This evidence-based project aims at enhancing quality by implementing culturally significant nutritional changes to regulate blood sugar levels in African American females who have diabetes using the current research and clinical procedures. The purpose of this section is to elaborate on the implementation approach for this evidence-based project.

Setting

The implementation of the project will take place in a health care facility dealing with adult inpatients. The implementation process will comprise practitioners and clinical nurse leaders who work with the patient population. All the practitioners participating must have served in the unit for at least one year (LoBiondo-Wood et al., 2018). All the health care providers that have been in the institution for less than a year will not be included in the project implementation process. To be specific, fifty percent of the health care practitioners will participate in the implementation process. At the same time, consent will be necessary before the implementation process begins. All participants will be required to sign documents to indicate that they have agreed to be part of the implementation process. The forms filled by the participants will also suggest that they are free to leave at their wish during the implementation process.

Timeline

The implementation program is segmented into four categories. These are four months before the implementation, evaluating the organization readiness, picot and project proposal, identification of the research model, literature research, timetable for the beginning of the project, and efforts to locate and secure an organizational letter of support from a prospective implementation site, all occur. After that, the quality enhancement project will be submitted to the institutional review board four months before the day of implementation. The panel will approve or decline the project (University of Alabama at Birmingham Office of Research website, 2020).

Resources

Furthermore, for the efficiency of the implementation process, the project manager, licensed nutritionists, and diabetes educator mentor are significant. The American diabetes association handouts on diet adjustments include the African Heritage diet pyramid, meal planning guidelines, survey tools, and traditional foods sauces and spices. We will require a large conference room, tables, chairs, screens for PowerPoint presentations, computers, and culinary equipment for the implementation to kick off.

Implementation Methods

The participant’s geographical information will be gathered on the registration form at the onset of every diabetes training program. The geographical information of the participants attending the educational session will comprise race, age, ethnicity, diabetes diagnosis, and gender. Based on the mean and range, demographic information on the age of the participants will be provided (Gianinazzi et al., 2017). The remaining number of people and demographic information will be recorded based on their categories. At the same time, the participants will not be required to provide their names or contact information, but they will take part in HbA1c blood testing at the beginning of the study and at the end of each month during the implementation period. The REAP and RPS-DM are key instruments assessing diabetic health perceptions. Based on the scoring categories used, there will be six subscale categories pertinent to diabetes development; when the score is high, it will indicate an increased risk evaluated for the disease development in the subcategories.

When the subcategories are high, it will indicate that there will be a reduced risk of the disease developing. On the other hand, a lower subcategory will mean that there will be higher chances of the disease developing (Gianinazzi et al., 2017). The REAP-S survey comprises sixteen items to help health providers with patients who require nutritional advice. The REAP-S survey’s final section is also graded on a Likert scale, with options ranging from yes to no, extremely willing to not at all willing (Johnston et al.,2018).

Intervention Process

The first phase will evaluate the organizational readiness to change, develop a project proposal, identify the change model, initiate the project timeline, and plan how to obtain an administrative letter of endorsement from the prospective implementation site. Using the problem statement, intervention, comparisons, outcomes, time structure, the project manager will define and describe the project question to help establish the search approach and create a conceptual model and theoretical framework (Johnston et al.,2018). The project’s second phase will include recruiting fifty people and gathering all project paperwork comprising the IRB submission through the UAB to indicate the study will not involve human subjects. It will also include developing tools and instruments to endorse project objectives and contact every tool developer for authorization to utilize the tool in the project and specific telecommunications. The project manager will have to obtain an organizational letter of support from the implementation site (Johnston et al.,2018).

Furthermore, the project will be implemented in phase three. The implementation of this project will comprise of finding African American females with diabetes but are interested in switching to the African heritage diet and learn new techniques they can use to make food. The project manager and mentor will meet physically or over the phone to discuss the project’s goals. Facility providers and support staff will help in identifying and referring the identified patients to the educational program. They will also help place posters advertising the educational classes throughout the clinic, such as the reception, examination room, waiting area, and restrooms. At the same time, clinicians will identify patients and refer patients to self-register for the educational program with the receptionist.

