Identify a quality improvement opportunity in your organization or practice.
In a 1,250-1,500 word paper, describe the problem or issue and propose a quality improvement initiative based on evidence-based practice. Apply \\\”The Road to Evidence-Based Practice\\\” process, illustrated in Chapter 4 of your textbook, to create your proposal.
Include the following:
Provide an overview of the problem and the setting in which the problem or issue occurs.
Explain why a quality improvement initiative is needed in this area and the expected outcome.
Discuss how the results of previous research demonstrate support for the quality improvement initiative and its projected outcomes.
Introduction
The US health expenditure is one of the highest globally, yet outcomes continue to be ranked as the lowest among its developed countries peers. Healthcare experts agree that much of the health expenses occur during the management of chronic diseases like dyslipidemia, cardiovascular diseases, chronic pulmonary disease as well as diabetes amongst several others. Nevertheless, despite the US health system allocating more on the provision of health services to the chronically ill, the results continue to be not only dismal but also unsatisfactory. As a result, the Affordable Care Act of 2010 incorporated several provisions meant to detect, manage, and improve the incidence of chronic diseases through change implementation that leads to quality improvement using the best available evidence. Consequently, this essay purposes of identifying a quality improvement opportunity in nursing area practice that tackles type 2 diabetes management through the implementation of evidence-based T2DM self – management education bundle (T2SMEB) for diabetic patients.(Quality Improvement on Type 2 Diabetes Management)
Overview of the Problem and the Setting in which the Problem Occurs
Diabetes (of which T2DM accounts for over 90 % of the cases) is ranked at number seven as one of the leading causes of death within the US and affects more than 25 million individuals. In the primary care setting, T2DM, in general, is said to lower life expectancy by up to fifteen years besides increasing the risk of cardiovascular diseases by twofold or even fourfold. It also leads to adult-onset blindness, leg amputations, kidney failure, and premature death. T2DM imposes a substantial economic and health burden, significantly contributing to one of the critical causes of hospital admissions in the US. It is estimated that close to half a million in-patients every year are due to T2DM, where about 100 000 of these patients have a one-month readmission rate (Ostling et al., 2017). Subsequently, the American Diabetes Association (ADA) and its counterpart, the American Association of Clinical Endocrinologists (AACE) have formulated guidelines as well as standards for T2DM management for nurses offering care to in-patients. Grown-up patients with T2DM embark on a treatment course that, among other things, includes a comprehensive medical evaluation, interprofessional team approach, glycemic control appropriate medication intervention in addition to those measures undertake by prediabetics. Be that as it may, the implementation of the T2SMEB project that is evidence-based requires effective communication not just for staff nurses but also for other healthcare professionals and the T2DM patients themselves coupled with sufficient diabetes resources in addition to T2DM information that is current and evidence-based.(Quality Improvement on Type 2 Diabetes Management)
Why a Quality Improvement Initiative is required for Patient Knowledge on Diabetes Self- Management Practices
One of the US national health goals is to decrease T2DM and its economic costs while also improving the quality of life for all individuals diagnosed with T2DM or those at risk of the disease. With the current quality improvement initiative based on educational interventions informed by current T2DM research, guidelines as well as competency assessments required to maintain the staff nurses’ professional knowledge base who, in turn, educates their patients. It is also expected that among the diabetic patient population, there will also be improved patient outcomes, as evidenced by decreased one-month readmission rates.(Quality Improvement on Type 2 Diabetes Management)
How Results of Previous Research Demonstrate Support for the QI Initiative
Nursing professionals gather knowledge in several ways. Translating knowledge into practice demands both review and analysis of the best studies available, assessing their relevance and the potential effect on clinical practice while simultaneously factoring in the position of the target population in the continuum of healthcare and the impact the EB clinical practice has on their outcomes. Using the keywords of the T2SMEB PICOT based question comprehensive and systematic search of electronic databases like PubMed, CINAHL, ProQuest and COCHRANE were performed using a combination of words and phrases like diabetes self- management, email message, and text messages and internet-based interventions. Citation chasing was also used as an additional search strategy. (Quality Improvement on Type 2 Diabetes Management)The articles that were considered for the project’s literature review comprised of studies whose target population individuals above eighteen years, with T2DM, was focusing on diabetes management with internet-based messaging whose findings were published in English between 2010 and 2020. Studies published before 2010, not published in English or including other chronic diseases or targeting children, were excluded. Of the 25 potential resources that up, only three made it to the final list. The first article was 2018 clinical practice guidelines by Sherifali et al. (2018) that singled out evidence in support of the use of internet initiatives to enhance lifestyle change and T2DM education among adults. These internet-based interventions covered ADA targeted behaviors like being active, healthy eating, adherence to prescribed medication, blood glucose level monitoring, and reducing risks. New online materials like use interactive modules allow the development of online communities that act as self-management support networks.(Quality Improvement on Type 2 Diabetes Management)
