NUR 445 Evidence-Based Management Proposal
Type: BSN Capstone Project
Subject: Nursing Leadership Course
Subject area: Nursing
Education Level: Undergraduate/College
Length: 10 pages
Referencing style: APA
Preferred English: US English
Spacing Option: Double
Title: Written Paper: Capstone Project Proposal
Instructions: the purpose of this assignment is to learn the process of proposing and planning for change by identifying a problem or need for change to address a quality care or patient safety issue as defined in the next paragraph proposing a solution that is supported by evidence identifying the process of change, including the costs and benefits to the stakeholders; and determining the criteria for the evaluation of the intervention. please keep your proposal focused on a single issue, not complex or complicated. it should be a project that you could actually implement during the nur464 course. this assignment is to learn how to propose and plan, not solve all the compelling issues in nursing today. it is expected that you will incorporate the faculty feedback received on your outline from week 2 of this course. this paper needs to be submitted to advance to nur 464. address a quality care or patient safety issue: identify one issue that exists on an inpatient, outpatient, or community setting that you have access to. review the issue utilizing management functions: organizing, planning, directing, controlling, and budgeting, and integrate each of these functions into the proposal. consider the impact of change to the organization’s mission, staffing, scheduling, staff development, staff and patient satisfaction, and budgetary performance. identify all stakeholders, such as finance, human resources, nursing, medical staff, pharmacy, and plan for coordination during implementation. important note: please review the detailed capstone project proposal nur 445.docx to complete this assignment. apa format is required. all support from the literature should be credible and relevant, meaning that it should fall with the previous 5 years and be from a peer-reviewed journal. these are settings you can choose when searching for articles in the asu library. this proposal will be used to design the implementation of the nursing practice project (capstone) as required in your capstone course, nur 464. the project will need to be implemented and evaluated within a 4 week time frame, so please keep your proposal focused on one issue. if you would like to view the video again, click here (links to an external site.). here is the rubric for this assignment: module 5 written paper capstone project proposal rubric.pdf here are previous student papers for your guidance. please understand that the papers are not perfect, and are included without the feedback/scoring from the instructor, but may be used to give you a general idea of the scope of a capstone. the apa may also not be the current edition. nur 445 proposal paper example #1.pdf nur 445 proposal paper example #2.pdf
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Also Read: Detailed Nursing Capstone Project Help
Evidence-Based Management Proposal
Student’s Name
Institutional Affiliation
Course Number: Course Name
Instructor
Date Due
Executive Summary
Diabetes is a chronic condition that undermines individuals’ quality of life. For instance, the disease damages the nerves, kidneys, blood vessels, and heart. Individuals diagnosed with diabetes are at risk of stroke, heart attacks, nerve damage, reduced blood flow, and limb amputation. However, lifestyle modification can prevent or delay the onset of diabetes. For instance, achieving and maintaining a healthy weight, being physically active, eating healthy meals, avoiding saturated fats and sugars, and smoking cessation reduce the risk of diabetes and related complications. Nonetheless, the lack of awareness about diabetes and its prevention strategies contributes to its prevalence globally.
Thus, the proposal aims to engage my facility and patients in a diabetes self-management program. The program will focus on educating patients about diabetes and related complications, the importance of monitoring their blood sugar levels, eating healthy meals, engaging in physical activities, adhering to their medication regimen, performing self-foot checks, and avoiding dehydration by drinking water. The program will last four weeks and the expected outcomes include improved quality of life, reduced number of patients admitted due to diabetes-related complications, reduced healthcare costs associated with treating diabetic patients, and enhanced patient understanding of diabetes, its associated complications, and diabetes prevention strategies.
Overview of the Capstone Project Proposal
Diabetes remains a significant public health challenge globally. Kumah et al.(2018) note that it ranks fifth as the leading cause of mortality in high-income countries while in middle and low-income countries; it is increasingly becoming an epidemic. In 2014, approximately 422 million individuals globally were diagnosed with diabetes with 175 million undiagnosed. The number of those diagnosed with diabetes is expected to increase to 592 million by 2035 (Kumah et al., 2018). The rise will be attributable to reduced exercise levels, urbanization, dietary changes, unhealthy behaviors, aging populations, and obesity prevalence. Diabetes care exerts a considerable financial burden on individuals and healthcare systems and is associated with severe complications like limb amputation, blindness, stroke, myocardial infarction, and kidney failure (Kumah et al., 2018). Despite the increased prevalence of diabetic disease, evidence indicates that effective management and early diagnoses can reverse the global disease trend.
