Evidence-Based Practice Proposal Essay

Section A: Organizational Culture and Readiness Assessment

The organizational culture survey tool that was used in the assessment is “Organization Culture and Readiness for System-Wide Integration of Evidence-Based Practice”. This tool helped to explore, assess, and determine the readiness of the organization to implement and adopt evidence-based practices (EBP) (Yoo et al., 2019).

Organization’s Level of Readiness

The findings from the survey indicate that the organization is ready to adopt EBP. According to the findings, the nurses have the required EBP skills and knowledge while doctors are dedicated to supporting EBP. Organizational management also supports quality improvement initiatives by financing and allocating resources. The organization also has nurse scientists who generate the latest evidence in the organization. The survey also identified nurse practitioners (NPs) who have the required skills to implement EBP. The NPs also mentor nurses and lead the implementation of quality improvement initiatives. Moreover, there are EBP champions who support and rally for the implementation of quality improvement projects. The organization provides access to numerous peer electronic databases for their staff and hence the staff members are able to search and retrieve peer-reviewed journal articles to inform EBPs.

However, the survey showed that there were some obstacles to the implementation of EBP such as resistance by the nurses to changes due to time limitation and heavy workload. The lack of time and heavy workload are attributable to staff shortages within the workplace. This obstacle can be solved by the organizational management hiring more nurses to reduce the heavy workload among nurses (Harper et al., 2017).

ORDER A PLAGIARISM-FREE PAPER HERE

References

Harper M, Gallagher-Ford L, Warren J, Troseth M, Sinnott L &Thomas B. (2017). Evidence-Based Practice and U.S. Healthcare Outcomes. Journal for Nurses in Professional Development, 33(4), 170-179.

Yoo, J. Y., Kim, J. H., Kim, J. S., Kim, H. L., & Ki, J. S. (2019). Clinical nurses’ beliefs, knowledge, organizational readiness, and level of implementation of evidence-based practice: The first step to creating an evidence-based practice culture. PloS one, 14(12), e0226742. https://doi.org/10.1371/journal.pone.0226742

Section B: Proposal/Problem Statement and Literature Review

PICOT Question

Among adult patients diagnosed with Type 2 DM (P), does Continuous Blood Glucose Monitoring (I) compared to Self-Blood Glucose Monitoring (SBGM) (C) result in glycemic control (O) within four weeks (T)?

Problem Statement

Glycemic control remains suboptimal for many people with diabetes and effective glycemic control in people with type 2 diabetes is a major public health issue and a major risk factor to diabetes complications (Mamo et al., 2019). The most common long-term diabetes complications include microvascular and macrovascular complications such as heart disease and kidney problems, eye problems, and amputation of the lower extremities. Poor glycemic control is also associated with increased healthcare costs and increased mortality rates due to complications (Wada et al., 2020). Since blood glucose level is affected by various factors, poor glycemic control is complex and multifactorial. Factors such as poor glycemic monitoring, poor adherence to treatment, exercise, and diet influence glycemic control. Therefore, effective glycemic control is the key therapeutic target in preventing diabetes complications.

Literature Review

Continuous blood glucose monitoring (CGM) continuously provides trends, readings, and notifications to the user (patient) in real-time to provide the patient with diabetes treatment decisions (Dungan & Verma, 2018). CGM updates and displays the blood glucose levels every one to five minutes. Evidence indicates that CGM provides real-time and retrospective information to detect hyperglycemic and hypoglycemic excursions; forecast looming hypoglycemia; and notify the patient about any notable fluctuations in blood glucose levels (Laffel et al., 2020). The use of CGM thus helps patients and their healthcare providers to make the appropriate adjustments to the treatment regimen and provides information and insight to the patient regarding the appropriate behavioral modifications to attain the target glycemic control.

According to Dungan & Verma (2018), while self-blood glucose monitoring (SBGM) provides information that helps to make treatment decisions, there are significant obstacles and shortcomings such as lack of regular and timely feedback and inconvenience. Additionally, with the SBGM, vital information about blood glucose trends can be missed. Therefore, continuous glucose monitoring provides an alternative to provide a more reliable tool to monitor blood glucose levels in people with diabetes. Taylor et al (2018) support this and provides that continuous glucose monitoring has shown efficacy in terms of reducing hypoglycemia, improving A1C, as well as in improving the range in time in target glucose.

Taylor et al (2018) further explain that SBGM is associated with poor adherence because of inconvenience, erroneous and decreased and erroneous measurement frequency that results in suboptimal glycemic control. Therefore, CGMs are able to continuously measure interstitial glucose levels for patients with diabetes, and this information can inform and improve behavior change and effective glycemic control. This is because CGM enables people with diabetes to observe and monitor their blood glucose levels, and comprehend interactions and effects between treatment choices, physical activity, and diet with greater feedback (Taylor et al., 2018).  This, therefore, indicates that continuous glucose monitoring can limit the onset and frequency of hypoglycemia in patients with type 2 diabetes, especially patients being administered with insulin therapy, patients with a history of severe hypoglycemia, or patients with irregular routines such as erratic meal-times, poor sleep patterns, and vigorous exercise.

