NUR-590 Evidence-Based Practice Project Proposal Implementation Plan
NUR-590 Evidence-Based Practice Project Proposal Implementation Plan
Implementing any change in a healthcare organization or facility entails several aspects that require one to develop an implementation as is the most important part of any evidence-based practice (EBP) project proposal. Implementation entails the actualization of the ideas developed in the proposal EBP projects are broken into several identifiable steps (Boehm et al., 2020). The implementation plan will focus on hand hygiene measures in pediatric setting among healthcare workers to reduce hospital acquired infections (HAIs). The implementation plan will consist of the setting where the project will take place, time, resources, methods and instruments, intervention of delivery process, and data collection plan. The plan also includes management of barriers, facilitators and challenges and the feasibility of the plan.
Hello! Nursing shortages continues to be an ongoing problem, and our patients are affected greatly when we continue to work short. Our patients are growing sicker and are requiring more time and care. Our nursing workload is increasing and the time that we are able to spend with our patients is decreased. When we have such as heavy workload, our time being spent collaborating with our patients and with the physician, decreases. This is where medical errors can happen and can lead to a poor communication amongst the interdisciplinary team, including our patients. Our patient’s quality of care decreases as well. Our patients are at a great risk for infection and poor outcomes when we are not able to spend time understanding and caring for their needs. Our nurses are having to take on such a great deal of workload that we are seeing an increase in our nurse burnout. Our nurses are being burned out by limited resources and shortages; our nurse satisfaction rates are going down. When nurses are feeling unsatisfied with their jobs, our patients care is also affected. Our nurses are not able to practice at the highest level that they can when they are feeling burned out, and unsatisfied with their positions. This is leading to an increase in workload and an increase in errors as well. We are not able to spend our time and knowledge in using our critical thinking skills. We may not be able to notice with the decrease in time spend on patient care when something may be going on with our patients.
Setting and Access to Potential Subjects
The implementation framework of any EBP project includes establishment of a motive for change, development of specific goals, attaining leadership support, creating a leadership teams and engagement of clinical support. In this case, the project setting will be a pediatric hospital where nurse practitioners and clinical nurse leaders involved in service delivery to the patient population will be the main subjects taking part in the proposed project. The selected participants should have served in this unit for the last 12 months. The project will select 20 healthcare staff to be involved in the implementation process.
The second component of this project is getting consent or approval from the participants and the institutional review board for the project to take place. Participants’ consent will be essential as it will demonstrate their willingness to be part of the project without any undue influence. The review board will give the project a green light and ensure that ethical provisions are met to protect the subjects. The consent will indicate that the main purpose of the project is to reduce the rate of HAI within six months by enhancing hand hygiene measures, specifically the use of alcohol-hand sanitizers or rubs alongside handwashing using soap and water. The participants will sign the consent form upon getting relevant information about the project and its overall benefits to the population.
The implementation timeframe for the EBP project will be six months. Different activities will take place each month to ensure that all components of the proposal are implemented effectively. The timeframe will include creation of a multidisciplinary team in the first two weeks of the program. The last two weeks of the first month will have collection of required resources and expertise for the implementation process. The training of the nursing staff will occur in the second month and will take two to three weeks to ascertain that the participants have sufficient knowledge and skills based on existing resource to implement hand hygiene measures aimed at reducing HAIs.
The first week of the third month will involve identification of any possible barriers that may influence or interfere with the
implementation. The duration will also be used to increase stakeholder engagement, participation and collection of their input and views to be incorporated in the final implementation activities (Luciano et al., 2019). The remain three and half months will involve the actual implementation. However, in the fifth month, the project team will review the implementation to ascertain if there will be need to have any modifications to the project. The implication is that the implementation process will be successful if the five months will be used as expected in the timelines proposed for the plan.
Studies show that success of any evidence-based project primarily rely on the availability of the needed resources (DeNisco, 2019; Luciano et al., 2019). The implementation of this project require human resources that will comprise of competent trainers who will impart the project team with necessary knowledge and skills. The most appropriate resource for this EBP project include nurse practitioners and clinical nurse leaders. Engagement of nurse practitioners and clinical nurse leaders with the requisite skills improves the success of quality improvement projects. In addition to the human resources, the project will also require financial resources to fund the implementation. the financial resources will be deployed to compensate the trainers and buy required stationeries like the training manuals. These resources will also be instrumental in overall implementation as they will be used to buy equipment like hand-rubs for demonstration. The resources will also include travel expenses for the project manager and the team. Changes needed in the implementation of the solution will include more education and awareness among caregivers since most of the pediatric patients may not comprehend the protocols that will be proposed to reduce hospital acquired infections.
