Evidence-Based Practice Proposal – Section F: Evaluation of Process Paper

my picot for the research is By establishing home and classroom diabetic training and education along with medication assistance for rural americans with abnormal HA1C levels, within three months, Ha1c levels will decrease by 10%…..I have uploaded the assignment in the documents. I have also uploaded the previous papers for reference.

Evidence-Based Practice Proposal – Section F: Evaluation of Process
This paper describes the evaluation of the process utilized by the author in implementing the evidence-based proposal. It involves a description of the rationale for the methods utilized by the project team in gathering the outcome data. Additionally, it will describe the techniques utilized by the outcome measures to assess the objectives of the project that have been achieved. It will also include an evaluation of the techniques of measuring the outcomes based on the evidence. Steps to be taken if the outcomes fail to provide positive results will be included. Finally, the paper will include implications for practice and future research.
Techniques for Collecting the Outcome Data
Outcome data is essential since it reflects the effectiveness of the implemented evidence-based practice proposal. In other words, the project team will use this data to determine whether the project was a success in achieving the set objectives or not. Various techniques can be used to gather the required outcome data. First, questionnaires will be used to collect this data. Questionnaires with closed-ended questions will be administered to the nurse practitioners. These professionals will be required to fill the results of home diabetes education. Questionnaires will be utilized due to their effectiveness in gathering clinical data from a particular targeted population (Ponto, 2015). Additionally, data gathered through closed-ended questionnaires are easy to analyze using statistical methods. Secondly, outcome data will be collected through interviews in which physicians, nurses, dieticians, physiotherapists, and laboratory technicians will be interviewed to provide the required data. During a personal interview with these professionals, the interviewer will inquire from them about the implemented project outcomes. Evidence-Based Practice Proposal – Section F: Evaluation of Process Paper.
The Techniques Utilized by the Outcome Measures to Assess the Objectives of the Project that have been Achieved.
The outcome measures portray the objectives of the project that have been achieved. Various techniques can be utilized during this process. First, the extent to which the project’s objectives have been attained can be assessed by comparing the level of a particular outcome measure before and after the project’s implementation. For instance, the achievement of the set objective in this project (reduction of the hemoglobin A1c (HA1c) levels by 10% over three months among the rural Americans) can be evaluated based on several individuals with high HA1c before the implementation of the project and those with this level after the project was adopted.
Additionally, the extent to which the project’s objectives have been attained can be based on the positive or negative outcome measures associated with the project’s implementation. For example, readmissions cases among individuals diagnosed with HA1c can be used to evaluate the set objectives’ achievement. The decline in these cases indicates that the objectives have been achieved while an increase indicates that they have not been attained.
The Techniques of Measuring and Evaluating the Outcomes based on the Evidence
Evidence will be used as the basis for evaluating and measuring the outcomes of the project. First, the effectiveness of the outcomes of the project will be based on their validity. The outcomes will be considered valid if they correspond accurately to the set guidelines of the healthcare sector (Renda et al., 2015). Based on reliability, the outcomes of the project will be considered effective if they are consistent. That is, similar results are obtained if the project is repeated over and over again. Finally, the applicability of the outcomes defines their accuracy and efficacy. Outcomes are considered effective if they assist in solving a particular issue in the healthcare sector. In this case, the applicability of the outcomes will be based on their ability to reduce the hemoglobin A1c (HA1c) levels by 10% over three months among the rural Americans.
Measures to adopt in case the Outcomes fails to give Positive Results.

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Failure of the outcomes to give positive results indicates that the entire project has backfired. Therefore, the whole project should be repeated to give accurate outcome measures that will produce positive results. Additionally, the error can be corrected by evaluating all the stages of the project to identify where the error occurred. Inaccuracy in the results could have resulted from a single mistake that can be easily rectified. Correcting the error will give outcomes that will produce positive results.
The Impact of the Outcomes on the Practice and Future Research
The outcomes of this project have an impact on the practice. It provides the nurse practitioners with guidelines to adhere to in their practices, thus reducing hemoglobin A1c (HA1c) among patients. Lowering the level of HA1c will prevent further complications that are likely to arise from the condition. According to Ikeda and Shimazawa (2019), HA1c indicates long‐term glycemia. Additionally, the outcomes of this project will guide future researchers on how to conduct their studies. A researcher can adhere to the utilized guidelines if interested in getting similar results.
In conclusion, the evaluation of the process reflects the accuracy and efficacy of various aspects of the project. First, it justifies the methods utilized by the project team to gather the outcome data. Additionally, it captures the techniques utilized by the outcome measures to assess the objectives of the project that have been achieved. For instance, the achieved objectives were assessed by evaluating the level of HA1c before and after the project’s implementation.

