Assignment: Evidence-Based Project, Part 4: Recommending an Evidence-Based Practice Change
\nThe collection of evidence is an activity that occurs with an endgame in mind. For example, law enforcement professionals collect evidence to support a decision to charge those accused of criminal activity. Similarly, evidence-based healthcare practitioners collect evidence to support decisions in pursuit of specific healthcare outcomes.
\nIn this Assignment, you will identify an issue or opportunity for change within your healthcare organization and propose an idea for a change in practice supported by an EBP approach.
\nTo Prepare:
\nReflect on the four peer-reviewed articles you critically appraised in Module 4, related to your clinical topic of interest and PICOT.
\nReflect on your current healthcare organization and think about potential opportunities for evidence-based change, using your topic of interest and PICOT as the basis for your reflection.
\nConsider the best method of disseminating the results of your presentation to an audience.
\nThe Assignment: (Evidence-Based Project)
\nPart 4: Recommending an Evidence-Based Practice Change
\nCreate an 8- to 9-slide narrated PowerPoint presentation in which you do the following:
\nBriefly describe your healthcare organization, including its culture and readiness for change. (You may opt to keep various elements of this anonymous, such as your company name.)
\nSuperior Essay Writers Describe the current problem or opportunity for change. Include in this – description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general.
\nPropose an evidence-based idea for a change in practice using an EBP approach to decision making. – – Note that you may find further research needs to be conducted if sufficient evidence is not discovered.
\nSuperior Essay Writers Describe your plan for knowledge transfer of this change, including knowledge creation, dissemination, and organizational adoption and implementation.
\nExplain how you would disseminate the results of your project to an audience. Provide a rationale for why you selected this dissemination strategy.
\nSuperior Essay Writers Describe the measurable outcomes you hope to achieve with the implementation of this evidence-based change.
\nBe sure to provide APA citations of the supporting evidence-based peer reviewed articles you selected to support your thinking.
\nAdd a lessons learned section that includes the following:
\nA summary of the critical appraisal of the peer-reviewed articles you previously submitted
\nAn explanation about what you learned from completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template (1-3 slides)
\n___________________________________________________________________________________
\nEvaluation Table<\/p>\n
Use this document to complete the evaluation table requirement of the Module Assessment, Part A: Critical Appraisal of Research<\/p>\n
Full APA Paper Writing Service by Expert Writers Pro Paper Help: Online Research Essay Helpted citation of selected article.\tArticle #1\tArticle #2\tArticle #3\tArticle #4<\/p>\n
Kim, Y., Cubbin, C., & Oh, S. (2019). A systematic review of neighbourhood economic context on child obesity and obesity\u2010related behaviours. Obesity reviews, 20(3), 420-431.<\/p>\n
Sirico, F., Bianco, A., D’Alicandro, G., Castaldo, C., Montagnani, S., Spera, R., … & Nurzynska, D. (2018). Effects of physical exercise on adiponectin, leptin, and inflammatory markers in childhood obesity: systematic review and metaanalysis. Childhood Obesity, 14(4), 207-217.\tTaylor, R. W., Gray, A. R., Heath, A. L. M., Galland, B. C., Lawrence, J., Sayers, R., … & Taylor, B. J. (2018). Sleep, nutrition, and physical activity interventions to prevent obesity in infancy: follow-up of the Prevention of Overweight in Infancy (POI) randomized controlled trial at ages 3.5 and 5 y. The American journal of clinical nutrition, 108(2), 228-236.\tMora-Gonzalez, J., Esteban-Cornejo, I., Cadenas-Sanchez, C., Migueles, J. H., MolinaGarcia, P., Rodriguez-Ayllon, M., … & Ortega, F. B. (2019). Physical fitness, physical activity, and the executive function in children with overweight and obesity. The Page Essay – Journal of pediatrics, 208, 50-56.
