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NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice

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Capella University

NURS-FPX 6011 Evidence-Based Practice for Patient-Centered Care and Population Health

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Implementing Evidence-Based Practice

Diabetes Mellitus (DM) is a critical worldwide medical concern that has evolved to epidemic levels in the past few years. DM is a complex illness caused by unusual body responses towards insulin, resulting in hyperglycemia. It ultimately causes significant health risks and several chronic diseases (Zhao et al., 2020). Diabetes treatment with drugs is expensive. According to studies, a lifestyle modification program that emphasizes healthy food and workout can lower the incidence of DM by about 50% for high-threat patients (CDC, 2024). To treat and control diabetes effectively and improve patient outcomes, healthcare practitioners must employ Evidence-Based Practice (EBP) procedures (Janssen et al., 2020). This assessment proposes an evidence-based approach to improve the standard of care for adult American DM patients.

Develop a PICOT Question for a Chosen Clinical Problem

A PICO(T) is a technique for developing a clinical question by specifying the patient Population, Intervention, Comparison, Outcome, and Time frame. For adult American individuals with DM (P), does a telehealth-based lifestyle management education program (I) compared to traditional clinical administration (C) result in an improvement in self-management of diabetes (O) over three months (T)? 

  • Population (P):  For adult American individuals with DM
  • Intervention (I): Telehealth-based lifestyle management education programs
  • Comparison (C): Traditional clinical administration
  • Outcome (O): Improvement in self-management of diabetes
  • Timeline (T): Three months

Background on the Clinical Problem

DM is the most costly and prevalent long-term condition in the United States. Diabetes can lead to significant health issues and organ damage. It can result in other serious health issues, including cardiac disorders, renal complications, and strokes. Most DM patients have a shorter lifespan as compared to healthy individuals. One-third of all Americans are expected to develop DM at some stage in life (Koyama et al., 2022). Center for Disease Control and Prevention (CDC) highlighted that DM difficulties are rising in adults aged 45 to 64. Providing care for DM accounts for one out of four dollars allocated to medical care in the United States. A total of $237 billion is invested in primary expenses related to healthcare, alongside a further $90 billion in reduced efficiency (CDC, 2024).

Outline an Action Plan to Implement the Evidence-Based Project 

This proposed action plan presents a reasonable strategy for implementing a telehealth-based extensive lifestyle modification education program for adult American diabetes patients. The plan focuses on developing culturally appropriate educational resources and educating medical professionals in telehealth administration (Joo & Liu, 2021).

Collaboration and coordination with medical professionals and community groups will assist in developing an inter-professional team that will provide complete care to adult DM patients. Implementing telehealth tools for video-based interactive sessions and secure confidential data gathering will improve the educational program’s efficacy. It also enables the monitoring of participants to manage improved eating habits and physical activity (Gonzalez et al., 2022).

This action plan implies a three-month execution time frame. The first month is devoted to designing culturally responsive educational resources and advocating for legislative changes (Joo & Liu, 2021). The second month is dedicated to implementing counseling and educational programs and establishing collaboration and coordination with community groups and medical professionals (Gonzalez et al., 2022). The third month is dedicated to assessing the interventions’ effects on adult American diabetes patients by obtaining feedback and making any required changes to ensure the plan’s effectiveness (Poppe et al., 2019).

NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice

Appropriate resources and capabilities are required to properly execute telehealth-based education and classes, like video consultation, allowing communication among medical professionals and DM patient participants (Joo & Liu, 2021). DM patients also require fitness tracking devices or smartphone applications to monitor their exercise or physical activity levels and communicate this information to their medical staff for plan enhancement (Poppe et al., 2019).

The action plan for delivering a telehealth-based integrated lifestyle modification education program is practical and reasonable (Badri & Hamdy, 2021). The approach emphasizes creating culturally sensitive and successful educational programs for the adult American community (Joo & Liu, 2021). Collaborations and coordination with community groups and medical experts promote comprehensive therapy by leveraging digital platforms for collaborative discussions and safe information sharing. The three-month action plan enables effective development, execution, and assessment of the educational program’s effectiveness (Sharma et al., 2024).

Stakeholders, Opportunities for Innovation, and Potential Barriers 

The effective execution of the telehealth-based lifestyle modification education program necessitates stakeholder involvement. Medical officials and adult American DM patients are critical stakeholders. Medical professionals will take on a significant part in implementing the initiative, while adult American DM patients will be the primary recipients. Collaboration and coordination with community groups are critical for DM patients’ medical requirements and continuous assistance (Drovandi et al., 2023).

Establishing culturally adapted educational resources to accommodate the varied cultural backgrounds of adult Americans is an opportunity for innovation for DM management. Understanding patients’ unique desires and requirements can improve patients’ involvement and the program’s efficacy. Employing telehealth services, like live video discussions and safe collection and sharing of data platforms, will make medical care more accessible to all DM patients, irrespective of geographical barriers (Tan et al., 2019).

