Complete your paper of 6–8 pages, plus cover page and references page, explaining your investigation of three hypothetical practice sites for an EBP QI project.

NURS 8114 Module 3 Assignment: Exploring EBP Quality Improvement

Complete your paper of 6–8 pages, plus cover page and references page, explaining your investigation of three hypothetical practice sites for an EBP QI project.

Investigating Ways to Boost the Quality of EBP The care that patients receive is significantly impacted by the work that nurses do. They investigate interventions that are supported by evidence and can be implemented to improve the safety, quality, and effectiveness of patient care. EBP quality improvement strategies enable health organizations to provide services that match with the needs and expectations of their communities. Therefore, the purpose of this study is to investigate the practical issues that can be solved by implementing EBP QI projects.
Potential Sites
Utilizing proper practice locations is essential to the achievement of a successful implementation of projects based on evidence-based practice. A tertiary hospital where I work as a registered nurse is being considered as a potential location for one of the potential locations of an evidence-based practice quality improvement initiative. A tertiary setting is a major hospital that treats patients from a wide variety of demographics and cultural traditions and offers both specialist and general medical care. The location offers a comprehensive selection of medical care services, such as obstetrics, gynecology, surgery, intensive care, pediatric care, inpatient care, and outpatient care. Maternity care is also available. The hospital addresses patients from all backgrounds requiring specialized or general care. The tertiary hospital is a private institution that was set up to meet the ever-increasing medical requirements of a variety of patient groups. The institution’s primary goal is to establish itself as a forerunner in the delivery of cutting-edge medical services to the communities it serves. There is only one institution comprising the organization.

A nursing home located in the area where I currently call home is the second possible location for an evidence-based practice (EBP) quality improvement initiative. The nursing home is a mid-level entity that was designed to give general and specialized care to patients from varied backgrounds. The home is a private organization that offers a variety of medical services, including obstetrical, pediatric, inpatient, and outpatient care, as well as surgery. The institution is a single entity whose purpose is to meet the requirements of individuals, families, and the community as a whole by providing treatment that is centered on the patient and is of the highest possible standard of safety and effectiveness.

The last feasible location for the EBP quality improvement project is a specialized center for the elderly patients in the neighborhood. Patients of elderly age who are experiencing a variety of health issues can receive specialized care at the clinic. The institution is a private company that provides its services to all the elderly patients irrespective of their backgrounds. The center is a single institution whose objective is to provide care to senior patients that is both of a high standard and innovative in nature, with the goal of increasing the patients’ overall health and well-being.

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Contrast between the Environments

All of the aforementioned environments come with their own unique mix of advantages and disadvantages, making each of them a potential candidate for the site of an EBP quality improvement project. When it comes to the delivery of patient care, the tertiary hospital has ingrained in its culture the utilization of evidence-based practice solutions. Healthcare practitioners are encouraged to employ best practices in optimizing the outcomes of care such as safety, quality, and efficiency (Platz, 2019). (Platz, 2019). In addition, the hospital possesses the financial and people resources necessary to put Evidence-Based Practice (EBP) quality improvement projects into action. In addition, the institution has sufficient manpower, which boosts the likelihood that an EBP quality improvement effort would be successfully implemented. Teamwork is heavily implemented in the organization. According to Jolley (2020), effective collaboration in the provision of patient care contributes to the achievement of care outcomes such as quality, safety, and efficiency. However, there are a few problems with the configuration. One of them is the heavy workload for the healthcare practitioners, which may make it difficult for them to conduct EBP quality improvement projects. The heavy workload is attributed to the significant number of patients that utilize the services provided in the facility. In addition, the nursing home possesses a variety of positive qualities. One of them is the fact that it was recently named among the top five nursing homes in the region in terms of providing of high quality services to the patients. In addition, the nursing home fosters a culture of teamwork and places an emphasis on the results for patients when providing care to residents. The facility also recently incorporated health information technologies to increase the safety and quality of care delivered to the patients. The research that is now available suggests that the implementation of health information technologies improves the performance and competitiveness of health organizations by fostering improvements in safety, quality, and efficiency (Kushniruk, 2019). However, the nursing home faces the difficulty of insufficient resource availability, which has the potential to hinder the successful implementation of EBP quality improvement programs. For instance, it has been having trouble retaining its qualified staffs, which could potentially affect the way in which the change is implemented. As a possible location for the execution of an EBP quality improvement project, the senior care facility also possesses a number of favorable qualities that make it an attractive option. To begin, this location is well-known throughout the area for the excellent geriatric care that it provides. It has healthcare providers who have been trained and specialized on geriatric care. In addition to this, the provision of medical treatment in this context makes use of patient-centeredness paradigms. Care that is based on the needs of the patient is associated with positive results such as increased adherence to treatment as well as patient satisfaction and a sense of control over their own care (Kuipers et al., 2019). The environment nonetheless has disadvantages such as inadequate manpower to undertake EBP quality improvement initiatives and suffers difficulty in financing quality improvement projects. As a consequence of this, the aforementioned factors should be taken into consideration while determining an efficient environment in which to carry out the EBP quality improvement project.

