NUR590 Evidence Based Practice Project Week 5 Assignment Evidence-Based Practice Proposal – Section E: Implementation Plan
Grand Canyon University NUR590 Evidence Based Practice Project Week 5 Assignment Evidence-Based Practice Proposal – Section E: Implementation Plan-Step-By-Step Guide
This guide will demonstrate how to complete the NUR590 Evidence Based Practice Project Week 5 Assignment Evidence-Based Practice Proposal – Section E: Implementation Plan 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 NUR590 Evidence Based Practice Project Week 5 Assignment Evidence-Based Practice Proposal – Section E: Implementation Plan
Whether one passes or fails an academic assignment such as the Grand Canyon University NUR590 Evidence Based Practice Project Week 5 Assignment Evidence-Based Practice Proposal – Section E: Implementation Plan 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 NUR590 Evidence Based Practice Project Week 5 Assignment Evidence-Based Practice Proposal – Section E: Implementation Plan
The introduction for the Grand Canyon University NUR590 Evidence Based Practice Project Week 5 Assignment Evidence-Based Practice Proposal – Section E: Implementation Plan 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 NUR590 Evidence Based Practice Project Week 5 Assignment Evidence-Based Practice Proposal – Section E: Implementation Plan
After the introduction, move into the main part of the NUR590 Evidence Based Practice Project Week 5 Assignment Evidence-Based Practice Proposal – Section E: Implementation Plan 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 NUR590 Evidence Based Practice Project Week 5 Assignment Evidence-Based Practice Proposal – Section E: Implementation Plan
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 NUR590 Evidence Based Practice Project Week 5 Assignment Evidence-Based Practice Proposal – Section E: Implementation Plan
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 NUR590 Evidence Based Practice Project Week 5 Assignment Evidence-Based Practice Proposal – Section E: Implementation Plan
Implementing any change in a healthcare organization or facility entails several aspects that require one to develop an implementation as is the most important part of any evidence-based practice (EBP) project proposal. Implementation entails the actualization of the ideas developed in the proposal EBP projects are broken into several identifiable steps (Boehm et al., 2020). The implementation plan will focus on hand hygiene measures in pediatric setting among healthcare workers to reduce hospital acquired infections (HAIs). The implementation plan will consist of the setting where the project will take place, time, resources, methods and instruments, intervention of delivery process, and data collection plan. The plan also includes management of barriers, facilitators and challenges and the feasibility of the plan.
Evidence-based practice (EBP) is the combination of research evidence, experience, and expertise, patient preferences in the process of performance of care. Clinicians bring up experience and knowledge and patients describe personal beliefs, these two components contribute to valuable research displayed by methodology to develop the best outcome. EBP requires nursing professionals to develop skills in searching the literature and finding guidelines for the application of evidence. Study designs are categorized from case reports to case-control studies, cohort studies, randomized control trials, systematic reviews, and meta-analyses, which are the most specified study designs, examining multiple validated hypotheses and combining the most reliable results (Samonte et al., 2020). Non-experimental research describes a study that lacks the manipulation of an independent variable, researchers conducting non-experimental study measure variables as they naturally happened. The distinction between non-experimental and experimental research is a significant one as the experimental research provides strong evidence that changes in an independent variable cause difference in a dependent variable; non-experimental research cannot provide this evidence and it is used in cases where the experimental study is not able to be evidenced. Experimental research is evidenced when the researcher has a specific research question or hypothesis regarding a correlation between two variables and it’s feasible and ethical to manipulate the independent variable. Thus, the non-experimental study is approached when these aspects are not met. Non-experimental research is performed when the research question or hypothesis is related to a single variable rather than two variables, the research question approaches a non-causal relationship between variables. The difference between these two types of methods of evaluating evidence is dictated by the nature of the research question. When the goal of the research question is to explain a nursing aspect and the research questions pertain to a causal relationship, the experimental evidence is approached. If the goal of the science is to describe or predict a non-experimental approach is evidenced. The two pieces of evidence can be used to address the same research question. The non-experimental study encompasses correlational research and observational research; correlational type is considered non-experimental because emphasizes the statistical relationship between two variables but does not incorporate the manipulation of an independent variable; observational type focuses on making observations of behavior in a natural setting without manipulation (Jhangiani, 2019). A quantitative non-experimental study explored students’ perceptions of faculty responses following medication errors that students perform while advancing through a four-year BN Program. The objective of the study is to determine factors which increase the likelihood of nursing students reporting medication discrepancies. The predisposition factors of medication errors are human factors (knowledge deficit, failure to follow procedure) and system factors (patient acuity, level of workload). Consistent reporting of medication errors is mandatory to maintain patient safety. Nursing students even though supervised by clinical instructors are predisposed to perform a high number of medical errors. The study evidenced that 30 % of nursing students made at least one error during the program of study and the average number of medication errors recalled per student was 1.93. The reporting of medication errors cannot be underestimated. Nurses must take all actions necessary to minimize patient safety incidents. Nursing education programs inspire ethical and moral standards in nursing students, advocating for patient safety being not only a mandate but also a moral and ethical requirement (Walsh, Anstey, Tracey, 2018).
