Abstract
Changing health lifestyles in society has predisposed many people to diabetes and diabetic foot. Trends in diabetes mellitus are alarming since type II diabetes, which was an exclusive disease of the adults, is gradually becoming dominant in young adults and adolescents. Since diabetes type II is the major predisposing factor of diabetic foot, it means that not only the adults are at risk of developing diabetic foot but also the young adults and adolescents. Statistics have revealed that diabetic patients are 20 times more susceptible to diabetic foot than the general population because high glucose levels in diabetic patients damage the blood vessels and nerves of the feet causing poor circulation of blood and insensitivity respectively leading to the development of diabetic foot. Due to rising cases of diabetes mellitus and associated complications like diabetic foot, it is imperative for the health care system to come up with comprehensive programs that will mitigate development of diabetic conditions in the population. The research proposes that a comprehensive education program can effectively reduce increasing incidences of diabetes mellitus and concomitantly reduce the incidences of diabetic foot by 10% in the population of diabetes mellitus type II at the Veterans Affairs.
Comprehensive education program is an effective program that enhances prevention, diagnosis, treatment, and management of diabetic conditions in the population since it increases awareness making the entire population become responsive to healthcare mitigation measures. The comprehensive education program targets veterans with the diabetic conditions, diabetes mellitus, and diabetic foot, and the entire population that is at risk of developing the diabetic conditions. The research expects that at the end of the comprehensive education program, the general population will have sufficient information regarding prevention, diagnosis, treatment and management of diabetic, which will enable them to live healthy lifestyles and seek medical services in time, and thus become responsive to healthcare mitigation measures. The research is consistent with World Health Organization recommendation that education of the population is imperative in boosting preventive and management measures of diseases.
To achieve its major objectives of reducing the incidences of diabetes mellitus and diabetic foot in the veteran population, the research outlines plans of comprehensive education targeting both the patients and the general population in various Veterans Affairs health care organizations across the country for a period of six months. The research will employ health care educators in carrying out extensive and intensive education programs across various health care institutions in Veterans Affairs. In addition to health care educators, the implementation of the comprehensive educational program requires resources such as educational materials, health care educators, health care institutions, subordinate personnel, attendance cards, questionnaires, patients’ database, record books, notebooks, and teaching materials among other stationeries. These resources are very critical for successful implementation of the comprehensive education program in the Veterans Affairs.
The research will take a period of six months to enhance both external and internal validity of the findings and at the same time minimize utilization of the resources. During the research period, the health care educators will collect data inform of questionnaires and from patients’ databases. Weekly questionnaires in which both the patients and Veteran population will fill show the extent of compliance to the prevention, treatment, and management measures of the diabetic conditions while patient’s databases are critical sources of data because they provide the trends of diagnosis and treatment of patients in selected health care institutions. Ultimately, the research will employ SPSS as a statistical tool in establishing if there is any significant correlation to justify that comprehensive education program is effective in reducing incidences of diabetes mellitus and diabetic foot.
Problem Identification
Problem Identification
Diabetes mellitus is a disease that occurs when the body fails to regulate the level of glucose in the blood. There are two types of diabetes mellitus, type I, and type II, classified according to availability of insulin in the body. Type I diabetes occurs because of failure of the pancreas to secrete enough insulin into the body causing glucose levels to increase, and mainly affects children and young adults. Type II diabetes occurs due to insensitivity of the body to insulin making blood glucose level to increase and the cells to experience physiological hunger. Type II diabetes mainly affects adults but due to changing lifestyles in society and there are increasing incidences of such in young adults and adolescents. Diabetes mellitus is responsible “for the development of diabetic foot because high levels of glucose in blood damage nervous system and blood vessels leading to insensitivity and poor circulation of blood in the feet” (American Heart Association, 2010).
Importance of the Problem
Diabetes mellitus if not managed in time will cause many complications to patients and extend treatment burden to their families. According to Donald, “high blood glucose levels due to diabetes mellitus can damage the nerves, kidneys, eyes, blood vessels, immune system and cause foot problems” (Donald, 2009, p. 8). The many complications associated with diabetes are very grave and thus require immediate attention from the health care system to give guidelines on how to manage rising cases of diabetes mellitus. Diabetic foot is a complication that arises due to damage of blood vessels and nerves around the feet by the high levels of glucose in the blood. Damage of blood vessels impairs circulation of blood and subsequently affects the immune system causing slow healing of wounds. Damage of nerves makes the feet become insensitive and lose physiological mechanism of sweats and oils leading to the development of sores and cracks in the feet. Because damaged blood vessels impair circulation of blood, it is very difficult to administer antibiotics into target sites leaving the infection to develop into gangrene.