References
Ikeda, M., & Shimazawa, R. (2019). Challenges to hemoglobin A1c as a therapeutic target for type 2 diabetes mellitus. Journal of general and family medicine, 20(4), 129-138.
Ponto, J. (2015). Understanding and evaluating survey research. Journal of the advanced practitioner in oncology, 6(2), 168.
Renda, S., Baernholdt, M., & Becker, K. (2015). Evaluation of a Worksite Diabetes Education Program at a Large Urban Medical Center. Workplace Health & Safety, 64(1), 17-23. Evidence-Based Practice Proposal – Section F: Evaluation of Process Paper.

This paper describes the implementation plan of home diabetes education as the most effective intervention to reduce HA1C levels among rural Americans with abnormal HA1C levels. It describes the setting, duration, resources, methods and instruments, feasibility, and maintenance of the evidence-based proposed intervention. Evidence suggests that diabetes education that can be delivered at the home and workplace can increase diabetes self-management and improve productivity and reduce health care costs (Renda, Baernholdt, & Becker, 2015).

PICOT Question: In rural Americans with elevated HA1C levels (P), will providing home diabetes education in a classroom setting and medication assistance (I), compared to none (C), reduce hemoglobin A1c (HA1c) levels by 10% (O), over 3-months period (T)?

Setting

The implementation of this evidence-based proposal will be in designated classroom settings of two elementary schools within the community. There will be a schedule for the education program including a question-answer session lasting thirty minutes daily to address potential knowledge gaps. Besides, the education program will run from Monday to Friday for two consecutive weeks. Every day, there will be two education sessions (9.00 am to 10.00 am) and (5.00 pm to 6.00 pm) to consider individuals with tight work schedules.

Participation will only include adult patients aged 18 years or older living with or recently diagnosed with type 2 diabetes mellitus. To promote access to potential participants, the author will use posters, social media (Facebook), broadcast media, and radio to make public announcements. Before beginning home-based education on diabetes, the author will conduct an initial evaluation to test participants to include only those with an abnormal HA1C in the study. Since the study will involve a pre- and post-intervention analysis of HA1C levels, participants will sign a written informed consent.

Time

For the successful implementation of this evidence-based project, the author identified and prioritized all the tasks and created a 12-week timeline. This was an essential step towards ensuring a clear description of activities and tasks to be completed with ease in monitoring progress. The author will provide prior notice to colleague staff, community members, hospital stakeholders, the local government, and community partners (American Diabetes Association, CDC, and National Institute of Health). The implementation team will communicate through memos, posters, social media platforms (Facebook) broadcast media, and radio. Prior communication helps to plan in terms of financial resources from partners and to plan for activities such as staff training.

The author will then assign each member in the implementation team with specific roles and responsibilities to perform as a step towards promoting the preparation of materials, tools, and data to use in the home education program. Evidence-Based Practice Proposal – Section F: Evaluation of Process Paper.  Just before the program kicks off, all members of the implementation, the team will undergo mandatory one-week training as suggested by Pereira et a. (2015), to improve their knowledge of DM. Afterward, the implementation team will spend an additional one week to enroll participants before proceeding to conduct the actual home-based education. Two weeks later, the author will evaluate the outcomes to determine whether the anticipated outcomes have met the expected evidence-based practice goals.

Resources

Since an implementation team with different healthcare providers in collaboration with community partners will implement this evidence-based project, the human resource needed will be a physician, nurse, dietitian, physiotherapist, and laboratory technician. The following with being their specified roles.

Nurse- recording a maintaining up to date participant data

Physician- educating participants about antidiabetic agents and diabetes

Dietitian- educate participants on the appropriate nutrition for patients with diabetes and help them to develop dietary plans.

Physiotherapist- educate participants about physical exercise in patients diagnosed with diabetes and help them to develop routine physical activity schedules.

