Evidence-based Practice Proposal (Problem Description)

In the contemporary medical world, diabetes is one of the leading chronic conditions that affect a high proportion of the total population. For instance, according to Nicoll, et al.,(2014), approximately, 26 million persons are victims of this condition in the USA. More worrying is the non-selective nature of the diabetes, which makes it a disease of both the young and elderly persons. In the elderly population, diabetes has disastrous effects in the body if not well managed and controlled. A key element of the diabetesmanagement is the use of health education to empower the patients on how they should manage the condition. A variety of health educational programs is existent but the commonly known is the traditional education program.However, with the increase in quality improvement initiatives, the self-management education program is an emerging tool whose use is increasingly growing.In essence, this paper focuses on introducing self-management education programs as an EBP intervention for the management of elderly type II diabetic patients in Cornerstone Family Healthcare. Informing this desire is the existence of poor outcomes such as abnormal A1C levels in elderly diabetic patients despite undergoing the traditional education sessions before discharge. Central to the analysis are various aspects, namely, the problem background, stakeholders, PICOT question, project’s purpose as well as objectives and relevance of the project.

Problem background

Of particular interest in the management of diabetic elderly patients in Cornerstone Family Healthcare is the reliance of the traditional patient education. Globally, many healthcare organizations are reliant on the same practice. Despite the dependence on the practice, controversy over its efficacy in maintaining glycemic control (normal A1C levels) is existent. That is for sure given the existence of poor outcomes such as abnormal A1C levels in elderly diabetic patients despite undergoing the traditional education sessions before discharge. As such, there isa need for trying new and emerging patient education techniques such as self-management education programs for diabetes, which have proven success records in other healthcare organizations (Ricci-Cabello, Ruiz-Perez, Rojas-García, Pastor, &Gonçalves, 2013).

Stakeholders and Change agents

Fundamental to the institutionalization of the EBP intervention are various stakeholders and change champions that are worth mention. The stakeholders include nurses (staff and advanced practice), physicians,administrators, elderly patients, and family caregivers. On the contrary, the change champions include advanced practice nurses, staff nurses, physicians and administrators. Precisely, the success of this project implementation solely relies on the engagement of these stakeholders. As such, seeking for the stakeholders’buy in is necessary ifthe EBP project is to bear fruit.

The PICOT Question

The PICOT question that will facilitate the realization of the project’s purpose and specific objectives is:

In adult patients (aged 65 years and above) with type II diabetes in a family healthcare center (P), how does self-management education program (I) compared to traditional education (C) influence A1C level over a period of 6 months?

Purpose of the Project

Of utmost significance to this quality improvement project is thedetermination of the impact ofself-management education program on A1C levels of elderly patients. Precisely, this is the solitary and main purpose as well as the overall goal of this project.

Objectives of the Project

Central to the achievement of the primary goal of the project are various specific objectives, which are as follows:

To determine the efficacy of self-management education program in maintaining glycemic control as evidenced by normal A1C levels
To investigate the commonly used health education techniques in the self-management education program

Relevance of the Project to Nurses

The EBP intervention (self-management education program) comes with several advantages to individuals in the nursing profession. That is for sure because institutionalization of this EBP intervention will result in patients who are not knowledgeable about diabetes but also empowered to manage the disease on their own while in their homes. Moreover, the project will ensure the realization of better healthcare and patient outcomes such as high patient and staff satisfaction levels as well as reduced incidences of complications due to poor glycemic control (Peña-Purcell, Boggess, & Jimenez, 2011). With such capabilities, it is beyond question that this EBP project will greatly improve nursing practice.

Sources of Evidence

Full APA Citation for Sources of Evidence

Lepard, M. G., Joseph, A. L., Agne, A. A., &Cherrington, A. L. (2015).Diabetes self-management interventions for adults with type 2 diabetes living in rural areas: a systematic literature review. Current diabetes reports, 15(6), 37.

Nicoll, K. G., Ramser, K. L., Campbell, J. D., Suda, K. J., Lee, M. D., Wood, G. C., Sumter, R., &Hamann, G. L. (2014). Sustainability of improved glycemic control after diabetes self-management education. Diabetes Spectrum, 27(3), 207-211.

Peña-Purcell, N. C., Boggess, M. M., & Jimenez, N. (2011). An empowerment-based diabetes self-management education program for Hispanic/Latinos: a quasi-experimental pilot study. The Diabetes Educator, 37(6), 770-779.

Ricci-Cabello, I., Ruiz-Perez, I., Rojas-García, A., Pastor, G., &Gonçalves, D. C. (2013).Improving diabetes care in rural areas: a systematic review and meta-analysis of quality improvement interventions in OECD countries. PloS one, 8(12), e84464.

Worswick, J., Wayne, S. C., Bennett, R., Fiander, M., Mayhew, A., Weir, M. C.,Sullivan, K.J.,&Grimshaw, J. M. (2013). Improving quality of care for persons with diabetes: an overview of systematic reviews-what does the evidence tell us?. Systematic reviews, 2(1), 26.

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.

Conclusion

Concisely, this paper aimed at justifying the need for institutionalizing a self-management education programthat targets elderly type II diabetic patients (65 years and above).Central to the justification, the analysis focused on highlighting the problem background, stakeholders, PICOT question, project’s purpose as well as objectives and relevance of the project. Indeed, from the discussion, it is apparent that there is a need for trying out this self-management education program. Such is the case given the vast state of evidence demonstrating the multiple advantages that it can yield in the glycemic control of diabetic elderly patients.However, in the absence of such a consideration, realization of these benefits will remain a dream for the unforeseeable future.

References

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