Evidence-Based Practice Project Proposal Final Paper

Evidence-Based Practice Project Proposal Final Paper

Evidence-Based Practice Project Proposal Final Paper

Individual and population health is one of the most important or key aspects in the healthcare domain. The implication is that the healthcare sector and the healthcare professionals engage in various activities to help improve health and prevent potential aspects of human living that degrade health. However, such efforts have never been free of barriers and drawbacks. One of the most difficult aspects to address is the chronic conditions that affect individuals and populations. Among such chronic conditions is diabetes (Hildebrand et al., 2020). Diabetes adversely impacts an individual’s health as the normal functioning of an individual is greatly reduced while at the same time, people have to spend a lot of money for better outcomes.

The current research indicates that individuals from minority groups and those from economically disadvantaged backgrounds are likely to be negatively impacted more by diabetes. The implication is that professionals and stakeholders should use appropriate strategies to control diabetes among these groups for better outcomes (Soyoye et al., 2020). Therefore, the purpose of this project is to explore the use of culturally tailored education programs among Hispanic adults for improved self-management of diabetes. As such various aspects will be discussed, including the problem statement, organizational culture and readiness, literature review, change model, the implementation plan, and the evaluation plan

Problem Statement

Type II diabetes mellitus is one of the most common chronic conditions impacting various populations. The condition among Hispanic adults is particularly alarming. As of the year 2018, the Hispanics were almost twice as likely to die from diabetes as compared to the non-Hispanics, while they are also 70% more likely to be diagnosed with the condition (Hildebrand et al., 2020). Diabetes among this population has been shown to have various adverse impacts such as prolonged hospitalization and increased healthcare spending. Diabetes can also lead to other conditions such as blindness and lower-limb amputations among individuals with the condition (Soyoye et al., 2020). Even though various interventions exist to date that is used in the prevention and management of the condition, the condition is still prevalent and affects millions of people. Therefore, there is a need to come up with more effective strategies to improve patient outcomes. Interventions such as culturally tailored education have the potential to improve self-management among Hispanic adults with diabetes mellitus type 2.

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Organizational Culture and Readiness

The implementation of a quality improvement project or an evidence-based practice in an organization usually requires that a change is undertaken. Making changes in any setup requires that those involved in the change efforts make comprehensive arrangements that can work as a springboard for success. One of such includes assessing the organization’s culture and readiness for changes. According to  Gallagher-Ford & Connor (2020), assessing an organization for change readiness gives an important insight into the organization’s cultural perspective and readiness regarding the implementation of an evidence-based practice project or a change effort. The assessment process is appropriately accomplished by using standard tools that can effectively help in assessing the culture and readiness.

The success of the implementation process depends on how ready the organization is, as revealed by the culture and readiness assessment. The assessment helps in coming up with strategies for overcoming potential organizational barriers. For example aligning the project’s aims with the organization’s vision, values, and mission. From the assessment, it was not the organization’s leadership, and other employees supported the change. The organization focuses on improved patient care, safe care, and quality care. As such, it can be concluded that the organization’s culture supports evidence-based practice and is ready for the implementation of the proposed change.

The Readiness Assessment Tool

The readiness assessment tool chosen was the System-Wide Integration of EBP survey tool. The tool is key in the evaluation of the ability of the organization to promote EBP implementation. As such, the tools were applied to assess the basic understanding of the leaders and the staff regarding the proposed change (Gallagher-Ford & Connor, 2020). The score was an impressive eighty percent implying that the leadership and the staff were certain about the change and therefore would support it. It is worth noting that various barriers are expected, such as a potential lack of support from some staff hence change resistance. The assessment also helps in revealing the weaknesses and strengths in responding to the change and managing it. As such, the support from the leadership will also be important in the implementation process as making the right decisions to spur the implementation process.

The Recommended Health Care Process and Systems

The project’s focus is to adopt an intervention for better patient outcomes. The implication is that there will be a need for collaboration and partnerships to help in ensuring that the implementation process is a success. The interdisciplinary team will also form a partnership with us in this journey to help us achieve better outcomes. Like the I.T. team will help us locate relevant patients to commence the process at the institution (Gallagher-Ford & Connor, 2020). Efforts to improve the quality would need to be measured to show sections that need improvement and determine new barriers affecting the proposed intervention.

