NUR 590 Organizational Culture and Readiness
NUR 590 Organizational Culture and Readiness
Organizational Culture and Readiness
The culture of an organization affects the change process. It shapes the attitudes and support that the adopters have towards the change. Organizational stakeholders should support the creation of an enabling culture for change. Therefore, this section examines the culture and readiness of the organization for change.
Organizational Culture
The organization’s analysis showed it has a positive culture that will facilitate the success of the proposed project. First, the organization has effective leadership, as seen from the leaders and managers encouraging teamwork in the provision of patient care. The mission and vision of the organization support innovation in healthcare practice. The organization has allocated resources for use in quality improvement initiatives to improve patient care outcomes. The employee level of responsibility is also high in the organization, leading to enhanced undertaking of the organizational tasks. Open communication is also practiced where staffs have the freedom to express their ideas and views on issues related to patient care (Bouckenooghe et al., 2019).
Findings show that religious engagement among students declines during college, but their spirituality shows substantial growth. “Students become more caring, more tolerant, more connected with others, and more actively engaged in a spiritual quest.” (“Cultivating the Spirit – Spirituality in Higher Education”) The authors also found that spiritual growth enhances other outcomes, such as academic performance, psychological well-being, leadership development, and satisfaction with college. The study also identified a number of college activities that contribute to students’ spiritual growth. Some of these–study abroad, interdisciplinary studies, and service learning–appear to be effective because they expose students to new and diverse people, cultures, and ideas. Spiritual development is also enhanced if students engage in “inner work” through activities such as meditation or self-reflection, or if their professors actively encourage them to explore questions of meaning and purpose. (“Cultivating the Spirit – Spirituality in Higher (Alexander W, 2010)”). By raising public awareness of the key role that spirituality plays in student learning and development, by alerting academic administrators, faculty, and curriculum committees to the importance of spiritual development, and by identifying strategies for enhancing that development, this work encourages institutions to give greater priority to these spiritual aspects of students’ educational and professional development
Organizational Readiness Assessment
Researchers have used the tool by the Capacity Building Center for States to assess organizational readiness. The tool comprises of three sections that include readiness items, checklist for key change as well as implementation milestones and summary of readiness findings and organizational areas to improve. The assessment results showed that the organization was ready for the change, as seen from its scores of ‘strongly agreed’ and ‘partially agreed’ in the assessment. The highest scores were seen in resource availability, supportive structures, leadership, staff capacity, and climate. Moderate scores were seen in receptivity to change, compatibility, and simplicity of management.
Organizational strengths, weaknesses, and opportunities were identified from the assessment. The presence of adequate resources for implementation of the change was one of the strengths. It also showed organizational strengths of effective leadership and competent staffs that could support the change. The lack of effective management in the organization was the identified weakness since the organization lacks simplistic management systems for change. Staff shortage was identified as a threat that may make it difficult to implement change due to high workload facing the existing personnel. However, a focus on aspects such as the effective use of resources and timing of change will be used to address the above issues.
Assessment Description
In order to successfully implement a change within an organization, the change agent must assess the organization’s culture and readiness for change. In 750-1,000 words, analyze the culture and level of readiness of the organization for which your evidence-based practice project is
proposed. You will use the assessment of the organization’s culture and readiness in the Topic 8 assignment, during which you will synthesize the various aspects of your project into a final paper detailing your evidence-based practice project proposal.
Include the following:
- 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.
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Health care organizations should be committed to improving patient outcomes continuously. Among many interventions, evidence-based practice (EBP) projects effectively promote the desired change by introducing in-depth researched methods. Such projects identify the needs of specific patient populations and propose interventions for enhancing outcomes. Improving patient care improves the organization’s overall performance and reputation. Although continuous improvement is critical in health care settings, success depends on the organizational culture. Readiness to change is vital to adopt new practices such as using the Ventilator-Associated Pneumonia (VAP) bundle to improve care outcomes in mechanically ventilated patients. This paper evaluates the organizational culture and readiness, care processes for improving outcomes, facilitating readiness, stakeholder roles, and technologies needed for the EBP intervention.
Organization’s Culture and Supporting Change
A close analysis of the work relationships, managerial support, communication, and values demonstrates an organization that adopts a clan culture. Unlike hierarchies, where the approach to everyday work is highly centralized, a clan culture encourages a collaborative approach to work and treating all employees as equals (Alsaqqa & Akyürek, 2021; Tietschert et al., 2019). Honest opinions and open feedback are highly valued as the entire staff work towards excellence as one family. A strong emphasis on excellence depicts a culture that embraces and supports change fully. The organization’s missions and values are anchored on continuous improvement and creative problem-solving. Besides teamwork and progressive growth, the organization invests heavily in innovative processes and technologies to improve health outcomes.
Organizational Readiness Assessment
Readiness assessment tools reliably indicate the extent to which an organization is likely to adopt change. The organizational readiness for knowledge translation (OR4KT) tool was used to assess the organization’s readiness level. OR4KT measures an organization’s readiness for knowledge translation by assessing the climate, contextual factors, change content, leadership, and motivation (Gagnon et al., 2018). During the survey, selected items (three) under each group gave a score of 90% (Appendix 1). A high score indicates that the organization is ready for change (Dearing, 2018). Hence, the current culture will fully support and sustain the EBP project.