Qualitative or Quantitative Design in Data Collection and Effectiveness
The selected design to collect data for the evidence-based practice project proposal is qualitative. The qualitative approach is deployed to understand thoughts, concepts, and experiences of participants through techniques like interviews, focus groups, observations, and a review of existing literature (Rebekah & Ravindran, 2018). The qualitative research design will be effective in the project proposal since it will entail getting opinions through deployment of different methods from healthcare workers about the need to enhance hand hygiene measures to prevent and reduce the occurrence of hospital acquired infections, especially in pediatric settings (Vandermause et al., 2017). The evidence-based practice project proposal on hand hygiene measures among healthcare workers to reduce and prevent hospital acquired infections (HAIs) in pediatric settings will inform stakeholders about the importance of handwashing protocols. The EBP project proposal is effective as it will ensure that healthcare workers in the selected settings adhere to hand hygiene measures for effective care delivery and minimize the prevalence of infections that negatively impact patient outcomes and quality care delivery.
Methods and Instruments for Monitoring
The implementation process will entail various methods and instruments in its monitoring. Firstly, an audit tool and satisfaction survey will be used in the implementation process. The project team will use satisfaction survey to evaluate the effectiveness of the measures executed to decrease high prevalence of hospital acquired infections in the pediatric unit. The audit framework will be deployed to complete the auditing process. The tool will enhance the auditing of gathered data on specific hand hygiene interventions and their outcomes (Vandermause et al., 2017). Additionally, the project will use questionnaires to collect the required data from the participating nurse. questionnaires are effective data collection tools and nurse leaders and practitioners will fill them out to offer information about the effectiveness of hand hygiene measures that can reduce occurrence of HAIs in pediatric patient population. The information will guide the project implementation team during the process for effective outcomes. The auditing tools and satisfaction surveys alongside the questionnaire use will be critical in attaining the expected project goals.
Delivery of the Intervention
The delivery process for the intervention will involve project team members that comprise of nurse leaders and practitioners. The nurses and practitioners will develop and execute necessary protocols like setting hand sanitizer stations at different points of the care delivery process (Luciano et al., 2019). These points will include the nursing stations and having points in pediatric wards as well as other key points to enhance hand hygiene measures. The participants will require training to enable them perform their respective duties well. Training will consist of giving information to nurse leaders about the components of the proposed so that they can effectively supervise the nurse practitioners to ensure that they carry out their mandate as expected. The practitioners will also require training to implement the proposed measures as planned to meet the set project goals.
Stakeholders Required to Implement the Plan
Stakeholder support is a critical component of evidence –based practice project proposal as they provide critical resources, input, and implement the recommendations of such programs. In this case, several stakeholders will be needed to implement the project (DeNisco, 2019). The initial stakeholders will include clinical nurse leaders and practitioners who will ensure that the components of EBP project are realized. The second set of stakeholders include the project team and trainers that shall offer direction on the implementation of the EBP intervention. The third stakeholder group needed comprise of organizational leaders and managers who shall provide the requisite resources; especially financial resources, to implement the proposed plan to reduce hospital acquired infections in the target population.
Aspects of the Implementation Plan and Potential barriers, Challenges and Proposed Strategies
The success of the project will depend on how the project team manage different aspects like facilitators, barriers, and develop effective strategies to respond adequately. For instance, organizational leaders and managers will be critical facilitators as they offer necessary support through resource allocation and a buy-in. The management will also support the new project will the aim of improving overall care quality.
Time and resource limitation, insufficient knowledge and skills among healthcare workers would be significant barriers in implementation of the project. Negative attitudes that will fuel resistance will also hamper effective implementation of the project as many will feel that it will be sufficient to assess the overall effectiveness of the intervention (Vandermause et al., 2017). It is essential to mitigate these barriers through effective strategies like sticking to the timeframe for implementation, engaging all stakeholders like leaders and managers, and enhancing communication among all players.
