Monica Bullock    1 posts   Re: Topic 3 DQ 1  Paz-Pacheco, E., Sandoval, M. A., Ardena, G. J. R., Paterno, E., Juban, N., Lantion-Ang, F. L., … Bongon, J. (2017). Effectiveness of a community-based diabetes self-management education (DSME) program in a rural agricultural setting. Primary Health Care Research & Development (Cambridge University Press / UK), 18(1), 35–49. https://doi- org.lopes.idm.oclc.org/10.1017/S1463423616000335  This study was done to assess the effectiveness of diabetes self-management in rural agricultural towns. It gives a great out line of how the programs were implemented and great statistics. This fits with the population that I deal with at my practicum sight. The down side is that the study was conducted in the Philippines. Not that the information is not valid it just makes it less relatable. On that not I think I would need more information for evidence based practice changes, something relatable to the US. For my capstone project I think it provides great ideas to solve the problem.  Carlos Vasconcelos, António Almeida, Maria Cabral, Elisabete Ramos, & Romeu Mendes. (2019). The Impact of a Community-Based Food Education Program on Nutrition- Related Knowledge in Middle-Aged and Older Patients with Type 2 Diabetes: Results of a Pilot Randomized Controlled Trial. International Journal of Environmental Research and Public Health, (13), 2403. https://doi-org.lopes.idm.oclc.org/10.3390/ijerph16132403  This study focused on food based interventions. Educating the community on food and how it will affect the body. Randomly people were assigned a workout program and diet program then tested the knowledge of food nutrients through a questionnaire before and after to produce results. I think this is a good study to use because it shows how food is a major role in life style changes and the effects on A1C. The down side is the study data is confusion to read and it does only focus on a specific demographic, but it does apply to the question I want to answer. This would be relatable and with the support of another study would be great for evidence based change.  Prezio, E. A., Pagán, J. A., Shuval, K., & Culica, D. (2014). The Community Diabetes Education (CoDE) Program: Cost-Effectiveness and Health Outcomes. American Journal of Preventive Medicine, 47(6), 771–779. https://doi- org.lopes.idm.oclc.org/10.1016/j.amepre.2014.08.016  The study looks at how effective community based teaching programs are with minority and low income groups. Once education was initiated the participants A1 C was tracked for a year to observe for any improvements. Cost was also evaluated vs benefits. I think this is a good one study to use since in recent years I have seen these type of programs pop up in the community. The study focuses on Mexican American who are uninsured, a large part of my community population. I think this would provide enough for evidence based practice changes since it is relatable to my community.  Bielamowicz, M. K., Pope, P., & Rice, C. A. (2013). Sustaining a Creative Community-Based Diabetes Education Program: Motivating Texans With Type 2 Diabetes to Do Well With Diabetes Control. Diabetes Educator, 39(1), 119–127. https://doi- org.lopes.idm.oclc.org/10.1177/0145721712470605  This is an interesting one that take place in Texas and uses cooking as the way to have patients take action in the their own self-care. Using a free healthy cooking class offered to anyone that signed up participants were interviewed at the beginning to see what they viewed as healthy life style changes and cooking. A1Cwere also measured and glucoses levels. At the end of the classes the same things were measured to show improvement and more interest in self-care. This is a unique way to have patients take responsibility for their care through the food they prepare. The down side is the person has to have an interest in cooking and food. On its own I think this would have a strong argument for evidence based changes, but would be stronger with added support from a different study.  Aguiar, E. J., Morgan, P. J., Collins, C. E., Plotnikoff, R. C., Young, M. D., & Callister, R. (2016). Efficacy of the Type 2 Diabetes Prevention Using LifeStyle Education Program RCT. American Journal of Preventive Medicine, 50(3), 353–364. https://doiorg.lopes.idm.oclc.org/10.1016/j.amepre.2015.08.020  This study looks at the PULSE program which contains education on weight loss through life style modifications. It followed high risk men for one year to see if there was improvements in A1C and glucose with the implementation. The program is gender tailored and individually tailored. Weakens would be it only focusses on men, but still could provide good information on life style changes and the effects.

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Two professional registered nurses are interested in evidence-based practice and have developed research questions to study.  The nurses discuss what evidence-based practice is all about and are trying to determine if the organizational culture supports nurses who seek out and use research to change long-standing practices that are rooted in tradition rather than science.

1. What is the best explanation of the difference between evidence-based practice and best practices?

2. The two registered nurses review a variety of research studies to answer their proposed research questions. What is the difference in the efficacy of randomized controlled trials, integrative reviews, or meta-analysis with practice-based evidence for continuous process improvement?

3. The registered professional nurses must consider alternative support mechanisms when searching for the best evidence to support their clinical practice. What are possible mechanisms of support for evidence-based practice?

4.  Describe the challenges that exist today for nurses in implementing evidence-based practice?

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Name two different methods for evaluating evidence. Compare andcontrast these two methods

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Evidence-based practice is essential to providing safe, quality care to a diverse population in the acute care setting as well as in the community. Understanding the health care system at the local level is essential to consider when planning the implementation of evidence-based practice (EBP) because it helps those implementing changes understand and execute the move in an area of greatest need. Franklin and Hopson (2007) write that implementing evidence-based practice change in the community setting is challenging. Interventions that work in research or acute care setting are often very challenging to implement locally in the community setting due to the struggle with “building partnerships between clinical practitioners and researchers” (Franklin & Hopson, 2007, p. 379). Maintaining the effectiveness and reliability of interventions once moved to the community setting is difficult thus careful attention to the specific needs of the local community health care system is imperative (Franklin & Hopson, 2007).

Information from my course mentor that I will consider for my project is to ensure that I am following the hospital’s shared governance model to allow other nurses on the unit to have a voice in the project change (T. Brock, personal communication, August 20, 2019). The hospital where I am implementing my project change is a Magnet culture and uses a shared governance model when considering implementation of evidence-based practice change. My practice change does not only affect me, so it is imperative to share accountability and partnership with my unit manager, peers, and unit-based council members when implementing a project change on the unit for effective outcomes (T. Brock, personal communication, August 20, 2019).

Reference

Franklin, C., & Hopson, L. M. (2007). Facilitating the use of evidence-based practice in 

community organizations. Journal of Social Work Education, (3), 377-404. Retrieved 

from https://search-ebscohost-com.lopes.idm.oclc.org/login.aspx?

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What interview types did this person describe? For example, consider the screening, the selection, the group, the competitive, the panel, or the stress interview types.

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