Benchmark – Evidence-Based Practice Project Proposal: Organizational Culture and Readiness

Grand Canyon University Benchmark – Evidence-Based Practice Project Proposal: Organizational Culture and Readiness-Step-By-Step Guide

This guide will demonstrate how to complete the Benchmark – Evidence-Based Practice Project Proposal: Organizational Culture and Readiness assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for Benchmark – Evidence-Based Practice Project Proposal: Organizational Culture and Readiness

Whether one passes or fails an academic assignment such as the Grand Canyon University Benchmark – Evidence-Based Practice Project Proposal: Organizational Culture and Readiness depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for Benchmark – Evidence-Based Practice Project Proposal: Organizational Culture and Readiness

The introduction for the Grand Canyon University Benchmark – Evidence-Based Practice Project Proposal: Organizational Culture and Readiness is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for Benchmark – Evidence-Based Practice Project Proposal: Organizational Culture and Readiness

After the introduction, move into the main part of the Benchmark – Evidence-Based Practice Project Proposal: Organizational Culture and Readiness assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for Benchmark – Evidence-Based Practice Project Proposal: Organizational Culture and Readiness

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for Benchmark – Evidence-Based Practice Project Proposal: Organizational Culture and Readiness

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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NUR 590 Benchmark – Evidence-Based Practice Project Proposal: Organizational Culture and Readiness

In 750-1,000 words, analyze the culture and level of readiness of the organization for which your evidence-based practice project is proposed.

Describe the organization’s culture and explain to what degree the culture supports change. Consider organizational and leadership structure, mission and values, interprofessional collaboration/team engagement, communication, perception of the organization by employees, etc.
Select an organizational readiness tool and assess the level or readiness for change within your organization. Identify the readiness tool and summarize the survey results. Discuss the degree to which the culture will support and sustain an evidence-based practice change. Consider strengths and weaknesses, potential barriers, stakeholder support, timing of the proposal, and resources. Provide rationale.
Discuss what health care process and systems you would recommend for improving quality, safety, and cost-effectiveness for the organization.
Propose strategies to better facilitate the readiness of the organization.
Identify the stakeholders and team members for the project. Include what their duties will be in the evidence-based practice project proposal.
Explain what information and communication technologies are needed for the implementation and how they will be integrated in the setting by the internal stakeholders. Explain how these will help improve nursing practice and care delivery for individuals and populations for your intervention.

Nursing leader’s server as advocates within their organizations. Leaders have requisite knowledge, skills, and understanding and represent the front door into the healthcare service delivery. Nursing leaders need to be comfortable withing their administrative structures to use their powers to advocate for the role of nurses. Advocating in policy discussions to help reduce health care cost and improvement in patients’ outcomes and quality of life through collaborative team-based care. (Stevenson, 2021) Advocating for nursing staff can begins with assessing needs. Do the nurses have the correct tools they need to provide best practice care. Are nurses being treated fairly and are they assuring measures to prevent nursing fatigue and burn out such as appropriate breaks and lunches.

EBP is on fall reduction in a medical-surgical ward within 24 weeks

The provision of safe and high quality care is imperative in nursing and healthcare. Evidence-based interventions have proven effective in facilitating the realization of care outcomes in healthcare. Nurses and other healthcare providers have the responsibility of utilizing care interventions that optimize the care outcomes of patients. Therefore, this section of the project explores the organizational culture and readiness level of the organization to support the proposed intervention.

Organizational Culture

Culture plays an important role in the implementation of evidence-based and change interventions. An organizational culture should support the successful use and sustainability of change projects (Mallette & Rykert, 2018). The culture of the organization where the project will be implemented is supportive. The supportive nature of the culture can be seen from a number of aspects. Firstly, the organization utilizes transformational leadership styles that encourage innovation in the provision of care. The leadership of the organization supports its staff in implementing change projects that would contribute to safety, quality and efficiency in patient care. The organization also has values that support change. The values include openness in communication, transparency, teamwork, and active stakeholder involvement in implementing change. The organizational values are supportive in nature because they underpin collectivism in the assessment, planning, implementation, and evaluation of change.

