CAPSTONE PROJECT PAPER – DRAFT 18
CapstoneProject Paper – Draft
CapstoneProject Paper – Draft
Reportfrom National Institute of Health (2008), indicates that at least 38%adults aged 18 years and above and nearly 12 % children aged 17 yearsand below are using some form of complementary and alternativemedicine. For instance in the United States most cancer patients arewidely using acupuncture as alternative medicine for relieving pain.The practice is most common among women with breast cancer. There isgenuine proof that cancer patient prefers acupuncture therapy toconventional medicine therapy because of the fewer side effects andthe fact that it increases the quality of life. Acupuncture practicesare being exercised in dealing with various medical conditions tomanage the chronic treatment effects and reduce the reoccurrence ofthe conditions.
Despitethe effectiveness of acupuncture in treating some chronic conditions,there are still barriers facing the use of acupuncture for patienthealth care. Most of the cases where the use of acupuncture has beeneffective goes unreported and up to date there are no laid down plansto integrate acupuncture with conventional medicine. While as patientprefer to discuss their health with the health provider there is noguarantee that they will be able to get unbiased, credibleinformation. This is mainly due to lack of knowledge on the part ofthe nurses and physicians.This study paper, therefore, focuses onthe implementation of acupuncture as a change intervention, theeffect it has on a different condition about the traditional medicineand Why patient opt for acupuncture as alternative medicine?Acupuncture is considered as safe medical procedure for pain reliefand other health conditions. It is the insertion of stainless steelneedles that are hair thin into the skin at specific body parts withan aim of manipulating the energy flow in the body. Studies onacupuncture have proven that it can be used to treat nausea, vomitingand pain. It does this by stimulating the nervous system thusreleasing chemicals that alter the pain perception and affects theinternal regulation system of the body. Therefore, restoring theproper flow of energy in the body and, as a result, the body naturalhealing abilities are stimulated. The problem with conventionalmedicine and the reasons why people seek alternative medicine arebecause (1) they are not contended with the convention treatment (2)find alternative medicine to be offering control and autonomy inmaking a decision about their health. (3) Lastly, the patient findsalternatives medicine to be more compatible with the beliefs,worldviews and values of the patient.
Theface of healthcare in the world is changing with the increased use ofalternative medicine in particular acupuncture being used. This isbased on the fact that alternative medicine -acupuncture has a lowfrequency of harmful side effects, increased demand by patient andefficacy. The reason I decided to study the effect of acupuncture ondifferent conditions is because there is sufficient evidence thatseems to support the value of this alternative medicine in treating avariety of ailments. All in all, the rationale that people have forthe use of alternative medicine is the drive towards self-carewhereby by seeking alternative medicine the patient feels that theyhave more say in making decisions about their health. Moreover, theefficacy of conventional medicine is raising a lot of questions, thiscombined with the side effects of convention medicine forces patientsto turn to alternative medicine (Xia, 2010). Another common reasonfor the increased use of alternative medicine is a failure ofconventional therapy. Most patients consider acupuncture asalternative medicine to be safer compared to conventional medicine.The motivating factor leading patients to seek alternative medicineis the fact that most have been led to believe that it is free fromside effects and is less toxic.
Theimplementation of acupuncture as alternative medicine comes withgreat benefits to the patient due to low cost associated. Moreover,when conducted by the physician, his or her experience increases asthey learn new treatment, techniques. Today there is increasedenthusiasm by the public for incorporation of both complementary andalternative therapies. The reason for this is because of the positiveoutcome associated with the two. Sadly skeptics are unconvinced as towhat trends and issues should be taught in nursing schools.
PICOTstatements are useful in this study paper because they offer a senseof direction especially in outlining the proposed intervention thatin this case is acupuncture. The population of study represented bythe P in PICOT is volunteers who are eligible. I stand forintervention that as mentioned is the acupuncture. C is for thecomparison that is the traditional medicine in this case that acts asthe control group the result should show that when a comparison ismade between the traditional medicine and acupuncture the latter ismore useful. O in PICOT represents the outcomes that arecharacterized by the qualitative and quantitative methods. The Tstands for timeframe whereby this study considers the importance ofthe time it takes for acupuncture to show finally results. The PICOT/outline is important because when implementing change the outlinehelp in communicating the success of the proposed change.
