Capstone Change Project Proposal Essay

Capstone Change Project Proposal Essay

 

Background

Diabetes is among the chronic conditions that result in multiple health and economic ramifications, including mortalities, increased care costs, and compromised quality of life. According to the Centers for Disease Control and Prevention (CDC, 2021), more than 37 million Americans have diabetes, representing one in ten Americans. Out of the total population with diabetes, 90-95% of them have type 2 diabetes which emanates from the body’s inability to respond normally to insulin, leading to insulin resistance. The high prevalence of type 2 diabetes is consistent with people’s exposure to multiple risk factors such as physical inactivity, sedentary lifestyle, alcoholism, smoking, unhealthy diets, and psychosocial issues like low education attainment (Bellou et al., 2018). Although the disease’s symptoms are progressive and difficult to notice, diabetes type 2 manifests through fatigue, blurred vision, thirst, hunger sensations, unintended weight loss, slow-healing sores, and frequent urination (Mayo Clinic, 2021). Diabetes Self-Management Education and Support (DSEMS) and adherence to pharmacologic interventions emerge as the primary treatment and management approach for type 2 diabetes. Amidst the need to empower patients to address risk factors for the disease, it is essential to train and educate them to promote preventive behaviors and improve their quality of life.

Clinical Problem Statement

Undoubtedly, type 2 diabetes is among the leading causes of global mortalities and increased care costs. Goyal & Jialal (2021) contend that the international diabetes federation (IDF) predicts a global prevalence of about 600 million by 2040 if effective preventative and treatment measures are inadequate. With such expectations of the upsurge in the global prevalence of diabetes and the subsequent ramifications, it is essential to emphasize the need for educating and training diabetic patients about the tenets of self-management. According to Dehghan et al. (2017), the primary focus of training and educating diabetic patients about self-care promotes self-efficacy. In essence, diabetes management self-efficacy is consistent with diabetic patients’ confidence in diet control, exercise, and medical treatment. The need to bolster self-efficacy when managing type 2 validates the rationale for shifts from the regular Diabetes Self-Management Training (DSMT) to more comprehensive, weekly self-management training and education programs.

Purpose of the Change Proposal concerning Providing Patient Care in the Changing Healthcare System

Undeniably, empowering patients to implement self-care interventions is one of the norms in the current healthcare systems that seek to reduce the burden of chronic conditions. When preventing and managing type 2 diabetes, training and educating patients about effective self-management interventions translates to improved outcomes. According to Powers et al. (2020), diabetes Self-Management Education and Support (DSMES) can improve clinical and behavioral outcomes, including improving hemoglobin (A1C), reducing the onset and worsening of diabetes-related complications, improving quality of life, and enhancing lifestyle behaviors like healthful meal planning and participation in regular physical activity. As a result, implementing this capstone change project proposal is consistent with the overarching objectives of reducing the severity of diabetes-related complications and promoting preventative behaviors such as lifestyle changes and physical activeness.

PICOT Question

Among adults with type 2 diabetes (P), is it possible for a weekly self-management training and education program in a nursing home and rehab facility (I), in contrast with regular Diabetes Self-Management Training (DSMT) (C), to enhance greater understanding of diabetes self-management behavior and improve quality of life (O), within 2 months?

Literature Search Strategy

This study involved insights from external evidence, especially scholarly articles that support the tenets of diabetes self-management training and education. The criteria for selecting appropriate literature for this study involved various aspects, including the utilization of keywords and subtitles, considerations of peer reviews, publications’ databases, and literature’s currency. The ideal keywords and subtitles for selecting literature include diabetes self-management training and education, diabetes management self-efficacy, educating diabetic patients, and patient education to promote preventive behavior. On the other hand, only sources from reputable databases such as SAGE, PUBMED, CINAHL, and the Centers for Disease Control and Prevention (CDC) satisfied the criteria. Finally, the study uses scholarly articles and publications published between 2017 and 2022 to ensure that the information is up-to-date.

