Discussion: Hypertension Evidence Based Practice Proposal
I’m studying for my Nursing class and need an explanation.
Evidence-Based Practice Proposal – Section E: Implementation Plan
In 1,000-1,500 words, provide a description of the methods to be used to implement the proposed solution. Include the following:
Describe the setting and access to potential subjects. If there is a need for a consent or approval form, then one must be created. Although you will not be submitting the consent or approval forms in Topic 5 with the narrative, you will include the consent or approval forms in the appendices for the final paper.
Describe the amount of time needed to complete this project. Create a timeline. Make sure the timeline is general enough that it can be implemented at any date. Although you will not be submitting the timeline in Topic 5 with the narrative, you will include the timeline in the appendices for the final paper.
Describe the resources (human, fiscal, and other) or changes needed in the implementation of the solution. Consider the clinical tools or process changes that would need to take place. Provide a resource list. Although you will not be submitting the resource list in Topic 5 with the narrative, you will include the resource list in the appendices for the final paper.
Describe the methods and instruments, such as a questionnaire, scale, or test to be used for monitoring the implementation of the proposed solution. Develop the instruments. Although you will not be submitting the individual instruments in Topic 5 with the narrative, you will include the instruments in the appendices for the final paper.
Explain the process for delivering the (intervention) solution and indicate if any training will be needed.
Provide an outline of the data collection plan. Describe how data management will be maintained and by whom. Furthermore, provide an explanation of how the data analysis and interpretation process will be conducted. Develop the data collection tools that will be needed. Although you will not be submitting the data collection tools in Topic 5 with the narrative, you will include the data collection tools in the appendices for the final paper.
Describe the strategies to deal with the management of any barriers, facilitators, and challenges.
Establish the feasibility of the implementation plan. Address the costs for personnel, consumable supplies, equipment (if not provided by the institute), computer-related costs (librarian consultation, database access, etc.), and other costs (travel, presentation development). Make sure to provide a brief rationale for each. Develop a budget plan. Although you will not be submitting the budget plan in Topic 5 with the narrative, you will include the budget plan in the appendices for the final paper.
Describe the plans to maintain, extend, revise, and discontinue a proposed solution after implementation.
You are required to cite five to 10 sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.
You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.
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NUR 590 Topic 2 DQ 2
Do you foresee any issues with the proposed implementation of your project? Identify a strategy to help create or sustain a higher level of readiness to change with your organization and discuss how current research or literature will be used to ensure that change is based on current evidence.
As with any project implementation its best to envision any potential issues before they arise. Therefore, I anticipate a few potential issues with the proposed implementation of my project. The first foreseen issue identified for the proposed implementation of my evidence-based project are financial concerns and will continue to be an ongoing concern. I was able to identify a couple of strategies to help with the financial concerns including executive leadership engagement in the process. Being fully transparent with the executive leadership team regarding the implementation plan including cost and methods of saving will aid in gaining their support. Another financial strategy would be to develop a team of subject matter experts/educators on the Physician Orders for Life-Sustaining Treatment (POLST) program utilizing the system Respecting Choices Model within the system. With the development of the program within the system there will be a reduction in further cost to outside resources.
The second foreseen issue is a lack of clinician buy in to the program and change management. In order to address this area education, engagement, and communication are necessary strategies. The education will include up-to-date best practices, refresher courses, audit, and review. The engagement strategies include ensuring confidence in their work, standardized workflow, ensuring collaboration and stakeholder involvement. The communication strategies include ongoing updates on education and engagement opportunities, events, current POLST literature, and development of newsletter.
The third foreseen issue is lack of quality of the POLST process and order sets. Quality of the work is a multifactorial problem; in that it relies heavily on the first two foreseen issues. “The quality of POLST documentation is only as good as the conversations that precede it” (Abbott, 2019, p. 297). Therefore, if there is a lack of financial support or clinician buy in, ultimately leading to a reduction in POLST quality.
Research on POLST implementation is actively being reviewed and updated therefore in order to ensure that my proposed evidence-based practice proposal is based on current evidence it’s necessary to regularly search for the most up-to-date literature.
Abbott, J. (2019). The POLST paradox: Opportunities and challenges in honoring patient end-of-life wishes in the emergency department. Annals of Emergency Medicine, 73(3), 294–301. https://doi.org/10.1016/j.annemergmed.2018.10.021
The only issue I see with the proposed implementation of my project is allowing both nurses and patients the time to get used to the implemented process. Most organizational change initiatives fail because we apply strategies that are not tailored for the structure of the concerned organization. I work at the VA in Lancaster and our structure is a healthy one. Changing a healthy structure requires trust, clarity, and integrity. Employees are accountable for what they do. If they need skills, they can get trained or ask support to their managers. Anyone in the organization, not only managers, is likely to ask questions like: “When will you be ready?” or “Have you tested the quality of your realization?” Everyone is accountable to their colleagues. Here are the guidelines to follow to identify the most appropriate change approach. It decomposes the movement from the current state to the future state in five steps (Cavarec, 2014):
- Formulate change
- Plan change
- Implement change
- Manage transition
- Sustain change
Threats to sustainability may be identified both at the beginning of a project and when it is ready for implementation. The National Health Service Sustainability Model is reviewed as one example to help identify issues that affect long-term success of quality improvement projects. Tools to help sustain improvement include process control boards, performance boards, standard work, and improvement huddles (Silver et al., 2016).
Investments in new clinical practices do not stop with their developers; enormous effort and resources are directed to introducing new clinical knowledge to healthcare organizations. These investments include mobilizing human resources through the establishment of knowledge brokers, evidence-based practice committees or teams and identifying opinion leaders and champions who will support the practice excellence (Virani et al., 2009).
Cavarec, Y. (2014). Increase your organization readiness to change. Paper presented at PMI® Global Congress 2014—North America, Phoenix, AZ. Newtown Square, PA: Project Management Institute.
Silver, S. A., McQuillan, R., Harel, Z., Weizman, A. V., Thomas, A., Nesrallah, G., Bell, C. M., Chan, C. T., & Chertow, G. M. (2016). How to Sustain Change and Support Continuous Quality Improvement. Clinical journal of the American Society of Nephrology : CJASN, 11(5), 916–924.
Virani, T., Lemieux-Charles, L., Davis, D. A. & Berta, W. (2009). Sustaining Change: Once Evidence-Based Practices Are Transferred, What Then? Healthcare Quarterly, 12(1), pp 89- 96