Evidence-Based Capstone Project, Disseminating Results
Assignment: Evidence-Based Capstone Project, Part 6: Disseminating Results
The dissemination of EBP results serves multiple important roles. Sharing results makes the case for your decisions. It also adds to the body of knowledge, which creates opportunities for future practitioners. By presenting results, you also become an advocate for EBP, creating a culture within your organization or beyond that informs, educates, and promotes the effective use of EBP.
Review the final PowerPoint presentation you submitted in Module 5, and make any necessary changes based on the feedback you have received and on lessons you have learned throughout the course.
Consider the best method of disseminating the results of your presentation to an audience.
· Create a 5-minute, 5- to 6-slide narrated PowerPoint presentation of your Evidence-Based Project.
· Be sure to incorporate any feedback or changes from your presentation
submission in Module 5.
· Explain how you would disseminate the results of your project to an audience. Provide a rationale for why you selected this dissemination strategy.
· Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.
Chapter 10, “The Role of Outcomes on Evidence-based Quality Improvement and enhancing and Evaluating Practice Changes” (pp. 293–312)
Chapter 12, “Leadership Strategies for Creating and Sustaining Evidence-based Practice Organizations” (pp. 328–343)
Chapter 14, “Models to Guide Implementation and Sustainability of Evidence-based Practice” (pp. 378–427)
· Gallagher-Ford, L., Fineout-Overholt, E., Melnyk, B. M., & Stillwell, S. B. (2011). Evidence-based practice, step by step: Implementing an evidence-based practice change. American Journal of Nursing, 111(3), 54–60. doi:10.1097/10.1097/01.NAJ.0000395243.14347.7e. Retrieved from https://journals.lww.com/ajnonline/Fulltext/2011/03000/Evidence_Based_Practice,_Step_by_Step_.31.aspx
· Newhouse, R. P., Dearholt, S., Poe, S., Pugh, L. C., & White, K. M. (2007). Organizational change strategies for evidence-based practice. Journal of Nursing Administration, 37(12), 552–557. doi:0.1097/01.NNA.0000302384.91366.8f. Retrieved from http://downloads.lww.com/wolterskluwer_vitalstream_com/journal_library/nna_00020443_2007_37_12_552.pdf
· Melnyk, B. M. (2012). Achieving a high-reliability organization through implementation of the ARCC model for systemwide sustainability of evidence-based practice. Nursing Administration Quarterly, 36(2), 127–135. doi:10.1097/NAQ.0b013e318249fb6a
· Melnyk, B. M., Fineout-Overholt, E., Gallagher-Ford, L., & Stillwell, S. B. (2011). Evidence-based practice, step by step: Sustaining evidence-based practice through organizational policies and an innovative model. American Journal of Nursing, 111(9), 57–60. doi:10.1097/01.NAJ.0000405063.97774.0e. Retrieved from https://www.nursingcenter.com/nursingcenter_redesign/media/EBP/AJNseries/Sustaining.pdf
· Melnyk, B. M., Fineout-Overholt, E., Giggleman, M., & Choy, K. (2017). A test of the ARCC© model improves implementation of evidence-based practice, healthcare culture, and patient outcomes. Worldviews on Evidence-Based Nursing, 14(1), 5–9. doi:10.1111/wvn.12188. Retrieved from https://sigmapubs.onlinelibrary.wiley.com/doi/abs/10.1111/wvn.12188
· Melnyk, B. M., Fineout-Overholt, E., Gallagher-Ford, L., & Stillwell, S. B. (2011). Evidence-based practice, step by step: Sustaining evidence-based practice through organizational policies and an innovative model. American Journal of Nursing, 111(9), 57–60. doi:10.1097/01.NAJ.0000405063.97774.0e. Retrieved from https://journals.lww.com/ajnonline/Fulltext/2011/09000/Evidence_Based_Practice,_Step_by_Step__Sustaining.27.aspx
Nursing 6052- Dr. Smith
Essentials of Evidence-Based Practice
The organization I am affiliated with is a correctional facility. It houses over 300 detainees with some being newly diagnosed diabetics. The officers need training because the facility doesn’t have 24-hour nursing and they are responsible for letting the detainees check their blood sugar levels at night and providing snacks. There is increasing interest in quality improvement strategies to improve diabetic management.
The purpose is to provide ongoing preventive care through new activities which will allow us to identify and interfere in the advancement of diabetes while in jail.
The current problem is over half the time the nurses are unaware of the people who have diabetes unless they puts in a medical request which sometimes takes days. The jail has an intake process of getting booked into jail but does not have a medical intake process. And that’s a big change that needs to happen. The stakeholders who needs to be part of the design and implementation for it to make a difference are the quorum courts, the Sherriff, and the Jail’s Chief Administrator. The risk associated with the change is jail administration have no standard strategies to follow when implementing something new..
Patients with a diagnosis of diabetes should have a complete medical history and physical examination by a licensed health care team member in a timely manner. Goals should be individualized depending on the situation. This should be documented in the patient’s record and communicated to all persons involved in his/her care, including security staff.
The necessity of the change must be acknowledged and acceptable. Staff must be trained for the new procedures. A training curriculum must explain the role, its technical procedures, its strengths and weaknesses, legal requirements, and professional relationship standards. The success of this project prompts conversation with the major, chief and the sheriff. With the organizational adaption and staff involvement the implementation of the change should be successful (Melnyk & Fineout-Overholt, 2018).
