NURS FPX 6011 Assessment 3 Implementing Evidence Based Practice

Background on the Clinical Problem

• Increased risks commonly characterize women’s life in the post-menopause stage to physical and psychological health.
• Menopause is a transitional stage in the life of women aged 45 to 55 and so comes along with significant physical, hormonal, and psychological changes that create undesirable health symptoms such as somatic, vasomotor, psychiatric, cardiovascular, and urinary tract complications (Diyu et al., 2022).
• Despite menopause being a natural aging process and significant differences in the health symptoms recorded between pre-menopause and post-menopause middle-aged women, there is no single effective treatment for arising health complications.
• Hence, with older women constantly increasing worldwide, there is a need to find a viable, quality, life-oriented, and long-term solution to the issues post-menopausal women face.

PICOT Question

• Does exercise and diet (I) in post-menopausal women (P) decrease symptoms of menopause (O) compared to post-menopausal women who do not exercise and diet (C)?

Outline of Action Plan

• The action plan is based on practice change focused on the replacement of medical, surgical, and other fast-results short-term implication interventions to the prevention and management of different post-menopause symptoms with behavioral change techniques based on exercise and diet to foster the attainment of reliable positive long-term results and offer a lifelong tool to sustaining women’s quality of life post-menopause (Febriliant et al., 2021). 
• The intervention is planned to be a long-term initiative with patients encouraged to take it as a lifelong practice and consistently engage in exercise and maintenance of a healthy diet for at least a year to attain recognizable behavior change (Kerksick et al., 2020).
• The tools and resources needed for the intervention include;

• Finance support to sustain consistent access to a healthy diet and physical exercise therapy.
• Digital health care monitoring and patient data tools record patients’ interaction with the intervention and allow sharing of information between clinicians.
• A collaborative relationship between clinicians, the patients, and their family members.

Potential Stakeholders and Potential Barriers

NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice

• The main stakeholders affected by the clinical problem and identified change are;

• Nurses
• Patient care tech
• Physical therapist
• Physician
• Nutritionist
• Patients
• Family members

• The potential barriers to the success of the behavioral change approach intervention include the following;

• Length period before significant positive results is recorded.
• Low motivation in patients.
• Distrust in the effectiveness of behavioral change technique.
• Relapse and inconsistency in engaging in exercise and maintaining a healthy diet.
• Lack of collaboration between stakeholders curtailed by poor relationships.
• Lack of support to consistently engage in the behavior changes with optimal motivation.
• Poverty and poor quality of life limit access to resources needed for consistent maintenance of productive exercise and a healthy diet routine (Lenora et al., 2019).
• Lack of sufficient distribution of information on menopause and its symptoms.

Proposed Outcome Criteria

• Outcomes will be measured in four phases, each being conducted after every four months to establish changes attained in individual employees.

• Current condition and symptoms status.
• First/ Introductory phase to the behavior change interventions with outcomes measured at the end of month four.
• Growth phase to foster stronger behavior change with outcomes recorded at the end of month eight.
• New behavior reinforcement phase to support the maintenance of new exercise and diet routines with impacts recorded at the end of month twelve.
• The maintenance phase to support the maintenance attained positive behaviors with outcomes measured at the end of month sixteen.

• The learning outcomes are connected to the Quadruple Aim through;

NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice

• Improvement of post-menopause symptoms patients’ experience with clinical interventions and long-term productivity.
• Improvement of post-menopause women population health care conditions, risks, and promotion of general well-being (Sediva et al., 2022).
• Reducing the cost of medical and surgical interventions by applying a cost-effective approach in behavior and lifestyle change approach that promotes improvement of quality of life and decreases post-menopause symptoms.

Evidence Evaluation

• A literature review search strategy was used with a focus on healthcare-based journal article providers found in the Google Scholar database and its associates in delivering scholarly information.
• The research findings established that exercise and a healthy diet were effective lifestyle interventions that helped reduce the prevalence of post-menopause complications in women. The findings came from peer-reviewed articles that engaged in cross-sectional and experimental studies engaging diverse women populations and subjects on the case before coming to valid and reliable conclusions. The authors of the articles are also recognized professionals in the health care, nursing, nutrition, physical exercise, and reproductive system field, which offered them great competence and authority to discuss issues relating to clinical problems.

NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice

• The action plan is considered reasonable and realistic because it is established on quality and reliable evidence while offering a solution with extensive potential in dealing with the clinical problem.
• The specific actions that can be used to limit the impacts of barriers include building a strong stakeholder relation, providing sufficient funds and support to patients and clinicians, constant monitoring of the process, and providing menopause education.
• The outcome measures align with the Quadruple Aim by seeking the desired objectives in a four-phase process with unique but gradual adjustment of factors to meet intervention objectives within 16 months of operation

References

Diyu, I. A., & Ni, S. L. (2022). Menopausal Symptoms in Women Aged 40-65 Years in Indonesia. International Journal of Health and Medical Sciences, 5(2), 169-176. Retrieved from https://dx.doi.org/10.21744/ijhms.v5n2.1896

Febriliant, M. R., Suryana, B. P., Rosandi, R., Lestari, W., & Sukarlin, S. (2021). Factors Associated With Changes In Bone-Mass Density In Post Menopause Female Patients With Osteopenia. Clinical and Research Journal in Internal Medicine, 2(2), 177–186. Retrieved from https://doi.org/10.21776/crjim.2021.002.02.3

Kerksick, C. M., Roberts, M. D., Campbell, B. I., Galbreath, M. M., Taylor, L. W., Wilborn, C. D., & Lee, A. (2020). Differential Impact of Calcium and Vitamin D on Body Composition Changes in Post-Menopausal Women Following a Restricted Energy Diet and Exercise Program. Nutrients, 12(3), 1-17. Retrieved from https://doi.org/10.3390/nu12030713

Lenora, J., Rathnayake, N., Alwis, G., & Lekamwasam, S. (2019). Prevalence and Severity of Menopausal Symptoms and the Quality of Life in Middle-aged Women: A Study from Sri Lanka. Nursing Research and Practice, 1-9. Retrieved from https://doi.org/10.1155/2019/2081507

Sediva, H., Cartwright, T., Robertson, C., & Deb, S. K. (2022). Behavior Change Techniques in Digital Health Interventions for Midlife Women: Systematic Review. JMIR Mhealth Uhealth, 10(11), 1-20. Retrieved from https://mhealth.jmir.org/2022/11/e37234