[ANSWERED 2023] When you have chosen a topic and received approval from your capstone mentor, you can proceed to complete the capstone proposal template

When you have chosen a topic and received approval from your capstone mentor

Submit a proposal based on the Capstone proposal template.

When you have chosen a topic and received approval from your capstone mentor, you can proceed to complete the capstone proposal template. The template is designed to guide you through specific steps that will become the blueprint to follow for the rest of your project.

Project Title 
Write the name of your project.

Project Description 
This should be a half page to a page detailed description of what exactly your project is.

Project Rationale 
Two to three paragraphs stating the need for, and justification of, selecting this project. Who will benefit and how will they benefit from this project (not including yourself)? What is the significance of the project, and how will it advance nursing science?

Personal/Professional Expectations 
Two to three paragraphs on what you hope to gain from this project, both professionally and personally.

Project Goals 
Succinctly describe the long-and short-term goals of your project. This may include a research question or hypothesis, depending upon the major objectives of the project.

Analysis of the Literature

Your proposal should also include a brief review of the existing research on your topic and a discussion comparing this research to your project focus. How will your proposed research meet the gaps in existing nursing knowledge? The proposal should address how you plan to review the existing literature, what sources you plan to use. 

Procedure 
This is the major section of your proposal, and includes a step-by-step description of how you intend to carry out your project. It includes a discussion of how you intend to meet your goals, including resources you will need, where you intend to find them, and an estimated timeline of how long each step will take.

Evaluation 
Half a page to a page on how your project is to be evaluated. Is your healthcare organization/academic setting going to evaluate it? How? Community evaluation? What specifically will make your project a success, both to you and to others?

Expert Answer and Explanation

Project Title

The National Council of Aging (NCOA)’s EnhanceFitness Program’s Impact on Weight of Obese Adult Individuals with Diabetes

Project Description

My project is about improving the health and wellbeing of diabetic adult individuals with obesity. The problem is that diabetic patients in getting treatment at my healthcare facility are obese, yet obesity is one of the health issues diabetic patients should avoid. According to Okoniewski et al. (2019), people who are diabetic and have BMI of 30 and above risk getting readmitted because the conditions prevent them from regulating their blood sugar and puts them at risk of suffering other medical conditions.

This argument can be used to describe the alarming rates of diabetic patients being readmitted to my health facility. Currently, the nursing department is doing nothing to help these patients improve their wellbeing and health. This project proposes the introduction of the EnhanceFitness exercise program (NCOA) to help the target population improve their body weight and control their blood sugar and diabetes impacts in general.

Project Rationale

Currently, diabetic patients who are obese and receiving treatment in my healthcare facility are getting readmitted often. Whenever they appear for a checkup, their blood sugar is always up, meaning that their condition is not well controlled. However, there is nothing done to help these patients overcome their predicaments. This proposed quality improvement project aims to reduce the patients’ BMI to help them control their condition. Lean et al. (2018) report that obesity can impact how one’s body utilizes insulin to control their blood sugar.

Therefore, if the patients’ BMI is reduced, they will easily control their blood sugar, hence put their diabetes in check. Apart from accelerating diabetes symptoms obesity can also cause other health problems including sleep apnea, osteoarthritis, and digestion problem Lean et al. (2019), considering that the patients’ immune system is weakened by diabetes.

The individuals that will benefit from the program are diabetic patients who are obese. If the project is implemented, the individuals will be better positioned to control their blood sugar and avoid other health impacts of obesity. According to Batsis et al. (2020), obesity also increases the cost of health. Frequent readmissions can highly increase medication cost for patients who are already diabetic and are struggling with financial problems brought by the pre-existing condition.

The healthcare facility will also benefit in that its reputation will be improved due to low readmission rates. High readmission rates can drastically impact a health facility by making people lose trust in its competency to provide quality and safe care. The project will advance nursing in that new knowledge will be availed. The proposed solution was meant for older people. The project aims to find out if it can be used in adults.

Personal/Professional Expectations

Nurses should always aspire to gain experience in every clinical practice they engage in and undertake. As a nursing professional, I hope to improve my knowledge and skills in research and development. Research and development are among the significant skills of nurses. The research and development skills I gain from the project will help me in my future practice when my employers or community requires me to identify problems and develop solutions for them. I will also gain knowledge of new strategies to reduce or prevent obesity after finishing this project. One of the strategies will know how to apply is the one proposed here.

Personally, I will also gain a lot from the project. One of the things I will gain is communication, both verbal and non-verbal. For the project proposal to be accepted by the hospital management, I must use proficient communication skills to present my ideas and convince the organization leadership that this program is worth investing it. I will also have a skill in designing, preparing, and writing a project proposal which will help me personally and professionally. In terms of profession, I will use the skill to develop proposals to improve the quality of nursing practices.