Concerning the strengths, the EBP project’s goals align with the organization’s goal of progressive improvement in health care delivery. It identifies a critical and vulnerable population (mechanically-ventilated population in ICU settings) and proposes a creative, evidence-based intervention (VAP bundle and enhanced oral hygiene using chlorhexidine) to improve outcomes (reduce the risk of VAP rates). The nature of the project earns massive leadership and organizational support. Weaknesses include a culture that recommends contribution from the majority, which can lengthen the implementation process. Potential barriers include dependence on a large care team, which is highly committed in its routine practice. Considerable organizational resources are also needed, and availability cannot be guaranteed. However, stakeholder support and the timing are excellent. The project seeks to improve health outcomes among mechanically ventilated patients when their infection rates and problem sensitivity are worrying. To address the resource problem, nurse trainees and volunteers can help implement the project to save costs.
Health Care Process and Systems for Improving Quality, Safety, and Cost-Effectiveness
Several health care processes and systems can work independently or jointly to improve quality, safety, and cost-effectiveness in the organization. A suitable strategy is screening programs for at-risk populations. The organization must invest in procedures and technologies that identify different patient populations and their health problems. Such interventions will improve patient handling and promote patient-centeredness. Technologies such as health informatics also increase efficiency and reduce wastage, promoting cost-effectiveness (Xu et al., 2021). Up-to-date systems such as patient portals and wearables are vital to improving patient monitoring.
Facilitating Readiness
Health care organizations must respond to the fast-moving internal and external environments. Among many strategies, the organization should consider holding strategic workshops. Such workshops focus on introducing new initiatives to increase readiness for change (Roos & Nilsson, 2020). Another effective strategy is continuous performance assessments. Whether process or outcome-based, such assessments will enable the organization to identify areas that require intervention and respond timely. Importantly, it should embrace a spirit of inquiry and make it a core element of its culture.
Stakeholders and Team Members
The organization’s management will be a key stakeholder in this EBP project. The management influences change in organizations and will be integral in providing resources and support needed to implement the project. The head of operations in the ICU will also guide the project to ensure that all operation protocols in the ICU are followed. Team members include nurse colleagues who will help execute the necessary activities, including observing patients, assisting in VAP bundle and oral hygiene practices and data collection.
Information and Communication Technologies
Broadly, the EBP project is a quality improvement initiative focusing on process improvement. To reduce exposure to mechanical ventilation and collaborate when providing oral care and subglottic suctioning, the care team needs timely and effective communication. Appropriate information and communication technologies include an interactive portal, chat rooms, and conferencing technology. Electronic, live monitoring of patients and record-keeping technologies are crucial too. The internal stakeholders will incorporate these technologies by adopting them, purchasing new ones where necessary, and promoting their use through staff education and guidance where necessary. Generally, the information and communication technologies will enable the implementation team to collaborate effectively during the implementation process. They will also allow real-time patient monitoring, assistance, and data collection to evaluate the effectiveness of the VAP bundle and oral hygiene using chlorhexidine. Improving areas of need and health outcomes as situations prompt will help improve nursing practice and care delivery for mechanically ventilated patients in the ICU.
Conclusion
Mechanically ventilated patients in ICU settings are highly vulnerable to Ventilator-Associated Pneumonia (VAP). The EBP project seeks to improve health outcomes among this critical population through the VAP bundle and enhanced oral hygiene using chlorhexidine. However, the project can only succeed if the organization is ready for a change. This discussion has explained the outcomes of culture and readiness assessment. The scores reveal readiness, implying that the project will get the required support.
References
Alsaqqa, H. H., & Akyürek, Ç. E. (2021). Assessment of organizational culture types, leadership styles and their relationships within governmental and non-governmental hospitals in Gaza Strip of Palestine. BMC Health Services Research, 21(1), 1-11. https://doi.org/10.1186/s12913-021-06351-1
Dearing, J. W. (2018). Organizational readiness tools for global health intervention: A review. Frontiers in Public Health, 6, 56. https://doi.org/10.3389/fpubh.2018.00056
Gagnon, M. P., Attieh, R., Dunn, S., Grandes, G., Bully, P., Estabrooks, C. A., Légaré, F., Roch, G., & Ouimet, M. (2018). Development and content validation of a transcultural instrument to assess organizational readiness for knowledge translation in healthcare organizations: The OR4KT. International Journal of Health Policy and Management, 7(9), 791–797. https://doi.org/10.15171/ijhpm.2018.17
Roos, J., & Nilsson, V. O. (2020). Driving organizational readiness for change through strategic workshops. International Journal of Management and Applied Research, 7(1), 1-28. https://doi.org/10.18646/2056.71.20-001
Tietschert, M. V., Angeli, F., Van Raak, A. J., 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), 1-10. https://doi.org/10.5334/ijic.4681
Xu, J., Glicksberg, B. S., Su, C., Walker, P., Bian, J., & Wang, F. (2021). Federated learning for healthcare informatics. Journal of Healthcare Informatics Research, 5(1), 1-19. https://doi.org/10.1007/s41666-020-00082-4
Refer to the “Evidence-Based Practice Project Proposal – Assignment Overview” document for an overview of the evidence-based practice project proposal assignments.
You are required to cite a minimum four peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.
Complete the “APA Writing Checklist” to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as an appendix at the end of your paper.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance. NUR 590 Benchmark Evidence-Based Practice Project Proposal Organizational Culture and Readiness
Week 3 Assignment (NUR 590 Evidence-Based Practice Project Assignments)
Evidence-Based Practice Proposal – Section C: Solution Description
Write a paper of 500-750 words for your proposed evidence-based practice project solution. Address the following criteria:
Proposed Solution: (a) Describe the proposed solution (or intervention) for the problem and the way(s) in which it is consistent with current evidence. Heavily reference and provide substantial evidence for your solution or intervention. (b) Consider if the intervention may be unrealistic in your setting, if it may be too costly, or if there is a lack of appropriate training available to deliver the intervention. If the intervention is unrealistic, you may need to go back and make changes to your problem statement before continuing.
