AN EDUCATIONAL TRAINING PROGRAM FOR NURSES REGARDING THE IMPORTANC.docx

AN EDUCATIONAL TRAINING PROGRAM FOR NURSES
REGARDING THE IMPORTANCE OF A HEALTHY DIET
FOR PATIENTS WITH OBESITY
By
Student name
A Project
Submitted to the Faculty of D’Youville
Division of Academic Affairs
In partial fulfillment of the requirements for the degree of
Master of Science in
Family Nurse Practitioner
Buffalo, NY
[Month Day, Year]
Copyright © 2022 by student name. All rights reserved. No part
of this project may be copied or reproduced in any form or by
any means without the written permission of the student name.
29
PROJECT APPROVAL
Project Committee Chairperson
Name:
__
____________________________________________________
Signature:
___________________________________________________
Discipline:
___________________________________________________

Project Defended
On
[Month Day, Year]
Abstract
Acknowledgment

Table of Contents
Chapter
I. PROJECT INTRODUCTION
..................................................................... 8
Statement of Purpose
................................................................................... 9
Theoretical Framework
............................................................................... 9
Initial Review of the Literature
...................................................................13
Significance and Justification
.....................................................................19
Project Objectives
.......................................................................................19
Definition of Terms
...................................................................................
Project Limitations
....................................................................................
Project Development Plan
.........................................................................
Plan for Protection of Human Subjects
.....................................................
Plan for Project
Evaluation........................................................................
Summary
...............................................................................................
....
II. REVIEW OF LITERATURE
....................................................................
Summary
...............................................................................................

....
III. PROJECT DEVELOPMENT PLAN.
.......................................................
Project Setting and
Population..............................................................
Content Expert Participants
....................................................................... Data
Collection Methods
...........................................................................
Project Tools
.............................................................................................
The Protection of Human Subjects
...............................................................
Summary
...............................................................................................
....
IV. PROJECT EVALUATION, IMPLICATIONS, AND
FUTURE RECOMMENDATIONS
………………………………………….....
Project Evaluation
.....................................................................................
Implications for Future Practice
................................................................
Future Recommendations
..........................................................................
Summary
...............................................................................................
....
References
...............................................................................................
.. 21
Appendices
...............................................................................................
.

List of Appendices
Appendix
A D’Youville Patricia H. Garman School of Nursing Full
Approval Letter
…………………….…. 60
B Letter of Intent
...............................................................................................
.. 62
C Evaluation
Tool........................................................................................
....... 64
D Educational training
program..................................................................................
.......................... 66
E Survey tool results in
graph……………………………………………….
Chapter I
The age of fast food and instant gratification brought about by
the growth of technology has affected the general population in
many ways. In America, obesity is becoming problematic, with
a prevalence estimate of 41% leading to risk in the severity of
diseases (Kalligeros
et al., 2020). As a result, there is a need for nursing
practice to take accountability in developing a relationship with
collaborative patient care. Obesity can be a lifestyle disease.

Therefore, all stakeholder participation must be considered a
need to look at the four-metaparadigm perspectives in
caregiving using a foundational basis in a theoretical
framework. First, a nurse needs expertise in addressing health
issues, especially those reversible through natural means, for
example, obesity. Obesity is reversible through natural means,
including dietary modification and practicing fasting.
The factors that make a successful program include proper
planning. Proper planning allows for allocating adequate time
and resources toward the project, resulting in the successful
implementation of the program (Shi, 2017). Another factor is
incorporating experienced project managers with knowledge
about the program. For example, specialists such as nutritionists
and experts in physical activity and breastfeeding are essential
when developing a program to improve nutrition in children and
adults and minimize obesity. Finally, it is essential to practice
monitoring and control for a program to succeed. Regular
evaluation of the progress and the program results allows for
modification and alignment in case of an error or a potential
error—effective communication results in a program's success.
The programs in the articles are good ways to effect cultural
change. Education plays a significant role in making people
adopt healthy habits. Education is well achievable after
evaluating the clients through wellness programs and other
community programs that involve health checkups and
screening. However, personal barriers such as individual change
resistance may negatively impact the success of the social
change (Allan, 2020). Some people are susceptible to changes
they perceive as threats to their social environment, including
the workplace. Individuals may develop resistance to change
when they feel uncertain about the intervention when the change
comes as a surprise without the time to prepare mentally, and
the questions about the competency of the intervention
concerning the new environment—the resistance results in
difficulty in implementing the intervention to achieve social

