Capstone Project: Milestone 2: Design Proposal

Physical Fitness Training for Stroke Patients Stroke is a critical health condition that is a notable cause of chronic disability in adults. This is evident in the United States where it is a principal contributor to long-term disability; second major contributor to dementia, and the fourth dominant contributor to deaths in the country. From a global perspective, the impact of stroke is far-reaching despite the fact that the overall approximation of the effect varies widely and are not consistently reliable. According to statistics, the prevalence of stroke in the United States is approximately 3% of the American adult population, which makes up seven million individuals (Ovbiagele & Nguyen-Huynh, 2011). Concerning incidence, 800000 cases of first-time and recurring strokes occur annually in the United States, with the bulk of the cases being made up of first-time stroke (an estimated 600000 incidences). Of the stroke incidences estimated 3% are subarachnoid hemorrhage, 10% primary hemorrhages, and 87% ischemic infarctions (Ovbiagele & Nguyen-Huynh, 2011). It is noteworthy that stroke has an enormous impact on the patients’ life quality and daily living activities. As such, survivors of stroke cases undergo rehabilitation with the aim of restoring the quality of life and their ability to engage in daily living activities. After the restoration, a significant number of patients tend to walk independently. Nonetheless, there is also a significant number of patients who develop residual walking disabilities. As cited in Vloothuis and other (2014), following the rehabilitation only 7% can walk appropriately. Additionally, 28% of patient remain dependent in their daily living activities such as indoor mobility, toileting, and dressing (Vloothuis et al.,2014). With this problem, most of the patients who leave rehabilitation live at home permanently because of their inactivity. It is clear that there is need to reduce the burden associated with stroke for patients, caregivers, and the community capstonewriting.com by using any intervention that promotes functional outcome. PHYSICAL FITNESS TRAINING FOR STROKE PATIENTS 3 To solve the disease burden issue, there exists a broad body of knowledge that emphasis on the effectiveness of highly intensive exercise therapy in achieving a functional outcome in people with stroke (Vloothuis et al.,2014). In line with this, training that is mediated by nurses has been termed as a resource-efficient intervention. This will ensure that the patient and caregiver exercise perform the exercise together thus augmenting practice intensity without rocketing the healthcare cost. Additionally, in the physical fitness training, the caregivers are actively engaged as compared to standard rehabilitation services. From a system point of view, this solution for stroke patients will also reduce the inpatient length of stay, and improve the outcome in areas such as empowerment, self-management, and the quality of life for the caregiver and patients too (Vloothuis et al.,2014). Change Model Overview Theoretically, evidence-based practice is a foundational principle in the nursing practice; however, the challenge is rooted in putting it into practice. The ACE Star Model of Knowledge Transformation (ASM) is a model for comprehending the phases and attributes of knowledge used in various facets of evidence-based practice (EBP). It is essential to note that the ASM model is critical in changing practices (Stevens,2013). It aligns both traditional and new concepts of care improvement into a whole and puts forth a model which guides the organization of the processes and strategies of EBP. At its basic, this ACE Star Model is a simple, close depiction of the association between the phases of knowledge transformation, as new novel knowledge is appropriated in practice (Stevens, 2013). Furthermore, the process takes into account the typical processes and also promotes the unique elements of EBP. The model incorporates nursing’s previous scholarly work