Laboratory technician-conduct HA1C tests and maintaining up to date records of the findings.

The author will liaise will utilize community partnerships with organizations such as the American Diabetes Association to obtain a diabetes educator. The educator will share knowledge with participants on how to join community support groups and how membership benefits individuals. Families and communities. Besides, the author will also give participants education resources about diabetes mellitus from the National Diabetes Education Program (Griffey, 2015).

Methods and Instruments

The author will use a variety of questionnaires to monitor the execution of the proposed solution. Questionnaires will help to identify potential knowledge gaps that indirectly hinder participants from achieving optimal glycemic control. Based on the gaps identified, participants will be re-educated to ensure that they make healthy informed decisions or given professional assistance to develop glycemic goals. The intervention (home diabetes education) will be provided by a team of nurses, physicians physiotherapists, dieticians, and laboratory technicians.

The nurse will record and maintain up to date participant data, physicians will educate participants about antidiabetic agents and diabetes, a dietician will educate participants on the appropriate nutrition for patients with diabetes and help them to develop dietary plans (Pereira et al. 2015). Some clinicians have observed that low-carbohydrate, low-energy diets can improve blood glucose control, with reports of remission from type 2 diabetes in some patients (Morris et al., 2019). The physiotherapist will educate participants about physical exercise in patients diagnosed with diabetes and help them to develop routine physical activity schedules while the laboratory technician will conduct HbA1C tests and maintaining up to date records of the findings. However, before implementing the intervention, members of the implementation team will undergo rigorous training to improve their skills and knowledge of DM. Evidence-Based Practice Proposal – Section F: Evaluation of Process Paper.

Data Collection

The nurse and laboratory technician will collaborate to collect data using questionnaires. A data manager will input and manage the collected data. The data collected will include the participant’s details, baseline, and follow-up HA1C and follow-up. Key implementation facilitators include adequate knowledge about DM and using electronic documentation methods.

Feasibility

The proposed solution is cost-friendly to implement. The National Diabetes Education Program provides free educational resources on its website. The only costs that the author may incur in this case would be printing costs. Similarly, the only personnel-related costs incurred would be transport-related costs to and from the setting.

Maintenance Plan

If the proposed solution provides the best outcomes, the author will proceed to develop written guidelines and policies to guide the implementation of home diabetes education to improve diabetes control. These guidelines will clearly explain the dos and don’ts of a home diabetes program and stakeholders to involve, improving outcomes.  As recommended by Beck (2018), the policy will also explain the actions to take when a patient with diabetes fails to achieve desired outcomes within a specific time. From time to time, these guidelines and policies should be reviewed with comparisons between outcome data and baseline data, as this will influence potential modifications to achieve the desired outcomes. 

References

Beck, J., Greenwood, D. A., Blanton, L., Bollinger, S. T., Butcher, M. K., Condon, J. E., & Kolb, L. E. (2018). 2017 National standards for diabetes self-management education and support. The Diabetes Educator, 44(1), 35-50.

Griffey, S., Piccinino, L., Gallivan, J., Lotenberg, L. D., & Tuncer, D. (2015). Applying national survey results for strategic planning and program improvement: The National Diabetes Education Program. Evaluation and Program Planning, 48, 83-89.

Morris, E., Aveyard, P., Dyson, P., Noreik, M., Bailey, C., Fox, R., . . . Jebb, S. A. (2019).

Dietary Approaches to the Management Of type 2 Diabetes (DIAMOND): Protocol for a

randomised feasibility trial. BMJ Open, 9(1). doi:10.1136/bmjopen-2018-026460

Pereira, K., Phillips, B., Johnson, C., & Vorderstrasse, A. (2015). Internet-delivered diabetes self-management education: a review. Diabetes technology & therapeutics, 17(1), 55-63.

Renda, S., Baernholdt, M., & Becker, K. (2015). Evaluation of a Worksite Diabetes Education Program at a Large Urban Medical Center. Workplace Health & Safety, 64(1), 17-23. doi:10.1177/2165079915607869. Evidence-Based Practice Proposal – Section F: Evaluation of Process Paper

Evidence-Based Practice Proposal

Section A: Organizational Culture and Readiness Assessment

The organization culture survey tool utilized to assess the readiness of the organization for evidence-based practice is the “Organization Culture and Readiness for System-Wide Integration of Evidence-Based Practice”. This tool is effective in assessing and investigating the beliefs and knowledge of the staff about EBP, as well as the organization’s readiness to adopt evidence-based practice (EBP) (Yoo et al., 2019).