change. This study will assess interpersonal relations in nursing
theory to draw mechanisms for developing effective strategies
for an educational plan for nurses taking care of patients with
obesity in an outpatient department. The program will major on
how nurses can effectively pass educative information to the
clients on dietary intervention as a critical mechanism for
reversing obesity. The idea considers all the possible challenges
that nurse educators may experience while trying to enhance
social change among patients.
Statement of Purpose
The purpose of this project is to develop an educational training
program for nurses in an outpatient setting to provide education
regarding the importance of a healthy diet for patients with
obesity.
Theoretical Framework
Hildegard Peplau's (2004)
Interpersonal Relations in Nursing Theory is the
theoretical framework for developing this project. A brief
overview of the theory is presented, and a discussion regarding
how the theory was utilized to guide the project's development.
In addition, Peplau’s (2004) theoretical definitions for nursing’s
four metaparadigm concepts and the Project Author's
operational definitions will be presented. These metaparadigm
concepts include orientation, identification, exploitation, and
resolution defined within nurse, health, patient, and
environments aspects of nursing healthcare provision. As such,
the theory emphasizes the importance of crosscutting issues and
their effect on nursing care and patient wellness, such as
nursing education on dietary interventions for patients with
obesity, as in this study.
It thus facilitates better planning to understand the
complexities of issues underlying the patient's conditions,
which would hinder getting well. Therefore, this project aims to

bring to attention the definition of the metaparadigm concept of
patient care within this theory by looking at its significance and
interpersonal relationship as contextualization in patient care as
a tool for promoting patient education on a healthy diet. In this
essence, the project will look at its application as employed in
modern nursing care—concerning how the patient-nurse
relationship influences the efficiency of healthcare delivery
through patient education and implementation of the
interventions, i.e., education on a healthy diet for patients with
obesity. Finally, the deliberate look of this theory within this
aspect will facilitate a conclusion on the modern-day emphasis
and necessitated patient-centered model of care. Significance of
Interpersonal Relations Theory
As a mother of nursing psychiatry, Peplau (2004) describes
interpersonal relations as a conditional aspect that includes first
the interaction of the nurse and patient. She points out that this
is attained when understanding each patient's condition is an
experience that allows for improving nursing care (Peplau,
2004). Therefore, the focus in the definition of the theory
begins with grasping the nurse and patient metaparadigm
concepts as the interaction between patient and nurse makes the
relationship personal. Similarly, considerable insights thus
point out that the patient care process is personalized in a way
that responsibility is both technical and emotional. Peplau
(2004) explains that effective patient outcome delivery comes
from trust in diagnostics and, thus, acceptance of health as an
essential metaparadigm aspect.
The nurse-patient interaction and the collaboration mechanisms
between them to attain health are the main topics of Hildegard
Peplau's middle-range theory of interpersonal relations. The
nurse and patient can achieve the healthcare objective together
by completing a series of distinct stages in a precise sequence.
The patient can continue with that path even after the
partnership ends. This hypothesis is crucial since it explains
how the nurse-patient interaction might improve the patient's

comprehension of the value of the treatment they are receiving.
Once the patient is well-informed about their treatment, they
can carry on implementing the interventions to attain wellness
without the nurse's ongoing assistance (Peplau, 2004). This
theory is a perfect fit for the proposed educational training
program for nurses in an outpatient setting to provide education
regarding the importance of a healthy diet for patients with
obesity. The relationship between the outpatient and the nurse
must be founded on trust so that information can be shared
comfortably and with trusted support from nurses (Peplau,
2004). A support system must be developed because obesity and
the issues surrounding obesity can often bleed into self-esteem
and mental health. This theorist ideology will assist in
identifying and orienting nurses to the causes of obesity,
introducing a perfectly balanced diet with regular exercise, and
finally producing solutions for diabetic prevention, a foundation
that this theoretical framework supports.
Hildegard Peplau's theory is significant and relevant to this
project because it supports the notion that nursing encompasses
beyond simply administering medications and tending to
wounds. Patients can preserve their health to the highest
possible standard by being informed about their therapy's
reasons and composition. In addition, Peplau's theory provides
information on how the nurse can relate to the patient in a way
that promotes comfort and the sense of patient control of their
treatment. Also, it makes the patient feel like the treatment can
be carried out independently after being discharged from the
nurse's care (Peplau, 2004).Interpersonal Relations Nursing
Theory and Nursing Metaparadigm
Thus, nursing can be defined based on culture and concrete
work (Peplau, 2004). Thus, it promotes health through
appropriate methods and illness prevention by recognizing
triggers for all patients. Therefore, the nurse can only facilitate
treatment and not make a diagnosis; hence, the critical aspect is
ensuring that the environment is conducive and that

