Nursing Assignment: Evidence-Based Practice for Diabetes Management

This nursing assignment, focusing on evidence-based practice (EBP), addresses the barriers and enablers to implementing EBP in the workplace, particularly within the context of diabetes management. The assignment highlights organizational culture, lack of training, and nurse-to-patient ratios as significant barriers, while emphasizing incentives, resources, and professional development as enablers. It explores the use of physical activity as an EBP for type 2 diabetes mellitus (T2DM), supported by research showing that a combination of resistance and aerobic training improves HbA1c levels. The assignment also discusses the importance of patient education and the potential need for personalized EBP approaches due to individual health conditions. The rationale for decision-making is rooted in the analysis of scientific articles and emphasizes the importance of diet in conjunction with physical activity. The assignment also acknowledges uncertainties, such as the need for specific dietary plans and the potential impact of healthcare professionals' biases on patient outcomes.

Running head: NURSING
Nursing: Part 3
Name of the Student
Name of the University
Author Note

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What are some of the barriers and enablers to you in implementing evidence-based
practice in your workplace?
The main barriers of the evidence-based practice (EBP) are the organizational culture.
The organizational culture that fails to up-held the concept of teamwork or support from the
team leaders (nurse manager) experiences gap in implementing evidence-based practice. The
lack of training of the nursing professionals and poor nurse to patient ratio also act as a
barrier towards comprehensive implementation of the evidence-based practice (Baatiema et
al. 2017).
The enablers of the EBP implementation are the incentives and resources. The
availability of incentives and resources help to effective implementation of EBP. The
incentives act as a source of motivation and resources help in optimal therapy management
through EBP (Baatiema et al. 2017). Other enabler of the EBP is effective training of the
nursing professionals. Moreover, the nursing professionals who provide the scope for the
continuous professional development helps to increase the probability of the effective
implementation of the EBP (eva 2016).
The main barrier in the implementation of EBP for the effective diabetes management
is the unwillingness of the target population who conduct the physical activities on time and
in a desired intensity. Korkiakangas et al. (2011) highlighted the people who lead a sedentary
life, have high BMI and HbA1c level are less likely to participate in the physical activity,
daily. Patient-education about the disease progression will help to generate awareness and
thereby helping to overcome the barrier (Chimeddamba et al. 2015).
Another barrier in implementation of this EBP is, hard aerobic and resistance training
might not be suitable for the people who are suffering from micro and macro vascular

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complication of diabetes like cardio-vascular problem. For them, a different EBP is required
to be implemented thus promoting the importance of person-centered EBP (Korkiakangas et
al. 2011).
The enablers of this EBP is non-pharmacological interventions (physical exercise
training) helping to recover from diabetes. Non-pharmacological interventions have less
significant side effects on the body and thus considered to be effective in disease
management. The motivation of the people to manage their body image by the practice of the
physical activity can be considered as an enabler of this EBP (Korkiakangas et al. 2011).
Provide a short summary of the important information that relates to your clinical
question; explain the rationale for your decision making to your situation of
uncertainty.
The important information that relates to the clinical question that was extracted from
the analysis of the scientific article is, practice of a combination of physical activities help in
effective management of type 2 diabetes mellitus (T2DM). In other words, it can be said that
practice of combination of two types of physical activities that is resistance training and
aerobic exercise help to improve the Hb1Ac level and thereby helping to improve the state of
T2D. This can be regarded as one of the EBP for the management of T2DM or an evidence-
based pharmacological intervention (Church et al. 2010). The rationale of the decision-
making is based on the RCT conducted by Church et al. (2010) that showed if people who
leads a sedentary life and has high BMI and HbA1c practice physical activity then are more
likely to recover from the disease state fast. However, the uncertainty is, whether specific diet
plan is required to be followed in order to see a significant change in the HbA1c effects. Thus
in order to extract the best-possible out come from the EBP (physical activity and diabetes
management), the patient’s diet plan is required to be designed strictly. Esposito et al. (2015)

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state that proper use of the Mediterranean diet or low calories and high protein diet helps in
reducing the blood glucose level and thus facilitating the effect of the physical activity in
reducing the HbA1c concentration in the blood. Another uncertainty is the decision-making
process under this situation is nursing professionals under-estimation of the severity of the
diabetes mellitus die their own biased behavior or attitude leading to less compliance to the
effective management plan of diabetes and thus affecting the outcome (Lawton et al. 2005).

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References
Baatiema, L., Otim, M.E., Mnatzaganian, G., Aikins, A.D.G., Coombes, J. and Somerset, S.,
2017. Health professionals’ views on the barriers and enablers to evidence-based practice for
acute stroke care: a systematic review. Implementation Science, 12(1), p.74.
Chimeddamba, O., Peeters, A., Ayton, D., Tumenjargal, E., Sodov, S. and Joyce, C., 2015.
Implementation of clinical guidelines on diabetes and hypertension in urban Mongolia: a
qualitative study of primary care providers’ perspectives and experiences. Implementation
Science, 10(1), p.112.
Church, T.S., Blair, S.N., Cocreham, S., Johannsen, N., Johnson, W., Kramer, K., Mikus,
C.R., Myers, V., Nauta, M., Rodarte, R.Q. and Sparks, L., 2010. Effects of aerobic and
resistance training on hemoglobin A1c levels in patients with type 2 diabetes: a randomized
controlled trial. Jama, 304(20), pp.2253-2262.
Esposito, K., Maiorino, M.I., Bellastella, G., Chiodini, P., Panagiotakos, D. and Giugliano,
D., 2015. A journey into a Mediterranean diet and type 2 diabetes: a systematic review with
meta-analyses. BMJ open, 5(8), p.e008222.
Eva, K.W., Bordage, G., Campbell, C., Galbraith, R., Ginsburg, S., Holmboe, E. and Regehr,
G., 2016. Towards a program of assessment for health professionals: from training into
practice. Advances in Health Sciences Education, 21(4), pp.897-913.
Korkiakangas, E.E., Alahuhta, M.A., Husman, P.M., Keinänen‐Kiukaanniemi, S., Taanila,
A.M. and Laitinen, J.H., 2011. Motivators and barriers to exercise among adults with a high
risk of type 2 diabetes–a qualitative study. Scandinavian journal of caring sciences, 25(1),
pp.62-69.

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Lawton, J., Peel, E., Parry, O., Araoz, G. and Douglas, M., 2005. Lay perceptions of type 2
diabetes in Scotland: bringing health services back in. Social science & medicine, 60(7),
pp.1423-1435.