4-One potential barrier to the success of my projet will be being able to keep children and their parents and caregivers is keeping them engaged long enough to see positive changes. Weight loss and management is a process and keeping with it can be trying. One way to combat this would be to check in periodically to provide encouragement and assess progress. A lack of trust in the process or not fully understanding the EBP can hinder healthcare professionals from continuing to adhere to the practice (Spallek et al., 2010). 


Spallek, H., Song, M., Polk, D. E., Bekhuis, T., Frantsve-Hawley, J., & Aravamudhan, K. (2010). Barriers to implementing evidence-based clinical guidelines: A survey of early adopters. J Evid Based Dent Pract., 195-206



5-Two potential barriers that might prevent the EBP change proposal from continuing to obtain the same required results are patients’ culture. Many times, nurses take for granted the patients culture and beliefs.  For example, in the Hispanic culture, men are considered weak if they asked for assistance; this can increase patient falls rates.  An additional barrier will be an Asian postpartum woman, who believes she needs to stay in bed rest for the first 40 days, making her a higher risk for falls, due to muscle weakness as well as prone to blood clots.
Another factor that will impact the  EBP change proposal is the staff knowledge toward fall and safety precautions. Safety education has a substantial impact on patients’ and staff safety.  Strategies to overcome these barriers would be patient and staff education and identifying patient culture barriers.





6-To continue to impact outcomes over time in ensuring practice change is making sure nursing educators or clinicians should inform the families of the right time and ways to take the drugs, and how to monitor the blood sugar. The family members or patients themselves should be taught how to make detailed record every time after testing blood sugar. For patients that are on long term medications , they should be taught and encouraged to take insulin subcutaneous injections on time, to avoid elevated blood glucose and problems such as ketoacidosis due to belated drug use. Secondly , dietary education is considered for specific and individualized regimen for each patient . The patients with their families are informed of the importance of eating right in the whole process of treatment which will be achieved by following advice of nutritionists and cultivating a good dietetic habit. The concerns or barriers such as not taking drugs timely, healthy diets, keeping exercises, testing and recording the level of blood glucose are barriers that may prevent EBP change proposal. Periodic telephone follow-up should be made during 3 months after discharge from the hospital to explore the effects of family rehabilitation on patients especially children that are impacted by the disease.


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