Implementation Plan
Implementation of the Proposed Solution
The research proposes to use a comprehensive education program to reduce the incidence of diabetes mellitus and diabetic foot in the Veteran population. Diabetes mellitus and diabetic foot are diseases that occur because of changing lifestyles in society. Corken (2009) argues that comprehensive education of the population is the effective way of reversing the alarming trends of diabetic conditions (Corken, 2009, p. 7). To meet its objectives, the research outlines plans of comprehensive education of both the patients and the general population in various Veterans Affairs health care organizations across the country for six months to enhance the external validity of the findings. Education of patients focuses on treatment and management of diabetic conditions, although education of the general Veteran population aims to create awareness critical in prevention, treatment, and management of the same through healthful lifestyles.
Resources for Implementation
Implementation of the comprehensive educational program requires resources such as educational materials, health care educators, health care institutions, subordinate personnel, attendance cards, questionnaires, patients’ database, record books, notebooks, and teaching materials among other stationeries. Because the research entails intensive and extensive education of the patients and Veteran population, it will require educational materials in form of pamphlets, charts, and brochures that patients can retain after attending and participating in the educational process. Health care educators are also necessary for he or they play a critical role in educating patients and the general Veteran population at their respective health care facilities. The subordinate personnel is members of the community that participate actively by encouraging the participation of patients and the general community in the comprehensive educational program. Participation of the subordinate personnel is very important as Kandel (2000) asserts that “education of patients regarding diabetic foot complications should be provided using a variety of techniques, incorporating both community and medical settings” (Kandel, 2000, p. 5). The other necessary materials are part of researchers’ tools that ensure the collection of valid and reliable information in the field. For more details about the resources and their respective estimated costs, see appendix A.
Methods for Monitoring Implementation
To monitor the implementation of a comprehensive educational program, the health care educators will be recording the daily number of patients and the general Veteran population who participate in the educational process to ascertain the trend of attendance. Patients and the general Veteran population will have attendance cards, which indicate the number of days one has participated in the educational process and thus an important parameter of determining the extent of education. The health care educators will ask questions at the end of the educational process to ascertain whether the participants are understanding health tips essential in the prevention, treatment, and management of diabetic conditions. Poljicanin, Pavlic-Renar, Metelko, and Coce (2005) recommend that frequent assessment of the participants enables the health care educators to customize their mode of teaching to suit the demands of the patients and the general population (Metelko, & Coce, 2005, p. 45). Participants, who have an attendance of more than a week, will complete questionnaires that seek to establish the extent of the practical application of health tips regarding prevention, treatment, and management of diabetic conditions at their respective homes.
Theory of Planned Change
The research employed Lewin’s theory of change in the design of the implementation plan. Based on Lewin’s theory of change, a comprehensive education program exists in the balance of opposing forces between health care educators and the participants, patients, and the general population. While health care educators are the driving forces of change that ensure the implementation of comprehensive education programs, the participants are restraining forces that prevent the implementation of the program. Therefore, for the planned change of comprehensive education to occur effectively, it requires competent health care educators to motivate participants, and the incorporation of subordinate personnel from the community to enhance their attendance. According to Kritsonis (2005), “some activities that can assist in the unfreezing step include: motivate participants by preparing them for change, build trust and recognition for the need to change, and actively participate in recognizing problems and brainstorming solutions within a group” (Kritsonis, 2005, p. 1). These activities are critical in enhancing the effectiveness of a comprehensive education program.
Feasibility of Implementation Plan
The implementation plan is feasible because the plan does not require many resources that may stall the progress of the project in the event of resource insufficiency. The plan takes six months, which is neither too short to compromise the discoveries nor too long to demand more resources. Because the health care institutions and educators are already available resources in the health care system, the only critical requirements are customized educational materials and research logistics, which depend on the performance of the researchers. Availability of the above requirements greatly enhances the feasibility of the implementation plan.
Outcome Measure
Evaluation of Project Objective
To evaluate the impact of a comprehensive education program, the research will assess patients’ databases and questionnaires during six months and compare with other previous records or current records in other health care institutions that do not have a comprehensive education program to ascertain if there are any significant changes. The research will derive several parameters from patients’ databases and questionnaires as shown in appendix B. Since the objective of the research is to reduce incidence rates of diabetes mellitus in the Veteran population with the view of preventing diabetic foot and other complications associated with diabetes mellitus, diagnostic, and treatment records will provide essential information concerning the incidence rates of the diabetic conditions (Tobin, & Kennedy, 2009, p. 34). The trends of diagnosis and treatment of diabetic conditions in the health care institutions reflect the changes in lifestyles of the patients and the general Veteran population in response to a comprehensive education program.
Validity and Reliability
The outcome measure of assessing patients’ databases is valid and reliable because a comprehensive education program has a compounding effect in reducing the occurrence of diabetic conditions in the Veteran population. Thus, indirect assessment of patients’ databases in terms of the rate of diagnosis and treatment of diabetic conditions shows the impact of a comprehensive educational program. The research expects that increasing cases of diagnosis and treatment during the early period of the project will be due to increasing awareness of diabetic conditions. The extent to which patients respond to medical appointments and treatment measures shows compliance, which is an impact of a comprehensive education program (Ortegon, Redekop, & Nissen, 2004, p. 905). The research will expect that incidences of diabetes mellitus and diabetic foot will decrease due to healthful lifestyles, early diagnosis, treatment compliance, and enhanced management of the diabetic conditions.
