GUIDELINES FOR ASSIGNMENT: The Final Steps
Who will your participants be in your project idea? What are the inclusion and exclusion criteria? Will the sample be one of convenience or of randomization? How will you encourage participation?
What do you think are going to be the outcomes from the strategy(s) you choose to implement? Provide a rationale for your selection of outcomes.
In Assignment #2, you identified best practices that may impact the practice problem or issue. What do you think are going to be the outcomes from the strategy(s) you selected to implement for your quality improvement initiative (I am including the (s) behind the strategy because some of you may have more than one best practice that you are going to use)? Provide a rationale for your selection of outcomes (you will need more than one outcome; try to think of at least 3 that are appropriate). You will have a course in outcomes measurement and program evaluation so this is by no means an exhaustive paper. Our goal is for you to start thinking about what outcomes would be appropriate to use to evaluate the effectiveness of your program.
Data Collection Methodology and Measurement:
What are your ideas about how you will measure these outcomes? What data collection methods are you going to use to measure the outcomes you have selected? Will you use qualitative or quantitative methods or both to measure the outcomes? What kind of instrument or measurement methodology will be used? What is the validity and reliability of the instrument(s) you have chosen? Provide 2 instruments that would be appropriate and share the validity and reliability of each.
Cultural Sensitivity: There are cultural implications for every people group. In order to plan an effective intervention, you have to consider cultural implications. How would you modify your intervention to meet the needs of a different culture? How would you modify to use in Latino, African American or a third group found in your community? What strategies might you use to get buy in from one or more culture groups? Remember, all groups of people require cultural sensitivity. If your project idea is more administrative in nature that is not impacted by different culture groups, then choose a people group that you see in your community and speak to the cultural norms of that group and what nurses and other healthcare professionals need to consider when caring for this population in your community. For example, in Baldwin County, we have a Hispanic population of migrant workers who move to various farms for harvesting. What do nurses need to know about the group in order to provide the most effective care for them? How do we alter the care we provide to meet their needs? Feel free to reference your Purnell culture text in this section of your paper. It is an excellent resource for use. Organizational Culture: Within the system where you practice or hope to implement your project idea, describe the organizational culture of that system and how might that culture impact your implementation of best practices? Are you going to have to modify or change your strategies based on that information? For example, if someone works in a system that is very hierarchal in decision making (top down) or there are problems with staff morale, they may have challenges to overcome that someone else in a collaborative environment may not have. Reflect on your system and consider the problems and strengths of that system. How might that impact the implementation of your project idea?
Ethical and HIPAA Concerns:
Will you need to obtain Institutional Board Review (IRB) approval? I will go ahead and tell you that all USA DNP students will navigate the IRB following final project approval. How does the IRB protect human subjects? Do you expect to submit an application for a full, expedited, or exempt review?
What are possible challenges related to ethics and HIPAA issues you may encounter? Think about what could happen if your best practices were implemented. How would you plan to address the possible challenges? You must include at least one ethical concern and at least one possible challenge related to HIPAA.
We want you to find a conference that you think is appropriate for your clinical area and share about the conference. Also, locate a journal that you think would possibly be interested in your final manuscript.
The paper should be carefully written in a formal style, based on primary sources and provide an integration of ideas. Organized flow, logical progression of ideas, and clarity in thought processes are essential. Page limit: 6-7 pages. Page length does not include the title page, reference list or any Appendix.
Make sure you follow the guidelines above for each section of the rubric. You MUST use headings corresponding to rubric points. Criteria Points
Introduction paragraph. There must be a thesis statement that tells reader purpose of paper and what will be discussed. 2
Data Collection Methodology and measurement (Include Instruments in Appendices) 4
Cultural Considerations: People Group and Organizational 3
Ethical and HIPAA Considerations 3
Conclusion: Summarize the essential points of paper. 1
The Final Steps
In this paper, the purpose is to define the sample for my project idea, including the participants as well as the exclusion and inclusion criteria. The outcomes from the strategies I chose to implement are specified, and a rationale for my selection of outcomes is provided. This paper also describes how these outcomes would be measured, and the data collection methods that would be used in measuring the outcomes. The instrument/measurement methodology that would be used is specified. This paper also describes how I would modify my intervention to meet the needs of a different culture. The ethical and HIPAA concerns, along with how the final manuscript would be disseminated are described comprehensively in this paper.
