NUR 590 Evidence Based Practice Project -Week 2 Assignment
Grand Canyon University NUR 590 Evidence Based Practice Project -Week 2 Assignment-Step-By-Step Guide
This guide will demonstrate how to complete the Grand Canyon University NUR 590 Evidence Based Practice Project -Week 2 Assignment 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 Evidence Based Practice Project -Week 2 Assignment
Whether one passes or fails an academic assignment such as the Grand Canyon University NUR 590 Evidence Based Practice Project -Week 2 Assignment 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 Evidence Based Practice Project -Week 2 Assignment
The introduction for the Grand Canyon University NUR 590 Evidence Based Practice Project -Week 2 Assignment 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 Evidence Based Practice Project -Week 2 Assignment
After the introduction, move into the main part of the NUR 590 Evidence Based Practice Project -Week 2 Assignment 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 Evidence Based Practice Project -Week 2 Assignment
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 Evidence Based Practice Project -Week 2 Assignment
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.
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Sample Answer for NUR 590 Evidence Based Practice Project -Week 2 Assignment
Week 2 Assignment
Evidence-Based Practice Proposal – Section A: Organizational Culture and Readiness
Assessment and Section B: Proposal/Problem Statement and Literature Review
Culture is an important component that determines organizational success. Culture relates to the behaviors in an organization, values, and beliefs that influence decisions made by organizational stakeholders. It is important for nurses to assess the culture and readiness of their organizations prior to implementing change initiatives. Therefore, this paper is a summary of culture and readiness assessment that was performed on my organization.
Summary
A tool developed by World of Work Project (2019) was used to perform organizational culture and readiness assessment. The tool examines the various dimensions of organizational culture that include teamwork, decision-making process, focus on employees, tradition, and implementation of change. The organization scored high in aspects that included promotion of change, objectivism in employee behaviors, and consensus in decision making. Low scores were recorded in areas that included change being drive by rules and encouraging of individual performance. Assessment results showed that the organization is ready to implement change. The readiness was seen from the existence of effective leadership styles that encourage teamwork, decentralized decision making, rewarding employee performance, and strong emphasis on excellence. Readiness for change was also seen from the enabling nature of the organizational culture where teamwork, implementation of change, and strong emphasis on quality guided organizational processes.
The assessment revealed a number of facilitators as well as barriers for change. The facilitators included the existence of a strong culture focused on excellence and quality, teamwork, decentralized decision-making, and reward for performance. Some of the barriers identified from the assessment included employees encouraged to use tested interventions and implementation of change being driven by rules. Strategies such as teamwork, active stakeholder involvement will therefore be adopted to strengthen the organizational weaknesses.
Conclusion
change. The readiness could be seen from cultural practices such as teamwork, shared decision-making and facilitative leadership. The assessment also revealed a number of organizational weaknesses and barriers. Therefore, a focus will be placed on ensuring that strategies that address the organizational weaknesses are adopted.
References
World of Work Project. (2019, July 11). A Simple Organizational Culture Assessment Questionnaire. The World of Work Project. https://worldofwork.io/2019/07/organizational-culture-assessment-questionnaire/
Section B: Proposal/Problem Statement and Literature Review
Occupational stress is one of the health problems that registered nurses face in their practice. Occupational stress increases the risk of poor health outcomes such as depression, anxiety, and errors in the care that nurses give to their patients. Effective interventions to address occupational stress in nursing are therefore required. Consequently, this section of the project refines the focus of the project and review of literature that is relevant to the aim of the evidence-based project.
Problem Statement
Occupational stress is a critical health problem that nurses face in their daily basis through their professional encounters. According to Faremi et al., (2019), nursing is a stressful profession that requires energy use in many levels of care. Often, nurses suffer from physical, social, and emotional distress in the process of delivering their care to patients (Yuwanich et al., 2017). The distress predisposes them to occupational stress that is associated with adverse outcomes such as decline in productivity, low job dissatisfaction, burnout, and errors in care (Chatzigianni et al., 2018). Occupational stress among nurses also increases the costs incurred in health organizations due to errors in care, absenteeism, and inefficient use of health care resources (Said & El-Shafei, 2021). Studies conducted in the past have shown that interventions such as the provision of educational support to nurses can reduce the prevalence of occupational stress among them. The study conducted by Amiri et al., (2018) showed that educating nurses about occupational stress was associated with improvements in dimensions of job stress such as role incompetence, safety in care, responsibility, and duality of role. Similar results were seen in the research conducted by Petchiammal (2018). Despite the above evidence on the efficacy of health education of nurses on occupational stress, my organization has not embraced its use, hence, the focus of the project on implementing online education on stress management strategies to address the problem. The refined PICOT statement is as follows:
In registered nurses (P), does online education on stress-management strategies (I), compared to no intervention (C), reduce the prevalence of occupational stress (O) within 6 months (T)?