The organization also supports two-way communication between employees, management and leadership. The employees have the freedom to express their ideas and concerns in the organization. The management and leadership also ensure openness in strategy analysis and implementation. Through it, the employees are motivated to play a proactive role in implementing change (Chaudhry, 2018). Consequently, the above aspects of organizational culture will support the implementation of change.

Survey Results

Health organizations should be assessed for their culture and readiness to embrace change. The organizational culture and readiness assessment was done using the tool by Buildingmovement.org. The tool examines the culture and readiness of the organization from the organization, leadership, and staff’s perspectives (Buildingmovement.org, n.d). The results showed that the organization performed excellently in its culture and readiness for change. The organization scored 17/24 in all the areas of rating in the yes its true component of the tool. This score implies that the organization has supportive culture and is ready to implement the change. The organization scored 5/24 in the ‘this is developing or in process’ component of the tool that implies the organization’s mechanisms being in place to facilitate change. Lastly, the organization scored 2/24 in the ‘don’t know/not sure’ column of the tool, representing the lack of awareness of the stakeholders on the culture and readiness level of the organization to support change.

The assessment of the culture and readiness level of the organization revealed a number of organizational strengths, weaknesses, barriers and facilitators for the change. One of the evident strengths in the assessment was the supportive nature of the organizational leadership. The assessment showed the organization to have effective leadership that supports transformational and innovative interventions in healthcare. The other strength is the existence of culture of teamwork in the organization. Teamwork is important in implementing change, as it minimizes resistance to change. One of the weaknesses identified in the assessment is the low level of knowledge among the staffs on the implementation of evidence-based interventions. Low level of knowledge may hinder the successful implementation of change due to lack of the needed skills as well as fear of the unknown effects of the change (Fagerström, 2021). One of the identified barriers to the change in the organization is staff shortage. Shortage of the needed staff may hinder the implementation process due to the high workload and lack of time for the staffs to engage in project initiatives. The barriers will be addressed by utilizing the existing resources in the organization to hire additional staffs in the setting where the project will be implemented. The project will also be implemented over an extended period to enable its adequate utilization in practice.

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Recommended Healthcare Process and Systems

One of the recommendations that should be considered in the organization to improve quality, safety, and cost-effectiveness of care is increasing the adoption of health information technologies. Health information technologies such as telehealth and barcode system of medication administration should be adopted to promote efficiency, safety and quality of care. Health technologies such as telehealth have been shown to reduce healthcare costs and resource utilization for patients and healthcare institutions (Menachemi et al., 2018). The other recommendation is the need for increasing the ratio of nurses to patients in the institution. Adequate staffing level is important for the profession of high quality, safe and efficient care. Adequate staffing eliminates issues such as high workload, burnout, and low job dissatisfaction among the healthcare providers (Castro-Sánchez & Santillán-García, 2020).

Strategies to Facilitate Readiness

Successful implementation of change requires that the adopters have the required knowledge and skills to facilitate the process. A number of strategies will be utilized to facilitate readiness among the nurses to implement the proposed change. One of the strategies will be training. Nurses and key stakeholders involved in the implementation of the project will be trained. They will be trained about the implementation of the intervention to ensure that they have the desired knowledge and skills. Training minimizes resistance to change from those involved in the implementation process (Yazdani & Wells, 2018).

The second strategy will be encouraging active stakeholder participation. Nurses and other stakeholders will be actively involved in all the change processes such as assessment, planning, implementation, monitoring, and evaluation. Active involvement will promote their empowerment as well as ownership of the change initiative by the organizational stakeholders (Mallette & Rykert, 2018). The last strategy will be the provision of accurate information about the change. The need for change will be communicated consistently with accurate information about the benefits of change being provided to influence and persuade the adopters to implement it.

