The rates of diabetes in the United States and globally continue to rise, while this condition affects more adults daily. Currently, more than 8% of all US adults have type 2 diabetes, and it is expected that more than 15% – 60 million – of the total population will have diabetes in 2060 (Powers et al., 2020; Xu et al., 2018). These numbers indicate a serious and urgent problem for all healthcare practitioners, including nurses. Diabetes is a condition that requires attention and daily management from people, implying that they constantly need to make choices that will impact their health.
Based on the latest statistics, the need to educate and support people with type 2 diabetes becomes increasingly urgent. This responsibility falls on nurses whose relationship with patients is founded on communication, learning, and advocacy. However, not all facilities are equipped with human and financial resources to handle this issue. Thus, a practice problem arises – finding and implementing a solution by nurses to help patients manage their condition.
The following paper includes an organizational needs assessment of the selected practicum site. First, the practice need will be identified and described using the latest statistics and scholarship. Then, stakeholders for the project will be discussed, including those who may support or oppose the change and those who will have the most influence on the outcome of solving the problem. A gap analysis of the practicum site will show the organization’s current state, the desired outcome, and the factors that affect this discrepancy. Currently, the practicum site does not have an easily accessible self-management program for patients with type 2 diabetes, and its introduction to the organization can improve patients’ quality of life and nurses’ preparedness to educate patients.
Identification of the Practice Problem or Need
The rate of diabetes is high, and it is estimated to continue growing in the following years. As noted above, the different statistics show that every third adult can have diabetes by 2050 (CDC, 2021). The numbers also demonstrate that most individuals with this condition have type 2 diabetes – more than 90% (Xu et al., 2018). This prevalence implies that the disease develops based on internal and external factors, personal choices, and the environment in which people live. In some cases, their socioeconomic status and living conditions significantly increase the risk of diabetes. (Bullard et al., 2018; Morgan et al., 2018). In other cases, the lack of information about how to prevent the development of this condition leads to health problems. Furthermore, while type 2 diabetes can be prevented, its treatment is based on management and requires commitment from patients and their healthcare providers.
The need for self-management arises from people’s limited knowledge about type 2 diabetes and the risk of complications in cases where this condition is left unnoticed. According to the CDC (2022), the financial benefits of self-management and education are also vital to consider – the US spends approximately $300 billion on diabetes-related care, and individual Americans also spend significant amounts to cover their health costs. Education, support, and self-management programs that focus on lifestyle change can substantially cut these costs by shifting the attention from costly medical treatments to improving individuals’ daily lives (Morgan et al., 2018). Thus, the practice need is to introduce these initiatives to facilities that serve many patients with type 2 diabetes.
The practice problem at the particular practicum site is directly related to this need, as the facility offers rehabilitation and nursing assistance to many adults with type 2 diabetes. In line with the statistics, the knowledge about diabetes management is low among patients, and education programs are not equally available to everyone (Morgan et al., 2018). At the same time, studies show a correlation between participation in such programs and people’s improved health outcomes (CDC, 2022; Morgan et al., 2018; Powers et al., 2022). The evidence discussed above was collected from scholarly articles and the Centers for Diseases Control and Prevention materials. At the practicum site, the information was obtained by talking to the employed Nurse Practitioners (NPs). They commented on the absence of a structured and accessible self-management system that could be offered to patients with type 2 diabetes.
Identification of Stakeholders
Although the practice problem focuses on patient health outcomes, many stakeholders can affect the program’s implementation. First, the leading group that influences any change is NPs working at the organization. NPs are responsible for this change project’s outcome as they will be the ones to distribute and collect information. Moreover, they have an impact not only during the project’s process but also after it has been completed if the program becomes a part of daily operations.
Therefore, NPs may be on both sides – in opposition to and in support of the change. For example, nurses who believe that self-management programs are ineffective or those who simply do not want to change their routine will likely resist the change. In contrast, nurses interested in implementing new ideas into their practice may support the change. In particular, nurse leaders may welcome the new program if it brings more financial savings, improved health outcomes, and better customer reviews of the facility. Similarly, the organizational leader, nurses who work with diabetes patients, and nurse managers will influence the change most. The leader and managers will oversee how the program is implemented, and the nurses will be responsible for patient communication and education.
Gap Analysis Table
|What is currently happening at the practicum site?||What should be happening at the practicum site based on current evidence?||What is your practice gap? (state what is currently happening and state what should be happening)||Why is there a practice gap?||What factors are contributing to the practice gap?||What evidence do you have to demonstrate there is a practice gap?|
|There is no accessible self-management and education program for patients with type 2 diabetes.||NPs should educate and provide resources for patients with type 2 diabetes to improve their health outcomes.||A large number of patients have type 2 diabetes and do not know how to manage it with changes to their lifestyle; a program that would provide this information and share resources for self-management is not used at the practicum site.||The practice gap exists because type 2 diabetes is a condition that is not currently covered by a specific program at the facility, but there are many patients that have it.||The lack of change and high level of resistance to it may contribute to the practice gap. The focus on other conditions is another factor.||Communications with NPs and the absence of diabetes-related self-management programs at the practicum site that caters to a population with a high prevalence of diabetes support the existence of the practice gap.|
Such conditions as diabetes present a growing problem globally and in the United States. As the rates of people with type 2 diabetes continue to grow, the need for education increases as well. At the considered practicum site, the lack of a self-management program for dealing with type 2 diabetes is a practice gap. Many patients at the facility have diabetes but do not receive any education related to its management in their daily lives. There are many stakeholders who can affect the proposed change, the main groups being NPs, the organizational leader, and nurse managers. NPs can be opposed to and supportive of the proposed change based on their view of practice improvement and patient education. Overall, the combination of statistical evidence, scholarship, and communication with NPs reveals the need to introduce a self-management program to support positive change for patients with type 2 diabetes.
Bullard, K. M., Cowie, C. C., Lessem, S. E., Saydah, S. H., Menke, A., Geiss, L. S., Orchard, T. J., Rolka, D. B., & Imperatore, G. (2018). Prevalence of diagnosed diabetes in adults by diabetes type — United States, 2016. Morbidity and Mortality Weekly Report, 67(12), 359-361. Web.
Centers for Disease Control and Prevention (CDC). (2021). Diabetes Self-Management Education and Support (DSMES) toolkit: Background. Web.
Morgan, J. M., Mensa-Wilmot, Y., Bowen, S. A., Murphy, M., Bonner, T., Rutledge, S., & Rutledge, G. (2018). Implementing key drivers for diabetes self-management education and support programs: Early outcomes, activities, facilitators, and barriers. Preventing Chronic Disease, 15, E15. Web.
Powers, M. A., Bardsley, J. K., Cypress, M., Funnell, M. M., Harms, D., Hess-Fischl, A., Hooks, B., Isaacs, D., Mandel, E. D., Maryniuk, M. D., Norton, A., Rinker, J., Siminerio, L., M., & Uelmen, S. (2020). Diabetes self-management education and support in adults with type 2 diabetes: A consensus report of the American Diabetes Association, the Association of Diabetes Care & Education Specialists, the Academy of Nutrition and Dietetics, the American Academy of Family Physicians, the American Academy of PAs, the American Association of Nurse Practitioners, and the American Pharmacists Association. Diabetes Care, 43(7), 1636-1649. Web.
Xu, G., Liu, B., Sun, Y., Du, Y., Snetselaar, L. G., Hu, F. B., & Bao, W. (2018). Prevalence of diagnosed type 1 and type 2 diabetes among US adults in 2016 and 2017: Population based study. BMJ, 362, k1497. Web.