Evaluation of Literature

Undoubtedly, evaluating the selected literature is an essential strategy for promoting the tenets of evidence-based practice. Although various frameworks and models for appraising evidence sources exist, this study relies massively upon the CRAAP (currency, relevance, authority, accuracy, and purpose) test as the primary strategy for evaluating the literature. According to Kurpiel (2018), this framework requires researchers to include current, relevant, authoritative, accurate, and purposeful evidence that answers clinical questions. For example, it is essential to determine how the information relates to the topic or research question when assessing the sources’ relevance. Equally, it is crucial to establish authors’ or publishers’ credibility when assessing the sources’ authority (Kurpiel, 2018). By adhering to these considerations, it is possible to select and use credible evidence sources that support or answer the PICOT question.

Applicable Change or Nursing Theory

The nursing theory that resonates with the need to empower patients through training and education is Dorothea Orem’s self-care theory. Hellqvist (2021) contends that Orem’s self-care deficit theory operates under the premise that nursing interventions should aim at strengthening patients’ ability to perform self-management activities to maintain life, health, and well-being. The major contention of Orem’s theory positions patients at the forefront of concerted efforts to address health threats such as diseases. Borji et al. (2017) argue that nurses can help patients to regain their health by providing direct care and educating them. By educating and training patients grappling with type 2 diabetes, it is possible to improve their health and enhance the quality of their lives.

Proposed Implementation Plan with Outcome Measures

The proposed project encompasses educating and training diabetic patients about appropriate self-care interventions. In this sense, it contains various approaches, including educating patients about healthy diet planning, physical activities, self-monitoring approaches, and assisting them to transform risky behaviors and lifestyle habits like smoking and alcoholism. The implementation of weekly education programs will rely massively upon stakeholder collaboration and other components of the project cycle, including need assessment, proper planning, and budgeting, developing stakeholder partnerships, settings goals and objectives, allocating responsibilities, and evaluating the project. The desired outcome measures of the project include:

• Enhance patient’s knowledge and awareness of self-care interventions for reducing the severity of diabetes-related complications
• Improve patients’ knowledge of vital sign monitoring
• Promote preventative behaviors by enhancing patients’ participation in physical activities, healthy diet plans, and smoking cessation initiatives.

How Evidence-based Practice Influenced the Intervention Plan

Undoubtedly, evidence-based practice is a profound dimension that improves nursing research activities and clinical practices by prompting healthcare professionals to utilize the best available evidence in supporting decisions and improving practices (Dagne & Beshah, 2021). When developing the intervention plan, the need to consider insights from the current literature became a prerequisite for evaluating the effectiveness of weekly diabetes self-management training and education programs. In essence, many scholarly articles support the importance of educating and training patients on appropriate diabetes management strategies. The presence of scholarly backing renders the intervention plan empirically testable and justifiable.

Evaluation Plan

Project evaluation processes are essential in determining whether the project is consistent with the strategic objectives. Also, these processes reveal discrepancies between the implemented version and the proposed project. When evaluating this intervention plan, it would be essential to conduct weekly formative assessments and one summative evaluation. In this sense, formative assessments will reveal unanticipated barriers, justify the processes for plan implementation, and expose participants’ satisfaction levels, opinions, and perspectives on the plan. On the other hand, a summative evaluation will determine whether the program has achieved the desired objectives and reveal the need to duplicate, replace, or improve the project. The evaluation team will conduct a summative evaluation after 2 months to determine the project’s outcomes and inputs in promoting participants’ ability to implement self-management interventions for managing type 2 diabetes.

Potential Barriers to Plan Implementation and Possible Solutions

The potential barriers to the plan implementation are lack of stakeholder support, knowledge constraints, and participants’ unwillingness to change their behavior. It is possible to address the problem of limited stakeholder support by convincing medical partners to support the change project by providing justifications for the change process. At this point, providing scientific findings that support the project can be ideal in convincing stakeholders to support the project. Secondly, it is plausible to address the problems of participants’ knowledge constraints and unwillingness to change their behavior by educating them about the adverse consequences of diabetes and appropriate self-management interventions. Notably, patient education is vital in dismantling unhealthy perceptions of the project and enhancing their knowledge of various self-care interventions.