The findings of the survey showed that the organization is ready to participate in EBP. As per the findings from the survey, the nursing staff has the required EBP skills such as computer skills, the ability to research, and access the internet. The management supports the implementation of EBP in terms of funding, availing staff, and providing a supportive environment. The nursing staff and physicians are also committed towards EBP. Moreover, there are also nurse scientists in the organization; the nurse scientists focus on generating evidence and guiding nurses throughout the process of generating evidence. There are various advanced practice nurses (APNs) and EBP champions who are actively involved in research and act as role models when it comes to EBP in the organization.

However, the survey indicated that some nursing staff members were resistant to EBP because of heavy workload and thus lacked time to research and participate in the implementation of EBP. The main contributing factor to this barrier is due to the shortage of nurses and thus nurses are always engaged in nursing practice and lack time to participate in EBP activities. This barrier can be addressed by the organizational management recruiting more nurses to lower the workload among the nursing staff (Harper et al, 2017).

Section B: Proposal/Problem Statement and Literature Review

PICOT Question

In rural Americans with elevated ha1c levels (P), will providing home diabetes education in a classroom setting and medication assistance (I), compared to none (C), reduce hemoglobin A1c (HA1c) levels by 10% (O), over 3-months period (T)?

Problem Statement

Diabetes is a chronic disease associated with high mortality and morbidity burden. According to Cunningham et al (2019) in 2015 about 9.4% of Americans had diabetes and 95% of this population had type 2 diabetes. Type 2 diabetes leads to complications such as kidney disease, retinopathy, neuropathy, and increased risk of stroke, high blood pressure, peripheral arterial disease, and coronary artery disease. Evidence-Based Practice Proposal – Section F: Evaluation of Process Paper. People in rural areas within the US have limited access to healthcare (Cunningham et al., 2019). Additionally, some may not have the appropriate health literacy and thus may not adhere to the treatment plans: this leads to diabetes complications due to poor glucose control.  Therefore, poor glucose control predisposes people with diabetes to complications, increasing the risk of morbidity and mortality.

Literature Review

According to Tran et al (2019), in 2015 about 23.1 million adult Americans had type 2 diabetes. Diabetes is a serious chronic disease that can cause complications like chronic kidney disease, cardiovascular disease, neuropathy, diabetic retinopathy, and increased mortality rate. The purpose of the study by Tran et al (2019) aimed to identify disparities in the screening of diabetes for Americans living in urban and rural areas. In this study, the Behavioral Risk Factor Surveillance System (BRFSS) surveys were used as data. The BRFSS surveys include information regarding health behaviors within all states in the US. The findings of this study indicated that rural populations had a higher risk of diabetes and also a higher prevalence of diabetes when compared to people in urban/suburban areas (Tran et al., 2019). This study recommends increased screening of diabetes in rural areas to allow prompt diagnosis and treatment of diabetes in this population.

Cunningham et al (2019) conducted a systematic review and meta-analysis to examine the impact of a diabetes self-management education (DSME) on the quality of life and HbA1c levels in people with type 2 diabetes. The findings of this study indicated there are major disparities in type 2 diabetes regarding the prevalence and health outcomes among African Americans. Additionally, the findings demonstrated that an educational intervention was effective in reducing the HbA1c levels and improving the quality of life in people with diabetes (Cunningham et al., 2019). The study thus recommends the integration of diabetes education intervention in the care plan of people with type 2 diabetes.

The study by Salahshouri et al (2018) investigated the efficacy of the educational intervention on helping people with diabetes adhere to lifestyle modifications and maintain the appropriate levels of HbA1c and glucose levels in individuals with type 2 diabetes. The study adopted a randomized controlled clinical trial as the methodology. The findings of this study showed that educational intervention helped individuals with type 2 diabetes to adhere to the prescribed lifestyle modifications. Additionally, the study participants had reduced levels of HbA1c and glucose levels after the educational intervention, highlighting the efficacy of the intervention (Salahshouri et al., 2018).   

