategies in funded research in Canada and Australia: A case study. Technology Innovation Management Review, 6(9), 16-27. Retrieved from https://www(dot)proquest(dot)com/scholarly-journals/implementing-knowledge-translation-strategies/docview/1963138602/se-2?accountid=130654
Tremblay, M., Martin, D. H., McComber, A. M., McGregor, A., & Macaulay, A. C. (2018). Understanding community-based participatory research through a social movement framework: A case study of the Kahnawake schools diabetes prevention project. BMC Public Health, 18 doi:http://dx(dot)doi(dot)org/10.1186/s12889-018-5412-y
Section F will be completed this week by you. Thank you so very, very much for your patience and time in helping me through this project. If I need to provide you with anymore information, do not hesitate to contact me. Please remember to strictly adhere to the APA Format. That has been the request from the instructor of this course.