Setting and Access to Potential Subjects
The implementation framework of any EBP project includes establishment of a motive for change, development of specific goals, attaining leadership support, creating a leadership teams and engagement of clinical support. In this case, the project setting will be a pediatric hospital where nurse practitioners and clinical nurse leaders involved in service delivery to the patient population will be the main subjects taking part in the proposed project. The selected participants should have served in this unit for the last 12 months. The project will select 20 healthcare staff to be involved in the implementation process.
The second component of this project is getting consent or approval from the participants and the institutional review board for the project to take place. Participants’ consent will be essential as it will demonstrate their willingness to be part of the project without any undue influence. The review board will give the project a green light and ensure that ethical provisions are met to protect the subjects. The consent will indicate that the main purpose of the project is to reduce the rate of HAI within six months by enhancing hand hygiene measures, specifically the use of alcohol-hand sanitizers or rubs alongside handwashing using soap and water. The participants will sign the consent form upon getting relevant information about the project and its overall benefits to the population.
Timelines
The implementation timeframe for the EBP project will be six months. Different activities will take place each month to ensure that all components of the proposal are implemented effectively. The timeframe will include creation of a multidisciplinary team in the first two weeks of the program. The last two weeks of the first month will have collection of required resources and expertise for the implementation process. The training of the nursing staff will occur in the second month and will take two to three weeks to ascertain that the participants have sufficient knowledge and skills based on existing resource to implement hand hygiene measures aimed at reducing HAIs.
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The first week of the third month will involve identification of any possible barriers that may influence or interfere with the implementation. The duration will also be used to increase stakeholder engagement, participation and collection of their input and views to be incorporated in the final implementation activities (Luciano et al., 2019). The remain three and half months will involve the actual implementation. However, in the fifth month, the project team will review the implementation to ascertain if there will be need to have any modifications to the project. The implication is that the implementation process will be successful if the five months will be used as expected in the timelines proposed for the plan.
Resources
Studies show that success of any evidence-based project primarily rely on the availability of the needed resources (DeNisco, 2019; Luciano et al., 2019). The implementation of this project require human resources that will comprise of competent trainers who will impart the project team with necessary knowledge and skills. The most appropriate resource for this EBP project include nurse practitioners and clinical nurse leaders. Engagement of nurse practitioners and clinical nurse leaders with the requisite skills improves the success of quality improvement projects. In addition to the human resources, the project will also require financial resources to fund the implementation. the financial resources will be deployed to compensate the trainers and buy required stationeries like the training manuals. These resources will also be instrumental in overall implementation as they will be used to buy equipment like hand-rubs for demonstration. The resources will also include travel expenses for the project manager and the team. Changes needed in the implementation of the solution will include more education and awareness among caregivers since most of the pediatric patients may not comprehend the protocols that will be proposed to reduce hospital acquired infections.
Qualitative or Quantitative Design in Data Collection and Effectiveness
The selected design to collect data for the evidence-based practice project proposal is qualitative. The qualitative approach is deployed to understand thoughts, concepts, and experiences of participants through techniques like interviews, focus groups, observations, and a review of existing literature (Rebekah & Ravindran, 2018). The qualitative research design will be effective in the project proposal since it will entail getting opinions through deployment of different methods from healthcare workers about the need to enhance hand hygiene measures to prevent and reduce the occurrence of hospital acquired infections, especially in pediatric settings (Vandermause et al., 2017). The evidence-based practice project proposal on hand hygiene measures among healthcare workers to reduce and prevent hospital acquired infections (HAIs) in pediatric settings will inform stakeholders about the importance of handwashing protocols. The EBP project proposal is effective as it will ensure that healthcare workers in the selected settings adhere to hand hygiene measures for effective care delivery and minimize the prevalence of infections that negatively impact patient outcomes and quality care delivery.