Asa therapeutic intervention, the most participant in this study haveadmitted using acupuncture in the past to treat pain relatedconditions and musculoskeletal. The study population mainly consistedof the patient who felt that convention medicine had left themdissatisfied. In additional, the patient felt that the problem sourcehad not been addressed while other patient did not like theirexperience with medical professionals. In this regard, the use ofacupuncture was perceived to be appropriate for treating the chronicconditions and offering the quality of life health issues. Thiscomparison explains the reason most patients opted for acupuncture inplace of convention medicine. The outcomes are acupuncture fulfillscertain health needs that are not met by conventional medicine.
Ina pilot study to record the changes that occur when acupuncture isused as a change intervention from the conventional medicine a groupof volunteer patient who were eligible was used. The study wasconducted by Jan T W Lim Erin T Wong Steven K H Aung.
Thepatient receiving conventional medicine were randomly selected withtheir consent they agreed not to use the convention medicine andfocus wholly on acupuncture medicine therapies. The control groupcontinued using the convention medicine therapy. The studyparticipant received treatment for at least four weeks, and resultswere recorded.
Theresults showed that the patient that received acupuncture treatmenthad 14% decline in symptoms while those receiving conventionalmedicine received only 22% decline. Further, follow-up showed areduction of 19% in acupuncture and 26% reduction in conventionalmedicine.
Thepatient tends to benefit more from the incorporation of acupuncturein their treatment. From the study, the participant toleratedacupuncture especially because there were minimal or no side effectswhen administering it.
Theaim of this literature review is to compare and contrast thedifferent author’s views on acupuncture. I will group the authorwith a similar conclusion highlight the gaps and exemplary studies.Additionally I will show how my study relates to the literature ingeneral and conclude by summarizing the message delivered by theliterature. Different researchers have investigated the role ofacupuncture in treating the patient and its effectiveness, forinstance, Pazzaglia (2015), investigated whether abdominalacupuncture could reduce pain showed that a correlation between painreception and acupuncture existed. This article is useful in thisstudy paper because it shows the healing effects the practice ofacupuncture has on the patient. Ka-Fai Chung Wing-Fai Yeung Chi-WaKwok Yee-Man Yu in their study “Risk factors associated withadverse events of acupuncture: a prospective study (2014)”questions the use of acupuncture in treatment according to themfurther exploration and research on acupuncture ought to be carriedout. In their findings, they found out that the risk of adverseevents was higher on a participant that received the traditionalacupuncture. The reason I decided to use these research is because itoffers insight into the negative effect of acupuncture.
Lee,Shaun Wen Huey Liong, Men Long Yuen, Kah Hay Krieger, John Nconducted a study with an objective of researching whetheracupuncture therapy can reduce the pain and reduce the adverse effectof chronic of chronic prostatitis and chronic pelvic pain syndrome.The finding of this study was that acupuncture causes a positiveimpact on immune function for patient with chronic prostatitis. Theauthors suggested further research on the field before application ofacupuncture as alternative medicine. I found this study to benecessary for my paper because it provided data because it offeredinformation on what I intended to research on my paper.Nursingtheory
Thenursing theory selected is the holistic nursing theory the rationalebehind selecting this theory is that it concentrates on healing thepatient wholly by connecting the mind the body, the spirit, emotions,context, social, relationship and the environment. According to thetheory, all these aspect combines to create an individual and to healsuch an individual a nurse must focus on all aspects, and they effecton patient health.
Howdoes this nursing theory support the implementation plan? Acupuncturethe intervention, mainly focuses on stimulating specific body parts,this is done by using needles to puncture holes to the skin so thatimbalances in the body energy can be corrected. The holistic nursingplay a huge role in implementing acupuncture, by using holisticnursing theory patient will be provided a healthcare treatment planthat is well rounded and aimed at improving physical, emotional,spiritual and psychological ailment compared to convention medicineacupuncture sounds more preferable (George, 2010). The outcomes areby using this theory to implement the use of acupuncture asalternative medicine the nurses or people administering it willbecome self-aware of their limiting motives, opinions, training andtreatment thus forcing them to connect with their spirituality, andmental health so that they can be able to care for the patientbetter.
