Apparently, an intervention strategy in any setting must be accompanied by an implementation plan for its effect to be felt. Implementations vary from one institution to another even though the intervention strategy may be similar. Thus the need to address the issue of implementation which incorporates various emerging practices and technology to achieve the success of the intervention plan.
Management and Leadership
Incorporating a new intervention plan like Obesity and Type 2 Diabetes-Weight loss with the Ketogenic Diet especially in children and young adults involve a number of changes that will affect the medical practitioners in a health facility (Abbasi, 2018). In such an intervention where a number of professionals in the medical team have to come together and no one is in-charge, a collaborative leadership strategy is the most appropriate to use to effectively implement the plan ( Cherry & Jacob, 2016 ). With the collaborative approach, the medical practitioners involved in implementing the intervention plan will easily buy-in to the plan and fully support its implementation which increases its chances of succeeding. The strategy also ensures turf issues that arise in related professions like nurses and doctors are eliminated. The team members behind implementing the intervention plan will have mutual trust for each other and they will work in unison without anyone feeling his or her profession is invaded.
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Since medical practitioners are usually adapted to a certain way of operation, any slight change or disruption of the norm can negatively affect their morale and enthusiasm. Therefore, in order to implement the Ketogenic diet as an intervention plan for patients with Obesity and Type 2 Diabetes, the management can use an environmental-adaptive strategy which ensures people adapt readily to new circumstances ( Cherry & Jacob, 2016 ). The strategy will ensure the medical team involved quickly adapts to the new plan and effect a transformative change that is required. The strategy is time-sensitive hence saves time thus reducing unnecessary operational costs. As opposed to power-coercive strategies that achieve a short time of adoption due to use of authority and fear, the environmental-adaptive strategy will achieve a short time of adoption although without using force but collaboration among the various professions involved in implementing the plan ( Cherry & Jacob, 2016 ). However, due to the expertise recorded in medical facilities, experts advise that a mix of different implementation strategies aims at covering the weaknesses of each other and ensuring more success of the intervention plan.
Delivery and Technology
A good delivery method for implementation of an intervention strategy is one that ensures a transformational intervention like Ketogenic diet for diabetes patients’ cascades across and down the organization in an acceptable way for the various stakeholders involved. One of the appropriate delivery methods to implement the intervention plan is the transtheoritical model (TTM) which uses information tailored to understand the integrative theory of therapy ( Garcia & Benavidez, 2016) . With TTM as an intervention delivery method, the medical practitioners will be able to assess if the target patients are ready to adopt Ketogenic diet which is healthier than the previous plans. In many instances, the delivery methods used to implement intervention in the nursing care are never stage-matched to ensure patient compliance. With the transtheoretical model, the intervention plan goes through stages of change, the process of change, levels of change, decisional balance, and self-efficacy which ensures it is fully implemented and acceptable by the target users. Apparently, information technology has not been previously used in the TTM-based delivery method ( Garcia & Benavidez, 2016) . However, current nursing interventions are trying to use information communication technology to combine TTM-based and stage-based delivery methods.
Most health records in nursing have been computerized. But new intervention strategies are handled on manual records which make follow-up process to be difficult. With an electronic medical record, the patients on the Ketogenic diet can be followed up to find out if they are maintaining the prescribed diet ( Rieger & Brooks, 2016 ). Also, their health records and tests can be recorded and easily retrieved for follow-up. Since the intervention plan requires interprofessional collaboration, information put in the electric record can easily be shared to different departments within a health facility so that they reach the appropriate professionals handling the intervention plan. The patients can be provided with electronic PowerPoint presentation outlining the different foods and precautions that they are supposed to take ( Rieger & Brooks, 2016 ). Also, a patient-based portal can be opened for the patient and designed in a way that the target users can be recording their diet on daily basis.