Also, patient education programs are important in reducing diabetes-related complications and the costs associated with care delivery. Self-Management education entails active participation of individuals in decision-making and self-monitoring of their condition. It also entails equipping diabetes patients with the required skills and knowledge to manage crises, engage in self-care behaviors, and modify their lifestyles (Engelhard et al., 2018). Diabetes self-management programs improve the health status and behaviors of the patient.
Current Practice, the Identification of Clinical Issue, and the Need for the Project
The patients in my facility are receiving diabetes usual care. For instance, diabetes patients manage their condition based on advice from the practice nurse and general practitioner regarding appropriate medication, physical activity, and diet. Advice is not adequate in helping diabetes patients self-manage their condition. Therefore, a diabetes self-management program is necessary because it supports and promotes positive self-management behaviors resulting in improved quality of life and long-term diabetes outcomes. The program also reduces mortality and morbidity related to diabetes complications and is cost-effective. Therefore, self-management education program is necessary because it will improve diabetes patients’ outcomes and quality of life.
Steps That Will Be Involved In Implementing the Project
The first step in implementing the project is designing the self-management education program. The program will cover various topics, including an overview of diabetes, medication, physical activity, nutrition, social support and family involvement, monitoring of blood glucose levels, treatment, detection and prevention of diabetes-related complications, and dental, skin, and foot care. Other topics will include behavior change approaches, community and healthcare resources utilization, and psychological and stress adjustment. The topics will be printed on brochures and flyers to enhance patients’ understanding of diabetes self-management strategies. The program’s stakeholders will hold interactive classes with diabetic patients for four weeks. The programs will be organized weekly, and the target population will identify their preferred time to join the programs. For instance, individuals may choose to enroll in evening or daytime classes. However, individuals can meet the program manager individually to enhance their competence in using the blood glucose meter and their behavior modification. Although the program will take four weeks, the information will be posted on the company’s website to enhance patient access after the program completion.
The Impact of the Proposed Practice on Organizations, Patients, and Community
The patients will benefit from continuous support and education on managing and controlling diabetes. They will learn to cope with their condition, acquire self-management skills, and modify their behaviors. The program’s outcome will be enhanced quality of life, reduced complications and improved blood sugar levels. These outcomes will benefit the healthcare organization because of reduced costs of treating diabetes-related complications and overusing of emergency department. The community will also benefit because individuals will be productive because of improved quality of life. They will not skip work because the program will prevent diabetes-associated complications.
Assessing Need for Change
PICOT Question: In diabetic patients, does a diabetes self-management program compared to usual care improve glycemic control within four weeks?
P= Diabetic patients
I=Diabetes self-management program
C= Usual care
O= Improved glycemic control
T= Four weeks
Patient education is vital in enhancing successful diabetes self-management. The self-management program’s goal is to support and encourages diabetic patients to self-manage their behaviors to boost their health outcomes, control their blood sugar levels, and improve their quality of life. Additionally, the program reduces mortality and morbidity rates among diabetic patients, prevents complications, and reduces the financial burden on individuals and healthcare facilities related to managing diabetes-related complications (Kumah et al., 2018). Equally, group-based education compared to individual education is cost-effective because it reduces funding and the time required to teach individuals about diabetes self-management behaviors. Unlike personal visits, group-based diabetes self-management programs provide healthcare providers a chance to offer detailed information regarding the condition and respond to individual queries (Odgers‐Jewell et al., 2017). Additionally, the program makes it easier to engage carers and families and allow individuals to learn from others through support and discussion.
Existing self-management programs integrate multiple behavioral, psychological, and educational interventions. The programs also use collaborative and interactive teaching methods that reflect individual patients’ needs. Additionally, the program is characterized by brief instructions from nurses, dieticians, and physicians that aim to empower individuals to engage in behaviors that improve their health and well-being (Engelhard et al., 2018). Kumah et al. (2018) also note that diabetes self-management education programs benefit the patient through improved health behavior, health status, and healthcare services, further reducing the cost of treating diabetes-related conditions. Other benefits associated with diabetes self-management programs are improved weight loss, glycemic control, reduced blood pressure, increased awareness of diabetes and the importance of lifestyle modification, enhanced exercise habits and diet, and reduced need for diabetic prescriptions (Odgers‐Jewell et al., 2017). However, the program’s effectiveness should be supported by primary care providers, patients’ organizations, social and health organizations, voluntary health agencies, and the centers for disease control and prevention.
Health professionals, managers, and policymakers are trying to integrate self-management programs into healthcare settings, especially in European Countries like Denmark and Germany. However, integrating the program into the health system has faced significant barriers, including lack of engagement from health providers, challenges in recruiting patients, staff shortage, financial challenges, and accountability for the education program quality (Kumah et al., 2018). Regardless of these barriers, diabetes self-management education program benefits diabetic patients because by equiping them with the skills to manage their conditions effectively. For instance, diabetic patients learn to monitor their blood sugar levels frequently, remain active, eat healthy meals, cope with stress, and adhere to their treatment regimen (CDC, 2018). Also, the program is individualized based on the patient’s life experiences, goals, and needs and is founded on evidence-based standards. Overall, diabetes patients with the necessary support and information to manage their condition are healthier than their peers.