References

Cunningham, A. T., Crittendon, D. R., White, N., Mills, G. D., Diaz, V., & LaNoue, M. D. (2018). The effect of diabetes self-management education on HbA1c and quality of life in African-Americans: a systematic review and meta-analysis. BMC health services research, 18(1), 367.

Harper M, Gallagher-Ford L, Warren J, Troseth M, Sinnott L &Thomas B. (2017). Evidence-Based Practice and U.S. Healthcare Outcomes. Journal for Nurses in Professional Development, 33(4), 170-179.

Salahshouri, A., Alavijeh, F. Z., Mahaki, B., & Mostafavi, F. (2018). Effectiveness of educational intervention based on psychological factors on achieving health outcomes in patients with type 2 diabetes. Diabetology & metabolic syndrome, 10(1), 67. Evidence-Based Practice Proposal – Section F: Evaluation of Process Paper.

Tran, P., Tran, L., & Tran, L. (2019). Impact of rurality on diabetes screening in the US. BMC public health, 19(1), 1190.

Yoo, J. Y., Kim, J. H., Kim, J. S., Kim, H. L., & Ki, J. S. (2019). Clinical nurses’ beliefs, knowledge, organizational readiness, and level of implementation of evidence-based practice: The first step to creating an evidence-based practice culture. PloS one, 14(12), e0226742. https://doi.org/10.1371/journal.pone.0226742

Section D: Change Model

This paper describes the change model that will guide the implementation of the author’s evidence-based proposal. It includes a description of the selected change model, its relevance to the evidence-based project, and the stages of the change model. It also describes how the author will apply each stage of the change model in the proposed implementation.

Selected Change Model and Relevance To The EBP Project

The selected change model of choice that will guide the implementation of this evidence-based proposal is the transtheoretical model (TTM) of behavior change. This change model examines a person’s readiness level to act on healthy and new behavior. Besides, it describes the change strategies and processes that an individual should follow to achieve specific outcomes (Prochaska, Redding & Evers, 2015).

The TTM model requires a user to identify the stage that an individual is undergoing to promote the person’s understanding of the expected outcomes after embracing positive behavioral practices such as observing a diabetic diet, routine physical exercise, medication adherence, and routine blood glucose monitoring. To improve the success of outcomes using this model, education will be paramount. Education will improve participants’ knowledge and help to eliminate common diabetes-related biases, myths, and misconceptions.

Stages of TTM

The TTM posits that change in behavior occurs in five stages namely; pre-contemplation, contemplation, preparation, action, and maintenance. Some constructs influence ways in which a person goes through the stages before he/she decides to adopt a new behavior. These constructs are; liberalization, consciousness, reinforcement, re-evaluation, stimulus control, and counterconditioning (Prochaska, Redding & Evers, 2015). In this context, consciousness describes caregivers’ ability to increase a patient’s awareness about a healthy behavior such as maintaining an exercise schedule, optimal hydration, adhering to medication, avoiding or limiting cigarette smoking, and alcohol intake.

Re-evaluation involves understanding how unhealthy behaviors can affect other people, while liberalization involves a person’s commitment to change behavior with a strong belief that it is possible to achieve specific health behaviors (Prochaska, Redding & Evers, 2015). In counter-conditioning, individuals substitute unhealthy thoughts and behaviors with healthy thoughts and behaviors. Stimulus control includes environmental re-engineering for cues and reminders that not only support but also encourage healthy behavior and eliminate those that encourage unhealthy behaviors (Prochaska, Redding & Evers, 2015). In reinforcement management, caregivers reward diabetic patients with positive behavior and decrease rewards in case of negative behavior.

In the context of this EBP, the intervention for implementation is that, by establishing home and classroom education and training with medication assistance for rural Americans with abnormal HbA1C levels, there will be a 10% decrease in the HbA1C levels. An integral aspect of behavior change using the TTM model is educating all PCPs and nurses about the intervention to promote its adoption and subsequently, increase the chances of more successful outcomes.

Change is a comprehensive process to which individuals respond differently. It is for this reason that this change model proposes that, its users should identify the facilitators and barriers to implementing change and identify potential solutions before the implementation of actual change practice.