Thechange theory selected is Lewin’s change theory this study paperwill show how the theory supports the implementation plan. Anoverview of the theory, Lewin`s change theory comprise of threedistinct and vital stages these are the unfreezing stage, the changestage, and the refreezing stage. In addition, the theory has threemajor concepts: driving forces, the restraining forces, and theequilibrium. The driving force is those forces that push towards aparticular direction for change to occur for instance the failure ofconventional medicine to treat some conditions forces the patient tolook for alternative treatment. The restraining forces are a lack ofscientific research on acupuncture as effective treatment for someconditions may hinder the change from occurring because they tend topush the patient towards opposite direction (Roussel, 2013). A stateof equilibrium occurs when the desire for change or driving force isequal to the restraining force. Depending on which force is greaterthe equilibrium can be lowered or raised.
Accordingto Lewin`s change theory, the unfreezing stage involves coming upwith a method that facilitate people to let go of old patterns thatare unsuccessful in some way it is at this stage that a recognitionfor a desire to change is made. For instance too much use of drugs totreat some organs poisons the liver and other body organs thus adesire to change to a more drug-free healing approach is what wouldlead people to seek acupuncture. Another cause for the need of changeis the desire for a treatment alternative that fights off harmfuldiseases at a fast pace. Acupuncture therapy heals diseases such asdepression, angina, vertigo, high blood pressure, bodily pains,obesity, and inflammation. The rising cost of treatment and shortageof workforce is another cause for the need to change. All in all, tomove through this stage requires inclusion and transparency processesthat are necessary.
Changeor moving to a new level is the stage where the population of thestudy is convinced in thoughts, behavior and feelings thatacupuncture is the better alternative compared to the former mode oftreatment. The present situation, processes, and new structure areanalyzed and put in place so as to attain the desired change. Inaccordance with this theory, this stage is costly and time-consumingbut all the same very productive when it comes to tangible results.The challenges encountered in this stage include ineffectivecommunication, having poorly developed an action plan andinappropriate leadership.
Therefreezing stages are the final stage in involved in establishingchange as the new process. Here acupuncture becomes the standardoperating procedure. The changes implemented are frozen this is meantto ensure that acupuncture is part of the normal working procedure.To attain this, supportive mechanisms such as rewards, policies,solid orientation and ongoing support for the new procedure areexercised. It is paramount to note that the nursing literature pointsout numerous complexities that come with transforming the plans intoaction. This is the reason this implementation plan as the changeagent has considered the significance of a well-structured approachto implementation.
Innursing practice, a planned change is necessary for various reasonsbut implementing change can be challenging. The change needed in thiscase is introducing acupuncture into alternative medicine. Whenimplementing acupuncture as the intervention medicine, we are movingfrom the conventional medicine to a more traditional method(acupuncture has been used by the Chinese healers for thousands ofyears thus the term traditional medicine) which means during themoving a lot of barriers will be encountered.
Therole of the stakeholders, a stakeholder in this implementation planis anybody who affects or is affected by the implementation ofacupuncture as alternative medicine. The stakeholder will provideresources, and offer insight into the probable cause of action. In animplementation plan, the role of the stakeholders is alwaysimportant. Importance means that priority will be given to satisfyingthe interest and needs of the stakeholders. The stakeholders willattribute towards the success of the project through the roles thatthey play. Influence and power of stakeholders affect theimplementation in that stakeholders have the ability to cause failureor success. To ensure that the stakeholder in these project conductthey duties appropriately a stakeholder management plan will be usedthis will show a list of key players and determine how eachstakeholder is engaged in the implementation plan.
Planningis one of the key benefits of stakeholder in this implementation planthey involvement in the planning process will reduce doubts of theproject outcomes (Lubkin & Larsen, 2013). Furthermore, it willincrease their commitment to the project process and objectives andheighten their credibility when it comes to project outcome.
Allthe stakeholders must have the necessary information about theproject. The following are the benefits of engaging the stakeholdersin this project: 1.) the stakeholders will help in putting more ideas2.) Strengthen our position about acupuncture as the change we needin the medical field 3.) Increase the project credibility and 4.)Include different views from all elements and sectors of thecommunity affected. 5.) The stakeholders will handle financing theproject thus we need their approval for the project.