The feasibility of this project will be assessed based on a cost-benefit analysis approach. The cost incurred in the implementation process will be estimated to assess the overall benefits that will accrue to patients and healthcare organization’s unit (Rebekah & Ravindran, 2018). The cost will also include funds to compensate trainers and buy the needed project implementation materials to evaluate the overall feasibility of the plan. the unit should implement the plan since its cost-benefit analysis will be positive to the organization.
The implementation of the project stage is essential as it consists of the real practical application of expected changes and subsequent outcomes. Therefore, it is important to evaluate all aspects of the stage for effective outcomes and project’s sustainability. The highlighted plan will be effective through increased stakeholder engagement and participation.
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Diabetes mellitus is a public health issue that requires effective implementation of interventions like self-management as a way of empowering patients and their families to adhere to monitoring aspects to reduce adverse events. The act of implementing changes in a health population, especially integration of self-care management, can be challenging and entails different components (Melnyk & Fineout-Overholt, 2019). The implementation of the evidence-based practice (EBP) interventions in any setting entails having the solution put into practical application to attain hypothesized outcomes. Evidence on self-care management and its efficacy is overwhelming and is the driving factor about the implementation of this project proposal to improve the quality of life for individuals with diabetes (Alhaiti et al., 2020). The purpose of this essay discuss the implementation plan for the proposed EBP on self-care management for patients with diabetes. The plan outlines setting, timelines and resources, methods and approaches and the delivery process intervention as well as management if different aspects like challenges, stakeholders and project’s feasibility
Setting and Access to Potential Subjects
The setting for this self-management to control glycemic levels will be in patient homes with the project involving about 30 patients from its diabetes outpatient program. The recruitment of the subjects will be voluntary. However, they will be engaged each time they come for their clinics about the need for the project and if they can volunteer to participate. All studies involving human subjects need participants to give informed consent. Therefore, all participants who are diabetic patients would give consent before being part of the project. The consent will show that all patients understand their involvement in the project.
The delivery of effective self-management approaches will lead to better personal approaches to monitoring of glycemic levels among the patients and based on the need to enhance better understanding, the project will run for six months. In their paper Captieux et al. (2018) self-management entails giving individuals with chronic diseases confidence to be active in the management of their conditions in partnership with their healthcare providers. The timelines begin with the problem identification and getting support from stakeholders by providing evidence on the need to implement the intervention. Stakeholders’ meeting to communicate the expectations and involvement of all people as well as development of requirements will occur in the first two months of the project. The remaining time will be rollout of the activities, collection of data before and after implementation, evaluation and development of the final report for the organization.
Success of EBP projects relies on the availability, access, and deployment of resources to meet the expected goals (Alhaiti et al., 2018). The implementation of this project will require human resources comprising of nurse practitioners, dieticians, informatics nurses, and social workers as well as data analysts. The financial resources will be critical as they will be used for logistics, developing and acquiring tools and devices for self-monitoring and management; especially through the use of telehealth. The project will involve buying blood sugar monitoring devices for all patients involved to help them control their glycemic levels. Training on the use of these devices and reports for nurses and patients will form a core part of the financial aspects of the project as highlighted in the appendix.
Design to Collect Data & Evaluation of the Effectiveness of the EBP Project Proposal
The project proposal on the need for self-management will deploy a qualitative design in collection of data and views from all stakeholders. The design is effective as it highlights thoughts, opinions, ideas and experiences of the research subjects through the use of methods like interviews, focus groups and review of literature to get best trends and practices to deploy on self-management (Melnyk & Fineout-Overholt, 2019). The design is effective because it will help get views from participants and nurses on the efficacy of lifestyle changes to enhance adherence to right levels of blood sugars to prevent adverse effects of diabetes. The design will enhance compliance to enhanced blood sugar monitoring for individuals with chronic diabetes.
Monitoring Methods and Instruments
The implementation of self-management is critical to the overall health of diabetic patients and their families in reducing possible emergency room visits due to exacerbation in the disease because of inability to monitor blood sugar levels (Mukona & Zvinavashe, 2020). Therefore, it project will deploy an audit tool and satisfaction survey to evaluate the success of the plan. The audit tool will evaluate the overall effectiveness of implementing the self-management on quality of life of the participants. The satisfaction survey will evaluate the effectiveness of the devices like glucose meters and adherence to them by patients in their homes. The glucose monitors and meters and their efficacy will be evaluated based on each case since every patient is unique in their situation and disease status. The project will use questionnaires to collect data from the participating patients and nurses so that they offer required information on the effectiveness of the different devices.