In the organization that the author will implement the proposed change, implementation facilitators include; a quality and patient safety organizational culture, an organizational philosophy that accepts accountability for systemic failures, and collaborative organizational leadership. Potential barriers to implementation are; nurses resisting change due to a nursing shortage that contributes to tight work schedules and heavy workloads.

Applying Each TTM Stage In The Proposed Implementation.

In the pre-contemplation stage, nurses will encourage patients to start thinking about changing behavior by educating and training them about DM and providing assistance with medication. Education will include methods to maintain healthy dietary habits, a physical activity schedule, medication adherence, limiting or avoiding cigarette smoking, and alcohol intake, which collectively promote good glycemic control. According to Kriska, et al. (2018), in this stage, most patients will not be aware that their behaviors have negative consequences. However, they will underrate the benefits of behavior change and focus more on the consequences. Evidence-Based Practice Proposal – Section F: Evaluation of Process Paper.

In the contemplation stage, with continuous education, patients will intend to start practicing healthy behaviors such as maintaining a diabetic diet, a physical activity schedule, and adhering to medications (Prochaska, Redding & Evers, (2015). After recognizing that healthy dietary habits, a physical activity schedule, medication adherence, limiting or avoiding cigarette smoking, and alcohol intake have consequences, the participants will consider the benefits rather than the consequences of behavior change. In the preparation stage, patients will be ready to take action and small steps towards maintaining healthy dietary habits, a physical activity schedule, medication adherence, quitting cigarette smoking and alcohol intake with a strong belief that behavior change can result to a healthier life (Hankonen et al., 2015).

In the action stage, patients will embrace healthy dietary habits, a physical activity schedule, medication adherence, quitting cigarette smoking, and alcohol intake. They will also intend to continue moving forward with the new behavior change practices (Sheeran, Klein, & Rothman, 2017). In the maintenance phase. Patients will sustain and maintain newly adopted behaviors to prevent short and long-term diabetes complications.

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References

Hankonen, N., Sutton, S., Prevost, A. T., Simmons, R. K., Griffin, S. J., Kinmonth, A. L., & Hardeman, W. (2015). Which behavior change techniques are associated with changes in physical activity, diet, and body mass index in people with recently diagnosed diabetes?. Annals of Behavioral Medicine, 49(1), 7-17.

Kriska, A., El Ghormli, L., Copeland, K. C., Higgins, J., Ievers‐Landis, C. E., Levitt Katz, L. E.,  & TODAY Study Group. (2018). Impact of lifestyle behavior changes on glycemic control in youth with type 2 diabetes. Pediatric Diabetes, 19(1), 36-44.

Prochaska, J. O., Redding, C. A., & Evers, K. E. (2015). The transtheoretical model and stages of change. Health behavior: Theory, research, and practice, 97.

Sheeran, P., Klein, W. M., & Rothman, A. J. (2017). Health behavior change: Moving from observation to intervention. Annual Review of Psychology, 68, 573-600.

This paper discusses the implementation of an education intervention as an intervention to decrease HBA1C levels among patients diagnosed with DM.

Proposed Solution

DM   is a global epidemic with a social, personal, and economic health burden and is associated with a sedentary lifestyle and other behavioral factors. The worldwide DM prevalence among people aged 20-79 exceeded 400 million (Adu et al., 2019). Besides, DM remains a leading cause of mortalities globally. It accounted for more than 1 million deaths the year 2015, which was a 60% increase from 1 million deaths that occurred in 2000.

This EBP proposes the establishment of home and classroom diabetic training and education along with medication assistance as an effective intervention to decrease the HBA1C levels among rural Americans with abnormal HBA1C levels. According to Adu et al. (2019), education is a health-coach intervention that targets behavior change and self-determined goals resulting in better self-care and management actions. Education and training improve a patient’s self-efficacy and understanding. Improved understanding increases individual knowledge on the association between diabetes self-care actions and how they impact outcomes (Cooke et al., 2015).  In contrast, self-efficacy promotes a person’s innate ability to execute tasks directed towards achieving good glycemic control. Evidence-Based Practice Proposal – Section F: Evaluation of Process Paper

This intervention is not only appropriate but also realistic for implementation in the organization since it is affordable and nurses have up-to-date knowledge and resources to obtain information about DM. This enhances their ability to engage in evidence-based research processes of collecting appraising and synthesizing research articles. Besides, all healthcare staff understands the relevant procedures and policies that support quality improvement initiatives.