Stakeholders and Team Members

The stakeholders and team members for the change initiative will comprise of trainers, registered nurses, nurse managers, and laboratory technologists. Registered nurses will be the primary implementers of the change. They will implement the change by working with patients requiring urinary catheters. Registered nurses will also collect the data that will be used in determining the effectiveness of the intervention. Nurse Managers will oversee the implementation of the project. They will ensure that the right strategies are utilized in selecting the patients to be placed in the intervention and control group. Nurse managers will also coordinate with the project team on issues such as the needs and concerns of the implementers.

Moreover, laboratory technologists will be involved in the analysis of the urine samples of the patients involved in the project. Trainers will provide registered nurses, nurse managers, and laboratory technologists with the knowledge and skills they need for the successful implementation of the project. The information technologies that would be needed for the implementation of the project will include projectors and educational videos. Projectors will be used in the training and results dissemination phases of the project. Educational videos will be used as part of the reinforcements for the project in the unit. They will also be used for educational purposes for the new staffs in the department. Information and communication technologies will contribute to knowledge and skill development among nurses as well as reduction in the risk and rate of urinary tract infections among catheterized patients.

Conclusion

In summary, the organizational culture supports the implementation of change initiative. Recommendations that include the adoption of health information technologies and increasing the staffing in the institution should be considered for the improvement in processes and systems. Strategies such as stakeholder training and active participation will be utilized to facilitate change. Active stakeholder participation will be encouraged to minimize resistance to change by the adopters.

References

Buildingmovement.org. (n.d.). Organizational Readiness Assessment. http://www.buildingmovement.org/wp-content/uploads/2020/03/Organizational_Readiness_Assessment_Tool.pdf

Castro-Sánchez, E., & Santillán-García, A. (2020). Smart lobbying for minimum nurse staffing ratios in spain: not just numbers. Policy, Politics & Nursing Practice, 21(2), 60–61. https://doi.org/10.1177/1527154420923753

Chaudhry, S. (2018). Managing employee attitude for a successful information system implementation: a change management perspective. Journal of International Technology and Information Management, 27(1), 57–90.

Fagerström, L. M. (2021). Leading Change When Implementing Advanced Practice Nursing. In L. M. Fagerström (Ed.), A Caring Advanced Practice Nursing Model: Theoretical Perspectives And Competency Domains (pp. 219–233). Springer International Publishing. https://doi.org/10.1007/978-3-030-53555-1_12

Mallette, C., & Rykert, L. (2018). Promoting positive culture change in nursing faculties: Getting to maybe through liberating structures. Journal of Professional Nursing, 34(3), 161–166. https://doi.org/10.1016/j.profnurs.2017.08.001

Menachemi, N., Rahurkar, S., Harle, C. A., & Vest, J. R. (2018). The benefits of health information exchange: An updated systematic review. Journal of the American Medical Informatics Association, 25(9), 1259–1265. https://doi.org/10.1093/jamia/ocy035

Yazdani, A., & Wells, R. (2018). Barriers for implementation of successful change to prevent musculoskeletal disorders and how to systematically address them. Applied Ergonomics, 73, 122–140. https://doi.org/10.1016/j.apergo.2018.05.004

Organizational culture is a system of shared values and beliefs that contributes to behavior norms and determines an organizational way of life. Organizational culture is evaluated based on core values, shared assumptions, and common approaches to work (Nguyen Van et al., 2018). This paper seeks to analyze the culture and level of readiness of the organization for which my EBP project is proposed.

Organizational Culture and Degree to Which Culture Supports Change

The project on incorporating peer support in trauma-informed care will be implemented in my current healthcare organization. Our organization has an Adhocracy culture, which is defined by the flexibility and external focus aspects. Our culture is rooted in energy and creativity and involves innovation as a way of organizational functioning (Nguyen Van et al., 2018). Besides, the employees are encouraged to take risks, and our leaders are perceived as innovators. The work environment is agile and transformative, which has made the Adhocracy culture thrive (Nguyen Van et al., 2018). In addition, we emphasize specialization and rapid change within the organization, and thus change will be highly appreciated. Due to the innovative spirit in the organization, the employees are continuously engaging in activities that will promote positive change in the organization to achieve our goals and vision.

