NUR 590 EBP Project Proposal Implementation Plan
Obesity among ware veterans with mental health issues continue to pose a challenge to the health care sector. According to studies, a direct correlation exists between the two phenomena. The associated mortality and morbidity rates concerning obesity related to PTSD in war veterans have also increased exponentially since researchers started examining the association. As a result, the healthcare sector has undergone a resource strain based on the fact that no evidence-based research has comprehensively examined the matter and suggested an effective plan. In the wake of this gap, the current project seeks to determine the effectiveness of the application of a strategy known as the MOVE! to reduce the incidences of PTSD among war veterans. Nevertheless, it remains uncertain whether the MOVE! will effectively deal with the issue.
In the present section, the author will formulate an implementation plan for the study that plans to use the MOVE! solution to improve obesity rates among veterans with PTSD. During the implementation, the metrics necessary for the reduction of weight among the war veteran population with PTSD seeking care at a selected facility will be examined. In addition, the MOVE! intervention is going to establish a correlation between the intervention and anticipated outcomes as related to discussions that will follow.
Settings and Access to Potential Subject
In the intervention, the author sought to use the counseling phase of the MOVE! program that will encompass patient education. In order to perform this, the selected health care setting, which is the author’s current place of work will be used for the project. The setting will make certain that evidence-based practice precedes everything during the execution of the project by examining the pertinence of the program to the selected patients (Atkins, 2017). Moreover, the option of the facility that will be used to execute the program is vital as it will facilitate monitoring of the intervention’s performance metrics. This review will occur when the patients visit the care facility. Further, the performance metrics associated with counselling will form an integral part of ensuring that the war veteran’s improve their weights as well as ameliorate their mental health issues.
However, the target population for the present study is one that enjoys certain privileges in the country. War veterans have their own health care system known as the Veteran Affairs. Therefore, recruiting them to the program may not be a straightforward matter. As a result, an approval will be sought from the Department of Defense and relevant authorities. Upon acceptance of the request, the participants’ consent will also be sought as they are entitled to know the purpose and objective of the program. Further, the consent sought from the participants will also be premised on informing them the future use of the study.
Timeframe for the Project
The project’s program is premised on managing weight among obese war veterans suffering from PTSD as a result of the ravages of the various wars that the United States government undertakes. Whereas the achievement of the desired results can occur within a span of 12 weeks, which is the average time for a therapeutic intervention, the study will extend to six months. According to literature on the matter, whereas 3 months may be ideal to address the mental health aspect, the issue of weight is a complex matter (Janney et al., 2017). While the participants will demonstrate reduction of pounds by the 12th week, it remains debatable whether the reduction will be in the confines of their ideal weights. As a consequence, running the program for six months will allow the participants to incorporate lessons from the therapy and education sessions as relates to self-care management of obesity. Indeed, during the six months, the health care facility will also be monitoring the study participants in relation to their compliance with the self-care strategies that will have been emphasized during the first 3 months. During the period, adjustments will also be made to the interventions to ensure maximum weight reduction for the participants.
The project has far reaching repercussions not only in individual war veterans but the entire military industry given the immense benefits that it can accrue the country. As such, the investment into it will have to be substantial. In order to successfully implement the solution, nurses and finances will play crucial roles. Therefore, the project will require six nurses, 3 professional therapists, 3 professional counselors, and 2 physicians. The above-mentioned professionals will undergo further training regarding their treatment of the study population. Further, the finances will also be necessary in the procurement of prescription medications, medical supplies, stationeries, and other relevant materials for the project (Hoesrter et al., 2017). In more specific terms, the project team will require the availability of body mass index (BMI) charts, height boards and weighing scales. Nevertheless, during the acquisition of the said materials, the team should observe care so as to avoid cost overruns.
