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Evidence-Based Practice Project Proposal: Implementation Plan

NUR-590 Evidence-Based Practice Project Proposal: Implementation Plan

Implementation Plan

Alcohol use disorder is one of the health problems that nurses face in their practice. Patients affected by alcohol use disorder have complex needs that the care team should prioritize for the health and wellbeing of the patients. Evidence-based interventions can be utilized in ensuring that the health needs of patients affected by alcohol use disorder are met. Therefore, the purpose of this paper is to explore the implementation plan that will be used in the project.

Setting and Access to Potential Subjects

The setting for the proposed project will be the psychiatric unit in a tertiary hospital. The psychiatric unit addresses the care needs of different patients suffering from mental health problems that include alcohol use disorder. The potential subjects for the project will comprise mainly of patients diagnosed with alcohol use disorder. The patients should be undergoing treatment in the unit for the disorder. The participation o

Evidence Based Practice Project Proposal Implementation Plan
Evidence Based Practice Project Proposal Implementation Plan

f the subjects will be voluntary. As a result, informed consent will be obtained from them prior to their initiation in the project (Schmidt & Brown, 2021). Approval to undertake the project will also be sought from the institution.

Timeline

The proposed timeline for the project is 12 months. It is expected that the timeline will be adequate to enable the undertaking of the entire project activities. The draft for timeline as well as the different activities that will be undertaken is included in the Appendix section.

Budget and Resources

The project will require adequate supply of resources for its implementation. Human, financial and material resources will be needed for the project. Human resources will comprise of healthcare providers that will educate the selected participants about the use of behavioral interventions in minimizing withdrawal symptoms and symptoms of alcohol use disorder. The healthcare providers will also be involved in care coordination to ensure that the optimum outcomes of care for the subjects are met. The other human resource is trainers for trainees. Trainers will be hired to educate the staffs on the use of behavioral interventions and care coordination in the management of alcohol use disorder. The project will also require financial resources. Money will be needed for use in the purchase of the needed resources as well as remuneration of the healthcare providers who will be involved in the implementation of the project (Wensing et al., 2020). Material resources will also be needed for the successful implementation of the project. The materials needed will include reading materials, booklets for patients, and projectors for the training. The successful implementation of the project will require a budget of $68,000. The budget will be used for purchasing and undertaking the different activities of the project. They will include needs analysis, data collection, analysis, and presentation, remuneration for staffs and trainers, purchase of materials, and follow up of patients. The budget for the project is attached in the appendix section.

Clinical Processes or Tools

There will be a need for a change in clinical processes for the successful implementation of the project. Healthcare providers will be required to incorporate behavioral strategies into the interventions that they will utilize in caring patients with alcohol use disorder. They will have to educate the patients about the behavioral interventions and ways of sustaining their use in minimizing withdrawal symptoms and improving treatment outcomes. Through it, sustained change will be achieved in the organization.

Design

The project will utilize quantitative design. The project will aim at determining the effect of the intervention on observed clinical

Evidence-Based Practice Project Proposal Implementation Plan
Evidence-Based Practice Project Proposal Implementation Plan

outcomes. The clinical outcomes will be measured in numbers, making quantitative design the most appropriate. The project will also provide insights into the relationship between variables such as exposure of the subjects to an intervention to influence outcomes (Sharma et al., 2018). The project also does not generate theories about cause-effect relationship between variables. As a result, quantitative design will be the most appropriate for the intervention.

 

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Methods and Instruments

Outcome and process measures will be used in monitoring the implementation of the proposed intervention. Outcome measures will focus on whether the desired goals and objectives are being achieved at every stage of the project. Periodic assessment will be done to determine the strengths, weaknesses, and opportunities for the project. Process measures will focus on the determination of the effectiveness of the interventions utilized to achieve the set outcomes. Questionnaires will be used for data collection. Questionnaires will provide both objective and subjective data about the project success and its effectiveness in enhancing the care outcomes for patients with alcohol use disorder. Questionnaires are also easy to administer, hence, their appropriateness for the project (Schmidt & Brown, 2021). The questionnaire that will be used in the project is attached in the Appendix section.