The second study explored the impact social media use had on interventions for diabetes (Gabarron, Arsand & Wynn, 2018). While acknowledging scarcity of good quality evidence on the use of social; media in assisting patients with T2DM, the use of social media was linked to some benefits on patients’ outcomes. The third and last of the resource had content addressing the role of mobile phone applications in self-management practices for T2DM among app users and those, not the apps (Jeffery et al., 2019). As they had anticipated, the integration of user-centered features had the potential of improving health outcomes among T2DM patients who were using the apps.(Quality Improvement on Type 2 Diabetes Management)
Steps Necessary to Implement the T2SMEB Project
Prior to quality improvement through a practice change implementation, the change agent must be aware of the best available evidence required to implement evidence-based practice. (Quality Improvement on Type 2 Diabetes Management)The implementation of the EBP project commences with a pertinent clinical question or dilemma concerning a person or a group, followed by a search for and subsequent appraisal of the best evidence or research available before those findings are utilized together with clinical skills. At the same time, patient preferences are integrated into scientific theory coupled with EBP framework using a systematic approach and appropriate appraisal tools to ensure that the retrieved evidence is grounded on sound and scientific research principles that can be applied to the population in context. The systematic appraisal of evidence is followed by the synthesis of relevant evidence, which is then incorporated into the clinical skills and preferences of the patients to guide the clinical decision for change. (Quality Improvement on Type 2 Diabetes Management)
Evaluation of the change in clinical practice, together with the impact on patient outcomes, marks the last step of the EBP project. Based on these the clinical question based on PICOT structure that will guide this quality improvement initiative states ‘In T2DM grown-up patients- population (P) will become a six-week self –management education on T2DM delivered thorough email services -Intervention (I) compared to convention diabetes care- Comparison(C) lead to decreased one-month hospital readmission rates due to improved patient self-care knowledge-Outcome (O) over three months- Time (T). (Quality Improvement on Type 2 Diabetes Management)
How the T2SMEB Will Be Evaluated To Determine Whether There Was Improvement
Diabetes evaluation tools indicate proven validity as well as reliability in measuring diabetes knowledge in general. The Diabetes Knowledge Test (DKT) 23-question multiple-choice tests comprising of 14 questions connected to general knowledge on diabetes ranging from diagnosis to treatment, all the way to complications, lifestyle behavior modifications will be used to establish diabetes knowledge level among adult T2DM patients. Another outcome measure that will show there was an improvement in DSME is a percentage decrease in the one readmission rate of T2 diabetes patients. The independent variable that the PICOT Question seeks to address the direct connection posited by this researcher to determine if patient knowledge on DSME an indicator of high levels of health education literacy significantly impacts on dependent variables of self –management practices a health behavior that is postulated lead to lowered rates of hospital readmissions due to T2DM within one month of discharge. The measurement of dependent variables of DSME practices will be conducted by combining the four items of diabetes self- management that consist of whether the individual exercised every week, checked their blood glucose levels at least one time every day, checked their feet for irritation or sores every day and whether the person had ever participated in a course program on T2DM management.(Quality Improvement on Type 2 Diabetes Management)
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Quality Improvement on Type 2 Diabetes Management
Hypothesis testing will involve diabetes self-management practices as the dependent variable with the highest level of education included the only covariate in testing. This study will have a directional hypothesis that predicts that the implementation of the T2SMEB project will lead to increased patient knowledge on T2 self-management practices that, in turn, cause a decrease in the rate of hospital readmission within one month of hospital discharge. The null hypothesis for this program states that the implementation of T2SMEB has no effect on patient knowledge concerning diabetes self-management practices and leads to increased one-month hospital readmission rates due to T2DM. At the same time, a paired T-Test will be the statistical test testing the difference between two variables from the same adult T2DM patients comprising of the pre-test scores and post-test scores before and after the implementation of T2SMEB compared to those who were having the usual convention care.(Quality Improvement on Type 2 Diabetes Management)
Conclusion
In conclusion, the purpose of this quality improvement initiative will be to design and implement a T2DM self- management education bundle project that embraces an innovative delivery platform that overcomes the limitations of traditional face to face visits after every three months. This quality improvement program involves the implementation of a six week T2SMEB for grown-up patients with T2DM delivered through email from a patient portal to a personal internet-enabled device like a smartphone or personal computer. The goal of the EBP will be to improve patient outcomes, as demonstrated by reduced one-month hospital readmission rates after the discharge of T2DM grown-up patients.
