Evidence-based Practice Proposal (Solution Description)
Currently, the self-management education initiative employs various techniques in the management of diabetes among the elderly. For instance, the program entails the use of telehealth, social support and face-to-face diabetes interventions. As such, there is need for considering all these available options before implementation of self-management education program for the effective management of diabetes among elderly persons. In essence, this paper aims at establishing the practical details of the proposed solution (diabetes self-management educational program) adopted for the maintenance of glycemic control among diabetic elderly population. The discussionwill offer a fulldescription ofthe proposed solution, proposed solution’s consistency with the organizational culture, the expected outcomes, methods of outcome achievement and outcome impact.
Primarily, the proposed solution is a diabetes self-management educational program use of a variety of interventions whose identification and their implications are worth highlighting. The interventions that will come in handy for this program are mainlythe common categories of self-management education, namely, telehealth interventions and in-person diabetes self-management education (Lepard, Joseph, Agne, &Cherrington,2015). The telehealth interventions such as videoconferencing, telephone calls or the internet will use the already existent hospital’s technology to deliver services from a remote area. On the contrary, the in-person diabetes self-management education entails group and individual sessions.
Concisely, both interventions (telehealth interventions and in-person diabetes self-management education) are consistent with current evidence. For instance, Lepard, Joseph, Agne, andCherrington,(2015) suggest that these interventions have a high efficacy in the maintenance of glycemic control.Lastly, these interventions are realistic and cost-effective. That is for sure since they will rely mainly on the already existent technology and workforce for their full implementation. As such, new costs are minimal during implementation of the project.
Of utmost significance to the success of any quality improvement project is its consistency with the organizational culture of an institution. Primarily, the proposed solution of diabetes self-management educational program is consistent with the organizational culture in a variety of ways that are worth noting. For example, the proposed solution (diabetes self-care educational program) is a component of preventative healthcare services, which Cornerstone Family Healthcare envisions to provide in its mission statement (Cornerstone Family Healthcare, 2017). With suchan alignment with the organizational mission, it is beyond doubt that the self-management educational program is consistent with the organizational culture.
Worth noting during the evaluation of the project evaluation are various outcomes. However, the primary outcome of interest for this proposed solution is HbA1c level, which signifies the average serum glucose levels carried out after 2 or 3 months. Secondary outcomes considered in other studies and that may prove to be important for this project evaluation include fasting blood glucose (FBG) levels, lipid profiles and body mass index (BMI) measurements (Lepard, Joseph, Agne, &Cherrington,2015).
Precisely, achievement of the HbA1c levels will be through measurement of the serum glucose levels three months prior to the implementation of the intervention, which will serve as the baseline measurement. Also, the project will measure the HbA1c levels1 and 2 years after implementation for comparison with the baseline measurement.
From the organization evaluation, it is apparent that barriers to the project implementation abound and are worth noting. A case in point of such impediments is the partial support for the EBP movement within the organization by the administrators. Lack of full support by the organizational administrators is not good for the implementation of EBP projects because it leads to resistance to the implementation of the project (Hirschman, Shaid, McCauley, Pauly, Naylor, 2015).
Another likely barrier for the institutionalization of this project is the limited number of EBP champions among the physician and nurse educators within this organization. Such a challenge slows down the pace of implementation of this project given the least likelihood of physicians and nurse educators taking part in this project’simplementation (Hirschman, Shaid, McCauley, Pauly, Naylor, 2015).
The achievement of the outcome of interest, normal HbA1c level, will have several impacts on various indicators that are worth mentioning. A case in point, maintenance of a normal HbA1c leveltranslates to quality of care offered to an individual. That is for sure because well-controlled diabetes highlighted by maintenance of normal HbA1c levels prevents development of complications and instances of readmissions, which are characteristic of poor quality of care (Nicoll, et al., 2014). Clearly, with such an illustration, it is beyond question thatachievement of the primary outcome (HbA1c level) influence positively the quality of care provided.
In closure, this paper aimed at providing a full description of the proposed solution, proposed solution’s consistency with the organizational culture, the expected outcomes, methods of outcome achievement and outcome impact. Indeed, from the discussion, it is beyond doubt that the paper has not fallen short of meeting these objectives. An implication drawn from this analysis is the need for evaluation of the practical details of the project such as the potential cost of the project before implementing it. In the absence of such consideration, however, the failure of project implementation is inevitable.
Cornerstone Family Healthcare.(2017). Family Healthcare Practice | Cornerstone Family Healthcare | New York | Cornerstone Family Healthcare. Cornerstonefamilyhealthcare.org. Retrieved 10September 2017, from http://www.cornerstonefamilyhealthcare.org/about-cornerstone/
Hirschman, K., Shaid, E., McCauley, K., Pauly, M., Naylor, M. (2015). Continuity of care: the
transitional care model. The Online Journal of Issues in Nursing, 20(3).DOI: 10.3912/OJIN.Vol20No03Man01
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.