The Strategies to Improve Readiness

It is important to use various strategies to ensure that the organization is ready for the proposed change. As such, resources will have to be aligned to help in driving the change and achieving the targeted goals. The culturally specific education will be key in training the patients to have better skills in self-management. As part of the project, the nurses involved will also be trained on how to teach the patients hence improving their chances of accepting the intervention and fully participating in the project to make it a success (Luckenbaugh & Auffenberg, 2018).

Literature Review

            As part of the project, and having assessed the organization’s culture and readiness in terms of the project implementation, efforts were made to conduct a comprehensive literature review and find evidence that supports the proposed intervention. Therefore, various literature databases were searched, and relevant articles were obtained. Therefore this section focuses on a review of the obtained articles.

In one of the research efforts, Flores-Luevano et al. (2020) did a study that focused on a diabetes education program and focused on its impact on diabetes-related outcomes such as clinical, self-management, and psychosocial outcomes among the Mexican Americans. This study involved a total of two hundred and nine study subjects. Upon the implementation of the intervention, the participants experienced improvements in several aspects such as glycated hemoglobin, total cholesterol, glucose self-monitoring, exercise, nutritional behavior, knowledge, and diabetes-related emotional distress. Therefore, this source is important to the project as it indicates that culturally tailored education is key to improving patient outcomes among patients with diabetes.

Recently, Goff et al. (2021) also conducted a  study that examined the acceptability, trial feasibility, and fidelity of a culturally tailored intervention among patients with type II diabetes. In a quantitative study with a total of fifty-five participants, this study revealed significant results. For example, the culturally tailored intervention was found to be of high fidelity, had high feasibility, and the high acceptability. The implication is that this research shows that culturally tailored interventions are key in the management of diabetes type 2 and are also highly feasible and acceptable.

Another study was conducted by Huang et al. (2019) with the objective of analyzing the diabetes care cost-effectiveness in American Samoa intervention when compared to standard care. In a randomized controlled study, the researchers divided two hundred and sixty-eight American Samoans into either an intervention or a control group. From the analysis of the data, the researchers noted that the use of a culturally tailored intervention was associated with a significant reduction in the HbA1c levels in the intervention groups more than in the control group. In terms of cost-effectiveness, the culturally tailored intervention was found to be more cost-effective. Therefore, while a culturally tailored intervention can be effective in improving diabetes outcomes, such interventions are also cost-effective.

Islam et al. (2018) also explored the impact of a culturally tailored diabetes intervention on the outcomes among immigrant patients living with diabetes. The researchers recruited a total of three hundred and six patients who were assigned to either the control or the intervention group. The major intervention explored entailed five two-hour monthly group educational sessions integrated with one-on-one visits lasting for one and half hours. Upon the analysis of the data, the researchers noted that the individuals in the intervention group experienced a notable reduction in the HbA1c levels as compared to the control group. In addition, the individuals in the intervention group experienced a notable decreased in mean cholesterol, BMI, low-density lipoprotein-cholesterol, triglycerides, and high-density lipoprotein-cholesterol. Therefore, this source also supports the proposed project as it shows the efficacy of a culturally specific educational effort in managing diabetes.

Li-Geng et al. (2020) also published a systematic review focusing on the East Asian American cultural perspectives that influence self-management of diabetes and appropriate educational interventions. From the analysis of the research articles reviewed, the researchers found out that the research subjects’ beliefs on food impacted their ability to adapt to the recommended dietary requirements related to diabetes management. The interventions applied had a substantial role in lowering the stress that individuals could undergo while modifying their diet. The interventions were also demonstrated to help in lowering the patient’s HbA1c levels. Therefore, this systematic review is important and supports the intervention as it shows the effectiveness of various interventions in diabetes management and control.

Recently, Moore et al.(2019) performed a study that explored the application of a change wheel in formulating a culturally sensitive self-management support program for people living with diabetes in the African and the Caribbean communities. A total of forty-one patients were recruited to participate, and they were guided through an educational program involving physical activity, diet, and weight management. The analysis showed that those who participated in the study showed a high willingness and motivation to avoid diabetes-connected consequences. The study identified barriers to healthy behavior, such as knowledge gaps regarding self-management behaviors. Some of the aspects which enhanced the impact of the intervention include social comparison strategies, change techniques, and social support. This source is also key as it demonstrates various strategies which can be applied to optimize diabetes outcomes among patients living with diabetes.