In my project idea, the participants would be children and adolescents of 16 years of age and below in the primary care setting with risk factors for type 2 diabetes mellitus. Inclusion criteria are essentially the traits that the prospective subjects need to have if they are to take part in the research study. On the other hand, exclusion criteria are the traits that rule out potential subjects from inclusion in the research study (Bowers et al., 2013). The inclusion criteria in this research study are: (i) age: the participants must be children who are of age 5 through 16 years; (ii) the participants must have particular risk factors for T2DM for instance fatness; (iii) a child or adolescent in the primary care setting with risk factors for type 2 diabetes mellitus. The exclusion criteria are as follows: people who do not fall between the required age bracket; children and adolescents without any risk factors for type 2 diabetes mellitus; as well as those not in the primary care setting.
The sample will be one of randomization. Random sampling would be done, which is basically a probability-based technique of gathering data. This method of sampling will ensure that selecting subjects from the population is based upon random selection, and not based upon easy availability. Moreover, selection bias would be impossible in random selection. Although this method would be more expensive and time consuming in relation to convenience sampling, it is more comprehensive and would allow for more accurate theories to be formulated (Venkatesh, Brown & Bala, 2013). I will encourage participation by offering financial incentives; one would be given $23.75 for taking part in the study. Besides financial incentives. Other essential ways of encouraging participation include communicating clearly about the project, and contacting the prospective participants severally (Morton, 2009).
The strategies which I chose to implement are: (i) lifestyle modifications; (ii) screening for T2DM with the use of glycated hemeoglobin (HbA1c), two-hour oral-glucose tolerance test, and fasting plasma glucose (FPG); and (iii) risk assessment basing on the presence of conditions or signs of related insulin resistance, personal and family history of the child or adolescent, and body mass index (BMI). From 3 these strategies, the outcomes would be: (i) change of lifestyle in which the subjects will now engage in physical activity, maintain weight that is healthy, and eat diet that is healthy. (ii) Identifying individuals with and those without T2DM after the screening activity. (iii) A detailed description of the risk of those subjects with the presence of conditions or signs of related insulin resistance, personal and family history of the child or adolescent, and body mass index. These outcomes are appropriate and relevant since they directly link to the strategies, and they would be obtained after the strategies are implemented.
Data collection methodology and measurement
I will employ mixed research method that will entail both quantitative and qualitative methods in measuring the outcomes. Mixed research method is basically a methodology used to conduct research and it entails gathering, analyzing, as well as integrating qualitative and quantitative research (Bowers et al., 2013). The instruments or measurement methodology that I will use are: survey, questionnaires and interviewing. Questionnaires would be completed by the subjects. Reliability and validity concerns would assist in alleviating usability issues. The main usability considerations include: how much time would it take to administer; are all the directions understandable; how is it easy to score; are there equivalent forms; have other researchers reported any problems who utilized the instruments (Cameron et al., 2013). The instruments that would be used are those which have been developed and tested severally. Reliability is understood as consistency, and validity is the degree to which a given instrument will measure that it is believed to measure, and performs as it is intended to. The instruments employed in this research score high in validity and reliability.
Cultural considerations/cultural sensitivity
The United States is without doubt a varied multi-ethic and multi-cultural society and people from the minority communities comprise about ⅓ of the country’s entire population. Comprehending the concept of culture is essential to comprehending cultural sensitivity (Arvidson et al., 2011). The strategies that I might use to get buy in from one or more cultural groups are: (i) selecting staff that is diverse. This will entail involving people from the diverse and different cultures in the intervention by having them as staff members. (ii) Having input from various varied groups from diverse cultural backgrounds. (iii) Appearance of the facility will reflect diverse communities. The décor of the facility would make an inclusive statement in that the walls would reflect cultural openness, with images and posters demonstrating people representative of the client population. It is of note that the clients would feel welcomed whenever they see images of people who look like themselves (Truong, Paradies & Priest, 2014).
Within the system wherein I practice, the organizational culture is receptive to new, unique and constructive ideas. This culture would be of advantage to my project idea since the top management, middle level managers, in addition to other the employees would be open to my idea. They would most likely accept and support my project idea, and encourage me to continue with it. Moreover, there is also high staff morale in the organization and this would help to make them be more amenable of my project idea. As such, I will not have to modify or alter my strategies. However, the problem with the system is that the organization is very hierarchical in regards to decision making, given that the organization’s top-level management makes all the decisions. This might impact the implementation of my project idea in that it might take time to get the authorization of the Board chairman given that accessing him is not easy.