\nEvidence Level *
\n(I, II, or III)
\nLevel 1\tLevel 1\tLevel 1\tLevel 1
\nConceptual Framework<\/p>\n
Superior Essay Writers Describe the theoretical basis for the study (If there is not one mentioned in the article, say that here).**<\/p>\n
The study did not have a conceptual framework<\/p>\n
The study did not have a conceptual framework<\/p>\n
The study did not have a conceptual framework<\/p>\n
The study did not have a conceptual framework
\nDesign\/Method<\/p>\n
Superior Essay Writers Describe the design and how the study was carried out (In detail, including inclusion\/exclusion criteria).
\nMixed method
\nSystematic review with meta-analysis of controlled randomized trials
\nRandomized controlled trial
\nCross-sectional study
\nSample\/Setting<\/p>\n
The number and characteristics of
\npatients, attrition rate, etc.<\/p>\n
39 studies<\/p>\n
250 participants in 7 trials<\/p>\n
802 women<\/p>\n
100 children with overweight and obesity
\nMajor Variables Studied<\/p>\n
List and define dependent and independent variables
\nIndependent variable is neighborhood economic context<\/p>\n
Dependent variable is child obesity and obesity-related behaviors
\nIndependent variable is physical Exercise<\/p>\n
Dependent variable is childhood obesity
\nIndependent variables are sleep, nutrition, and physical activity interventions<\/p>\n
Dependent variable is overweight in Infancy
\nIndependent variables are physical fitness, physical activity, and the executive function in children<\/p>\n
Dependent variable is overweight and obesity
\nMeasurement<\/p>\n
Identify primary statistics used to answer clinical questions (You need to list the actual tests done).
\n60% showed an inverse association between higher neighborhood economic status and obesity
\n7 trials with a total of 250 participants among children up to 18 years.
\n802 women (86% European, 48% primiparous) were rrecruited with a 58 percent response rate.
\n100 children with overweight and obesity (10.1 \u00b1 1.1 years old; 58.0% boys)
\nData Analysis Statistical or
\nQualitative findings<\/p>\n
(You need to enter the actual numbers determined by the statistical tests or qualitative data).\tOf the analyzed studies 60% indicated an inverse relationship between higher economic status and obesity, while 33% and 14% showed positive relationship between higher economic status and healthy diet and physical exercise.\twithout lifestyle changes, physical exercise triggers reduction in leptin [standardized mean difference (SMD) \u22121.13; 95% confidence interval (95%CI): \u22121.89 to \u22120.37; I2\u2009=\u200979.9%] and interleukin-6 (SMD \u22120.84; 95%CI: \u22121.45 to \u22120.23, I2\u2009=\u20090.9%) and an increase in adiponectin plasma concentration (SMD 0.69; 95%CI: 0.02\u20131.35; I2\u2009=\u200974.3%).\tChildren under the Sleep intervention had significantly lower BMI z scores at age 3.5 y (\u22120.24; 95% CI: \u22120.38, \u22120.10) and at age 5 y (\u22120.23; 95% CI: \u22120.38, \u22120.07) than children who did not\tHandgrip strength was positively related to planning ability (P = .025). The study did not find relationship between physical activity and sedentary time with executive function (P \u2265 .05).
\nFindings and Recommendations<\/p>\n
General findings and recommendations of the research\tThe study finds positive relationship between various moderators and neighborhood-related obesity\tPhysical exercise improved the inflammatory state in children with obesity\tBrief sleep intervention in infancy reduced the risk of obesity at 2 years
\nCardiorespiratory fitness is related to indicators of cognitive flexibility
\nAppraisal and Study Quality<\/p>\n
Superior Essay Writers Describe the general worth of this research to practice.<\/p>\n
What are the strengths and limitations of study?<\/p>\n
What are the risks associated with implementation of the suggested practices or processes detailed in the research?<\/p>\n
What is the feasibility of use in your practice?
\nThe research is worthy since it demonstrates the relationship between various moderators and obesity.<\/p>\n
The study examined 39 studies and 60 percent had a positive outcome<\/p>\n
The study examined a small number of studies.<\/p>\n
The study can be used in practice to unlock the moderators causing obesity.
