Develop a proposed evidence-based change-project plan specific to the environment you are using to implement your change project. Your environmental assessment will include a work breakdown structure, a budget plan, and a measurement tool.
This week, you will design a plan that is at least four pages in length and includes all the information listed in the instructions below to discuss the elements of your proposed plan.
Develop an environmental assessment of your change project area and its readiness for the specific change project you are going to implement.
Include a work breakdown structure. For example, you could create a (timeline/task list/Gantt chart)—a hierarchical definition of the planned tasks and activities of a project that normally begins with the highest-level activities and works downward into the individual tasks.
Include a proposed project budget (table or spreadsheet) for the project that addresses the needed personnel, equipment, and supplies that may have associated costs. Click this link for a sample budget template Click for more options .
Include your measurable evaluation methods (indicators/metrics). Include the actual measurement tool you will use and describe any of the following that are applicable to your project: cost savings, improved efficiencies, access to care (visits/procedures/admissions), patient/family satisfaction, associate satisfaction, associate engagement, retention, clinical outcomes, injury prevention, and risk reduction.
The project will take place in Sanitas medical center where patients will fill out a questionnaire
There is no budget needed, please address this in the paper.
The measurable tool is the DSMQ, which I have attached.
Please review the attachments.
WCU Word Mark REQUEST FOR REVIEW BY THE
College of Nursing
WEST COAST UNIVERSITY
COLLEGE OF NURSING RESEARCH COMMITTEE
Project Title: Evaluating Diabetes Self Management to Improve HbA1c
Submitted by: Lisette Duque
MSN- Advance General Nursing Program 05/07/2018-06/28/2018
Program Anticipated dates for project
1.Who are the subjects involved in the research? How will their voluntary participation be obtained?
The participants of the research are patients of a primary care office. The participation will be obtained from a questionnaire.
2. How will informed consent be obtained from the subjects? Attach a copy of the consent form* if one
will be used. If no informed consent will be obtained, explain why.
Informed consent is attached
3.How will the subjects’ rights to privacy and safety be protected?
The participants right to privacy and safety will be protected because the questionnaire will be anonymous. There will be no identifying information such as; name, date of birth, account number, or address.
4. Describe the study’s purpose, design and procedures. Include an overview of the entire proposed project that clearly delineates every step of the project. Include who, what, why, when, where, & how.
World Health Organization estimated that more than 346 million people worldwide have diabetes, this is likely to more than double by 2030 without any intervention (WHO, 2017). There are several essential self-care behaviors in people with diabetes, such as a healthy diet, and being physically active. The needs of diabetic patients are not only limited to adequate glycemic control but also correspond with preventing complications.
The participants are from a primary care office with type II Diabetes. The self-management data will be collected form anonymous questionnaire. The purpose for the study is to evaluate effective self-management to improve HbA1c. The study will be conducted in Sanitas Medical center for 8 weeks. The American Diabetes Association released new research estimating the total costs of diagnosed diabetes have risen to $245 billion form $174 billion (ADA, 2015). The questionnaire measured patient understanding and self-care management of diabetes; improving diabetes self management will lead to improved compliance because it enables an efficient assessment of self-care behaviors associated with glycemic control and participants will be aware of the effectiveness of self-management and the beneficial effect on HbA1c control. The data will be used by the health care providers to educate patients on the effective interventions of diet and physical activity to improve the HbA1c.
5. Name and describe any tests, questionnaires, opinionnaires, surveys, etc. that will be used. Attach copies if these are newly developed or not in common use. What risk, if any, is involved in their use?
The questionnaire will assess self-care behavior, which can be related to the measure of HbA1c.
Questionnaire is attached
6. Describe any physical procedures that will be used. What risk, if any, is involved in their use?
No physical procedures are involved in the research.
7. Describe any equipment, special apparatus, drug or pharmaceutical that will be used in the study.
What risk, if any is involved in its use?
There is no equipment needed for the purpose of the research.
8. In your own judgment, what is the level of risk to human subjects? Give reasons.
EXEMPT NO RISK MINIMAL RISK RISK
E E E E
Lisette Duque 04/09/18
Student Signature Date
Running Head: THEORETICAL FRAMEWORK 1
Theoretical Framework 4
West coast University
Diabetes type 2 is a global health issue that affects more than 387 million individuals. According to the American Diabetes Association the course of diabetes is largely determined by health behaviors including a dietary regimen that has healthy food choices that facilitates optimal blood glucose control and a healthy weight, engagement in consistent physical activity and maintenance of good glycemic control (ADA, 2015).
The first theoretical framework that applies to the project is Orem Self-care Deficit Theory which is constituted by three mid-range theories: The Self-Care theory, which describes and explains why and how people take care of themselves; Self-care deficit theory that describes and explains how nursing can help people. The theory identifies five methods of helping: acting for and doing for others; guiding others; supporting another; providing an environment promoting personal development in relation to meet future demands; and teaching another.
and the theory of the nursing system that describes and explains how the patient’s self-care needs will be met by the nurse, the patient, or by both. Orem identifies three classifications of nursing system to meet the self-care requisites of the patient: wholly compensatory system, partly compensatory system, and supportive-educative system. This concept is defined as “the practice of activities that individuals initiate and develop for their own benefit in the maintenance of their life, health and well-being” (Compean-Ortiz, 2013).