Organizational Readiness Tool and Readiness Assessment

The cultural assessment questionnaire developed by the World of Work Project (2019) will be used to conduct an organizational culture and readiness assessment. The tool is useful for organizations or teams that are going through change. The cultural assessment questionnaire evaluates several dimensions of organizational culture, including the decision-making process, treatment of employees, teamwork, tradition, and change implementation (World of Work Project, 2019). The organization scored high in teamwork, objectives-driven employees, change, a strong emphasis on employees, consensus decisions, team communication, and cooperation. However, low scores were noted in decentralization, focusing on customer service, building long-term customer relationships, and attention to detail.

The culture assessment results reveal that our organization’s culture will support and sustain an evidence-based practice change. As a result, incorporating peer support in TIC will be readily accepted and implemented in the department and staff that provide TIC services. Strengths that will facilitate change implementation of the peer support intervention include: employees are driven by targets and objectives, encouraging and rewarding teamwork, leaders encourage change and innovation, consensus decision, frequent and transparent team communication, and coordination and cooperation in the delivery of patient care.

Weaknesses and potential barriers exist and might hinder change implementation. Weaknesses include a lack of a decentralized decision-making system and a lack of attention to detail with staff employing the 80/20 rule. Barriers include shortage of qualified peer support workers, self-care needs of peer workers, and lack of finances to pay for service and wages of peer support workers. The change proposal will be readily implemented since stakeholders’ support change in the organization. Besides, the timing of the proposal is appropriate since the organization has many clients on TIC.

Health Care Process and Systems Recommended for Improving Quality, Safety, and Cost-Effectiveness

A quality improvement (QI) program would be an effective healthcare process to improve quality, safety, and cost-effectiveness. A QI program entails systematic activities organized and executed by an organization to track, evaluate, and enhance its quality of health care (De La Perrelle et al., 2020). The activities are usually repeated so that the organization continues to strive for higher performance levels to improve the care for its patients. I would recommend a QI program since it helps an organization improve patient health outcomes that entail both process outcomes and health outcomes (De La Perrelle et al., 2020). It also enhances the efficiency of managerial and clinical processes. An organization can minimize waste and costs attributed to system failures and redundancy by improving processes and outcomes related to high-priority health needs.

Strategies to Facilitate Organizational Readiness

Organizational readiness to change is the organizational members’ commitment to change and mutual belief in their collective capability. Strategies that would better facilitate readiness in our organization include consistent leadership messages and actions, teamwork, and active stakeholder involvement. Consistent leadership messages and actions can promote organizational readiness by leaders conveying consistent messages and acting consistently to foster change (Metwally et al., 2019). This can inspire employees to embrace common perceptions of readiness to change and foster cooperation when implementing the project. Fostering teamwork would promote organizational readiness since it encourages employees to collaborate to implement the change and achieve desired goals. Besides, active stakeholder involvement can facilitate organizational readiness since stakeholders determine if a change will be implemented and how the change process will occur (Metwally et al., 2019). Stakeholders in the organization can be encouraged to be active in implementing change to encourage other employees to put more effort, be persistent, and cooperative in the change process.

Stakeholders and Team Members Needed

Stakeholders and team members needed for the TIC project will include the hospital administrator, nurses, physicians, therapists, peer support trainers, and peer support workers. The hospital administrator will be responsible for overseeing the project’s activities and approving resource allocation to the project. Nurses and physicians will be tasked with screening patients for trauma, developing patients’ treatment plans, and referring patients to therapists and peer support workers (Shalaby & Agyapong, 2020). In addition, therapists will be involved in providing psychotherapy to patients affected by trauma. Peer support trainers will provide special training to peer support workers before they are part of the care team (Shalaby & Agyapong, 2020). Lastly, peer support workers will be tasked with implementing peer support interventions to overcome the isolation among patients with trauma experiences.

