The essentials for the Doctor of Nursing Practice (DNP) dictate that DNP’s utilize “organizational and systems leadership for quality improvement and systems thinking” (AACN, 2006, pg. 10). Because of this essential, it is critical that DNP students engage with organizations in various settings in order to improve the quality of healthcare nurses deliver to their patients. This paper intends to outline a plan for implementing a protocol to utilize motivational interviewing (MI) to improve fruit and vegetable intake in older adults who are patients in a primary care setting. The methodology proposed for implementing such a protocol will be the utilization of an organizational development strategy known as action research. This paper aims to explore the problem of inadequate approaches to fruit and vegetable intake counseling to older adults by their advanced practice nurse (APN) providers, propose a potential protocol for addressing this problem, and finally to discuss the process of implementing this new protocol in a hypothetical nurse-led primary care clinic with a DNP student acting as the change agent.
Problem
Inadequate intake of fruits and vegetables in older adults (65 years and older) is a significant and serious issue in the United States. Adequate intake of fruits and vegetables has been directly linked with better management of chronic diseases such as diabetes mellitus, heart disease, obesity, and the prevention of certain types of cancers that are prevalent in older adults (Greene, et al., 2008; Herne, 1995; Bazzano, Serdula, & Liu, 2003; Block, Patterson, & Subar, 1992; Harding, et al., 2008; Rolls, Ello-Martin, & Tohill, 2004). Despite this knowledge, less than 30% of Americans aged 65 and older are thoug...
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...rning: Albany, NY.
United States Centers for Disease Control and Prevention. (2009). 5 a day surveillance data. Retrieved from http://apps.nccd.cdc.gov/5ADaySurveillance/displayV.asp?State=US &group=2&yr=2009
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The definition of motivational interviewing (MI) has evolved and been refined since the first publications on its use as a way to deal with behaviour change. The technical therapeutic definition of motivational interviewing is a collaborative, and goal oriented method of communication with giving specific observation to the language of change. It is intended to reinforce an individual’s motivation for and development towards a particular objective by evoking and investigating the individual's own arguments for change (Miller & Rollnick, 2012). Motivational interviewing was created to enable clients to prepare for changing addictive behaviours like drug and alcohol abuse (Miller & Rollnick, 1991, 2002) and has been viable to lessen other harmful behaviours including tobacco, drugs, alcohol, gambling, treatment
Zhang, Y. B., Harwood, J., Williams, A., Ylänne-McEwen, V., Wadleigh, P. M., & Thimm, C.
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As noted by Wolfe, Frongillo, & Valois, (2003) hardships such as functional impairments, chronic health problems and money are major causes of food insecurity among the elderly. The US Department of Agriculture 's Continuing Survey of Food provided data on dietary intakes and behaviors were obtained from the elderly. There data showed that that lower-income elderly consume significantly fewer calories than higher-income elderly, fewer servings of major Food Guide Pyramid food groups, and most nutrients. Additionally, 6% of elderly households report some degree of food insecurity. Interventions have been established to reduce rates of food insecurity among the elderly.
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The population in the United States as of 2009 was 307,006,550 the younger population is projected to slightly increase and eventually plateau though the older population has been steadily increasing and projected to continue on an upward trend (Vincent & Velkoff, 2010). The lack of a healthier diet is something that has been highlighted in the media for the past decade and more often than not we are seeing the effects of overindulging and the consumption of highl...
This paper will discuss what motivational interviewing is , who developed motivational interviewing and why it was developed. In addition, the most important aspects of motivational interviewing will be covered. Furthermore, the paper will discuss how I hope to use motivational interviewing in the future. At the conclusion of the paper the reader should have a better understanding of motivational interviewing.
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According to the U.S. Department of Agriculture, “despite the emphasis by nutritionists and other health professionals on the importance of fruit in a well-rounded healthy diet,” a survey taken during 1994-1996 revealed that “only 57.8 percent of people age 19 and younger ate fruits on a given day” (Fisher, 2004, p. 16).