Imagination & Innovation in Nursing Care: Obesity Project Proposal

This assignment presents a Level 6 nursing project proposal and management plan focusing on addressing obesity in individuals with learning disabilities within an inpatient unit. The project proposes the use of nutrition posters to raise awareness of healthy eating habits. The introduction outlines the project's aim to manage obesity through nutrition, emphasizing the use of evidence-based practices and literature review. The project proposal section defines the project's focus, contextualizing the choice and providing supporting evidence from literature. The objectives are defined using the SMART framework. The rationale provides a coherent argument for the project, highlighting the increasing risk of obesity in this population and the need for interventions. The literature review explores the prevalence of obesity in people with learning disabilities and the associated health risks, discussing contributing factors such as poor diet, lack of exercise, and medication side effects. The management plan incorporates SWOT and PDSA models to provide a comprehensive approach.

IMAGINATION & INNOVATION IN EVIDENCE
BASED NURSING CARE – LEVEL 6.
PROJECT PROPOSAL & MANAGEMENT PLAN.
Name/Student Number:
Field of Nursing: Learning disability

Page(s). Contents.
Introduction. (Suggested - 150 words)
Project Proposal Briefing Paper (500 words)
Literature Review (Suggested -2,500 words)
Project Management Plan (Suggested -1,700 words)
Conclusion. (Suggested -150 words)
References.
Appendices.
Introduction.
The aim of this essay is to support how to manage obesity in people with learning
disability through nutrition in inpatient unit using a poster. It will highlight by
raising awareness of a healthy diet through posters. It contains different
information of weight loss, exercises, healthy living, easy read and sign
language. The rationale of the proposal will be explored by using different
literature, statistics and evidence-based experiences. The management plan will
be discussed, using the strengths, weaknesses, opportunities, and threats

(SWOT) analysis table. Plan Do Study Act will be also discussed in this project.
Along with it, in order to write the project plan PSDA model is going to be used.
Lastly, the conclusion will summarise the literature review and project
management plan. Obesity and overweight are conditions in which weight gain
has reached the point where it poses significant risks to health (Carsley, 2018). It
is also more than a lifestyle disorder and considered as a disease and a risk
factor such as type two diabetes (Gadde et al, 2018).
Project Proposal Briefing Paper (500 words)
Field of Nursing
(Adult, Child, Learning Disability or
Mental Health).
Learning Disability
Proposed Project/Innovation.
Contextualize the choice & clearly define
the focus of the project proposal that has
been generated and informed from your
area of practice?
(For example, what is the proposed
project and where are you proposing the
project could be implemented)?
Include supporting literature/evidence in
this section.
(Suggested 200 words).
Managing obesity in people with learning disability through nutrition
poster in inpatient unit. Obesity is defined by World Health
Organisation (2019) as abnormal or excessive fat build-up that
presents a risk to health. To measure someone who is obese or
overweight is the body mass index (BMI) an individual's weight
divided by square of her or his height in metres (WHO,2019). An
individual with a BMI of more than 30 is generally considered obese.
An individual with BMI equal to or more than 25 is considered as
overweight (World Health Organisation,2019).
Individual who are inpatient might become obese because of their
prescribed medication including psychotropic, high calorie food
provision, restricted physical activity and inactive lifestyles. Also,

people which have learning disabilities are also seen as inpatient.
Individuals with learning disability appear to be at high risk of Obese
or overweight, and there are more possible reasons for this. Some
people with learning disabilities are sometimes not able to access the
public health messages because of difficulties in understanding
product labelling and health campaigns, (Mackay, 2017) as well as
reduced capacity to understand the implications of a certain
behaviours (Russell et al 2018). To introduce health eating within
inpatient unit by developing effective nutritional awareness poster.
Project Aim/Objectives.
The project aim should be clear and
precise and inform the marker about the
main intention of the project.
The objectives should be more specific
and provide the marker with an insight
into what your project sets out to achieve.
Try to ensure the objectives are, Specific,
Manageable, Achievable, Realistic and
Time scaled (SMART Objectives).
(Suggested 50 words).
The aim of the innovation is to introduce health eating within inpatient
unit by developing effective nutritional awareness poster.
Objective
- To raise awareness of a healthy diet through the poster within
an inpatient unit within 5 months
- To improve exercise routine among 5 % people suffering from
obesity
- To promote Healthy living habits with the help of poster
presentation
- The easy read
- To evaluate the outcome of the implementation poster plans
after six months

