NUR 590 Assignment Implementation Plan
Best Practices for Implementing Evidence-Based Practice (EBP)/ Guidelines
Studies show that despite EDP being the gold standard in the provision of patient care, several hospitals among other healthcare organizations take up to 17 years to be able to fully adopt the new practice after it has gained substantial evidence showing its safety and effectiveness among patients (Brownson, Fielding, & Green, 2018). To promote the timely and appropriate implementation of best EBP into clinical practice, four key approaches must be followed.
The first step is to fully understand the data and the new practice being implemented. This is mainly because not all data behind EBP can translate to your organization, despite applying to multiple clinical contexts (Stirman, Baumann, & Miller, 2019). An in-depth understanding of the proposed changes helps leaders adapt only the evidence best practice that best suits the healthcare organization.
The second step is to consider the available resources concerning the data behind the evidence best practice. This will help leaders modify the new practice to fit the resources which are available within the organization (Osborne, 2017). Consequently, this approach will also help in the adoption of strategies that can help reduce costs while optimizing the outcome.
The third step is to establish patient-centered goals. It is important to ensure that the new practice does not only benefit the hospital in promoting the rate of productivity but must also enhance patient-centered care. For instance, when implementing strategies to help inappropriate polypharmacy among the elderly, it is important to focus on approaches that will help reduce multiple uses of prescription drugs, while at the same time ensuring that the patient achieves the treatment goals (Cadogan et al., 2018).
The last step is to identify the organization’s preferences and educate staff members about the new practice. This will help the change leader evaluate the possibilities of adoption and retainment of the new practice among staff members (Osborne, 2017). When the change is fully accepted by the staff members, the process of implementation can then be initiated.
Strategies for Overcoming Barriers in Implementing Evidence-Based Practice
According to most research findings, the most common barriers to EBP implementation include resistance, time and knowledge, and inadequate finances. To be able to overcome these challenges, several strategies will be utilized. The first strategy is to engage appropriate stakeholders. This will help in building trust which will enable the project leader to learn from their experience and provide effective input. The stakeholders will also help in identifying outcome measures (Brownson, Fielding, & Green, 2018). The second strategy is to seek administrative support. The administration will be able to provide insight on other similar projects and how certain techniques were utilized in promoting the implementation of such projects. The administration will also help in promoting a supportive culture among employees to reduce resistance levels. The last strategy is to carry out substantial background research and involve staff members in the implementation process. This will help identify gaps within the current practice and come up with appropriate and readily acceptable EBP such as the 10 items of MAI (Cadogan et al., 2018).
Formative Evaluation Plan
The formative evaluation plan aims at fostering the development and improvement of the plan before initiating the implementation step. The evaluation plan will also consider the summative approach in assessing whether the expected results of the project have met the stated goals, by collecting feedback and presenting them to the stakeholders (Stirman, Baumann, & Miller, 2019). The formative evaluation plan will involve completing need assessment questionnaires, conducting implementation analysis, and performing progress analysis. In the implementation of the 10 items MAI into practice, prescribers will be utilized as the main source of feedback (Cadogan et al., 2018).
The need assessment questionnaires will be filled by involved stakeholders regarding the areas of improvement, potential barriers, and facilitators to promoting the change. The implementation analysis will involve assessment of the fidelity to the implementation strategy and the clinical intervention being proposed. Progress analysis on the other hand will focus on monitoring the progress towards implementation and improvement of the set goals during the intervention (Brownson, Fielding, & Green, 2018). The feedback for the evaluation process will include semi-structured interviews with stakeholders, focus groups, structured surveys, electronic health records, charts, document reviews, and management information systems. Feedback will also be collected by direct observations through site visits.
Plan for Formative Evaluation in this Pandemic Situation
The Covid-19 pandemic has led to several changes in the protocol of how healthcare services are being provided. In the same case, the methods in which formative evaluation will be conducted must be modified to meet the current standards of practice. For instance, reducing contact among people is very crucial in curbing the spread of the virus (Osborne, 2017). As such, face-to-face interviews will be avoided. Instead, feedback will be collected through social media and online platforms such as the use of Emails. Consequently, video conferences will be preferred to conduct discussions rather than crowded conference rooms. However, for those who will be forced to be involved directly with the evaluation process, protocols such as vaccination will be applied.
During week 2, in a simulated scenario when your formative evaluation plan reveals not all of the staff have implemented the evidence-based intervention. What is your next step?
Upon incomplete adoption of the new practice, it is necessary to assess the cause of the situation, come up with appropriate strategies, and promote complete adoption of the change. Feedback will be collected from staff members who will not have adopted the new practice, to find out the reasons behind their lack of participation (Shelton, Cooper, & Stirman, 2018). In most cases, incomplete adoption of change is normally caused by a lack of time or limited knowledge regarding the use of the new approach. As such, it is necessary to work with the employee’s schedule and find an appropriate time to promote education regarding the new practice and its benefits. With a full understanding of the reasons behind the proposed change, and the benefits if implemented, staff members will be more interested to use the new practice and realize the benefits.
