Evidence-Based Practice Project Proposal Implementation Plan NUR 590
Process of Delivering the Intervention
The first step in project delivery will be needs assessment to identify knowledge and skills gaps among healthcare providers. Active stakeholder engagement will also be used to promote competency development. Training will be provided to the adopters to ensure they are equipped with the desired competencies in the use of integrated health records (Lehane et al., 2019). Coaching, mentorship, and supervision will be provided to ensure the effective and consistent use of the system in patient care.
Stakeholders
Nurse managers and nurse leaders, nurses, physicians, and information technology workers will be the primary project stakeholders. Nurse leaders and managers will supervise project execution and provide implementers with the assistance they require to use the system in patient care. They will also advocate for proper project resource allocation. Nurses and physicians will be the primary users of the integrated system. They will be involved in the project throughout its duration and will provide feedback on how to improve its efficiency and outcomes. Information technology personnel will provide technical support for the integrated systems.
Stakeholder resistance is one of the challenges that may arise as a result of their lack of knowledge and skills, or their fear of unforeseeable consequences. The challenge will be overcome.
Assessment Description
In 1,250-1,500 words, . When required, create the appropriate form, table, image, or graph to fully illustrate that aspect of the intervention plan and include them in an appendix of your paper. You will use the implementation plan, including the associated documents in your appendices, in the Topic 8 assignment, during which you will synthesize the various aspects of your project into a final paper detailing your evidence-based practice project proposal.
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. Include a draft of the form as an appendix at the end of your paper.
- Create a timeline. Make sure the timeline is general enough that it can be implemented at any date. Based on the timeline you created, describe the amount of
Evidence-Based Practice Project Proposal Implementation Plan NUR 590 time needed to complete this project. Include a draft of the timeline as an appendix at the end of your paper.
- Develop a budget and resource list. Consider the clinical tools or process changes that would need to take place. Based on the budget and resource list you developed: (a) describe the resources (human, fiscal, and other) or changes needed in the implementation of the solution; (b) outline 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). Include a draft of the budget and resource list as an appendix at the end of your paper.
- Explain whether you would select a qualitative or quantitative design to collect data and evaluate the effectiveness of your evidence-based practice project proposal. Provide rationale to support your selection.
- Describe the methods and instruments (questionnaire, scale, or test) to be used for monitoring the implementation of the proposed solution. Include the method or instrument as an appendix at the end of your paper.
- Explain the process for delivering the intervention and indicate if any training will be needed.
- Consider all of the aspects of your implementation plan and discuss potential barriers or challenges to the plan. Propose strategies for overcoming these.
- Establish the feasibility of the implementation plan.
Also Read:
Refer to the “Evidence-Based Practice Project Proposal – Assignment Overview” document for an overview of the evidence-based practice project proposal assignments.
You are required to cite a minimum of five peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content. Evidence-Based Practice Project Proposal Implementation Plan NUR 590
Complete the “APA Writing Checklist” to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as an appendix at the end of your paper.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.
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. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
What are some of the obstacles or barriers to implementing evidence-based practice (EBP) in nursing? Explain how at least one of the obstacles you have described could impact the implementation for your EBP project.
Obstacles to evidence-based practice research can keep research from reaching its full potential. Barriers to evidence-based practice research include resource management, interdisciplinary involvement, and a lack of support at varying levels depending on the research setting or question being investigated. Building research within a medical center has both advantages and disadvantages in terms of achieving research goals for health outcomes. In terms of research implementation, health-related education, in particular, can sometimes take a back seat to patient-care interventions (Swindle, Johnson, Davenport, Whiteside-Mansell, Thirunavukarasu, Sadavsin & Curran, 2019)
Interdisciplinary communication for educational purposes is one barrier that I believe will impede the implementation process. Although education can be used to disseminate information to health care providers and the general public, the nature of information and coordination may make this difficult. This would have an impact on my project because collaborating with nutrition and educational departments will be critical to the research outcomes, and the level of involvement or coordination may be determined by the ability to use these connections with other disciplines (Shayan, Kiwanuka & Nakaye, 2019).