Rationale.
Create a sound and coherent argument
for an appropriately selected work-based
project.
The rationale should provide an
explanation as to why you have chosen
to focus your project on a particular area
of practice within your own field of
nursing. For example, what has caused
you to identify this area of practice? The
rationale provides the opportunity to put
your argument forward to support the
proposed project.
Include supporting literature/evidence in
this section.
(Suggested 200 words).
The research evidence showcases that people with learning disability
holds the increasing risk of being obese or overweight (Atkinson, et al
2013). The chosen practice of area is inpatient unit for women who
are having personality disorders, the ones which are not practicing
healthy eating and exercises (Booth, 2014). Obesity and overweight
are caused by many issues which includes the combination of
metabolic, genetic, environmental, behavioural cultural and socio-
economic influences. Environmental factors and behavioural are the
large contributors of overweight and obesity. Various interventions
are designed in order to provide effective healthcare services to
people (Chapman et al, 2008).
Public Health England (2017) highlight that the lack of adequate
knowledge about healthy eating leads to insufficient and improper
care for people with learning disabilities. It is important to make a
healthy eating poster as guideline for the people with learning
disabilities which are living in the ward. Public Health England, (2017)
stated that there are barriers when supporting people with learning
disabilities, it might be difficult to balance the issues of choice and the
duty of care around exercise and diet. An individual can have a right
to make whatever decision. However, people need the right
information and be supported to understand the consequences and
the risks of their choices (Dare, 2017). It is important for care staff to
understand the principles of informed choices.

Potential / Intended Outcome.
How will your project proposal/innovation
meet the NHS Outcomes Framework?
Include supporting literature/evidence in
this section.
(Suggested 50 words).
Davies and Bhatia (2015) stated that obesity cost the NHS billions
between 2006 and 2007 including the medication of obesity. The use of
bariatric surgery and equipment’s to accommodate bigger people. To
improve this, healthy eating and quality care by nurses is required to
provide support to people with learning disabilities.
Domain 2 Enhancing quality of life for people with long term conditions
Domain 4 Ensuring that people have positive experience of care
Domain5 Treating and caring for people in a safe environment; and
protecting them from avoidable harm
Reference List.
(Key literature / evidence cited within the
Project Proposal Briefing paper only).
Please note: The accompanying
reference list is not included in the word
count for the Project Proposal Briefing
paper.
Atkinson D., Boulter P., Hebron C., Moulster G., Giraud-Saunders A.,
Turner S (2013) The Health Equalities Framework and
Commissioning Guide, Retrieved from
www.ndti.org.uk/resources/useful-tools/the-health- equality-
framework-and-commissioning-guide1.
Chapman, M.J., Craven, M. J. & Chadwick, D. D. (2008) Following up
fighting fit: The long-term impact of health practitioner input on obesity
and BMI amongst adults with intellectual disabilities. Journal of
Intellectual
Disabilities,12(4),309-323.https://doi:org10:1177/1744629508100557
Davies, A. & Bhatia, T. (2015) ‘Can the NHS help tackle the UK’s
obesity epidemic?’. Nuffield Trust comment, 20 March 2015.
Retrieved from https://www.nuffieldtrust.org.uk/news-item/can-the-
nhs-help-tackle-the-uk-s-obesity-epidemic
Gadde, K. M., Martin, C. K., Berthoud, H., & Heymsfield, S. B.
(2018). obesity. Journal of the American College of Cardiology, 71(1),
69-84. doi: 10.1016/j.jacc.2017.11.011
Public Health England 2017). Supporting people with learning
disabilities to have a healthy diet and be active. Retrieved from
https://assets.publishing.service.gov.uk/government/uploads/system/

uploads/attachment_data/file/656264/
Social_care_staff_supporting_diet_and_exercise_in_learning_disabili
ties.pdf
Russell, R. and et.al., 2018. The prevalence of overweight and
obesity levels among forensic inpatients with learning disability.
British Journal of Learning Disabilities. 46(2). 101-108.
World Health Organisation. (2019). Obesity. WHO.Retrieved
February 20, 2019. DOI: <https://www.who.int/topics/obesity/en/>