On the other hand, the educational sessions will be divided into sixty and ninety minutes based on the size of the classes; the project manager will provide a concise review and aims of the session and layout. To undertake the REAP-S and RPS-DM surveys, the participants must fill registration forms and receive diabetic education during the first session (Johnston et al.,2018). The second half of the project will focus on nutrition options, meal planning, budget-friendly cooking, and a dollar store purchasing guide. The project manager surveys the class participants as well as record their diabetes development and nutritional choices. Following each instructional session, the participants will be required to choose dietary modifications and return commitment forms to the project manager. The final part of the project will be data evaluation and outcome distribution.

Obtaining Information

The last phase of the project will be reviewing RPS-DM, and REAP-S forms, survey findings and alter the commitment forms. At this point, the project manager is the person in charge of collecting all the paperwork and compiling the results. The hand tallies, questionnaires, and nutritional change commitment forms will allow the project manager to determine whether the participants better understood the correlation between diabetes and nutrition. The survey outcomes, change commitment sheets will help doctors decide whether or not they should continue with the diabetes education programs for African American females.

Data Examination

Data from the quality improvement project will be reviewed using survey responses from both the RPS-DM and the REAP-S based on the created scales. The REAP-S survey targeted fifty percent or more participants choosing poor nutrition habits (LoBiondo-Wood et al., 2018). Hence the REAP-S survey is divided into two sections diabetes nutrition and pre/post diabetes education. The pre/post nutrition education aims to enhance each participant’s understanding of diabetes development and nutritional choices by more than fifty percent. The project will collect the change commitment forms and tally them with the indicated change after each session—the goal of this dietary modification is to get the total commitment of all participants. The resulted will be tallied before being displayed in a table format.

Managing Obstacles, Facilitators, and Difficulties

Managing barriers to project implementation by participants and diabetes self-management education and support to increases patient awareness of the disease and empower individuals to handle their care must be offered in a culturally competent manner (LoBiondo-Wood et al., 2018). Patient care is significant because diabetes is a chronic infection; hence they should monitor blood glucose, medication administration, physical activity, and proper nutrition. To accomplish this, it is essential to introduce nutritional culture to the population. A diabetic educator and competent dietitian will help to educate the participants. Participants may face challenges such as inability to cook and unavailability of healthy foods. It is essential to have meal planning, effective shopping lists, and information about local food stores to address these challenges.

Feasibility

To create the diabetes instructions posters is estimated to be under %6000, depending on the expected participants. The labor expenses for a licensed dietician, diabetes educator, the secretarial staff is approximately $50000. The cost of cooking is estimated to be $11000; hence the overall cost will be around $66000. Diabetes complications such as microvascular issues and myocardial infarction will be reduced depending on the AIC levels. Therefore, lowering the incidence and burden of diabetes through early intervention will mitigate the significant complications and healthcare costs to the patient and healthcare system.

Maintenance

Dietary administration should be offered to all diabetic patients. Furthermore, nutritional modifications are now available in almost all clinics. This provides patients with the option of making the appropriate choices.

Conclusion

To sum up, the project’s design, the role of the project manager, evidence-based teaching material for the class, population identification, and setting were all critical components. The project’s implementation will provide African American females with the opportunity to receive culturally relevant diabetes and dietary education. The questionnaires utilize in this implementation are REAP and RPS-DM, which allowed participants to assess their views of disease progress and nutritional choices.

Appendix

Timeline need to complete the entire project: – four months

Resource list: A large conference room, culinary equipment, tables, and chairs, as well as a computer and screen for PowerPoint presentations, are all required.

Budget: The labor expenditures of a licensed dietician, secretarial staff, and diabetes educator mentor are approximately $50,000. The estimated cost of cooking items, including food, is $11,000. The overall cost is expected to be $61,000

The method used: The project manager is in charge of collecting all documentation and tallying the outcomes. The questionnaires, hand tallies, and dietary change commitment forms allow the PM to determine whether or not participants developed a better awareness of the relationship between diet and diabetes.