References:
Swindle, T., Johnson, S. L., Davenport, K., Whiteside-Mansell, L., Thirunavukarasu, T., Sadasavin, G., & Curran, G. M. (2019). A Mixed-Methods Exploration of Barriers and Facilitators to Evidence-Based Practices for Obesity Prevention in Head Start. Journal of Nutrition Education and Behavior, 51(9), 1067–1079.
Shayan, S. J., Kiwanuka, F., & Nakaye, Z. (2019). Barriers Associated With Evidence‐Based Practice Among Nurses in Low‐ and Middle‐Income Countries: A Systematic Review. Worldviews on Evidence-Based Nursing, 16(1), 12–20. https://doi-org.lopes.idm.oclc.org/10.1111/wvn.12337
Identify two stakeholder barriers you might experience during the implementation phase of your evidence-based practice project. What strategies can you implement to gain stakeholder support for the project implementation. Provide a suggestion you would give to a colleague who is struggling with obtaining stakeholder support.
Cohesive Collaboration is important to the survival of and success of an organization. Implementation plans can face numerous challenges as a result of lack of knowledge of the problems hurting an organization. This lack of knowledge is common in many organizations were leaders and management are disconnected from day to day operations that help to run the organization. When a person rises through the ranks of the organization into a leadership role they have knowledge of and experience that other managers lack if they hired from the outside. The person who rises through the ranks has more understanding of the how the organization works, the weakness that exist, the organizations strength and how the organization needs to function in order to survive. Where there is s disconnect between stakeholders in higher positions and those working the day to day operations, noting will get done.
Some of the things that one might experience during the implementation phase are resistance and timing. “Lack of time is often cited as a barrier to implementing EBP. In addition, uncertainty or lack of knowledge about the EBP process is also a barrier, which includes related to the clinical problem being addressed” (Ginex, 2018). In busy hospitals lack of time to study and understand new changes and policies can be a barrier. On time of this, resistance to change can also be a barrier. In there is already a flow that nurses are accustomed to even if it is chaotic, having to change that flow requires learning something new or changing ones workflow habits and that can cause resistance to change.
The one suggestion I would give to a fellow colleague would be for them to ask questions, slow down the pace in order for them to understand the new policy and give themselves time to become accustom to it and to always remember that it will take them time to learn something new before they can master it.
Reference:
Ginex, P. (2018). Overcome Barriers to Applying an Evidence-Based Process for Practice Change. Retrieved from https://voice.ons.org/news-and-views/overcome-barriers-to-applying-an-evidence-based-process-for-practice-change
NUR 590 Topic 2 DQ 1
Compare two organizational readiness tools. Identify the tool you selected and explain why it is most appropriate for assessing your organization.
The two organizational readiness tool that I had chosen are The Patient Assessment of Chronic Illness Care (PACIC) and the Organization Readiness Change Assessment (ORCA). The organization’s readiness assessment for change is a crucial factor in the implementation phase of any given public health intervention (“Selecting A Tool”, n.d.). These tools can assist in evidenced-based practice (EBP) interventions. The Patient Assessment of Chronic Illness Care Questionnaire also known as PACIC is a tool that is used to make an evaluation of the perspective of the patient with regards to the receipt of patient care delivery in the 5 domains namely: activation, delivery system, goal setting, problem solving, and follow-up (Gensichen et al., 2011). PACIC tool can be used for conditions that incurable and illnesses that lasts for a prolonged period time. On the other hand, the ORCA tool has 4 main purposes: learning about the degree of motivation, assessment of organizational abilities, improvement of organizational capacities, and empowerment of organizations (Dearing, 2018).
The most appropriate tool for assessing my organization is the ORCA tool because it can help with identifying and monitoring of organizational strengths and weakness or an organization (“Organizational Readiness”, 2017).By using this tool in clinical settings which it was originally intended for, can help with providing support and success of EBP.