Organization Culture: Explain the way(s) in which the proposed solution is consistent with the organization or community culture and resources.
Expected Outcomes: Explain the expected outcomes of the project. The outcomes should flow from the problem statement.
Method to Achieve Outcomes: Develop an outline of how the outcomes will be achieved. List any specific barriers that will need to be assessed and eliminated. Make sure to mention any assumptions or limitations that may need to be addressed.
Outcome Impact: Describe the impact the outcomes will have on one or all of the following indicators: quality care improvement, patient-centered quality care, efficiency of processes, environmental changes, or professional expertise.
You are required to cite three to five sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.
Note: After submitting the assignment, you will receive feedback from the instructor. Use this feedback to make revisions for your final paper submission. This will be a continuous process throughout the course for each section.
NUR 590 Evidence-Based Practice Project
Week 4 Assignment – Evidence-Based Practice Proposal – Section D: Change Model
Roger’s diffusion of innovation theory is a particularly good theoretical framework to apply to an EBP project. However, students may also choose to use change models, such as Duck’s change curve model or the transtheoretical model of behavioral change. Other conceptual models, such as a utilization model (Stetler’s model) and EBP models (the Iowa model and ARCC model) can also be used as a framework for applying your evidence-based proposal in clinical practice. Apply one of the above models and carry your implementation through each of the stages, phases, or steps identified in the chosen model.
In 500-750 words (not including the title page and references page), discuss applying one of the change models to the implementation plan:
Identify the selected model or theoretical framework and discuss its relevance to your project.
Discuss each of the stages in the change model/framework.
Describe how you would apply each stage in your proposed implementation.
In addition, create a conceptual model of the project. Although you will not be submitting the conceptual model you design in Topic 4 with the narrative, you will include the conceptual model in the appendices for the final paper.
You are required to cite three to five sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.
Note: After submitting the assignment, you will receive feedback from the instructor. Use this feedback to make revisions for your final paper submission. This will be a continuous process throughout the course for each section.
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NUR 590 Evidence-Based Practice Project
Week 5 Assignment
Evidence-Based Practice Proposal – Section E: Implementation Plan
In 1,000-1,500 words, provide a description of the methods to be used to implement the proposed solution. Include the following:
Describe the setting and access to potential subjects. If there is a need for a consent or approval form, then one must be created. Although you will not be submitting the consent or approval forms in Topic 5 with the narrative, you will include the consent or approval forms in the appendices for the final paper.
Describe the amount of time needed to complete this project. Create a timeline. Make sure the timeline is general enough that it can be implemented at any date. Although you will not be submitting the timeline in Topic 5 with the narrative, you will include the timeline in the appendices for the final paper.
Describe the resources (human, fiscal, and other) or changes needed in the implementation of the solution. Consider the clinical tools or process changes that would need to take place. Provide a resource list. Although you will not be submitting the resource list in Topic 5 with the narrative, you will include the resource list in the appendices for the final paper.
Describe the methods and instruments, such as a questionnaire, scale, or test to be used for monitoring the implementation of the proposed solution. Develop the instruments. Although you will not be submitting the individual instruments in Topic 5 with the narrative, you will include the instruments in the appendices for the final paper.
Explain the process for delivering the (intervention) solution and indicate if any training will be needed.
Provide an outline of the data collection plan. Describe how data management will be maintained and by whom. Furthermore, provide an explanation of how the data analysis and interpretation process will be conducted. Develop the data collection tools that will be needed. Although you will not be submitting the data collection tools in Topic 5 with the narrative, you will include the data collection tools in the appendices for the final paper.
Describe the strategies to deal with the management of any barriers, facilitators, and challenges.
Establish the feasibility of the implementation plan. Address the costs for personnel, consumable supplies, equipment (if not provided by the institute), computer-related costs (librarian consultation, database access, etc.), and other costs (travel, presentation development). Make sure to provide a brief rationale for each. Develop a budget plan. Although you will not be submitting the budget plan in Topic 5 with the narrative, you will include the budget plan in the appendices for the final paper.
Describe the plans to maintain, extend, revise, and discontinue a proposed solution after implementation.
You are required to cite five to 10 sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.
Note: After submitting the assignment, you will receive feedback from the instructor. Use this feedback to make revisions for your final paper submission. This will be a continuous process throughout the course for each section.
NUR 590 Evidence-Based Practice Project
Week 6 Assignment (NUR 590 Evidence-Based Practice Project Assignments)
Evidence-Based Practice Proposal – Section F: Evaluation of Process
In 500-750 words, develop an evaluation plan to be included in your final evidence-based practice project. Provide the following criteria in the evaluation, making sure it is comprehensive and concise:
Describe the rationale for the methods used in collecting the outcome data.
Describe the ways in which the outcome measures evaluate the extent to which the project objectives are achieved.
Describe how the outcomes will be measured and evaluated based on the evidence. Address validity, reliability, and applicability.
Describe strategies to take if outcomes do not provide positive results.
Describe implications for practice and future research.
You are required to cite three to five sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.