Project Goals

Short-term goals 

1. To engage in EnhanceFitness exercise program at least three days a week.
2. To reduce 1 to 2 pounds of body weight per week.
3. Taking body weight and wait for measurement every week.

Long-Term Goals

1. The first objective is to reduce 25 pounds of body weight by six months.
2. The second objective is lowering participants’ BMI to 26 by Six months.
3. The third objective is reducing the participants’ dependence of medication to lower heart rate.

Analysis of the Literature

A literature review will be conducted to identify gaps in the topic. The following six-step plan will guide the review. The first step is defining the research question. The research question for this study has been designed in a PICOT format. The question is; in diabetic adults who are obese, what impact do 30 minutes practicing EnhanceFitness exercise program for at least three times a day compared to current behavior have in a weight loss of 25 pounds within six months?

The second step is planning the framework of the review. In the plan, the inclusion and exclusion criteria will be highlighted, and the databases that will be used to search for the sources will also be identified. The third step is conducting the literature search. The search will be done in two databases, and they include the Cumulative Index of Nursing and Allied Health Literature (CINAHL) and PubMed.

The fourth step is analyzing the searched material. The articles will be analyzed by briefly describing the articles, stating their purpose statement, describing their methodologies, results, and conclusion. In other words, the sources will be analyzed by looking at their major parts. The fifth step is managing the results of the research articles. Here, the results and findings will be analyzed to identify the gaps and need for future studies.

I will be able to support the need for my project through this approach. The last step is writing the review. After the other five steps have been completed successfully, the review will be written and included in the report. The sources that will be used in the project are empirical or primary studies. Some of the topics that will be looked at during review include obesity and its causes and its impact of physiology, psychology, and cost of care.

Obesity and Its Causes

Obesity is defined as a disorder where an individual has a lot of body fat instead of muscles (Fishleder et al., 2019). The authors note that obesity is not just a beauty issue; it is a medical problem that can increase one’s risk of other health issues, such as diabetes, heart conditions, and kidney diseases. A person with obesity is considered to have a BMI of 30 and above. Obesity can also be diagnosed by measuring an individual’s waist circumference.

A man with a waist circumference of 40 inches and above and a woman with a waist circumference of 38 inches and above are considered obese. Obesity is caused by unhealthy lifestyle behaviors, such as eating unhealthy food and living a sedentary life. Obesity can also be caused by genetic factors. Salemonsen et al. (2018) note that parents who are obese are more likely to conceive children who are obese. The authors also note that people with a low metabolic rate can easily become obese.

Impact of Obesity

Obesity has many health impacts on people. A study was done by Ueland et al. (2019) using 31 participants, found that obesity can highly impact people’s psychological health. The authors note in the study that most people who are obese often feel low self-esteem because of body image issues. Another study was done by Jung et al. (2017) using 874 obese individuals supports Ueland by reporting that obesity can impact mental health by body dissatisfaction and self-stigma on the desire to weigh less.

Another impact of obesity is physical. Özbey et al. (2019) studied and found that obesity can reduce the pulmonary function of people with asthma, hence increasing the symptoms of the disease. Another study done by Cooper et al. (2018) reported that obesity could impact the body in causing musculoskeletal pain and discomfort. Therefore, this project is significant in that the participants will avoid the impacts of the disease.

Procedure

The project is a quasi-experimental program. The experiment will be carried out by manipulating the independent variable (EnhanceFitness exercise program) without random assignment to impact participants’ weight. Data will be collected using document analysis, survey, and focused groups method. In observations, the project manager and other project team members will observe how they perform the program.

In some instances, the project team members will engage in a virtual training session with the participants to observe them and collect data on their performance. The project goals will be met by implementing the project following these seven steps. The first step is setting the objectives of the program. The objectives will be the guide for the experiment. Second, the process variables will be selected. The project variables include EnhanceFitness exercise program (independent) and weight of the participants (dependent).

Third, the sample population will be recruited and trained on how to perform the proposed fitness program. The sample will be selected using purposive sampling, where 60 diabetic obese patients (30 men and 30 female) will be included in the study. Fourth, the experiment will be executed. The fifth step is checking data to ensure they are consistent with the project assumptions.

The sixth step is analyzing collected data during the experiment to draw conclusions. Then, data will be interpreted and meaning made out of them. The last step is drawing conclusions based on results and presenting them to the stakeholders. The project’s conclusions will determine whether goals were met or not and whether the program should be launched on a large scale.

