TIFF assignment
Assignment KTA Part 1 – Alternate Intervention Paper
Introduction
You are going to construct an APA formatted paper for the assignment.
Provide an APA formatted title page.
Develop an introduction section that includes the professional nurses’ role in using evidence from the literature to address a practice problem.
Provide a review of the practice problem from the Unit 4 paper (include any suggested edits from the faculty).
Conduct a search of the literature for evidence-based interventions to address the problem from the Unit 4 paper.
Imagine the problem exists in your practice setting, then select one of the interventions you located that you believe would be the best fit for implementation in your practice; write a review of the literature for your selected intervention supported with a minimum of three (3) articles.
NOTE: the three (3) additional articles for the literature review cannot be articles that are referenced in the article you selected from the list in Unit 4.
Ideally the 3 additional articles will have a publication date within the last 5 to 10 years.
Do not do a summary of each intervention individually.
Develop a conclusion section for the paper that summarizes your thoughts about the significance of the using evidence from the literature to address practice problems.
Provide an APA formatted reference page and include citations for each source in the body of the assignment where appropriate.
The suggested length for this submission, excluding title and reference pages, is no less than 3 pages.
Estimated time to complete: 8 hours
Assignment Resources
Survive (and DOMINATE) Your First Literature Review (Smart Student, 2021)
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Identifying a Practice Problem in Nursing
Tiffany Williams
Herzing University
NU700
3/28/202
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Identifying a Practice Problem in Nursing
Nurses are directly responsible for identifying and addressing practice problems
impacting patient outcomes. As frontline healthcare professionals, they apply clinical expertise,
evidence-based practice, and patient-focused care to eliminate holes in healthcare provision.
Among such red-hot issues is ineffective self-management of diabetes in Cuban Americans,
driven by cultural, linguistic, and socioeconomic factors. Diabetes mellitus and type 2 diabetes,
in this case, disproportionately affect minority populations due to systemic inequalities in
healthcare access, education, and social determinants of health. Yedjou et al. (2024) show that
Hispanic/Latino populations, such as Cuban Americans, have higher rates of incidence for
diabetes complications compared to non-Hispanic whites. Contributing to this are minimal
exposure to culturally sensitive care, linguistic imbalances, and socio-economic constraints.
Practice Problem
Cuevas and Brown’s (2018) “Self-Management Decision Making of Cuban Americans
with Type 2 Diabetes” addresses Cuban American diabetes self-care predictors. The study is
based on qualitative design, in which data is gathered from Cuban American adults who have
type 2 diabetes and were interviewed. Outcomes identify several obstacles to effective self-
management that consist of cultural beliefs, language proficiency, and inadequate individualized
education.
Key Challenges Identified
One of the main challenges is cultural influences, as the typical Cuban diets that are
primarily carbohydrate-based necessarily contradict medical dietary recommendations. It is hard
Michelle English DNP FNP-BC
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This is fairly specific statements about this population, and would be more credible if cited with a source.
Michelle English DNP FNP-BC
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Your introduction is missing your paper’s thesis or purpose statement.
Michelle English DNP FNP-BC
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So I am still wondering what the specific practice problem is that you will addressing as we move forward. Is the problem lack of education on self management? Is the problem education was provided in a language other than their primary language? The problem has to be clearly identified in order to try to fix it. You cannot fix the symptoms, because the problem would then still occur because you did not address the root of the symptoms.
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for people to modify entrenched eating habits, and thus it is hard to adhere to diabetes treatment
plans.
Another barrier, linguistic variation, makes it more challenging to self-care as limited
English skills limit exposure to educational resources and communication with healthcare
providers. Without explicit and understandable directions, patients are destined to become
bewildered by the medication or dietary counseling instructions.
In addition, suspicion of the health system is another barrier since some Cuban
Americans distrust Western medicine. This distrust normally leads to excessive reliance on home
remedies or unnecessary delay in coming forward to professional medical services, which results
in more complications like neuropathy and retinopathy.
Literature Review
Research conducted among Haitian immigrants, African Americans, and Vietnamese
Americans shows that there are equivalent barriers to health diabetes self-management, focusing
on the importance of culturally competent nursing intervention. Magny-Normilus et al. (2023)
documented Haitian immigrant diabetes self-care and listed socioeconomic barriers, cultural
incongruence, and lack of confidence in health care. All Haitian immigrants lack economic
resources for the acquisition of medicine and materials and promote negative health outcomes.
Cultural beliefs about illness and treatment are likely to conflict with clinical guidelines and lead
to non-adherence. Past marginalization also causes deeply ingrained distrust of the health system,
and patients are not as likely to access medical treatment. Ajuwon and Insel (2022) discussed
diabetes care for African Americans and determined that poor health literacy, mental illness, and
structural disparities were the biggest barriers.
Michelle English DNP FNP-BC
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This is an incomplete paragraph.
Michelle English DNP FNP-BC
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I read about many contributing factors, but what is the problem in the practice in the article that you will be addressing as this project moves forward?