Change Design (Action Plan)
My overall objective is to empower diabetic patients to manage their condition by educating them about the importance of healthy eating, physical activity, monitoring their blood sugar levels, and adhering to their treatment regimen. Therefore, the implementation will be characterized by various activities as outlined in the table below:
|
Activities |
Timeline |
|
I week |
|
Two days |
|
Three days |
|
Two weeks |
The program is affordable and will be implemented by healthcare workers. Healthcare providers will use their time screening those at risk of diabetes and educating them on the importance of healthy eating and physical activity to reduce their risk of being diabetic. The approximate cost is $50. The cost will include travel expenses and the printing of flyers to increase individuals’ awareness of diabetes self-management techniques. An exercise trainer will be included in the design of fitness programs to reflect individual patients’ preferences. Exercise improves insulin sensitivity, boosts glycemic control, and prevents diabetes-related complications like cardiovascular damage.
Factors that May Hinder or Assist the Implementation of the Program
Various factors will enhance the implementation of diabetes self-management programs. The involvement of peers or family members will support and encourage diabetic patients to manage their conditions. Also, the program’s effectiveness will depend on individual patients’ resolution to self-manage their condition and reduce their vulnerability to diabetes-related complications. Also, communication effectiveness between patients and healthcare providers will determine the patient’s involvement in the program. For instance, a relationship based on shared decision-making, respect, and trust will compel diabetic patients to participate in the diabetes self-management program (Adu et al., 2019). Other factors like higher education levels, self-efficacy, and sufficient self-management skills will contribute to individuals’ participation in diabetes self-management.
However, barriers like non-medication adherence, difficulty making lifestyle modifications such as eating healthy or being active, inadequate diabetes self-management skills, financial constraints, and language barriers may undermine the implementation of diabetes self-management programs (Adu et al., 2019). Addressing these barriers is paramount because the program will improve diabetic patients’ health outcomes and quality of life while reducing the healthcare costs incurred by the community, patients, and healthcare providers in treating diabetes-related complications.
Evaluation Plan for Project Assessment
Evaluation provides project managers with a systematic method to assess intervention effectiveness in achieving its goals. The evaluation helps determine the program’s strengths and weaknessess and identify ways to address the program’s challenges. Therefore, program managers use program evaluation to identify improvement efforts, collect information about what works or does not work well with the program, and seek support to enhance the program’s effectiveness. Program evaluation also provides answers to various questions like are the target audience benefiting from the diabetes self-education program? Do healthcare workers have adequate skills and training to deliver the program, are the target audience contended with the program?. The answers to these questions will help the project managers to channel resources to vital elements that will benefit the target population. Although program evaluation may appear overwhelming, expensive, and complicated, it acts as a strategy to boost the program’s effectiveness. Additionally, program evaluation helps target and streamline resources and share lessons and findings with other healthcare facilities to improve patient healthcare outcomes.
The Criteria that will be used to evaluate the Project Results
The program’s effectiveness will be evaluated using survey questions and interviews. Healthcare providers will be surveyed to determine the program’s effectiveness (see appendix). For instance, they will help identify data about diabetic patients and whether their admission rate has increased or declined. Additionally, healthcare providers will provide details about patients’ awareness of diabetes, complications associated with the disease, and lifestyle modifications required to manage the diseases. Patients will also be interviewed to determine the program’s effectiveness in their lives, including its influence on lifestyle modification, glucose monitoring, and treatment adherence. The patients should verbalize self-management strategies to control diabetes. Additionally, the number of patients visiting the facility because of abnormal blood sugar levels should considerably decline, suggesting program effectiveness in self-managing diabetes and preventing complications associated with the disease.
How Change Should Be Communicated To the Stakeholders
Ineffective communication can result in change resistance. Therefore, the first step is talking to the stakeholders, including board members, volunteers, nursing staff, and healthcare administrators about the change process to build trust and credibility. Engaging staff in the change process will enhance their buy-in and improve the patient’s experience. The second strategy is helping the stakeholders understand the need for change. I will communicate the need for change in a compelling way so that stakeholders can comprehend and accept the change. The communication will address the how, when, what, and who specifics of the change process. I will also communicate how the change fits in the larger context of the changes in the healthcare industry. I will also use various strategies to communicate the change to stakeholders, including e-newsletters and email, automated email updates, project summary reports, presentations, and face-to-face meetings. However, the communication strategies will depend on the stakeholders’ health literacy levels, cultural competence, media exposure, and internet access.
