NUR 590 Week 7 Assignment  Benchmark – Evidence-Based Practice Proposal Final Paper

NUR 590 Week 7 Assignment  Benchmark – Evidence-Based Practice Proposal Final Paper

Grand Canyon University NUR 590 Week 7 Assignment  Benchmark – Evidence-Based Practice Proposal Final Paper-Step-By-Step Guide

 

This guide will demonstrate how to complete the Grand Canyon University  NUR 590 Week 7 Assignment  Benchmark – Evidence-Based Practice Proposal Final Paper assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

 

How to Research and Prepare for NUR 590 Week 7 Assignment  Benchmark – Evidence-Based Practice Proposal Final Paper                                   

 

Whether one passes or fails an academic assignment such as the Grand Canyon University   NUR 590 Week 7 Assignment  Benchmark – Evidence-Based Practice Proposal Final Paper depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

 

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

 

How to Write the Introduction for NUR 590 Week 7 Assignment  Benchmark – Evidence-Based Practice Proposal Final Paper                                   

 

The introduction for the Grand Canyon University   NUR 590 Week 7 Assignment  Benchmark – Evidence-Based Practice Proposal Final Paper is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

 

How to Write the Body for NUR 590 Week 7 Assignment  Benchmark – Evidence-Based Practice Proposal Final Paper                                   

 

After the introduction, move into the main part of the NUR 590 Week 7 Assignment  Benchmark – Evidence-Based Practice Proposal Final Paper assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

 

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

 

How to Write the Conclusion for NUR 590 Week 7 Assignment  Benchmark – Evidence-Based Practice Proposal Final Paper                                   

 

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

 

How to Format the References List for NUR 590 Week 7 Assignment  Benchmark – Evidence-Based Practice Proposal Final Paper                                   

 

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

Stuck? Let Us Help You

 

Completing assignments can sometimes be overwhelming, especially with the multitude of academic and personal responsibilities you may have. If you find yourself stuck or unsure at any point in the process, don’t hesitate to reach out for professional assistance. Our assignment writing services are designed to help you achieve your academic goals with ease. 

 

Our team of experienced writers is well-versed in academic writing and familiar with the specific requirements of the NUR 590 Week 7 Assignment  Benchmark – Evidence-Based Practice Proposal Final Paper assignment. We can provide you with personalized support, ensuring your assignment is well-researched, properly formatted, and thoroughly edited. Get a feel of the quality we guarantee – ORDER NOW. 

Sample Answer for NUR 590 Week 7 Assignment  Benchmark – Evidence-Based Practice Proposal Final Paper

The wellness of a population’s health using improved patient safety protocols implores healthcare workers (HCWs) especially nurses, to develop evidence-based practice interventions to reduce and prevent occurrence of adverse events like hospital acquired infections (HAIs) and medication administration errors (MAEs) among others. These adverse events lead to poor patient outcomes, increase the overall cost of care and disease burden, and lowers the quality of care delivered by healthcare professionals. Hospital acquired infections are some of the leading healthcare concerns that affect patient safety and quality of care. Many patients suffer from these infections that result into lengthened stays in hospitals, increased cost of care, and in extreme circumstances death.

There are many challenges in improving the health of populations and one of the biggest challenges has to do with the delivery and utilization of the interventions that are being proposed (Dearing, 2018). When it comes to the delivery of the interventions, it incorporates more than one factor. The factors that are considered in the delivery of the interventions include communication, training, leadership, coordination, and management (Dearing, 2018). When it comes to change, organizational readiness needs to be assessed. Two tools that can be used to assess organizational readiness includes the Organizational Readiness to Change Assessment (ORCA) tool and the Organizational Readiness for Implementing Change (ORIC). As my organization is a Magnet facility and already supports and implements evidence-based practices, I chose the ORIC tool to discuss. The ORIC tool is the most appropriate for assessing my organizations readiness as this tool focuses on the readiness of the organizational members for implementing change. Being a Magnet facility, my organization has proven that they support nursing excellence and to determine if the team members are ready for change implementation, the ORIC tool would be ideal to evaluate this. When the organization’s readiness is high, the members are more likely to initiate and put forth greater effort for implementing change and on the flip side when the organization’s readiness is low, the team members are more than likely to view change as undesirable and may resist change (Shea et al., 2014). With my proposed evidence-based change, it does involve a fully engaged team which is even more of a reason to use the ORIC tool to help determine the team’s readiness for change and hopefully lead to a successful change implementation.

Nurse practitioners and other healthcare professionals transmit infections to patients through poor hand hygiene measures and protocols (Alotaibi & Federico, 2017). As such, nurses and other providers should leverage evidence-based practice (EBP) interventions to reduce and prevent the occurrence of hospital acquired infections and guarantee quality care. The use of evidence-based practice interventions allows these providers to offer better services through increased quality, increased engagement of patients and their preferences, and leveraging clinical experience and expertise. The purpose of this evidence-based practice project proposal paper is to discuss how nurses in pediatric settings can integrate hand hygiene measures and protocols to reduce and prevent the occurrence of hospital acquired infections. These measures and protocols include handwashing using soap and water alongside hand sanitizers compared to handwashing with water and soap alone.

Problem Statement

Hospital acquired infections or nosocomial infections are newly acquired infections that patients contract during their stay in hospital settings or facilities. The transmission of the nosocomial infections happens through healthcare workers, patients, hospital equipment like catheters and interventional procedures that include catheterization. Studies demonstrate that healthcare workers who include nurse practitioners infect patients when they fail to adhere to effective hand hygiene measures like handwashing with soap or using alcohol-based sanitizers and hand rubs when handling and interacting with patient in the care process (Liana 2021). The use of evidence-based practice interventions using PICOT question is important in assisting nurses to implement better practices to reduce the susceptibility of patients acquiring nosocomial infections that have adverse effects on overall care delivery and quality. These infections lead to increased length of stay in hospitals, a rise in cost of healthcare and cause deaths, especially in critical care settings like pediatric units (Setty et al., 2019). Hand hygiene measures that include handwashing with soap and water alongside sanitizer will improve patient safety among healthcare workers. The implication is that healthcare workers will adhere to these measures in pediatric settings to reduce hospital acquired infections within six months’ period and improve quality outcomes.

PICOT Statement

Population- Healthcare workers in pediatric settings

Intervention-Hand Hygiene using handwashing with soap and water and sanitizer

Comparison-Handwashing with soap and water alone

Outcome- Reduced Hospital acquired infections

Time- in Six months

Refined PICOT Question

The refined PICOT question for the EBP project is “Among healthcare workers in pediatric setting (P), does hand hygiene practices that include handwashing with soap and water alongside hand sanitizer (I) compared to handwashing with soap and water alone (C) reduce hospital acquired infections (O) within six months (T)?”

Organizational Culture and Readiness

The culture of an organization is essential in implementing changes and it impacts its overall vision, mission and values and employees’ perception in embracing new ways of executing tasks. A culture entails employees with strong norms and values, management and approaches to overall way of doing things.  A culture that involves employees, possesses strong values and norms, and encourages an open-door policy with decentralized approach is important in achieving set change objectives in an organization (Real et al., 2017). To effectively implement this EBP project proposal, pediatric healthcare settings and practitioners should use a decentralized organizational and leadership structure. The model is effective in enhancing motivation of subordinates and enhancing growth and increased diversification. Decentralization in healthcare organizations leads to better communication and adoption of innovative practices, ideas and strategies to improve quality of care. Through decentralization, the management leads a transformational approach to enhance agility and respond to new and best practices in care delivery.

The implementation of this EBP project proposal requires organizational culture that focuses on patient-centered care delivery. Through being patient-centered, an organization can support change programs to improve patient safety, quality and access while minimizing the occurrence of hospital acquired infections (HAIs). Increasing patient engagement and promoting inter-professional collaboration leads to a competitive advantage for healthcare organizations.

The evaluation of an organization’s readiness for change based on its culture is essential in implementing evidence-based practice projects. Readiness demonstrates the level to which organizational members are prepared to implement and embrace change, behaviorally and psychologically. Dearing (2018) opines that readiness is a psychological state of the mind that shows commitment to certain course of actions. As such, this EBP project proposal will leverage the Organizational Capacity Assessment Tool developed by the United Nations Development Program (UNDP) that assesses an organization’s readiness in promoting and enhancing the use of global health interventions. Through the tool, organizations identify substantive capacities and strengths that are present and the required one to attain their set objective. In this case, pediatric settings that aim to implement this EBP recommendations should demonstrate exemplary capacities in their attributes, have a superb and influential culture based on their missions, purposes and better values (De la Perrelle et al.., 2020). The capacity assessment tool looks at the various capabilities that include human resources, processes, financial resources, and systems as critical components of readiness for change implementation. Ready organizations possess sufficient strengths that include having the best skills, effective communication and adequate resources, availability of sufficient nurse workforce and effective engagement of their stakeholders.