People with diabetes should obtain care that meets national standards. Being incarcerated does not change these standards. Patients must have right to medication and nutrition needs to manage their disease. In patients who do not meet treatment goals, medical and behavioral plans should be adjusted by health care providers in collaboration with the prison staff (Worswick, Wayne, Bennett, Fiander, Mayhew, Weir, & Grimshaw, 2013).
It is critical for correctional facilities to identify patients in need of more intensive evaluation and therapy, including pregnant women, patients with advanced complications, a history of repeated severe hypoglycemia, or recurrent DKA (ADA, 2011).
Critical Appraisal Summary
Diet and physical activity made a major decline in the HbA1c at three and six months, but not at 12 and 24 months. (Cradock, ÓLaighin, Finucane, Gainforth, Quinlan, & Ginis, n.d.).
Meta-analysis of interventions showed that a adjustment in behavior reduced HbA1c more than a change in the environment (Cradock, OLaighin, Finucane, McKay, Quinlan, Ginis, & Gainforth, 2017).
By persuading physical activity, diet and sleep, this may build environmental characteristics which affect the risk of T2DM. (den Braver, Lakerveld, Rutters, Schoonmade, Brug, & Beulens, 2018).
Exercise displayed good improvement indicated by a decline in HbA1c level. The results are both clinically and statistically important (Thomas, Elliott, & Naughton 2006).
What I’ve learned from the evaluation table is it organizes data so comparisons and relationships could be identified and used to make recommendations for change (Melnyk & Fineout-Overholt, 2018).
I learned that the level of evidence integrates an objective description of the existence and type of studies supporting the recommendation and expert consensus. The recommendation of class indicates the strengths and weaknesses of the evidence, the importance of the risks, and the benefits identified (Melnyk & Fineout-Overholt, 2018).
Evidence Table Explanation
Outcomes synthesis table Explanation
I learned that synthesis helps to integrate all the different resources together, which facilitate the outcome of information on a specific topic. Synthesis involves joining ideas or results from two or more sources in a meaningful way. In EBP the synthesis is focused on the clinical question (Fineout-Overholt, Melnyk, Stillwell, & Williamson, 2010c).
Evidence based decision making must be contextualized by the clinician through objectifying patient-provider relationships , concerns, and goals (Melnyk & Fineout-Overholt, 2018).
Policies and procedures should be implemented to confirm that the health care staff has sufficient awareness and skills to direct the management and education of persons with diabetes. The health care staff needs to be involved in the development of the correctional officers’ training program. Training should be accessible at least biannually, and the curriculum should cover the following.
- what diabetes is
- signs and symptoms of diabetes
- risk factors
- signs and symptoms of, and emergency response to, hypo- and hyperglycemia
- glucose monitoring
- nutrition issues including timing of meals and access to snacks
American Diabetes Association (2011). Diabetes management in correctional institutions. Diabetes care, 34 Suppl 1(Suppl 1), S75–S81. doi:10.2337/dc11-S075
Braver, N. R., Lakerveld, J., Rutters, F., Schoonmade, L. J., Brug, J., & Beulens, J.W.J. (2018). Built environmental characteristics and diabetes: a systematic review and meta- analysis. BMC Medicine, (1),1
Cradock, K. A., ÓLaighin, G., Finucane, F. M., Gainforth, H. L., Quinlan, L. R., & Ginis, K.A . (n.d). Behaviour change techniques targeting both diet and physical activity in type 2 diabetes: A systematic review and meta-analysis. The international journal of behavioral nutrition and physical activity, 14(1), 18. doi:10.1186/s12966-016-0436-0
Cradock, K. A., OLaighin, G., Finucane, F. M., McKay, R., Quinlan, L. R., Ginis, K. A. M., & Gainforth, H. L. (2017). Diet Behavior Change Techniques in Type 2 Diabetes: A Systematic Review and Meta-analysis. DIABETES CARE, 40(12), 1800–1810.
Fineout-Overholt, E., Melnyk, B. M., Stillwell, S. B., & Williamson, K. M. (2010c). Evidence-based practice, step by step: Critical appraisal of the evidence: Part III: The process of synthesis: Seeing similarities and differences across the body of evidence. American Journal of Nursing, 110(11), 43–51. doi: 10.1097/01.NAJ.0000390523.99066.b5. Retrieved from https://www.nursingcenter.com/nursingcenter_redesign/media/EBP/AJNseries/Critical3.pdf
Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.
Thomas D, Elliott EJ, & Naughton GA. (2006). Exercise for type 2 diabetes mellitus. Cochrane Database of Systematic Reviews, N.PAG. Retrieved from https://search- ebscohostcom.ezp.waldenulibrary.org/login.aspx?direct=true&db=rzh&AN=105838614&site=eds-live&scope=site
Worswick, J., Wayne, S. C., Bennett, R., Fiander, M., Mayhew, A., Weir, M. C., … Grimshaw, J. M. (2013). Improving quality of care for persons with diabetes: an overview of systematic reviews – what does the evidence tell us?. Systematic reviews, 2, 26. doi:10.1186/2046-4053-2-26