Stakeholders, Policy, and Regulations
An intervention is usually made to address something affecting different people at different levels. Such people are referred to as stakeholders. In the Ketogenic diet intervention, the primary stakeholders are the target population (patients with obesity and type-2 diabetes). The intervention plan is geared towards addressing their health challenges through diet to improve their management outcome. Therefore, they are the determinants of the success of the intervention. If they stick to the ketogenic diet provided in the plan, they will have an improved health outcome which is the main goal of the intervention plan ( Friedberg et al., 2014 ). Since the condition being addressed mostly affects children and young adults, the patient family are also stakeholders who should ensure the patient sticks to the prescribed diet and remind them in case they forget. The nurses who implement the plan are a major category of stakeholders. They introduce all the elements of the intervention to the target users in a correct and understandable way and ensure the patients follow them. They also keep records for future discussion or follow-up. A comprehensive success of each stakeholder contributes to the success of the intervention plan.
Other stakeholders may impact the implementation process through regulatory policies. The policies set in a health facility where the plan is to be implemented may have a negative or positive impact on the implementation process. A hospital where the management does not support innovations may be reluctant to invent the Ketogenic Diet for its type-2 diabetes and obese patients and stick to their conventional methods. The government under health regulatory bodies may impact implementation of a new plan (Abbasi, 2018). For instance, a regulatory official may state that ketogenic diet has components that are helpful to this category of patients. Thus hindering the implementation process. However, regulatory policies that motivate people to research and come up with better interventions for lifestyle chronic conditions will make the implementation process of the ketogenic diet easier for the innovators. For instance, a supportive government may provide funds to ensure all patients have access to ketogenic diet through incentives and free food supplements rich in ketones (Abbasi, 2018).
Nursing interventions are usually geared towards bettering the health outcome of the patients under long-term treatment. Therefore, they require policy considerations that support their effort and make it easier to implement the interventions plans. For instance, the policy of quality healthcare in an effort to achieve the vision of HealthyPeople2020 encourages medical practitioners and researchers to invest their time into research activities and come up with better management regimen for chronic illnesses ( Friedberg et al., 2014 ). A policy on graduate nurse leadership education ensures that nurses are in a position to link with other medical practitioners and ensure that they provide comprehensive medical care. An intervention plan like ketogenic diet requires insights from physicians, nutritionist, and nurses who can collaborate and ensure that they come up with the best choices that will improve patient management outcome (Abbasi, 2018).
However, there is need to improve the field of health in terms of training and scientific research. Therefore, policies that promote continuous education and evaluation of medical practitioners such as nurses are supposed to be put in place to handle emerging illnesses and complications developing as a result of lifestyle changes. Other policies should ensure integration of information technology in health education and training so that the field of health can take advantage of the advancement in technology especially scientific and information technology ( Friedberg et al., 2014 ). For the proper provision of healthcare, senior medical practitioners should cooperate with the young medics to ensure that innovations are shared across the medical team. Thus the implementation of an intervention strategy like ketogenic care will be supported by the whole medical team.
References
Abbasi, J. (2018). Interest in the Ketogenic Diet Grows for Weight Loss and Type 2
Diabetes. JAMA: Journal of the American Medical Association , 319(3), 215-217.
Cherry, B., & Jacob, S. R. (2016). Contemporary nursing: Issues, trends, & management . Elsevier Health Sciences.
Friedberg, M. W., Chen, P. G., Van Busum, K. R., Aunon, F., Pham, C., Caloyeras, J., ... & Crosson, F. J. (2014). Factors affecting physician professional satisfaction and their implications for patient care, health systems, and health policy. Rand health quarterly , 3 (4).
Garcia, R., & Benavidez, D. (2016). Transtheoretical Model Key Constructs Applied to the Intervention & Treatment of Weight Cycling & Yoyo Dieting Cognitive-Affective Bases of Health for Weight Management. Int J Complement Alt Med , 3 (3), 00071.
Rieger, R., & Brooks, P. D. (2016). U.S. Patent No. 9,519,728 . Washington, DC: U.S. Patent and Trademark Office.