Another relevant research was conducted by Wadi et al. (2021). These researchers conducted a study with the aim of exploring the impact of a culturally tailored intervention in managing diabetes-related measures such as glycemic control. This study reviewed a total of sixteen randomized controlled trials. The analysis of the results showed that using culturally tailored interventions is associated with significant improvement in diabetes-related outcomes such as the HbA1c levels. These interventions have also been proven to improve patients’ ability and knowledge to carry out diabetes self-management activities.

The last articles that were reviewed reported research conducted by Yorke & Atiase (2018). This is also another systematic review that focused on assessing the impact of structural education on hypoglycemia and glucose control among patients living with diabetes. This study analyzed thirty-six published studies. Most of the studies reviewed in this source showed that structured education led to a significant impact on glycemic control. For example, one of the studies indicated that the intervention is efficacious in lowering the blood sugar levels of the participants.

The Change Model

The change model or framework is key in the implementation of the change or evidence-based practice projects. These change models offer theoretical underpinnings upon which the project can be based. As such, it is key selecting the most suitable framework or model. The selected model to be used as a guide for this project is Kurt Lewin’s change model (Hussain et al., 2018). As earlier indicated, this project entails the implementation of a culturally tailored diabetes education program to improve self-management of diabetes mellitus among adult Hispanic patients. Therefore, the change will entail a possible transition from the traditional form of education to a culturally tailored educational program.

The proposed change model has three phases that can be used as the basis for implementing a change process. The three phases include unfreezing, change, and refreezing. During the first phase, the need for change is created in the organization and among the staff. The creation of the need for change is key in driving the individuals toward embracing the proposed change (Hussain et al., 2018). It is worth noting that communication is vital during the unfreezing stage as the change implementers have to share the vision for change. In addition, effective communication is key in ensuring that the stakeholders have a comprehensive understanding of everything that is taking place and ensuring that they become part of the change process.

The unfreezing phase is then followed by the change phase, which is the second phase. This phase entails a transition into the changed state. The implication is that the proposed change is implemented, and the staff learn and adopt the new practice, manner of thinking, and new strategies of doing things (Hussain et al., 2018). Again, communication is key during this phase. The change leaders have to support the stakeholders and other staff in their efforts to try and embrace the change. In addition, it is important to remind the staff and the stakeholders of the importance, needs, and expected benefits of the proposed change to ensure that everyone sticks to the goals of the proposed change.

The refreezing phase is the final phase and involves the integration of the implemented change into the organization’s normal routine and can form part of new standards. One of the most important considerations for this stage is that the individuals have to be restrained from going back to the previous practices and activities. This is to help and support the individuals to effectively adopt the new culture and the new practice.

During the unfreezing phase, there will be sensitization of the Hispanic adults living with diabetes regarding the need for better diabetes management. The healthcare professionals will also be informed of the need to change the approach from the traditional approach to the culture-specific strategy. Making them know the need for change will be key in enhancing their understanding hence reducing potential resistance which could derail the change process (Grove and Gray, 2018). The educational approach will be applied to give a rationale for adopting the new strategy for diabetes management among the selected patient population. The change stage will majorly entail guiding the team to implement the project. The implication is that the diabetes care team will transition from using the traditional approach of diabetes education to the culturally specific approach. Stakeholders will also be supported to accomplish various roles, implying that effective communication will be important.

As earlier indicated, the final phase of using this change model is the refreezing stage. This phase will mainly entail entrenching the new methods of educating the patients on diabetes self-management practices. As such, the culturally tailored intervention will form part of the current practice to ensure that the Hispanic adults with diabetes can manage the disease better for improved patient outcomes. One of the most important aspects of this phase is that it will support the care team not to revert to older interventions (Grove and Gray, 2018). This phase will be a testament that the change process is complete and that the proposed better method of culturally tailored education has been accomplished. The implication is that the new method will now form part of the organization’s programs.

The Implementation Plan

            Implementation is one of the key aspects of the evidence-based practice process and requires that the change implementers appropriately use the available resources to ensure that the process is a success. The plans should be put in place to ensure that the implementation is a success (Kendall & Frank, 2018). Therefore, this section focuses on the implementation of the proposed project.