Research Summary
Studies have been conducted in the past to determine the effect of education of nurses on stress management strategies on prevalence of occupational stress among them. One of the studies is the research by Babanataj et al., (2019) that investigated the effect of resilience training on resilience and occupational stress among critical care nurses. The study was a quasi-experimental study that used 30 critical care nurses who were selected using convenience sampling. The participants received educational sessions on resilience for five sessions each lasting for 90-120 minutes. The analysis of the results of the project showed a significant reduction in the occupational stress in the participants and increase in the mean score of resilience (Babanataj et al., 2019). The study is associated with the strength of using relevant population and controlling the intervention. However, it has the weaknesses of using a small sample size, convenient sampling, and failing to incorporate the aspect of online training.
Magtibay et al., (2017) conducted another study that aimed at examining the efficacy of blended learning with stress management and resilience training program in decreasing the rate of occupational burnout and stress among nurses. The study used nurses who were provided with different learning styles such as web-based, facilitated discussions, and independent learning on occupational stress and burnout management. Data obtained after 3 months showed that the use of stress management education and resilience training were associated with statistically significant decreases in stress, anxiety, and burnout and increases in happiness, resilience, and mindfulness (Magtibay et al., 2017). This study was associated with the strength of using mixed methods of learning and interventions. It however has the weakness of failing to randomize the participants and using a small sample size that affects the generalizability of findings.
Conclusion
The review of the above literature reveals that the provision of health education on stress management has a positive effect on the prevalence of occupational stress among nurses. The review shows that health education on stress management reduces anxiety, burnout, and stress among the nurses. There has however been limited focus on the effectiveness of online health education on stress management on occupational stress. Therefore, the aim of the proposed project is to bridge gap in evidence by focusing on this area of practice.
References
Amiri, A., Setoodeh, G., & Sajjadi, S. F. (2018). The Effect of Educational Stress Management on Job stress of Operating Room Nurses at Hospitals Affiliated to Shiraz University of Medical Sciences During Year 2016: A Randomized Controlled Clinical Trial. Women’s Health Bulletin, 5(1), 1–8. https://doi.org/10.5812/whb.14171
Babanataj, R., Mazdarani, S., Hesamzadeh, A., Gorji, M. H., & Cherati, J. Y. (2019). Resilience training: Effects on occupational stress and resilience of critical care nurses. International Journal of Nursing Practice, 25(1), e12697. https://doi.org/10.1111/ijn.12697
Chatzigianni, D., Tsounis, A., Markopoulos, N., & Sarafis, P. (2018). Occupational Stress Experienced by Nurses Working in a Greek Regional Hospital: A Cross-sectional Study. Iranian Journal of Nursing and Midwifery Research, 23(6), 450–457. https://doi.org/10.4103/ijnmr.IJNMR_120_17
Faremi, F. A., Olatubi, M. I., Adeniyi, K. G., & Salau, O. R. (2019). Assessment of occupational related stress among nurses in two selected hospitals in a city southwestern Nigeria. International Journal of Africa Nursing Sciences, 10, 68–73. https://doi.org/10.1016/j.ijans.2019.01.008
Magtibay, D. L., Chesak, S. S., Coughlin, K., & Sood, A. (2017). Decreasing Stress and Burnout in Nurses: Efficacy of Blended Learning With Stress Management and Resilience Training Program. JONA: The Journal of Nursing Administration, 47(7/8), 391–395. https://doi.org/10.1097/NNA.0000000000000501
Petchiammal, P. (2018). Assess the effectiveness of education module on stress management in reduction of occupational stress among nurses working in intensive care units at Rajiv Gandhi Government General Hospital at Chennai [Masters, College of Nursing, Madras Medical College, Chennai]. http://repository-tnmgrmu.ac.in/11660/
Said, R. M., & El-Shafei, D. A. (2021). Occupational stress, job satisfaction, and intent to leave: Nurses working on front lines during COVID-19 pandemic in Zagazig City, Egypt. Environmental Science and Pollution Research, 28(7), 8791–8801. https://doi.org/10.1007/s11356-020-11235-8
Yuwanich, N., Akhavan, S., Nantsupawat, W., & Martin, L. (2017). Experiences of Occupational Stress among Emergency Nurses at Private Hospitals in Bangkok, Thailand. Open Journal of Nursing, 7(6), 657–670. https://doi.org/10.4236/ojn.2017.76049
Sample Answer for NUR 590 Evidence Based Practice Project -Week 2 Assignment
There is no question that nurses are on the frontline of healthcare on multiple levels. In the arena of pregnancy and postpartum care, nurses play a vital role in not only the assessment of mother and baby’s physical well-being, but mental and emotional well-being as well. Recent studies show that women who are at an increased risk for developing postpartum depression (PPD) can be identified prior to delivery and prior to developing the disorder (Mughal et al., 2022). Quite naturally, nurses are at in the perfect position to identify these women that may be at risk, recommend treatment or support, and maintain follow-up care. Currently, there are screening questionnaires such as the Edinburgh Postnatal Depression Scale (EPDS) that are commonly completed by women post-delivery, often during the newborn well-check appointments.