Methods and Instruments
The intervention will be delivered through the usage of professional counselling and diet education sessions. The participants will require active involvement in the program given that self-care will form an integral part of the process. During the process, several instruments will be used. One of the most pertinent ones will be questionnaires to the participants. Further, closed interview sessions will be used during the therapy sessions to understand the perceptions that war veterans have on obesity and treat their mental illness (Janney et al., 2017). Lastly, formative evaluation will also be employed during the study to check the progress of the process.
Solution Delivery Process
The outcome of the project will be communicated to the Veteran Affairs department. Given that they exclusively address health care challenges associated with war veterans, they will need the latest evidence-based interventions to combat the issue of obesity and PTSD among veterans. The entire program will occur at varied phases. Initially, the study participants will be recruited and enrolled to the program after permission has been granted by the relevant authorities (Goldberg et al., 2016). The subsequent phase will entail the participants being enrolled to therapy and diet education sessions at the facility. Their vital information will be taken during the beginning of the phase for review a month later. Further, diet therapists and nurses will deliver the diet education while the physician will monitor the participants for any attendant medical conditions during the duration of the program as well as prescribe weight management drugs.
Data Collection Plan
The nurses will record the subjective and objective data on the weight improvement during the process. Stratification of the data depending on time and condition of collection will also occur to determine their relevance. In-patient interviews with the participants as relates to the need for dietary and lifestyle changes will occur. Press Graney survey will be adopted to enable stakeholders track the outcomes of the study. The data will be stored in MS Excel after cleaning and subjected to analysis by the Statistical Package for Social Sciences (SPSS).
Strategies to Overcome Barriers
These will entail adhering to the ethical guidelines for research. This will include consent forms issuance to the study subjects. Further, training of the professionals will also manage various challenges related to teamwork and project delivery (Klingaman et al., 2016). In addition, project facilitators will have training on managing the cultural diversities that may be present during the project.
Feasibility of the Plan
The effectiveness of the plan to reduce weight and ameliorate weight issues among the veterans is unquestionable. However, the necessary financial burden may be a factor yet it is still possible to execute it. The entire cost for the project may come to $ 300 000 with the breakdown entailing medical supplies, miscellaneous costs, and allowances and salaries.
Plan to Maintain/Extend/Revise/Discontinue the Project
The program will immensely benefit the veteran population suffering from PTSD and obesity. Thus, it should be integrated into the VA health care model. However, the diets and mental health fitness of the soldiers will need adjustment. The project could also incorporate other aspects of the MOVE intervention to make it more effective.
Therefore, the management of the PTSD symptoms alongside dietary education will play a crucial role in ensuring that veterans do not suffer from obesity. Nevertheless, adequate resources will become pertinent to achieve the desired results. The project’s performance metrics will also require constant examination.
Atkins D. (2017). Improving Weight Management among Veterans. Journal of general internal medicine, 32(Suppl 1), 1–3. doi:10.1007/s11606-017-4007-0
Goldberg, W., Reeves, R., Gloria, T., Medoff, S., Dickerson, D., Goldberg, P., Ryan, A.S, Fang, A, Li, D., (2016). “MOVE!”: Outcomes of a Weight Loss Program Modified for Veterans With Serious Mental Illness. Psychiatric services (Washington, D.C.), 64. 10.1176/appi.ps.201200314.
Hoerster, K. D., Lai, Z., Goodrich, D. E., Damschroder, L. J., Littman, A. J., Klingaman, E. A., … & Kilbourne, A. M. (2014). Weight loss after participation in a national VA weight management program among veterans with or without PTSD. Psychiatric Services, 65(11), 1385-1388.
Janney, C. A., Masheb, R. M., Lutes, L. D., Holleman, R. G., Kim, H. M., Gillon, L. R., … & Richardson, C. R. (2017). Mental health and behavioral weight loss: 24-month outcomes in Veterans. Journal of affective disorders, 215, 197-204.
Klingaman, E. A., Hoerster, K. D., Aakre, J. M., Viverito, K. M., Medoff, D. R., & Goldberg, R. W. (2016). Veterans with PTSD report more weight loss barriers than Veterans with no mental health disorders. General hospital psychiatry, 39, 1-7.