The Setting and Access to Potential Subjects

It is important to describe the setting for implementing the proposed project so that plans can be put in place to access the potential research subjects. The plan is to implement the project in a large urban public hospital in the US. The implication is that the data to be used in evaluating the efficacy of the proposed project will be obtained from this setting. As a diabetes center, the patients visiting the clinic for primary diabetes care will be recruited to take part in the study, and their information as recorded in their health records will be used in the analysis (Kendall & Frank, 2018). The data to be analyzed will be retrieved by the nurses on a consistent basis to help in the analysis process.

The Project Timeline

Setting a timeline for the implementation of a proposed project is important as it acts as a guideline on when to undertake various aspects or components of the project. Therefore, the success or failure of a project may hinge on the timeline. However, it is important to note that coming up with a definite or accurate timeline for a project is, in most cases challenging as a lot of dynamics are involved. Therefore, it is proposed that this project will cover a period of six months. Within the six months, various activities will be accomplished, including problem definition, literature review, data collection and analysis, implementation, and the evaluation of the outcomes.

Budget and Resource List

It is important to come up with a viable budgetary requirement for the proposed project. It is projected that the cost of the whole project will be $21,230. A detailed budgetary breakdown has been included in the appendix. The resources are significant in fortifying the technical aspect of quality improvement in healthcare (Kendall & Frank, 2018).

The Research Design

This project will be based on a quantitative research design. This means that quantitative data collection methods be used in the project (Jolley, 2020). Data will be evaluated on a monthly basis. Such a consistent evaluation will be key in allowing the researchers to evaluate how well the process is working and making necessary adjustments for better results. The quantitative methods have been chosen since they enhance data accuracy. Accurate data, data collection methods, and data analysis methods are key in helping the project team make better decisions related to the project. The data obtained from the healthcare records will be observed by applying interval tests with equal distances between the points. Such interval tests will be key in ensuring data reliability and accountability. Such tests will be key in allowing the project team to effectively draw a comparison between the efficacy of the culturally tailored diabetes education program and the traditional type of the education program.

The Process of Delivering the Intervention

The intervention delivery process is key as it determines the success of the process. The nursing staff will be integral to the project and, therefore, will be trained on the delivery of the intervention (Jolley, 2020). As part of the plan, the process of delivery will be shared with the team through online platforms such as email. If need be and the condition allows, physical meetings will also be held. The formulated educational materials will be shared with the staff involved in the intervention delivery to enhance their knowledge and enable them to deliver the intervention with confidence. The educators will also assess the knowledge acquired through various means, such as questioning.

The Needed Stakeholders

Stakeholders are an important part of the implementation of a project. Therefore, it is important to identify them in time. As such, various stakeholders were identified. They included unit leaders, physicians, nurse educators, the nurse manager, the nursing staff, patients, and their families. The frontline workers and administration would also form part of this team as they will have an objective role of putting the laid strategy into action. A committee will be formed to draft a plan that will collaborate with other professionals through effective communication that would enable the project’s success (Burke et al., 2019). Nurses are key stakeholders are they are directly involved in training and educating the patients living with diabetes. The implication is that the implementation process’ success heavily depends on them.

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The Potential Barrier and a Plan to Overcome Them.

            The proposed project focuses on introducing a new way of diabetes management, and therefore, it is expected that the process will face various barriers which need to be overcome for the success to be realized. Among the expected barriers are differing perceptions and opinions among the team (Jolley, 2020). For instance, while some would have a positive attitude and perception regarding the project, others would express the opposite. In solving this, the project leader has to ensure that the project goals and objectives are clear and well defined. The next barrier is a possible resistance by the staff. Such resistance can derail the project and, therefore, should be solved. The solution to such is offering training and involving everyone. In addition, the project team has to provide a clear timeline and guidelines. Another way of overcoming the barriers is to practice effective and open communication to enable everyone to be on the same page.

The Evaluation Plan

This is the final process of an evidence-based project, or a quality improvement implementation is an evaluation. Evaluation is key as it provides vital information regarding how effective the project has been (Jolley, 2020). In addition, evaluation serves to reveal how effective the methods used in the project have been. As such, this section covers the evaluation plan.