Barriers and Solutions

Significant hurdles must be addressed to ensure the program’s achievement. Some adult American DM patients struggle because of restricted availability of technology, like slow connections or inadequate connectivity in impoverished regions. Integrated promotional activities and educational programs in remote regions can assist with overcoming internet access constraints by promoting awareness of the benefits of telehealth benefits (Samarraie et al., 2021). Moreover, language challenges and cultural differences can impede communication among medical professionals and patients.

Language difficulties can be overcome by providing language assistance services, such as interpreters and translation services, to enable clear communication. Furthermore, implementing cultural competency techniques and creating understanding among medical professionals about the positive aspects of telehealth and the need for cultural competence can assist in resolving any reluctance or lack of knowledge (Schouten et al., 2020).

Propose Outcome Criteria to Evaluate the Evidence-Based Practice Project 

The EBP project’s evaluation will concentrate on improved self-care among adult American DM patients in telehealth-based education sessions. EBP like patient questionnaires, feedback approaches, and medical assessments can be used to measure an EPB initiative’s performance in reducing DM complications and enhancing self-care (Poppe et al., 2019).

These outcome metrics will demonstrate the program’s efficiency in better self-management objectives. Surveys can examine various factors, including patient satisfaction with the educational intervention, improvements in eating habits, and workout activity. Feedback provides insight into the aspects that need further improvements. Clinical evaluations of serum sugar levels and glycated hemoglobin indicate the intervention’s efficacy in DM management (Sawani et al., 2020).

The assessment of participants’ compliance with prescribed lifestyle changes, such as eating habits and routine exercise patterns. The assessment will aid in estimating the practicality and long-term viability of adopting these changes using telehealth (Garedow et al., 2023). Furthermore, participant satisfaction and involvement with the telehealth-based educational sessions will be evaluated, encompassing effectiveness, accessibility, and compliance with medical professional support. Integrating patient opinions and needs in policies and guidelines for offering lifestyle modification educational sessions using telehealth can improve EBP and patient outcomes (Joo & Liu, 2021).

NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice

Evaluating permanent behavioral alterations in the diet by tracking persistent lifestyle shifts after the program’s completion aids in assessing the program’s efficacy among adult American diabetes patients. These outcome evaluations will serve as best practices and offer guidelines for diabetes management among adult Americans (Garedow et al., 2023).

The evaluation results are consistent with the Quadruple Aim concept, which focuses on strengthening medical systems. The EBP initiative intends to improve the medical conditions of adult American diabetes patients by assessing a drop in complications and enhancing self-management (Pearson et al., 2019). Monitoring participants’ compliance with lifestyle changes and their participation helps to improve patient outcomes.

Furthermore, monitoring behavior change benefits adult American DM patients’ health by encouraging persistent lifestyle modifications. These findings reflect the quadruple goal of addressing medical outcomes, DM patient satisfaction, and diabetes control among the adult American population with telehealth-based education programs (Garedow et al., 2023).

Evaluate the Evidence that Supports the Need for Practice Change

The efficacy and applicability of EBP for a related issue can be evaluated by assessing the significance and relevance of the research supporting the practice change (Dhediya et al., 2023). A systematic research approach was used to discover appropriate research and literature for assessment. Databases like PubMed, Science Direct, Google Scholar, and CINAHL are employed to evaluate material. The keywords used for research are diabetes management, lifestyle modifications, telehealth and diabetes management, and the American diabetic population. In the last five years, research resources were only considered.

The evidence’s validity and relevance to adult Americans with diabetes were evaluated extensively. By carefully analyzing the data, medical personnel and stakeholders can make educated and well-informed choices on the necessity for an approach and the implementation of telehealth-based lifestyle modification. The assessment guarantees that evidence-based guidelines and suggestions are based on credible and pertinent research findings (Dhediya et al., 2023).

For instance, Gonzalez et al. (2022), highlighted that employing a telehealth strategy for lifestyle modification educational sessions among adult American DM patients has successfully reduced DM complications. The approach has led to significant outcomes, notably in boosting self-management. The research demonstrates that telehealth for lifestyle modification training can be a beneficial approach to managing diabetes-related problems in the adult American population, leading to successful self-control (Joo & Liu, 2021).

Conclusion

In conclusion, the PICOT question is a valuable tool for the clinical research of a particular issue. DM is a persistent and complicated health issue. Telehealth services providing self-management and lifestyle modification education are vital to improving patient outcomes. Implementing culture competency strategies and language approaches improves communication among adult American DM patients and medical professionals, improving self-care abilities.