References
Gabarron, E., Årsand, E., & Wynn, R. (2018). Social media use in interventions for diabetes: a rapid evidence-based review. Journal of medical Internet research, 20(8), e10303.(Quality Improvement on Type 2 Diabetes Management)
Jeffrey, B., Bagala, M., Creighton, A., Leavey, T., Nicholls, S., Wood, C., & Pit, S. (2019). Mobile phone applications and their use in the self-management of Type 2 Diabetes Mellitus: a qualitative study among app users and non-app users. Dialectology & metabolic syndrome, 11(1), 84.(Quality Improvement on Type 2 Diabetes Management)
Kim, S. H., & Utz, S. (2019). Effectiveness of a Social Media–Based, Health Literacy–Sensitive Diabetes Self‐Management Intervention: A Randomized Controlled Trial. Journal of Nursing Scholarship, 51(6), 661-669.(Quality Improvement on Type 2 Diabetes Management)
Ostling, S., Wyckoff, J., Ciarkowski, S. L., Pai, C. W., Choe, H. M., Bahl, V., & Gianchandani, R. (2017). The relationship between diabetes mellitus and 30-day readmission rates. Clinical diabetes and endocrinology, 3(1), 3.
Sherifali, D., Berard, L. D., Gucciardi, E., MacDonald, B., & MacNeill, G. (2018). Self-management education and support. Canadian Journal of diabetes, 42, S36-S41.(Quality Improvement on Type 2 Diabetes Management)
Question – Quality Improvement on Type 2 Diabetes Management
Identify a quality improvement opportunity in your organization or practice.
In a 1,250-1,500 word paper, describe the problem or issue and propose a quality improvement initiative based on evidence-based practice. Apply \\\”The Road to Evidence-Based Practice\\\” process, illustrated in Chapter 4 of your textbook, to create your proposal.(Quality Improvement on Type 2 Diabetes Management)
As you continue, premiumacademicaffiates.com has the top and most qualified writers to help with any of your assignments. All you need to do is place an order with us. (Quality Improvement on Type 2 Diabetes Management)
Quality Improvement on Type 2 Diabetes Management
Include the following:
Provide an overview of the problem and the setting in which the problem or issue occurs.
Explain why a quality improvement initiative is needed in this area and the expected outcome.
Discuss how the results of previous research demonstrate support for the quality improvement initiative and its projected outcomes. (Quality Improvement on Type 2 Diabetes Management)
Include a minimum of three peer-reviewed sources published within the last 5 years, not included in the course materials or textbook, that establish evidence in support of the quality improvement proposed.
Discuss steps necessary to implement the quality improvement initiative.
Provide evidence and rationale to support your answer. (Quality Improvement on Type 2 Diabetes Management)
Explain how the quality improvement initiative will be evaluated to determine whether there was improvement.
Support your explanation by identifying the variables, hypothesis test, and statistical test that you would need to prove that the quality improvement initiative succeeded
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