Various resources will be needed for implementation of the program. The first resource is financial support. Finance will be required to pay fitness coaches, buying data collection forms, and other equipment. The second resource is internet connectivity because the program will be done online due to covid-19 pandemic.

Other resources include human labor, including fitness coaches and technologist experts, to work on video links and other computer stuff, music, weights, facilities, and performance measure equipment. The program will partner with six gym facilities to provide enough scape for training. I intend to hold talks with the gym owners, management, and other stakeholders to get the program’s needed resources.

Timeline

Evaluation

The project will be evaluated using the outcome evaluation approach. This approach allows me to analyze the project and determine whether it has achieved the desired outcomes highlighted in both long and short-term goals. This evaluation will be done through a survey approach where participants will be asked questions. Pre-test and post-test method will also be used, especially to measure the weight and waist of participants.

The data gathered during the evaluation will be compared with comparative data. For credibility and objectivity, my healthcare organization will appoint two individuals to oversee the evaluation process. I will also be present during evaluation to ensure that the set protocol is followed as designed. The success of my project will be based on the following outcomes;

1. Shedding 25 pounds of body weight by six months.
2. Lowering participants’ BMI to 26 by Six months.
3. Reducing readmission of diabetic obese patients by 15% within six months.

Conclusion

My project will focus on reducing the weight of adults aged 19 and above by introducing them to EnhanceFitness exercise program. The project will take 32 weeks and will be evaluated using outcome evaluation based on the above outcomes.

References

Batsis, J. A., Zagaria, A. B., Brooks, E., Clark, M. M., Phelan, S., Lopez-Jimenez, F., … & Carpenter-Song, E. (2020). The use and meaning of the term obesity in rural older adults: a qualitative study. Journal of Applied Gerontology, 0733464820903253. https://doi.org/10.1177%2F0733464820903253

Cooper, L., Ells, L., Ryan, C., & Martin, D. (2018). Perceptions of adults with overweight/obesity and chronic musculoskeletal pain: an interpretative phenomenological analysis. Journal of Clinical Nursing, 27(5-6), e776-e786. https://doi.org/10.1111/jocn.14178

Fishleder, S., Petrescu-Prahova, M., Harris, J. R., Leroux, B., Bennett, K., Helfrich, C. D., … & Hannon, P. (2019). Predictors of Improvement in Physical Function in Older Adults in an Evidence-Based Physical Activity Program (EnhanceFitness). Journal of Geriatric Physical Therapy, 42(4), 230-242. doi:10.1519/JPT.0000000000000202.

Jung, F., Spahlholz, J., Hilbert, A., Riedel-Heller, S. G., & Luck-Sikorski, C. (2017). Impact of weight-related discrimination, body dissatisfaction and self-stigma on the desire to weigh less. Obesity Facts, 10(2), 139-151. https://doi.org/10.1159/000468154

Lean, M. E., Leslie, W. S., Barnes, A. C., Brosnahan, N., Thom, G., McCombie, L., … & Taylor, R. (2018). Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial. The Lancet, 391(10120), 541-551. https://doi.org/10.1016/S0140-6736(17)33102-1

Lean, M. E., Leslie, W. S., Barnes, A. C., Brosnahan, N., Thom, G., McCombie, L., … & Taylor, R. (2019). Durability of a primary care-led weight-management intervention for remission of type 2 diabetes: 2-year results of the DiRECT open-label, cluster-randomised trial. The l Lancet Diabetes & e Endocrinology, 7(5), 344-355. https://doi.org/10.1016/S2213-8587(19)30068-3

Okoniewski, W., Lu, K. D., & Forno, E. (2019). Weight loss for children and adults with obesity and asthma. A systematic review of randomized controlled trials. Annals of the American Thoracic Society, 16(5), 613-625. https://www.atsjournals.org/doi/full/10.1513/AnnalsATS.201810-651SR

Özbey, Ü., Uçar, A., & Çalış, A. G. (2019). The effects of obesity on pulmonary function in adults with asthma. Lung India: Official Organ of Indian Chest Society, 36(5), 404. doi: 10.4103/lungindia.lungindia_16_19

Salemonsen, E., Hansen, B. S., Førland, G., & Holm, A. L. (2018). Healthy life Centre participants’ perceptions of living with overweight or obesity and seeking help for a perceived “wrong” lifestyle-a qualitative interview study. BMC obesity, 5(1), 1-13. https://bmcobes.biomedcentral.com/articles/10.1186/s40608-018-0218-0

Ueland, V., Furnes, B., Dysvik, E., & Rørtveit, K. (2019). Living with obesity—existential experiences. International Journal of Qualitative Studies on Health and Well-Being, 14(1), 1651171. https://doi.org/10.1080/17482631.2019.1651171