Note: After submitting the assignment, you will receive feedback from the instructor. Use this feedback to make revisions for your final paper submission. This will be a continuous process throughout the course for each section.
NUR 590 Evidence-Based Practice Project
Week 7 Assignment Benchmark – Evidence-Based Practice Proposal Final Paper
Throughout this course, you have developed a formal, evidence-based practice proposal.
The proposal is the plan for an evidence-based practice project designed to address a problem, issue, or concern in the professional work setting. Although several types of evidence can be used to support a proposed solution, a sufficient and compelling base of support from valid research studies is required as the major component of that evidence. Proposals must be submitted in a format suitable for obtaining formal approval in the work setting. Proposals will vary in length depending upon the problem or issue addressed (3,500 and 5,000 words). The cover sheet, abstract, references pages, and appendices are not included in the word count.
Section headings for each section component are required. Evaluation of the proposal in all sections will be based upon the extent to which the depth of content reflects graduate-level critical thinking skills.
This project contains seven formal sections:
Section A: Organizational Culture and Readiness Assessment
Section B: Proposal/Problem Statement and Literature Review
Section C: Solution Description
Section D: Change Model
Section E: Implementation Plan
Section F: Evaluation of Process
Each section (A-F) will be submitted as a separate assignment in Topics 1-6 so your instructor can provide feedback (refer to applicable topics for complete descriptions of each section).
The final paper submission in Topic 7 will consist of the completed project (with revisions to all sections), title page, abstract, compiled references list, and appendices. Appendices will include a conceptual model for the project, handouts, data and evaluation collection tools, a budget, a timeline, resource lists, and approval forms, as previously assigned in individual section assignments.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.
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NUR 590 Evidence-Based Practice Project
Week 8 Assignment (NUR 590 Evidence-Based Practice Project Assignments)
Evidence-Based Practice Presentation
Develop a 10-15-slide presentation with comprehensive speaker’s notes that covers all of the major areas of your evidence-based practice proposal.
You will need to post a rough draft of your evidence-based practice presentation to the Main Forum in Topic 8 DQ 1 for peer feedback.
While APA style is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references compiled from the final project should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are not required to submit this assignment to LopesWrite. NUR 590 Evidence-Based Practice Project Assignments
Benchmark Information
This benchmark assignment assesses the following programmatic competencies:
MBA-MSN; MSN-Nursing Education; MSN Acute Care Nurse Practitioner-Adult-Gerontology; MSN Family Nurse Practitioner; MSN-Health Informatics; MSN-Health Care Quality and Patient Safety; MSN-Leadership in Health Care Systems; MSN-Public Health Nursing
3.1: Assess health care processes and systems to recommend measures for improving quality, safety, and cost-effectiveness across an organization.
3.3: Integrate appropriate information and communication technologies to improve nursing practice and care delivery for individuals and populations.
Resources
The Checklist: Recognize Limits, but Harness Its Power
Read “The Checklist: Recognize Limits, but Harness Its Power,” by Grif Alspach, from Critical Care Nurse (2017).
Evidence-Based Practice in Nursing and Healthcare : A Guide to Best Practice
Read Chapters 15 and 18 in Evidence-Based Practice in Nursing and Healthcare: A Guide to Best Practice.
A Multisite Health System Survey to Assess Organizational Context to Support Evidence-Based Nursing
Read “A Multisite Health System Survey to Assess Organizational Context to Support Evidence-Based Nursing,” by Pitmann et al., from Wor
…
Supporting the Uptake of Nursing Guidelines: What You Really Need to Know to Move Nursing Guidelines Into Practice
Read “Supporting the Uptake of Nursing Guidelines: What You Really Need to Know to Move Nursing Guidelines Into Practice,” by Matthew-Maich
…
Readiness Assessment
Read “Readiness Assessment” (2015), located on the Agency for Healthcare Research and Quality (AHRQ) website.
The Cochrane Collaboration
Explore the Cochrane Collaboration website.
Advanced Practice Nursing: Essential Knowledge for the Profession
Read Chapters 23 and 24 in Advanced Practice Nursing: Essential Knowledge for the Profession.
Cochrane Library
Explore the Cochrane Library website.
Organizational Readiness Tools for Global Health Intervention: A Review
Read “Organizational Readiness Tools for Global Health Intervention: A Review,” by Dearing, from Frontiers in Public Health (2018). NUR 590 Benchmark Evidence-Based Practice Project Proposal Organizational Culture and Readiness
…
Agency for Healthcare Research and Quality
Explore the Agency for Healthcare Research and Quality (AHRQ) website.
Cultivate a Culture of Excellence at the Point of Care
Read “Cultivate a Culture of Excellence at the Point of Care,” by Medeiros, from Nursing Management (2020).
6 Steps for Transforming Organizational EBP Culture
Read “6 Steps for Transforming Organizational EBP Culture,” by Ogiehor-Enoma, Taqueban, and Anosike, from Nursing Management (2010
…
JBI EBP Resources
Use the JBI EBP Resources to search for EBP resources related to your project.
Aligning Organizational Culture and Infrastructure to Support Evidence-Based Practice
Read “Aligning Organizational Culture and Infrastructure to Support Evidence-Based Practice,” by Ost, Blalock, Fagan, Sweeney, and Miller-H
…
Healthcare organizations adopt evidence-based practice (EBP) interventions to enhance patient outcomes through the provision of quality and patient-centered care. Effective implementation of the EBP proposed project requires these organizations to identify both facilitators and barriers through use of tools that evaluate readiness and culture for change (Melnyk et al., 2022). The organizational culture and readiness assessment is a critical step in ascertaining if the organization is prepared for the EBP implementation. Dearing (2018) advances the need for EBP project implementers to use simple tools to assess the culture and readiness of an entity to implement EBP. The purpose of this paper is to provide the outcomes of the organizational culture and readiness assessment to implement the proposed EBP project.
