Fluent Essays

Evidence - Based Practice proposal Section - A February 8, 2021 Section A The place of employment is in an acute care hospital and usually dealing with the step-down patients. The facility is providing an intermediate level of care between the intensive care units and the general medical-surgical wards. The facility is handling different patients from different ethnic groups. The focus of the facility is to reduce the rate of common chronic illness such as type – 2 diabetes. The healthcare providers promote healthy behaviors in the facility. For the patient with these chronic illnesses, the management is focused on supporting health behaviors approaches to reduce the risk of complications from these illnesses and reducing the risk of developing these illnesses. One of the strengths of the facility in relation to the promotion of healthy behaviors is that it focuses on patient education. At the healthcare facility of employment, even though the healthcare providers are focused on the promotion of healthy behaviors to help in the reduction of chronic illnesses like type 2 diabetes, there is a lack of the diabetic educator. There are no specialized exercise trainers in the facility to guide every patient on the type of exercise that they should be involved in to reduce the risk of developing the disease. Even though the facility does not have a diabetic educator, nurses play a significant role in educating the patient via written education, demonstration and verbal education. If it is not within the budget of the organization to have an onsite diabetic educator, nurses should be educated extensively and should be provided with tools necessary to educate diabetic patients effectively. The facility is weaker when it comes to the follow-up especially when the patients are discharged from the facility. This is making it hard to ensure that patients are adhering to the practice guidelines and taking foods to ensure that they are free from exposure and complications associated with diabetes disease. The poor follow-up process is caused by the limited number of healthcare providers in the facility especially nurses and the increase in the number of patients seeking services in the facility. It will be recommended for the facility to follow up on the patients who are discharged from the facility to know if the community - based exercise program is working for them. Patients should be given a log to record daily blood sugar readings and information about the program so that effectiveness of the program can be understood. The nurse educator at the facility focuses on EBP and brings out EBP practices and explains to the nurse. For example, recently the educator started nurse driven protocols to remove foley catheters which is based on EBP. Nurses were given education in detail. Nurses and physicians provide patient care based on EBP. Only problem with the facility is that sometimes the administration doesn’t agree to some of the EBP and policiesEvidence - Based Practice Proposal Section - C February 9, 2021 Section C: Proposed Solution The solution to the issue of concern is the community-based exercise/physical activity program. The effective process of managing diabetes mellitus among the population targets the process of changing unhealthy behaviors for example sedentary lifestyle and inactivity. People including those who have not yet been diagnosed with diabetes should be actively involved in the performance of aerobic exercise regularly. Aerobic activity bouts should be ideally taken at least 10 minutes with the objective of attaining 30 minutes per day or more. The community-based exercise/physical activity program is important since it targets neighborhoods, families, and other relevant social groups to help in increasing physical activity. The program involves the use of peer-support or group-based classes to promote a more active lifestyle among the targeted individuals (Collberg, et al., 2016). The community-based exercise/physical activity program is realistic since it simply involves the dedication of time and commitment. According to Mendes et al (2017), the implementation of a community-based exercise program for middle and older patients with type 2 diabetes is cheaper. It helps in ensuring that the costly medication for the diabetes complication is prevented. It helps in the control and management of diabetes and cardiovascular risks. The development of a long-term community-based exercise program involves a lower cost (Mendes et al., 2017). Some of the exercise activities such as yoga can be performed by individuals at their homes. Yoga can tackle the physiological aspect of diabetes and help to manage the disease and reduce the complication (Raveendran, Deshpandae, & Joshi, 2018). It is cheaper and involves a commitment of an individual to the program to help in the management and preventing exposure to diabetes. The short-term implementation of yoga-lifestyle is assisting in the reduction of the fasting plasma glucose among individuals with type 2 diabetes (Venugopal et al., 2017). good Organizational Culture The organization is committed to the improvement of the overall healthy behaviors to help in the reduction of the prevention of the exposure and management of chronic illnesses. One of the policies of the facility is to ensure that patients and the community population are empowered to actively take part in the management of their health. This is done through educating the patients on healthy nutrition and how to minimize the time being taken while seated or watching television. Parents are informed about the importance of ensuring that their children are restricted from over-spending their time watching television and taking fast foods. These activities and programs are therefore aligned to the community-based exercise/physical activity program since they are both aimed at improving the well-being and health of the population (Collberg, et al., 20EBP - Section D February 10, 2021 Section D: The Selected Model or the Theoretical Framework The project is based on the use of a community-based exercise/physical activity program to help in the management of type 2 diabetes. Physical activity is an important component of treating type 2 diabetes mellitus. However, to ensure that its associated morbidities are prevented, the physical activity requires an instant and long-term change of lifestyle. The utilization of the behavioral change theories like the trans-theoretical model is helping in the promotion of physical activity. According to this model, individuals vary in terms of their motivation and the progress through some stages of the motivational readiness towards the behavioral change. According to this model, people tend to utilize diverse approaches and methods at every stage of change (Kang & Kim, 2017). This model is therefore important in the implementation of the community-based exercise/physical activity program through providing a framework that is used in the categorization of the individuals preparedness to the changes in their behaviors. It includes the stages that individuals have to take through to ensure that the habit of physical exercise becomes a norm. It helps in ensuring that there is the existence of self-efficacy and a successful process of change (Kleis et al., 2020). Discussion of Each Stage in the Model There are six sequential stages that involves the change process. In the pre-contemplation, the intention is not to take action in the next 6 months. Individuals are not well informed about the problems of their behaviors. In the contemplation stage, the intention is to start healthy behavior in the future i.e. 6 months. In this stage, people have discovered about the adviser impacts of their behaviors and have made a thoughtful consideration. In the preparation stage, there is determination and people are ready to engage in the action in the next 30 days. People are making necessary steps in changing their behaviors (Mettling et al., 2018). In the action stage, there is a change in the behavior and there is an intention of keeping them. There is modification of the problem behaviors and the acquisition of the new and healthy behaviors. There is maintenance where there is sustenance of the behavior change for sometimes and there is an intention of maintaining them. There is an effort being made to prevent any relapse. In the termination stage, there is no desire of returning back to the unhealthy behaviors. The relapse is not accepted in this stage and therefore, individuals will stay in the maintenance stage (Kleis et al., 2020). How the Stages would be Applied to the Proposed Implementation Based on the intervention of the community-based exercise/physical activity program, the pre - contemplation stage is where the individual is still in a sedentary lifestyle and have no intention of changing or actively taking part in the physEBP proposal - Section F February 24, 2021 Section F - Evaluation Plan The Methods to Collect the Data The collection of the data on the values of the body weight, A1C, Body Mass Index, waist circumference, blood pressure levels, body fitness, the HDL levels, and the muscular strength will be iOS Applications which will then be transferred to the nurses or healthcare provider. This will help monitor the progress of the participants and guiding on the need to make necessary adjustments. One of the major aspects of recording the above data is to ensure that the participants are free from the risk of exposure to type 2 diabetes. The process of monitoring the above key values reveals the effectiveness of the physical exercise involvement. Therefore, the determination of the success of the physical exercise in controlling the body weight, BMI, waist circumference, and the HDL levels among others would show a reduction in the blood sugar level based on the records generated from the GlocoseZone or mySugr Application (Colberg, et al., 2016). Outcome Measures Evaluate the Project Objectives The focus of the physical exercise program is to help in the reduction of the risk of exposure to diabetes or any diabetic-related complications. The outcome of the values of the HDL, waist circumference, A1C, and blood pressure levels among others after the implementation is expected to reveal healthy levels that reduce the exposure of the participants to type 2 diabetes (Center for Disease Control and Prevention, n.d). Therefore, the successful implementation of the physical; exercise program is expected to record the lowest value of the blood sugar levels as compared to the baseline data i.e. the data generated before the implementation of the program. It is also expected that there will be an improvement in physical fitness, muscular strength, BMII, and the value of the A1C among others (Kordonouri & Riddel, 2019). Outcomes Measured and Evaluated Based on Evidence The recording of the values will be done using the iOS application on the phones of the patients. The records from the implementation program are done after getting the baseline data of each participant. The data on the key values will be recorded throughout implementation. Each participant will be actively involved in the type of physical activities designed for them based on their level of fitness (Cha, et al., 2017). Throughout this period, data on the HDL, body fitness, waist circumference, and A1C will be recorded. The records of these key values are recorded every 2 - 3 months and data like blood sugar values is recorded daily basis. The data is reported using the application and then forwarded to the healthcare provider. The daily recording of the blood glucose is also recorded and forward using other important applications such as GlocoseZone or mySugr Application. The reliability and the validity of the data or the outcome are attained by ensuring that the participa