Ethical and HIPAA Concerns
I will need to obtain Institutional Board Review (IRB) approval. IRB is essentially a committee responsible for approving, monitoring, and reviewing behavioral as well as biomedical research that involve humans. The main priority for the institutional review board is to protect people from both psychological and physical harm. The IRB, in essence, must give approval to the proposed non-exempt research prior to the participation of human subjects might commence (Department of Health and Human Sciences, 2014). The Institutional Board Review protects the welfare and rights of persons enlisted to partake in research activities by assessing clinical studies regulated by the Food and Drug Administration under sections 520, 507 and 505 of the Federal Food, Drug and Cosmetic Act (Holt, 2013). I expect to submit an application for a full review. The Health Insurance Portability and Accountable Act (HIPAA) establishes new rules and standards aimed at protecting patients from unsuitable disclosures of their protected health information that could result in harm to their privacy, employability and insurability (Lori, 2013). The potential challenges linked to HIPAA and ethics issues that I might encounter include inapt disclosures that of the patients’ protected health information that may lead to harm to their employability, insurability, and confidentiality. If my best practices were implemented, I would address the possible challenges by not disclosing the private health information of the patients.
The conference that is appropriate for my clinical area is the 2014 Keystone Conference organized by the children’s diabetes foundation. The conference would be held in Keystone, Colorado. During the 4-day conference, the everyday hurdles in managing diabetes in children and the practical ways of overcoming those challenges would be emphasized (Children’s Diabetes Foundation, 2014). The journal which would possibly be interested in my final manuscript is the Journal of Pediatric Health Care, which is basically the publication of the National Association of Pediatric Nurse Practitioners.
In conclusion, in my project idea, the participants would be children and adolescents of 16 years of age and below in the primary care setting with risk factors for type 2 diabetes mellitus. The inclusion criterion in this research study is the participants the participants must be children who are of age 5 through 16 years with risk factors for T2DM, and exclusion criteria is people not within this age bracket without any risk factors. I will encourage participation by offering financial incentives. Both quantitative and qualitative methods would be used in measuring the outcomes. The instruments that are employed in this research score high in validity and reliability. I will need to obtain Institutional Board Review approval.
Arvidson, J., Kinniburgh, K., Howard, K., Spinazzola, J., Strothers, H., Evans, M., & … Blaustein, M. E. (2011). Treatment of Complex Trauma in Young Children: Developmental and Cultural Considerations in Application of the ARC Intervention Model. Journal Of Child & Adolescent Trauma, 4(1), 34-51. doi:10.1080/19361521.2011.545046
Bowers, B., Cohen, L. W., Elliot, A. E., Grabowski, D. C., Fishman, N. W., Sharkey, S. S., & Kemper, P. (2013). Creating and Supporting a Mixed Methods Health Services Research Team. Health Services Research, 48(6pt2), 2157-2180. doi:10.1111/1475-6773.12118.
Cameron, R., Dwyer, T., Richardson, S., Ahmed, E., & Sukumaran, A. (2013). Lessons from the field: Applying the Good Reporting of A Mixed Methods Study (GRAMMS) framework. Electronic Journal Of Business Research Methods, 11(2), 53-64.
Children’s Diabetes Foundation. (2014). 2014 Practical Ways to Achieve Targets in Diabetes Care.
Department of Health and Human Sciences. (2014). Institutional Review Boards (IRBs).
Holt, E. (2003). The HIPAA Privacy Rule, Research, and IRBs. Applied Clinical Trials, 12(6), 48.
Lori, S. (2013). Overview of the HIPAA Final Omnibus Rule. Journal of Health Care Compliance; 15(3): 53-64.
Morton, L. M. (2009). Encouraging Participation in Medical Research: What Strategies Work? Journal of Clinical Epidemiology. /
Truong, M., Paradies, Y., & Priest, N. (2014). Interventions to improve cultural competency in healthcare: a systematic review of reviews. BMC Health Services Research, 14(1), 1-31. doi:10.1186/1472-6963-14-99
Venkatesh, V., Brown, S. A., & Bala, H. (2013). Bridging the Qualitative-Quantitative Divide: Guideline for Conducting Mixed Methods Research in Information Systems. MIS Quarterly, 37(1), 21-54.