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Considerations and Challenges for Implementation
One of the primary difficulties implementing a guide on patient engagement by Smith et al. (2017) is ensuring the cooperation of patients, as well as other stakeholders, especially setting staff and management (Byers, 2017). Given the specifics of the project (ensuring patient engagement), the former is going to be ensured with the help of weekly journals, which will track the patients involvement in their own care. This way, the project will make sure that its intervention is implemented.
It should be acknowledged that as self-developed journals, the solution cannot guarantee patient cooperation or the effective implementation of the intervention, but it is a form of tracking it. The data of the patients who fail to fill out journals will not be used for analysis.
In terms of staff and management involvement, some preliminary support has already been obtained, which is a major facilitator, but more cooperation will be required, especially during the recruitment stage. The materials that have been prepared for the project, especially the ones that justify the intervention, will be used to engage this group of stakeholders. In Kotters terms, that would mean creating urgency by demonstrating the potential of the proposed intervention (Chappell et al., 2016). Since the staff of the setting is dedicated to improving the well-being of patients, which is another facilitator, compelling arguments should assist in getting them to cooperate.
Finally, it should be mentioned that the intended sample (50 patients) might not be involved because of the lack of eligible and willing participants. From this perspective, the project needs to be flexible and adjust to the issue by making use of the data collected. If the sample is too small for applying the statistical tests that are initially planned, for example, their non-parametric analogs would be used, and the limitations of a small sample will be considered while reporting the results (Polit & Beck, 2017). To summarize, a number of issues can be encountered while implementing the project, but there exist solutions to them, as well as meaningful facilitators.
Outcomes
The outcome that is going to be used by the project is blood glucose. This measurement is common for tracking the health of people with diabetes (Quinn et al., 2018; Taylor et al., 2019), which explains the choice. Admittedly, there is no evidence that the patient engagement methods of Smith et al. (2017) reduce or stabilize blood glucose in adults with diabetes, but there is no research on the guide by Smith et al. (2017), which makes this research the first attempt to find out the relevant outcomes.
However, the likelihood of patient well-being improvement as a result of patient engagement is evidenced by research (Bombard et al., 2018; Kim et al., 2018; Park & Giap, 2020). Since blood glucose is a common measure for the well-being of people with diabetes (Quinn et al., 2018; Taylor et al., 2019), the choice of this outcome makes sense.
Blood glucose is measured on a continuous scale with the help of blood samples (Quinn et al., 2018; Taylor et al., 2019). It is planned to carry out two measurements: one before the implementation of the intervention (during week one), and one by the end of the project during week eight.
The results will be compared with the help of a t-test or an analogous test that can work with abnormal distributions (if the distribution is not normal) since the specifics of the data (continuous) require that type of test (Polit & Beck, 2017). Additionally, some demographic data will be collected at the beginning of the project to explain the specifics of the sample, including gender, age, and health conditions. The results will be reported through descriptive statistics.
References
Bombard, Y., Baker, R., Elaina, O., Bhatia, P., Casalino, S., Onate, K.,& Pomey, M. (2018). Engaging patients to improve quality of care: A systematic review. Implementation Science, 13(1), 1-22. Web.
Byers, V. (2017). The challenges of leading change in health-care delivery from the front-line. Journal of Nursing Management, 25(6), 449-456. Web.
Chappell, S., Pescud, M., Waterworth, P., Shilton, T., Roche, D., Ledger, M.,& Rosenberg, M. (2016). Exploring the process of implementing healthy workplace initiatives. Journal of Occupational and Environmental Medicine, 58(10), e341-e348. Web.
Kim, J. M., Suarez-Cuervo, C., Berger, Z., Lee, J., Gayleard, J., Rosenberg, C.,& Dy, S. (2018). Evaluation of patient and family engagement strategies to improve medication safety. The Patient Patient-Centered Outcomes Research, 11(2), 193-206. Web.
Park, M., & Giap, T. (2020). Patient and family engagement as a potential approach for improving patient safety: A systematic review. Journal of Advanced Nursing, 76(1), 62-80. Web.
Polit, D.F., & Beck, C.T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.
Quinn, C., Butler, E., Swasey, K., Shardell, M., Terrin, M., Barr, E., & Gruber-Baldini, A. (2018). Mobile diabetes intervention study of patient engagement and impact on blood glucose: Mixed methods analysis. JMIR Mhealth and Uhealth, 6(2), e31. Web.
Smith, K., Baker, K., Wesley, D., Zipperer, L., Clark, M. D., Hanneke, C. R.,& Goeschel, C. A. (2017). Guide to improving patient safety in primary care settings by engaging patients and families. Web.
Taylor, P., Thompson, C., Luscombe-Marsh, N., Wycherley, T., Wittert, G., & Brinkworth, G. (2019). Efficacy of real-time continuous glucose monitoring to improve effects of a prescriptive lifestyle intervention in type 2 diabetes: A pilot study. Diabetes Therapy, 10(2), 509-522. Web.
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