Organization’s Culture and Level of Readiness
Organization’s culture is a vital part of its readiness for change as it has values and attributes, assumptions, and common goals that all stakeholders share and focus on in their operations and processes. The leadership structure in the organization is supportive of the change while the culture is also change-oriented. The leadership encourages participation of all providers, especially nurses who have new ideas. The culture supports change because it values innovative ways of offering patient care. The mission and the values of the organization like transformative care provision based on integrity, respect, and honesty imply that the organization has an effective culture. The evaluation also shows that the organization and its leadership value inter-professional collaboration and engagement of team through effective communication (DeNisco, 2021). The employees’ perception in the organization is positive as many believe in making change a normal occurrence for better outcomes and care delivery. Therefore, the EBP project will enhance the level of readiness for the organization to implement more projects to improve quality of care delivered to patients.
Organizational Readiness & Degree of Support by the Culture
Organizational culture also impacts the evaluation of readiness in implementing the EBP project. The primary areas of assessment for the proposed change include beliefs, leadership, quality improvement, and degree of awareness. To evaluate the readiness level for the organization, the selected assessment tool is the organizational readiness to change assessment (ORCA). The tool focuses on the level of evidence for the proposed change and the entity’s capacity to execute change and the suggested context (Dearing, 2018). On the application of the survey tool, the results indicate that nursing leadership was well prepared to implement the change because it communicates the importance of EBP to the clinical staff. The implication is that based on this tool, the level of readiness in the organization is about 4.5 out of the possible 5. The results of the scale-based survey completed showed that the organization was fairly prepared to incorporate EBP in the clinical setting. The nursing team and other stakeholders, especially those supporting nursing, were aware of the need to make changes to the current processes and operations.
The culture will also support the proposed EBP since it is change-oriented, participative, and transformative. The organizational culture in the facility encourages input from all stakeholders. However, a core weakness may be its inability to establish limits and effective ways of presenting change issues. Possible barriers may include financial support and sufficient resources to implement the EBP in the facility (DeNisco, 2021). Stakeholder support will be critical as the evaluation shows increased support from all players. Again, the timing of the proposal is effective as it emerged during the evaluation that the organization has been keen on implementing initiatives aimed at improving the quality of care.
Health Care Process and System
Improving quality, safety and cost-effectiveness in this organization would require changes in the process and systems of the organization. The organization should establish processes that are patient-centered and encourage submission of opinions and views from diverse individuals and stakeholders. The organization should establish systems that leverage on health information technologies to improve assessment of patients and delivery of care (Tzeng et al., 2021). The incorporation of monitoring technology will assist nurses and physicians to adhere to the correct procedures and processes for all patients under their care. Further, patient involvement ensures that they are aware and understand their treatment plans. This will enhance their safety and ensure that they exercise their ethical principles of autonomy and beneficence. Cost efficiency approaches would also be significant for the organization. Therefore, the entity should consider patient care approaches that lead to better experiences and outcomes.
Strategies to Facilitate Readiness of the Organization
The initial strategy to facilitate change in the organization is to define and align it with the business goals of the entity. Through this approach, the organization demonstrates its readiness for change. Secondly, the organization should identify those who will be affected by the change through knowing the purpose of change and its long-term effects on the various levels of its operations (Melnyk et al., 2022). The third strategy is having an effective communication model to create awareness, enhance participation of all people, and ensure that employees do not resist change.
Stakeholders and Team Members
The EBP project will have different stakeholders with diverse roles. These include project manager, nurse leaders, organizational managers from different departments, especially the executive and quality assurance manager, the finance manager, and nurses. Patients will be also critical stakeholders as the end users of this EBP project proposal. The project manager will be in charge of all processes and operations as well as the deliverables of the initiative (Tucker et al., 2019). The nurse leaders will ensure that nurses implement the TIPS care bundle while the organizational manager will allocate financial resources. The quality assurance manager will ensure that the TIPS model leads to quality outcomes and protects patients from harm (Tzeng et al., 2021). Patients will be the end users with better outcomes aimed at preventing falls during their stay in the facility.
Information & Communication Technologies Required in the EBP Implementation
The use of TIPS bundled model to reduce falls will integrate diverse information and communication technologies to improve care delivery. These will include electronic health records, the use of patient portals, and clinical decision support systems (CDSS). The project will also require integration of telehealth and even telemedicine for patients to get alerts among other integrated technological aspects. These will improve nursing practice by allowing nurses to closely monitor patients and customize their interventions based on status and other aspects (Khasnabish et al., 2020). The use of these technologies will enhance patient participation in decision making and ensure that all providers align their treatment goals with patient preferences.
Conclusion
The readiness of an organization to implement EBP interventions is based on the effective assessment and evaluation using recommended tools. In this case, the evaluation demonstrates that the organization is ready for change based on its supportive culture and management. As such, all stakeholders and team members must integrate effective technologies to attain the goals of the proposed EBP project of using TIPS model to reduce falls among patient in medical-surgical settings.
References
Dearing, J. W. (2018). Organizational Readiness Tools for Global Health Intervention: A
Review. Frontiers in Public Health. https://doi.org/10.3389/fpubh.2018.00056
DeNisco, S. M. (2021). Advanced practice nursing: Essential knowledge for the profession.