How I Will Integrate the Change into Practice
I will use various strategies to integrate change into practice. The first strategy is frequent communication at individual, operational, and strategic levels. Effective communication will ensure that individuals understand the details of the change practice, those involved, project expectations, and change implications on patients and practice. Effective communication will allow stakeholders to raise their concerns regarding the project, ask questions, make suggestions, and make clarifications. The second strategy is fostering a team culture to ensure individuals understand their role and expectations in meeting the change objectives. The culture will ensure that individuals are empowered to work towards change implementation as a team and contribute ideas that will enhance the effectiveness of the change program. The third strategy for integrating change into practice is identifying and empowering change champions. The champions will lead others to achieve the change goals. I will provide the change champions with the resources and tools required to integrate the change into practice, and provide positive reinforcement and feedback. Constructive feedback will sustain the change process by celebrating successes and milestones to boost change efforts and enhance team cohesion.
How Change should be monitored
Change will be monitored by recording and evaluating data to determine project failures, barriers, or successes. Data assessment will identify the project’s negative and positive impacts during the implementation phase. Data collection and evaluation will provide project leaders with the necessary information to identify the way forward to modify or celebrate the project’s successes. Equally, the collected data will identify aspects of the change process that undermined the effective implementation of the project. Similarly, the data will expose processes that are working and those that should be embraced to improve change outcomes. Therefore, continued monitoring of the change initiative will highlight whether a combination of initiatives will be crucial to determine the project sustainability, and the changes required in the future to enhance the change initiative’s success.
Summary
Diabetes is a preventable and manageable condition. However, it remains a significant public health challenge globally, and leading cause of mortality in high-income countries and an epidemic in developing nations. Diabetes prevalence is attributable to reduced activity levels, unhealthy diet, urbanization, aging populations, and increased obesity prevalence. Diabetes exerts a considerable financial burden on individual patients, their families, and the healthcare system. It is also associated with severe complications, including kidney failure, myocardial infraction, and stroke, blindness, and limb amputation. However, effective treatment and early diagnosis can reverse the disease trend globally. Equally, patient awareness of the diseases, its complications, and prevention can reduce diabetes-related complications and the financial burden associated with it.
Diabetes self-management program equips patients with the necessary knowledge and skills to manage their condition, engage in self-care behaviors like glucose monitoring, being active, and eating healthy. Additionally, the program reduces mortality and morbidity rates among diabetic patients, prevents complications, and reduces the financial burden on individuals and healthcare facilities related to managing diabetes-related complications. Equally, diabetes self-management education is cost-effective because it reduces funding and the time required to teach individuals about diabetes self-management behaviors. Also, group-based diabetes self-management programs allows healthcare providers to offer detailed information regarding the condition and respond to individual queries. Additionally, the program makes it easier to engage carers and families, and allows individuals to learn from others facing the same disease burden through support and discussion. Given the benefits of diabetes self-management education, the practice should be integrated into practice.
References
Adu, M. D., Malabu, U. H., Malau-Aduli, A. E., & Malau-Aduli, B. S. (2019). Enablers and barriers to effective diabetes self-management: A multi-national investigation. PloS one, 14(6), e0217771. https://doi.org/10.1371/journal.pone.0217771
CDC.(2018, December 18). Managing diabetes. Retrieved from, https://www.cdc.gov/learnmorefeelbetter/programs/diabetes.htm
Engelhard, C., Lonneman, W., Warner, D., & Brown, B. (2018). The implementation and evaluation of health professions students as health coaches within a diabetes self-management education program. Currents in Pharmacy Teaching and Learning, 10(12), 1600-1608.
Kumah, E., Sciolli, G., Toraldo, M. L., & Murante, A. M. (2018). The diabetes self-management educational programs and their integration in the usual care: A systematic literature review. Health policy, 122(8), 866-877. https://doi.org/10.1016/j.healthpol.2018.06.003
Odgers‐Jewell, K., Ball, L. E., Kelly, J. T., Isenring, E. A., Reidlinger, D. P., & Thomas, R. (2017). Effectiveness of group‐based self‐management education for individuals with Type 2 diabetes: a systematic review with meta‐analyses and meta‐regression. Diabetic Medicine, 34(8), 1027-1039. https://doi.org/10.1111/dme.13340
Appendix
Healthcare Providers Survey Question
- Can you explain the effectiveness of diabetes self-management education program in improving patient’s health outcomes
- Highlight the strengths and weakness of the program
- What do you think should be done to improve the program effectiveness
- What was the program’s impact on the practice and healthcare organization?