The organizational readiness also evaluates the process and systems that require improvement to effectively implement the requisite changes (Vax et al., 2021). For instance, the improvement that pediatric care settings require include their patient handling process, the need for healthcare workers to adhere to hand hygiene measures and protocols, and delivery of patient-centered quality care. The organization will need quality improvement and collaborative approaches to enhance implementation. These organizations will also require quality data assessment tools for better and accurate analysis of their respective data (Dearing, 2018). The readiness will also include engagement of stakeholders and integration of information and communication technologies to ensure that all components to implement the project proposal are present. Using selected technologies, the project team and practitioners will pursue outcomes based on patient needs through enhanced alerts, reminders, and notifications on the need to comply with set hand hygiene protocols and measures that include effective handwashing and use of hand sanitizers to reduce hospital acquired infections in the pediatric settings.

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.

ALSO READ: NUR 590 Topic 5 DQ 1 Identify two stakeholder barriers you might experience during the implementation phase of your evidence-based practice project

Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: NUR 590 Week 7 Assignment  Benchmark – Evidence-Based Practice Proposal Final Paper

Sample Answer 2 for NUR 590 Week 7 Assignment  Benchmark – Evidence-Based Practice Proposal Final Paper

The healthcare sector, healthcare professionals, and other stakeholders have, in the past and present, focused on improving patient outcomes using various strategies. Such strategies aim at improving the efficiency of patient care and the safety of patients while in the patient care environment. The efforts and initiatives aimed at improving care outcomes are usually triggered by a host of incidences happening in the care settings, such as patient falls, patient injuries, pressure ulcers, and healthcare-acquired infections, among other incidences. (Jaul et al.,2018) Among the most common healthcare-acquired infections are catheter-associated urinary infections (CAUTIs). CAUTIs have been shown to cause various negative impacts, such as increased healthcare spending, longer hospital stays, and other adverse impacts, such as death. Therefore, this evidence-based practice project focuses on lowering the rates of CAUTI among patients in admission settings and using indwelling catheters(Shadle et al.,2021). As such, the purpose of this paper is to formulate aproposal for the EBP. Various aspects which will be explored include the problem statement, the organizational culture, the literature review, the change framework, and the implementation and evaluation plans.

Problem Statement

Hospital-acquired infections have been shown to be on the rise in the past and present. One of the most common types of such infections is catheter-acquired urinary tract infections caused by the use of urinary catheters, especially indwelling ones. According to Flores-Mireles.(2019), CAUTIs lead to various adverse impacts. Even though the condition is largely preventable, it continues to cause havoc as it leads to increased patient morbidity and mortality, longer hospital stay, and increased healthcare spending (Kranz et al.,2020). This problem can, however, be prevented by applying various nursing interventions. It is important to note that, while various nursing interventions have been implemented, especially single activity-based interventions, the problem still persists hence calling for the use of more robust approaches which can integrate various interventions such as the use of CAUTI bundle.

Organizational Culture and Readiness

The process of evidence-based practice is impacted by various aspects, some of which are organizational aspects. The implication is that the EBP implementers should take their time and assess the nature of the organization, such as its culture related to EBP implementation and the readiness of various staff. Such a step is key in determining how easy or difficult the process of implementing an EBP project can be since a positive culture is needed for a successful implementation to occur (Cleary‐Holdforth et al.,2021). The assessment revealed that the organization’s leaders support patient improvement initiatives such as the EBP process for better patient outcomes. The organization also focuses on gaining magnet status, which has made them support various change initiatives. The assessment of the organization’s aim and mission showed that it focuses on offering exemplary and excellent patient services by using the latest care strategies at affordable costs. In addition, it was also noted that the organization adores interprofessional collaborations and teams in the provision of care. Therefore, it is evident that the organization’s culture is ready for change and also supports EBP.

The organization’s culture and readiness were assessed using a chosen tool, the System-Wide Integration of the EBP survey tool. This tool has widely been applied, especially to assess an organization’s capacity to adapt to and cope with change (Melnyk et al.,2022). This tool was used to explore the staff’s and the leader’s understanding of the proposed change of application of the CAUTI bundle to control the CAUTI rates. The survey tools showed that up to 91% of the staff support the proposed change, which is a majority. In addition, the majority of the leaders also supported the initiative, as up to 80% indicated that they were ready for the change. Therefore, this tool also revealed that the organization’s culture could support and sustain the proposed change.

Even though the culture supports the proposed change, it is worth noting that there are potential barriers and weaknesses that may derail implementation. For example, lack of support by minority leaders as staff can be a major drawback. The assessment will also be key in exploring the staff knowledge in using the proposed CAUTI bundle, which will then help to formulate strategies for improving their knowledge. The leaders supporting the initiative will play an important role in availing the required resources and supporting the project through making effective decisions and formulating change champions who can then help on driving the change initiative as appropriate. It was also important to identify the relevant stakeholders (Melnyk et al.,2022). Therefore, various stakeholders were identified, stakeholders include physicians, nurses, unit leaders, nurse managers, patients, and their families

Literature Review

The identified problem which informed the formulation of this project is increased rates of CAUTI in patient care settings. Therefore, the use of CAUTI bundles has been proposed as a potential EBP intervention. As such, it was important to perform a literature review to explore the existing evidence on the use of CAUTI bundles to reduce the rates of CAUTIs among patients admitted to the hospital and using indwelling urinary catheters. A PICOT question formulated earlier was used in the literature search. The formulated PICOT was: Among patients using indwelling urinary catheters, what is the efficacy of using CAUTI bundle care as compared to no intervention in lowering the rates of CAUTI by at least 60% within six months?

An article search strategy was also used to access the most relevant articles and evidence as appropriate. The search was accomplished in various article databases such as PubMed, google scholar, CINHAL, and Cochrane databases. The search also focused on peer-reviewed articles published in the last five years. Various search terms were also used in the search for relevant articles, including CAUTI, CAUTI bundles, intervention, and prevalence. Even though the search yielded several articles, the most relevant was chosen, and the literature review of the ten articles was performed and presented in the next section.

Elkbuli et al.(2018) conducted a study on the prevention of CAUTI among the trauma population. This study aimed at determining the efficacy of using a 5-S CAUTI bundle in the reduction of CAUTI rates among trauma patients. In a quantitative study, the researchers recruited a total of 2926 trauma patients. The analysis of the data showed that the use of the 5-S bundle led to a significant reduction in CAUTI rates among trauma patients (p-value of 0.002).

Davies et al.(2018) also conducted a study to explore the impact of using a CAUTI bundle. In a pre-and-post-study design, the researchers recruited a total of 6236 patients to take part in the study. The analysis of the data compared the rates of infections before the application of the CAUTI bundle and after its implementation. The results showed that the rates of CAUTI after the implementation of the CAUTI bundle were significantly lower compare as compared to the rates before, showing the efficacy of the CAUTI bundle.

Recently, Reynolds et al. (2022) conducted research that aimed at exploring the impact and sustainability of a multifaceted intervention in lowering CAUTI rates. This study was conducted in three large adult intensive care units among patients using urinary catheters. The analysis of the data showed a significant impact of bundle care. For example, the researchers noted a drop in CAUTI rates and the use of indwelling catheters. The positive impacts were directly associated with the implementation of the CAUTI bundle care as a strategy.

In a similar study, Mundle et al. (2020) explored the effectiveness of implementing a CAUTI bundle in preventing CAUTI incidences. The researchers conducted the study in internal medicine units where every patient admitted during the study took part in the study. The analysis of the data showed significant results relevant to this study as the researchers observed a 79% reduction in the rates of CAUTI among the patients, showing that the implementation of the CAUTI bundle care positively impacted CAUTI rates.

Sultan et al. (2022) explored the effect of using a CAUTI bundle to help prevent CAUTI occurrence among critically ill patients. In a quantitative study, the researcher recruited a total of eighty patients admitted to the intensive care units. The analysis of the data showed that the implementation of the CAUTI bundle led to a significant reduction in CAUTI rates. For example, they noted that upon the implementation of the CAUTI bundle, the CAUTI rates among the ICU patients were reduced by 50%, showing the efficacy of the intervention.

Another relevant study was conducted by Tyson et al. (2020), which focused on implementing a nurse-driven protocol designed to support catheter removal approaches to help reduce CAUTI rates. The aim of the study was to compare the CAUTI rates and the use of indwelling urinary catheters before and after implementing a nurse-driven CAUTI bundle among patients admitted to the surgical trauma intensive care unit. The analysis of the collected data led to significant results. For example, upon the implementation of the protocol, the researchers noted a significant reduction in the rates of catheter use. In addition, they also found that the protocol led to a reduction in CAUTI rates.

Shadle et al. (2021) also conducted a study to determine the impact of using a CAUTI bundle to reduce CAUTI rates. In a quantitative study design, the researchers collected data using electronic health records. The analysis of the collected data also showed relevant results. For example, the researchers realized that during the study, no CAUTI cases or incidences were reported showing that the CAUTI bundle implemented was highly effective in preventing and controlling the CAUTI rates.