Jones & Bartlett Learning
Khasnabish, S., Burns, Z., Couch, M., Mullin, M., Newmark, R., & Dykes, P. C. (2020). Best
practices for data visualization: creating and evaluating a report for an evidence-based fall prevention program. Journal of the American Medical Informatics Association, 27(2), 308-314. DOI: 10.1093/jamia/ocz190.
Melnyk, B. M., & Fineout-Overholt, E. (2022). Evidence-based practice in nursing &
healthcare: A guide to best practice. Lippincott Williams & Wilkins
Tucker, S., Sheikholeslami, D., Farrington, M., Picone, D., Johnson, J., Matthews, G., … &
Cullen, L. (2019). Patient, nurse, and organizational factors that influence Evidence‐Based fall prevention for hospitalized oncology patients: an exploratory study. Worldviews on Evidence‐Based Nursing, 16(2), 111-120. DOI: 10.1111/wvn.12353.
Tzeng, H.-M., Jansen, L. S., Okpalauwaekwe, U., Khasnabish, S., Andreas, B., & Dykes, P. C.
(2021). Adopting the Fall Tailoring Interventions for Patient Safety (TIPS) Program to Engage Older Adults in Fall Prevention in a Nursing Home. Journal of Nursing Care Quality. https://doi.org/10.1097/ncq.0000000000000547
Benchmark – Evidence-Based Practice Project Proposal: Organizational Culture and Readiness – Rubric
Organizational Culture and Degree to Which Culture Supports Change
Criteria Description
Organizational Culture and Degree to Which Culture Supports Change
5. 5: Excellent
12 points
The organizational culture and the degree to which it supports change is thoroughly discussed. The various aspects of the culture are included. Thorough explanations and strong supporting research are provided.
4. 4: Good
11.04 points
The organizational culture and the degree to which it supports change is discussed. Key aspects of the culture are included. In general, explanations and support are provided. Minor detail is needed for clarity or support. NUR 590 Benchmark Evidence-Based Practice Project Proposal Organizational Culture and Readiness
3. 3: Satisfactory
10.56 points
The organizational culture and the degree to which it supports change is summarized. Some key aspects of the culture are outlined but lack explanation and supporting research.
2. 2: Less Than Satisfactory
9.6 points
The discussion of organizational culture and the degree to which it supports change is incomplete.
1. 1: Unsatisfactory
0 points
The organizational culture and the degree to which it supports change is not discussed.
Organizational Readiness Tool and Readiness Assessment
Criteria Description
Organizational Readiness Tool and Readiness Assessment
5. 5: Excellent
13 points
The organizational readiness tool is identified, and the survey results are presented. The degree to which the culture will support and sustain an evidence-based practice changes is thoroughly discussed. Strengths and weaknesses, potential barriers, stakeholder support, timing of the proposal, and resources are clearly considered. Thorough explanations and strong supporting research are provided.
4. 4: Good
11.96 points
The organizational readiness tool is identified, and the survey results are presented. The degree to which the culture will support and sustain an evidence-based practice changes is discussed. Strengths and weaknesses, potential barriers, stakeholder support, timing of the proposal, and resources are generally considered. Some minor rationale is needed.
3. 3: Satisfactory
11.44 points
The organizational readiness tool is identified, and the survey results are summarized. The degree to which the culture will support and sustain evidence-based practice changes is generally discussed. The narrative lacks explanation and supporting research.
2. 2: Less Than Satisfactory
10.4 points
The organizational readiness tool is identified. The survey results and interpretation are incomplete.
1. 1: Unsatisfactory
0 points
An organizational readiness tool is not selected; the level or readiness is not assessed.
Health Care Process and Systems Recommended for Improving Quality, Safety, Cost-Effectiveness (B)
Criteria Description
Health Care Process and Systems Recommended for Improving Quality, Safety, and Cost-Effectiveness (C.3.1)
5. 5: Excellent
10 points
The health care process and systems recommended for improving quality, safety, and cost-effectiveness for the organization is thoroughly discussed. Thorough explanations and strong supporting research are provided.
4. 4: Good
9.2 points
The health care process and systems recommended for improving quality, safety, and cost-effectiveness for the organization is discussed. Minor detail is needed for clarity or support.
3. 3: Satisfactory
8.8 points
A summary on what health care process and systems are recommended for improving quality, safety, and cost-effectiveness for the organization is presented. The narrative lacks explanation and supporting research.
2. 2: Less Than Satisfactory
8 points
A discussion on what health care process and systems are recommended for improving quality, safety, and cost-effectiveness for the organization is incomplete.
1. 1: Unsatisfactory
0 points
A discussion on what health care process and systems are recommended for improving quality, safety, and cost-effectiveness for the organization is omitted.
Strategies to Facilitate Organizational Readiness
Criteria Description
Strategies to Facilitate Organizational Readiness
5. 5: Excellent
10 points
Strategies to better facilitate the readiness of the organization are proposed. Minor detail is needed for clarity or support.
4. 4: Good
9.2 points
Clear strategies to better facilitate the readiness of the organization are proposed. Thorough explanations and strong supporting research are provided.
3. 3: Satisfactory
8.8 points
General strategies to better facilitate the readiness of the organization are proposed. The strategies lack explanation and supporting research.
2. 2: Less Than Satisfactory
8 points
Strategies to better facilitate the readiness of the organization are incomplete.
