NUR 590 Week 5 Assignment Evidence-Based Practice Proposal – Section E: Implementation Plan
NUR 590 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:
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.
vShare Common Themes on HAIs and use of Hand Hygiene Measures
vApplication of evidence-based Practice Interventions
vHAIs as public health Concern
vStakeholders’ Role is essential in Mitigating HAIs
vNeed for More Studies to assess the effectiveness of hand hygiene Measures on Infection Control
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.
Timelines
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.
Resources
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.
Feasibility
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.
Conclusion
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.
References
Boehm, L. M., Stolldorf, D. P., & Jeffery, A. D. (2020). Implementation science training and
resources for nurses and nurse scientists. Journal of Nursing Scholarship, 52(1), 47-54. doi: 10.1111/jnu.12510.
DeNisco, S. M. (2019). Advanced Practice Nursing: Essential Knowledge for the Profession:
Essential Knowledge for the Profession. Jones & Bartlett Learning.
Klingbeil, C. & Gibson, C. (2018). The Teach Back Project: A System-wide Evidence Based
Practice Implementation. Journal of Pediatric Nursing, 42:81-85. doi: 10.1016/j.pedn.2018.06.002.
Luciano, M. M., Aloia, T. A. & Brett, J. F. (2019). 4 Ways to Make Evidence-Based Practice the
Norm in Health Care. Harvard Business Review. https://hbr.org/2019/08/4-ways-to-make-evidence-based-practice-the-norm-in-health-care
Rebekah, G., & Ravindran, V. (2018). Statistical analysis in nursing research. Indian Journal of
Continuing Nursing Education, 19(1), 62.
Vandermause, R., Barg, F. K., Esmail, L., Edmundson, L., Girard, S., & Perfetti, A. R. (2017).
Qualitative methods in patient-centered outcomes research. Qualitative health research, 27(3), 434-442. doi: 10.1177/1049732316668298
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.
Also Read: NUR 590 Week 4 Assignment Evidence-Based Practice Proposal – Section D: Change Model
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.
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.
- (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).
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