Evaluation of Data Collection
Methods for Data Collection
To collect the discoveries of the research, questionnaires, and patients’ databases in various health care institutions provide necessary data for analysis. Weekly questionnaires in which both the patients and General Veteran population filled will demonstrate the extent of compliance to the prevention, treatment, and management measures of the diabetic conditions. Patient databases are critical sources of data because they provide the trends of diagnosis and treatment of patients in selected health care institutions. As a control experiment, the study will rely on previous and current databases in health care institutions in which comprehensive education programs were not covered or presented.
Resources for Evaluation
Questionnaires and patients’ databases are prime resources that provide a vast amount of data that require statistical tools to evaluate. Statistical Package for Social Sciences (SPSS) is the appropriate resource essential in the analysis of the data to establish if there is any significant reduction in the incidence rates of diabetes mellitus and diabetic foot. SPSS tool is accurate in correlation analysis of the data, hence helpful in determining whether there is a strong or negative correlation between comprehensive education and incidences of diabetic conditions relative to control data.
Feasibility of the Evaluation Plan
An evaluation plan is feasible because questionnaires and patients’ databases provide enough information that warrants the use of the SPSS tool. Questionnaires and patients’ databases contain detailed information of the general population and diabetic patients respectively, thus their statistical analysis gives credible results. Therefore, so long as the data in the questionnaires and patients’ databases are accurate, statistical analysis will present viable and valid results of the research.
Decision Making
Plans to Maintain and Extend Successful Project Solution
To maintain the success of the project according to its objectives, health care educators will ensure that participants of the comprehensive education program obtain some rewards for regular attendance and bringing more participants. The use of rewards will ensure that the attendance of the education process increases with time thus keeping the study running for six months or even more if needed. Realization of the project’s objectives will lead to expansion and extension of the project to include all health care intuitions and become a yearly assessment of diabetes mellitus and diabetic foot incidence rates with the view of diminishing their incidences in the Veteran population. The provision of a comprehensive education program concerning diabetic conditions in all health care institutions is the prime extension of the project.
Plans to Revise and Terminate Unsuccessful Project Solution
The major challenge in this project is attracting a greater number of participants in the comprehensive educational program to enhance the external validity of the findings. If the research does meet a sufficient number of participants, it will consider ways of reaching a greater number of patients and the general Veteran population. Measures such as extensive advertisement of the comprehensive educational program to attract the general population and selective use of health care institutions that have relatively more diabetic patients will increase the number of participants. As a contingency measure, the researchers will produce educational materials and other requirements in small amounts to avoid unnecessary loss if the comprehensive education program appears unviable. For the sake of the few patients and members of the population who will have participated in the education program, the researchers will liaise with various health care institutions in ensuring that he or she continues receiving relevant education to improve their health status concerning diabetic conditions. This ensures smooth termination of the project without adversely affecting the participants.
Provision for Contributions and Criticisms
Due to the complexity of diabetes mellitus and diabetic foot, the proposed solution of comprehensive education program targeting the patients and the general Veteran population have some weaknesses that need contributions and criticisms. Moreover, because the proposed research is at the formative stages of implementation, the researchers will be seeking criticism and contribution from other researchers to refine various parameters of the proposed solution. The researchers will also consider seeking firsthand information from the health care professionals and experts concerning factors critical in enhancing the validity and credibility of discoveries to warrant generalization of the findings.
Reference
Corken, A. (2009). Prevention and Early Intervention for Diabetes Foot Problems: A Research Review. American Association of Diabetes Educators, 1-13.
Kandel, S. (2000). Take Care of Your Feet for a Life Time. American Association of Diabetes, 1-13.
Kritsonis, A. (2005). Comparison of Change Theories. International Journal of Scholarly Academic Intellectual Diversity, 8(1), 1-7.
Ortegon, M., Redekop, W., & Nissen, L. (2004). Cost-Effectiveness of Prevention and Treatment of Diabetic Foot: A Markov analysis. Diabetes Care, 27(4), 901-907.
Poljicanin, T., Pavlic-Renar, I., Metelko, Z., & Coce, F. (2005). Draft Program of Prevention of Diabetic Foot Development and Lower Extremity Amputation in Persons with Diabetes Mellitus. Diabetologia Croatica, 34(2), 43-49.
Tobin, C., & Kennedy, C. (2009). A Health Care Provider’s Guide to Preventing Diabetes Foot Problems. National Institute of Health and the Centers for Disease Control and Prevention, 1-50.
Appendix A: Budget
The table below shows requirements of the study and their respective estimated costs essential for the completion of comprehensive education program.
Appendix B: Outcome Measure
The table below shows different parameters of patients derived from patients’ databases and questionnaires.