Information and Communication Technologies Needed

Communication about the project will be facilitated by technologies such as the internet and email. Stakeholders and team members will be sent emails to inform them of the project proposal and its implementation. Peer support trainers will require technologies such as computers and projectors to facilitate training. Besides, the internet, computers, and referral software will be needed to facilitate the referral of patients to therapists and peer support workers.

Conclusion

The organization for the EBP project has an Adhocracy culture with a culture rooted in energy and creativity. The culture highly supports change since the work environment is agile and transformative. A cultural assessment using the World of Work Project tool revealed that the organization would support and sustain the EBP change. It scored high in aspects that promote organizational change such as objectives-driven employees, change, emphasis on employees, consensus decisions, team communication, and cooperation. Strategies that would better facilitate readiness in our organization include consistent leadership messages and actions, teamwork, and active stakeholder involvement.

References

De La Perrelle, L., Radisic, G., Cations, M., Kaambwa, B., Barbery, G., & Laver, K. (2020). Costs and economic evaluations of quality improvement collaboratives in healthcare: a systematic review. BMC health services research, 20(1), 1-10. https://doi.org/10.1186/s12913-020-4981-5

Metwally, D., Ruiz-Palomino, P., Metwally, M., & Gartzia, L. (2019). How ethical leadership shapes employees’ readiness to change: the mediating role of an organizational culture of effectiveness. Frontiers in psychology, 10, 2493. https://doi.org/10.3389/fpsyg.2019.02493

Nguyen Van, H., Nguyen, A. T., Nguyen, T. T., Nguyen, H. T., Bui, H. T., Tran, P. T., & Nguyen, A. L. (2018). Individual and occupational differences in perceived organizational culture of a central hospital in Vietnam. BioMed research international, 2018. https://doi.org/10.1155/2018/3759290

Shalaby, R. A. H., & Agyapong, V. I. (2020). Peer support in mental health: literature review. JMIR Mental Health, 7(6), e15572. https://doi.org/10.2196/15572

World of Work Project. (2019). A Simple Organizational Culture Assessment Questionnaire. The World of Work Project. https://worldofwork.io/2019/07/organizational-culture-assessment-questionnaire/

Healthcare organizations encounter multiple practice problems that differ in magnitude and scope of interventions needed to control their adverse impacts. Due to the profound impacts of these problems on patient safety and care quality, nurses should design evidence-based interventions and actively participate in their implementation. Despite nurses’ readiness to implement practice change, many organizational factors, including the culture and resources, determine the success of evidence-based practice (EBP) change. Therefore, the purpose of this paper is to analyze the organizational culture and level of readiness for the evidence-based practice (EBP) project.

Organizational Culture and Degree of Supporting Change

Organizations have varying values, missions, and strategic goals that affect how individuals work, interact, and respond to change. In nursing, organizational culture represents shared beliefs and values that shape behaviors and inform team members’ actions (Tietschert et al., 2019). A close analysis of how leaders and staff interact, cooperate, and respond to issues depicts the current organization’s culture as an adhocracy. According to Tietschert et al. (2019), adhocracy centrally focuses on supporting individual initiatives to improve health outcomes, achieved by continued management support. As a culture that readily supports change, leaders value the staff’s contribution to organizational change to achieve the organization’s mission of delivering high-quality care to improve patients’ and the population’s health. Shared values include collaboration, integrity, and servant leadership. Open communication is also highly encouraged to ensure positive interactions and the achievement of shared goals. Employees perceive the organization positively since they get adequate support for personal and professional development.

Organizational Readiness Tool and Level of Readiness

Nursing professionals and leaders use different tools to evaluate their organizations’ readiness for change. The current evaluation was done using the Organizational Readiness to Change Assessment (ORCA) survey. Appropriate for small and large organizations, ORCA assesses an organization’s readiness from three dimensions: evidence proposing the practice change, organizational context, and internal facilitation context (Kononowech et al., 2021). The current organization scored 85/90 (Appendix A), demonstrating it as a facility ready for change and willing to support innovation. The EBP project is supported by high-level evidence. Other factors include leaders supporting innovation and a strong belief in the progressive improvement of processes and outcomes.