The Expected Outcome

This project aims to improve the self-management of diabetes among Hispanic adults. Therefore, various outcomes are expected upon the implementation of the culturally tailored intervention. It is worth noting that the improved self-management strategies focus on improving the diabetes outcomes among these patients. Therefore, one of the targeted outcomes is better glycemic control which will be shown by more controlled HbA1c levels. This project revolves around training and teaching the patients to be more proficient in managing diabetes. Therefore, the next targeted outcome is increased knowledge of self-management skills. In addition, the staff is also expected to have better skills and increased education on diabetes management as they will be trained before they embark on delivering the culturally tailored intervention to the patients.

The Data Collection Tools

One of the data collection tools to be used in the project is questionnaires. Questionnaires will be key in collecting vital information before and after the implementation of the intervention (Jolley, 2020). Questionnaires have been chosen as they are easy to use and will enable a faster collection of the required data. Quantitative methods also have the advantage of enabling easier analysis as the collected data can be ordered and numerically analyzed. The quantitative methods have been chosen since they are relatively cheaper.

The Statistical Test

The analysis of Variance (ANOVA) is key in determining the statistical difference between two or more groups. Therefore this test will be used to determine the difference between the two groups (Connelly, 2021). That is, the group engaging in the traditional method and the ones recruited to take part in the culturally tailored intervention. In addition, this test will also be key in enabling the researcher to understand the variations between the variables applied.

The Data Collection Methods

One of the data collection methods will be the use of questionnaires. These will be used in collecting data from both the nurses and the patients. The questionnaires will be self-administered. The plan is to administer the questionnaires to the patients at baseline and by the end of the program (Jolley, 2020). The staff will get a different questionnaire that will be used in assessing their knowledge of the proposed intervention and prompt them to write down what they think needs to be done to support them better in the project process. The use of the questionnaires is preferred as it will enable an objective assessment of the effectiveness of the project.

Strategies to be Taken if the Outcomes are Not Positive

Even though the outcomes are expected to be positive, this is not always the case. Therefore, plans should be in place to ensure that there are well-laid down strategies to pursue if the outcomes are not positive. One of the solutions is to focus more on financial and human resources. These resources will have to be redistributed and realigned to ensure that the process is successful. Again, in case the outcomes are not as expected, a re-examination of the interventions applied in the project will be done. Such a reanalysis will be explored to reanalyze the intervention in an effort to reveal any weaknesses and areas that need fast improvements (Linsley et al., 2019). This will give the project a better chance of improvement for better outcomes. One other solution is to extend the timeline to enable the project team to enforce corrective measures. The time has to be extended to enable the implementation team to monitor the effects of the strategies in relation to achieving the project goals and objectives.

Plans to Maintain, Extend, Revise and Discontinue the Proposed Solution

Plans have also been put in place to maintain, extend, revise or discontinue the proposed solution. In the case where the outcomes will be as needed and as predicted, then the plan is to maintain the project. The maintenance of the project will also depend on its cost-effectiveness. If the project is cost-effective, then it will be maintained. Concrete conclusions are needed. As such, if no tangible conclusions are possible, then the duration of the project will have to be extended in order to have enough data that can be used to draw useful conclusions (Whitehead et al., 2020). A revision will also be undertaken if the strategies are not aligned with the outcomes. The strategies will be revised to increase the chances of the project’s success. Other conditions will trigger the termination of the project. For instance, in the case where the project or its aspects are causing harm to patients, then the project will be discontinued.

Conclusion

            Diabetes is one of the most prevalent diseases hence a need to better manage it. While various strategies have been applied toward its management and prevention, the condition still impacts several individuals negatively. This means that more robust interventions are needed to ensure that patients have better outcomes. Therefore, this project proposes to use culturally tailored education to improve self-management of diabetes skills among adult Hispanics. A comprehensive literature review revealed that culturally specific education and interventions are efficacious in improving diabetes outcomes among patients with diabetes. The write-up has presented various important aspects of the project, such as the implementation plan and evaluation plan. In addition, the organizational culture and readiness in terms of implementation of the project have all been explored and presented.