Theintegration of acupuncture with other treatment options in thehospitals will have positive impacts. Studies conducted in the pasthave proven that acupuncture has a greater ability to reduce pain incancer patient plus treating several other conditions. The followingis a description of expected impact of acupuncture as an interventionon health organization.
Accordingto the studies discussed in this paper, most of the patient who tookpart in receiving acupuncture treatment showed signs of satisfactionand expressed relief from symptoms. In addition to this the patientby receiving acupuncture was empowered and developed a closerelationship with their practitioners. According to them, thepractitioners understood them better. Another positive outcome ishealth belief whereby there is the wide perception of Chinesemedicine being congruent with patient personal health beliefs. Thus,the expected outcome of a patient after acupuncture is integratedinto the organization is that there will be improved the relationbetween the patient and the health practitioners, patientempowerment, a relief from symptoms and personal health beliefs.Additionally, acupuncture will create a positive environment. Whenadministering acupuncture treatment to the patient, the patient tendsto report more reduction in pain. A positive environment, in thiscase, is an environment that is enhanced by encouraging andsupporting the patient. Most practitioners who exercise acupuncturetend to build good relation with the patient thus creating a positiveand conducive environment for the patient. On nursing care, we cansay that introduction of training on acupuncture will help improvethe nursing care offered to patients (Bauer, 2005). Also, theengagement of the interdisciplinary team is effective to offering thepatient effective health care. Through integrating acupuncturedifferent teams will be required to work together so that they canprovide the patients with the best healthcare possible.
Severalstudies have in the past have estimated the cost of implementingacupuncture as change intervention in the hospital to range from$10,000 to $30,000. These costs depend on several factors such as thetraining and purchase of equipment. Moreover, funds need to be setaside to create awareness to the patient about this treatment option.Doing the math, the estimated cost will be distributed betweenpurchasing the necessary equipment, training, promotions for creatingawareness, integration and implementation assistance.
TheReturn On Investment ROI
Whenmaking consideration such as implementing the change intervention, itis important to put into consideration the rate of return oninvestment. The reason being for the hospitals to invest in thisproject the stakeholders need to be sure that the project will beprofitable. ROI is the incremental economic gain from the changeintervention minus the cost divided by the investment cost. Whentalking about the return on investment we can say that the amountspends by the patient on health care is going to reduce since themethod will be more effective. While as ROI is mostly considered asbeing purely financial in health, in this case, I have decided tofocus more on quality benefits of the investment. Some of theexamples of nonfinancial benefits include reducing the patient safetyincidents, less intensive treatment and making an improvement onpatient experiences.
Thereturn on investment for the hospital will be experienced in term ofreduction in the cost of unnecessary procedures. Also the hospitalwill save regarding readmitting patients who did not get better andless cost regarding the number of days patient spend on a bed.Moreover, with the introduction of this alternative the cost ofwaiting will be reduced.
Trainingand education to all the stakeholders involved in the implementationof acupuncture are paramount because without education it would bechallenging for the physicians to obtain accurate information fromthe patient on the alternative modality. In this project, thephysician will assist the patient in coming up with informed choicesabout opting for acupuncture. Moreover, by getting training on how toadminister acupuncture the physician and the nurses will be able tobe sensitive to the needs of the patient. Patients with intractablemedical conditions for instance cancer, degenerative neurologicdiseases, and chronic pain who seek hope and relief from thealternative therapies will find acupuncture very helpful.
Impactof acupuncture on improving the quality of life
Theimpact of acupuncture after implementation is that it improves thequality of life by reducing pain for a patient suffering from chronicdiseases. This study report has proven that acupuncture not onlyreduces pain but also plays a tremendous role in treating someconditions such as cancer. Even though there are misconceptions thatacupuncture is opted for because it is cheap, this study paper hasproven that this statement is not valid. Most patients who seekacupuncture are people who opt for it because of failure ofconvenient medicine to treat them. Acupuncture has helped save thelives of many people and helped in improving their health too. Byimplementing acupuncture, a lot of lives will be saved and thequality of life for patient suffering from chronic conditionsimproved In (Micozzi, 2011).
Inimplementing this project, the following are the likely barriers thatwill be encountered being aware of this barrier will help in avoidingand overcoming them.