\nThe study shows that physical exercise improved the inflammatory state in children with obesity. However, it is unclear if the effect can lower the risk of cardiovascular and metabolic disease.<\/p>\n
The risk associated with the implementation is the unclear relationship between the variables.
\nThe research is worth since it offers insights into a friendly option of sleep intervention which is doable by children below 5 years.<\/p>\n
Out of the 802 women recruited, the study had a retention rate of 77 percent at 3.5 years<\/p>\n
The results cannot be applied across different ethnic groups due to the limited participants<\/p>\n
– – One of the risks associated with the implementation is that the study is not conclusive since it recommends need for further investigation<\/p>\n
It is difficult to implement by forcing children to sleep more hours yet they need time to play.
\nThe study is relevant since it adds knowledge to the study on obesity by exploring physical fitness and executive function<\/p>\n
The study had cross-sectional study design which is effective in measuring physical fitness and physical activity with executive function<\/p>\n
The study had only 100 participants, a number which is relatively low<\/p>\n
The risks associated include difficult in accurately assessing muscular strength, speed agility, and cardiorespiratory fitness<\/p>\n
The study findings can be used in the practice to assess risk of obesity<\/p>\n
Key findings<\/p>\n
The study finds that gender, age, race\/ethnicity, individual-level economic status, rurality and social connectedness are moderators in neighborhood-obesity association\tPhysical exercise improved the inflammatory state in children with obesity
\nA conventional intervention had unexpected adverse long-term weight results.
\nCognitive flexibility is associated with fitness<\/p>\n
Outcomes<\/p>\n
Gender, age, race\/ethnicity, individual-level economic status, rurality and social connectedness are moderators in neighborhood-obesity association\tIt is unclear if the intervention can reduce the risk of cardiovascular and metabolic disease in adulthood.\tBrief sleep intervention in infancy reduced the risk of obesity at 2 years
\nCardiorespiratory fitness is related to indicators of cognitive flexibility
\nGeneral – – Notes – essay service -\/Comments<\/p>\n
Societies should address the factors causing abortion<\/p>\n
Children with obesity can attract health benefits from physical exercise.\tSleep intervention may have positive long-lasting results and should be investigated.
\nChildren should remain physically fit and maintain cognitive flexibility to reduce the risk of overweight or obesity.<\/p>\n
Part B
\nCritical Appraisal Tool
\nCritical appraisal is an essential process in the academic field to establish the credibility and trustworthiness of research. Establishing credibility and using the information to change the nursing practice is vital. – – One of the best practices identified in the research studies is using physical activity to reduce the risk of obesity. Obesity in America starts at a tender age. Research shows an increase in the number of children with the condition, unlike the previous years (Mora-Gonzalez et al., 2019). It is thus vital to integrate physical exercise in the therapeutic management of obesity and overweight. Nurses have a duty to educate parents and children about the need for physical exercise. Physical exercise is critical in burning the excess fat stored in muscles leading to unnecessary weight.
\nPhysical exercise leads to body fitness and reduces the risk of obesity. The research shows that neighborhoods with affluent families regularly go out jogging or running to keep fit (Kim et al., 2019). It is unlike low-income families that do not have time or knowledge about the importance of exercising. Physical exercise should be coupled with eating healthy meals. Children should avoid junk food or foods with excess fat. Eating vegetables is essential to address the risk of obesity.
\nThe proposal recommends that nurses educate parents and children to exercise regularly. Schools should take up the matter and ensure they subject the learners to physical exercise. It is essential for children coming to the clinic to undergo a BMI test to assess if their height, weight, and body are aligned. The focus is to use preventive measures to reduce the occurrence of obesity among children and cultivate a habit of physical exercise.<\/p>\n
References
\nMora-Gonzalez, J., Esteban-Cornejo, I., Cadenas-Sanchez, C., Migueles, J. H., MolinaGarcia, P., Rodriguez-Ayllon, M., … & Ortega, F. B. (2019). Physical fitness, physical activity, and the executive function in children with overweight and obesity. The Page Essay – Journal of pediatrics, 208, 50-56.
