further diabetes education. The EBP change project was able to increase diabetes knowledge among African Americans with prediabetes by discussing risk factors associated with type 2 diabetes, proper nutrition and promoting health promotion behaviors. Currently, there is no diabetes education program or policy that’s in place targeting patients with prediabetes at the EBP change project site. Therefore, it is the project manager goal that the EBP change project site will begin to implement a diabetes education program focusing on the prediabetic patient population.
A policy that is currently being implemented on a national level regarding type 2 diabetes prevention is being spear headed by Patient Protection (PP) and the Affordable Care
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Links to Health Promotion
According to Rural Health Information Hub (2017), the fundamental purpose of disease prevention is to keep individuals healthy. One implements health promotion interventions in an effort to promote healthy behaviors and to decrease the risks of developing chronic illnesses (RHIH, 2017). According to the ADA (2016) individuals that participate in health promotion behaviors are more likely to have better health outcomes compared to those who do not. The EBP change project has shown that educating patients with prediabetes can increase diabetes knowledge and promote an increase in health promotion behaviors. The EBP change project outcome has indicated that participants who completed the 6-week diabetes education program were able to increase their knowledge regarding type 2 diabetes. Therefore, with the positive outcome of the EBP change project, the EBP change project site can incorporate certain aspects of the diabetes education program into their patient education to increase diabetes knowledge, picking healthier food options and participants in activities that would increase physical fitness.
Role of DNP-prepared nurse. The American Association of Colleges of Nursing AACN (2006) created VIII essentials that define the key elements that are necessary for a doctor of nursing practice program. Two key essentials that played a major role in the project manager’s planning and implementation during the EBP change project are:
The health disparities among the Blacks/African American is on the rise which is of being mostly affected by diabetes the United States and Maryland. Diabetes and cardiovascular diseases are connected which can lead to increase mortality among this population. In that matter, the Health Empowerment African Americans Diabetes Program proposal includes my creating awareness which will offer diabetes education as connected to other commodities and self-management and counseling. This will be done through outreach programs in the community in health classes and health fairs through health screening, blood glucose screening, A1C, exercise activities, body mass index (BMI), weight, monitoring of individual self-monitor log, and
Several nationwide programs and incentives were administered in the last couple of decades to promote awareness of diabetes and hopefully help prevent millions of Americans from developing diabetes. Health Agencies, such as World Health Organization (WHO) and Center of Disease Control and Prevention (CDC), have developed objectives to tackle diabetes. Some of these objectives include conducting surveillance and obtaining diabetes data to identify trends in the population, spreading awareness about the condition, and developing programs that will enhance diabetes care and ensure the longevity of the patients. Various programs have been developed but while some excel, others fail to benefit the lives of the patient.
The rate of diabetes in the United States is one of the highest compared to other developed countries. An estimate of 9.3% of the population have diabetes, of those with diabetes 27.8% have yet to be diagnosed (Centers for Disease Control and Prevention [CDC], 2014). This means that approximately 8.1 million people are currently living with diabetes, but are unaware of it. As of 2012, 12.3% of people with diabetes were 20 years old or older, the largest population diagnosed with diabetes were adults 65 years old or older. 25.9% of this population lives with diabetes (CDC, 2014). On a national level, the CDC have launched initiatives that focus on prevention and disease management. The National Diabetes Prevention Program is an example of one such initiative. This program focuses on lifestyle changes,
Type II diabetes is a disease that affects millions of people in the United States and is also a disease that is continually growing in numbers. The cost of the individual and national health care systems is also a number that is growing. Policy for prevention of diabetes and pre-diabetes is something that while has changed some in the past, has been basically the same for the past 20-25 yeas. This disease affects many throughout the country, but effects those in the middle and lower classes due to the cost of eating healthier being greater than the alternative and also due to the fact that these groups are less likely to go for routine health care.
The planned intervention for this scholarly EBP change project was to implement a culturally sensitive diabetes education program. Information that was part of the culturally sensitive diabetes education program included educational materials on type 2 diabetes, training guides,
Diabetes (DM) is one the many initiatives that Healthy People 2020 have been focusing on to reduce this disease morbidity and mortality rates throughout the communities. In the United States alone, the number of individuals diagnosed with diabetes has increased from 1.5 million in 1958 to 25.8 million in 2011. The Center for Disease and prevention (CDC) also estimates in the year 2011, 79 million people age 20 and over were noted to have pre-diabetes, in which the blood sugar was higher than normal levels, however, have not reached the level for a diagnosis of DM. Eleven percent of those individuals with pre-diabetic readings of raised blood glucose will progress in full blown diabetes a matter of three years. Healthy People 2020 have used evidence –based practices to aid in the prevention and treatment of diabetes. Evidence have shown by simply modifying one’s lifestyle such regular exercising and healthy eating have been recognized to effectively prevent or delay the onset of type 2 diabetes in high-risk persons. Case in point, the Diabetes Prevention Program research trial revealed that the utilization of lifestyle interferences had its utmost impact in elderly adults and was also effective in all racial groups.