communication in the relationship with patients is constant.
This means the nurse favors patients' understanding of their
issues by explaining the problem and the treatment plan. This
includes a preventive measure to ensure informed decision-
making is enhanced and, thus, a partnership that, in essence, is
therapeutic.
Communicative action in the digital age between nurse and
patient is bold navigation of interpersonal relationships. On the
other hand, the increase in maintenance tendency takes a newer
approach, as information overload can be present due to media.
This could be advantageous for outpatient care, but the opposite
is true. As such, following Peplau’s underpinning of patient
care, nursing is the implementation of need-based healthcare
delivery through the respectable promotion of perception and
prevention of escalation of illness (Peplau, 2004). Therefore, it
can be said that the operational definition of nursing is ensuring
that patient needs are met adequately and suitably hence unique
to the patient. With that, a different relationship develops
between nurse and patient.
In recognition, a person is operationally defined as an entity
with individual preconceptions and a mutual understanding of
the nature of a medical issue and collaborates towards a
productive solution. Therefore, this contextualizes the
environment as conditions that allow for human processes that
facilitate tendencies supportive of positive development to
attain health (Peplau, 2004, p. 12). By this definition, health
can operationally be defined as a symbolic future positive goal
that is attained after effective healthcare hence instrumental for
the person moving in the forward direction of well-being
(Peplau, 2004, p. 13).
Operations Definition of Nursing Metaparadigm under
Interpersonal Relations Nursing Theory
For this project, the operational definition of the nurse is a
supporter who ensures that patient needs are unique and met
adequately and suitably to their circumstance. This recognizes
that a different relationship develops between nurse and patient

from one. In the same stance, a person is operationally defined
as an entity with individual preconceptions and a mutual
understanding of the nature of a medical issue. Within this
understanding, they can collaborate with informed decision-
making toward a productive solution. It thus supports the
operational definition of the environment as contextualized
conditions that allow for human processes that facilitate
tendencies supportive of positive development to attain health
(Peplau, 2004, p. 12). By this definition, there is support for
operationally defined health as a symbolic future positive goal
attained after effective healthcare, which is instrumental for the
person moving in the forward direction of well-being (Peplau,
2004, p. 13).Initial Review of the Literature
The literature review will be conducted to explore studies
associated with nursing education for obesity and healthy diet.
Using the following words singularly and in multiple
combinations: nursing training, obesity, outpatient care, nursing
psychiatry, overweight, diet, obesity facts, obesity prevention,
body weight, and care management planning. Databases
searched, limited to the years 2017 and 2022, will include
AMED, Alt Health Watch, CINAHL Plus with Full Text,
EBSCO, Medical Journal sites for nursing care, nursing
training, PubMed, Scopus, Science Direct, Directory of Open
Access Journals, Google Scholar, JSTOR and the D'Youville
library to loan articles through interlibrary loan. The search is
limited to 2017 to 2022 to ensure that current evidence-based
literature is reviewed and summarized for this project. A
summary of the review of literature is presented.
Dynamics of Outpatient Care
According to Balani
et al. (2019), the epidemic of obesity is a significant
health crisis that continues to increase globally. It is reported
that in the United States, more than two-thirds of adults are
considered either overweight or obese. Therefore, a lifestyle