Lackof clarity this might occur if some or all the employees don’tcomprehend what the project goals, objectives, responsibility androles are. Moreover, the stakeholders may fail to see what gains theywill make especially if the goals, plans and objectives of theproject are not clear.
Inadequatelyresearched requirements whereby the patient requirement is not putinto consideration.
Inadequateresources this are the resources necessary to have so as to foreseethe completion of the project.
Lackof customer support, in this case, the customer is the patient duringthe implementation plan there ought to plan on how to address theyneed and make them loyal to the new project.
Biasesoccur when the customer is overpromised so much yet given so littlethis should be avoided at cost as it might lead to loss of customers.Other barriers include resistant to change especially coming fromelderly nurses and physicians this might delay the implementation ofthe plan.
Thepolitical barrier may also occur especially if the managers areunwilling to step in and help because of various reasons. Such asproject contradicting the company culture and when the project motiveis not clear.
Asan alternative medicine, acupuncture is not sound regulated asconventional medicine. This causes ethical concerns especially aboutthe people performing the treatment exercises using this method onwhether they have the right knowledge to perform treatment onpatients. Acupuncture is done by people without a medical license andpatient misinformation about alternative medicine makes it not onlyunethical but also dangerous. The fact that alternative medicine hasbeen considered to be in an ethnic free zone has led inaccurate andmisleading claims of supposed benefits of acupuncture as alternativemedicine. To save people lives, alternative treatment such asacupuncture needs to be subjected to scientific testing.
Evaluatingthe project success
Thiswill be done with an aim of finding out whether the project objectivedoes meet the goals and objective laid down, in other words, it ismeant to prove the value of the project. The aim of the project wasto identify an alternative medicine called acupuncture itseffectiveness in treating some conditions and importance ofimplementing it to the hospital. As a successful project, it isexpected that THE outcome this project will play a great role inimproving the quality of life.
Theapproach used in evaluating this project is determined by the natureof the project and the objectives. In this evaluation, I intend touse the qualitative method to evaluate by assessing the weaknessesand strengths of acupuncture as a change intervention the informationgathered will be open-ended. The projected outcome is acupuncture iseffective in treating some medical conditions and a betteralternative to a patient who have given up on conventional medicine.
Usingthis method will allow both the patients and health care providers todiscuss openly their opinion, thoughts, and feelings. Thus, aquestionnaire with open-ended questions will be used whereby thepatient, the physician, and nurses will be asked to fill in somepersonal information about what they think about the project.
Ifurther plan to conduct personal interviews with the participant soas to know what their opinions and feelings are. Other means ofgathering data include use of focus discussion, observation andcomments boards these methods are suited for in-depth studies.
Inthis project, the dissemination plan is intended to inform thecommunity about acupuncture as alternative medicine and the benefitsof using it
Thedissemination strategy is to focus on the needs to learn by a patientwhat they ought to know and the embedding process needed.
Thedissemination plan lays out how the project shares the outcome withthe organization and relevant stakeholders and how the project willcontribute to the overall dissemination strategy. In this regard, theplan will explain the significant of acupuncture to the stakeholdersso that to encourage them to embrace the project.
Thepurpose that this dissemination plan serves is raising awareness,educating the community, engaging them so that we can get feedbackfrom them and selling the output through promotion.
Themessage implementing acupuncture as alternative medicine especiallyfor a patient who feel that conventional medicine has failed to helpthem.
Theaudiences are the patient, the physicians, and the nurses.
Thedissemination method includes the use of newsletter, press releases,demonstrations, online discussion and through journal articles.
Evaluationof success will be through the use of a questionnaire.
Bauer,M. D. (2005). Thehealing power of acupressure and acupuncture: A complete guide totimeless traditions and modern practice.New York: Avery.
InMicozzi, M. S. (2011). Fundamentalsof complementary and alternative medicine.
Lubkin,I. M., & Larsen, P. D. (2013). Chronicillness: Impact and interventions.Burlington, Mass: Jones & Bartlett Learning.
Roussel,L. (2013). Managementand leadership for nurse administrators.Burlington, MA: Jones & Bartlett Learning.
Xia,Y. (2010). Acupuncturetherapy for neurological diseases: A neurobiological view = Zhen cizhi liao shen jing xi tong ji huan : shen jing sheng wu xue yan jiu.Heidelberg: Springer.