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Week 6 Assignment: EBP Change Process Form

ACE Star Model of Knowledge Transformation
Follow Nurse Daniel as your process mentor in the weekly illustration section of the lesson.
Please do not use any of the Nurse Daniel information for your own topic, nursing
intervention, or change project. Nurse Daniel serves as an example to illustrate the change
process.

Name: _____________________

Star Point 1: Discovery (Identify the topic and practice the issue.)
Identify the topic and the nursing practice issue related to it. (This must involve a nursing practice
issue.)
Topic: Management of Type 2 Diabetes
Nursing Practice Issue: Type 2 diabetic patients’ blood sugar levels and A1C are not well regulated
under conventional drug therapy.

Briefly describe your rationale for your topic selection. Include the scope of the issue/problem.

Rational: Type 2 diabetes is a common illness that needs to be comprehensively managed so as to

maintain normal blood sugars and avoid various complications. Medication alone does not normally
work; hence, improved glycemic control can be achieved through dietary changes together with physical
activities like exercise.
Scope: This has been a major problem among many individuals suffering from type 2 diabetes, thus
leading to poor health status and high medical bills for most of them.

Star Point 2: Summary (evidence to support the need for a change)

Describe the practice problem in your own words, and formulate your PICOT question.

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Practice Problem: Many type 2 diabetes patients struggle to achieve optimal blood sugar and A1C levels
with medication regimens alone, leading to an increased risk of complications.
PICOT Question: In adult type 2 diabetes patients (P), what is the effect of a nurse-led dietary and
exercise program (I) in relation to a medication regimen approach (C) regarding blood sugar levels and
A1C levels (O) after six months (T)?
List the systematic review chosen from the CCN Library databases. Type the complete APA
reference for the systematic review selected.
Batalha, A. P. D. B., Ponciano, I. C., Chaves, G., Felico, D. C., Britto, R. R., & da Silva, L. P. (2021).
Behavior change interventions in patients with type 2 diabetes: a systematic review of the effects on self-
management and A1C. Journal of Diabetes and Metabolic Disorders, 1–22.

List and briefly describe other sources used for data and information. List any other optional
scholarly source used as a supplement to the systematic review in APA format.
Hildebrand, J. A., Billimek, J., Lee, J. A., Sorkin, D., H., Olshansky, E. F., Clancy, S. L., and Evangelista,
L. S. (2020). Effects of diabetes self-management education on glycemic control in Latino adults with
type 2 diabetes: a systematic review and meta-analysis. Patient Education and Counseling, 103(2), 266-
275.

Briefly summarize the main findings (in your own words) from the systematic review and the
strength of the evidence.
According to a systematic review by Batalha et al. (2021), diabetes self-management education programs,
including diet and exercise components, were found to be effective in improving glycemic control among
type 2 adults with diabetes. Overall, the evidence strength was moderate to high, and numerous studies
showed positive outcomes.

Outline one or two evidence-based solutions you will consider for the trial project.
1. A nurse-guided self-management program for diabetics that includes dietary instructions and exercise.
2. Incorporation of modification counseling into routine care visits for diabetes.

Star Point 3: Translation (Action Plan)

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Identify care standards, practice guidelines, or protocols that may be in place to support your
intervention planning (these may come from your organization or from the other sources listed in
your Summary section in Star Point 2).
American Diabetes Association Standards of Medical Care in Diabetes (2022)
Organizational protocols for diabetes management

List your stakeholders (by title and not names; include yourself) and describe their roles and
responsibilities in the change process (no more than 5).
Nurse educator (myself): effect the production and execution of the nurse-controlled programs; teach
patients.
Physician: send patients to the project; work together on therapy schemes.
Dietician: provide dietetic counseling as well as guidelines for meal planning.
Physical therapist: make exercise recommendations and guide physical activity for clients.
Nurse Manager: enable staff participation, allocate resources, and ensure that programs fit into care
systems.

What specifically is your nursing role in the change process? Other nursing roles?
Establishing a nurse-led diet and exercise program, liaising with other stakeholders, educating and
counseling patients, assessing patient progress, and evaluating program outcomes.
List your stakeholders by position titles (charge nurse, pharmacist, etc.). Why are the members
chosen (stakeholders) important to your project?
Nurse educators have special knowledge and skills in diabetes instructions that are vital for the creation
and execution of an effective, nurse-led program.
Primary care physician: possess full knowledge about diabetes management to ensure the medical
appropriateness and safety of the program with medical oversight.
Dietitian: It becomes crucial to have nutritional expertise for the customization of diet plans and
recommendations aimed at improving glycemic control.
Physical therapist: provide expertise in physical activity and exercise prescriptions important for lifestyle
modifications and dealing with physical barriers.
The nurse manager plays a key role in implementing the program within a healthcare setting so as to
enable it to acquire the resources required.
What type of cost analysis will be needed prior to a trial? Who needs to be involved with this?
It is necessary to carry out a comprehensive cost analysis that covers program development,
implementation, and potential cost savings before the trial. The key stakeholders who need to be involved

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in this include finance representatives, nurse leaders, physicians, data analysts, and administrative
representatives to enable them to accurately assess financial feasibility and return on investment.

Star Point 4: (Implementation)

Describe the process for gaining permission to plan and begin a trial. Is there a specific group,

committee, or nurse leader involved?

The project proposal would be presented to the appropriate committee or nurse leader, such as the quality

improvement committee or the nursing practice council, for approval and support.

Describe the plan for educating the staff about the change process trial and how they will be

impacted or asked to participate.

Design educational materials and conduct training sessions for the nurses and other relevant members on

the goals of the program, the process of implementation, and their roles. Provide continuing support and

resources.

Outline the implementation timeline for the change process (start time/end time, what steps are to

occur along the timeline).

Month one: This will involve creating program materials, securing approvals, and conducting staff

training.

Month two: pilot the program with a small group of patients, gather feedback, and refine.

Months three through six: three months will see the full implementation of the program, including patient

enrollment, ongoing education, and the provision of support.

Month six: evaluate results with regard to this particular initiative by making a report.

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List the measurable outcomes based on the PICOT. How will these be measured?

Changes in blood sugar levels were measured at regular intervals.

Baseline A1C change levels were measured at eight weeks.

Patient-reported or objective measures of diet and exercise adherence

Patients’ satisfaction as well as quality of life measures.

What forms, if any, might be used for recording purposes during the pilot change process. Describe.

Standardized forms or templates need to be developed so as to document patient progress, education

provided, if any, and their participation in the program.

What resources are available to staff (including yourself) during the change pilot?

Educational materials should be provided; access to dieticians and physical trainers; program

coordinators’ assistants; self-monitoring tools like glucometers or food diaries.

Will there be meetings of certain stakeholders throughout the trial? If so, who and when will they

meet?

Regular meetings twice a month with core stakeholders are intended to evaluate progress made by the

organization while attending to their challenges accordingly.

Star Point 5: (Evaluation)

How will you report the outcomes of the trial?

Summarize the process of implementing this program and its outcomes in terms of patient blood sugar,

A1C, adherence, and satisfaction levels; however, reflect on challenges that were encountered and

learnings from the same. Share the report with committees or any relevant stakeholders.

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What would be the next steps for the use of the change process information?

Have a look at how successful the program has been and think about making it bigger so that more

patients can benefit from it or incorporating it into diabetes guidelines as a whole. Also, use feedback

received as well as outcomes to continuously adjust and improve the plan. The findings are to be spread

through professional outlets like publications or conference arrangements for distribution among the

nursing community at large.

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