disease is critical to the discussion on nursing care for
outpatient obesity. As such, care focuses on management and
fostering better and healthy weight maintenance (Kalligeros
et al., 2020). Thus, it does not necessarily focus on age
but understands that eagerness is also a risk factor for
comorbidities associated with being overweight.
Furthermore, Kalligeros
et al. (2020) study point out that the exploration of the
association between obesity and chronic diseases is something
that should be understood. This is because there is a direct
relation between the severity of the outcomes seen in intensive
care units and admission rates. For example, research that
analyzes a retrospective cohort with 103 patients found that of
the patients admitted to the hospital history of heart disease is a
direct result of obesity. Therefore, a recommendation is that
vigilance should be given to treating patients with obesity
starting from the outpatient setting, alluding to necessitated
prevention of escalation when faced with other conditions
(Kalligeros
et al., 2020).
Role of Nursing
The role of nursing is to provide integrated care and enhance
patient comfort by providing interventions to alleviate
symptoms of obesity. Findings from Rezaei
et al. (2022) study point out that high morbidity rates
are caused by poor health maintenance, which aligns with the
results in Smith
et al.’s (2020) and Sutaria
et al. (2020) studies. Furthermore, Gadde
et al. (2018) study findings indicate a significant
reduction in morbidity and mortality rates among patients in
weight maintenance trials. The high number of obesity cases
creates a risk factor in the population; this points to the need to
emphasize training for this. Recognizing physician efforts in

collaboration with outpatients by sensitization on environmental
awareness is essential (Walia
et al., 2022). This includes considering that proper
evaluation starts by recognizing the appropriateness of the
environment for supporting weight management. Achieving and
maintaining weight loss or gain requires physician-patient
collaboration in a way that can be facilitated by nurses
providing pertinent information. Again, support and motivation
are also determined by letting a carefully defined plan be
identified with the patient to understand the expected health
outcomes. This is the nurse's work as it allows for the
recognition of a strategy of control for each patient (Stonerock
& Blumenthal, 2017:p.1457).
According to Rezaei
et al. (2022), the combination of aspects such as the
cost of health, care expenditures, and hospitalization risks are
some of the reasons that can be used in motivating outpatients
to adhere to their plan of losing weight. This study aligns with
the findings of Piché
et al. (2020) study findings. The findings indicate that
advanced heart diseases are often caused by obesity and lack of
maintenance, and the determinant of failure lies in the early
handling of the issue. Therefore, health literacy is an integral
part of the nursing fraternity to impart to the patients as it
allows for the opportunity to understand the implication of
obesity in the long run. Consequently, the narrative is
applicable because by the time medication is involved. The
progression will be higher risk associated and thus significant
mortality risk. However, creating a provider-patient relationship
with a healthy diet, diabetes, and obesity teaching without
having a judgmental response, whereby both parties agree on
goals and share a vision of improvement in general metabolic
health status, is beneficial. The patient and provider can create
a personalized and participatory lifestyle change plan as
described by Foley

et al. (2019) study. Furthermore, Alexander
et al. (2021) study findings indicate that health literacy
as part of outpatient training will provide the necessary support
for proper weight loss and maintain it while allowing room for
recognition of mental health too. This caters to the grasping of
the incorporation of strategies that align outcomes centered on
the totality of patient care within the six sigma of quality
improvement in healthcare delivery.
Alexander
et al. (2021) research focuses on promoting healthcare
delivery as a focal point in preventive care and is supported by
Levine
et al. (2019), which look at a similar issue but with a
different approach. Levine
et al. (2019) surveyed to find out why the use of
preventive healthcare is still low in the modern healthcare
system. The findings from the survey linked modernization and
the advancement in technology as one the contributors to the
limited use of preventive medicine. Nevertheless, Harris
et al. (2017) point out how using preventive healthcare
would enhance the efficiency of care and result in better
outcomes. Therefore, Alexander
et al. (2021), Levine
et al. (2019), and Harris
et al. (2017) studies collectively look at transitioning
patients from outpatient to inpatient and provide insight into
what to avoid and what is necessary to promote better care.
From the start, the studies allow room for relativity in practices
that promote and optimize safety, and within those points to the
relevance of individual patient circumstances. While the paper
gives valuable information on the standard procedure, it
contributes to the general discussion on the improvement of
health by nurses. It thus applies that, for all patients,
recognition of the value in situation background assessment
facilitates the improvement of health outcomes. The