What are you learning about project implementation? What issues have you identified? How will you address these? Use these examples as headings or substitute with the same number of examples that are appropriate to your case study project be robust:
- You identify that the staff needs more information about evidence-based practice. What will you do?
Teaching programs will be designed based on the information needed of the staff members regarding evidence-based practice. The teaching programs will utilize effective communication strategies to promote conveying of the knowledge to staff members (Stirman, Baumann, & Miller, 2019). Such strategies include tailoring the message, ensuring that the tailored messages are targeted to audience segments, use of narratives, and framing of the message.
- You identify that staff needs more information about the evidence-based intervention. What will you do?
To promote more information regarding the evidence-based intervention, it is necessary to promote self-initiated background research on the healthcare problem and available interventions use to solve the problem (Brownson, Fielding, & Green, 2018). The staff members will then be provided with brochures and fliers giving background information on the new intervention, and its benefits. Training programs will also be designed to fit the needs of the employees and the patient regarding the new intervention.
- You identify that you need to provide remedial training. How will you accomplish this?
To provide remedial training to staff members, a group of specialists will be involved in assessing the information gap and setting the new training goals. New microlearning approaches will be considered such as short videos to avoid burnouts as a result of long working hours (Stirman, Baumann, & Miller, 2019). Different learning habits will also be involved such as the use of software that has a user-friendly interface especially for the case of the 10 items MAI (Cadogan et al., 2018).
In your simulated Case Study some staff state “I am too busy” or “I do not see a need for change since the ‘way we have always done it’ works fine.” How will you address this?
In this situation, I will have to spare as little time as possible with the employee and try to convince them about the benefits of the new intervention over the current practice. I will provide backup evidence using data and statistics drawn from the organization that has successfully implemented the new approach, and the benefits being realized. I will also give examples of colleges who have already adopted the change and have them explain the benefits from their own experience.
What additional resources may be necessary for a successful implementation?
Additional resources for the implementation of this project will include infrastructures such as computers, wi-fi, and HER software (Shelton, Cooper, & Stirman, 2018). These resources will be used to collect and keep data recorded on the 10 items MAI. Investors may also be needed to help provide adequate finances to support the project.
You have opposition or pushback from the nursing staff about making a change in practice during a pandemic crisis, how would you respond to this pushback?
I will align the needs of the change to the current needs of the pandemic crisis, and explain to them, how this new intervention will benefit the current situation (Stirman, Baumann, & Miller, 2019). With the Covid-19 pandemic, the elderly population is being affected by comorbidities more than ever. This increases the risks of inappropriate polypharmacy, hence the need for the 10 items MAI tool.
Brownson, R. C., Fielding, J. E., & Green, L. W. (2018). Building capacity for evidence-based public health: reconciling the pulls of practice and the push of research. Annual review of public health, 39, 27. DOI:
Stirman, S. W., Baumann, A. A., & Miller, C. J. (2019). The FRAME: an expanded framework for reporting adaptations and modifications to evidence-based interventions. Implementation Science, 14(1), 1-10.
Shelton, R. C., Cooper, B. R., & Stirman, S. W. (2018). The sustainability of evidence-based interventions and practices in public health and health care. Annual review of public health, 39, 55-76.
Osborne, S. (2017). Making evidence-based perioperative practices stick: An introduction to an implementation science approach. ACORN: The Journal of Perioperative Nursing in Australia, 30(4), 53-55. https://search.informit.org/doi/10.3316/informit.317274992620092
Cadogan, C. A., Ryan, C., Gormley, G. J., Francis, J. J., Passmore, P., Kerse, N., & Hughes, C. M. (2018). A feasibility study of a theory-based intervention to improve appropriate polypharmacy for older people in primary care. Pilot and feasibility studies, 4(1), 1-12.
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. Please refer to the directions in the Student Success Center.
Note: After submitting the assignment, you will receive feedback from the instructor. Use this feedback to make revisions for your final paper submission. This will be a continuous process throughout the course for each section.
NUR 590 Assignment Implementation Plan
NUR 590 Assignment Implementation Plan
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.
Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.
Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.
The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.
ADDITIONAL INSTRUCTIONS FOR THE CLASS
Discussion Questions (DQ)
Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
I encourage you to incorporate the readings from the week (as applicable) into your responses.
Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.
APA Format and Writing Quality
Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
I highly recommend using the APA Publication Manual, 6th edition.
Use of Direct Quotes
I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
It is best to paraphrase content and cite your source.
For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.
The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
I do not accept assignments that are two or more weeks late unless we have worked out an extension.
As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.
Communication is so very important. There are multiple ways to communicate with me:
Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.