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NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice

Student Name

Capella University

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

Prof. Name

Date

Implementing evidence-based practice for promoting a healthy lifestyle

Hey everyone, this is ______, and my topic of presentation is the implementation of evidence-based practices for diabetes type 2 patients to promote a healthy lifestyle. Diabetes is one of the most prevalent problems that is often worsened by an unhealthy lifestyle. The core deficit in diabetes type 2 is the insulin resistance that is often built up due to unhealthy lifestyles such as lack of exercise and obesity. Due to insulin resistance, the body’s insulin cells become restrained, eventually reducing insulin secretion. According to the Centers for Disease Control and Prevention (CDC, 2022), around 37.3 million

Americans have diabetes, which makes up around 11.3% of the overall American population. From this population, almost 37.1 million patients are adults or 18 years old and older. Furthermore, other statistical reports have highlighted that out of all the diabetic cases within the country, 90.9% are of diabetes type 2, making up 21 million of all the cases (Julia, 2022). Studies have highlighted that diabetes and obesity often increase the future risk of cardiovascular diseases, making it more difficult to treat either of the conditions (Sharma et al., 2020). Also, other studies have highlighted that an unhealthy lifestyle and diabetes increase the risk of developing other coronary heart diseases, which may include vascular problems, issues in electrical mechanisms, and arrhythmias (Piché et al., 2020). There are studies that have linked the worsening condition of the heart with uncontrolled diabetes as well (Zareinu et al., 2020).

PICOT Question 

In adults with Type 2 diabetes, a healthy diet and regular exercise have a more significant impact as compared to standard diabetes management without a specific focus on lifestyle changes, which leads to lower blood glucose levels and weight management within a year.

Population: Adults 

Intervention: Implementation of comprehensive lifestyle changes (dietary modification and regular exercise)

Comparison: Standard Diabetes Management without Lifestyle Changes

Outcome: lower levels of blood glucose and weight reduction

Time: 1 year.

Action Plan to Implement an Evidence-Based Plan

Physical activities are associated with an increased risk of type 2 diabetes as the sedentary lifestyle works on the insulin resistance in the body, leading to overweight and other health-related issues (Li et al., 2022). whereas the World Health Organization (2023) has reported that a healthy diet, regular exercise, and maintaining a normal body weight have been linked with prevention and delay in the onset of diabetes type 2. Considerable evidence supports the idea that weight management has been identified as the cornerstone of metabolic health, while the quality of the diet is significantly more important (Forouhi et al., 2018). The lifestyle intervention has significantly reduced the risk of onset of type 2 diabetes to 36% in an RTC trial experimental study as compared to the control group (Pot et al., 2020).

The study revealed that the effects of the lifestyle intervention were greater for intensive interventions that combine dietary and physical activity as compared to single-component interventions. The program was developed within the course of 1 year, where the patients who have a lack of glycemic control and obesity were introduced to lifestyle changes such as a healthy diet, such as control food and low-carb and fat-free food options, along with regular exercise such as walking and low-paced exercise, helping people to reduce and maintain weight.

The current plan was developed to ensure that people who are overweight are encouraged to regulate and change their lifestyle choices to encourage them to have long-term sustainable lifestyles and healthy habits. Studies have highlighted that lifestyle changes have significant positive impacts on diabetes management and tend to provide long-term and persistent results (Pot et al., 2020).

NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice

The action plan will be based on

  • Project Overview and Objective: To help the type 2 diabetes patient adapt to healthier dietary habits and engage in regular physical activities to improve blood sugar levels, it is important to have clear goals for the project.
  • Team Building: To provide a better experience for the patients, assemble a team of endocrinologists, dietitians, nurses, physicians, and other staff members to assign roles and responsibilities to the team and to ensure that everyone’s role is being monitored and helpful for patients.
  • Need assessment. The initial step is to conduct a need assessment for the individuals to identify specific needs, preferences, and values of the target population.
  • Education and prevention program: Developing patient-friendly resources to educate regarding healthy eating and exercise, such as portion control, meal planning, physical activity guidelines and benefits, etc., while ensuring that information is culturally sensitive
  • Training and development: Training the development of healthcare professionals for delivering lifestyle interventions through workshops and effective communication training
  • Patient enrollment: Identification of the eligible patients through regular check-ups and then engaging them in voluntary conversation regarding the benefits of lifestyle changes
  • Individualized Care Plan: Developing treatment plans that are personalized for each patient while keeping their health status, readiness to change, and treatment preferences in mind. The goal is to set achievable goals.
  • Tools or resources needed: Dietary consultations, physical exercise equipment, and funding for program implementation
  • Monitoring and follow-up: Regular follow-up and monitoring of the patient’s progress through blood sugar checks and weight assessments
  • Timelines: Setting realistic timelines for achieving goals and then reviewing them