DNP preparation aims to provide the APRN a larger view of systems of health delivery. The American Association of Colleges of Nursing (AACN) states the DNP- FNP is to develop and evaluate care delivery approaches to address current and future needs of patient population using scientific findings not restricted to nursing, but adding from other sciences, as well as
To start my plan for implementation, I will first talk to my director of nursing, manager, and nurse educator for approval. I plan to implement increase evidence based practice use in my department (cardiac unit). I will obtain information from our quality assurance nurse to evaluate how our core measures like AMI, chf, and stroke bundle is being consistently followed by the nurses in my department. I plan to empower staff nurses to use EBP. I will schedule workshops for nurses interested in learning more about research and EBP, increase access to library resources and EBP information, interactive EBP skills and rounds, development of EBP mentors and champions. The change should be an ongoing support from the leaders and organization to
Although the American Association of Colleges of Nursing clearly defined the role of Doctor of Nursing Practice (DNP) degree in 2004, some confusion about the academic programs still exist. The role of both the DNP and PhD-prepared individuals is to improve the quality of health care and the health of population through the use of the best evidence when assisting them in making decisions about treatment options. Melnyk, B. M. (2013). According to the national leaders in major healthcare fields, mentioned a gap between research and practice and the importance to apply research findings and engage in evidence-based practice. In order to translate this knowledge, the clinician must understand the healthcare delivery in order to help narrow the research-to-practice gap and transform health care. DNP-prepared nurses are trained to reduce the research-to-practice gap. Because most nurse lack knowledge to critically appraise research studies and the skills to effectively implement evidence-based practice (EBP) in their clinical settings.
Type 2 diabetes is a chronic disease where patient education is imperative and requires education that surpasses the primary care office. According to Cha et al. (2012) basic education and family involvement is an essential component for pre-diabetic and diabetic population to achieve glycemic control. Time management and time constraint are obstacles that are affecting the primary care provider in initiating health promotion topics and disease prevention information (Kowinsky, Greenhouse, Zombek, Rader & Reidy, 2009). Recognizing the time constraint at the EBP change project site for health promotion and patient education a culturally sensitive educational program would be created to promote healthy lifestyle behaviors targeting African Americans with prediabetes.
My teaching on primary prevention of type II diabetes adheres to HP2020 objectives D-1 to D-16 on diabetes, specifically objective D-1 that deals with reducing the annual number of new cases of diagnosed diabetes in the population. (Target is a 10% improvement from the baseline of 8.0 new cases of diabetes per 1,000 population aged 18 to 84 years occurred in the past 12 months to the target of 7.2 new cases per 1,000 population aged 18 to 84 years). Education on the preventive measures needed to be taken by an at-risk population tackles this issue of reducing the annual number of cases.
Improving the management and prevention of diabetes is at the forefront of public quality initiatives improvements. Government agencies such as, The National Institute of Diabetes and Digestive and Kidney Disease and The Centers for Disease Control and Prevention (CDC), work together to fund research studies to improve disease management and prevention initiatives across the nation. The most effective initiatives are those that center on the health care team, and the interactions between the team and patient (Shojania et al., 2006). Team based initiatives that focus on education and patient involvement highlight the correlation between increased health literacy and improved disease management and prevention.
The review of literature section will define diabetes and prediabetes, identify the prevalence and major risk factors for diabetes, and present behavioral changes that can reduced the risk of developing diabetes. This section discusses the types of presentations and teaching methods that have been utilized in diabetes prevention and the health belief model. The final paragraphs in the review of literature present the learning theory and delivery method of instructional designs, which are ideal for a diabetes prevention program.
This EBP change project is important because the clinical site currently lacking efforts focusing on health promotion initiatives for the pre-diabetic and type 2 diabetic patients. At the EBP change project site an estimated 40% of the patient population are diagnosed with either prediabetes or type 2 diabetes. Out of the 40%, an estimated 25% is diagnosed with prediabetes and is at risk for developing type 2 diabetes. Another reason as to why this project is important to the project manager is that majority of the patient population has a knowledge deficit regarding health promotion behaviors in preventing type 2
Health objectives and campaigns are designed to set the foundation for addressing health care issues prevalent across the nation. Diabetes is a disease that affects millions of people. Due to the complications that can often go along with diabetes, public health policies are implemented to clarify issues that will improve the health of individuals. As presented in the health campaign part one, there are numerous government agencies, which exploit health information on federal, state, and local levels to develop policies and allocate resources to programs and necessary organizations. Many models and systems are used to manage diabetes and bring forth