Process for Delivering the Intervention

The delivery of the intervention will require a number of interventions. The first one will be performing an organizational need assessment. The assessment will provide information about the knowledge and skills that the healthcare providers have in relation to the implementation of the project. The second step will be seeking approval from the organization. An approval will be obtained prior to the implementation process to ensure that the organizational rules and policies are followed in the process. The third step will be training of the healthcare providers. Healthcare providers will be trained about the delivery of the intervention. It will strengthen the knowledge and skills that the healthcare providers have in relation to the implementation of the project. Monitoring and evaluation will follow the implementation phase. Monitoring will aim at ensuring the correct implementation of the project. Evaluation will aim at determining whether the outcomes of the project were achieved or not.

Stakeholders Needed

Stakeholders will be needed for the successful implementation of the project. One of the stakeholders will be the healthcare providers. The healthcare providers will comprise mainly of the psychiatric mental health nurse practitioners and registered nurses working in the psychiatric department. The healthcare providers will be involved in the direct implementation of the project. They will provide health education and assistance to the patients about the use of behavioral interventions in managing withdrawal symptoms associated with alcohol abuse disorder. The other stakeholder will be nurse managers and leaders. Nurse leaders and managers will ensure the effective coordination of the activities of the project. The other stakeholders will include trainers of trainees. The trainers will ensure that the healthcare providers have the required knowledge and skills for the successful implementation of the project.

Potential Barriers

The potential barrier that may be experienced in the implementation of the project is the lack of interest in the project by patients with alcohol use disorder. The patients may not be willing to participate in the project due to low level of awareness, perceived lack of time, and fear of the unknown outcomes of the project. The barrier will be addressed by providing adequate information to the patients about the importance of the project. Adequate information will be needed to ensure that participants make informed decisions on their participation (Nakrem et al., 2019; Tappen et al., 2017).

Feasibility

The project is highly feasible for implementation in the organization. The organization has supportive culture that will ensure its successful implementation. It also has supportive leadership that will ensure the effective implementation of the project. The organization also has ready resources that will be utilized for the successful implementation of the project. Therefore, it is anticipated that the implementation process will be successful.

Conclusion

In summary, the proposed project will be implemented by utilizing carefully developed processes. Stakeholders will play critical roles in the implementation process. Efficient use of the resources will be encouraged to enhance the success of the project. Anticipated barriers will be minimized by adopting responsive interventions.

 

 

References

Nakrem, S., Stensvik, G.-T., Skjong, R. J., & Ostaszkiewicz, J. (2019). Staff experiences with implementing a case conferencing care model in nursing homes: A focus group study. BMC Health Services Research, 19(1), 191. https://doi.org/10.1186/s12913-019-4034-0

Schmidt, N. A., & Brown, J. M. (2021). Evidence-Based Practice for Nurses: Appraisal and Application of Research. Jones & Bartlett Learning.

Sharma, N., Herrnschmidt, J., Claes, V., Bachnick, S., Geest, S. D., & Simon, M. (2018). Organizational readiness for implementing change in acute care hospitals: An analysis of a cross-sectional, multicentre study. Journal of Advanced Nursing, 74(12), 2798–2808. https://doi.org/10.1111/jan.13801

Tappen, R. M., Wolf, D. G., Rahemi, Z., Engstrom, G., Rojido, C., Shutes, J. M., & Ouslander, J. G. (2017). Barriers and Facilitators to Implementing a Change Initiative in Long-Term Care Utilizing the INTERACTTM Quality Improvement Program. The Health Care Manager, 36(3), 219–230. https://doi.org/10.1097/HCM.0000000000000168

Wensing, M., Grol, R., & Grimshaw, J. (2020). Improving Patient Care: The Implementation of Change in Health Care. John Wiley & Sons.