Michelle English DNP FNP-BC
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This is an incomplete paragraph. A complete paragraph is 3 sentences.
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African Americans who have not mastered the fundamentals of diabetes care experience
most of them and make incorrect drug doses or have dietary blunders. Secondary complications
resulting from mental illness in the form of depression and anxiety also interfere with self-care
practice, with persons suffering from such psychological disturbances showing lower levels of
adherence to follow prescribed treatment pathways. Structural disadvantage in terms of food
deserts and absence of diabetes specialists deepens inequality. Sheen et al. (2023) also explored
diabetes management among Vietnamese Americans, and in their discussion mentioned language
difficulties, family responsibilities, and dietary struggles. Lack of translated papers restricts
access for many Vietnamese-speaking individuals to even understand their treatment plans fully,
risking mismanagement. Informal translators become members of their family as well, but that
creates the potential for miscommunication and errors in the management of diabetes. In
addition, typical Vietnamese diets that are rich in rice and sodium are challenging to gain
glycemic control.
Synthesis of Evidence
The reviews of the studies overall present systemic diabetes self-management obstacles
within minority populations such as cultural mismatch, language and literacy problems, and
structural inequality. Cultural ideas about food and health and cultural practices frequently
conflict with medical guidance, making adherence more difficult. Low health literacy and
language issues hinder people from comprehensively grasping their diabetes care plans, which
may result in poor disease management. In addition, socioeconomic factors such as poverty,
underinsurance, and food insecurity contribute to differences in diabetes outcomes. These may
be addressed with nurse-led care through the implementation of bilingual diabetes education, i.e.,
so that patients acquire knowledge in their native language but culturally appropriate nutrition
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accommodations are accommodated. Also, the involvement of community health workers
(CHWs)—unreliable neighbors who can provide culturally sensitive education and support—is
likely to maximize adherence and involvement. Lastly, implementing care models that are
integrated to address not only medical needs but also mental health and social determinants of
health can facilitate more sustainable diabetes management improvement among Cuban
Americans.
Conclusion
The issue of poor diabetes self-care among Cuban Americans is representative of broader
healthcare disparities in minority populations. The study highlights the need for culturally
competent, language-translatable, and structurally sensitive interventions to improve diabetes
outcomes. Nurses must demand policy changes, including increased funding for community-
based diabetes education programs and more sophisticated training in culturally competent care.
Subsequent studies ought to focus on measuring the effectiveness of focused interventions
through the utilization of frameworks such as the Knowledge-to-Action (KTA) Framework to
ensure long-term health equity and enhanced diabetes care.
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References
Cuevas, H. E., & Brown, S. A. (2018). Self-management decision making of Cuban Americans
with type 2 diabetes. Journal of Transcultural Nursing, 29(3), 222-228.
https://cuevaslab.com/wp-content/uploads/2021/01/1043659617696977
DeForest, N., & Majithia, A. R. (2022). Genetics of type 2 diabetes: implications from large-
scale studies. Current diabetes reports, 22(5), 227-235.
https://link.springer.com/content/pdf/10.1007/s11892-022-01462-3
Magny-Normilus, C., Whittemore, R., Nunez-Smith, M., Lee, C. S., Schnipper, J., Wexler, D., …
& Grey, M. (2023). Self-Management and Glycemic Targets in Adult Haitian Immigrants
With Type 2 Diabetes: Research Protocol. Nursing research, 72(3), 211-217.
https://journals.lww.com/nursingresearchonline/_layouts/15/oaks.journals/downloadpdf.a
spx?an=00006199-202305000-00007
Nguyen, A. T., Jones, E. J., O’Neal, K. S., Netter, M. K., & Dwyer, K. A. (2022). An academic-
community engagement: a roadmap for developing a culturally relevant diabetes self-
management program among Vietnamese Americans. Collaborations: A Journal of
Community-Based Research and Practice, 5(1).
https://collaborations.miami.edu/articles/10.33596/coll.104?_rsc=er9ci
Yedjou, C. G., Sims, J. N., Njiki, S., Chitoh, A. M., Joseph, M., Cherkos, A. S., & Tchounwou, P.
B. (2024). Health and Racial Disparities in Diabetes Mellitus Prevalence, Management,
Policies, and Outcomes in the United States. Journal of community medicine & public
health, 8(3), 460. https://pmc.ncbi.nlm.nih.gov/articles/PMC11654833/
https://cuevaslab.com/wp-content/uploads/2021/01/1043659617696977
https://link.springer.com/content/pdf/10.1007/s11892-022-01462-3
https://journals.lww.com/nursingresearchonline/_layouts/15/oaks.journals/downloadpdf.aspx?an=00006199-202305000-00007
https://journals.lww.com/nursingresearchonline/_layouts/15/oaks.journals/downloadpdf.aspx?an=00006199-202305000-00007
https://collaborations.miami.edu/articles/10.33596/coll.104?_rsc=er9ci
https://pmc.ncbi.nlm.nih.gov/articles/PMC11654833/
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