References

Burke, K. M., Shogren, K. A., Raley, S. K., Wehmeyer, M. L., Antosh, A. A., & LaPlante, T. (2019). Implementing Evidence-Based Practices to Promote Self-Determination. Education and Training in Autism and Developmental Disabilities, 54(1), 18-29. https://www.jstor.org/stable/26663959

Connelly, L. M. (2021). Introduction to analysis of variance (ANOVA). Medsurg Nursing, 30(3), 218-158. https://www.proquest.com/openview/f36618bf567ad1c0108cea9ffbebc18d/1?pq-origsite=gscholar&cbl=30764

Flores-Luevano, S., Pacheco, M., Shokar, G. S., Dwivedi, A. K., &Shokar, N. K. (2020). Impact of a Culturally Tailored Diabetes Education and Empowerment Program in a Mexican American Population Along the US/Mexico Border: A Pragmatic Study. Journal of Clinical Medicine Research, 12(8), 517–529. https://doi.org/10.14740/jocmr4273.

Gallagher-Ford, L., & Connor, L. (2020). Transforming healthcare to evidence-based healthcare: a failure of leadership. JONA: The Journal of Nursing Administration, 50(5), 248-250. https://doi.org/10.1097/mou.0000000000000404

Goff, L. M., Moore, A. P., Harding, S., & Rivas, C. (2021).Development of Healthy Eating and Active Lifestyles for Diabetes, a culturally tailored diabetes self-management education and support programme for Black-British adults: A participatory research approach.Diabetic Medicine, 38(11), e14594. https://doi.org/10.1111/dme.14594.

Grove, S. K., & Gray, J. R. (2018). Understanding nursing research e-book: Building an evidence-based practice. Elsevier Health Sciences.

Hildebrand, J. A., Billimek, J., Lee, J. A., Sorkin, D. H., Olshansky, E. F., Clancy, S. L., & Evangelista, L. S. (2020). Effect of diabetes self-management education on glycemic control in Latino adults with type 2 diabetes: a systematic review and meta-analysis. Patient education and counseling, 103(2), 266-275. https://doi.org/10.1016/j.pec.2019.09.009.

Huang, S. J., Galárraga, O., Smith, K. A., Fuimaono, S., &McGarvey, S. T. (2019).Cost-effectiveness analysis of a cluster-randomized, culturally tailored, community health worker home-visiting diabetes intervention versus standard care in American Samoa.Human Resources for Health, 17(1), 17. https://doi.org/10.1186/s12960-019-0356-6.

Hussain, S. T., Lei, S., Akram, T., Haider, M. J., Hussain, S. H., & Ali, M. (2018). Kurt Lewin’s change model: A critical review of the role of leadership and employee involvement in organizational change. Journal of Innovation & Knowledge, 3(3), 123-127. https://doi.org/10.1016/j.jik.2016.07.002.

Islam, N. S., Wyatt, L. C., Taher, M. D., Riley, L., Tandon, S. D., Tanner, M., Mukherji, B. R., & Trinh-Shevrin, C. (2018). A Culturally Tailored Community Health Worker Intervention Leads to Improvement in Patient-Centered Outcomes for Immigrant Patients With Type 2 Diabetes. Clinical Diabetes, 36(2), 100–111. https://doi.org/10.2337/cd17-0068.

Jolley, J. (2020). Introducing Research and Evidence-Based Practice for Nursing and Healthcare Professionals. Routledge

Kendall, P. C., & Frank, H. E. (2018). Implementing evidence‐based treatment protocols: Flexibility within fidelity. Clinical Psychology: Science and Practice, 25(4), 40. https://psycnet.apa.org/doi/10.1111/cpsp.12271

Li-Geng, T., Kilham, J., & McLeod, K. M. (2020). Cultural Influences on Dietary Self-Management of Type 2 Diabetes in East Asian Americans: A Mixed-Methods Systematic Review. Health Equity. https://doi.org/10.1089/heq.2019.0087.

Linsley, P., Kane, R., & Barker, J. H. (2019). Evidence-based Practice for Nurses and

Healthcare Professionals. SAGE

Moore, A. P., Rivas, C. A., Stanton-Fay, S., Harding, S., & Goff, L. M. (2019).Designing the Healthy Eating and Active Lifestyles for Diabetes (HEAL-D) self-management and support programme for UK African and Caribbean communities: A culturally tailored, complex intervention under-pinned by behaviour change theory.BMC Public Health, 19(1), 1–14. https://doi.org/10.1186/s12889-019-7411-z.

