Evidence-Based Practice Translation of Research in Evidence-Based Practice

Nursing involves men and women who are willing to help the patients with their skills like health maintenance, recovery of ill or injured people and the treatment. They develop a care plan for the patient sometimes in collaboration with the physicists or therapists. This paper discusses the current nursing practice in which I am involved and needs to be changed.

Identification of a Current Nursing Practice Requiring Change

Description of the Current Nursing Practice

Children of all age groups are facing a grave problem these days: obesity.

Childhood obesity is a major risk factor for future health problems, in addition to being a significant public health problem, given the evidence available in research literature. Literature properly documents the risk factors and multi-related factors associated with childhood obesity and overweight that threatens public health.

According to the Centers for Disease Control and Prevention (CDC), children above the 85th percentile body mass index (BMI) risk being overweight, defining it as above the sex-, BMI at or age-specific 95th percentile BMI cut points sourced from the CDC Growth Charts developed in 2000. Childhood overweight prevalence data for ages 6 to 19 years is provided by the National Center for Health Statistics (NCHS) Chartbook, Health, United States (2007), and based on various national studies conducted between 1960s and 2004. Data for race and ethnic subgroups are available from the 80s to 2004. Within each subgroup, prevalence in childhood overweight has increased steadily over the years since the 80s to 2004 (CDC, 2007).

Childhood overweight is even more common in younger children. (Nelson, Chiasson, & Ford, 2004) studies are increasingly documenting evidence of increased overweight prevalence in children aged two to three years. According to Patrick & Nicklas, 2005, overweight prevalence in children of 4 to 5 years rose from 5% to 10.4% since 1976 to 2000. Overweight children of 4 years have a 20% risk of overweight issues persisting into adulthood whereas that of teenagers stands at 80% (Thorpe et al., 2004). Overweight prevalence is greater in 4-year-olds than their younger counterparts. This indicates that overweight prevention efforts should begin early in childhood (Walker & Avis, 1999).

Obesity presents further risks to health problems. It has been demonstrated that childhood obesity prompts biomarket development for critical health conditions later in life. For instance, Hispanic children are predisposed to type 2 diabetes due to overweight or obesity and genetic susceptibility (Neufeld, et al., 1998). According to Poston et al. (2003), Mexican-American have an increased chance of developing serious atherogenic body fat distribution patterns and weight gain in upper parts of the body due to obesity. Obese children also risk developing joint problems, asthma, elevated cholesterol, anxiety and depression. Severe to moderate overweight can lead to psychosocial and physical effects like increased growth in puberty followed by stunted growth, obstructive apnea, early onset of puberty in females, hyperlipidemia, gall bladder disease, pancreatitis, polycystic ovary syndrome, hypertension and long-term cardiovascular damages (Barlow and the Expert Committee, 2007). According to Myers & Vargas (2000) in an epidemiologic Bogalusa Study that took 20 years, a major heart disease, atherosclerosis, has its roots in early childhood. Endurance performance and poorer development of the gross motors are also associated to childhood obesity (Graf et al., 2004).

According to Action for Healthy Kids (2004), absenteeism and decreased scholastic performance have also been associated to childhood obesity in various studies. Strauss (2000) relates overweight in children to mental-health-related conditions. According to Strauss, obese children with decreasing self-esteem experience loneliness, sadness, nervousness and have a higher likelihood of using substances like alcohol and cigarettes compared to their obese counterparts with increasing self-esteem.

Obesity considered as a chronic disease when the weight-gain reaches dangerously increased level, which becomes risky for the health. The raised body mass becomes dangerous for children and some schools are now looking into this matter with concern. They are sending notices to the parents to take care of their child's diet, and within the schools, the management is trying to take help of nurses so that their intervention might prove helpful in reducing child obesity. An effective strategy needs to be formulated to alleviate the effects of obesity in children and some steps have been taken for that purpose. The strategy involves contact with children and parents on their dietary and general health education, and increased activities for them (Clark, 2004, p. 29). It is well understood that strategy implementation of this problem needs intervention of the health professionals, such as school nurses....

In recent studies, four researches were probed to measure the reduction in child obesity due to nurse intervention, out of which only two show positive results in intervention groups as compared to control groups (Berkowitz & Borchard, 2009, p. 4).
Weight management interventions in adolescents were studied so that efficacy of the school nurses weight management could be investigated (Pbert et al., 2013, p. 182). Six high schools were taken as a sample, from where eighty-four obese adolescents were selected. They were in grade 9 to 11 and were asked to complete behavioral and psychological assessments. A two-month and two three-month follow ups were recorded and it was revealed that nurse intervention helped in controlling their weight. It improved their weight as the obese adolescents were able to control their cola intake and fast foods once in a week, which showed health betterments.

Another study was undertaken to observe the effects of providing education on weight management among children, adolescents and their parents along with reducing BMI index. The foundation of this project was Primary Care Healthy Choices Intervention Program for Overweight and Obese School-aged Children and their Parents (Jenike, 2013, p. 15). Remote methods were used to increase their knowledge about healthy nutrition and physical activity. A seven-week, one group pre-/post-test design was used for this purpose. The results showed that that project was informative for the children and their parents via remote methods such as telephone counseling. A decreased BMI percentile was observed along with increased information regarding physical activity and healthy diet benefits.

Why the Practice Needs Change

The current practice needs to be changed since dramatic increase in children weight becomes perilous for their health. Most of the reasons for child obesity include lack of exercise and less time spent on physical activities. Today, children are more into using laptops and video games rather than going out and playing in the open play grounds with their friends. Even if the children decide to hang out, they do that at one of their friend's place and arrange competitions on their video games. A small example of this lack of physical activity is proved by the study indicating that less than five percent of school children now go to school via cycling as compared to more than 80% around twenty years ago (Clark, 2004, p. 29).

School nurses or those that work in hospitals or other health units should be able perform their primary health care tasks, such as weight management in obese children in order to reduce weight after treatment of 3 months or more.

The various treatment stages of childhood obesity represent a progressive rise in the level of counseling, supervision and intervention. Nurses and other clinicians involved in the treatment interventions have reported several obstacles to obesity treatment in children. These barriers include: lack of clinician time, support services, available treatment skills and clinician knowledge. Reimbursement for obesity-related management services is typically poor. According to a study on a tertiary weight management program, obesity treatment only receives reimbursement at a rate of 11%. As a result, related programs are forced to seek significant financial support from external parties for long-term viability. The variation in reimbursement among various programs was reported to range from 0% to 100% (Story et al., 2002; Tershakovec et al., 1999). These clearly explain why there's a need for change in this nursing practice.

Nurses should be able to use their critical thinking skills for better diagnosis and devising of treatment plans. A weight management program could be devised by the nurses to see if the weight in obese children is controlled or not and how much change is observed, if any. It can then be compared to no nurse intervention so that a clear comparison can be made between nurse intervention for weight management and no intervention at all. Secondly, a three-month check would ensure the effect of a particular intervention strategy.

Part B: Identification of Key Stakeholders That Are Part of the Change

The key stakeholders that would be the part of change are nurses, doctors (physicians, therapists etc.), top management of the health care unit or hospital, school management, and parents and children.

Role of Each Stakeholder

Nurses

The role of nurses would be to give full care to the obese children with their expert thinking skills and knowledge of the field. The roles of nurses in childhood obesity include, but are not limited to the following:

Advocating for governments to increase physical activity in obese children

Engaging families in prevention efforts and activities geared towards managing childhood obesity.

Encouraging parenting styles that facilitate enhanced physical activity in obese children while minimizing sedentary behaviors

Encouraging parental…