References
Dearing, J. (2018). Organizational readiness tools for global health intervention: A review. Frontiers In Public Health.
Gensichen J, Serras A, Paulitsch MA, Rosemann T, König J, Gerlach FM, Petersen JJ. (2011).The Patient Assessment of Chronic Illness Care questionnaire: Evaluation in patients with mental disorders in primary care. Community Ment Health J, 47(4):447-53. doi: 10.1007/s10597-010-9340-2.
“Organizational Readiness”. (2017). National Collaborating Centre for Methods and Tools.
“Selecting A Tool”.(n.d.). National Collaborating Centre for Methods and Tools. https://www.nccmt.ca/knowledge-repositories/search/279
Organizational readiness assessments allow for change leaders and champions to assess key areas of organization structure, stability and culture in order to make an informed decision as to whether or not a change or improvement initiative is going to be successful, and the right intervention at the right time (HRSA, 2021). Upon comparison of two different examples of organizational readiness assessments designed for healthcare, there are certainly similarities but also differences that must be considered when selecting one that is right for a particular organization and initiative.
The Agency for Healthcare Research and Quality (AHRQ) has an evidence-based safety and teamwork communication program by the name of TeamSTEPPS. This evidence-based program has been around for 20 years, and is now an evidence-based intervention effective at improving perceptions of teamwork, communication and trust, as well as sound data supporting improved patient safety metrics in an organization (AHRQ, 2021). With this, a readiness assessment is highlighted as a key part of the process to ensure an organization is ready for TeamSTEPPS implementation. Utilizing the AHRQ TeamSTEPPS Readiness Assessment, areas of defined need, readiness for change in culture, time/resources/personnel, and sustainment of the change are assessed in a checklist format that is easy-to-use for any individual assessing whether or not this intervention is right for one’s organization (AHRQ, 2021).
Comparatively, the Maryland Healthcare Commission (2019) provides a tool for healthcare organizations interested in implementing a standardized telehealth program with aim to improve the safety, quality, fiscal stewardship and patient experience side of healthcare. The readiness assessment provided- includes core readiness, financial considerations, operations, staff engagement and patient readiness. Maryland Healthcare Commission highlights a toolkit they’ve created to guide the assessment of successful improvement of one’s healthcare system telehealth practices.
Identify two stakeholder barriers you might experience during the implementation phase of your evidence-based practice project. What strategies can you implement to gain stakeholder support for the project implementation. Provide a suggestion you would give to a colleague who is struggling with obtaining stakeholder support.
Stakeholders are the people involved in carrying out the process under review or individuals who become affected with the change in practice (“John Hopkins Nursing”, 2021). It is important to determine the potential stakeholder barriers that will be encountered in order to address them accordingly. The two stakeholder barriers that can be experienced are resistance to change and lack of authority. Physicians, who are one of the main stakeholders, are perceived to be the least supportive in EBP implementation (Jordan et al., 2021). Without their support, it can make the implementation process difficult. Resistance of practitioners to change from traditional practices to newer concepts introduced in EBP can be a barrier to the implementation process (Jordan et al., 2021). Moreover, some staff nurses feel that they lack authority to make changes in their unit or they do not have the “power” to implement the EBP project. One study suggested that majority of the nurses in a private ICU reported that they lacked the authority to change practice in order to facilitate the implementation of EBP (Jordan et al., 2021).
There are several strategies to gain stakeholder support. First, the support of physicians for the implementation of EBP should be encouraged (Jordan et al., 2021). It is important to keep an open communication between the researcher and physicians. Explaining the goals and benefits of the EBP project in improving patient care can help gain their support. Second, it is recommended to carefully identify individual barriers versus organizational barriers at an early stage (Jordan et al., 2021). Lastly, identifying your stakeholders as well as engaging them early in the EBP process is important because stakeholder buy-in is important for its successful implementation (“John Hopkins Nursing”, 2021). The goal is to gain their trust and confidence and gain as much support as possible for the successful project implementation.