The occurrence of medication administration errors hinders effective attainment of quality and safe patient care and outcomes. Medication administration errors are significant safety issue in health care sector, especially when there are different crises affecting healthcare and quality outcomes. The susceptibility of patients to medication administration errors increase with reduced number of healthcare workers against an increase in demand for services due to several factors. Medication administration errors (MAEs) increase the length of stay for critically ill patients and cost of care. Studies demonstrate that leveraging health information technologies that include barcode scanning and other interventions can reduce and prevent the occurrence of these events, especially among the critically ill patients. The purpose of this literature review is to offer a comparison of the articles that supports the evidence-based practice project of using health information technology to reduce the occurrence of medication administration errors among the critically ill patients. The review also identifies the methods used to search the literature and synthesizes it for effective understanding and use for the selected eight articles.
PICOT Statement
The use of health information technology can reduce and prevent the prevalence of medication administration errors (MAEs) among critically ill patients. The use of interventions like barcode scanning and electronic dispensation ensures that human errors that occur during medication dispensation are reduced or minimized, especially the critically-ill patients in different health settings.
PICOT Question for the Evidence-Based Practice Project
Among the critically ill patients (P), does the integration of health information technology (I) compared to conventional medication administration process (C), lead to a reduction in medication administration errors (O) during patient’s stay (T)?
Search Methods of the Literature
Effective search of articles comprises of using appropriate approaches and terms that align with the topic of interest. In this assignment, I employed different yet related strategies to search for the articles that support the EBP project. These included using institutional library to get databases of journals and their published peer-reviewed articles. I used terms like “peer review” and “scholarly works” about medication administration errors. Through these approaches, I obtained the articles that I used in providing this literature review as they support my EBP project. I also ensured that the article meet the criteria of being published within the last five years and are relevant to the nursing context and use.
Synthesis of Literature
Article 1
The first article is by Alotaibi and Federico (2012) who discuss the impacts of health information technology on patient safety. Through a review of present scientific evidence on the effects of health information technologies on improving patient safety, the authors demonstrate the effectiveness of these interventions in reducing medication administration errors. Their findings support the implementation of health information technology to reduce medication errors and mitigate adverse events while increasing compliance to established guidelines in nursing practice. The article supports the PICOT as it shows the interventions that can be used to improve quality care and enhance overall patient safety. The article also supports the PICOT by showing the time frame that facilities can use to attain the benefits of these interventions.
Article 2
The second article by Barakat and Franklin (2020) focuses on the effects of using barcode medication administration (BCMA) on nursing practice activity and workflow. The authors use a qualitative study design in two surgical wards at a large acute facility in London. Through observations, the authors found that BCMA increased the nursing workflow, patient verification and efficiencies in medication administration. The authors are emphatic that the use of barcode and other health information technologies can enhance care delivery by minimizing occurrence of medication administration errors. The article supports the PICOT as it addresses how nurse practitioners handling critically ill patients can use technology-based interventions to enhance workflow and increase efficiencies aimed at mitigating MAEs.