Diabetic foot arises due to diabetes mellitus and statistics reveal that people suffering from diabetes mellitus are 20 times more susceptible to diabetic foot relative to the general population. Such revelation affirms that diabetic foot is a grave complication of diabetes mellitus that requires urgent attention due to rising cases of diabetes mellitus in the population. “Out of the total number of all lower limb amputations, 40% to 60% are carried out in persons with diabetes mellitus, and more than 85% of them are the consequence of a diabetic foot affected by deep infection and gangrene” (Poljicanin, Pavlic-Renar, Metelko & Coce, 2005, p. 43). Because diabetes mellitus contributes about half of all cases of limb amputations, proper management of the condition is imperative in decreasing cases of diabetic foot that leads to limb amputation. Thus diabetes mellitus and diabetic foot are health problems that have serious consequences such as increasing rates of disability, morbidity, stress, and medical burden among the population.
In the United States, studies by the National Hospital Discharge Survey demonstrates that in 1996, approximately 86, 000 of diabetic patients developed diabetic foot and underwent amputations of lower limbs. These discoveries made by the National Institute of Health and the Health Care System declare that diabetes mellitus is increasingly becoming the leading cause of limb amputations. “People who have diabetes are vulnerable to nerve and vascular damage that can result in loss of protective sensation in the feet, poor circulation, and poor healing of foot ulcers …All these conditions contribute to high amputation rates” (Tobin & Kennedy, 2009, p. 6). Because diabetic foot is becoming a global issue, St. Vincent Declaration in 1989 aimed at reducing incidences of amputations across Europe by at least half in every five years. Therefore, to control and manage occurrence of diabetes mellitus and diabetic foot, it requires concerted efforts of the public and the health care system.
Project Objective
The major objective of the project is to reduce incidence rates of diabetes mellitus type 2 in the diabetic population with the view of preventing diabetic foot and other complications associated to diabetes mellitus. The research hypothesizes that comprehensive education program can effectively reduce increasing incidences of diabetes mellitus and concomitantly reduce the incidences of diabetic foot by 10% in the diabetes mellitus type 2 population at the Veterans Affairs. Tobin and Kennedy argue that, “…keeping blood glucose level as close to normal as possible significantly slows the onset and progression of diabetic nerve and vascular complications, which can lead to lower extremity amputations” (Tobin & Kennedy, 2009, p. 5). Thus a nursing education program targeting the Veterans Affairs population that will enhance the awareness of diabetes and diabetic foot in terms of prevention, diagnosis, treatment, and management is critical in achieving the research objective.
Solution and Description
A comprehensive education program will enhance the Veteran awareness of diabetes mellitus and its associated complications such as diabetic foot. The enhanced awareness will assist Veterans and their families to participate in prevention, diagnosis, treatment, and management of diabetes mellitus and diabetic foot. Donald advices that, “people with diabetes should learn how to examine their own feet, recognize the early signs and symptoms of diabetic foot problems, carry out routine foot care at home, and seek emergency treatment” (Donald, 2009, p. 11). Individuals can perform all of these activities if there is sufficient awareness of diabetes mellitus and diabetic foot.
Solution Description
Description of the Proposed Solution
To enhance awareness of diabetes mellitus and diabetic foot, comprehensive education of patients and the entire population regarding prevention, diagnosis, treatment, and management of these conditions is imperative. The comprehensive education programs target two groups of Veterans in the population, the Veterans of diabetes mellitus and diabetic foot, and Veterans that have risk factors for diabetes and diabetic foot. Patients of diabetes mellitus need education on how to treat and manage their diabetic condition and prevent occurrence of diabetic foot. Moreover, patients of diabetic foot require education on how to manage their condition and prevent it from aggravating their health conditions and subsequent amputation of their lower limbs. According to Ortegon, Redekop, and Nissen, “management of the diabetic foot according to guideline-based care improves survival, reduces diabetic foot complications, and is cost-effective and even cost saving compared with standard care” (Ortegon, Redekop, & Nissen, 2004, p. 901). Hence, comprehensive education provides guidelines of managing diabetes mellitus and diabetic foot resulting in improved standard of health care.
