NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice

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NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice

NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice

Name

Capella university

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

Prof. Name

Date

Implementing Evidence-Based Practice

Type 2 Diabetes Mellitus (T2DM) is a type of diabetes caused by inadequate functioning of pancreatic beta cells. It has severe implications for the functioning and quality of individuals’ lives. T2DM is a crucial public medical condition that has reached pandemic proportions in the past decade (Padhi et al., 2020). It poses serious health threats and contributes to a number of long-lasting disorders. The pharmaceutical care of T2DM is costly, putting financial strain on patients and the medical system. Research by Sarker et al. (2020), revealed that non-pharmacological approaches, including nutrition therapy, Body Mass Index (BMI) management, active lifestyle, and physical activity, assist in improving the conditions of T2DM patients. It also aids significantly in avoiding T2DM. Medical providers should use Evidence-Based Practice (EBP) approaches to treat and control T2DM successfully and enhance the quality of life for patients (Mathieson et al., 2019). This assessment suggests an EBP approach to improving the care quality for adult American T2DM patients.

Develop a PICOT Question for a Chosen Clinical Problem

A PICO(T) is the method for formulating medical inquiries that include the patient Population, Intervention, Comparison, Outcome, and Time. For adult American T2DM patients (P), does a telehealth-based non-pharmacological intervention including a lifestyle modification awareness program (I) compared to standard clinical management (C) result in an enhancement in self-care of T2DM (O) over six months (T)? 

  • Population (P):  Adult American T2DM Patients
  • Intervention (I): Telehealth-based non-pharmacological intervention, including lifestyle modification awareness program
  • Comparison (C): Standard clinical management
  • Outcome (O): Enhancement in self-care of T2DM
  • Timeline (T): Six months

Background on the Clinical Problem

T2DM is recognized as a crucial clinical condition with severe consequences for people’s lives and healthcare costs. T2DM reduces people’s productivity and quality of life, creating serious health issues and even mortality. Annually, T2DM harms around 1 million people, thus becoming the ninth-most prevalent cause of fatalities (Li et al., 2023). According to studies, T2DM has impacted 536.6 million individuals in 2021. The majority of T2DM patients experience a reduced lifetime than normal individuals (Yan et al., 2022). The Centers for Disease Control and Prevention (CDC), illustrated that around 38 million Americans individuals have diabetes, and 90% to 95% of patients are suffering from T2DM. T2DM is most commonly occurs at the age of 45. However, young adults are now becoming victims of this disease (CDC, 2023). In the United States of America, approximately one out of every four medical dollars is spent on diabetic care. On a median, individuals with diabetes incur yearly medical expenses of about $19,736, and about $12,022 is associated with T2DM care (Parker et al., 2023).

Action Plan to Implement the Evidence-Based Project 

This suggested action plan outlines a precise and practical approach to incorporating a telehealth-based integrated lifestyle change education and awareness program for adult American T2DM patients. The strategy concentrates on creating culturally relevant educational and awareness initiatives and training medical personnel in telehealth-based service delivery and patient administration (Dragomanovich & Shubrook, 2021). Moreover, establishing cooperation and coordination with clinical personnel and community organizations to create a multidisciplinary group that will deliver comprehensive assistance and care to American T2DM patients. Employing telehealth solutions for video-based collaborative discussions and safe exchange and gathering of patients’ private data will boost the awareness program’s productivity. Telehealth tools assist in the surveillance of individuals to manage healthier eating habits and exercise routines (Mori et al., 2024).

This action plan specifies a six-month duration for implementation. The first two months are dedicated to developing culturally and socially suitable instructional materials and encouraging reforms (Dragomanovich & Shubrook, 2021). In the third and fourth months, the focus will be on developing counseling and awareness programs. These programs are based on education about dietary modifications, self-care education, the significance of physical activity such as brisk walking to control weight, and the proper functioning of insulin (Gortzi et al., 2024). It is also dedicated to creating coordination and partnerships with community resources and other clinical experts (Fruchard et al., 2020).

NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice

The fifth and sixth months are devoted to analyzing the programs’ impact on adult American T2DM patients by conducting surveys, receiving feedback, and introducing any necessary adjustments to ensure the plan’s efficacy (Olesen et al., 2020). Sufficient resources and medical professionals’ expertise are essential to carry out telehealth-based educational sessions through video conferences. It offers effective communication and interactions among patients and clinicians. Furthermore, to improve productivity, T2DM patients need monitoring devices and apps for tracking their workout or physical activity levels and health indicators and sharing their data with their healthcare team for plan optimization (Mähs et al., 2022).