More recently, Pajerski et al. (2022) carried out research that explored the impact of using CAUTI bundles in controlling the rates of CAUTI. This study was conducted in a trauma brain injury rehabilitation unit. Upon the analysis of the data, the researchers noted that there was a reduction in the CAUTI rates when the CAUTI bundle care approach was implemented. Soundaram et al. (2020) also carried out research with the aim of exploring the impact of implementing a CAUTI bundle in the control and prevention of CAUTI rates and incidence. The researchers carried out the study in adult intensive care units. The analysis of the data showed that upon the use of the CAUTI bundles, the cases of CAUTI were observed to reduce significantly by sixty percent. As such, this is another study that shows the efficacy of using a CAUTI bundle in controlling and preventing CAUTI incidences and rates.

Another study was conducted by Ravi and Joshi (2018). This study was conducted with the major aim of exploring the efficacy of a CAUTI care bundle in lowering CAUTI rates. The researchers used a bundle care approach which included training and educating the nursing staff on how to appropriately use and manage the indwelling catheters. Upon the analysis of the data, the researchers also noted a significant reduction in the rates of CAUTI among admitted patients. Therefore, this is another study that shows the efficacy of using CAUTI bundles in the prevention and control of CAUTI.

Change Model or Framework

Change models play a crucial role in the implementation of evidence-based practice projects since they offer foundations upon which the project is implemented (Jayatilleke & Lai, 2018). As such, the selected change model for this project is Kurt Lewin’s change model. According to Lewin change occurs in three distinct faces, and there are two major forces involved in a change process, the driving and restraining forces. The driving forces are known to enhance the change process, while the restraining forces oppose the change. As such, the driving forces have to overcome the restraining forces for the change process to occur successfully.

The three phases include unfreezing, change, and refreezing. In the first phase, which is refreezing, the major activity is creating an urgent need for change by pointing out the evidence of why the change should urgently be undertaken (Hussain et al.,2018). Letting the stakeholders know that there is a need for change requires effective communication.  The second phase, which is the change phase, is associated with the implementation of the proposed intervention, where the change implementers implement the initiatives to help solve the identified clinical issue. The third phase is known as refreezing. This stage entails using various efforts to ensure that the implemented change becomes part of the organization’s culture and supporting the staff to accept and sustain the change.

The stages of the model will be applied to implement the CAUTI bundles. In the unfreezing stage, the stakeholders will be alerted to the urgent need for change to help reduce the rates of CAUTI in the care setting. Appropriate communication channels will be used to inform the staff of the need to address the issue of rising CAUTI cases. The second phase, which is the change phase, will involve training the nursing staff on the proposed new bundle and how to use it. The process will then be followed by the implementation of the CAUTI bundle to help reduce the rates of CAUTI. Effective communication will also be key in this phase(Hussain et al.,2018). The last phase, which is the refreezing stage, will entail sustaining the implemented change and ensuring that the CAUTI bundle becomes part of the organization’s protocol for preventing CAUTI incidence.

Implementation Plan

Implementation is one of the most important phases of an EBP project cycle. Therefore, a conducive environment should be created to enhance the implementation process. It is also important to explore various aspects, such as the setting and how to access the potential subjects. As discussed earlier, this project involves using CAUTI bundles to reduce or lower the rates of CAUTI among patients using indwelling urinary catheters (Elkbuli et al.,2018). Therefore, the targeted setting for the project is the admission wards with patients who used indwelling urinary catheters. The patients to be considered are those who will be admitted to the admission units and using the indwelling catheters. The other targeted population is the nurses who offer nursing care to the patients in these settings. The data for evaluating the project will be obtained from electronic health records. Therefore, there will be no need to obtain informed consent. Nonetheless, the organization leaders will need to offer permission to allow the implementation process.

It is also important to consider a suitable timeline for the proposed project. A timeline acts as a guide to knowing when particular activities should be accomplished (Melnyk & Fineout-Overholt, 2019). Therefore, a period of six months has been proposed for the project. It is hoped that this duration will be sufficient to cover various project phases such as project, initiation, literature review, project implementation, monitoring, and evaluation. This duration will also be used in obtaining project feedback from the stakeholders, such as indications of carrying out corrective measures to help solve various identified problems.

The Budget and Resource List

The success of a project heavily depends on the availability of needed resources; therefore, it is important to procure the necessary resources in time. There will be a need to train the staff on the use of the new CAUTI bundle. Therefore, both material and financial resources will be required to support such an education and training process (Melnyk & Fineout-Overholt, 2019). Besides, additional resources will also be needed to help in the development of the CAUTI bundle protocol to be used in controlling and preventing the CAUTI rates. Human resources will also be required to help accomplish the project goals. The budget implication is that the project team will need to get sufficient resources that can help in training and educating the nursing staff, purchasing the training materials, hiring the educators, collecting data, data analysis, project monitoring, and well as outcome evaluation. It has been projected that the cost of the project will be $36,000, and the detailed budget and resource list have been included in the appendix.

The Study Design

A study design is important in guiding a project; therefore, it is important to choose various aspects of study design appropriately. As such, the design chosen for this project is the quantitative design which will be used in both data collection and analysis. This design has been chosen since the targeted project data is quantitative. Statistical tests will also be used as part of the project to analyze the project data, which further corroborates the use of the quantitative study design as compared to the qualitative study approach (Jolley, 2020). The quantitative study approach also supports easier data collection and analysis. The quantitative study approach is also relatively cheaper in comparison to the qualitative study design and approaches.

Methods and Instruments

Instruments and methods are a crucial part of the implementation plan, and they are important for various activities such as data collection, data analysis, and data evaluation. One of the instruments to be used in this project is the questionnaire. Questionnaires will be applied to test the nurse’s knowledge of CAUTI prevention and management. The nurses’ knowledge will be assessed before and after the education (Gunawan et al.,2021). The rationale for choosing questionnaires is that they are easier to use in collecting data. Another instrument is electronic health records which will be used to obtain the baseline data on CAUTI rates. The same instrument will also be used to obtain data on CAUTI incidences after the implementation of the proposed CAUTI bundle care.

The Process of Delivering the Intervention

The success of the implementation process hinges on the process of delivering the intervention. As part of the plan, the intervention will be delivered in various phases. In the initial phase, an assessment of the clinical setting is to be undertaken through a needs assessment approach to explore the nature of the needs (Grove & Gray, 2018). The assessment involves studying the CAUTI statistics within the organization, including the impacts and trends among patients admitted to the facility. The assessment also involves assessing the nurses’ levels of knowledge and awareness regarding CAUTI and control of CAUTI using CAUTI bundles. The process will be key in coming up with relevant strategies to use in the project. The next step will entail educating and training the nurses on the use of the proposed CAUTI bundles to help reduce the rates of CAUTI. The next step will then involve the implementation of the intervention, where the efficacy of the intervention will be tested. As part of the plan, the staff will be closely supervised for a considerable duration to ensure that they are correctly and adequately implementing the bundle elements. The next part involves collecting the data associated with the intervention and analyzing the data to determine the efficacy of the intervention in reducing the CAUTI rates.

The Stakeholders Required to Complete the Project

Stakeholders form a crucial part of the project. As such, it is crucial that they be identified in time so that they can be involved from the onset of the project (Lehane et al.,2018). Early involvement of stakeholders helps in limiting the chances of resistance. The following stakeholders have been identified; the chief executive officer, the nurse manager, the unit managers, the hospital finance officer, the nursing staff working in the admission wards, and the physicians. The hospital’s chief executive officer will give permission to accomplish the project in the organization. The nurse manager will play a critical role in coordinating the unit activities related to the project implementation. The unit managers will discharge duties related to each unit. The finance officer will also help with feasibility assessment, financial viability, and the best ways to acquire the needed resources. The nurses are at the forefront of the project and will help in the active implementation of the intervention. The physicians also take part in the treatment of the patients admitted to the wards and, therefore, will support the nursing team in implementing the proposed CAUTI bundle.

Potential Barriers or Challenges to The Plan

Implementing an evidence-based practice project may face various challenges or barriers which may need to be mitigated if the project implementation process is to be a success. The implication is that appropriate strategies should be formulated in time to help overcome the challenges or barriers. Among the potential challenges are potential difficulties in obtaining the resources needed, especially financial resources (Lehane et al.,2018). Project failure may be the result if sufficient funds are not obtained. Therefore, a solution should be explored. One of the solutions is writing funding proposals to potential sponsors or financiers. The other expected barrier or challenge is resistance by the leadership or the nursing staff. The nursing staff may offer resistance to the use of the proposed bundle since it may need more time. The resistance can be reduced by training the nurses to help them have a better understanding of the proposed initiative to reduce the chances of resistance.