Stakeholders and Potential Barriers to Project Implementation

The stakeholders in this intervention project are:

  • The patient has type 2 diabetes. One of the major stakeholders in the project’s implementation are the patients for whom the project is being devised. The aim of the project is to improve the lifestyle of diabetic patients to control their blood glucose levels and their diet. The primary beneficiary of the project is the patient, and involving them can help in management and adherence to the treatment plan.
  • Healthcare providers.  Health care providers such as endocrinologists, dietitians, physicians, nurses, etc. hold a significant position in the project implementation as they are the direct deliverables that would provide the intervention plan to the patient, monitor progress, and provide support and encouragement to the patient.
  • Project team member. The role of the project team members, such as analysts, educators, and managers, is to conduct the need-based assessment, design the intervention, provide the educational resource material, and then evaluate the efficacy of the project to understand how much the project has benefited the patients.
  • Healthcare organizations. Healthy organizations are the ones that hold the resources and infrastructure for the implementation of the project, and the availability of the infrastructure and resources helps to evaluate the efficacy and reachability of the project to the desired patient.
  • Families. Families and care give us an important role in the treatment plant, as the support and motivation from the families can help the patient stay committed to the lifestyle changes and in following up on post-treatment follow-ups.
  • Community support organizations Community support organizations are the groups that provide support and motivation to the patient while living in a community and help them follow their treatment regime.

NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice

Similarly, the following are the potential barriers to the implementation of the project:

  • Lack of patient engagement When it comes to patients, one of the biggest barriers to the implementation of the patient-based intervention is that some patients might struggle with motivational change and misconceptions about lifestyle modification, which makes it more challenging for them to adapt to a change. Therefore, creating accountability and self-monitoring can help overcome such issues.
  • socioeconomic and cultural factors. Values and preferences differ from individual to individual. The economic status, cultural beliefs, and other values may act as a significant barrier to the implementation of the treatment and influence the patients to accept it. Therefore, it is important to have cultural relevance to the intervention plan.
  • Limited knowledge. The lack of unlimited health literacy among the patients at my company served as a potential barrier for the patient to understand and comprehend complex dietary and exercise recommendations and link them to their medical disease. Hence, easy-to-understand information and suggestions can be more beneficial.

NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice

  • Resistance to change. If a patient is not willing to change, the resistance will become a significant barrier, as the help professional may require more training and support to transition from our transitional care model to a behavior change focus model while encouraging patients to change their perspective of diabetes management based on standard medication interventions to a lifetime change and to help them understand that it might be beneficial for them. Therefore, education and preventive programs can help to clear out myths.
  •  Financial constraints.   Healthy food options, exercise equipment, and other exercise-related sources could be here for the patient, as they may impact their ability to respond to certain kinds of lifestyle interventions. Thus, having home-based food options or walking or low-paced exercises at home would be more suitable options for people who cannot afford them.

Outcome Measures 

The targeted action plan based on evidence-based practice should be assessed through certain set parameters, which can help evaluate the outcomes of the intervention plan. The outcome measures were aligned with the quadruple aims of the Thai action plan, which have an impact on controlling and reducing blood sugar levels. This plan is significantly effective for the organization and the professionals while managing the overall financial burden of supporting and providing medication to diabetic patients. The expected outcomes are:

  • Better blood glucose levels
  • Significant reduction in weight
  • Adherence to healthy eating
  • Increased physical activity
  • Patient satisfaction

All of these outcomes align with the aim of patient outcomes, satisfaction, cost reduction, and well-being through improved blood glucose levels, a reduction in weight, healthy eating habits, patient satisfaction, and increased physical activity.

Search strategies and databases

The search strategies and databases utilized for the current assessment were PubMed, the National Library of Medicine (NIH), and Google Scholars. Other sources that aided in providing statistical and trend-based information were the Centers for Disease Control and Prevention (CDC), the Centre for Food and Animal Health (CFAH), and the World Health Organization (WHO).