Self-care maintenance reflects those behaviors used to preserve health, maintain physical and emotional stability, or improve well-being. Self-care maintenance includes illness related behaviors, such as adherence to follow up visits and examination, and healthy promoting behaviors, such as eating a healthy diet or engaging in physical activity. Health behavior performed to avoid disease or complications are included in self care maintenance as well (Ausili, 2017).
Self-care actions over time are learned and developed by people in both stable and changing environments, within the context of their patterns of daily life. Self-care must be learned and must be carried out continuously. In this study, self-care was defined as the actions that the person with diabetes carries out in their daily routine with respect to physical activity and diet.
Since self care activities to an extent, determine blood glucose level, physical activity and healthy eating plays a very significant role in control, monitoring and management of type II diabetes. It is clear that physical activity intervention based on theoretical framework contributes to improvement of patients suffering from type II diabetes (Schoenberg, 2008). In that connection, the theoretical framework will be applied to evaluate behavioral changes of diet and physical activity of patients in type 2 diabetes. The framework also indicates that the increase in physical activity and healthy diet in the process of managing and monitoring diabetes results to improvement of BMI and HBA1C.
The second framework is social cognitive theory in developing theoretical framework. The concept of self-efficacy is based on social cognitive theory, which describes the interaction between behavioral, personal, and environmental factors in health and chronic disease. The theory of self-efficacy proposes that patients’ confidence in their ability to perform health behaviors influences which behaviors they will engage in. Diabetes self-management incorporates behavioral, personal, and environmental factors into daily performance of recommended activities, the concept of self-efficacy is relevant for improving self-management (Urmimala, 2006). Self-efficacy has been shown to be important for appropriate self-management for many chronic health conditions.
This theory suggests a multifaceted causal structure in which self-efficacy beliefs operate together with goals, outcome expectations, and perceived environmental impediments and facilitators in the regulation of human motivation, behavior, and well-being (Bandura, 2014). Belief in one’s efficacy to exercise control is a common pathway through which psychosocial influences affect health functioning. Self-efficacy is an important concept derived from Social Cognitive theory that refers to people’s beliefs and judgments on for executing the duties and responsibilities. The theorists believe that humans possess a self-management system through which control their own thoughts, emotion and behaviors and thus significantly determine their own destiny. Therefore, this study attempts to explain the self-efficacy role in self-care of diabetes patients.
Most adults with diabetes are failing to meet the minimum recommendations for exercise and consume a poor diet. According to the American College of Sports Medicine, adults with type II diabetes should participate in at least 20–60 min of moderate intensity exercise on 3–7 days per week. Social cognitive theory is a useful framework for identifying correlates of exercise and diet. Research using social cognitive theory has identified self-efficacy as a determinant regular exercise and healthy diet for adults with type II diabetes (Heiss, 2016).
The summary of social cognitive theory is to design a framework that considers the intervention of diet and physical activity to deliver anticipated changes as per the goals and objectives.
The participants are from a primary care office with type II Diabetes. The self-management data will be collected form anonymous questionnaire. The purpose for the study is to evaluate effective self-management to improve HbA1c. The study will be conducted in Sanitas Medical center for 8 weeks. The questionnaire measured patient understanding and self-care management of diabetes; improving diabetes self management will lead to improved compliance because it enables an efficient assessment of self-care behaviors associated with glycemic control and participants will be aware of the effectiveness of self-management and the beneficial effect on HbA1c control. The study will be used by the health care providers to educate patients on the effective interventions of diet and physical activity to improve the HbA1c.
Ausili, D., Barbaranelli, C., Rossi, E., Rebora, P., Fabrizi, D., Coghi, C., . . . Maurorbara, S. D. (2017). Development and psychometric testing of a theory-based tool to measure self-care in diabetes patients: The self-care of diabetes inventory. BMC Endocrine Disorders, 17doi:http://dx.doi.org.westcoastuniversity.idm.oclc.org/10.1186/s12902-017-0218-y
Compean-Ortiz, L. G., Quintero-Valle, L. M., Del Ángel-Pérez, B., Reséndiz-González, E., Salazar-González, B. C., & González-González, J. G. (2013). Education, Physical Activity and Obesity among Adults with Type II Diabetes from the Standpoint of Orem’s Self-care Theory. Aquichan, 13(3), 347-362.
Heiss, V. J., & Petosa, R. (2016). Social cognitive theory correlates of moderate-intensity exercise among adults with type 2 diabetes. Psychology, Health & Medicine, 21(1), 92-101. doi:10.1080/13548506.2015.1017510
Schoenberg, N. E., Traywick, L. S., Jacobs-lawson, J., & Kart, C. S. (2008). Diabetes self-care among a multiethnic sample of older adults. Journal of Cross-Cultural Gerontology, 23(4), 361-76. doi:http://dx.doi.org.westcoastuniversity.idm.oclc.org/10.1007/s10823-008-9060-z