Methods and Instruments for Monitoring
The implementation process will entail various methods and instruments in its monitoring. Firstly, an audit tool and satisfaction survey will be used in the implementation process. The project team will use satisfaction survey to evaluate the effectiveness of the measures executed to decrease high prevalence of hospital acquired infections in the pediatric unit. The audit framework will be deployed to complete the auditing process. The tool will enhance the auditing of gathered data on specific hand hygiene interventions and their outcomes (Vandermause et al., 2017). Additionally, the project will use questionnaires to collect the required data from the participating nurse. questionnaires are effective data collection tools and nurse leaders and practitioners will fill them out to offer information about the effectiveness of hand hygiene measures that can reduce occurrence of HAIs in pediatric patient population. The information will guide the project implementation team during the process for effective outcomes. The auditing tools and satisfaction surveys alongside the questionnaire use will be critical in attaining the expected project goals.
Delivery of the Intervention
The delivery process for the intervention will involve project team members that comprise of nurse leaders and practitioners. The nurses and practitioners will develop and execute necessary protocols like setting hand sanitizer stations at different points of the care delivery process (Luciano et al., 2019). These points will include the nursing stations and having points in pediatric wards as well as other key points to enhance hand hygiene measures. The participants will require training to enable them perform their respective duties well. Training will consist of giving information to nurse leaders about the components of the proposed so that they can effectively supervise the nurse practitioners to ensure that they carry out their mandate as expected. The practitioners will also require training to implement the proposed measures as planned to meet the set project goals.
Stakeholders Required to Implement the Plan
Stakeholder support is a critical component of evidence –based practice project proposal as they provide critical resources, input, and implement the recommendations of such programs. In this case, several stakeholders will be needed to implement the project (DeNisco, 2019). The initial stakeholders will include clinical nurse leaders and practitioners who will ensure that the components of EBP project are realized. The second set of stakeholders include the project team and trainers that shall offer direction on the implementation of the EBP intervention. The third stakeholder group needed comprise of organizational leaders and managers who shall provide the requisite resources; especially financial resources, to implement the proposed plan to reduce hospital acquired infections in the target population.
Aspects of the Implementation Plan and Potential barriers, Challenges and Proposed Strategies
The success of the project will depend on how the project team manage different aspects like facilitators, barriers, and develop effective strategies to respond adequately. For instance, organizational leaders and managers will be critical facilitators as they offer necessary support through resource allocation and a buy-in. The management will also support the new project will the aim of improving overall care quality.
Time and resource limitation, insufficient knowledge and skills among healthcare workers would be significant barriers in implementation of the project. Negative attitudes that will fuel resistance will also hamper effective implementation of the project as many will feel that it will be sufficient to assess the overall effectiveness of the intervention (Vandermause et al., 2017). It is essential to mitigate these barriers through effective strategies like sticking to the timeframe for implementation, engaging all stakeholders like leaders and managers, and enhancing communication among all players.
Feasibility
The feasibility of this project will be assessed based on a cost-benefit analysis approach. The cost incurred in the implementation process will be estimated to assess the overall benefits that will accrue to patients and healthcare organization’s unit (Rebekah & Ravindran, 2018). The cost will also include funds to compensate trainers and buy the needed project implementation materials to evaluate the overall feasibility of the plan. the unit should implement the plan since its cost-benefit analysis will be positive to the organization.
Conclusion
The implementation of the project stage is essential as it consists of the real practical application of expected changes and subsequent outcomes. Therefore, it is important to evaluate all aspects of the stage for effective outcomes and project’s sustainability. The highlighted plan will be effective through increased stakeholder engagement and participation.
References
Boehm, L. M., Stolldorf, D. P., & Jeffery, A. D. (2020). Implementation science training and
resources for nurses and nurse scientists. Journal of Nursing Scholarship, 52(1), 47-54. doi: 10.1111/jnu.12510.
DeNisco, S. M. (2019). Advanced Practice Nursing: Essential Knowledge for the Profession:
Essential Knowledge for the Profession. Jones & Bartlett Learning.
Klingbeil, C. & Gibson, C. (2018). The Teach Back Project: A System-wide Evidence Based
Practice Implementation. Journal of Pediatric Nursing, 42:81-85. doi: 10.1016/j.pedn.2018.06.002.
Luciano, M. M., Aloia, T. A. & Brett, J. F. (2019). 4 Ways to Make Evidence-Based Practice the
Norm in Health Care. Harvard Business Review. https://hbr.org/2019/08/4-ways-to-make-evidence-based-practice-the-norm-in-health-care
Rebekah, G., & Ravindran, V. (2018). Statistical analysis in nursing research. Indian Journal of
Continuing Nursing Education, 19(1), 62.
Vandermause, R., Barg, F. K., Esmail, L., Edmundson, L., Girard, S., & Perfetti, A. R. (2017).