References

Dungan, K., & Verma, N. (2018). Monitoring technologies–continuous glucose monitoring, mobile technology, biomarkers of glycemic control. In Endotext [Internet]. MDText. com, Inc.

Laffel, L. M., Kanapka, L. G., Beck, R. W., Bergamo, K., Clements, M. A., Criego, A., … & Messer, L. H. (2020). Effect of continuous glucose monitoring on glycemic control in adolescents and young adults with type 1 diabetes: a randomized clinical trial. Jama, 323(23), 2388-2396.

Mamo, Y., Bekele, F., Nigussie, T., & Zewudie, A. (2019). Determinants of poor glycemic control among adult patients with type 2 diabetes mellitus in Jimma University Medical Center, Jimma zone, southwest Ethiopia: a case-control study. BMC Endocrine Disorders, 19(1), 91.

Taylor, P. J., Thompson, C. H., & Brinkworth, G. D. (2018). Effectiveness and acceptability of continuous glucose monitoring for type 2 diabetes management: A narrative review. Journal of diabetes investigation, 9(4), 713–725. https://doi.org/10.1111/jdi.12807

Wada, E., Onoue, T., Kobayashi, T., Handa, T., Hayase, A., Ito, M., … & Sugiyama, M. (2020). Flash glucose monitoring helps achieve better glycemic control than conventional self-monitoring of blood glucose in non-insulin-treated type 2 diabetes: a randomized controlled trial. BMJ Open Diabetes Research and Care, 8(1), e001115.

ORDER A PLAGIARISM-FREE PAPER HERE

The PICOT question I came up with was: Among adult patients diagnosed with Type 2 DM (P), does Continuous Blood Glucose Monitoring (I) compared to Self-Blood Glucose Monitoring (SBGM) (C) result in glycemic control (O) within four weeks? (T)

References used when developing PICOT:

Janapala, R. N., Jayaraj, J. S., Fathima, N., Kashif, T., Usman, N., Dasari, A., Jahan, N., & Sachmechi, I. (2019). Continuous Glucose Monitoring Versus Self-monitoring of Blood Glucose in Type 2 Diabetes Mellitus: A Systematic Review with Meta-analysis. Cureus11(9), e5634. https://doi.org/10.7759/cureus.5634

Laffel, Kanapka, BeckBergamo, K., Clements, M. A., Criego, A.  & Messer, L. H. (2020). Effect of continuous glucose monitoring on glycemic control in adolescents and young adults with type 1 diabetes: a randomized clinical trial. Jama, 323(23), 2388-2396.

Papatheodorou, K., Banach, M., Bekiari, E., Rizzo, M., & Edmonds, M. (2018). Complications of Diabetes 2017. Journal of diabetes research2018, 3086167. https://doi.org/10.1155/2018/3086167

Evidence-Based Practice Proposal – Section A: Organizational Culture and Readiness Assessment and Section B: Proposal/Problem Statement and Literature Review

In order to formulate your evidence-based practice (EBP), you need to assess your organization. In this assignment, you will be responsible for setting the stage for EBP. This assignment is conducted in two parts: an organizational cultural and readiness assessment and the proposal/problem statement and literature review, which you completed in NUR-550.

Section A: Organizational Culture and Readiness Assessment

It is essential to understand the culture of the organization in order to begin assessing its readiness for EBP implementation. Select an appropriate organizational culture survey tool and use this instrument to assess the organization’s readiness.

  1. Develop an analysis of 250 words from the results of the survey, addressing your organization’s readiness level, possible project barriers and facilitators, and how to integrate clinical inquiry, providing strategies that strengthen the organization’s weaker areas.
  2. Make sure to include the rationale for the survey category scores that were significantly high and low, incorporating details or examples. Explain how to integrate clinical inquiry into the organization.
  3. Submit a summary of your results. The actual survey results do not need to be included.

Section B: Proposal/Problem Statement and Literature Review

In NUR-550, you developed a PICOT statement and literature review for a population quality initiative. In 500-750 words, include the following:

  1. Refine your PICOT into a proposal or problem statement.
  2. Provide a summary of the research you conducted to support your PICOT, including subjects, methods, key findings, and limitations.

ORDER A PLAGIARISM-FREE PAPER HERE

General Guidelines:

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.

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. Refer to the LopesWrite Technical Support articles for assistance.

× How can I help you?