Education of the public is essential in preventing, diagnosis, treatment, and management of diabetes mellitus and diabetic foot conditions. In the research, the public will receive educational materials that contain relevant information that will increase their awareness of the two conditions with the prime objective of encouraging individuals in becoming proactive in taking care of their health. Healthy lifestyles and regular medical examination is very important in preventing diabetes mellitus and subsequent development of diabetic foot. “Current clinical recommendations call for a comprehensive foot examination at least once a year for all people with diabetes to identify high risk foot conditions, while people with one or more high-risk foot conditions should be evaluated more frequently” (Rangnarson, & Apelquist, 2001, p. 2081). Sensitization of the population will enhance regular medical examinations and early diagnosis of diabetes mellitus and diabetic foot, hence prevention, treatment, and proper management of the conditions. The research expects that at the end of education program, individuals will be in a position to live healthy lifestyles by keeping their blood sugar within normal range, conduct regular foot check and care, and remain physically healthy.
Consistency with Current Research
Because diabetes mellitus and diabetic foot cases are medical conditions that require management of health rather than treatment; therefore, comprehensive education programs put novel foundations that are critical in prevention and management of the conditions in the population. According to the Center for Disease Control and the National Institute of Health, effective prevention and management of diabetes mellitus and diabetic foot need, “early diagnosis of diabetes mellitus, early detection of foot problems, early intervention to prevent further deterioration that may lead to amputation, and patient education for proper care of the feet and footwear” (Kandel, 2000, p. 8). Therefore, patient education is one of the approaches that the health care system employs in prevention and management of diabetes mellitus and diabetic foot.
Feasibility of the Solution
A comprehensive education program is a feasible approach of preventing and managing diabetes mellitus and diabetic foot because increased awareness of the conditions in the population will enhance the efforts of the health care system. According to World Health Organization, people can prevent and manage most diseases if they have enough information concerning causes, prevention, and treatment of varied diseases (Armstrong, Holtz-Neiderer, Wendel, Mohler, & Kimbriel, 2007, p. 1044). Hence, comprehensive education of the patients and the public is a feasible approach of preventing and management of the diabetic-related conditions.
Consistency with the Resources and Culture
Conducting comprehensive education concerning diabetes, and diabetic foot across the Veterans Affairs within a specific region of the United States, do not require much finances since health institutions already provides necessary framework of conducting the research. Therefore, health care professionals coupled with relevant information is important in the research work of this disease. The research also has no ethical barriers because education of Veterans and their families regarding diabetes and diabetic foot does not conflict with any cultural belief in the society.
Conclusion
The incidences of diabetes mellitus are increasing alarmingly in the population due to change in lifestyles. Recent studies reveal that Type II diabetes is gaining prominence in adolescents and young adults causing complications such as diabetic foot. Diabetic foot occurs when high level of glucose in blood damage blood vessels resulting into poor circulation of blood in the lower limbs. Moreover, high glucose levels in blood damage nerves causing lower limbs to lose sensitivity and develop sores. Collective complications of damaged blood vessels and nervous system results in diabetic foot in which if not properly managed will eventually lead to amputation of lower limbs. To prevent and manage these diabetic conditions, comprehensive education program enhances public awareness on how to improve their healthy lifestyles and perform foot care so to improve in the control and management of diabetes and diabetic foot.
Project Support
Guideline to Preventing Diabetic Foot
Tobin and Kennedy wrote the article, A Health Care Provider’s Guide to Preventing Diabetes Foot Problems in 2009 in collaboration with National Institute of Heath, the Centers for Disease Control and Prevention, and joint efforts of other partners in the health care system. The study aimed at enhancing awareness of diabetes mellitus and diabetic foot in the population by providing guidelines in prevention and management of the diabetic conditions. In 1996, statistical studies carried out in the United States showed that about 86,000 patients of diabetes developed diabetic foot, which forced them to undergo amputation. Following the statistics, Tobin and Kennedy, realized that, “diabetes is the leading cause of amputation of lower limbs, yet it is clear that as many as half of these amputations might be prevented through simple but effective foot care practices” (2009, p. 6). For effective foot care practices to occur in the health care institutions and in the population, comprehensive education was imperative.