Evaluation Plan

Evaluation is one of the most important stages and the last stages of evidence-based practice project initiatives. As such, it is crucial to come up with an evaluation plan which can be applied in assessing the impact of the implemented intervention. This phase is also crucial in exploring how effective the strategies or methods used in the project have been (Dang et al.,2021). As part of the evaluation plan, it is important to explore the expected outcomes as far as the project is concerned. In the previous sections, it was indicated that the nursing staff would need training regarding the use of the proposed CAUTI bundle. Therefore, among the expected outcomes is improved nurse knowledge and skills in the use of CAUTI bundles to control the rates of CAUTI (Elkbuli et al.,2018). The next expected project outcome is the reduction in CAUTI rates. It is hoped that the implementation of the CAUTI bundle will lead to a reduction in CAUTI rates by at least 60%. Such a feat will be used as a reflection of the efficacy of the intervention. Another expected outcome is that the organization will adopt the CAUTI bundle protocol as a standard intervention for preventing and managing CAUTI in the organization. Such an expectation will be made easier by positive project outcomes.

The Data Collection Tools

Data collection tools are important in the project phases, especially the evaluation phase in obtaining project data to be used in evaluating the efficacy of the implemented intervention. One of the data collection tools is electronic health records. The electronic health records will be applied to obtain data on the rates of CAUTI after implementing the CAUTI bundle protocol. This data will then be compared with the baseline data which was obtained at the start of the project. Such a comparison will ventilate more on whether the intervention has been effective or not.

The next targeted tool is the questionnaires. The questionnaires will be used to assess the nurses’ skills and knowledge concerning the use of the CAUTI bundle to prevent and control CAUTI. The knowledge gained after education will be compared with the baseline knowledge to determine the efficacy of the education program. Questionnaires will also be used to assess the attitude of patients and nurses concerning the implementation of the new CAUTI bundle. Questionnaires will be appropriate as the project utilizes a quantitative design approach. The tool is also valid as they have been validated and shown to be effective in measuring knowledge (Yaddanapudi& Yaddanapudi, 2019). The tool is reliable since the same set of questions will be used

The Statistical Tests

Statistical tests are used in the data analysis process to help determine the efficacy of the intervention. The major thrust of this project is to compare the rates of CAUTI in the admission units before and after the implementation of a CAUTI bundle. Therefore, one of the most appropriate statistical tests to use in this case is paired t-test. The paired t-test has been chosen since it has been shown to be effective in measuring the variation between a set of paired samples. This project will focus on the pre and post-test rates scores and CAUTI rates. Therefore, the chosen statistical test will help in determining the significance of the considered set of scores. Mean will also be used, especially in the nurse knowledge scores regarding the use of CAUTI bundles to control the rates of CAUTI.

The Methods of Use and the Evaluation of the Outcomes

Methods and strategies used in the project may impact project outcomes; hence it is important to explore them. The questionnaire to be applied in the project, as part of the plan, is expected to have scaling questions, multiple-choice questions, and dichotomous questions. It is important to use different formats and approaches to questions since the project should determine various changes associated with the implemented initiative. Various validated scales will be used in formulating the scaling questions and use scales, such as 1 to 5. On the other hand, the dichotomous questions require the research subjects to either answer a yes or a no. It is important to use these kinds of questions for a complete evaluation of the project (Melnyk & Fineout-Overholt, 2022).

Strategies to Be Taken If the Outcomes Do Not Provide Positive Results.        

Quality improvement projects and evidence-based practice projects are usually designed with the hope and aim of positive outcomes. Indeed, positive outcomes are usually achieved under normal circumstances (Linsely et al.,2019). It is important to note that in some cases, positive outcomes may not be the results observed. Hence the project team should always put measures in place that can be used as part of the mitigation process in the event that the results obtained are not positive. As part of the plan, among the strategies to be used in the event that the results are not positive is the do a reexamination of the implemented intervention. Reexamination can be vital in offering insights into particular or specific areas which might have led to the observed failure. Another expected strategy is the extension of the project timeline. Extending the project timeline can be necessary to help the project team identify areas of weakness, revise vital parts of the project and implement corrective measures to help in improving the chances of the project succeeding.

The Plans to Maintain, Extend, Revise, and Discontinue the Proposed Solution

An implemented evidence-based practice project can lead to various outcomes; in some cases, the outcomes can be desirable, while in other cases, the outcomes may not be desirable. Therefore, it is important to put in place an appropriate plan to maintain, extend, revise, or discontinue the implemented solution or initiative as part of the overall plan; the project will be maintained if the outcomes turn out to be as expected. In other words, the project will be maintained if the outcomes are positive and the implemented solution is positively affecting or impacting the patients.

As part of the plan, the project will also be maintained if it is cost-effective. Healthcare cost has recently become an important point in the healthcare environment as the costs have been going up. As such, any quality improvement projects or evidence-based practice projects should be cost-effective. Therefore, this project will not be different and will, therefore, be maintained if it is cost-effective. In some cases, the evaluation phase may produce or give results that are not conclusive. In such cases, there may be a need to get appropriate results that can be used in evaluating the project outcomes. Such cases require that the project be extended. Therefore, the project will be extended if the outcomes and inconclusive (Melnyk & Fine-Overholt, 2022). The major purpose of extending the project is to obtain appropriate additional data that can then be applied to determine the effectiveness of the project.

Under certain conditions, the project may need to be revised. A revision will be pursued if the strategies do not align with the project outcomes. The revision will be undertaken to get more time which can be used in adopting improvement interventions. Such improvement interventions will increase the chances of the project succeeding. As part of the plan, the project may also be discontinued under particular instances or circumstances. For example, discontinuation will occur in the case that the project causes harm to the patients and the staff. The solution will also be discontinued if it pauses a risk to the lives of the staff and the patients.

Conclusion

The adverse impacts of CAUTI have led to research efforts over the years to help control and prevent these infections. Therefore, various evidence-based interventions exist. However, it is worth noting that these evidence-based interventions have shown varied efficacy; in addition, the problem still persists in the patient care setting. As such, the proposed evidence-based approach or intervention is the use of a CAUTI bundle. As opposed to single interventions which can be applied to prevent and reduce the rates of CAUTI, a bundle-based care approach entails combining or integrating various interventions for better outcomes. Therefore, the bundle care approach chosen entails various activities that can have a synergistic effect of reducing CAUTI rates or preventing them. It is expected that the proposed evidence-based practice solution of using a CAUTI bundle will lead to a significant reduction in the number of patients acquiring CAUTI in hospital settings. The literature review performed showed that the use of CAUTI bundles in controlling the rates of CAUTI could largely be effective when appropriately applied. This write-up has also explored various aspects of the project, such as literature review, organizational culture and readiness for change, the change framework, project implementation, and project evaluation.

References

Cleary‐Holdforth, J., O’Mathúna, D., & Fineout‐Overholt, E. (2021). Evidence‐based practice beliefs, implementation, and organizational culture and readiness for EBP among nurses, midwives, educators, and students in the Republic of Ireland. Worldviews on Evidence‐Based Nursing, 18(6), 379-388. https://doi.org/10.1111/wvn.12543

Davies, P. E., Daley, M. J., Hecht, J., Hobbs, A., Burger, C., Watkins, L., … & Brown, C. V. (2018). Effectiveness of a bundled approach to reduce urinary catheters and infection rates in trauma patients. American Journal of Infection Control, 46(7), 758-763   https://doi.org/10.1016/j.ajic.2017.11.032

Elkbuli, A., Miller, A., Boneva, D., Puyana, S., Bernal, E., Hai, S., & McKenney, M. (2018).   Targeting catheter-associated urinary tract infections in a trauma population: a 5-S bundle preventive approach. Journal of Trauma Nursing| JTN, 25(6), 366–373. 10.1097/JTN.0000000000000403

Flores-Mireles, A., Hreha, T. N., & Hunstad, D. A. (2019). Pathophysiology, treatment, and prevention of catheter-associated urinary tract infection. Topics in Spinal Cord Injury Rehabilitation, 25(3), 228-240. https://doi.org/10.1310/sci2503-228

Grove, S. K., & Gray, J. R. (2018). Understanding nursing research e-book: Building an evidence-based practice. Elsevier health sciences.

Gunawan, J., Marzilli, C., & Aungsuroch, Y. (2021). Establishing an appropriate sample size for developing and validating a questionnaire in nursing research. Belitung Nursing Journal, 7(5), 356-360. https://doi.org/10.33546/bnj.1927

Hussain, S. T., Lei, S., Akram, T., Haider, M. J., Hussain, S. H., & Ali, M. (2018). Kurt Lewin’s change model: A critical review of the role of leadership and employee involvement in organizational change. Journal of Innovation & Knowledge, 3(3), 123-127. https://doi.org/10.1016/j.jik.2016.07.002

Jaul, E., Barron, J., Rosenzweig, J. P., & Menczel, J. (2018). An overview of co-morbidities and the development of pressure ulcers among older adults. BMC Geriatrics, 18(1), 1-11. https://doi.org/10.1186/s12877-018-0997-7

Jayatilleke, S., & Lai, R. (2018). A systematic review of requirements changes management. Information and Software Technology, 93, 163-185. https://doi.org/10.1016/j.infsof.2017.09.004

Jolley, J. (2020). Introducing Research and Evidence-Based Practice for Nursing and Healthcare Professionals. Routledge

Kranz, J., Schmidt, S., Wagenlehner, F., & Schneidewind, L. (2020). Catheter-associated urinary tract infections in adult patients: Preventive strategies and treatment options. Deutsches Ärzteblatt International, 117(6), 83. https://doi.org/10.3238%2Farztebl.2020.0083

Lehane, E., Leahy-Warren, P., O’Riordan, C., Savage, E., Drennan, J., O’Tuathaigh, C., … & Hegarty, J. (2018). Evidence-based practice education for healthcare professions: an expert view. BMJ Evidence-Based Medicine. http://dx.doi.org/10.1136/bmjebm-2018-111019

Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based Practice in Nursing & Healthcare: A Guide to Best Practice. Wolters Kluwer.