Literature Review
Moradi et al. (2016) stated that Obesity is an issue which is causing morbidity
and mortality and is associated with high medical expenses for the people.
People are lacking healthy eating habits and are not involved in regular physical
exercises, for this these are factors that are common reasons associated with
obesity in people with disabilities. It also includes lack of healthy food choices,
difficulty with chewing and swallowing food, or taste of food, medication is also
contributing to this, by gaining weight and changes in appetite, pain, lack of
energy and physical limitation (NICE, 2006). Overweight or obesity can result in
significant societal and personal costs. It has been seen that the relationship
between disability, obesity and health care expenses is strengthening. It can also
reduce opportunities in certain types of community participation activities such as
employment and leisure among people with learning disabilities.
Public Health England (2016) highlighted that obese people are at greater
risk of getting disease such as high blood pressure, heart disease, diabetes,
strokes, mobility difficulties and several types of cancer. As per the views of
Mizock (2017) many years ago has been established that people with learning
disabilities are at risk of being obese or overweight compared to the general
population, by eating poorly balanced diet and very little of physical activity. It can
increase the likelihood of a range of health and social problems (Public Health
England,2017). Royal College of Nursing, (2015) explored that levels of obesity
are higher in people with learning disabilities are noticeable in those people with
learning disabilities, especially in women. Obesity can increase the likelihood of
stroke, heart disease and type 2 diabetes. Also, people tend to become obese
because of lack of activities and lack balanced diet and less likely to take regular
physical exercises.
According to Haw and Rowell (2011) survey inpatients in a secure mental health
service, the findings that, over 33per cent of men were overweight and 47.2
percent are obese and among women 20 percent were overweight and 63.3,

percent obese, considerably higher than the general population. Many patients
who are receiving treatment in a secure unit appear to experience additional
difficulties in maintaining their healthy weight (Johnson et al. 2018). It is because
they are spending their most of the time on bed and are not involved in any
physical exercise. However, Long et al. (2009) investigated that the nutrition of
women in a secure inpatient setting, reporting that the meals of patients that they
are eating are full of carbohydrates and fat of which that this will make the
patients gain weight. However, today across the world take-away’s are also
reportedly consumed more than twice a week. There are also several barriers to
physical activity, including opportunities being limited by staffing levels, issues of
risks mental physical health or low motivation (Haw and Rowell, 2011).
Therefore, staff must encourage patients to eat healthy, however you
cannot force them because they have capacity to make decisions. The nurse and
the support workers must support patients, to have more activities such as
walking, so that there will be less watching television and playing games
(Lobstein, 2017). Interventions must adapt to each individuals’ preferences and
circumstances and should aim to improve people`s beliefs in their ability to
change (Nursing, Midwifery and Allied Health Professions Policy Unit, 2016).
Research Johnson et al. (2018) indicates that overweight or obese are higher in
people with mental illness than the general population. Therefore, it can be
triggered by antidepressant and antipsychotic medications, as side effects lack of
physical exercise and diet. Another reason why patients who are in inpatient unit
gain weight is because they tend to order takeaways. Takeaways provide easy
facility to the people from which they tend to eat more. It increases the risk of
obesity and other related diseases.
In accordance with NHS (2011) it has been outlined that there has been a
problem which is leading worse health conditions, for example being on diet
leads to mood disorders that is mood swings which can lead to failure in diet
plan. However, it has been suggested that professionals should encourage the
patient to engage behaviours that might improve conditions such as exercise,