References

Badri, A. M., & Hamdy, O. (2021). Diabetes clinic reinvented: Will technology change the future of diabetes care?. Therapeutic Advances in Endocrinology and Metabolism12, 2042018821995368. http://dx.doi.org/10.1177/2042018821995368

CDC. (2024). Health and economic benefits of diabetes interventions. cdc.gov https://www.cdc.gov/chronicdisease/programs-impact/pop/diabetes.htm

Dhediya, R., Chadha, M., Bhattacharya, A. D., Godbole, S., & Godbole, S. (2023). Role of telemedicine in diabetes management. Journal of Diabetes Science and Technology17(3), 775-781. https://doi.org/10.1177/19322968221081133

Drovandi, A., Wong, S., Seng, L., Crowley, B., Alahakoon, C., Banwait, J., & Golledge, J. (2023). Remotely delivered monitoring and management of diabetes-related foot disease: An overview of systematic reviews. Journal of Diabetes Science and Technology17(1), 59-69. https://doi.org/10.1177/19322968211012456

NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice

Garedow, A. W., Jemaneh, T. M., Hailemariam, A. G., & Tesfaye, G. T. (2023). Lifestyle modification and medication use among diabetes mellitus patients attending Jimma university medical center, Jimma zone, south west Ethiopia. Scientific Reports13(1), 4956. https://doi.org/10.1038%2Fs41598-023-32145-y

Gonzalez, S. M. D. R., Bourguet-Ramirez, B., Lazaro-Carrera, L. S., Martagon-Rosado, A. J., Gomez-Velasco, D. V., & Viveros-Ruiz, T. L. (2022). Evaluation of a web platform to record lifestyle habits in subjects at risk of developing type 2 diabetes in a middle-income population: Prospective interventional study. Journal of Medical Internet Research Diabetes7(1), e25105. https://doi.org/10.2196/25105

Joo, J. Y., & Liu, M. F. (2021). Experience of culturally-tailored diabetes interventions for ethnic minorities: A qualitative systematic review. Clinical Nursing Research30(3), 253-262. https://doi.org/10.1177/1054773819885952

Kloda, L. A., Boruff, J. T., & Alexandre Soares Cavalcante. (2020). A comparison of Patient, Intervention, Comparison, Outcome (PICO) to a new, alternative clinical question framework for search skills, search results, and self-efficacy: A randomized controlled trial. Journal of the Medical Library Association108(2). https://doi.org/10.5195/jmla.2020.739

Koyama, A. K., Cheng, Y. J., Brinks, R., Xie, H., Gregg, E. W., Hoyer, A., & Imperatore, G. (2022). Trends in lifetime risk and years of potential life lost from diabetes in the United States, 1997–2018. Plos One17(5), e0268805. https://doi.org/10.1371/journal.pone.0268805

Pearson, T. L., Bardsley, J., Weiner, S., & Kolb, L. (2019). Population health: The diabetes educator’s evolving role. The Diabetes Educator45(4), 333-348. https://doi.org/10.1177/0145721719857728

NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice

Poppe, L., De Bourdeaudhuij, I., Verloigne, M., Shadid, S., Van Cauwenberg, J., Compernolle, S., & Crombez, G. (2019). Efficacy of a self-regulation–based electronic and mobile health intervention targeting an active lifestyle in adults having type 2 diabetes and in adults aged 50 years or older: Two randomized controlled trials. Journal of Medical Internet Research21(8), e13363. https://doi.org/10.2196/13363

Samarraie, A. H., Ghazal, S., Alzahrani, A. I., & Moody, L. (2020). Telemedicine in Middle Eastern countries: Progress, barriers, and policy recommendations. International Journal of Medical Informatics141, 104232. https://doi.org/10.1016/j.ijmedinf.2020.104232

Sawani, S., Siddiqui, A. R., Azam, S. I., Humayun, K., Ahmed, A., Habib, A., & Iqbal, R. (2020). Lifestyle changes and glycemic control in type 1 diabetes mellitus: A trial protocol with factorial design approach. Trials21(1), 1-9. https://doi.org/10.1186/s13063-020-4205-7

Schouten, B. C., Cox, A., Duran, G., Kerremans, K., Banning, L. K., Lahdidioui, A., & Krystallidou, D. (2020). Mitigating language and cultural barriers in healthcare communication: Toward a holistic approach. Patient Education and Counseling103(12), 2604-2608. https://doi.org/10.1016/j.pec.2020.05.001

Sharma, V., Feldman, M., & Sharma, R. (2024). Telehealth technologies in diabetes self-management and education. Journal of Diabetes Science and Technology18(1), 148-158. https://doi.org/10.1177/19322968221093078

Tan, E., Khoo, J., Gani, L. U., Malakar, R. D., Tay, T. L., Tirukonda, P. S., & Tang, T. Y. (2019). Effect of multidisciplinary intensive targeted care in improving diabetes mellitus outcomes: A randomized controlled pilot study–the Integrated Diabetes Education, Awareness and Lifestyle Modification in Singapore (IDEALS) program. Trials20(1), 1-10. https://doi.org/10.1186/s13063-019-3601-3

Zhao, X., An, X., Yang, C., Sun, W., Ji, H., & Lian, F. (2023). The crucial role and mechanism of insulin resistance in metabolic disease. Frontiers in Endocrinology14https://doi.org/10.3389/fendo.2023.1149239

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