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.  Evaluation of Process And Evidence Based Practice Proposal

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.

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Section F: Evaluation of Process

The Rationale for the Methods used in Collecting the Outcome Data

The data that will be collected includes participant’s details, baseline HA1c, and follow-up HA1c. The rationale for collecting the baseline HA1c and follow-up HA1c is to determine if the intervention (home diabetes education and medication assistance) was effective in reducing the HA1c levels for the target population. The HA1c levels of the study participants before the implementation of the intervention will be compared with HA1c levels of the participants after the implementation of the intervention. Reduced HA1c levels among the study participants will indicate that the intervention (home diabetes education and medication assistance) was effective (Pikkemaat et al., 2018).

Measuring if Outcomes of the Project Objectives are achieved

The key aim of an evaluation is to produce information about how the project performed in terms of relevance, efficacy, and efficacy. An evaluation is also used to determine the overall impact of a project. The specific objectives in the evaluation project include examining the effect and impact of diabetes education in a classroom setting and medication assistance on rural Americans with elevated HA1c levels.

The outcome of the project that will demonstrate the achievement of the project’s objectives include the reduced HA1c levels among the rural Americans and improved adherence to the treatment regimen for the target population. This is because the overall goal of the project is to improve the HA1c levels of rural Americans with increased levels of HA1c.

Measuring and Evaluating Outcome Basing on the Evidence

The outcome data will be collected using questionnaires and scaled checklists to ease data collection and due to the tractability of these two data collection techniques. Questionnaires can collect a large volume of data and from a large sample size with minimal costs (Abildgaard et al., 2016).  Quantification of findings and data collected using questionnaires is possible and this the outcomes can be measured easily to determine any change after comparing the data. Scaled checklists streamline the assessment process and thus informs decision-making. Therefore, it is possible to integrate checklists into the routine care of individuals with diabetes and thus improve the continuous identification and eradication of risk factors for elevated HA1c levels (Cho, 2016).

Evidence shows that the common treatment target for adults with diabetes is an HA1c level of 7% or less (Torimoto et al., 2017). Therefore, questionnaires and checklists will collect data about the levels of HA1c among the study subjects and this data will be compared against the target HA1c levels.

When the HA1c levels reduce, this will indicate the validity of the project (Ruark & Miller, 2016). The checklists will provide continuous feedback about the project to ensure the reliability of the study outcomes. The validity and reliability of the findings from this project will indicate the applicability of the findings to the general population (Beidas et al., 2015). Evaluation of Process And Evidence Based Practice Proposal 

Strategies to Take if Outcomes do not Provide Positive Results

In case the outcomes do not provide positive results, a root cause analysis will be conducted to identify the primary cause of the failure. If the failure occurred due to methodological issues, the project will be performed again, with different research methods. If the analysis indicates that the methodology did not cause the failure, the project will not be repeated (Ruark & Miller, 2016).

Implications for Practice and Future Research

Reducing the HA1c levels for individuals with diabetes is very important to avoid diabetes complications. Therefore, it is necessary to educate individuals with diabetes about self-management to equip them with the necessary knowledge and skills to manage the condition. This is important in ensuring these individuals appropriately control blood glucose levels and avoid any complications (Pikkemaat et al., 2019). There is a need to perform further research to establish factors that hinder people with diabetes from acquiring the necessary diabetes self-management skills.

References

Abildgaard J, Per S & Nielsen K. (2016). How to Measure the Intervention Process? An Assessment of Qualitative and Quantitative Approaches to Data Collection in the Process Evaluation of Organizational Interventions. Front Psychol. 7(1380).

Beidas R, Stewart R, Walsh L, Lucas S, Downey M, Jackson K & David M. (2015). Free, brief, and validated: Standardized instruments for low-resource mental health settings. Cogn Behav Pract, 22(1): 5–19.

Cho M. (2016). Preliminary reliability of the five-item physical activity questionnaire. J Phys Ther Sci, 28(12), 3393–3397.

Pikkemaat, M., Boström, K. B., & Strandberg, E. L. (2019). “I have got diabetes!” – interviews of patients newly diagnosed with type 2 diabetes. BMC endocrine disorders, 19(1), 53. https://doi.org/10.1186/s12902-019-0380-5.

Ruark A & Miller R. (2016). Using Qualitative Methods to Validate and Contextualize Quantitative Findings: A Case Study of Research on Sexual Behavior and Gender-Based Violence Among Young Swazi Women. Glob Health Sci Pract, 4(3), 373–383.

Torimoto, K., Okada, Y., Sugino, S., & Tanaka, Y. (2017). Determinants of hemoglobin A1c level in patients with type 2 diabetes after in-hospital diabetes education: A study based on continuous glucose monitoring. Journal of diabetes investigation, 8(3), 314–320. https://doi.org/10.1111/jdi.12589

Evidence-Based Practice Proposal – Section C: Solution Description

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Introduction

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.

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. Evaluation of Process And Evidence Based Practice Proposal

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.

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

Evaluation of Process And Evidence Based Practice Proposal