\nKim, Y., Cubbin, C., & Oh, S. (2019). A systematic review of neighbourhood economic context on child obesity and obesity\u2010related behaviours. Obesity reviews, 20(3), 420-431.
\n_________________________________________________________
\nBased on the four peer-reviewed articles I critically appraised in Module 4, related to my clinical topic of interest and PICOT, I have identified an opportunity for change within my healthcare organization. My topic of interest is childhood obesity and my PICOT question is: How does a neighborhood economic context affect child obesity and obesity-related behaviors in low-income areas?
\nThe current problem or opportunity for change that I have identified is the high prevalence of childhood obesity in low-income areas. The circumstances surrounding the need for change include the increasing rates of childhood obesity and the health consequences that come with it, such as diabetes and heart disease. The scope of the issue is significant as it affects not only the children and their families but also the healthcare system and society as a whole. The stakeholders involved include parents, children, healthcare providers, community organizations, and policymakers. The risks associated with change implementation in general include resistance to change and lack of resources.
\nThe evidence-based idea for a change in practice that I am proposing is to implement a community-based program that focuses on promoting healthy behaviors in low-income areas. This program would include education on healthy eating and physical activity, as well as access to affordable and healthy food options. This approach is supported by the evidence from the systematic review by Kim, Cubbin, and Oh (2019) which found that neighborhood economic context plays a significant role in child obesity and obesity-related behaviors.
\nMy plan for knowledge transfer of this change includes assignment brief – creating knowledge through the implementation of the program, dissemination of the results through presentations at conferences and publications in peer-reviewed journals, and organizational adoption and implementation through partnerships with community organizations and policymakers. I will disseminate the results of my project to an audience through a combination of oral presentations and written publications. I have selected this dissemination strategy because it will reach a wide audience and allow for the results to be shared with both the scientific community and the general public.
\nThe measurable outcomes I hope to achieve with the implementation of this evidence-based change include a reduction in the prevalence of childhood obesity in low-income areas, an improvement in the health outcomes of children and their families, and a reduction in healthcare costs.
\nIn my lessons learned section, I will summarize the critical appraisal of the peer-reviewed articles I previously submitted. I will explain what I learned from completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template, such as the importance of considering the study design and the potential biases in the research. Overall, I have learned that implementing an evidence-based approach to decision making is crucial in improving healthcare outcomes and addressing complex health issues such as childhood obesity.<\/p>\n
_________________________________________________________
\nEvidence-Based Project
\nRecommending an Evidence-Based Practice Change<\/p>\n
Introduction
\n\u2022\tObesity has been increasing among children and adolescents in many countries. According to the World Health Organization, the global prevalence of obesity in children and adolescents increased from 4.2% in 1990 to 5.6% in 2010 among boys, and from 5.0% to 5.5% among girls.
\n\u2022\tThe prevalence of obesity among children and adolescents aged 5\u201319 years was 11.3% in 2016. The prevalence of obesity is highest in the WHO Region of the Americas, at 22.2% in 2016, and lowest in the WHO South-East Asia Region, at 3.0% in 2016.
\nBackground
\n\u2022\tIts culture is one of innovation and continuous improvement, constantly seeking new ways to improve the quality of care and the patient experience.
\n\u2022\tThe organization is open to new ideas and is willing to invest in new technologies and processes, it has a strong commitment to evidencebased practice and is always looking for ways to improve the quality of care.
\nProblem identification
\n\u2022\tThe prevalance of obesity and the lack of activity and understanding of its causes in children is a concern.
\n\u2022\tThe scope of the issue is that obesity is a global epidemic and is rising at an alarming rate.
\n\u2022\tThe stakeholders involved are the children, their families, the healthcare providers, and the government.
