Type 2 Diabetes
The already established EBP assessment is critical in evaluating the success and issues that face the practicum project. Notably, it has facilitated in-depth analysis of the project’s outcome against the initially developed goals. As noted by Madison Community Foundation (n.d), these outcomes are essential in determining the program’s impact on the participants, as well as steering the project towards the intended goal in case of any deviations. I have integrated my skills and knowledge in nursing to promote change and support the EBP practice in the community.
Promoting Change and Supporting EBP
To encourage change and support the EBP, I chose to synchronize the existing practices with the updated protocols by the American Diabetes Association to facilitate open communication with the employees. After assuming the leadership role, I was able to enlighten the involved team about some of the ADA guidelines on diabetes care, including the process measures and glucose regulation in patients by the DRN (“Diabetes Care,” n.d). The main aim of incorporating ADA protocols was to ensure that patients’ needs were considered during treatment. Communication played an integral part because it accounted for the outcomes of the program (Ulutasdemir, 2018). Through communication, the objective of the project, which is to promote healthy weight reduction among the participants, was relayed, while nurses were encouraged to be part of the initiative.
Despite efforts made in promoting the proposed change, some components of the system may influence the initiative, and hence, affect its implementation. The internal aspects, such as employees, influence the proposed change because a lack of consensus and motivation will jeopardize the initiative. The government also has a direct impact on the success of the dietary plans, since the majority of the participants rely on food stamps. Hence, limited access to relief food from the authority may affect the desired change. Besides, local and state support in terms of employment opportunities among members of the community will also influence the proposed change because the more participants are financially stable, the higher the chances of affording healthy diets.
Furthermore, evolving issues, such as a timeline for change, cost of food, and employee resistance, might also affect the implementation and sustainability of the initiative. Based on my evaluation, it may be challenging to facilitate healthy weight reduction within the initially postulated time frame. In addition, the high cost of healthy food may prove it difficult for participants to maintain a healthy diet plan. With the resistance that the initiative is already facing, it may be challenging to maintain the sustainability plan for long.
The project practicum was based on the following objectives:
- To identify an area in nursing practice that requires change.
- To develop an EBP that would facilitate positive outcomes.
- To assess the outcomes of the project and develop strategies for overcoming barriers to the EBP.
- To evaluate the impact of the strategies on the current policies.
Until now, I have managed to accomplish some of the intended objectives. I recognized the significance of introducing an EBP to promote weight reduction among diabetes patients, through dietary plans because overweight is one of the drivers of increased prevalence of type 2 diabetes mellitus (Wilding, 2014). In addition, barriers to the EBP practice, including limited timeline, cost of food, and resistance among employees, were also identified (Forouhi et al., 2018; Adu et al., 2019). Some of the strategies that I have put in place to overcome the above barriers include:
- Use of the PDSA cycle, which consists of Plan, Do, Study, and Act (“Plan-Do-Study-Act,” d). The cycle shall be used to keep track of the EBP and to measure patients’ outcomes. Hence, I plan to indulge in frequent data collection to pilot the EBP on a small scale and to create adequate time to analyze data and results to refine the EBP accordingly.
- Integrate the Lean system framework in the project practicum to facilitate the rapid adaptability of the program. As proposed by Toussaint (2015), the lean system brings together standard work from different stakeholders to transform the service delivery process by solving issues that matter the most. By bringing the junior, middle, and executive management on board, it might be easier to overcome some of the barriers that the project is currently facing. However, this change may also affect practice at other levels beyond my initial focus. For instance, more personnel will be required in different departments in the facility to streamline goals with those of the initiated project to achieve the forecasted outcomes.
Overall, it was essential to conduct a project assessment on the proposed EBP. The exercise has helped me to identify some of the barriers to the EBP and to incorporate literature in devising strategies to overcome them. The assessment has also proven the importance of effective communication in the different stages of project management. Furthermore, ADA protocols have been vital in promoting and supporting EBP.