The research focused on educating both the health care professionals and the patients on the need to reverse the increasing trends of diabetes mellitus and diabetic foot in the population. The health care professionals in various institutions filled questionnaires to show whether their diabetic patients had any education concerning their conditions. Discoveries revealed that, only 55% of the diabetic patients were aware of prevention, treatment, and management measures of their diabetic conditions (Tobin & Kennedy, 2009, p. 23). The research proposed that comprehensive education of diabetic patients would effectively reduce the incidences in the population and encourage patients to seek health care services. The strength of the research is that health care professionals filled medical details of the diabetic patients in the questionnaires, and the weakness is that the data collected is partial because it only focused on the diagnosed patients who attend various health care institutions leaving many undiagnosed in the population (Tobin & Kennedy, 2009).
Prevention of Diabetic Foot Development
According to the article, Draft Program of Prevention of Diabetic Foot Development and Lower Extremity Amputation in Persons with Diabetes Mellitus, which was completed in 2005 by Poljicanin, Pavlic-Renar, Metelko, and Coce, 40-60% of amputations occur in patient with diabetes mellitus, although over 85% are because of diabetic foot. Due to high incidences of amputations, the objective of the research was to enhance health care practices of prevention and management of diabetic conditions through comprehensive education of patients at a specific clinic with the aim of reducing amputations by 50% within a five-year period. Research carried extensive education on regular patients and those on first diagnosis of diabetic conditions. Poljicanin, Pavlic-Renar, Metelko, and Coce argue that, the objective of extensive education program is “to enhance the patients’ motivation and to improve their skills in diabetic foot care …the patient should be educated on how to recognize the potential foot problems and undertake necessary measures in case these occur” (Poljicanin, Pavlic-Renar, Metelko, & Coce, 2005, p. 47). The extensive education provided the patients with healthy skills of managing diabetes mellitus and the prevention of diabetic foot.
The research planned to conduct yearly assessment of patients through the five-year period. The level of glucose in the blood was the parameter that showed the extent of managing diabetes mellitus while occurrence of diabetic foot and other complications depicted the degree of prevention of the diabetic conditions. The weakness of the research is that it only concentrated its studies in one clinical center making it to have low external variability. The strength of the research is that its duration was a period of five years, thus enhancing credibility of its discoveries by eliminating possible extraneous variables.
Prevention and Treatment of Diabetic Foot
Ortegon, Redekop, and Nissen wrote the article, Cost-Effectiveness of Prevention and Treatment of Diabetic Foot: a Markov Analysis in 2004. The objective of the study was to ascertain the cost effectiveness of standard guidelines in prevention and treatment of the diabetic conditions. According to Ortegon, Redekop, and Nissen “management of the diabetic foot according to guideline-based care improves survival, reduces diabetic foot complications, and is cost-effective and even cost saving compared with standard care” (Ortegon, Redekop, & Nissen 2004, p. 901). The research employed the Markov model by carrying out prospective studies of patients, newly diagnosed with diabetes mellitus and managed through guideline-based care of optimal foot care and intensive glycemic control. The research assessed occurrence of foot complications, quality of health, costs of managing diabetic conditions and survival of period of patients as the outcomes of prospective management of diabetic conditions.
The research suggested that intensive education of patients using guideline-based care is very effective in prevention and reduction of incidences of diabetic conditions. Ortegon, Redekop, and Nissen argue that, “intensive glycemic control and optimal foot care reduces foot ulcers and amputations, and leads to an improvement in life expectancy” (Ortegon, Redekop, & Nissen, 2004, p. 904). Because the research is a prospective study that examined and assessed lives of patients, it has strong external validity but its weakness is that, it used estimates of health and economic costs in determining effectiveness of preventive and management measures.
Prevention and Early Intervention
Prevention and Early Intervention for Diabetes Foot Problems: A Research Review is a 2009 article by Corken in collaboration with American Association of Diabetes Educators. The purpose of the research was to explore various preventive measures, critical in the reduction of diabetic conditions in the population. Corken argues that, the key preventive measures “…include: annual examination of the feet by health care providers to determine risk factors for ulceration; subsequent exams of high risk feet at each patient visit; patient education about daily self-care of the feet; and careful glucose management” (Corken, 2009, p. 4). The research carried out patient-intensive education that significantly enhanced patients’ compliance with the preventive treatment and management measures, thus reducing the incidences of diabetic conditions. The weakness of the study is that it only screened diabetic patients for ulceration leaving the entire population undiagnosed for diabetes, but its strengths lies in comprehensive education of diabetic patients and subsequent assessment, which increase external validity.