Melnyk, B. M., Hsieh, A. P., & Mu, J. (2022). Psychometric properties of the Organizational Culture and Readiness Scale for System‐Wide Integration of Evidence‐Based Practice. Worldviews on Evidence‐Based Nursing, 19(5), 380-387. https://doi.org/10.1111/wvn.12603

Mundle, W., Howell-Belle, C., & Jeffs, L. (2020). Preventing catheter-associated urinary tract infection: A multipronged collaborative approach. Journal of Nursing Care Quality, 35(1), 83-87. Doi: 10.1097/NCQ.0000000000000418

Pajerski, D. M., Harlan, M. D., Ren, D., & Tuite, P. K. (2022). A clinical nurse specialist–led initiative to reduce catheter-associated urinary tract infection rates using a best practice guideline. Clinical Nurse Specialist, 36(1), 20-28. Doi: 10.1097/NUR.0000000000000643.

Ravi, P. R., & Joshi, M. C. (2018). Role of “bladder care bundle” and “infection control nurse” in reducing catheter-associated urinary tract infection in a peripheral hospital. Journal of Marine Medical Society, 20(2), 116. Doi: 10.4103/jmms.jmms_8_18

Reynolds, S. S., Sova, C. D., Lewis, S. S., Smith, B. A., Wrenn, R. H., Turner, N. A., & Advani, S. D. (2022). Sustained reduction in catheter-associated urinary tract infections using multifaceted strategies led by champions: a quality improvement initiative. Infection Control & Hospital Epidemiology, 43(7), 925-929. https://doi.org/10.1017/ice.2021.135

Shadle, H. N., Sabol, V., Smith, A., Stafford, H., Thompson, J. A., & Bowers, M. (2021). A bundle-based approach to prevent catheter-associated urinary tract infections in the intensive care unit. Critical Care Nurse, 41(2), 62-71.https://doi.org/10.4037/ccn2021934

Soundaram, G. V., Sundaramurthy, R., Jeyashree, K., Ganesan, V., Arunagiri, R., & Charles, J. (2020). Impact of care bundle implementation on the incidence of catheter-associated urinary tract infection: A comparative study in intensive care units of a tertiary care teaching hospital in South India. Indian Journal of Critical Care Medicine: Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine, 24(7), 544. https://doi.org/10.5005%2Fjp-journals-10071-23473

Sultan, M. A., Ahmed, H., & Kandeel, N. A. (2022). The Effect of Implementing CAUTIs Bundle on Prevention of Hospital-Acquired Urinary Tract Infections among Critically Ill Patients. Mansoura Nursing Journal, 9(1), 141-153. https://mnj.journals.ekb.eg/article_259013_7bf12c0832ee68848bd1ddcedfa1e4f7.pdf

Tyson, A. F., Campbell, E. F., Spangler, L. R., Ross, S. W., Reinke, C. E., Passaretti, C. L., & Sing, R. F. (2020). Implementation of a nurse-driven protocol for catheter removal to decrease catheter-associated urinary tract infection rate in a surgical trauma ICU. Journal of Intensive Care Medicine, 35(8), 738-744. https://doi.org/10.1177/0885066618781304

Yaddanapudi, S., & Yaddanapudi, L. N. (2019). How to design a questionnaire. Indian Journal of Anesthesia, 63(5), 335–337. https://doi.org/10.4103/ija.IJA_334_19

Sample Answer 3 for NUR 590 Week 7 Assignment  Benchmark – Evidence-Based Practice Proposal Final Paper

Nurses work in diverse healthcare settings and routinely encounter patients with varying health needs. A critical part of their professional responsibility is to improve patient outcomes through comprehensive interventions that address health problems. Evidence-based practice (EBP) is the foundation of safe, holistic, high-quality care. According to the American Nurses Association (2023), nursing professionals should embrace EBP to ensure that current practice is founded on scientific evidence. Effective EBP application obliges nurses to identify issues affecting patient care and lead in designing and implementing appropriate interventions. The purpose of this paper is to describe the EBP project proposal recommending a twice-weekly tailored physical training program for improving functional fitness and independence among older adults with type 2 diabetes.

Problem Statement

Healthcare facilities should be safe, friendly environments for patients and care providers. Guided by this principle, nursing professionals and leaders should be committed to addressing issues that increase costs, patient visits, and healthcare management burdens. Despite population aging being an inevitable worldwide spectacle, the physical decline and functional capacity loss that ensue are severe problems that should worry healthcare providers. In a review of the link between aging and functional decline, Wickramarachchi et al. (2023) found that muscular strength loss occurs at 12%-14% every decade after an adult reaches fifty years. The leading causes of the decline are the loss of muscle mass, sensory system changes, and a significant reduction in aerobic capacity. Older adults with type 2 diabetes are more vulnerable to this physical decline, resulting in many health issues like accidental falls, poor mental health, and fractures (Zarco et al., 2021; Cui et al., 2023). These issues further increase healthcare costs due to increased patient visits and consumption of scarce resources. Hence, programs that prevent muscle mass loss, enhance body balance, and lead to better physical health are essential.

Organizational Culture and Readiness

Organizational Culture and Degree to Which Culture Supports Change

Organizational culture is integral to the success of EBP projects. Within nursing, organizational culture represents the shared norms, values, or ideas that influence employees’ behavior and the organization’s reaction to internal and external issues (Ghiasi et al., 2022). Since positive norms are crucial in enabling cooperation and shared decision-making, organizational leaders usually institutionalize them through continuous employee education that teaches them (employees) about expectations regarding behaviors, actions, and decisions. A balanced analysis of the present site’s shared norms, leadership, and routine practices depicts a clan culture. According to Ghiasi et al. (2022), a clan culture is characterized by high internal focus, people-centered actions, and flexibility. Other attributes include teamwork, employee participation in decision-making, and friendly leadership. Such features demonstrate a nursing environment that supports change to a significant degree, hence a high chance of a successful EBP project.

Organizational Readiness Tool and Readiness Assessment

Before commencing any innovation, nursing professionals should ensure that their organization is ready for change. Readiness assessment allows change leaders to make informed decisions regarding the appropriateness and timeliness of the proposed change. Vax et al. (2021) defined organizational readiness as the extent to which stakeholders are willing to adopt a new practice and their perceived capacity for adoption. This implies that EBP success is directly proportional to the organization’s readiness. In the current setting, change readiness through the Organizational Readiness for Change Assessment (ORCA) tool demonstrated high readiness for change. When using the ORCA tool, change leaders determine readiness by assessing three interrelated aspects: evidence, context (leadership), and facilitation (Kononowech et al., 2021). In this case, solid scientific evidence should support a successful project. The context is mainly about the organizational culture and leadership that support implementing new interventions. The third variable, facilitation, denotes the organization’s capacity to influence positive behavior change among people (employees) to embrace innovation (Kononowech et al., 2021). After surveying these aspects using the ORCA tool, the organization scored 92.8%, indicating a high likelihood of a successful EBP project (Appendix A).

Strategies to Facilitate Organizational Readiness

Organizations that enable progressive improvements in safety, care quality, and other critical elements should be change-driven. This goal could be achieved through various strategies implemented independently or jointly. One of the main strategies is fostering a culture of innovation and teamwork to ensure effective responses to workplace concerns. Nursing research supports a culture of innovation as the foundation of improved patient care quality and safety. It enables organizations to develop and sustain action plans that accelerate new methods (O’Hara et al., 2022). The primary purpose of teamwork is to bring together diverse nursing professionals to share skills and perspectives to address present challenges through evidence-based initiatives. Pomare et al. (2020) also advised healthcare facilities to improve change readiness by addressing issues hampering staff well-being. The well-being aspect influences attitude toward change since physically and mentally healthy employees are psychologically ready for organizational change.

Present Organizational Culture in Evidence-Based Practice Change

Encouragingly, the current organization’s clan culture is predicted to support the proposed change fully and sustain the essential EBP culture. According to Ghiasi et al. (2022), the clan culture enables continuous improvements in patient care through interventions driven by teamwork and employee engagement. The clan culture also creates a sense of community where employees and leaders come together to address issues facing them as people with a common objective. Stakeholder support is also predicted to be high, considering that the proposed project aligns with the organization’s values and is results-oriented. The timing is also appropriate since the present leadership stresses innovation through EBP. The only barrier that requires attention and careful planning is the implementation team’s availability due to nurses’ busy schedules.

