Assess the Need for Practice Change

  1. What have you identified as opportunities for improvement in the practicum?
  2. What is your clinical problem?
    Give a one-sentence problem statement.
    The problem addressed in this EBP proposal is….
  3. What possible interventions may help solve the problem?
  4. What are critical outcome indicators?
  5. What is your specific goal for the EBP?
    Give a one sentence goal (purpose) statement:
    The goal (or purpose) of this EBP proposal is to…

Assess the need for practice change

My experiences during the practicum have been very informative about the various aspects
expected of me as a nurse. However, during the exercise, I observed that Diabetes Type 2
patients somewhat lack support on ways to manage this chronic disorder. I interacted with
one of them, who narrated her experiences of how the healthcare facility does not empower
her enough to understand effective strategies to manage Diabetes Type 2. This is true as the
advice-giving technique used in this healthcare facility assumes that patient must change their
behaviour and they want to change behaviour. This method completely undermine autonomy
and generated resistance and have failed to work in most cases as most fails to consider
what is or not important to the patient. I feel obliged to discuss this issue, as the comfort of
the patient in all three states of life i.e. physical, mental and spiritual is vital so as to sustain
quality delivery of care.

Assess the need for practice change
Diabetes is a challenging disorder because the care regimen is usually complex. Despite the
fact that patients with good self-care have excellent glyemic control, most of the patients do
not achieve proper glycemic control and as a result, they suffer associated health
complications. The healthcare providers understand that through proper education, the
patients could avoid the increased diabetes- related complications (American Diabetes
Association, 2013). Generally, the evidence based practice indicate that diabetes regimen as a
multidimensional as adherence in one component is usually unrelated to the adherence of the
other regimen. Therefore, with proper education of the patients diagnosed with type II
diabetes (Ahmad Ali, 2014).
The clinical problem that will be addressed in the EBP is establishing strategies that will
ensure proper education on ways to manage their health complication among Type 2 diabetes
patients. The proposed effective interventions is the application of teach back method in
enhancing effective behavioural interventions is recommended. This education strategy helps
the healthcare provider understand how, why, and when the patient fails to engage in optimal
diabetes self-management practices. This assessment is very important as it shapes the care
plan by identifying strategies that could fail if specific regimen are not understood or dealt
with effectively as part of the intervention. This is because in some cases, the disease related
knowledge could be lacking, or in other cases the patients could be having negative attitudes
and health beliefs that hinder effective care. There could be environmental or even
psychological barriers. The use of teach back education model helps in screening of these
potential problems, and offers comprehensive training on the appropriate therapies and
medication is achieved (Kirk et al., 2011).
The critical outcomes expected include improved and valuable mentoring of the type 2
diabetes patients and improved patient satisfaction. This will translate into lower hospital

Assess the need for practice change
associated health complications. This is because the peer support of the nurses will ensure
delivery of quality care (Al-Akour et al., 2011).
The goal of this EBP proposal is to understand the impact of proper education of patients
with Type II diabetes in promoting quality care management regimen.

Assess the need for practice change
References

Ahmad Ali, S. (2014). The Role of Educational Level in Glycemic Control among Patients
with Type II Diabetes Mellitus. Int J Health Sci (Qassim).; 8(2): 177–187. PMCID:
PMC4166990

Akour N A., Khader YS., Alaoui AM. (2011). Glycemic Control and Its Determinants
among Patients with type 2 Diabetes Mellitus Attending a Teaching Hospital. J Diabetes
Metab;2:4.

American Diabetes Association. (2013). Standards of Medical Care in Diabetes. Diabetes
care. 2013 Jan;3(supplements 1)

Kirk JK., Davis Stephen W, Hildebrandt, C A., Strachan EN., Peechara M L., Lord, R.
(2011). Characteristics Associated With Glycemic Control Among Family Medicine
Patients With Type 2 Diabetes. NCMJ. 11;72(5)

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