Prevention and Management
O’Bryan and Caputo wrote the article, Prevention and Management of Common Diabetic Foot Problems in 2008. The article seeks to demonstrate that preventive and management measures of diabetic conditions can effectively reduce the incidences of diabetic conditions in the population. The study used four patients to demonstrate effective management of diabetes mellitus and diabetic foot. O’Bryan and Caputo argue that, “the program for prevention should include foot self-care education for the patient, periodic professional foot care and proper foot wear” (O’Bryan & Caputo 2008, p. 2). The results of the research revealed that proper management of the diabetic patients through education and enhanced health care services are critical in prevention of diabetic conditions. Intensive education enhances patient awareness of his or her health condition and therefore, he or she is able to make informed decisions regarding the kind of lifestyles he or she is living.
The strength of the research is that it is a prospective study, which enhances internal validity of the findings because examination of patients over long period reduces extraneous influence of confounding factors. The weakness of the research lies in the fact that it has weak external validity because the discoveries from the four patients are not credible to allow generality of the findings. More patients are necessary to enhance external validity of the research.
Foot Care
Kandel, in conjunction with the American Association of Diabetes wrote the article, Take Care of Your Feet for a Life Time in 2000. The objective of the study was to establish the extent of reducing incidences of diabetic conditions through comprehensive education of the diabetic patients and the general population. Kandel (2000) argues that, “education of health care providers and patients regarding diabetic foot complications in various settings, using multiple methods is effective for improving foot care to patients with diabetes” (Kandel, 2000, p. 4). The study did carry out intensive education of health care professionals and the patients in various health care institutions for a period of one month. The researchers assessed improvement of patients by comparing the number of patients who seek medical services in different periods.
The discoveries revealed that there was tremendous decline in the number of diabetic patients who seek regular treatment of diabetic foot. Thus the research confirms that comprehensive education is imperative in prevention, treatment, and management of diabetic conditions in the population. The weakness of the study is that a month of education and assessment of diabetic patients is not enough to warrant extrapolation of the results because they may be due to confounding variables. Nevertheless, the strength of the research is that the rate of seeking medical services by the diabetic patients is a plausible parameter that can significantly demonstrate the impact of comprehensive education.
Implementation Plan
Implementation of the Proposed Solution
The research proposes to use a comprehensive education program to reduce the incidence of diabetes mellitus and diabetic foot in the Veteran population. Diabetes mellitus and diabetic foot are diseases that occur because of changing lifestyles in society. Corken (2009) argues that comprehensive education of the population is the effective way of reversing the alarming trends of diabetic conditions (Corken, 2009, p. 7). To meet its objectives, the research outlines plans of comprehensive education of both the patients and the general population in various Veterans Affairs health care organizations across the country for a period of six months to enhance external validity of the findings. Education of patients focuses on treatment and management of the diabetic conditions although education of the general Veteran population aims to create awareness critical in prevention, treatment, and management of the same through healthful lifestyles.
Resources for Implementation
Implementation of the comprehensive educational program requires resources such as educational materials, health care educators, health care institutions, subordinate personnel, attendance cards, questionnaires, patients’ database, record books, notebooks, and teaching materials among other stationeries. Because the research entails intensive and extensive education of the patients and Veteran population, it will require educational materials in form of pamphlets and brochures that patients can retain after attending and participating in the educational process. Health care educators are also necessary for he or she play a critical role in educating patients and the general Veteran population at their respective health care facilities. The subordinate personnel are members of the community that participate actively by encouraging participation of patients and the general community in the comprehensive educational program. Participation of the subordinate personnel is very important as Kandel (2000) asserts that, “education of patients regarding diabetic foot complications should be provided using a variety of techniques, incorporating both community and medical settings” (Kandel, 2000, p. 5). The other necessary materials are part of researchers’ tools that ensure collection of valid and reliable information in the field.