Organization Culture

The proposed healthcare organization is a regional medical clinic that provides care to more than 60,000 people within the geographical regions it serves. The healthcare organization embraced quality and patient safety culture as championed in its vision and mission statements, goals, and objectives. The organization’s philosophy accepts accountability for failures within the system that they have minimal or little control. Besides, the organization’s administration uses the collaborative leadership style, which incorporates other health stakeholders in decision-making and management of healthcare teams (Zareban et al., 2014).

Expected Outcomes

Post-implementation, it is expected that patients who will continuously take part in the education and training sessions will have a 10%decrease in the HBA1C levels. As suggested by García et al. (2015), they will have good glycemic control, improved QoL, fewer complications, and decreased diabetes-associated deaths.

Method to Achieve Outcomes

The author will organize an initial training to identify potential knowledge gaps about the subject among participants. During implementation, a team that comprises of a physician, nurse, dietician, physiotherapist, and laboratory technician will conduct training and education. Each of these members will have a specific role to perform as follows. The nurse will record and ensure Up to date information of patients who attend the training and education. The physician will educate patients about DM medications, the dietician will discuss healthy nutritional habits while the physiotherapist will educate participants about physical activities. The role of the laboratory technician will be to perform a series of HBAIC tests and to maintain an up to date record of the findings.

Outcome Impact

Upon the implementation of the proposed intervention, it is expected that there will be a 10% decrease in HBA1C levels. A low HBA1C level is an indicator of good blood glucose control and decreases microvascular and macrovascular associated risks hence improved quality of care (Cooke et al., 2015). Since education and medication assistance will be tailored to address individual knowledge gaps, the overall outcome will increase patient self-care responsibility and subsequent patient-centered quality care.

Conclusion

This EBP suggests the establishment of home and classroom diabetic training and education and medication assistance as the most effective intervention to decrease HBA1C levels in the target population. The organization to implement this EBP adopted a patient-focused and quality culture that is reflected in its mission, vision, goals, and objectives and well as the organization’s philosophy. The expected outcome is that patients HBA1C level will decrease by 10% within three months.  Evidence-Based Practice Proposal – Section F: Evaluation of Process Paper.

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.

Cooke, D., Bond, R., Lawton, J., Rankin, D., Heller, S., Clark, M., & Speight, J. (2015). Modeling predictors of changes in glycemic control and diabetes-specific quality of life amongst adults with type 1 diabetes 1 year after structured education in flexible, intensive insulin therapy. Journal of behavioral medicine, 38(5), 817-829.

García, A. A., Brown, S. A., Horner, S. D., Zuniga, J., & Arheart, K. L. (2015). Home-based diabetes symptom self-management education for Mexican Americans with type 2 diabetes. Health education research, 30(3), 484-496.

Wayne, N., Perez, D. F., Kaplan, D. M., & Ritvo, P. (2015). Health coaching reduces HbA1c in type 2 diabetic patients from a lower-socioeconomic status community: a randomized controlled trial. Journal of medical Internet research, 17(10), e224.

Zareban, I., Karimy, M., Niknami, S., Haidarnia, A., & Rakhshani, F. (2014). The effect of self-care education program on reducing HbA1c levels in patients with type 2 diabetes. Journal of education and health promotion, 3, 123. https://doi.org/10.4103/2277-9531.145935

In 500-750 words, develop an evaluation plan to be included in your final evidence-based practice project. Provide the following criteria in the evaluation, making sure it is comprehensive and concise:

1. Describe the rationale for the methods used in collecting the outcome data.
2. Describe the ways in which the outcome measures evaluate the extent to which the project objectives are achieved.
3. Describe how the outcomes will be measured and evaluated based on the evidence. Address validity, reliability, and applicability.
4. Describe strategies to take if outcomes do not provide positive results.
5. Describe implications for practice and future research.

You are required to cite three to five sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

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. Please refer to the directions in the Student Success Center.

Note: After submitting the assignment, you will receive feedback from the instructor. Use this feedback to make revisions for your final paper submission. This will be a continuous process throughout the course for each section. Evidence-Based Practice Proposal – Section F: Evaluation of Process Paper .