Diabetes has a significant role in the healthcare system as it is one of the leading illnesses around the globe, with a prevalence of more than 90.9% among adults older than 18. Studies have highlighted that it is important for the diabetic patient to focus on lifestyle changes as they can help in better glycemic control and reduce the risk of comorbid diseases, while the sedentary lifestyle has been linked as a potential perpetuator of the high blood glucose level (Golovaty et al., 2022). Similarly, a systematic review highlighted that increasing adherence to health behaviors significantly lowers the risk of cardiovascular and cerebrovascular diseases (Zyriax & Windler, 2022).

Conclusion 

With the high prevalence of type 2 diabetes in the American population, it is important to develop programs that aim to address the issue of lifestyle changes and incorporate healthy lifestyles such as a balanced diet and regular exercise into the lifestyle of the diabetic patient to improve their overall health performance. As standardized medication-based diabetes management is affected, having a lifelong change and hearing about certain changes can have long-term benefits, as highlighted in the previous literature. Moreover, it is important to gauge patients and help professionals and other stakeholders provide a comprehensive and cohesive treatment plan for the management of diabetes while catering to the potential barriers and evaluating the change outcomes in accordance with the goals of the program.

References 

Centers for Disease Control and Prevention. (2022, March 28). By the Numbers: Diabetes in America. Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/health-equity/diabetes-by-the-numbers.html

Forouhi, N. G., Misra, A., Mohan, V., Taylor, R., & Yancy, W. (2018). Dietary and nutritional approaches for prevention and management of type 2 diabetes. BMJ361(4), 1–9.

Golovaty, I., Ritchie, N. D., Tuomilehto, J., Mohan, V., Ali, M. K., Gregg, E. W., Bergman, M., & Moin, T. (2022). Two Decades of Diabetes Prevention Efforts: A Call to Innovate and Revitalize Our Approach to Lifestyle Change. Diabetes Research and Clinical Practice, 110195. https://doi.org/10.1016/j.diabres.2022.110195

Julia, N. (2022, November 30). Diabetes Statistics: Facts & Latest Data in the US (2023 Update). CFAH. https://cfah.org/diabetes-statistics/

Li, D., Yang, Y., Gao, Z., Zhao, L., Yang, X., Xu, F., Yu, C., Zhang, X., Wang, X., Wang, L., & Su, J. (2022). Sedentary lifestyle and body composition in type 2 diabetes. Diabetology & Metabolic Syndrome14(1). https://doi.org/10.1186/s13098-021-00778-6

Piché, M.-E., Tchernof, A., & Després, J.-P. (2020). Obesity Phenotypes, Diabetes, and Cardiovascular Diseases. Circulation Research126(11), 1477–1500. https://doi.org/10.1161/circresaha.120.316101

Pot, G. K., Battjes-Fries, M. C., Patijn, O. N., van der Zijl, N., Pijl, H., & Voshol, P. (2020). Lifestyle medicine for type 2 diabetes: practice-based evidence for long-term efficacy of a multicomponent lifestyle intervention (Reverse Diabetes2 Now). BMJ Nutrition, Prevention & Health, bmjnph-2020-000081. https://doi.org/10.1136/bmjnph-2020-000081

NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice

Sharma, A., Mittal, S., Aggarwal, R., & Chauhan, M. K. (2020). Diabetes and cardiovascular disease: inter-relation of risk factors and treatment. Future Journal of Pharmaceutical Sciences6(1). https://doi.org/10.1186/s43094-020-00151-w

World Health Organization. (2023, April 5). Diabetes. World Health Organisation; WHO. https://www.who.int/news-room/fact-sheets/detail/diabetes

Zareini, B., Blanche, P., D’Souza, M., Elmegaard Malik, M., Nørgaard, C. H., Selmer, C., Gislason, G., Kristensen, S. L., Køber, L., Torp-Pedersen, C., Schou, M., & Lamberts, M. (2020). Type 2 Diabetes Mellitus and Impact of Heart Failure on Prognosis Compared to Other Cardiovascular Diseases. Circulation: Cardiovascular Quality and Outcomes13(7). https://doi.org/10.1161/circoutcomes.119.006260

Zyriax, B.-C., & Windler, E. (2022). Lifestyle changes to prevent cardio- and cerebrovascular disease at midlife: A systematic review. Maturitas. https://doi.org/10.1016/j.maturitas.2022.09.003