Exercises with Problems

A variety of concerns with clinical practice were investigated at the various healthcare institutes. One of the practice difficulties that were examined in the tertiary institution is infection prevention. Infection prevention and control is a key part in any healthcare business. It is the obligation of health organizations to ensure that patients receive care that is of a high quality, safe, and efficient nature, hence reducing the likelihood of sickness and injury for the patients. Healthcare professionals are encouraged to embrace evidence-based interventions such as the use of aseptic methods to prevent infections among patients and healthcare personnel (Greenhalgh et al., 2020). (Greenhalgh et al., 2020). The level of safety provided to patients was the subject of the tertiary institution’s investigation into the second practice issue. The incidence of medication errors and the number of falls that occur among hospitalized patients were two of the safety indicators that were investigated. The hospital keeps a close eye on the indicators to ensure that all patients receive safe and high-quality care (Alshammari et al., 2018). The evaluation of the data connected with safety indicators might have been able to drive the implementation of practice interventions, which would have made it possible to guarantee that patients receive care that is tailored to both their current and potential requirements. One of the practice difficulties that were investigated in the nursing home was burnout among nurses. Burnout among nurses is a serious issue that threatens the safety and quality of treatment that patients receive (Rezaei et al., 2018). (Rezaei et al., 2018). Factors such as increased workload, shortage of healthcare providers, and difficulty in maintaining work-personal life balance predispose nurses to suffering burnout. Studies have indicated that burnout is connected with poor outcomes such as medication errors, higher staff turnover, and low rates of job satisfaction among those who work in the healthcare industry. It also increases the likelihood of the provision of poor quality care to the patients (Lahana et al., 2017). (Lahana et al., 2017). The other issue with the clinic that I looked into was the percentage of patients with chronic conditions who were readmitted within 30 days. Patients who have chronic diseases are a good indicator of the quality and safety of treatment provided in an institution since they have higher readmission rates. It is the obligation of healthcare practitioners and institutions to work toward lowering the rate of readmissions that occur among patients who have chronic conditions. The fact that the number of readmissions has gone down suggests that the care that is being provided to patients is effective, of high quality, and cost-effective (Berre et al., 2017). It also translates into the provision of care that limits the burden of the condition for the patients. In the care center for senior patients, the practice concern that was investigated was one involving safety issues. These safety issues included medication errors as well as patient falls. Because of the state of their health, elderly patients have a significantly increased likelihood of experiencing safety concerns such as falling. They are more likely to experience falls as a result of the adverse effects that are associated with the use of medications. Patients who are elderly are more likely to encounter other health issues, such as dementia, which raises the probability that they may experience a fall. Due to the fact that they are of advanced age, geriatric patients also have diminished pharmacologic and pharmacotherapeutic processes (Ezaz et al., 2018). It is the responsibility of nurses and all other professionals working in the healthcare industry to ensure that their practices encourage patients to use pharmaceuticals in a safe manner. As a consequence of this, it became necessary to investigate the safety concerns mentioned earlier in the senior care facility.

Potentiality of the Problems

The above concerns are potential focus for EBP quality improvement efforts. As indicated above, infection prevention and control is a vital factor that defines the safety and quality of patient treatment. Health organizations presently faces difficulty in reaching their aims of infection prevention due to the covid19 pandemic. Accordingly, most of the healthcare institutions in severely affected areas encounter issues in the provision of adequate personal protective equipment to provide safety to the healthcare workers and patients (Adhikari et al., 2020). (Adhikari et al., 2020). The tertiary institution provides specialist care to patients impacted by covid19 in the region. As a result of this, it is essential to investigate the many evidence-based interventions that can be implemented inside the organization to meet the goals of infection prevention and control. It is critical that nursing and other areas of healthcare prioritize the protection of patients and the improvement of services. Health institutions have the task of ensuring that safe conditions are given to optimize on the safety and quality outcomes in care. Patients’ health and well-being might be negatively impacted by safety concerns such as incorrect medicine dosages, exhaustion, and accidental falls (Smith & Plunkett, 2019). Interventions that are supported by scientific evidence are a viable option for addressing the practice issues outlined above. For example, technology can be studied for use in preventing and reducing the rate of medication errors and patient falls. Institutional measures such as provider education and provision of counseling services can assist address the problem of burnout among the healthcare personnel (Prout et al., 2019). (Prout et al., 2019). Therefore, the following practice difficulties can be areas of potential focus in EBP quality improvement efforts.