 

 

 

Appendices

Appendix I: Informed Consent

Hello, I am undertaking a project that aims at improving the withdrawal symptoms and treatment outcomes in patients with alcohol use disorder. The project entails the provision of behavioral treatments alongside coordinated care. The proposed interventions have no known adverse effects. It has optimum benefits to the patients. We therefore request you to participate voluntarily in it. By agreeing to participate, you acknowledge that you understand the aims of the program, its implications and the fact that you will not receive any monetary or material rewards.

Signature                                             Date

 

 

 

 

Appendix II: Timeline

September-November December-January January-February February-May May-June June-July July-September
Needs assessment
Obtaining approval
Training
Implementation/Follow Up
Data Collection
Data Analysis
Presentation of findings

 

 

 

Appendix III: Budget

Item Cost ($)
Needs analysis 5000
Data collection 5000
Data analysis and presentation 8000
Remuneration for staffs and trainers 25000
Purchase of materials 10000
Follow up 5000
Extraneous 10000
68000

 

 

 

Appendix IV: Questionnaire

Hello, kindly provide your responses by ticking on the statements that best describe your experience with the project.

  1. What is your gender? Male [ ] Female [       ]
  2. How old are you? 18-30 years [ ] 30-40 years [             ] 40 and above [                 ]
  3. What is your highest level of education? High school and below [ ] College [       ] University [   ] Post-graduate [         ]
  4. What is your overall experience with the program? Very satisfied [ ] satisfied [      ] Neutral [       ] unsatisfied [  ] very unsatisfied [    ]
  5. Which of the following statements best describes your experience with the project?
Strongly agree Agree Neutral Disagree Strongly disagree
Behavioral interventions and care coordination are important in alcohol use disorder
Behavioral interventions equip individuals with the needed skills for managing withdrawal symptoms
Healthcare organizations should incorporate behavioral interventions into their practices
The risk and rate of withdrawal symptoms improve with behavioral and care coordination in alcohol use disorder
Healthcare providers play critical roles in the implementation of behavioral interventions and care coordination for alcohol use disorder
  1. What are some of the strengths of the program based on your experience?

 

 

 

  1. What are some of the strengths of the program based on your experience?

 

 

 

 

  1. What recommendations can you give on the ways in which the program can be improved further in the future?

 

Evidence-based practice (EBP) implementation involves actualizing ideas or best practices established by providers through their research. The implementation process entails several aspects that must be followed systematically to integrate a best practice identified in the research. In this case, the implementation plan focuses on the use of Fall TIPS (tailoring interventions for patient safety) as a bundled care approach to reduce and prevent the occurrence of falls among hospitalized adult patients in medical-surgical units by 20% within six months. Studies and evidence from the Agency for Healthcare Research and Quality (AHRQ) (2021) show that the Fall TIPS toolkit optimizes patient and family efforts in reducing falls. The implementation plan focuses on different aspects of executing the intervention for effective patient care quality delivery and outcomes. The purpose of this paper is to describe the implementation plan of the EBP project propose by exploring the different components of the plan, from setting to timelines and resources, methods and instruments as well as the interventions of the delivery process and barriers.

Setting and Access to Potential Subjects

The project’s setting is the medical-surgical ward with patients who are susceptible to falls due to their health status. The medical-surgical ward provides services to patients recovering from surgical procedures and a majority are susceptible to falls because of being weak. Patients in the unit will all be potential subjects (Barber, 2018). However, only those who will provide their informed consent voluntarily will be part of the subjects. The consent will be critical as it demonstrates their free will to be part of the project to reduce falls.

Timelines

The implementation timeline will be six months. The timeline will have different aspects that include creating an inter-professional collaboration team comprising all providers including nurses, nurse managers, and physicians. The initial week will be about planning and project requirement identification as well as the selection of research design. Nurse training will also happen in the first week on various aspects of the evaluation of the project. The entire activities and components of the time are in the appendix section of the paper.

Resources Required

Effective implementation of an evidence-based practice (EBP) project requires access to and availability of required resources. The EBP project will require resources from organizational leaders and managers as well as sufficient financial resources to implement Fall TIPs as an intervention in the facility to reduce falls (DeNisco, 2019). Human resources for the project will entail nurses, and trainers on the Fall TIPS as a bundled care approach and management. Financial resources for the project will be critical to facilitate training, purchase of required materials and equipment, especially technologies, and installation of the various components of the Fall TIPS. Nurses will require resources to produce informational sheets, enter key data on patients’ health status in electronic health records, and communicate within the setting.