Methods for Monitoring Implementation
To monitor implementation of a comprehensive educational program, the health care educators will be recording the daily number of patients and the general Veteran population who participate in the educational process to ascertain the trend of attendance. Patients and the general Veteran population will have attendance cards, which indicate the number of days one has participated in the educational process and thus an important parameter of determining the extent of education. The health care educators will ask questions at the end of the educational process to ascertain whether the participants are understanding health tips essential in prevention, treatment, and management of diabetic conditions. Poljicanin, Pavlic-Renar, Metelko, and Coce (2005) recommend that frequent assessment of the participants enable the health care educators to customize their mode of teaching to suit the demands of the patients and the general population (Metelko, & Coce, 2005, p. 45). Participants, who have attendance of more than a week, will complete questionnaires that seek to establish the extent of practical application of health tips regarding prevention, treatment, and management of diabetic conditions at their respective homes.
Theory of Planned Change
The research employed Lewin’s theory of change in the design of the implementation plan. Basing on Lewin’s theory of change, comprehensive education program exists in balance of opposing forces between health care educators and the participants, patients, and the general population. While health care educators are the driving forces of change that ensure implementation of comprehensive education program, the participants are restraining forces that prevent implementation of the program. Therefore, for the planned change of comprehensive education to occur effectively, it requires competent health care educators to motivate participants, and the incorporation of subordinate personnel from the community to enhance their attendance. According to Kritsonis (2005), “some activities that can assist in the unfreezing step include: motivate participants by preparing them for change, build trust and recognition for the need to change, and actively participate in recognizing problems and brainstorming solutions within a group” (Kritsonis, 2005, p. 1). These activities are critical in enhancing the effectiveness of a comprehensive education program.
Feasibility of Implementation Plan
The implementation plan is feasible because the plan does not require many resources that may stall progress of the project in the event of resource insufficiency. The plan takes a period of six months, which is neither too short to compromise the discoveries nor too long to demand more resources. Because the health care institutions and educators are already available resources in the health care system, the only critical requirements are customized educational materials and research logistics, which depend on the performance of the researchers. Availability of the above requirements greatly enhances the feasibility of the implementation plan.
Evaluation Plan
Outcome Measure
Evaluation of Project Objective
To evaluate the impact of a comprehensive education program, the research will assess patients’ databases during the period of six months and compare with other previous records or current records in other health care institutions that do not have a comprehensive education program to ascertain if there are any significant changes. Because the objective of the research is to reduce incidence rates of diabetes mellitus in the Veteran population with the view of preventing diabetic foot and other complications associated with diabetes mellitus, diagnostic, and treatment records will provide essential information concerning the incidence rates of the diabetic conditions (Tobin, & Kennedy, 2009, p. 34). The trends of diagnosis and treatment of diabetic conditions in the health care institutions reflect the changes in lifestyles of the patients and the general Veteran population in response to a comprehensive education program.
Validity and Reliability
Outcome measure of assessing patients’ databases is valid and reliable because comprehensive education program have compounding effect in reducing the occurrence of the diabetic conditions in the Veteran population. Thus indirect assessment of patients’ databases in terms of rate of diagnosis and treatment of the diabetic conditions shows the impact of a comprehensive educational program. The research expects that increasing cases of diagnosis and treatment during the early period of the project will be due to increasing awareness of diabetic conditions. The extent to which patients respond to medical appointments and treatment measures shows compliance, which is an impact of a comprehensive education program (Ortegon, Redekop, & Nissen, 2004, p. 905). The research will expect that incidences of diabetes mellitus and diabetic foot will decrease due to healthful lifestyles, early diagnosis, treatment compliance, and enhanced management of the diabetic conditions.
Evaluation of Data Collection
Methods for Data Collection
To collect the discoveries of the research, questionnaires, and patients’ databases in various health care institutions provide necessary data for analysis. Weekly questionnaires in which both the patients and entire Veteran population fill will demonstrate the extent of compliance to the prevention, treatment, and management measures of the diabetic conditions. Patient’s databases are critical sources of data because they provide the trends of diagnosis and treatment of patients in selected health care institutions. As a control experiment, the study will rely on previous and current databases in health care institutions which comprehensive education programs were not covered or presented.
Resources for Evaluation
Questionnaires and patients’ databases are prime resources that provide a vast amount of data that require statistical tools to evaluate. Statistical Package for Social Sciences (SPSS) is the appropriate resource essential in the analysis of the data to establish if there is any significant reduction in the incidence rates of diabetes mellitus and diabetic foot. SPSS tool is accurate in correlation analysis of the data, hence helpful in determining whether there is strong or negative correlation between comprehensive education and incidences of diabetic conditions relative to control data.