Health Care Process and Systems for Improving Quality, Safety, Cost-Effectiveness

As organizations continue embracing and adopting innovation, particular attention to processes and systems that improve quality, safety, and cost is crucial. They include scaling up knowledge translation in nursing, adopting virtual care, and continuous health education programs (Hill et al., 2020; Haleem et al., 2021). Broadly, these interventions can help to reduce healthcare costs, enable individuals and groups to value preventive health and improve access to care and knowledge. Reliable systems include information communication technologies supporting virtual care to improve access and safety. These processes and systems should be used interchangeably to enhance the efficiency, effectiveness, and delivery of health services.

Stakeholder Involvement

Stakeholders are crucial individuals who influence the uptake of the proposed changes in an organization. They will be involved in offering informed guidance and support and participate as implementation team members. In EBP implementation, stakeholders include the organizational leaders, nurses, policymakers, and patients since they directly experience the project’s impacts (Triplett et al., 2022). Besides nurses, family members are also valuable team members to ensure seamless implementation of the proposed project and adherence to the recommended practices.

Communication Strategies

Communication with the patients will occur through data exchange and chats/calls to guide them effectively. Suitable information and communication technologies for this purpose include diabetes monitoring tools, wearables, electronic questionnaires, and smartphones for recording and sharing health data. Using these technologies, the nursing team will share implementation materials and get progress data remotely. In response, the team will guide patients on the next steps as the health data obliges. The patients are also encouraged to call and seek advice in case of an emergency, inability to implement knowledge, or a need for clarity.

Literature Review

PICOT statement:  In older adults with type 2 diabetes (P), does a twice-weekly tailored physical exercise training program (I), compared to no exercise interventions (C), improve functional fitness and independent living (O) in 8 weeks (T)?

Nursing and healthcare literature on interventions to address functional decline is extensive, and the value of physical exercises has been comprehensively studied. However, not all research suits evidence-based practice, necessitating in-depth search and appraisal of current, authoritative, purposeful articles. The synthesized articles include research that supports the PICOT question and is appropriate to nursing. Broadly, this research explains the value of physical exercise training as the PICOT recommends and demonstrates its potential to improve functional fitness and independent living, the primary outcome of the proposed project’s intervention.

Synthesis of Literature

A decline in functional performance/fitness and independent living among older adults with type 2 diabetes is a significant healthcare issue requiring attention from leaders, healthcare providers, and policymakers. It hampers life quality and increases the risk of other health problems. Wickramarachchi et al. (2023) found that functional capacity loss and the decline in independence increase the risk of accidental falls among older adults. Supporting the PICOT, the authors recommend muscle-strengthening activity programs, highlighting the significance of regular physical exercises in healthcare settings and at the community level. Wickramarachchi et al. (2023) advised the program’s implementers to tailor the intensity of physical exercises according to the patient’s needs. Therefore, a strength test (hand grip and leg test) is essential for screening older adults to determine the risk of falls and functional disabilities.

In another article, Zarco et al. (2021) evaluated the perceived benefits of a guided physical exercise program (Essentrics) among older adults at Adelphi University. The program involved eccentric training and stretching for one hour twice weekly. To determine the program’s effectiveness, the authors conducted focus group discussions with open-ended and close-ended questions on motivation for trying the program and proceeding with it. After the program, Zarco et al. (2021) analyzed data via thematic analysis, revealing that older adults were positive about the physical exercise program since it improved functional mobility, body balance, flexibility, and energy. These outcomes support the PICOT by demonstrating the association between physical exercises and improved functional performance and independence among older adults.

Kirwan et al. (2022) examined the value of the Beat It program in improving anthropometric measures, physical health, and psychological outcomes among older adults with type 2 diabetes. Used in many countries to address type 2 diabetes, the Beat It program includes a nurse-led, twice-weekly supervised group exercise and education program (Kirwan et al., 2022). In this study, older adults with type 2 diabetes conducted the weekly group exercises for eight weeks, with data being compared at baseline and after the eighth week. The primary finding was that the program significantly improved weight, physical fitness, and waist circumference. These findings highlight the effectiveness of the Beat It (physical exercises) in improving fitness, hence better functional performance and healthy independent living among older adults.

In a different qualitative study, Harrison et al. (2020) explored the motivating factors, barriers, and benefits linked to active engagement in physical exercises among urban community dwellers. Participants were older adults at the community level whose experiences were studied through focus group discussions where they answered 5-8 questions on health benefits and other elements. A thematic analysis of the answers revealed that physical exercises are an effective healthy living approach to a high-quality life that increases physical energy and body strength. Strong physical bodies signify high functional performance and more capacity to perform daily activities independently. From these results, it can be deduced that the research supports the PICOT since it shows the value of physical exercises in improving critical aspects of physical health, particularly body strength and energy.

Syue et al. (2022) evaluated the positive association between physical activity, functional fitness, and life satisfaction in community-based older adults. Determined to understand whether physical activity leads to any significant changes in fitness and life satisfaction, researchers conducted a cross-sectional study involving 623 older adults. The program contained physical exercises varying in intensity, mainly dancing and strenuous household activities. Data were collected via questionnaires. Post-study comparative data analysis revealed that physical activity increased the participants’ functional fitness and life satisfaction. This study supports the PICOT by positively linking the intervention with outcomes like improved functional fitness, an objective that the proposed project seeks to achieve.

Change Model and Application

Successful change implementation requires a systematic process of interrelated steps. EBP models outline the knowledge implementation steps and appropriate decision points to ensure the effective application of scientific evidence to nursing (Duff et al., 2020). Therefore, choosing the suitable model determines how change is implemented and measured.

The Selected Framework/Model for Change and its Relevance

The Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model is the most appropriate for the proposed project. In a historical review of its introduction in nursing, Friberg and Creasia (2023) stated that the JHNEBP model was formulated in 2002 to address visible gaps in evidence translation to nursing. As Dusin et al. (2023) illustrated, the JHNEBP model has three interrelated components that guide change leaders in stepwise implementation: the practice question, evidence, and translation to practice. This model is relevant to the proposed project since it facilitates a phased implementation of change (Appendix B). Its other unique feature is the interrelationships between scientific inquiry in nursing, practice, and learning. These interrelationships enable nursing professionals to improve clinical outcomes while improving individual knowledge by consulting scientific evidence. The other important feature is the model’s team-driven nature, allowing nursing team members to share skills and values while implementing change.

The Stages in the Change Framework/Model

As mentioned, the JHNEBP model’s steps are question, evidence, and translation. The practice question is based on the issue nurses want to address and is expressed in the PICOT (problem/population, intervention, comparison, outcome, and time) format (McClinton, 2022). The evidence stage involves an intensive search and appraisal of research answering the clinical question (PICOT). In nursing, sources for search research are mainly the leading nursing databases to ensure that they are appropriate to nursing and peer-reviewed. The appraisal process ensures that the research is credible in terms of high validity and reliability. The third phase, translation to practice, involves applying scientific evidence to improve patient outcomes. This is accomplished by implementing a change through an action plan of implementation and evaluation steps. The findings should also be shared (dissemination) with stakeholders to facilitate large-scale uptake and utilization of the EBP project.

Applying the Framework/Model in the Proposed Implementation

The application of the JHNEBP model implies undertaking the activities outlined in each step. As previously stated, the proposed intervention is a twice-weekly tailored physical exercise program to improve functional fitness and independence among older adults with type 2 diabetes. The practice question (step 1 of the JHNEBP model) is: does a twice-weekly tailored physical exercise training program (I), compared to no exercise interventions (C), improve functional fitness and independent living (O) in 8 weeks (T)? Therefore, scientific evidence (step 2) should answer this question.

To answer this question, scientific evidence was sourced from the leading nursing databases, appraised, and rated according to the model’s recommendation. This evidence, as summarized in the literature review section, is mainly levels 1 and 2 nursing research articles demonstrating a positive link between the intervention and the projected outcomes. The third step (translation to practice) will be accomplished by implementing the project to achieve the targeted health outcomes. The findings will also be shared with internal and external stakeholders to maximize their uptake and utilization.

JHNEBP Conceptual Framework

The conceptual framework (Appendix B) visually represents the basic steps of the JHNEBP. It will be applied throughout the project to facilitate phased implementation. If stated differently, the conceptual framework will be the reference for ensuring the essential steps of the model are followed and key activities executed. It will also be used during project evaluation to determine whether the implementation was conducted appropriately.

Implementation Plan

Setting and Access to Potential Subjects

Healthcare organizations vary in specializations, resources, locations, and other factors. These variations also determine the volume of patients and healthcare issues handled daily. The current setting is a general healthcare facility providing inpatient and outpatient care to patients of all ages. Its operational framework is founded on the principle that all individuals seeking healthcare services deserve high-quality care in a friendly environment. To ensure patient needs are addressed comprehensively, and that the environment is appropriate for patient care, the current setting embodies a clan culture. This culture is integral to successfully implementing quality improvements for better patient outcomes. The proposed project involves human subjects, hence the need to adhere to ethical principles guiding such research. As a result, informed consent should be obtained from the participants. As Xu et al. (2020) stated, informed consent ensures voluntary participation since it shows participants understand the essentials of a project, particularly the benefits, risks, and procedures. Participants will fill out the consent form (Appendix C) to indicate voluntary participation.