Strategies to Better Facilitate Organization’s Readiness

Organizations committed to improving health outcomes should be ready for change. Organizational readiness represents the extent to which leaders and employees are mentally and behaviorally ready to implement change (Leslie et al., 2022). An effective strategy for improving readiness is progressive performance evaluation. Here, the management should ensure underperformance areas are continually assessed as the foundation of outcomes improvement. Continued leadership support is also critical in motivating the nursing staff to explore opportunities to change and engage in EBP implementation. A culture that values interprofessional collaboration and employee growth is also essential for collaboration in identifying shared problems and effective responses.

Supporting and Sustaining Evidence-Based Practice Change

The organizational culture assessment demonstrates an organization committed to supporting and sustaining an EBP change. Concerning strengths, the proposed project aligns with the organization’s mission of delivering high-quality care. Therefore, leadership support and presence are guaranteed. A major weakness includes overreliance on leadership support for success. Potential barriers during organizational change include inadequate resources, resistance to change, and ineffective change communication (Cheraghi et al., 2023). Resource barriers could be a significant barrier, but adequate stakeholder support will help to overcome them. The timing of the project is also encouraging since the organization is presently emphasizing progressive change for improved health outcomes. Dependence on internal resources is another critical success factor for the successful implementation and sustenance of the project.

Improving Quality, Safety, and Cost-Effectiveness

A valuable process for quality and safety improvement is continuous risk assessment. Its purpose is to ensure that human and technical risks hampering care quality and patient safety are identified and addressed in a timely manner. Lean management would also be highly effective in improving quality, safety, and cost-effectiveness. According to Mahmoud et al. (2021), lean management focuses on minimizing waste in processes and procedures for improved outcomes. Technological systems for optimizing efficiency are essential for improved accuracy and efficiency, hence reducing healthcare costs.

Stakeholders and Team Members for the Project

An EBP project involves various stakeholders and team members depending on the type and scope of work required. In nursing, stakeholders include individuals and groups directly affected by change implementation, hence the need for change to align with their values (Quanbeck, 2019). Stakeholders include the management, program analysts, nurse leaders, and patients. Team members include the nursing staff since their collaboration and direct participation are essential for successful implementation. The management should provide the material and financial resources needed for implementing the EBP project. Program analysts and nurse leaders will play the advisory role in critical phases, such as design, implementation, and evaluation.

Information and Communication Technologies and their Importance

Healthcare delivery is continually becoming a data-driven and tech-reliant practice. Crucial information and communication technologies for effective implementation include communication devices, data entry tools, and computers. Electronic health records (EHRs) and Microsoft Excel tools are also essential for data recording and analysis. Internal stakeholders will integrate these technologies by appropriate purchasing and training users as situations necessitate. Generally, these technologies will improve nursing practice and care delivery for the targeted individuals and populations by enabling communication and interactions to address a shared problem. They will also enable effective data gathering, analysis, and evaluation to guide continuous improvement for sustained health outcomes.

Conclusion

EBP projects help organizations improve health outcomes. Successful change requires a culture that supports innovation and seeks progressive organizational growth. The organization’s assessment through the ORCA survey reveals that it is highly ready for change. The leadership structure (adhocracy) also supports innovative interventions designed to address inefficiencies. Maximum resource facilitation and participation of stakeholders and team members are expected for successful implementation.

References

Cheraghi, R., Ebrahimi, H., Kheibar, N., & Sahebihagh, M. H. (2023). Reasons for resistance to change in nursing: an integrative review. BMC Nursing, 22(1), 310. https://doi.org/10.1186/s12912-023-01460-0

Kononowech, J., Hagedorn, H., Hall, C., Helfrich, C. D., Lambert-Kerzner, A. C., Miller, S. C., … & Damschroder, L. (2021). Mapping the organizational readiness to change assessment to the Consolidated Framework for Implementation Research. Implementation Science Communications, 2(1), 1-6. https://doi.org/10.1186/s43058-021-00121-0