improvement starts with a reduction in risks hence
understanding beneficial outcomes accurately first (Alexander
et al., 2021).
Recognition of Potential Barriers
There is also a need to recognize the impact of cultural
competency in nursing care (Chae & Park, 2019). With
outpatients, there is a risk of exposure to external biases and
pressure that may result in declining health whenever they leave
a session. Therefore, value must be provided in educating
patients on the potential risks they face in their environment.
This can only be achieved through collaboration which aligns
with the results of Seger's (2019) and Ogbolu
et al. (2018) studies. Furthermore, it is essential for the
patient's perspective of the community and support system to be
observed by the patient (Bloor & McIntosh, 2019). Therefore,
sharing with the nurse is a natural step of goal setting that
allows an informed understanding of the underlying implication
of the stereotypes and norms of expectation (Halvorson
et al., 2019). This will help focus on reducing the risk
of "temptation" of hindrances to improving patient health in a
way that respects them and their communities.
Similarly, (Balani
et al., 2019) study examined factors affecting healthy
weight in the community. The study explained that obesity is
not a lifestyle crisis but rather a complicated, chronic disease
affecting areas of behavioral, psychosocial, biological, and
environmental factors. For this reason, there is a need for a
collaborative and comprehensive approach to obesity
management. Therefore, foundational planning is essential for
the nurse and the patient to recognize early on.
Hee Soon
et al. (2019) opted to conduct a study on this subject
.focusing on the younger populations; one thing that tends to be

overlooked is that children learn from what they see happening
in their surroundings. Thus, even if a child is prone to eating
healthy in their respective homes, they are also prone to be
influenced by what they see in schools or other surroundings.
Therefore, this research study aimed to answer the question,
"What are the barriers at home and school to healthy eating?"
Furthermore, it also aimed at answering this through the
perspectives of parents and children who had or were suffering
from obesity; therefore, parents, teachers, and community
healthcare providers should alleviate the issues of obesity
through adequate healthy diet teaching and implementation.
It is imperative when it comes to the management of unvoiced
expectations of a patient in a way that recognizes their efforts
and input toward change. According to Ma
et al. (2019) study findings, obesity management
requires self-discipline at a higher level than average and
recognizing a gradual result, supported by Reas's (2017) study.
These studies describe how lack of self-discipline results in
binge eating disorder; at the same time, public and healthcare
professionals’ knowledge and attitudes toward the relationship
between self-awareness results in binge eating disorder and,
consequently, weight gain (obesity). The fact that it cannot be
cured by medication and results are not immediate is a cause of
concern that both nurse and patient should understand
(Boersema
et al., 2021:p.11). It requires patience and a lens where
small milestones can only weigh competent management.
Furthermore, obesity practitioners must have complete
comprehension and apply evidence-based knowledge while
administering care to patients with obesity (Srivastava
et al., 2019:p.196).
When management optimization is needed in the treatment
strategy for a patient with obesity, especially outpatients, there
is a need for longitudinal consideration of the

comprehensiveness of management aspects. According to Seger
(2019), a complication of obesity as a chronic illness is as
sophisticated as any other issue, which aligns with Godfrey
et al. (2017) study. Godfrey
et al. (2017) describe the complications primarily
associated with maternal obesity, including coronary artery
disease, obesity in the offspring, asthma, and allergies. In
addition, Schetz
et al. (2019) describe obesity as one of the current
health concerns affecting a large proportion of the world's
population. As such, an intensity level should be employed with
preventive controls in line with the responsibility set. This
allows for desired treatment to be the main goal rather than the
desired end product, such as specific weight. It removes the
tension without negating the implication of the process and thus
optimizes input by the small measures that can be seen
regularly. Therefore, a pathophysiological approach is
necessary for an all-hands-on methodology hence simplicity that
is specific to the patient in question rather than a generalization
as in Block
et al. (2020) study findings.
Nurses' knowledge of the management of obesity
Inadequacy of skills and knowledge among healthcare
professionals is one of the significant challenges facing the
fight against metabolic conditions such as obesity. Bucher Della
Torre
et al. (2018) describe one of the challenges in one of
the university hospitals as the presentation of poor knowledge,
skills, and attitude about obesity among nurses and physicians,
which aligns with the findings of Turner
et al.’s (2018) study. Turner
et al.’s study revealed inadequate knowledge
concerning managing obesity effectively. The results imply that
provider perception of optimal healthcare services for obesity is
at odds with research-based guidelines. Healthcare practitioners