stress and management and potential life style and just having simply diet. As
per the views of Bargain and Zeidan (2019) the problems associated with mental
health today includes obesity and side effects of mediation. Depression is one
of reasons which results due to rapid weight gain. This situation arises due to the
facts related with food habits and same can be used as a strategy to cope up
with the mental health by changing the decisions plans and with the change in
food plan an effective. Weight management program can directly lead in dealing
with the issues in effective manner. The second influence on the mental disorder
can be defined as side effect of the medication.
On the other hand, Avila et al. (2015) stated that for the people staying in
the mental health care hospital units one of the essential facts is to provide them
food full of nutrition values as a part of their care regime. Every person loves food
with good taste which is appealing to eat as well as healthy and nutritious. A
menu which offer this type of food with variety of choices is always welcomes
and appreciated. Provides a base for defined the requirements on nutrition in a
person and actions are taken as per the feedback and suggestion given by
consumers as well as the staff.
However, Johnson et al. (2018) stated that to live a good and healthy life
with no worries good food is an essential requirement as it gives both mental and
physical satisfaction to a person which improve his or her physical life. Healthy
food prevents chronic disease which is a factor of mental illness in certain
people. Another disorder associated with food and ideas of a person are
metabolic syndrome, side effects of the medication leading to hunger and gaining
weight (Petrescu et al., 2016) With the guideline over the nutrition values mental
health hospital providing care and support services can prepare the menu and
meals as per the need and requirement of the consumers and their preferences.
The food offered is designed to promote the health of people as well as
development of quality of healthy eating during and after the stay in the hospitals
(Johnson et al., 2018).Food in setting will be offered on basis of individual care
and nutritional needs which can be assessment by health care provider on the

basis of medication and health condition of patient. Further, involvement of
dietician for planning diets charts of individual patient will be effective in manging
supportive relationship with patients.
IIic and Rowe (2013) highlighted that posters are a common method of
presenting information in the community or at conferences. Anecdotal evidence
within the disciplines shows that health information framed in a poster
presentation might be an effective idea of transferring knowledge (IIic & Rowe,
2013). Furthermore, the poster might identify knowledge and skills and promote
changes in behaviours. Evidence shows that comparing posters to other
educational modalities is required to establish an evidence on how effective the
poster is achieving knowledge transfer.
Health Watch Lambert (2017) conducted questionnaires and observations
to find out that when patients visited their doctors, they waited long for their
appointments to see the GP. The environment and the seating arrangements
might affect their ability to sit comfortably as well as their mood. When posters
are put in the waiting room, it is also important point of communication between
the patient and the surgery. Many patients spend their time reading posters and
leaflets, and it is important for the patients to read health related messages. On
displaying health information carries a clear information through leaflets and
posters as well as implicitly implies which topics are to be on discussion. Even
though we explored waiting rooms from a mental health perspective, we also
recognise that the information and waiting room atmosphere influence all the
patients not only to those who suffers from mental health condition (Health Watch
Lambert,2017). Assisting patients in dietary needs can be will assist in improving
mood disorders of patients which is the major cause of mental health problems.
One might think that nowadays we only use the Internet, but the proof of
posters’ effectiveness is in science. A study which was published in the Health
Information and Libraries Journal highlighted that posters are mainly used for
communicating information in public health fields and in academic. Furthermore,
the report highlighted that these tools can increase knowledge, change

behaviours and change attitudes. Arslan et al. (2014) stresses that the
effectiveness of poster presentations is mainly present in the medical community,
as they prove to be very useful in waiting rooms and great at delivering
information in developing countries. Ninety seven percent of people who were
surveyed stated that they understand a poster which will be in healthcare
facilities (Journal of Pakistan Medical Association, 2017). For example, if the
poster is encouraging people to have blood pressure checked, a lot of people will
do so (Cross, 2009). Posters are a valued tool in healthcare sector. In addition,
posters are important because they provide a message around the topic,
ensuring that presenters convey essential information. This also promotes active
learning as the concise amount of information on posters helps people to
participate and ask some questions (Arslan et al., 2014).
Posters generally require reduced content as well as getting to the point.
Selecting what has to be included or omitted is not always easy. It can be a
challenge for patients with visual and hearing impairment or parents who cannot
read (Moradi et al., 2016). The reason behind section of the poster is that it is in
effective way of communication to a wide mass of the public with passing on the
ideas in simple yet effective manner (Carsley et al., 2018). Moreover, people
facing the problem weight gain and obesity will defiantly get attracted towards the
poster or the people who know some individual facing mental health issues due
to diet imbalance can also gain information and help others and themselves as
well. When an individual does not receive proper food, he tend to face issues
related to mental health. It is because mental health is directly connected to an
improper diet. Following a diet which is inadequate and the one which contains
foods which are harmful for health tends to make the individual’s mental health
suffer.