Leslie, H. H., West, R., Twine, R., Masilela, N., Steward, W. T., Kahn, K., & Lippman, S. A. (2022). Measuring organizational readiness for implementing change in primary care facilities in rural Bushbuckridge, South Africa. International Journal of Health Policy and Management, 11(7), 912–918. https://doi.org/10.34172/ijhpm.2020.223

Mahmoud, Z., Angelé-Halgand, N., Churruca, K., Ellis, L. A., & Braithwaite, J. (2021). The impact of lean management on frontline healthcare professionals: a scoping review of the literature. BMC Health Services Research, 21(1), 1-11. https://doi.org/10.1186/s12913-021-06344-0

Quanbeck, A. (2019). Using stakeholder values to promote implementation of an evidence-based mobile health intervention for addiction treatment in primary care settings. JMIR mHealth and uHealth, 7(6), e13301. https://doi.org/10.2196/13301

Tietschert, M. V., Angeli, F., van Raak, A. J. A., Clark, J., Singer, S. J., & Ruwaard, D. (2019). Can organisational culture of teams be a lever for integrating care? an exploratory study. International Journal of Integrated Care, 19(4), 10. https://doi.org/10.5334/ijic.4681

Summarize the intervention you are proposing:  

For healthcare workers in a rural pacific hospital (P), how does a multifaceted workplace violence program with spaced training, standardized debriefs and post-event support, violence risk screening and interventions, and a BHRT (I), when compared to annual training and WPV reporting encouragement (C), affect healthcare worker WPV injuries, WPV reporting, employee safety scores, employee comfort in the identification and handling of potential and actual violent incidents, and employee perception of WPV support (O) over a year (T)? 

The multifaceted approach includes:  

Update the WPV program to address data gaps in the completed ECRI WPV Self-Assessment (ECRI, 2020). 
Training:  
Expanding on the research from resuscitation training that found spaced training increases performance, increase the frequency of de-escalation training to quarterly, and include competency validation (Anderson et al., 2018; Hunter, 2020).   
Include psychiatric crisis training (Hunter, 2020) 
Focus/mentor less experienced healthcare workers (Hunter, 2020) 
Create a debrief checklist to ensure a standardized debrief is completed post-incident and track quality and performance indicators (QI/PI) related to WPV.  
Define/initiate post-event support for healthcare workers (Croke, 2022).  
Identify and initiate high-risk violence patient screening tool (Spelten et al., 2020).  
Initiate subsequent interventions, including care planning interventions in collaboration with a behavioral health registered nurse when the patient is in an acute medical unit.

Initiate a behavioral emergency response team (BHRT) (Rajwani et al., 2022).

Justify how the problem you selected to investigate is amenable to a research-based intervention using the PICOT format. 

The PICOT format helped to narrow the problem and search for literature to identify evidence-based WPV interventions that support a timely outcome for improvement within the institution. The above PICOT is an intervention question to guide the search for the best evidence in reducing WPV while supporting translational and implementation science (Lane-Fall et al., 2019; Melnyk & Fineout-Overholt, 2019).

How does this support the population of focus, your setting, and role? 

Healthcare workers composed 73% of all nonfatal workplace violence (WPV) injuries in 2018 after doubling rates of WPV since 2011 (U.S. Bureau of Labor Statistics, 2022). In more recent 2022 data, the Press Ganey (2022) National Database of Nursing Quality Indicators found a sharp rise in WPV, with nearly fifty-seven assaults occurring daily. Globally, workplace violence (WPV) against healthcare workers creates a significant occupational hazard (Liu et al., 2019; Ramzi et al., 2022). The stress of WPV reduces job satisfaction, engagement, and productivity. As such, evidence of poor quality of life from sleep disruption and burnout result in decreased retention amid rampant nursing workforce shortages (Mento et al., 2020). Unfortunately, the latest meta-analyses of WPV interventions identify that the typical healthcare de-escalation training does not consummate WPV prevention or reduction (Geoffrion et al., 2020; Spelten et al., 2020).