EBP status report

Running Head: CHANGE PROJECT PLAN 1

Change Project Plan 4

Change Project Plan

Lisette Duque

West coast University

Proposed Plan

The evidence-based change project focuses on identifying the best current evidence through the integration of clinical expertise and patient’s values to guide effective decision-making regarding patients with diabetes. This plan will incorporate strategies and tactics relevant for the evaluation of diabetes self-management among patients to improve HbA1c. To assess the environment, this change project will outline the knowledge base by providing the participants who are from the primary care office with type 11 Diabetes with questionnaires concerning their level of Diabetes Self Management. The diabetes coordinators will select the participants in the facility in which the awareness level and knowledge of the current approaches to managing diabetes will be assessed. This will help in barriers identification and enhance adjustments from the facilities approach.

Efficiency will be evaluated by working together with the nurse and nurse practitioner at the Sanitas Medical. The project lead will guide the team in the identification of the mission, vision and objectives that will guide the change project. Theoretical frameworks that have been identified will be adopted. They include Orem Self-care Deficit theory, social cognitive theory. The outcomes will be identified and analysed where all the activities planned will ensure value creation towards the change project aims.

What to Do

The project lead and the team of nurses will collect and analyse the questionnaire results as filled by the patients of primary care office which will then be presented to the diabetes coordinator in the next diabetic conference that will be organized. The involved nurses in the project will then give the changes that can be implemented to facilitate more self-care maintenance. This is to mean the actions that people with diabetes can adopt in their daily routine in regards to dietary intake and physical activity. Changes will also be proposed on how more self-awareness can be further improved which has an impact on self-management. By so doing, the evidence-based changes will be initiated to improve HbA1c. The feedback obtained from this meeting will be reviewed and evaluated to ensure agreement is reached. Philis-Tsimikas and Gallo (2015) state that change programs should offer supporting information that can be easily understood regardless of the socioeconomic status, cultural beliefs and literacy levels when enhancing self-management to reduce HbA1c levels. From the weekly meetings, the team of nurses will discuss the outcomes, identify any further challenges continually to mitigate anything that might hinder success.

Methodologies that will be adopted will analyse the problem from the root. They will be cost-effective and aimed to create more value for the patients. Observations will be applied constituted in the theoretical framework to understand how and why people take care of themselves, what the nursing team can offer assistance and the behaviours that can be adopted for the positive change. In this project, data will be collected by the use of an anonymous questionnaire. This will ensure that the privacy and rights of the patients are protected in the evidence-change plan process. The questionnaire will measure the understanding that patients have and self-care management in diabetes and control HbA1c. The questionnaire filling will be facilitated by the nurse at the primary care office

The Diabetic Self-Management Questionnaire (DMSQ) will be the measurable tool as indicated in figure 1. This tool pertains 16 items, and it is comprehensive as it will cover five varying aspects of diabetes self- management (Schmitt et al., 2016). The respondents will be required to rate the extent to which each item applies to them on a four Likert scale. Higher scores will be an indication of a self-management behaviour that is more desirable and vice versa. The DMSQ tool will be used for eight weeks where it will specifically involve the patients rating themselves in regards to their self-management level.

Figure one: DMSQ Tool

The Action

At this stage, the involved team will look at the lessons learnt to evaluate whether there are any changes that require being adjusted in the methodology and the proposal. Any modification will be better incorporated into the next change approach, and it will be based on the conclusions that will be made from this particular plan. On the other hand, if the evidence-based change plan on the evaluation of diabetes self-management to improve the HbA1c, strategies will require being developed to maintain the improvements realized.

Change project Timeline

Evaluating Diabetes Self Management to Improve HbA1c
Activities
Initiation
Presenting the proposal to Sanitas Medical Center		One week
Communication with the participants and the involved nurses
Planning		One week
Identify the participants and nurses in the plan
Meeting the Facilities' diabetes care coordinator.
Preparation of DMSQ questionnaires and analysis approaches
Implementation		Eight weeks ( from 05/07/2018---06-23/2018)
Collection of patients' responses		From
Identification of barriers and making rapid changes for mitigation
Evaluation and Refinement		One week
Reviewing the collected data
Process refinement
Highlighting the key outcomes
Identification of necessary changes

Proposed Budget

This evidence-based change project will not require any source of funding

Expected Outcomes

The projects hope to strictly adhere to the timeline between 05/07/2018-06/28/2018 in its implementation unless any propelling challenges arise that will impact on the project planning through its implementation. The project will adopt two methodologies as indicated earlier that will facilitate in the streamlining. The study aims at obtaining outcomes that can be implemented to minimize the global challenge by ensuring that essential control measures are undertaken to minimize HbA1c levels.

Conclusion

Experiences in glycemic control that is poor, have higher chances of contributing towards long-term complications that arise from diabetes. Identifiable evidence-based changes that are relevant to the behaviours of self-management will reduce the potential risk of long-term complications. It is therefore essential for clinicians to detect potential areas that require improvements

References

Andreas Schmitt, A. R. (2016). Assessing Diabetes Self-Management with the Diabetes Self- Management Questionnaire (DSMQ) Can Help Analyse Behavioural Problems Related to Reduced Glycemic Control. Pros One, https://doi.org/10.1371/journal.pone.0150774.

Gallo, A. P.-T. (2015). Implementing Community-Based Diabetes Programs: The Scripps

Whittier Diabetes Institute Experience. PMC , doi: 10.1007/s11892-013-0462-0.