The launch of EBP quality improvement projects requires consent from multiple stakeholders in the above-selected health care context. In order to move forward with the project at the postsecondary institution, one must first obtain permission from the institution’s ethics and review board. The ethics and review board is assigned with the job of ensuring that EBP quality improvement initiatives as safe and protect the needs of the organizational stakeholders. The board considers the proposed projects and evaluates them to decide whether or not they are feasible for the organization. Additionally, it investigates whether the planned initiatives take into account the requirements and rights of vulnerable individuals, such as patients. It also assures that the institutional, state, and federal regulations are obeyed in the course of project implementation. The senior managers and executives in the company are the second type of stakeholder that must give their consent for the project before it can be started at the institution. It is imperative that the senior managers and executives get behind the project. They need to come to an agreement about the fact that the initiative improves the overall level of care and security at the institution. Approvals will be necessary to be obtained from the quality assurance department in the nursing home. The nursing home has quality assurance section that oversees the implementation of quality improvement activities. The department will ensure that the project aligns with the purpose, vision, and strategic objectives of the organization. Additionally, authorization needs to be obtained from the senior management team of the organization. In order to move on with the evidence-based practice (EBP) quality improvement initiative at the geriatric care center, the senior management of the institution have to give their blessing. The senior management is burdened with the job of authorizing and managing quality improvement interventions that are conducted to ensure the quality and safety of patient care. As a result, approvals to undertake the investigation will be obtained from them in the center.

Comparing the Requirements of Different Stakeholders Similarities and Differences

There are some commonalities and some distinctive distinctions between the stakeholder requirements of the various organizations that were chosen. One of the things that the requirements for the various stakeholders have in common is that they center on finding out whether or not the quality improvement programs are safe. The stakeholders determine whether the projects infringe the rights of the vulnerable in the organization. The requirements of all of the stakeholders focus on determining whether the providers will accept or reject the projects, which is another aspect that is comparable between the requirements of all of the stakeholders. One distinction in the standards is that while the ethics and review committee is concerned in the ethical aspects of the projects, senior management and leadership extends their focus to the practicality of the initiatives. Senior management and leadership investigate whether or not the projects may be economically viable, in addition to determining whether or not they can be maintained inside the firm.

The Context of the Proposed Practice and the Issue

My hypothetical presentation to the stakeholders will focus on the tertiary hospital as the proposed site for delivery of health care services. The hospital is eligible for the study because of its well-known history of engaging in evidence-based practice programs. Additionally, the organization possesses highly qualified staff members who are likely to back the idea. Well-informed staffs are essential in project implementation to address difficulties such as resistance to change in the implementation of the project. The proposed healthcare issue for presentation to the healthcare stakeholders is drug mistakes. Errors in medication are a significant problem for the public’s health. Medication mistakes risk patients to unintentional damage. Medication errors also lead to other unfavorable outcomes, including increased expenses of care, lengths of hospital stays, and the utilization of healthcare resources (Asensi-Vicente et al., 2018). The prevention of errors in medicine administration is significantly helped by nurses. They investigate evidence-based treatments that can be applied in practice to establish culture of safety and quality (Marvanova & Henkel, 2018). (Marvanova & Henkel, 2018). Because of this, the tertiary hospital ought to conduct quality improvement interventions to deal with the issue of medication errors in order to improve safety, quality, and overall hospital efficiency.


The tertiary care institution, the nursing home, and the geriatric care center have been chosen as the sites for the EBP quality improvement program. The institutions experience a wide range of difficulties such as burnout among staffs, medication errors, infection prevention and control, and falls among patients. Before beginning the process of implementing EBP quality improvement initiatives, approvals need to be sought from a variety of stakeholders. Therefore, the objective of the EBP quality improvement programs should be to promote safety, quality and efficiency of care.