1. 1: Unsatisfactory
0 points
Strategies to better facilitate the readiness of the organization are not proposed.
Stakeholders and Team Members Needed
Criteria Description
Stakeholders and Team Members Needed
5. 5: Excellent
10 points
The stakeholders and team members for the project, including their respective duties, are thoroughly identified.
4. 4: Good
9.2 points
Key stakeholders and team members for the project, including their respective duties, are identified. Minor detail is needed for clarity or support.
3. 3: Satisfactory
8.8 points
Some key stakeholders and team members for the project, including their respective duties, are outlined.
2. 2: Less Than Satisfactory
8 points
Stakeholders and team members for the project are only partially identified.
1. 1: Unsatisfactory
0 points
Stakeholders and team members for the project are omitted.
Information and Communication Technologies Needed (B)
Criteria Description
Information and Communication Technologies Needed (C.3.3)
5. 5: Excellent
10 points
The information and communication technologies needed for implementation and how they will be integrated in the setting by the internal stakeholders are discussed. How they will help improve nursing practice and care delivery for individuals and populations for the intervention is explained. Minor detail is needed for clarity or support.
4. 4: Good
9.2 points
The information and communication technologies needed for implementation and how they will be integrated in the setting by the internal stakeholders are clearly discussed. How they will help improve nursing practice and care delivery for individuals and populations for the intervention is thoroughly explained. Clear support is provided.
3. 3: Satisfactory
8.8 points
The information and communication technologies needed for implementation and how they will be integrated in the setting by the internal stakeholders are summarized. More explanation is need for how these will help improve nursing practice and care delivery for individuals and populations for the intervention.
2. 2: Less Than Satisfactory
8 points
The information and communication technologies needed for implementation and how they will be integrated in the setting by the internal stakeholders are only partially explained.
1. 1: Unsatisfactory
0 points
The information and communication technologies needed for implementation and how they will be integrated in the setting by the internal stakeholders are omitted.
Required Sources
Criteria Description
Required Sources
5. 5: Excellent
5 points
Number of required resources is met. Sources are current, and appropriate for the assignment criteria and nursing content.
4. 4: Good
4.6 points
Number of required sources is met, but sources are outdated or inappropriate.
3. 3: Satisfactory
4.4 points
Number of required sources is met. Sources are current, but not all sources are appropriate for the assignment criteria and nursing content.
2. 2: Less Than Satisfactory
4 points
Number of required sources is only partially met.
1. 1: Unsatisfactory
0 points
Sources are not included.
Thesis Development and Purpose
Criteria Description
Thesis Development and Purpose
5. 5: Excellent
7 points
Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.
4. 4: Good
6.44 points
Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.
3. 3: Satisfactory
6.16 points
Thesis is apparent and appropriate to purpose.
2. 2: Less Than Satisfactory
5.6 points
Thesis is insufficiently developed or vague. Purpose is not clear.
1. 1: Unsatisfactory
0 points
Paper lacks any discernible overall purpose or organizing claim.
Argument Logic and Construction
Criteria Description
Argument Logic and Construction
5. 5: Excellent
8 points
Argument is orderly but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.
4. 4: Good
7.36 points
Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.
3. 3: Satisfactory
7.04 points
Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.
2. 2: Less Than Satisfactory
6.4 points
Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.
1. 1: Unsatisfactory
0 points
Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.
Mechanics of Writing
Criteria Description
Mechanics of Writing (includes spelling, punctuation, grammar, language use)
5. 5: Excellent
5 points
Writer is clearly in command of standard, written, academic English.
4. 4: Good
4.6 points
Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.
3. 3: Satisfactory
4.4 points
Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.
2. 2: Less Than Satisfactory
4 points
Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.
1. 1: Unsatisfactory
0 points
Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.
Paper Format (Use of appropriate style for the major and assignment)
Criteria Description
Paper Format (Use of appropriate style for the major and assignment)
5. 5: Excellent
5 points
Template is fully used; There are virtually no errors in formatting style.
4. 4: Good
4.6 points
All format elements are correct.
3. 3: Satisfactory
4.4 points
Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.
2. 2: Less Than Satisfactory
4 points
Template is used, and formatting is correct, although some minor errors may be present.
1. 1: Unsatisfactory
0 points
Template is not used appropriately, or documentation format is rarely followed correctly.
Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to as
Criteria Description
Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)
5. 5: Excellent
5 points
Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.
4. 4: Good
4.6 points
Sources are documented, as appropriate to assignment and style, and format is mostly correct.
3. 3: Satisfactory
4.4 points
Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.
2. 2: Less Than Satisfactory
4 points
Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.
1. 1: Unsatisfactory
0 points
Sources are not documented.
Welcome to NUR 590 Evidence-Based Practice Project!
Hello Everyone!
Welcome to NUR 590! My name is Dr. W and I will be your instructor for this course. During this course, you will be writing your evidence-based project proposal. Every week you will be writing a section of the proposal and submitting it into the assignments forum. I will provide feedback for you with each section. Please revise your sections according to my feedback and save the revisions. During week 7 you will compose the final draft of the proposal with the revised sections and the other required parts of the proposal that are described in the assignment guidelines. All of your writing must be followed by the APA 7th edition guidelines. Please purchase a hard copy of the APA manual 7th edition. I will have my copy and make references to the pages in the APA manual 7th edition in order for you to make your revisions. During the first two weeks of the course, I will post computer-assisted technique (CAT) questions for you to review APA 7th edition guidelines. The remainder of the CAT questions will be about the discussion questions.