Timeline

EBP projects involve various tasks that project leaders execute to achieve the desired outcomes. A critical component of effective planning and implementation is a timeline that projects the time needed to implement the project and the deadlines of specific activities. Adherence to this timeline (Appendix D) will also ensure efficient use of financial and material resources. The main project activity is the weekly exercise program, which should take eight weeks. The preparation should take approximately two weeks. Other post-program activities are outcome evaluation, results analysis, composing a detailed report of findings, and dissemination. These activities will take about two more weeks. Therefore, the project will take twelve weeks (Appendix D).

Budget and Resource List

Successful EBP implementation depends on resource availability and the ability of implementers to use resources efficiently. For internal projects, the management is usually the primary financier, while nurses play the leadership role. As a result, the management should be adequately prepared to provide the main resources and facilitate emergencies. The primary material resource is the toolkit/educational booklets to guide patients on conducting the program and reporting data. Other essential resources include the nursing team offering human resource support during orientation training, continuous guidance, and data collection/analysis. Communication devices/technologies and tools, such as questionnaires, will consume a significant portion of the budget. The proposed budget ($1,150) and resources are summarized in Appendix E.

Research Design

Project leaders require adequate and accurate data to determine whether the project achieved the desired goals. Therefore, an appropriate design is vital to guide the implementation team in setting objectives, data collection, and analysis. The project’s nature obliges a quantitative design. A quantitative design in nursing and healthcare research implies collecting numerical data to allow deductive testing of the hypothesis (Bazen et al., 2021). This design enables researchers/EBP leaders to ask how many and how much the project achieved. In this project, the deductive data collection and analysis approach is essential for high objectivity and reproducibility of results. Importantly, it will effectively quantify the project’s outcomes to show whether it is statistically and clinically significant.

Methods and Instruments

The data collection approach guides the implementation team in choosing suitable instruments to monitor the implementation of the proposed solution. Questionnaires are suitable for monitoring the proposed twice-weekly physical exercise program. According to O’Connor et al. (2022), questionnaires are highly preferred in quantitative research since they enable researchers to collect large amounts of primary data from the target population. They are also associated with high validity and reliability, which researchers accomplish through clear and consistent wording of the questions. In the current project, participants will mainly provide answers regarding the value of the physical exercise program in improving health variables related to functional performance and independence, including flexibility, muscle strength, body balance, and movement. The health statuses (greatly improved [4], improving [3], struggling [2], and no change [1]) will be compared at baseline, at four weeks, and after the end of the project. The rating of each status using a Likert Scale is provided in Appendix F.

Process for Delivering the Intervention and Needed Training

The initial phase will be identifying eligible project participants from the clinical records. These participants should be older adults with type 2 diabetes without physical health concerns. The next step will involve obtaining informed consent, which ensures compliance with the ethical requirements of research involving humans (Laurijssen et al., 2022). After participants willingly agree to be involved in the project, the orientation phase will follow, introducing the project and providing the essential toolkits and educational resources. The purpose of the orientation is to guide participants in conducting the program, collecting data, and reporting progress to the project leader. Data collection and reporting will primarily occur remotely since the patients are expected to conduct the physical exercise program at home. After four weeks, a summary of the progress will be compiled using the reported data, and the overall impact will be assessed after eight weeks. Communication, resource provision, and informed guidance will be available throughout the project.

Stakeholders for Implementation

Stakeholders are pivotal in EBP implementation through their direct participation, advice, and moral support. Magwood et al. (2022) highlighted stakeholders’ value in change implementation as individuals or groups that make critical healthcare decisions or experience their impacts directly. When implementing EBP projects, these healthcare decisions are informed by scientific evidence appropriate to nursing. The organization’s management is among the primary stakeholders responsible for financial, material, and moral support. The management also ensures a climate favorable for EBP projects by influencing positive behavior change in nursing environments. The other stakeholder group is the nursing team, which will guide patients on practical implementation and offer clinical guidance. The patients are also crucial stakeholders since the project’s success depends on their availability and commitment.

Barriers or Challenges to Implementing and Strategies for Overcoming

EBP projects encounter many barriers depending on their implementation approaches, participants, and the setting. The availability of stakeholders is a key implementation barrier that can affect many project aspects, including timelines and the size of the support team. The workload and administrative responsibilities are among the factors affecting leaders’ availability. Poor attitude toward change and inadequate EBP knowledge affect nurses’ participation in change and its adoption (Pitsillidou et al., 2021). From a change perspective, availability and attitude issues could be addressed through strategies that earn stakeholder buy-in (Magwood et al., 2022). A suitable example is open and consistent communication that stresses the importance of the project and why stakeholders should support it. The importance of the project should be centered on patient outcomes, patient-provider relationships, and the organization’s reputation. The other strategy to overcome these barriers is short individual and group meetings with the leaders and support team. Such meetings can help to demonstrate the project in detail, request the needed support, and clarify any concerns that may trigger a low perception of the EBP project.

Evaluation Plan

Expected Outcomes for Evidence-Based Practice Project Proposal

EBP projects characterize outcome-driven initiatives for addressing issues hampering patient care. Typically, old age leads to a gradual decline in physical strength and an inevitable loss of functional capacity. In response, the project aims to enhance functional performance/fitness and independence among older adults with type 2 diabetes, a highly vulnerable group. In support of such initiatives in healthcare, Wickramarachchi et al. (2023) found that physical activity prevents about 10%-40% of muscle mass loss and joint motion issues among older adults. Striving to achieve similar outcomes, the project will help participants improve physical health essentials, such as flexibility, body balance, movement, and muscle strength. Wickramarachchi et al. (2023) also stated that improving muscular strength is critical to preventing balance disorders and accidental falls typical in old age. These outcomes underline the project’s value in improving physical function, independence, and overall life quality among the participants.

Data Collection Tools

The project leader will collect quantitative data through questionnaires. As Bazen et al. (2021) stated, quantitative data is numerical and helps researchers to test hypotheses deductively. Questionnaires will facilitate quantitative data collection through questions regarding the value of the project and how participants experienced it. Participants will answer the same questions at baseline, after four weeks, and after the eighth week.

Statistical Test for the Project

The effects of healthcare interventions need accurate measurement to validate the resources and time used in project implementation. Among many statistical tests suitable for the project, inferential statistics will be used to measure the impact and enable the project leader to make sound deductions about its value in addressing the problem. Specifically, the range [the percentage differences in health outcomes before and after the project] will be used. Sharma (2022) described inferential statistics as reliable in helping researchers test hypotheses and make accurate generalizations about the surveyed data. Similarly, inferential statistics will provide accurate and quality measurements to deduce whether the project is statistically and clinically significant.

Methods Applied to Data Collection Tool

Using the questionnaires, older adults with type 2 diabetes will answer specific questions on how the proposed project improved crucial health aspects related to physical performance and independence. The four main aspects are flexibility, muscle strength, body balance, and movement (Lii et al., 2023). To calculate range, the health statuses ((greatly improved, improving, struggling, and no change) will be compared among the participants who will complete the program at baseline, four weeks, and eight weeks. As stated, and illustrated in Appendix F, each health status will be rated appropriately, and totals under each column will be converted into a percentage. A range of over 50% will indicate clinical significance and a successful project that deserves large-scale implementation.

Strategies for Outcomes that are Nonpositive

Despite committing much resources and time toward EBP projects, it is possible to achieve negative outcomes. As Lengnick-Hall et al. (2022) advised researchers and change leaders, performance gaps may indicate poor implementation, underscoring the need for a comprehensive outcome evaluation. In this case, the project leader will ask questions regarding how, when, and where the recommended activities were conducted and who conducted them. The other question that should be part of the outcome evaluation is the project’s barriers and facilitators. Their evaluation would help the project leader to understand issues that affected results. This analysis will be the basis for determining the modifications necessary to achieve the desired outcomes. A suitable modification is adjusting the frequency of the weekly exercises from two times to more (three or four times). The length of each session could be another practical modification as guided by the evaluation results.

Plans to Maintain, Extend, Revise, and Discontinue Proposed Solution

The project should be maintained if it achieves the expected (positive) outcomes. This implies that it should be continued if it contributes to clinically significant outcomes. Thus, visible changes in functional performance and independence, as hypothesized in the PICOT, are achieved. Its extension would be necessary if positive results are achieved, but modifications in some areas can maximize results. A revision would be appropriate if genuine implementation issues affected performance. The project should be discontinued if it is no longer feasible or the implementation team does not have the essential time and resources to continue supporting the participants.