The action plan for implementing a telehealth-based multimodal behavioral change education and awareness program is considered as productive and realistic. The suggested strategies revolve around designing culturally appropriate and effective educational materials and awareness programs for the adult American T2DM patients community (Dragomanovich & Shubrook, 2021). Partnerships and communication with community resources and clinicians encourage holistic intervention by utilizing online evidence-based resources for open debate and information exchange (Olesen et al., 2020).

Stakeholders, Opportunities for Innovation, and Potential Barriers 

The active participation of stakeholders is crucial for the effective incorporation of telehealth-based lifestyle-changing awareness programs. Stakeholders, including clinical specialists and adult T2DM patients, are vital as specialists play a significant role in incorporating educational initiatives, and T2DM patients act as recipients. Another stakeholder is a dietician who provides guidelines about adopting healthy eating habits and portion control to reduce BMI and improve patients’ health (Evert et al., 2019). Community resources, including community groups and organizations and online social groups, are also crucial for the effectiveness of educational programs. Coordination and partnership with community groups assist in addressing adult American T2DM patients’ needs and providing support.

An integrated, interdisciplinary, community-based strategy is regarded as ideal for meeting the psychological, physiological, and cultural needs of adult T2DM patients (Northwood et al., 2023). Providing culturally appropriate instructional resources that complement adult Americans’ diverse social and cultural experiences provides an opportunity for effective T2DM management. Considering patients’ preferences and desires enhances their participation and the intervention’s effectiveness (Dragomanovich & Shubrook, 2021). Using telehealth solutions, such as video conferences and safe information exchange channels, enable health services available to all T2DM patients, regardless of physical difficulties, improving all T2DM patients’ outcomes (Mori et al., 2024).

Barriers and Solutions

Related challenges should be addressed to improve the productivity of interventions and educational programs. Incompetency and poor skills of medical staff can act as potential barriers to implementing the action plan. Providing training regarding the use of telehealth solutions in T2DM patient management improves their expertise and knowledge (Haleem et al., 2021). Moreover, several adult American T2DM patients struggle due to limited access to technological devices and poor or no internet connections in rural and underdeveloped communities. Incorporating marketing campaigns and awareness initiatives by employing banners and brochures in rural areas can help address internet-based limitations. It assists in raising knowledge of the beneficial effects of telehealth solutions in T2DM management (Piotie et al., 2021).

Furthermore, linguistic obstacles and cultural distinctions can also limit communication and interaction between clinical staff and patients. Linguistic difficulties can be solved by offering multilingual support services, including interpreting services, automatic translation software, and interpretation services to facilitate clear and efficient communication (Hudelson & Chappuis, 2024). Furthermore, using cultural awareness strategies and building comprehension among personnel regarding the beneficial features of telehealth solutions based on cultural proficiency can help any resistance or unwillingness to provide information (Truong et al., 2021).

Propose Outcome Criteria to Evaluate the Evidence-Based Practice Project 

The evaluation EBP action plan will concentrate on boosting personal care among American T2DM patients using telehealth-based instructional programs. EBP tools, including patient surveys, feedback techniques, and clinical indicators evaluation, can be utilized to analyze the program’s effectiveness in mitigating T2DM complications and improving patients’ self-management (Olesen et al., 2020). These metrics for outcomes demonstrate the program’s progress in achieving better health outcomes goals. The survey approach can evaluate several aspects, including patient satisfaction and experience towards educational programs, improvement in dietary changes, and activity routine. Moreover, the feedback approach offers an understanding of the areas that require additional attention. Medical indicators assessments, including glucose levels and BMI, advocate the educational programs ‘accomplishment in managing T2DM patients’ condition (Lin et al., 2020).

The examination of participants’ adherence to modified behavior towards eating routines and activity regimens. The evaluation will help figure out the productivity and sustainability of these modifications through telehealth-based education (Bretschneider et al., 2022). These assessments of outcomes will act as guidelines and provide recommendations for T2DM management among adults in America. Additionally, program participant experience and satisfaction with telehealth-based instructional sessions will be assessed, considering their efficacy, convenience, and adherence to clinical guidelines. Considering patient feedback and demands of patients can enhance EBP and health outcomes (Dragomanovich & Shubrook, 2021). 