Conclusion

Type 2 diabetes poses health and economic challenges to the global healthcare systems by increasing mortality rates, care costs and compromising quality of care. Amidst dynamics in healthcare systems, patients emerge as ideal stakeholders for improving health and addressing chronic conditions. As a result, educating and training them on appropriate self-management approaches for preventing and managing diabetes can improve their health and reduce the disease’s health and economic burdens. This paper discusses the background and clinical problem of diabetes, the purpose of educating and training patients, literature search and evaluation strategies, applicable nursing theory, evaluation processes for the intervention plan, and potential barriers to effective plan implementation and possible solutions.

ORDER A PLAGIARISM-FREE PAPER HERE

References

Bellou, V., Belbasis, L., Tzoulaki, I., & Evangelou, E. (2018). Risk factors for type 2 diabetes mellitus: An exposure-wide umbrella review of meta-analyses. PLOS ONE, 13(3), e0194127. https://doi.org/10.1371/journal.pone.0194127

Borji, M., sharifi, A., Otaghi, M., & kazembeigi. (2017). The impact of Orem’s self-care model on the quality of life in patients with type II diabetes in Ilam. Biomedical and Pharmacology Journal, 10(1), 213–220. https://doi.org/10.13005/bpj/1100

Centers for Disease Control and Prevention. (2021, December 16). Type 2 Diabetes. https://www.cdc.gov/diabetes/basics/type2.html#

Dagne, A. H., & Beshah, M. H. (2021). Implementation of evidence-based practice: The experience of nurses and midwives. PLOS ONE, 16(8), e0256600. https://doi.org/10.1371/journal.pone.0256600

Dehghan, H., Charkazi, A., Kouchaki, G. M., Zadeh, B. P., Dehghan, B. A., Matlabi, M., Mansourian, M., Qorbani, M., Safari, O., Pashaei, T., & Mehr, B. R. (2017). General self-efficacy and diabetes management self-efficacy of diabetic patients referred to diabetes clinic of Aq Qala, North of Iran. Journal of Diabetes & Metabolic Disorders, 16(1). https://doi.org/10.1186/s40200-016-0285-z

Goyal, R., & Jialal, I. (2019, February 24). Diabetes mellitus type 2. Stat Pearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK513253/

Hellqvist, C. (2021). Promoting self-care in nursing encounters with persons affected by long-term conditions—a proposed model to guide clinical care. International Journal of Environmental Research and Public Health, 18(5), 2223. https://doi.org/10.3390/ijerph18052223

Kurpiel, S. (2018). Research guides: Evaluating sources: The CRAAP test. Benedictine University. https://researchguides.ben.edu/source-evaluation

Mayo Clinic. (2021, January 20). Type 2 diabetes – Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/symptoms-causes/syc-20351193

Powers, M. A., Bardsley, J. K., Cypress, M., Funnell, M. M., Harms, D., Hess-Fischl, A., Hooks, B., Isaacs, D., Mandel, E. D., Maryniuk, M. D., Norton, A., Rinker, J., Siminerio, L. M., & Uelmen, S. (2020). Diabetes self-management education and support in adults with type 2 diabetes: A consensus report of the American Diabetes Association, the Association of Diabetes Care & Education Specialists, the Academy of Nutrition and Dietetics, the American Academy of Family Physicians, the American Academy of PAs, the American Association of Nurse Practitioners, and the American Pharmacists Association. The Diabetes Educator, 350–369. https://doi.org/10.1177/0145721720930959

 

Assessment Description
In this assignment, students will pull together the capstone project change proposal components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. For this project, the student will apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice.