References
Jordan, P., Bowers, C., Cur, M. & Morton, D. (2016). Barriers to implementing evidence-based practice in a
private intensive care unit in the eastern cape. SAJCC, 32(2). DOI:10.7196/SAJCC.2016.v32i2.253
“John Hopkins Nursing”. (2021). Upstate Medical University. https://guides.upstate.edu/c.php?g=1023176&p=7411256
Implementation Plan
Setting and Access to Potential Subjects
The project will be implemented in a hospital setting using critically ill patients as the potential subjects. The appropriateness of the setting is attributed to the high number of critically ill patients seen and admitted for further management. Consent will not be sought from the potential subjects. However, approval will be sought from the institution before implementing the project.
Timeline
The duration of the project will be one year. The period is adequate to determine the effectiveness of the intervention and revision of strategies.
Budget and Resource List
Changes in clinical processes and systems are needed for the implementation of the project. The existing electronic health records will be integrated to execute the project interventions. The integration will enhance the efficiency of medication processes such as prescription and administration (Sitapati et al., 2017). Organizational processes will change as seen from the use of the new integrated systems. Human, financial, and material resources will be needed in the implementation of the project. Skilled healthcare providers, trainers of trainees, and information technology experts are some of the needed human resources. Financial resources will be required for system upgrade, purchase of the required materials and remunerating the participants. The materials that will be purchased for the successful implementation of the project will include writing materials, projectors, integrated health information system, and stationeries. The other cost will gather for the training, coaching and mentoring, data collection and analysis, and presentation of findings to the institutional stakeholders. The estimated budget of the project will be $48000
Design
Quantitative design will be used in data collection for the project. The quantitative design will be appropriate due to its focus on quantifying project data. Since the project does not generate a theory, quantitative design is appropriate for it. The project will also obtain numerical data, which makes the design appropriate rather than qualitative design (Dingwall & Staniland, 2020). The use of quantitative approach is expected to provide clear understanding of the effectiveness of the proposed project in preventing and reducing medication administration errors in practice.
Methods and Instruments
Regular monitoring will be done for the project to determine the success of the realization of its goals and objectives. It will also facilitate the implementation of revisions to enhance the project outcomes. Questionnaires and organizational statistics on medication administration errors will be used for monitoring the outcome data. The comparison of statistics will be done on pre and post-intervention periods. The questionnaires administered to healthcare providers will offer insights into project effectiveness. Questionnaires are appropriate, as they are inexpensive and need little time in administering them to participants (Dingwall & Staniland, 2020).
Process of Delivering the Intervention
The first step in project delivery will be needs assessment to identify knowledge and skills gaps among healthcare providers. Active stakeholder engagement will also be used to promote competency development. Training will be provided to the adopters to ensure they are equipped with the desired competencies in the use of integrated health records (Lehane et al., 2019). Coaching, mentorship, and supervision will be provided to ensure the effective and consistent use of the system in patient care.
Stakeholders
Nurse Managers and nurse leaders, nurses, physicians, and information technology personnel will comprise the main project stakeholders. Nurse leaders and managers will oversee project implementation as well as provide the support needed by implementers for system use in patient care. They will also advocate adequate resource allocation for the project. Nurses and physicians will be the primary users of the integrated system. They will be involved in the entire project process and provide feedback on ways of improving its efficiency and outcomes. Information technology personnel will provide the technical assistance needed in the use of the integrated systems.
Potential Barriers or Challenges
Stakeholder resistance is one of the barriers that may be experienced due to their lack of knowledge and skills or fear of unknown outcomes. The barrier will be addressed by training and promoting their active participation the project (Shayan et al., 2019). Inadequate support from the organization is the other barrier, which will be addressed using interventions such as aligning the project with organizational needs and ensuring its feasibility (Baatiema’ et al., 2017). The proposed project is feasible in the organization. It has adopted effective health information systems and trained its staff to ensure they are competent in enhancing safety, quality and efficiency of patient care using healthcare technologies.