Article 3
The third article is by Alomari et al. (2020) which evaluates the effectiveness of nurse-based interventions in reducing medication errors in pediatric wards. The authors investigate the effects of using bundled interventions to reduce medication administration errors. The author also focused on enhancing nurses’ perspective of medication administration process. Using a quantitative research approach in their selected settings, the authors shows through phased action research that these interventions, including use of health information technology, can reduce medication errors by over 60%. The authors emphasize that these benefits are not impacted by tan increase in the number of patients and prescribed medications. The article supports the PICOT question and statement as it shows the duration and interventions that can be implemented by nursing staff and other professionals to reduce and prevent the occurrence of medication administration errors.
Article 4
The fourth study by Devin et al. (2020) focuses on the effects of health information technologies in reducing prescribing errors in hospitals. The authors also focus on behavioral change techniques linked to HIT implementation that can reduce occurrence of medication errors. using a qualitative approach in different settings, the authors show that HIT prescribing reduces medication errors, especially prescribing errors. The authors’ findings emphasize the need for providers to integrate different approaches to ensuring that medication errors do not occur during the entire medication process. The article supports the EBP PICOT statement as it integrates the use of health information technology as a critical intervention to reducing medication administration errors.
Article 5
The fifth article by Zadvinski et al. (2018) explores the experience of nurses working with health information technology over time in their facilities. Using a longitudinal qualitative study design, the authors demonstrate the effects of nurses embracing technologies in a medical-surgical unit for a period of 18 months. The findings show that personal and organizational issues impact the adoption of HIT. The findings show that change of perception of these technologies is essential in attaining their intended benefits to the organization and patient safety goals. The article supports the PICOT statement as it shows that implementing health information technologies requires time for quality outcomes. Leveraging organizational policies and enhances the ability of nurses to adopt and use these technologies to enhance patient safety and quality outcomes.
Article 6
The study by Naidu and Alicia (2019) aims at evaluating the use of barcode medication administration and electronic medication administration records (e-MAR), outcomes, practice and policies and their effects on nurses in the medication administration duties in their nursing practice areas. Through an annotated literature review, the authors’ findings demonstrate that compliance to these interventions enhance patient safety and reduces reported medication administration errors. The use of these practices and policies also improves the efficiency of the BCMA system. The article is essential as it supports the PICOT by discussing the use of the health information technologies as interventions to reducing and preventing the prevalence of medication administration errors.
Article 7
The study by Jheeta and Franklin (2017) focuses on the how hospital electronic prescribing and medication administration system can enhance medication administration safety. Through an observational design, the authors show that implementation of these interventions encourages the occurrence of certain errors but also mitigates others. The implication is that using these interventions helps in reducing errors and enhancing patient safety. The article supports the PICOT statement as it emphasizes the need to use effective interventions and encourage their applications among all stakeholders in healthcare systems.
Article 8
The article by Härkänen et al. (2019) provides an analytical perspective of reported medication errors and their associated mortality in England and Wales for a period of nine years. The authors analyze medication errors in acute care that lead to death, identify the used drugs and describe the associated characteristics of the medication administration errors. Their findings show that most of deaths occurring due to medication administration errors happen in inpatients and among patients aged over 75 years with errors of omission being the most common form. The article supports the PICOT as it shows that medication errors occur due to several factors and should be addressed through integration of health information technologies.
Comparison of the Articles
The most prevalent issue in all these articles is the adoption of different health information technologies in mitigating and reducing the occurrence of medication administration errors (MAEs). Using an evidence-based practice approach, most of the articles demonstrate the effectiveness of having protocols and policies that supplement the use of technology in healthcare settings among healthcare workers. A majority of these articles use systematic reviews as they are considered the best level of evidence, especially in EBP projects. These reviews provide different interventions that healthcare providers can use to integrate health information technologies and reduce and prevent the occurrence of medication administration errors.
The main themes in these articles include use of medication administration processes, medication administration errors’ occurrence, the role of healthcare workers in embracing these interventions, and the effectiveness of the approaches to reduce medication administration errors. Some of the articles like the one by Jheeta and Franklin (2017) don not emphasize the effectiveness of health information technology in mitigating MAEs. However, the article emphasizes the need to have a multifaceted approach to the use of technologies to enhance care delivery. Each of the article has its unique shortcomings and areas not addressed. However, a common theme also emerges about the need to conduct further research to validate the outcomes and effectiveness of health information technology approaches to reduce and prevent medication administration errors, especially in acute care settings. Each of the article does not contain any controversy as the researchers complied with established guidelines to enhance validity and reliability.