Feasibility of the Evaluation Plan
Evaluation plan is feasible because questionnaires and patients’ databases provide enough information that warrants the use of the SPSS tool. Questionnaires and patients’ databases contain detailed information of the general population and diabetic patients respectively, thus their statistical analysis give credible results. Therefore, so long as the data in the questionnaires and patients’ databases are accurate, statistical analysis will present viable and valid results of the research.
Decision Making
Plans to Maintain and Extend Successful Project Solution
To maintain successfulness of the project according to its objectives, health care educators will ensure that participants of the comprehensive education program obtain some rewards for regular attendance and bringing more participants. The use of rewards will ensure that the attendance of education process increases with time thus keep the study running for a period of six months or even more if needed. Realization of the project’s objectives will lead to expansion and extension of the project to include all health care intuitions and become a yearly assessment of diabetes mellitus and diabetic foot incidence rates with the view of diminishing their incidences in the Veteran population. Provision of comprehensive education program concerning the diabetic conditions in all health care institutions is the prime extension of the project.
Plans to Revise and Terminate Unsuccessful Project Solution
The major challenge in this project is attracting greater number of participants in the comprehensive educational program to enhance external validity of the findings. If the research does meet sufficient number of participants, it will consider ways of reaching to greater number of patients and the general Veteran population. Measures such as extensive advertisement of the comprehensive educational program to attract general population and selective use of health care institutions that have relatively more diabetic patients will increase the number of participants. As a contingency measure, the researchers will produce educational materials and other requirements in small amounts to avoid unnecessary loss in the event that the comprehensive education program appears unviable. For the sake of the few patients and members of the population who will have participated in education program, the researchers will liaise with various health care institutions in ensuring that he or she continues receiving relevant education to improve their health status with respect to diabetic conditions. This ensures smooth termination of the project without adversely affecting the participants.
Provision for Contributions and Criticisms
Due to complexity of the diabetes mellitus and diabetic foot, the proposed solution of comprehensive education program targeting the patients and the general Veteran population have some weaknesses that need contributions and criticisms. Moreover, because proposed research is at the formative stages of implementation, the researchers will be seeking criticism and contribution from other researchers to refine various parameters of the proposed solution. The researchers will also consider seeking firsthand information from the health care professionals and experts concerning factors critical in enhancing validity and credibility of discoveries to warrant generalization of the findings.
References
American Heart Association. (2010). Diabetes Mellitus. American Heart Organization. Web.
Armstrong, D. et al. (2007). Skin Temperature Monitoring Reduces the Risk for Diabetic Foot Ulceration in High-Risk Patients. The American Journal of Medicine, 120, 1042-1046.
Corken, A. (2009). Prevention and Early Intervention for Diabetes Foot Problems: A Research Review. American Association of Diabetes Educators, 1-13.
Donald, T. (2009). Diabetic Foot Care. The Journal of E-Medicine and Health, 1-33
Kandel, S. (2000). Take Care of Your Feet for a Life Time. American Association of Diabetes, 1-13.
Kritsonis, A. (2005). Comparison of Change Theories. International Journal of Scholarly Academic Intellectual Diversity, 8(1), 1-7.
O’Bryan, T., & Caputo, G. (2008). Prevention and Management of Common Diabetic Foot Problems. Internal Medicine Board Review Manual, 10(2), 1-10.
Ortegon, M., Redekop, W., & Nissen, L. (2004). Cost-Effectiveness of Prevention and Treatment of Diabetic Foot: A Markov analysis. Diabetes Care, 27(4), 901-907.
Poljicanin, T., Pavlic-Renar, I., Metelko, Z., & Coce, F. (2005). Draft Program of Prevention of Diabetic Foot Development and Lower Extremity Amputation in Persons with Diabetes Mellitus. Diabetologia Croatica, 34(2), 43-49.
Rangnarson, T., & Apelquist, J. (2001). Prevention of Diabetes-Related Foot Ulcers and Amputations: A Cost-Utility Analysis Based On Markov Model Simulations. Diabetologia Croatica, 44, 2077-2087.
Tobin, C., & Kennedy, C. (2009). A Health Care Provider’s Guide to Preventing Diabetes Foot Problems. National Institute of Health and the Centers for Disease Control and Prevention, 1-50.