Delivery of Intervention
Self-care and management of diabetes entails a host of activities. These include adherence to diet, effective monitoring of blood sugar levels, foot care, and exercise where possible. These activities can only be realized through an effective delivery process (Mukona & Zvinavashe, 2020). Therefore, at the core of this process will be health promotion and education where nurse practitioners working with all members of the interdisciplinary team will visit patients; either physically or virtually to explain the significance of self-management.
The second aspect of the delivery would be development of tailored education plans on diabetes self-management for individual patients in their settings. The third aspect will be general education and awareness program targeted to all stakeholders; either medical professionals or patients and their families. Nurses and members of the interdisciplinary team will undergo effective training on the implementation of all these components together with the patients and their families.
Stakeholders to Implement the Plan
Stakeholders are an essential component of EBP project proposal implementation as they provide resources, inputs, ideas and support and execute the different aspects of the initiative as well as the recommendations. The EBP project proposal on self-management of diabetes will involve different stakeholders that comprise of nurse leaders, nurse practitioners, patients and their families, informatics nurses and data analysts and device vendors. The organization’s management and communities where the project will occur will be critical stakeholders. The trainers will also be a critical aspect of the project.
Aspects of the Implementation: Challenges, Barriers, Proposed Strategies
The success of this project will depend on how the team handles facilitators of the project on one part and on the other, possible challenges and barriers. The potential challenges may entail limited resources, acceptance of the project by the main stakeholders, limited knowledge on EBP intervention and cultural aspects, especially among patients from minority communities who may feel the interventions contradict their religious beliefs and practices (Mikhael et al., 2019). The need for better patient understanding and involvement of their families will also challenging to the overall success of the project. Addressing these barriers will require effective engagement and communication with the stakeholders. Positive change projects and initiatives occur when all stakeholders read from the same script. Further, providing sufficient need for change to the practitioners will also enhance acceptance of the project to all stakeholders.
Feasibility of the Project
The feasibility of a project is essential and requires stakeholders to assess the overall ability to implement the intervention. In this case, the project manager and team will evaluate the feasibility through the use of a cost-benefit analysis approach. The trajectory will allow them to evaluate the overall cost of the implementation against the expected benefits to patients and the healthcare facility (Melnyk & Fineout-Overholt, 2019). For instance, the implementation will lead to a reduction in emergency room visits for diabetic patients with poor blood sugar controls. Secondly, self-management will enhance adherence and compliance to medications and encourage change in lifestyle for the individuals. Therefore, the cost of the project is minimal as demonstrated in the appendix compared to the overall benefits that both patients and the facility.
The implementation plan for the proposed EBP project will provide a practical roadmap to integrate best practice for patients with diabetes mellitus in their homes with the help of nurse practitioners and other providers. The plan will be critical in reducing the number of emergency room visits for patients with diabetes who fail to adhere to the protocols to monitor their blood sugars. The implementation plan will show that self-management is an effective way of dealing with diabetes for patients and improves their quality of life.
Alhaiti, A. H., Senitan, M., Dator, W. L. T., Sankarapandian, C., Baghdadi, N. A., Jones, L. K.,
… & Lenon, G. B. (2020). Adherence of type 2 diabetic patients to self-care activity: tertiary care setting in Saudi Arabia. Journal of Diabetes Research, 2020(7). https://doi.org/10.1155/2020/4817637
Captieux, M., Pearce, G., Parke, H. L., Epiphaniou, E., Wild, S., Taylor, S. J., & Pinnock, H.
(2018). Supported self-management for people with type 2 diabetes: a meta-review of quantitative systematic reviews. BMJ open, 8(12), e024262. http://dx.doi.org/10.1136/bmjopen-2018-024262
Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing and
healthcare: A guide to best practice (4th ed.). Wolters Kluwer.
Mikhael, E. M., Hassali, M. A., Hussain, S. A., & Shawky, N. (2019). Self-management
knowledge and practice of type 2 diabetes mellitus patients in Baghdad, Iraq: a qualitative study. Diabetes, metabolic syndrome and obesity: targets and therapy, 12, 1. DOI: https://doi.org/10.2147/DMSO.S183776
Mukona, D. M., & Zvinavashe, M. (2020). Self-management of diabetes mellitus during the
Covid-19 pandemic: Recommendations for a resource limited setting. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 14(6), 1575-1578. DOI: 10.1016/j.dsx.2020.08.022.