Suggestions for Future Research
A majority of these articles recommend the need for further research on different aspects of the topic. The authors are categorical that while their studies offer evidence based on their research, it is imperative to conduct more studies on different aspects of these technologies to ascertain their overall effectiveness in addressing the issue under consideration (Alomari et al., 2020; Alotaibi & Federico, 2017). Gaps in effective research illustrating the interactions among various interventions and outcomes may require more approaches for better implementation of suggested approaches.
Conclusion
Medication administration errors (MAEs) remain a core concern in attaining better patient safety levels in different care settings. These events affect the quality of care and safety, especially for critically ill patients in hospitals who die for other causes other than their afflicted conditions. Therefore, stakeholders need interventions that leverage the best practices to reduce and prevent the occurrence of these events. The findings from these articles demonstrate the need for nurses and other healthcare workers to implement evidence-based practice interventions to reduce medication administration errors (MAEs). The selected articles show the need for enhance patient care and safety for better outcomes.
References
Alomari, A., Sheppard-Law, S., Lewis, J. & Wilson, V. (2020). Effectiveness of Clinical Nurses’
interventions in reducing medication errors in a pediatric ward. The Journal of Clinical Nursing, 29(17-18): 3403-3413. https://doi.org/10.1111/jocn.15374
Alotaibi, Y. K. & Federico, F. (2017). The impact of health information technology on patient
safety. Saudi Medical Journal, 38(12):1173-1180. doi: 10.15537/smj.2017.12.20631
Barakat, S. & Franklin, B. D. (2020). An Evaluation of the Impact of Barcode Patient and
Medication Scanning on Nursing Workflow at a UK Teaching Hospital. Pharmacy (Basel), 8(3):148. doi: 10.3390/pharmacy8030148
Devin, J., Cleary, B. J. & Cullinan, S. (2020). The impact of health information technology on
prescribing errors in hospitals: a systematic review and behavior change technique analysis. BMC Systematic Reviews, 9(275). https://doi.org/10.1186/s13643-020-01510-7
Jheeta, S. & Franklin, B. D. (2017). The impact of a hospital electronic prescribing and
medication administration system on medication administration safety: an observational study. BMC Health Services Research, 17(547). https://doi.org/10.1186/s12913-017-2462-2
Härkänen, M., Vehviläinen-Julkunen, K., Murrells, T., Rafferty, A. M., & Franklin, B. D.
(2019). Medication administration errors and mortality: Incidents reported in England and Wales between 2007 ̶ 2016. Research in Social and Administrative Pharmacy, 15(7), 858-863. https://doi.org/10.1016/j.sapharm.2018.11.010
Naidu, M. and Alicia, Y.L.Y. (2019). Impact of Bar-Code Medication Administration and
Electronic Medication Administration Record System in Clinical Practice for an Effective Medication Administration Process. Health, 11, 511-526. https://doi.org/10.4236/health.2019.115044
Zadvinskis, I. M., Smith, J. G., & Yen, P. Y. (2018). Nurses’ experience with health information
technology: Longitudinal qualitative study. JMIR medical informatics, 6(2), e38. doi: 10.2196/medinform.8734
In order to formulate your evidence-based practice (EBP), you need to assess your organization. In this assignment, you will be responsible for setting the stage for EBP. This assignment is conducted in two parts: an organizational cultural and readiness assessment and the proposal/problem statement and literature review, which you completed in NUR-550.
Section A: Organizational Culture and Readiness Assessment
It is essential to understand the culture of the organization in order to begin assessing its readiness for EBP implementation. Select an appropriate organizational culture survey tool and use this instrument to assess the organization’s readiness.
Develop an analysis of 250 words from the results of the survey, addressing your organization’s readiness level, possible project barriers and facilitators, and how to integrate clinical inquiry, providing strategies that strengthen the organization’s weaker areas.
Make sure to include the rationale for the survey category scores that were significantly high and low, incorporating details or examples. Explain how to integrate clinical inquiry into the organization.
Submit a summary of your results. The actual survey results do not need to be included.
Section B: Proposal/Problem Statement and Literature Review
In NUR-550, you developed a PICOT statement and literature review for a population quality initiative. In 500-750 words, include the following:
Refine your PICOT into a proposal or problem statement.
Provide a summary of the research you conducted to support your PICOT, including subjects, methods, key findings, and limitations.