Please become familiar with your syllabus during the first week. Please post something about yourself in the class introduction forum. There are some important due dates that are required with your initial response to the discussion questions. All initial responses to discussion question one are due on Saturday of each week by 11:59 pm Arizona time. If a response is late, 0.5 point will be deducted for each day late. The first deduction will be due to not submitting your response by the date and time. The initial response to discussion question two will be due on Monday of each week by 11:59 pm Arizona time. The same penalty applies to discussion question two as discussion question one. Each initial response must be a substantive response and is worth a total of 5 points for each discussion question. You will have a total of 20 participation points each week. Your participation points must be substantive and include at least three responses to your classmates and/or the CAT questions. ALL THREE RESPONSES MUST BE POSTED ON AT LEAST THREE SEPARATE DAYS OR POINTS WILL BE DEDUCTED!!! Please adhere to all guidelines. The due dates for the assignments will be every Wednesday by 11:59 pm Arizona time. There will be a 10% penalty for each late assignment submission. Please communicate with me with any questions or concerns. You may send me a private forum (which only I have access to), a Question to Instructor forum (which all members of the class can read), or you may text me at (406) 600-0884. Please only text me between the hours of 8 am and 8 pm Eastern Daylight Time. I will respond as quickly as I can.
Every week I will post scripture verses in the announcements. This week’s scripture verses come from Ephesians 4.
Assessment Description
Compare two organizational readiness tools. Identify the tool you selected and explain why it is most appropriate for assessing your organization.
The two organizational readiness tool that I had chosen are The Patient Assessment of Chronic Illness Care (PACIC) and the Organization Readiness Change Assessment (ORCA). The organization’s readiness assessment for change is a crucial factor in the implementation phase of any given public health intervention (“Selecting A Tool”, n.d.). These tools can assist in evidenced-based practice (EBP) interventions. The Patient Assessment of Chronic Illness Care Questionnaire also known as PACIC is a tool that is used to make an evaluation of the perspective of the patient with regards to the receipt of patient care delivery in the 5 domains namely: activation, delivery system, goal setting, problem solving, and follow-up (Gensichen et al., 2011). PACIC tool can be used for conditions that incurable and illnesses that lasts for a prolonged period time. On the other hand, the ORCA tool has 4 main purposes: learning about the degree of motivation, assessment of organizational abilities, improvement of organizational capacities, and empowerment of organizations (Dearing, 2018).
The most appropriate tool for assessing my organization is the ORCA tool because it can help with identifying and monitoring of organizational strengths and weakness or an organization (“Organizational Readiness”, 2017).By using this tool in clinical settings which it was originally intended for, can help with providing support and success of EBP.
References
Dearing, J. (2018). Organizational readiness tools for global health intervention: A review. Frontiers In Public Health. https://doi.org/10.3389/fpubh.2018.00056
Gensichen J, Serras A, Paulitsch MA, Rosemann T, König J, Gerlach FM, Petersen JJ. (2011).The Patient Assessment of Chronic Illness Care questionnaire: Evaluation in patients with mental disorders in primary care. Community Ment Health J, 47(4):447-53. doi: 10.1007/s10597-010-9340-2.
“Organizational Readiness”. (2017). National Collaborating Centre for Methods and Tools. http://www.nccmt.ca/resources/search/187.
“Selecting A Tool”.(n.d.). National Collaborating Centre for Methods and Tools. https://www.nccmt.ca/knowledge-repositories/search/279
APA Writing Checklist
Use this document as a checklist for each paper you will write throughout your GCU graduate program. Follow specific instructions indicated in the assignment and use this checklist to help ensure correct grammar and APA formatting. Refer to the APA resources available in the GCU Library and Student Success Center.
☐ APA paper template (located in the Student Success Center/Writing Center) is utilized for the correct format of the paper. APA style is applied, and format is correct throughout.
☐ The title page is present. APA format is applied correctly. There are no errors.
☐ The introduction is present. APA format is applied correctly. There are no errors.
☐ Topic is well defined.
☐ Strong thesis statement is included in the introduction of the paper.
☐ The thesis statement is consistently threaded throughout the paper and included in the conclusion.
☐ Paragraph development: Each paragraph has an introductory statement, two or three sentences as the body of the paragraph, and a transition sentence to facilitate the flow of information. The sections of the main body are organized to reflect the main points of the author. APA format is applied correctly. There are no errors.
☐ All sources are cited. APA style and format are correctly applied and are free from error.
☐ Sources are completely and correctly documented on a References page, as appropriate to assignment and APA style, and format is free of error.
Scholarly Resources: Scholarly resources are written with a focus on a specific subject discipline and usually written by an expert in the same subject field. Scholarly resources are written for an academic audience.
Examples of Scholarly Resources include: Academic journals, books written by experts in a field, and formally published encyclopedias and dictionaries.
Peer-Reviewed Journals: Peer-reviewed journals are evaluated prior to publication by experts in the journal’s subject discipline. This process ensures that the articles published within the journal are academically rigorous and meet the required expectations of an article in that subject discipline.
Empirical Journal Article: This type of scholarly resource is a subset of scholarly articles that reports the original finding of an observational or experimental research study. Common aspects found within an empirical article include: literature review, methodology, results, and discussion.
Adapted from “Evaluating Resources: Defining Scholarly Resources,” located in Research Guides in the GCU Library.
☐ The writer is clearly in command of standard, written, academic English. Utilize writing resources such as Grammarly, LopesWrite report, and ThinkingStorm to check your writing.