must be aware of the best ways to use pharmacotherapy and
behavioral counseling, such as adopting a healthy diet; these
interventions are widely applied in improving the health of
obese patients (Turner
et al., 2018:p.667).
Reinforcing Positive environment in Nurse-Patient Relationship
When looking at the studies, it is evident that nurse and patient
relationships are integral to the definition of health and the
understanding of treatment planning. These are essential to the
pathways to positive outcome expectation hence accurate to the
operational definitions. Given that outpatient care for obesity is
almost therapeutic, there is a sense of delivery requiring that
verbal and non-verbal communication are read. As such, the
nurse must have the core conditioning of genuine concerns,
which sometimes could be perceived as going above and beyond
the baseline required (Okdie & Ewoldsen, 2018). The
relationship between the two is skill-based, examining the level
of trust in both directions with absolute truths. The points of
conflict should thus be handled with care and isolated from the
goals by accepting attitudes as progression, hence removing fear
(Walia
et al., 2022). This also removes the anxiety of either
side as the nurse can trust that discipline will be employed
within the period they have not met. Similarly, the patient will
trust that information will not be withheld, anger will not be
enforced, and the care environment will be positively reinforced
with empathy rather than pity.
Significance and Justification
Findings from the initial literature review revealed a lack of
knowledge in nursing and patient care practice regarding
obesity management. In their study, Bucher Della Torre
et al. (2018) revealed a significant inadequacy of
knowledge and skill among nurses and physicians working in a
university hospital concerning the management of obesity

(Bucher Della Torre
et al., 2018: p.126). This gap exists, yet healthcare
professionals should be at the forefront of executing various
interventions to manage obesity. It is an implication that
patients suffering from obesity and related complications will
find it challenging to get adequate and effective nursing
education concerning diet to manage and treat their condition.
Similarly, there is inconsistency in provider understanding of
appropriate clinical care for obesity. The study recommends that
there is a need for healthcare professionals to develop an
understanding of how to effectively leverage health
interventions to promote outcomes for patients with obesity.
This article is a good choice for supporting the proposed project
because it points out the limitations of proper management of
obesity, one of which is the low knowledge level among health
professionals and the need to address them towards achieving
the goal of healthcare. Therefore, this study must enable nurses
to have a training program where they will get more knowledge
and skills concerning the management of obesity through
dietary interventions. It will optimize patient outcomes through
effective nursing education.
Project Objectives
The objectives of this project are to:
1. Conduct an extensive review of the literature exploring
healthy diets for patients with obesity using the following
keywords, both singularly and in multiple combinations: nursing
training, obesity, obesity prevention, outpatient care,
overweight, diet, and healthy diet. Databases searched, limited
to the years 2017 to 2022, will include AMED, Alt Health
Watch, CINAHL Plus with Full Text, EBSCO, Medical Journal
sites for nursing care, nursing training, PubMed, Scopus,
Science Direct, Directory of Open Access Journals, Google
Scholar, JSTOR and the D'Youville library to loan articles
through interlibrary loan;
2. Develop a (resource guide; brochure, PowerPoint, Video);

and
3. Have a panel of five content experts with extensive
knowledge and expertise in a healthy diet for patients with
obesity evaluate and critique the project for clarity, readability,
applicability, quality, organization, and evidence-based clinical
relevance.
Definition of Terms
The following concepts are defined both theoretically and
operationally for the purpose of this project:
Health Promotion
Theoretical Definition: Behavior motivated by the desire to
increase well-being and actualize human health potential. It is
an approach to wellness (Pender
et al., 2011, p. 45).
Operational Definition: Behaviors that promote HGH treatment
delivery and adherence resulting in improved health, treatment
outcomes, and better quality of life for adolescents diagnosed
with HGH deficiency.
Body mass index (BMI)
Theoretical Definition: BMI refers to a person's weight in
kilograms divided by the square of height in meters.
· Normal (BMI reading: 18.5 kg/m2≤ BMI 25 kg/m2
· Overweight BMI measure: 25 kg/m2≤ BMI 30 kg/m2
· Obese BMI: ≥ 30 kg/m2 (Xiang & An, 2015)
Operational Definition: BMI is a clinical measurement tool to
determine if a person may have elevated body mass obtained by
dividing a person’s weight in kilograms by the square of their
height in meters.
Healthy diet
Theoretical definition: Refers to both a health-promoting and
disease-preventing diet. It delivers adequate nutrients and other
health-promoting ingredients from wholesome foods while
avoiding ingesting harmful substances (Chaudhary
et al., 2018, p.3).