General Guidelines:
You are required to cite three to five sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.
Note: After submitting the assignment, you will receive feedback from the instructor. Use this feedback to make revisions for your final paper submission. This will be a continuous process throughout the course for each section.
NUR590 Evidence Based Practice Project
Week 3 Assignment
Evidence-Based Practice Proposal – Section C: Solution Description
Write a paper of 500-750 words for your proposed evidence-based practice project solution. Address the following criteria:
Proposed Solution: (a) Describe the proposed solution (or intervention) for the problem and the way(s) in which it is consistent with current evidence. Heavily reference and provide substantial evidence for your solution or intervention. (b) Consider if the intervention may be unrealistic in your setting, if it may be too costly, or if there is a lack of appropriate training available to deliver the intervention. If the intervention is unrealistic, you may need to go back and make changes to your problem statement before continuing.
Organization Culture: Explain the way(s) in which the proposed solution is consistent with the organization or community culture and resources.
Expected Outcomes: Explain the expected outcomes of the project. The outcomes should flow from the problem statement.
Method to Achieve Outcomes: Develop an outline of how the outcomes will be achieved. List any specific barriers that will need to be assessed and eliminated. Make sure to mention any assumptions or limitations that may need to be addressed.
Outcome Impact: Describe the impact the outcomes will have on one or all of the following indicators: quality care improvement, patient-centered quality care, efficiency of processes, environmental changes, or professional expertise.
You are required to cite three to five sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.
Note: After submitting the assignment, you will receive feedback from the instructor. Use this feedback to make revisions for your final paper submission. This will be a continuous process throughout the course for each section.
Successful implementation of evidence-based practice projects is important for organizational success. Organizational factors such as support from leadership and management are the critical determinants for the successful implementation of evidence-based practice projects. Therefore, this paper is an examination of the organizational readiness and culture assessment to determine its ability to support the proposed change. The second section is a review of literature to refine the PICOT of the project.
Sample Answer for NUR 590 Evidence Based Practice Project -Week 2 Assignment
Part A
The organizational readiness assessment was done using a tool developed by Buldingmovement.org. The tool examines the level of readiness as well as culture of health organizations in relation to the implementation of evidence-based practice interventions. The tool examines different organizational aspects that include vision, mission and goals, leadership and governance and staff. The assessment results showed that the hospital is ready to implement the proposed change. The readiness could be seen from the staffs scoring most of the responses in the assessment tool as either true or developing or in process. The assessment areas that had the highest scores in the tool included vision, mission and goals and staff sections. The high scores in the vision, mission and goals section were seen in the statements that included the organization having a written vision statement that staff, leadership and board understand and guides the organizational tasks. High scores were also seen in the statement about the mission statement being written in the organization and staffs, leaders, managers and board understand it, as it guides their actions. The statements that had the highest scores in the staff section included staffs being well-informed about the needs of those they serve, seeking contributions from others and expressing their awareness about the needs of others (Buildingmovement.org, n.d.).
The organization scored poorly in the leadership and governance section. The poor score in this section led to the identification of organizational weaknesses and possible barriers such as leadership and governance not be informed about the needs of the staffs and other stakeholders, not seeking input and contribution from others and not being adequately open for new ideas. Based on this, the organization seeks to address the weakness by introducing new leadership styles that emphasis stakeholder involvement and prioritization of their needs in strategy development. Therefore, clinical inquiry will be incorporated into the organization by creating a culture that supports continuous learning, innovation and focusing on organizational strengths and opportunities to minimize barriers and weaknesses.
Part B
Diabetes mellitus is a prevalent problem affecting the majority of African American populations. According to Mitchell et al., (2020), African Americans experience a disproportionate high rate of diabetes mellitus type 2 than non-Hispanic whites in America. African Americans are two times highly likely to be affected by diabetes when compared to non-Hispanic whites in the state (Mitchell et al., 2020). Diabetes mellitus type 2 is highly associated with modifiable and non-modifiable risk factors that include smoking, physical inactivity, alcohol consumption, poor dietary habits and genetics (Joseph et al., 2017). The health risks of diabetes such as diabetic foot, diabetic ketoacidosis and hypoglycemia can be managed and prevented effectively using community-based interventions such as nutritional education and physical activity. According to Soltero et al., (2018), community-based diabetes prevention intervention led to an improvement in insulin sensitivity, weight specific quality of life and reduction in the BMI among youths that were obese and at risk of diabetes. A systematic review performed by Shirinzadeh et al., (2019) showed that the use of community-based nutrition and physical activity programs were associated with a significant reduction in the risk of developing diabetes. There was also a significant reduction in body mass index, weight and weight circumference in the participants in the intervention groups (Shirinzadeh et al., 2019). Similar outcomes can be seen in the studies by Maheri et al., (2017) and Smith et al., (2019). Therefore, based on the results of the review, the refined PICOT statement is as follows:
In African American patients with diabetes, does the use of community-based programs that focus on physical activity and nutritional interventions result in improvement in treatment outcomes and complications when compared to no use within a period of six months?