Develop a 1,250-1,500 written project that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal:

Background
Clinical problem statement.
Purpose of the change proposal in relation to providing patient care in the changing health care system.
PICOT question.
Literature search strategy employed.
Evaluation of the literature.
Applicable change or nursing theory utilized.
Proposed implementation plan with outcome measures.
Discussion of how evidence-based practice was used in creating the intervention plan.
Plan for evaluating the proposed nursing intervention.
Identification of potential barriers to plan implementation, and a discussion of how these could be overcome.
Appendix section, if tables, graphs, surveys, educational materials, etc. are created.
Review the feedback from your instructor on the Topic 3 assignment, PICOT Question Paper, and Topic 6 assignment, Literature Review. Use this feedback to make appropriate revisions to these before submitting.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

RN to BSN

1.1: Exemplify professionalism in diverse health care settings.

2.2: Comprehend nursing concepts and health theories.

3.2: Implement patient care decisio

ORDER A PLAGIARISM-FREE PAPER HERE

Assignment #3 and #6 are similar. here is a copy.

PICOT statement for diabetes self-managementAccording to American Diabetes Association type 2 diabetes is a lifestyle disease that affects more than 10 percent of the Population in the Unites of America. Diabetes affects the way the body uses glucose in the blood. The symptoms of diabetes can range from mild to severe. Although diabetes is symptomatic, it can go unnoticed for certain people, or if they notice they lack of knowledge on the self-management of the condition. For patients to live their life to the fullest and reduce risk of complication it is important for them to properly manage their condition. This projects tends to increase type 2 diabetes self-management skills for patients who currently diagnosed with diabetes trough teaching and guidance on diabetes management. Diabetes Self-management training (DSMT) is a great tool health care providers use to manage diabetes, however other tools such as education and training are proving to be beneficial in increasing patient knowledge and self-management behavior. This topic plans to increase patient quality of life and better self-management through training and education.PICOT QuestionAmong adults with type 2 diabetes (P), is it possible for a weekly self-management training and education program in a nursing home and rehab facility (I), in contrast with regular DSMT, (C) enhance greater understanding diabetes self-management behavior and improve quality of life, (O) with a period of 2 months. (T)?Evidence-based solutionsThe proposed plan for type 2 diabetes self-management is an ongoing weekly training for 2 months. There more than one intervention that can be implemented to enhance patient quality of life living with diabetes. The combined intervention of dietary changes, maintain self-care, medication administration and increased physical activity in adults reduces the risk of developing complication associated with type 2 diabetes.Nursing interventionThere multiple steps nurses can take to help patients diagnosed with type 2 diabetes to properly self-manage the condition. Among many steps, nurses can encourage patients with type 2 diabetes to: Testing blood sugar on a regular basis, Consuming balanced meals and appropriate portion sizes, engaging in regular exercise, drinking water and avoiding dehydration, taking medications as prescribed, adjusting medications as needed, conducting self-foot checks and check with their doctor if something feels abnormal. Patient careThese interventions are linked to improve overall quality of life anyone living with type 2 diabetes. These interventions can reduce complications associated with type 2 diabetes such as high blood sugar levels, mortality risk, health care cost as well as excess weight.Health care agencyThe setting for my practicum immersion is in a nursing and rehabilitation center. The place has both short-term and long-term patients that can benefit with the training and education.
Nursing practiceImplementing the type 2 diabetes self-management training and education will greatly impact the daily nursing practice of those nurses who provide care for patients affected with type 2 diabetes. By educating patients to properly and efficiently self-manage type 2 diabetes the nurse empowers them to take control of their health, their life while at the same time reducing the burden on nurses, the shortage of nurses and give nurses more time to focus on other complicated health issues.References:https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/DSMT-Accreditation-ProgramManaging Diabetes: Medicare Coverage & Resources [PDF, 1220 KB] (in Spanish [PDF, 6027 KB])

feedback:
Instructor Comments

Good PICOT statement, nice detail. Good adherence to the rubric