Qualitative or Quantitative Design in Collecting Data and Effectiveness

The project will use a qualitative approach to collect data and perspectives from participants. Falls remain a critical health issue because the Center for Medicare and Medicaid Services (CMS) describes them as never events implying that facilities cannot be compensated for resources used in fall prevention efforts. Using a qualitative design is essential as it allows researchers to deploy techniques that include interviews, focus groups, observation, and literature through systematic review (DeNisco, 2019). The qualitative method would be effective for the proposed project as providers will implement a host of interventions that include fall risk assessment, safe ambulation, safe toileting, effective staff communication, early warning, and patient education. The use of different interventions means that providers will collect data, thoughts, experiences, and perspectives from patients and offer education or awareness information on the best strategies to address falls. Observation of the effects of each intervention would also be tabulated and focus groups will be established to implement certain aspects to assess the overall effectiveness of the Fall TIPS.

The proposed EBP project proposal focuses on reducing and preventing patient falls in the medical-surgical unit among adults. Through these interventions, providers will work collaboratively with all healthcare workers, patients, and their families to reduce the burden of falls by customizing the interventions based on patient needs (Dykes et al., 2018). As such, the project would be effective as it will help improve the quality of care for these patients, improve understanding of the efficacy of each intervention, and allow organizations to get reimbursement from CMS for quality improvement by reducing patient falls.

Monitoring Methods and Instruments

The project will have different methods and instruments or tools to monitor overall results for patients and the medical-surgical unit and the nurses. The team will use an audit tool and a patient satisfaction survey during the implementation process. The satisfaction survey will involve the research participants giving their opinions and perspectives on the overall efficacy of the different interventions. For instance, participants will identify an intervention that is suitable to their condition (Rebekah & Ravindran, 2018). The audit tool will assess the overall level of implementation of the different approaches and those that work for certain types of patients based on their conditions. Through these tools, stakeholders will evaluate the common effects of the Fall TIPS in improving patients’ overall mobility during their stay in the unit.

Intervention Delivery Process

Delivering the intervention will entail having an inter-professional team comprising different healthcare workers in the medical-surgical unit, especially nurses and other specialty nurses like anesthetists and those specializing in areas like ambulation, and data. The intervention will include having staff training on all aspects of the Fall TIPS, developing approaches to safe toileting, effective communication, and patient education. Patients and their families will get the education and know the possible signs of falls, and learn to use bed alarms where necessary, while nurses will learn and apply risk assessment approaches to the issue to ensure effective implementation.

Stakeholders Needed to Implementing the Plan

Stakeholders play a crucial role in the implementation of evidence-based practice project proposal since they offer resources, input, and feedback, collaborate to have a common goal and implement the recommended intervention to improve the quality of care and patient outcomes. The project will require a host of stakeholders, especially internal (Heng et al., 2020). These would include nurses, nurse leaders and managers, project team and trainers, patients and their families, organizational management, and health information technology vendors. The nurses, nurse leaders, and managers will implement the different parts of the Fall TIPS intervention while the project will be in charge of all actions, activities, and timelines for effective deliverables (Tang, 2019). Patients and families will be the beneficiaries of these interventions and will require knowledge as well as skills to improve their gait, mobility, and overall functioning. The organizational management and leaders will offer the resources needed to implement the project and support it.

Aspects of the Implementation Plan: Barriers, Challenges, and Proposed Strategies

The entire success of this EBP project proposal will rely on how stakeholders, especially the project manager, and team, handle different components of the initiative. The EBP implementation will encounter barriers that include resistance to change, limited resources, the need for organizational leaders’ support, and insufficient knowledge and skills by nurses on Fall TIPS (Pop et al., 2020). As such, the project will require facilitators who include organizational leaders and managers, nurse leaders, and change champions who will motivate others to accept the use of Fall TIPS as a bundled care approach to reduce and prevent falls in the medical-surgical unit.