Conclusion
Overall, the readiness assessment showed that our hospital is ready to implement the proposed evidence-based practice project. A focus will be placed on the strengths of the organization and its opportunities to minimize the effects of threats and weaknesses that it has. The review of literature supports the use of community-based interventions to improve the treatment outcomes in diabetes mellitus type 2. Therefore, it is anticipated that the organization will support the implementation of the project.
References
Buildingmovement.org. (n.d.). Organizational Readiness Assessment. Retrieved from http://www.buildingmovement.org/wp-content/uploads/2020/03/Organizational_Readiness_Assessment_Tool.pdf
Joseph, J. J., Echouffo-Tcheugui, J. B., Talegawkar, S. A., Effoe, V. S., Okhomina, V., Carnethon, M. R., Hsueh, W. A., & Golden, S. H. (2017). Modifiable Lifestyle Risk Factors and Incident Diabetes in African Americans. American Journal of Preventive Medicine, 53(5), e165–e174. https://doi.org/10.1016/j.amepre.2017.06.018
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Sample Answer for NUR 590 Evidence Based Practice Project -Week 2 Assignment
This section of the EBP project examines the organizational culture and readiness assessment. The section assesses whether the organization is ready to implement the project to improve quality of care given to patients. It examines its readiness, strengths, weaknesses, barriers, and interventions to address the weaknesses and incorporate clinical inquiry into practice.
The organizational culture and readiness assessment was undertaken using the Organizational Readiness to Change Assessment (ORCA) tool. Helfrich et al. (2009) developed the ORCA tool for use in the determination of the readiness of an organization to embrace change, including evidence-based practice. The ORCA tool comprises three scales that include evidence, context, and facilitation. The evidence scale determines the readiness of the organization to implement change and whether the change will take into consideration clinical experience, patient preferences and research evidence. Context focuses on the dimensions of organizational culture, leadership, resource availability, and management. Facilitation focuses on the organization’s ability to sustain the use of the change in its processes.
The assessment of the organization using the ORCA tool showed it to be ready to embrace change. The organization practices a transformational leadership style where the diverse needs of the employees are prioritized. The proposed EBP project also prioritizes clinical experience, patient preferences, and research evidence. The readiness of the organization was also seen in the ready availability of resources to support the intervention and utilization of teamwork in undertaking clinical roles. The organization scored high in sections that included facilitative leadership, effective leadership, teamwork, resource availability, and support of innovation in practice. It however scored low in sections that included technology use, tracking performance, and routine use of evidence-based data.
Some of the barriers that were identified from the assessment include low level of awareness among the staffs on evidence-based practice and low use of technology in the provision of care. These barriers will be addressed through training providers on the use of the intervention and advocating the utilization of evidence-based data in for patient care. Clinical inquiry will be incorporated into practice by establishing culture of the use of best available practices in the provision of patient care.
In summary, the assessment has revealed the organization to be ready to implement the EBP project. The organization has the necessary resources, leadership, teams, and management that will ensure the success of the project. A focus should however be placed on identifying the potential weaknesses and threats in the organization for the successful implementation of the change.
Section B: Proposal/Problem Statement and Literature Review
Evidence-based practice is an important component in nursing practice that promotes quality, safety, and efficiency in health organizations. Nurses should play an active role in implementing evidence-based practices in determining the interventions of care for their patients. Therefore, this section of the EBP project examines a refinement of the PICOT statement and review of the literature that relate to the study.