The evaluation findings are compatible with the Quadruple Aim theory, which aims to reinforce clinical cal systems. The EBP educational program seeks to enhance the healthcare conditions of adult American T2DM patients by reducing comorbidities and promoting self-care ability (Plazas et al., 2023). Observing participants’ adherence to behavioral and lifestyle adjustments contributes to better patient conditions. Moreover, observing altering behaviors improves the health of adult T2DM patients by promoting long-term changes in habits. These evaluation outcomes underscore the quadruple target of addressing health outcomes, T2DM patient experience and satisfaction, and managing diabetes among the adult T2DM population using telehealth-based awareness and education initiatives (Bretschneider et al., 2022).

Evaluate the Evidence that Supports the Need for Practice Change

The effectiveness and suitability of EBP educational programs for an associated problem can be assessed by examining the importance and relevance of the findings underlying the practice shift. A comprehensive systematic method of study was employed to identify pertinent and credible research studies for this assessment. Databases such as PubMed, Google Scholar, and Science Direct are used to explore research resources. The research keywords used were “Type 2 diabetes care”, “lifestyle adjustments impact,” “telehealth and T2DM management”, and “American T2DM population concerns”. The latest research sources of the last 3 to 5 years were selected for recent findings. The credibility and usefulness of the evidence to adult Americans with T2DM were thoroughly reviewed.

By meticulously examining the evidence, health professionals and other stakeholders can make well-informed and educated choices regarding the initiative’s implementation and the incorporation of a telehealth-based lifestyle change program. The assessment ensures that EBP procedures and suggestions are founded on trustworthy and pertinent research findings of T2DM patient care. For example, the finding of Bretschneider et al. (2022), demonstrated that using a telehealth solution for educating T2DM patients on behavioral and lifestyle modification can significantly influence mitigating T2DM-related complications and improve self-careT2DM.

The strategy has yielded incredible results, particularly in terms of self-management. According to Dragomanovich and Shubrook’s (2021), research, telehealth solutions for lifestyle change training considering cultural context can be an effective strategy to deal with T2DM in the adult T2DM population, contributing to improved self-control. Moreover, Piotie et al. (2021), asserted that telehealth-based educational programs assist remote populations by overcoming barriers. It supports in improving patient self-care.

Conclusion

The PICOT approach is effective for evaluating the impact of interventions and medical research related to medical issues. T2DM is a severe medical concern among adult American populations. Employing a telehealth-based awareness program for T1DM patients can effectively bring about behavioral and lifestyle changes, improving health outcomes. Considering cultural and other language difficulties enhances the program’s effectiveness.

References

Bretschneider, M. P., Klásek, J., Karbanová, M., Timpel, P., Herrmann, S., & Schwarz, P. E. (2022). Impact of a digital lifestyle intervention on diabetes self-management: A pilot study. Nutrients14(9), 1810. https://doi.org/10.3390%2Fnu14091810

CDC. (2023). Type 2 diabetes.| cdc.gov. https://www.cdc.gov/diabetes/basics/type2.html#:~:text=About%2038%20million%20Americans%20have,adults%20are%20also%20developing%20it.

Dragomanovich, H. M., & Shubrook, J. H. (2021). Improving cultural humility and competency in diabetes care for primary care providers. Clinical Diabetes39(2), 220–224. https://doi.org/10.2337/cd20-0063

Evert, A. B., Dennison, M., Gardner, C. D., Garvey, W. T., Lau, K. H. K., MacLeod, J., & Yancy Jr, W. S. (2019). Nutrition therapy for adults with diabetes or prediabetes: A consensus report. Diabetes care42(5), 731. https://doi.org/10.2337%2Fdci19-0014

Fruchard, L., Bizzoto, L., Aude Allemang-Trivalle, Renoult-Pierre, P., & Antier, D. (2020). Compared benefits of educational programs dedicated to diabetic patients with or without community pharmacist involvement. Primary Health Care Research & Development21https://doi.org/10.1017/s1463423620000390

Gortzi, O., Dimopoulou, M., Androutsos, O., Vraka, A., Gousia, H., & Bargiota, A. (2024). Effectiveness of a nutrition education program for patients with type 2 diabetes mellitus. Applied Sciences14(5), 2114. https://doi.org/10.3390/app14052114

Haleem, A., Javaid, M., Ravi Pratap Singh, & Suman, R. (2021). Telemedicine for healthcare: Capabilities, features, barriers, and applications. Sensors International2, 100117–100117. https://doi.org/10.1016/j.sintl.2021.100117

Hudelson, P., & Chappuis, F. (2024). Using voice-to-voice machine translation to overcome language barriers in clinical communication: An exploratory study. Journal of General Internal Medicine, 1-8. https://doi.org/10.1007/s11606-024-08641-w

NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice

Li, X., Liu, R., Chen, Y., Han, Y., Wang, Q., Xu, Y., & Jiang, S. (2023). Patterns and trends in mortality associated with and due to diabetes mellitus in a transitioning region with 3.17 million people: Observational study. JMIR Public Health and Surveillance9(1), e43687. https://doi.org/10.2196/43687

Lin, K., Zhang, W., He, F., & Shen, J. (2022). Evaluation of the clinical efficacy of the treatment of overweight and obesity in type 2 diabetes mellitus by the telemedicine management system based on the internet of things technology. Computational Intelligence and Neuroscience2022http://dx.doi.org/10.1155/2022/8149515

Mähs, M., Pithan, J. S., Bergmann, I., Gabrys, L., Graf, J., Hölzemann, A., & Teti, A. (2022). Activity tracker-based intervention to increase physical activity in patients with type 2 diabetes and healthy individuals: Study protocol for a randomized controlled trial. Trials23(1), 617. https://doi.org/10.1186/s13063-022-06550-z

Mathieson, A., Grande, G., & Luker, K. (2019). Strategies, facilitators and barriers to implementation of evidence-based practice in community nursing: A systematic mixed-studies review and qualitative synthesis. Primary Health Care Research & Development20, e6. https://doi.org/10.1017/S1463423618000488

Mori, H., Taniguchi, S., Tamaki, Y., Tamaki, M., Akehi, Y., Kuroda, A., & Matsuhisa, M. (2024). Telenutrition education is effective for glycemic management in people with type 2 diabetes mellitus: A non-inferiority randomized controlled trial in Japan. Nutrients16(2), 268. https://doi.org/10.3390/nu16020268

Northwood, M., Aimun Qadeer Shah, Charith Abeygunawardena, Garnett, A., & Schumacher, C. (2023). Care coordination of older adults with diabetes: A scoping review. Canadian Journal of Diabetes47(3), 272–286. https://doi.org/10.1016/j.jcjd.2022.11.004

Olesen, K., Hempler, N. F., Drejer, S., Valeur Baumgarten, S., & Stenov, V. (2020). Impact of patient‐centred diabetes self‐management education targeting people with type 2 diabetes: An integrative review. Diabetic Medicine37(6), 909-923. https://doi.org/10.1111/dme.14284

NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice

Padhi, S., Nayak, A. K., & Behera, A. (2020). Type II diabetes mellitus: A review on recent drug based therapeutics. Biomedicine & Pharmacotherapy131, 110708. https://doi.org/10.1016/j.biopha.2020.110708

Parker, E. D., Lin, J., Mahoney, T., Nwanneamaka Ume, Yang, G., Gabbay, R. A., ElSayed, N. A., & Bannuru, R. R. (2023). Economic costs of diabetes in the U.S. in 2022. Diabetes Care47(1), 26–43. https://doi.org/10.2337/dci23-0085

Piotie, N. P., Wood, P., Webb, E. M., Hugo, J. F., & Rheeder, P. (2021). Designing an integrated, nurse-driven and home-based digital intervention to improve insulin management in under-resourced settings. Therapeutic Advances in Endocrinology and Metabolism12, 20420188211054688. https://doi.org/10.1177/20420188211054688

Plazas, C. P., Robertson, M., Alvarado, B., Paré, G. C., Costa, I. G., & Duhn, L. (2023). Diabetes Self-Management Education (DSME) for older persons in western countries: A scoping review. Plos One18(8), e0288797. https://doi.org/10.1371%2Fjournal.pone.0288797

Sarker, A., Das, R., Ether, S., & Saif-Ur-Rahman, K. M. (2020). Non-pharmacological interventions for the prevention of type 2 diabetes mellitus in low and middle-income countries: Protocol for a systematic review and meta-analysis of randomized controlled trials. Systematic Reviews9(1). https://doi.org/10.1186/s13643-020-01550-z

Truong, M., Yeganeh, L., Cook, O., Crawford, K., Wong, P., & Allen, J. (2021). Using telehealth consultations for healthcare provision to patients from racial/ethnic minorities: A systematic review. medRxiv, 2021-08. https://doi.org/10.1101/2021.08.25.21262592

NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice

Yan, Y., Wu, T., Zhang, M., Li, C., Liu, Q., & Li, F. (2022). Prevalence, awareness and control of type 2 diabetes mellitus and risk factors in Chinese elderly population. BioMed Central Public Health22(1). https://doi.org/10.1186/s12889-022-13759-9

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