The management and project team should take an active role and integrate all stakeholders in the project. This requires effective communication and the application of models like Lewin’s change theory for employees to accept and embrace change. The integration and involvement of all nurses will ensure that the project attains its intended purpose. Again, predictable timelines would be critical for the success of this project.

Feasibility of the Project

The feasibility of the Fall TIPS intervention is high based on its cost-benefit analysis and approach. The cost incurred in implementing the intervention will be estimated and evaluate overall benefits that will accrue to patients and healthcare organizations, especially the medical-surgical unit (Tang, 2019). Based on the cost of implementation and the associated benefit compared to the effects of falls, the facility and unit will implement the Fall TIPS to reduce and prevent falls while improving the quality of care offered to patients.

Conclusion

Implementing this proposed EBP project to reduce and prevent falls in the medical-surgical unit will be critical to improving the quality of care offered to patients. Through the elaborate stages, stakeholders will assess the overall positive effects of the Fall TIPS intervention to reduce falls and improve the quality of life and patient outcomes. The implementation will focus on ensuring that all healthcare providers in the facility participate and develop a common goal to improve care provision. The Fall TIPS framework will help the unit reduce fall rates and improve the overall quality of care and patient satisfaction.

References

Agency for Healthcare Research and Quality (AHRQ) (2021). Fall TIPS: A Patient-Centered

Fall Prevention Toolkit. https://www.ahrq.gov/patient-safety/settings/hospital/fall-tips/index.html

Dykes, P. C., Adelman, J. S., Alfieri, L., Bogaisky, M., Carroll, D., Carter, E., … & Spivack, L.

  1. (2019). The fall TIPS (tailoring interventions for patient safety) program: A collaboration to end the persistent problem of patient Falls. Nurse Leader, 17(4), 365-370. https://doi.org/10.1016/j.mnl.2018.11.006

Barber, B. (2018). Research on human subjects: Problems of social control in medical

experimentation. Routledge.

DeNisco, S. M. (2019). Advanced Practice Nursing: Essential Knowledge for the Profession:

Essential Knowledge for the Profession. Jones & Bartlett Learning.

Heng, H., Jazayeri, D., Shaw, L., Kiegaldie, D., Hill, A. M., & Morris, M. E. (2020). Hospital

falls prevention with patient education: a scoping review. BMC Geriatrics, 20, 1-12. DOI: https://doi.org/10.1186/s12877-020-01515-w

Pop, H., Lamb, K., Livesay, S., Altman, P., Sanchez, A., & Nora, M. E. (2020). Tailoring a

comprehensive bundled intervention for ED fall prevention. Journal of emergency nursing, 46(2), 225-232. DOI: 10.1016/j.jen.2019.11.010.

Ratnapalan, S. (2019). 37 Leading and managing change in healthcare organizations. BMJ

Leader, 3(Suppl 1), A14-A14. http://dx.doi.org/10.1136/leader-2019-FMLM.37

Rebekah, G., & Ravindran, V. (2018). Statistical analysis in nursing research. Indian Journal of

Continuing Nursing Education, 19(1), 62.

Tang, K. N. (2019). Change management. In Leadership and Change Management (pp. 47–55).

I am going to be perfectly honest, the biggest barrier to implementing my evidence-based project is me. I have no clue what I am doing. I have never implemented an EBP before. I do not know where to start. I am a novice. I have not developed the skill set to complete a project of this magnitude. I have an idea in my head as to what I would like to do but getting it done is going to be a challenge. I can say things like, I feel like I will not get support from my organization but honestly, I do not know what support I will need. I want to do a respectable job. With that being said I am going to have a perception that I am not being supported when that is not factual. Am I going to allow bias to skew my perception of the support or lack thereof sabotage my project? I am unsure of how to make sure I have enough time to get all my components completed. While I certainly am grateful for the support I am getting from my professors, I genuinely believe that due to my lack of experience my lack of knowledge will be my biggest barrier in completing this project. (Li, 2019) Am I the only one who feels this way?