NUR 699 Examine the elements associated with implementing an evidence-based intervention.

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 12^th 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.

Resources for the Solution Implementation

            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.

Conclusion

            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.

References

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.

Evidence-Based Practice Project Proposal – Part D: Implementation Plan

The purpose of this assignment is to examine the elements associated with implementing an evidence-based intervention. In 1,000-1250 words, discuss the following aspects of implementation and explain how they apply to your proposed project.

Part A:

Apply an evidence-based practice (EBP) model or change model to your implementation plan.

Select a Model: Rogers’ diffusion of innovation theory is a particularly good theoretical framework to apply to EBP project. However, change models, such as Duck’s change curve model or the transtheoretical model of behavioral change, may also be used. Other conceptual models presented, such as a utilization model (Stetler’s model) and EBP models (the Iowa model and ARCC model) can also be used as a framework for applying your evidence-based intervention in clinical practice.

Application of Model: Apply one of the above-mentioned models, or another EBP model or change model, and carry your implementation through each of the stages, phases, or steps identified in the chosen model. An outline of the conceptual model is required as part of the appendices in the final paper.

ORDER NOW FOR AN ORIGINAL PAPER ASSIGNMENT:NUR699 Examine the elements associated with implementing an evidence-based intervention.

Evidence-based health care practices are available for a number of conditions such as asthma, heart failure, and diabetes. However, these practices are not always implemented in care delivery, and variation in practices abound. Traditionally, patient safety research has focused on data analyses to identify patient safety issues and to demonstrate that a new practice will lead to improved quality and patient safety. Much less research attention has been paid to how to implement practices. Yet, only by putting into practice what is learned from research will care be made safer. Implementing evidence-based safety practices are difficult and need strategies that address the complexity of systems of care, individual practitioners, senior leadership, and—ultimately—changing health care cultures to be evidence-based safety practice environments.

Nursing has a rich history of using research in practice, pioneered by Florence Nightingale. Although during the early and mid-1900s, few nurses contributed to this foundation initiated by Nightingale, the nursing profession has more recently provided major leadership for improving care through application of research findings in practice.