Refined PICOT Question
Chemotherapy is one of the treatments that are utilized in the treatment of cancer. Chemotherapy has significant side effects to the patients that might affect their experiences and perceptions towards its need in some patient population. The increasing need for the use of different chemotherapeutics increases the disease burden to the patients and their significant others. Guided imagery is an approach where a therapist guides an individual to generate mental images that recreate the negative experiences. Guided imagery can be utilized to improve the experiences of cancer patients on chemotherapy. Patients are guided to recreate their sensory perceptions of tastes, sights, smells, and touch. The existing evidence has shown that patients on chemotherapy can be assisted to develop positive experiences with their treatment using guided imagery. However, the use of guided imagery is yet to be explored in our organization, hence, the focus of the EBP. The refined PICOT question is as follows:
In patients undergoing chemotherapy, does the use of guided imagery and relaxation techniques improve their treatment experiences when compared to no use in a period of six weeks?
Literature Review
Several studies have been conducted in the past to determine the effectiveness of guided imagery and relaxation techniques in improving the treatment experiences of patients undergoing chemotherapy. One of the studies is the research by Kapogiannis et al. (2018) that investigated the effects of progressive muscle relaxation-guided imagery combination on patients receiving chemotherapy. The study was a systematic review of randomized controlled trials that used articles from electronic databases that included Scopus, Pubmed, AMED, and Cochrane Library. The results of the study showed that the use of guided imagery and relaxation techniques is associated with benefits such as improving mood, depression, anxiety, and toxicity of the treatment. The study was however associated with the weakness of not utilizing human subjects to determine the effect of the interventions.
Charalambous et al. (2016) conducted a randomized controlled trial that investigated the use of progressive muscle relaxation and guided imagery in patients receiving chemotherapy. The study used 208 patients who were assigned either to the control or intervention groups. Patients were assessed for side effects of treatment that included fatigue, pain, retching, depression, anxiety, nausea and vomiting. The results of the study showed that the use of progressive muscle relaxation and guided imagery were associated with significant improvement in symptoms that included vomiting, nausea, retching, fatigue, and pain. The study was associated with the strength of randomizing study participants to enhance the validity and reliability of findings. The study was, however, associated with the limitation of failing to control the effect of other interventions used to improve the treatment outcomes in chemotherapy.
The last study that support the utilization of the proposed intervention is the research by Hosseini et al. (2016). The study by Hosseini et al. (2016) investigated the effect of guided imagery on chemotherapy induced vomiting and nausea. The study design was quasi-experimental study where the sample was evaluated at the beginning and end of the study. The researchers used 55 patients with breast cancer. The results of the study showed that the use of guided imagery was associated with significantly reduced mean scores in the severity and frequency of vomiting and nausea pre- and post-chemotherapy. The study was associated with the strength of follow-up of the participants pre- and post-intervention. It was, however, associated with the weakness of using a small sample size that gave results that cannot be generalized to the larger population.
Conclusion
The review of literature has shown that guided imagery and relaxation techniques result in better treatment outcomes in cancer patients undergoing chemotherapy. The existing evidence supports the fact that guided imagery and relaxation techniques improve side effects of chemotherapy that include pain, anxiety, depression, nausea, and vomiting among others. Therefore, its clinical use should be adopted to improve treatment outcomes.
References
Charalambous, A., Giannakopoulou, M., Bozas, E., Marcou, Y., Kitsios, P., & Paikousis, L. (2016). Guided imagery and progressive muscle relaxation as a cluster of symptoms management intervention in patients receiving chemotherapy: A randomized control trial. PLOS ONE, 11(6), e0156911. https://doi.org/10.1371/journal.pone.0156911
Helfrich, C. D., Li, Y.-F., Sharp, N. D., & Sales, A. E. (2009). Organizational readiness to change assessment (ORCA): Development of an instrument based on the Promoting Action on Research in Health Services (PARIHS) framework. Implementation Science, 4(1), 38. https://doi.org/10.1186/1748-5908-4-38
Hosseini, M., Tirgari, B., Forouzi, M. A., & Jahani, Y. (2016). Guided imagery effects on chemotherapy induced nausea and vomiting in Iranian breast cancer patients. Complementary Therapies in Clinical Practice, 25, 8–12. https://doi.org/10.1016/j.ctcp.2016.07.002
Kapogiannis, A., Tsoli, S., & Chrousos, G. (2018). Investigating the effects of the progressive muscle relaxation-guided imagery combination on patients with cancer receiving chemotherapy treatment: A systematic review of randomized controlled trials. EXPLORE, 14(2), 137–143. https://doi.org/10.1016/j.explore.2017.10.008