Operational Definition: A diet composed of macronutrients,
micronutrients, and vitamins necessary for maintaining the
body's normal functioning and promoting health through
enhancing healthy weight loss in obese patients.
Limitations
The Project Author recognizes the following project limitations:
1. The implementation of the (PowerPoint); is not within the
context of this project;
2. The (product) is developed in the English language only and
may benefit a more culturally diverse population if written in
additional languages.
Project Development Plan
A detailed topical outline of this study’s content is created
based on the extensive review of evidence-based literature and
the theoretical framework used to support and guide the
development of the research. In addition, after permission is
granted from the D’Youville Patricia H. Garman School of
Nursing (Appendix A); five professionals with knowledge and
expertise in health promotion for patients with obesity will be
asked if they are interested in voluntarily participating as an
expert content reviewer for the study. The professionals will
involve those with experience in a healthy diet in education on a
healthy diet.
The content expert panel will consist of one nutritionist,
registered nurse, endocrinologist, bariatric healthcare provider,
and nurse educator. If interested, the Project Author will mail a
packet containing a Letter of Intent (Appendix B), a copy of the
Content Expert Project Evaluation Tool created by the Project
author specifically for the project (Appendix C), a copy of the
(product) (Appendix D), and a self-addressed stamped envelope.
The Letter of Intent will explain the project purpose and
provide instructions for completing and returning the Content
Expert Project Evaluation Tool to the Project Author. Six
evaluation criteria plus room for narrative comments and
recommendations make up the Content Expert Project

Evaluation Tool. Reviewing the resource manual and
completing the Content Expert Project Evaluation Tool will take
about 20 minutes. The Content Expert Project Evaluation Tool
must be returned to the Project Author in a self-addressed,
stamped envelope by the content experts. Data analysis and
reporting will be done when all evaluation tools have been
given back to the project author, both in narrative form and as
bar graphs. Finally, through postal mail, the content expert
reviewers will send a summary of the assessment outcomes,
including the observations of the six reflective elements in the
content expert project evaluation tool.
Start here
Instructions for the Plan for the Protection of Human Subjects
section
This section follows the Project Development Plan section and
discusses each of the required components noted in the
D’Youville IRB Manual regarding how the safety, privacy, and
rights of the human subjects (the content experts) will be
protected. This section should be presented as follows:
Plan for the Protection of Human Subjects
Following approval from the D’Youville Patricia H. Garman
School of Nursing, graduate faculty designee (Appendix A), (5)
professionals with knowledge and expertise in the area/field of
will be personally approached and asked to voluntarily
participate as a content expert in the review and evaluation of
the (product) (Appendix D). Content experts will be advised
that participation or non-participation as an expert reviewer will
have no effect on their employment status. The Project Author
has a collegial, professional, and non-supervisory relationship
with the content expert reviewers thereby protecting the
participants from any risk of coercion. Content experts will be

guaranteed confidentiality because identifying characteristics
will not be collected on the Content Expert Project Evaluation
Tool and because their names will not be revealed anywhere in
the project manuscript or in required project presentations. Only
the Project Author will know the names of the content expert
reviewers. Return of the completed content expert Project
Evaluation Tool (Appendix C) will indicate implied voluntary
consent to participate as a content expert reviewer. Content
experts will be advised that they will not be able to withdraw
from project participation once the project evaluation tool is
returned to the Project Author because the evaluation tool will
be returned without identifying information. Returned Content
Expert Project Evaluation Tools will be stored according to the
D’Youville Patricia H. Garman School of Nursing protocol in a
locked drawer located in the Project Author’s (home/office) for
a period of (three years (US)/six years (Canada)) and then
destroyed.
11. Instructions for the Plan for Project Evaluation section
The Plan for Project Evaluation section follows the Plan for the
Protection of Human Subjects section and discusses plans
regarding how the project will be evaluated and how data
resulting from the project evaluation will be analyzed. Tools
developed to evaluate the project need to be included in the
Appendices. When discussing the evaluation tool in the body of
the project manuscript, the student needs to make sure that the
order of items is presented as they appear on the evaluation
tool. The Plan for Project Evaluation section should be
presented as follows:
Plan for Project Evaluation
After obtaining full approval from the D’Youville Patricia H.
Garman School of Nursing (Appendix A), the Project Author