Soyoye, D. O., Abiodun, O. O., Ikem, R. T., Kolawole, B. A., & Akintomide, A. O. (2021). Diabetes and peripheral artery disease: A review. World Journal of Diabetes, 12(6), 827. https://dx.doi.org/10.4239%2Fwjd.v12.i6.827

Wadi, N. M., Asantewa-Ampaduh, S., Rivas, C., & Goff, L. M. (2021). Culturally tailored lifestyle interventions for the prevention and management of type 2 diabetes in adults of Black African ancestry: A systematic review of tailoring methods and their effectiveness. Public Health Nutrition, 1–15. https://doi.org/10.1017/S1368980021003682.

Whitehead, D., Ferguson, C., Faan, G. L.-W., PhD RN, & Faan, J. H., PhD RN. (2020). Nursing and Midwifery Research: Methods and Appraisal for Evidence Based Practice. Elsevier Health Sciences.

Yorke, E., &Atiase, Y. (2018).Impact of structured education on glucose control and hypoglycaemia in Type-2 diabetes: A systematic review of randomized controlled trials.Ghana Medical Journal, 52(1), 41–60.

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Appendices

Appendix A: The concept map

Appendix B: APA Checklist Summarized

Page numbering- flush right	Yes
Title of document appears at the top of the first page of text	Yes
The introductory paragraph or section should not be labeled	Yes
Double line spacing	Yes
Margins- 1 inch	Yes
Paragraph formatting- indented and left-aligned	Yes
Punctuations after quotations	None
Section headings- level 1 headings centered and in bold, and in title case	Yes
References- in a new page. The word references centered.	Yes

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Appendix C: Timeline

No.	Activity	Time (Months)
1	Definition of the question or the problem	1 month
2	Collection and analysis of data	Once a month
3	Developing a strategy of addressing the questions	1 month
4	Testing and modifying of the plan	3 months
5	Implementing the plan and gathering more data to see if it has had the desired effect	6 months

Appendix D: Budget

OFFICE RESOURCES
No.	Item	Monthly total	Total Projected cost in 6 months
1.	Laptop use (available)	0	0
2.	Printer/copier	$150	$600
3.	Current education program handouts		$1700
4.	Traditional education program handouts		$1700
5.	Healthstream modules	30min x 70 RNs	$3,100
STAFF RESOURCES
6.	(Physician network) software for data analysis		$4,000
7.	Project manager	10 hrs. x 63 hr.	$4,780
8.	Nurse educator	5 hrs. x 55 hr.	$2,690
9.	Frontline RN data collection	4 hrs./ 55 hr.	$2,340
	TOTAL		21,230

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EBP proposal/ PICOT question is: In Hispanic adults with Type II diabetes mellitus (P), does a culturally tailored diabetes education program (I) compared to a traditional diabetes education program (C) increase self-management of DM (O) in 6 months (T)?***

For this assignment, you will synthesize the independent evidence-based practice project proposal assignments from NUR-550 and NUR-590 into a 4,500-5,000-word professional paper.

Final Paper

The final paper should:

Incorporate all necessary revisions and corrections suggested by your instructors.
Synthesize the different elements of the overall project into one paper. The synthesis should reflect the main concepts for each section, connect ideas or overreaching concepts, and be rewritten to include the critical aspects (do not copy and paste the assignments).
Contain supporting research for the evidence-based practice project proposal.
Main Body of the Paper

The main body of your paper should include the following sections:

Problem Statement
Organizational Culture and Readiness
Literature Review
Change Model, or Framework
Implementation Plan
Evaluation Plan
Appendices

The appendices at the end of your paper should include the following:

All final changes or revisions for the drafts that will be included in the appendices of your paper.
Complete the “APA Writing Checklist” to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as the final appendix at the end of your paper. In each preceding course you have been directed to the Student Success Center for assistance with APA style, and have submitted the APA Writing Checklist to help illustrate your adherence to APA style. This final paper should demonstrate a clear ability to communicate your project in a professional and accurately formatted paper using APA style.
General Requirements

You are required to cite 10-12 peer-reviewed 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.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

MBA-MSN; MSN-Nursing Education; MSN Acute Care Nurse Practitioner-Adult-Gerontology; MSN Family Nurse Practitioner; MSN-Health Informatics; MSN-Health Care Quality and Patient Safety; MSN-Leadership in Health Care Systems; MSN-Public Health Nursing

1.1: Translate research and knowledge gained from practice, while adhering to ethical research standards, to improve patient outcomes and clinical practice.

5.1: Design ethically sound, evidence-based solutions to complex health care issues related to individuals, populations, and systems of care.