\n\u2022\tThe risks associated with change implementation are the lack of knowledge and understanding of the causes of obesity, the lack of resources to implement change, and the lack of motivation to change.
\nProblem statement
\n\u2022\tThe healthcare providers should discuss the importance of sleep with parents of overweight and obese children. This change is based on the article by Taylor et al. (2018). The intervention group in a randomized controlled trial had significantly lower body mass index (BMI) z-scores at 3.5 and 5 years of age.
\n\u2022\tAccording to Sirico et al. (2018) physical exercise can help to reduce the levels of adiponectin, leptin, and inflammatory markers in childhood obesity.
\n\u2022\tThis suggests that interventions that focus on increasing physical activity levels in children with obesity may help to improve their health by reducing levels of adiponectin, leptin, and inflammation.
\nInformation dissemination
\n\u2022\tThe first step in knowledge transfer is knowledge creation.
\n\u2022\tThis involves taking the research findings and translating them into a form that can be used by practitioners.
\n\u2022\tThe second step is dissemination.
\n\u2022\tThe third step is organizational adoption and implementation.
\n\u2022\tThis is the process of incorporating the knowledge into the organization and making it part of the culture.
\nResults
\n\u2022\tThe most effective method will be through a presentation at a conference since it allows the audience to see the results of the project and ask questions about the project.
\n\u2022\tAdditionally, the results of the project will be published in a peerreviewed journal where the audience can view the results of the project and read the comments of the reviewers.
\n\u2022\tThese results will also be disseminated through a webinar.
\nScope
\nThe measurable outcomes that I hope to achieve with the implementation of this evidence-based change are:
\n\u2022\tIncreased physical activity levels in children with overweight and obesity
\n\u2022\tImproved executive function in children with overweight and obesity
\n\u2022\tReduced adiposity in children with overweight and obesity
\n\u2022\tImproved sleep quality in children with overweight and obesity
\nCritical appraisal
\n\u2022\t“The critical appraisal of the four peer-reviewed articles showed that physical activity can help to reduce body mass index (BMI) and waist circumference in children” (Mora-Gonzalez et al., 2019).
\n\u2022\tThe articles also indicate that physical activity can help to improve executive function in children with obesity.
\nCritical appraisal
\n\u2022\tThe Critical Appraisal Tool Worksheet Template provides a framework for critically appraising the evidence to determine its strengths and weaknesses.
\n\u2022\tThis process allows the evidence to be evaluated in a systematic way, which leads to a better understanding of the quality of the evidence and its applicability to the clinical question.
\nReferences
\n\u2022\tKim, Y., Cubbin, C., & Oh, S. (2019). A systematic review of neighbourhood economic context on child obesity and obesity\u2010related behaviours. Obesity reviews, 20(3), 420-431.
\n\u2022\tSirico, F., Bianco, A., D’Alicandro, G., Castaldo, C., Montagnani, S., Spera, R., … & Nurzynska, D. (2018). Effects of physical exercise on adiponectin, leptin, and inflammatory markers in childhood obesity: systematic review and metaanalysis. Childhood Obesity, 14(4), 207-217.
\n\u2022\tTaylor, R. W., Gray, A. R., Heath, A. L. M., Galland, B. C., Lawrence, J., Sayers, R., … & Taylor, B. J. (2018). Sleep, nutrition, and physical activity interventions to prevent obesity in infancy: follow-up of the Prevention of Overweight in Infancy (POI) randomized controlled trial at ages 3.5 and 5 y. The American journal of clinical nutrition, 108(2), 228236.
\n\u2022\tMora-Gonzalez, J., Esteban-Cornejo, I., Cadenas-Sanchez, C., Migueles, J. H.,
\nMolinaGarcia, P., Rodriguez-Ayllon, M., … & Ortega, F. B. (2019). Physical fitness, physical activity, and the executive function in children with overweight and obesity. The Page Essay – Journal of pediatrics, 208, 50-56.<\/p>\n","protected":false},"excerpt":{"rendered":"
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