Conclusion

EBP is the spine of significant, progressive changes in patient outcomes. Its implementation is valuable in nursing to address clinical problems and ensure better outcomes for patients and healthcare providers. The proposed project typifies EBP since it aims to address a significant healthcare problem in old age. Its effective implementation is essential for improved physical health among older adults, reduced healthcare spending, and high-quality life for the participants. Stakeholders should support it wholeheartedly to ensure the anticipated impacts are accomplished within the projected timeline.

References

American Nurses Association.  (2023). What is evidence-based practice in nursing? ANA Nursing Resources Hub. https://www.nursingworld.org/content-hub/resources/workplace/evidence-based-practice-in-nursing/#:~:text=Besides%20keeping%20health%20care%20practices,of%20the%20science%20of%20nursing

Bazen, A., Barg, F. K., & Takeshita, J. (2021). Research techniques made simple: an introduction to qualitative research. Journal of Investigative Dermatology, 141(2), 241-247. https://doi.org/10.1016/j.jid.2020.11.029

Cui, Y., Liu, B., Qin, M. Z., Liu, Q., Ye, H., & Zhou, J. (2023). Effects of early mental state changes on physical functions in elderly patients with a history of falls. BMC Geriatrics, 23(1), 564. https://doi.org/10.1186/s12877-023-04274-6

Duff, J., Cullen, L., Hanrahan, K., & Steelman, V. (2020). Determinants of an evidence-based practice environment: an interpretive description. Implementation Science Communications, 1, 1-9. https://doi.org/10.1186/s43058-020-00070-0

Dusin, J., Melanson, A., & Mische-Lawson, L. (2023). Evidence-based practice models and frameworks in the healthcare setting: a scoping review. BMJ Open, 13(5), e071188. https://doi.org/10.1136/bmjopen-2022-071188

Friberg, E. E., & Creasia, J. L. (2023). Conceptual Foundations-E-Book: the Bridge to Professional Nursing Practice. Elsevier Health Sciences.

Ghiasi, A., Lord, J., Banaszak-Holl, J., Davlyatov, G., Hearld, L., & Weech-Maldonado, R. (2022). Organizational culture and high Medicaid nursing homes financial performance. Journal of Long-Term Care, (2022), 142–153. https://doi.org/10.31389/jltc.115

Haleem, A., Javaid, M., Singh, R. P., & Suman, R. (2021). Telemedicine for healthcare: Capabilities, features, barriers, and applications. Sensors International, 2, 100117. https://doi.org/10.1016/j.sintl.2021.100117

Harrison, E. A., Lord, L. M., Asongwed, E., Jackson, P., Johnson-Largent, T., Jean Baptiste, A. M., … & Jeffery, T. (2020). Perceptions, opinions, beliefs, and attitudes about physical activity and exercise in urban-community-residing older adults. Journal of Primary Care & Community Health, 11, 2150132720924137. https://doi.org/10.1177/2150132720924137

Hill, J. E., Stephani, A. M., Sapple, P., & Clegg, A. J. (2020). The effectiveness of continuous quality improvement for developing professional practice and improving health care outcomes: a systematic review. Implementation Science, 15, 1-14. https://doi.org/10.1186/s13012-020-0975-2

Kirwan, M., Chiu, C. L., Hay, M., & Laing, T. (2021). Community-based exercise and lifestyle program improves health outcomes in older adults with type 2 diabetes. International Journal of Environmental Research and Public Health, 18(11), 6147. https://doi.org/10.3390/ijerph18116147

Kononowech, J., Hagedorn, H., Hall, C., Helfrich, C. D., Lambert-Kerzner, A. C., Miller, S. C., Sales, A. E., & Damschroder, L. (2021). Mapping the organizational readiness to change assessment to the Consolidated Framework for Implementation Research. Implementation Science Communications, 2(1), 19. https://doi.org/10.1186/s43058-021-00121-0

Laurijssen, S. J., van der Graaf, R., van Dijk, W. B., Schuit, E., Groenwold, R. H., Grobbee, D. E., & de Vries, M. C. (2022). When is it impractical to ask informed consent? A systematic review. Clinical Trials (London, England), 19(5), 545–560. https://doi.org/10.1177/17407745221103567

Lii, Y. Y., Tai, Y. C., Wang, H. Y., Yeh, I. C., Chiu, Y. C., Hou, C. Y., & Tsai, F. H. (2023). The impact of exercise training on physical activity among elderly women in the community: a pilot study. Healthcare (Basel, Switzerland), 11(18), 2601. https://doi.org/10.3390/healthcare11182601

Magwood, O., Riddle, A., Petkovic, J., Lytvyn, L., Khabsa, J., Atwere, P., … & Tugwell, P. (2022). PROTOCOL: Barriers and facilitators to stakeholder engagement in health guideline development: A qualitative evidence synthesis. Campbell Systematic Reviews, 18(2), e1237. https://doi.org/10.1002/cl2.1237

McClinton, T. D. (2022). A guided search: Formulating a PICOT from assigned areas of inquiry. Worldviews on Evidence-Based Nursing, 19(5), 426–427. https://doi.org/10.1111/wvn.12598

O’Connor, S. (2022). Designing and using surveys in nursing research: a contemporary discussion. Clinical nursing research, 31(4), 567-570. https://doi.org/10.1177/10547738211064739

O’Hara, S., Ackerman, M. H., Raderstorf, T., Kilbridge, J. F., & Melnyk, B. M. (2022). Building and sustaining a culture of innovation in nursing academics, research, policy, and practice: Outcomes of the National Innovation Summit. Journal of Professional Nursing, 43, 5-11. https://doi.org/10.1016/j.profnurs.2022.08.001

Pitsillidou, M., Roupa, Z., Farmakas, A., & Noula, M. (2021). Factors affecting the application and implementation of evidence-based practice in nursing. Acta Informatica Medica, 29(4), 281–287. https://doi.org/10.5455/aim.2021.29.281-287

Pomare, C., Ellis, L. A., Long, J. C., Churruca, K., Tran, Y., & Braithwaite, J. (2020). “Are you ready?” Validation of the Hospital Change Readiness (HCR) Questionnaire. BMJ Open, 10(8), e037611. https://doi.org/10.1136/bmjopen-2020-037611

Sharma, S. (2022). Nursing research and statistics – e-book. Elsevier Health Sciences.

Schuler, E., Mott, S., Forbes, P. W., Schmid, A., Atkinson, C., & DeGrazia, M. (2021). Evaluation of an evidence-based practice mentorship programme in a paediatric quaternary care setting. Journal of Research in Nursing, 26(1-2), 149-165. https://doi.org/10.1177/1744987121991417

Syue, S. H., Yang, H. F., Wang, C. W., Hung, S. Y., Lee, P. H., & Fan, S. Y. (2022). The associations between physical activity, functional fitness, and life satisfaction among community-dwelling older adults. International Journal of Environmental Research and Public Health, 19(13), 8043. https://doi.org/10.3390/ijerph19138043

Triplett, N. S., Woodard, G. S., Johnson, C., Nguyen, J. K., AlRasheed, R., Song, F., Stoddard, S., Mugisha, J. C., Sievert, K., & Dorsey, S. (2022). Stakeholder engagement to inform evidence-based treatment implementation for children’s mental health: a scoping review. Implementation Science Communications, 3(1), 82. https://doi.org/10.1186/s43058-022-00327-w

Vax, S., Farkas, M., Russinova, Z., Mueser, K. T., & Drainoni, M. L. (2021). Enhancing organizational readiness for implementation: Constructing a typology of readiness-development strategies using a modified Delphi process. Implementation Science: IS, 16(1), 61. https://doi.org/10.1186/s13012-021-01132-0

Xu, A., Baysari, M. T., Stocker, S. L., Leow, L. J., Day, R. O., & Carland, J. E. (2020). Researchers’ views on, and experiences with, the requirement to obtain informed consent in research involving human participants: a qualitative study. BMC Medical Ethics, 21, 1-11. https://doi.org/10.1186/s12910-020-00538-7

Wickramarachchi, B., Torabi, M. R., & Perera, B. (2023). Effects of physical activity on physical fitness and functional ability in older adults. Gerontology & Geriatric Medicine, 9, 23337214231158476. https://doi.org/10.1177/23337214231158476

Zarco, E. P. T., Aquino, M., Petrizzo, J., Wygand, J., & McGorry, A. (2021). Perceived benefits of a guided exercise program among older adults. Gerontology and Geriatric Medicine, 7, 23337214211060147. https://doi.org/10.1177/23337214211060147

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.

Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.

One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.

I encourage you to incorporate the readings from the week (as applicable) into your responses.

Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately.

In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.

Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).

Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

APA Format and Writing Quality

Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).

Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.

I highly recommend using the APA Publication Manual, 6th edition.

Use of Direct Quotes

I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.

As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.

It is best to paraphrase content and cite your source.

LopesWrite Policy

For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.

Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.

Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?

Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.

Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.

If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.

I do not accept assignments that are two or more weeks late unless we have worked out an extension.

As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication

Communication is so very important. There are multiple ways to communicate with me:

Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.

Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.