will mail a packet to each content expert reviewer containing
one Letter of Intent (Appendix B), one copy of the Content
Expert Project Evaluation Tool (Appendix C), one copy of the
(product) (Appendix D), and one self-addressed stamped
envelope. The Letter of Intent will explain the project purpose
and instructions for completing and returning the Content
Expert Project Evaluation Tool to the Project Author.
The Content Expert Project Evaluation Tool will consist of (6)
evaluative items scored on a four- point Likert Scale that ranges
from (1) Strongly Disagree. (2) Disagree, (3) Agree, and (4)
Strongly Agree. Space will be provided for narrative comments
and suggestions following each evaluative item. Evaluative
items will ask reviewers to rate the (product) on clarity,
readability, applicability, quality, organization, and evidence-
based clinical relevance. Approximately 20 minutes will be
required to review the (product) and to complete the Content
Expert Project Evaluation Tool. Content experts will be given
(7) days to complete and return the Content Expert Project
Evaluation Tool to the Project Author via postal mail using the
self-addressed stamped envelope included in the original
packet. Likert scale responses will be presented narratively and
displayed in (tabular/bar graph) format. Content expert
suggestions and comments will be analyzed for common themes
and presented narratively. A summary of the evaluation results
including the findings of the six evaluative items in the content
expert project evaluation tool will be provided to the content
expert reviewers by postal mail.
*Make sure the order of evaluative items in your content expert
evaluation tool is stated in the same order in the body of your
proposal.
12. Instructions for the Summary section
The Summary section follows the Plan for Project Evaluation

section. The Summary section consists of one paragraph that
briefly summarizes what was completed in Chapter I of the
project proposal. The summary is written in past tense and
should be presented as follows:
Summary
Chapter I presented the project introduction, statement of
purpose, an overview of the theoretical framework guiding
project development, an initial review of the literature focusing
on (project purpose), the project significance and justification,
project objectives, definition of terms, project limitations, the
project development plan, the protection of human subjects, the
plan for project evaluation, and a chapter summary. Chapter II
will provide an extensive review of the literature focusing on
(project purpose) and a chapter summary. Chapter III will
discuss the intended project setting and population, the content
expert participants, data collection methods, project tools, the
protection of human subjects, and a chapter summary. Chapter
IV will discuss the evaluation of the project, implications for
future advanced nursing practice, recommendations for future
projects and research, and a chapter summary.
Summary
REDO THE SUMMARY--You should start like
this -->Chapter I presented the project introduction,
statement of purpose, an overview of the theoretical framework
guiding project development, an initial review of the literature
focusing on
There are several reasons why people seek medical attention.
The project improved the APRNs' understanding of obesity
among those who work in an outpatient setting. The practitioner

can better comprehend the need to interact with an obese patient
by applying interpersonal relations nursing theory concepts.
This gives practitioners a structure when guiding a discussion
with patients about their weight control. To achieve healthy
body weights and lead healthy lifestyles, one must consume
adequate nourishment and follow a healthy diet (Healthy People
2020, 2011). Improving health and well-being will result from
eliminating obesity in the long run.
The first chapter of this project introduced the topic and stated
the purpose. Then, the chapter elaborated on the theoretical
framework, discussing the nursing theory on which the project
will be based, its significance, and the concepts concerning the
project's aim. Other topics discussed in the initial chapter are
the project significance and justification, objectives, the
definition of terms, project limitations, and the project
development plan. A detailed examination of the literature on
establishing an educational plan for nurses working in an
outpatient setting to equip them with knowledge on healthy
diets for patients with obesity will be provided in Chapter II,
along with a chapter summary. The third chapter of the project
will entail the planned project setting and population, the
participating topic experts, data collection techniques, project
instruments, and a chapter summary. Finally, chapter IV will
cover the project's evaluation, implications for future advanced
nursing practice, suggestions for further projects and research,
and a chapter summary.
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