In 1,250-1,500 words, discuss the implementation plan for your evidence-based practice project proposal. When required, create the appropriate form, table, image, or graph to fully illustrate that aspect of the intervention plan and include them in an appendix of your paper. You will use the implementation plan, including the associated documents in your appendices, in the Topic 8 assignment, during which you will synthesize the various aspects of your project into a final paper detailing your evidence-based practice project proposal.
Include the following:
- Describe the setting and access to potential subjects. If there is a need for a consent or approval form, then one must be created. Include a draft of the form as an appendix at the end of your paper.
- Create a timeline. Make sure the timeline is general enough that it can be implemented at any date. Based on the timeline you created, describe the amount of time needed to complete this project. Include a draft of the timeline as an appendix at the end of your paper.
- Develop a budget and resource list. Consider the clinical tools or process changes that would need to take place. Based on the budget and resource list you developed: (a) describe the resources (human, fiscal, and other) or changes needed in the implementation of the solution; (b) outline the costs for personnel, consumable supplies, equipment (if not provided by the institute), computer-related costs (librarian consultation, database access, etc.), and other costs (travel, presentation development). Include a draft of the budget and resource list as an appendix at the end of your paper.
- Explain whether you would select a qualitative or quantitative design to collect data and evaluate the effectiveness of your evidence-based practice project proposal. Provide rationale to support your selection.
- Describe the methods and instruments (questionnaire, scale, or test) to be used for monitoring the implementation of the proposed solution. Include the method or instrument as an appendix at the end of your paper.
- Explain the process for delivering the intervention and indicate if any training will be needed.
- Discuss the stakeholders that are needed to implement the plan.
- Consider all of the aspects of your implementation plan and discuss potential barriers or challenges to the plan. Propose strategies for overcoming these.
- Establish the feasibility of the implementation plan.
Refer to the “Evidence-Based Practice Project Proposal – Assignment Overview” document for an overview of the evidence-based practice project proposal assignments.
You are required to cite a minimum of five peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.
Complete the “APA Writing Checklist” to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as an appendix at the end of your paper.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.
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. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
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NUR 590 Topic 5 DQ 1
Identify two stakeholder barriers you might experience during the implementation phase of your evidence-based practice project. What strategies can you implement to gain stakeholder support for the project implementation. Provide a suggestion you would give to a colleague who is struggling with obtaining stakeholder support.
Cohesive Collaboration is important to the survival of and success of an organization. Implementation plans can face numerous challenges as a result of lack of knowledge of the problems hurting an organization. This lack of knowledge is common in many organizations were leaders and management are disconnected from day to day operations that help to run the organization. When a person rises through the ranks of the organization into a leadership role they have knowledge of and experience that other managers lack if they hired from the outside. The person who rises through the ranks has more understanding of the how the organization works, the weakness that exist, the organizations strength and how the organization needs to function in order to survive. Where there is s disconnect between stakeholders in higher positions and those working the day to day operations, noting will get done.
Some of the things that one might experience during the implementation phase are resistance and timing. “Lack of time is often cited as a barrier to implementing EBP. In addition, uncertainty or lack of knowledge about the EBP process is also a barrier, which includes critiquing and appraising the literature related to the clinical problem being addressed” (Ginex, 2018). In busy hospitals lack of time to study and understand new changes and policies can be a barrier. On time of this, resistance to change can also be a barrier. In there is already a flow that nurses are accustomed to even if it is chaotic, having to change that flow requires learning something new or changing ones workflow habits and that can cause resistance to change.
The one suggestion I would give to a fellow colleague would be for them to ask questions, slow down the pace in order for them to understand the new policy and give themselves time to become accustom to it and to always remember that it will take them time to learn something new before they can master it.
Ginex, P. (2018). Overcome Barriers to Applying an Evidence-Based Process for Practice Change. Retrieved from https://voice.ons.org/news-and-views/overcome-barriers-to-applying-an-evidence-based-process-for-practice-chang