Capstone Project Change Proposal

Capstone Project Change Proposal Author’s Name Institution of Affiliation Course Name Instructor’s Name Date Capstone Project Change Proposal Background Quality health care comprises adequate staffing, which is crucial in identifying and reducing patient risks. World Health Organization groups diabetes mellitus (type 2 diabetes) among the four primary non-communicable illnesses the world should prioritize mitigating. Diabetes accounts for approximately 43% of all deaths globally, with its strongest risk factors being overweight and obesity (Harrington & Henson, 2021). Type 2 diabetes is also associated with increased cardiovascular diseases and stroke. In addition, it leads to a patient’s blindness, kidney failure, and lower limb amputation. While a large number of type 2 diabetes use inpatient services, WHO has raised concerns about the low quality of nursing care given to them. Among the factors cited as why diabetes patients receive low-quality care include understaffing and a lack of evidence-based processes (Nikitara et al., 2021). In diabetes management, nurses play a pivotal role in patient education, treatment, and rehabilitation, and engaging patients in regular physical exercises promotes better glycemic control and reduces cardiovascular disease risks (Harrington & Henson, 2021). Thus, increasing the number of well-educated nurses in health facilities is crucial to providing quality health services. Clinical Problem Recently, there has been an increased concern about the quality of health care for diabetes mellitus patients. Research identifies understaffing as the reason for this problem. Despite the government’s efforts to increase the number of nurses, the increase does not match the recommended nurse-to-patient ratio (Nikitara et al., 2021). Thus, nurses lack enough time to attend to patients, leading to poor quality care. In addition, nurses cannot perform duties to their total capacity or within their scope of practice. In an effort to prevent and manage type 2 diabetes, the nursing contribution is illustrated through care coordination, ensuring that nurses meet patients' needs promptly. Nurses also mobilize and empower the workforce to establish sustainable, cost-effective treatments and care access. Further, nurses engage in activities that empower patients and the community through education. However, these nursing functions in diabetes mellitus management are ineffective when facilities are understaffed. For this reason, diabetes mellitus patients have reported receiving inadequate medical care, whether they go for inpatient or outpatient services. The Purpose of the Change Proposal The proposed change is based on evidence research on the need for holistic patient care. Investing in increasing the nursing workforce ensures nurses have quality patient interactions. Thus, nurses provide health education and promotion, patient support, and various interprofessional services. Patient interactions facilitate patient-centered interventions that include engagement in regular exercises. Regular exercises are associated with reduced risks of diabetes mellitus patients developing cardiovascular diseases. Body exercises improve blood lipid profiles and glycemic control for diabetes mellitus patients. For example, aerobic exercises like jogging and walking improve cardio-metabolic risk factors, increase skeletal muscle capitalization and enhance blood flow. Such care coordination is only possible if medical facilities have adequate nurse staffing to ensure easy access to quality patient care (Winter et al., 2020). Increasing the number of nurses will meet the recommended nurse-to-patient ratio, leading to quality patient care for type 3 diabetes patients. PICOT Question The picot question for this project has been, “For adult patients that are suffering from type diabetes mellitus (P), does engaging in regular physical exercises for diabetes management benefit them (I) compared to the alternative of using standard care practices without exercises (C), promotes better glycemic control and reduced cardiovascular risk factors (O) for one year (T)?” Medical practices show that physical exercises improve type 2 diabetic patients' quality of life. For instance, aerobic exercises modify the insulin action of fibers without altering fiber size. In addition, for T2DM, aerobic exercises improve the patient’s metabolic profile. These benefits reduce patient’s risks of cardiovascular diseases. The American Diabetes Association recommends that patients engage in at least 150 minutes of moderate-intensity exercises weekly for T2DM patients. These exercises are known to increase overall body fitness, muscular strength and endurance, and flexibility. These benefits lead to improved glycemic control, bone mineral density, and blood lipid profiles. In addition, resistance training and aerobic exercises have been used in calorie intake restriction. These activities suppress appetite and increase satiety, which benefits patients in successful weight management practices. Incorporating exercises in diabetes mellitus management is only possible with adequate nurse staffing. Adequate staffing ensures quality nurse-patient interaction and that processes are modified to suit patients' needs. Literature Search Strategy The change project proposal above finds its roots in literature studies. The search for articles was done through keyword searches via library catalogs, search engines, and databases. To narrow the search results, precise and relevant keywords were utilized. In addition, the results filter by publication type, language, and date ensured the citation of only peer-reviewed sources for this project. Narrowing search results by publication dates ensured that only current information was used to complete the work. The publication type was limited to books, journals, periodical articles, and recognized websites. Literature searches based on databases considered database selection to ensure the database used suits the topic. In addition, collaboration and networking with colleagues helped discover relevant literature through discussions and recommendations. In addition, the search did not overlook gray literature results. Gray literature includes theses, reports, and conference proceedings not published among traditional academic sources. Gray literature was found rich with information regarding public health and diabetes mellitus. These search methods improved relevance and the quality of the search results. Literature Evaluation El Berri et al. (2020) found that understaffing in the nursing department significantly attributed to low nursing care for diabetes mellitus patients. The shortage of nurses in medical centers reduces the availability and access of patient care to T2DM patients. Managing diabetes mellitus needs nurses as they are the first contact with the patient. Nurses must lead in the detection, treatment, rehabilitation, and support of patients with diabetes. However, understaffing affects the...