NURS-FPX6011-Implementing Evidence-Based Practice

Implementing Evidence-Based Practice

School of Nursing and Health Sciences, Capella University

NURS-FPX6011- Evidence-Based Practice for Patient-Centered Care and Population Health

May 27, 2023

Implementing Evidence-Based Practice

PICOT

In adult patients with obesity (P), does a multidisciplinary weight management program (I) compared to standard care (C) lead to greater sustained weight loss and improved overall health outcomes (O) over a 12-month period (T)?

Background

Excessive fat storage throughout the body is the hallmark of obesity, a medical disease that may have far-reaching consequences for one's health. The tremendous increase in its prevalence over the last several decades makes it a major issue for public health across the world. Type 2 diabetes, cardiovascular disease, certain malignancies, musculoskeletal ailments, and mental health disorders are only few of the comorbidities linked to obesity (Holmes et al., 2019). Obesity has many root causes that include both biological and non-biological elements. The rising rate of obesity may be attributed to a combination of causes, including sedentary behavior, poor nutrition, and socioeconomic status. The negative effects of obesity extend well beyond the physiological to include psychological and social aspects of people's lives. The obesity pandemic can only be combated with a combination of public health measures and intensive therapeutic treatments. Lifestyle changes, nutritional treatments, increased physical activity, and behavioral therapy are just few of the components of weight management programs used to prevent and cure obesity.

Search strategy and databases that were used

The search strategy involved a systematic and comprehensive approach to identify relevant literature on the need for practice change in obesity management. The databases used for the search included PubMed, Embase, Cochrane Library, and Web of Science. The search terms utilized were "obesity," "weight management," "interventions," "evidence-based practice," and related keywords. The search aimed to identify both randomized controlled trials (RCTs) and systematic reviews/meta-analyses. The selected databases and search terms ensured a broad coverage of the literature related to obesity management and provided a diverse range of sources for analysis and critical appraisal.

Summary of findings with a critical appraisal of the quality and relevance of the resources.

The findings from the literature review indicate strong support for the need to implement practice changes in obesity management. The selected studies, including randomized controlled trials (RCTs), systematic reviews, and meta-analyses, demonstrated consistent evidence of the effectiveness of multidisciplinary weight management programs and lifestyle interventions in achieving sustained weight loss and improving health outcomes. The quality of the resources was appraised to be high, with well-designed RCTs and comprehensive systematic reviews contributing to the robustness of the evidence. The relevance of the resources was also evident, as they addressed key aspects of obesity management, such as individualized approaches, long-term behavior change, and cost-effectiveness. These findings provide a solid foundation for informing evidence-based practice, guidelines, and policies aimed at addressing the obesity epidemic.

Why the Action Plan is reasonable and realistic.

The proposed action plan for implementing the evidence-based project on obesity is reasonable and realistic due to several factors. First, it takes a systematic approach, beginning with a comprehensive review of evidence-based best practices and guidelines.  According to Sarma et al. (2021), ensuring that the program is based on current knowledge is essential. Second, the timeline allows for appropriate development, training, and gradual implementation, ensuring that healthcare professionals are well-prepared and adjustments can be made based on the pilot phase results. Third, the identified tools and resources, such as evidence-based guidelines, educational materials, digital platforms, and interdisciplinary collaboration, support the successful implementation of the program. Finally, the action plan acknowledges potential barriers and challenges, allowing for proactive strategies to overcome them. Overall, the action plan demonstrates a realistic and practical approach, considering the complexities of obesity management and the need for sustainable and long-term solutions.

Specific actions that could be taken to overcome barriers.

To overcome potential barriers in implementing the evidence-based project on obesity, specific actions can be taken. Firstly, addressing the lack of knowledge and training can be achieved through comprehensive education and training programs for healthcare professionals, focusing on evidence-based weight management approaches, behavioral counseling techniques, and interdisciplinary collaboration (Holmes et al., 2019). Time constraints can be mitigated by allocating dedicated time slots for patient consultations and program coordination, optimizing workflow processes, and potentially involving additional healthcare staff to support the workload (LeRouge et al., 2019). Thirdly, limited resources can be addressed through strategic resource allocation, seeking external funding opportunities, and exploring partnerships with community organizations or research institutions. Enhancing patient adherence and motivation can be achieved through patient education, ongoing support, regular feedback and reinforcement, and utilizing behavioral change techniques. Collaboration with insurance providers can help advocate for improved coverage and reimbursement policies for weight management programs. Finally, addressing resistance to change can be approached through clear communication, staff engagement, and providing evidence-based data and success stories to demonstrate the benefits and positive impact of the program. These specific actions can help overcome barriers and facilitate the successful implementation of the evidence-based project on obesity.

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How the outcome measures align to the Quadruple Aim.

The outcome measures identified in the project align with the Quadruple Aim, a framework that aims to improve healthcare in four key areas: patient experience, population health, cost-effectiveness, and healthcare provider well-being.

Firstly, the identified outcome measures directly impact the patient experience. Weight loss, improvement in health markers, adoption of healthy behaviors, and enhanced quality of life are all outcomes that contribute to a positive and satisfying patient experience. Successful weight management and improved health outcomes can lead to increased patient satisfaction, improved self-esteem, and an overall better quality of life for individuals with obesity. Secondly, the project aligns with the goal of improving population health. Obesity is a prevalent public health issue with numerous associated comorbidities. By targeting obesity and implementing evidence-based interventions, the project aims to improve the overall health of the population. The identified outcome measures, such as weight loss and improvement in health markers, directly contribute to reducing the prevalence and severity of obesity-related conditions, such as diabetes, cardiovascular diseases, and musculoskeletal disorders.

Furthermore, the project's focus on weight management and associated health outcomes aligns with the goal of cost-effectiveness. Effective weight management programs can lead to long-term cost savings by reducing healthcare expenses associated with obesity-related conditions, hospitalizations, and medication use. By achieving sustainable weight loss and improving health outcomes, the project aims to optimize resource utilization and promote cost-effective healthcare delivery (Semlitsch et al., 2019). Lastly, the project acknowledges the well-being of healthcare providers, aligning with the Quadruple Aim. Implementing evidence-based practices, achieving positive patient outcomes, and providing effective care can positively impact healthcare providers' well-being. Improved patient outcomes, job satisfaction, and a sense of fulfillment contribute to the overall well-being of healthcare providers, fostering a more sustainable and resilient healthcare system

References

Holmes, L., Cresswell, K., Williams, S., Parsons, S., Keane, A., Wilson, C., & Starling, B. (2019). Innovating public engagement and patient involvement through strategic collaboration and practice. Research involvement and engagement, 5, 1-12. https://doi.org/10.1186/s40900-019-0160-4

LeRouge, C., Durneva, P., Sangameswaran, S., & Gloster, A. M. (2019). Design guidelines for a technology-enabled nutrition education program to support overweight and obese adolescents: qualitative user-centered design study. Journal of medical Internet research, 21(7), e14430. https://doi.org/10.2196/14430

Sarma, S., Sockalingam, S., & Dash, S. (2021). Obesity as a multisystem disease: Trends in obesity rates and obesity‐related complications. Diabetes, Obesity and Metabolism, 23, 3-16. https://doi.org/10.1111/dom.14290

Semlitsch, T., Stigler, F. L., Jeitler, K., Horvath, K., & Siebenhofer, A. (2019). Management of overweight and obesity in primary care—A systematic overview of international evidence‐based guidelines. Obesity Reviews, 20(9), 1218-1230. https://doi.org/10.1111/obr.12889