Qualitative methods in patient-centered outcomes research. Qualitative health research, 27(3), 434-442. doi: 10.1177/1049732316668298
Evidence-Based Practice Proposal – Section E: Implementation Plan
In 1,000-1,500 words, provide a description of the methods to be used to implement the proposed solution. Include the following:
Describe the setting and access to potential subjects. If there is a need for a consent or approval form, then one must be created. Although you will not be submitting the consent or approval forms in Topic 5 with the narrative, you will include the consent or approval forms in the appendices for the final paper.
Describe the amount of time needed to complete this project. Create a timeline. Make sure the timeline is general enough that it can be implemented at any date. Although you will not be submitting the timeline in Topic 5 with the narrative, you will include the timeline in the appendices for the final paper.
Describe the resources (human, fiscal, and other) or changes needed in the implementation of the solution. Consider the clinical tools or process changes that would need to take place. Provide a resource list. Although you will not be submitting the resource list in Topic 5 with the narrative, you will include the resource list in the appendices for the final paper.
Describe the methods and instruments, such as a questionnaire, scale, or test to be used for monitoring the implementation of the proposed solution. Develop the instruments. Although you will not be submitting the individual instruments in Topic 5 with the narrative, you will include the instruments in the appendices for the final paper.
Explain the process for delivering the (intervention) solution and indicate if any training will be needed.
Provide an outline of the data collection plan. Describe how data management will be maintained and by whom. Furthermore, provide an explanation of how the data analysis and interpretation process will be conducted. Develop the data collection tools that will be needed. Although you will not be submitting the data collection tools in Topic 5 with the narrative, you will include the data collection tools in the appendices for the final paper.
Describe the strategies to deal with the management of any barriers, facilitators, and challenges.
Establish the feasibility of the implementation plan. Address the costs for personnel, consumable supplies, equipment (if not provided by the institute), computer-related costs (librarian consultation, database access, etc.), and other costs (travel, presentation development). Make sure to provide a brief rationale for each. Develop a budget plan. Although you will not be submitting the budget plan in Topic 5 with the narrative, you will include the budget plan in the appendices for the final paper.
Describe the plans to maintain, extend, revise, and discontinue a proposed solution after implementation.
You are required to cite five to 10 sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.
Note: After submitting the assignment, you will receive feedback from the instructor. Use this feedback to make revisions for your final paper submission. This will be a continuous process throughout the course for each section.
Sample Answer 2 for NUR590 Evidence Based Practice Project Week 5 Assignment Evidence-Based Practice Proposal – Section E: Implementation Plan
Evidence-based practice (EBP) projects are designed to make positive organizational changes by addressing specific practice problems. After an in-depth assessment of the issues facing a health care organization or a system, a change agent applies the most current and relevant evidence as the basis for intervention. However, the required operational benchmark cannot be realized without implementing the project proposal. This section describes the implementation plan, focusing on time, resources, methods, process, data collection, and strategies to overcome barriers.
Setting and Access to Potential Subjects
The setting is characterized by a technologically advanced, intricate, and stressful nature of health care that greatly compromises nurses’ ability to discharge their duties diligently. In such a state, nurses are usually overwhelmed, burdened, and stressed. Such conditions among other issues such as poor shift rotation, complex interpersonal relationships, and lack of motivation increase the nurses’ vulnerability to burnout and stress (Dall’Ora et al., 2020). Accordingly, the nurses are the primary subjects for the EBP project whose primary role is increasing their focus and readiness to provide patient by mindfulness meditation training.
Accessing the VA healthcare system’s nurses is not complicated as long the reasons for accessing them are clear and the necessary administrative protocols are followed. With the management being pro-change, a change agent should present the EBP project proposal and explain how it will enhance outcomes. Next, the change agent should work closely with the management to search for the resources necessary to implement the change fully. In this case, nurses’ training and progressive evaluation should be done collaboratively with the management. The management provides several appointees depending on the type and scope of the project to serve as members of the project team. They also monitor how the change process occurs to ensure that all procedures are correct and subjects are not harmed.
Time Needed to Complete the Project
The entire process should take a maximum of six months. The first month should be about preparation for change. Nuño-Solinís (2018) postulated that change readiness depicts a scenario where health care organizations can initiate and respond to change with minimal risk and in a way that creates advantage and sustains excellent performance. Here, the change agent alongside the management should share the vision for change with the nurses. Preparation for change is necessary to ensure that the health care staff understands the type of change coming and its reasons (Miake-Lye et al., 2020). Doing so is vital to minimize resistance to change and achieve the desired goals within the projected timelines.
The second month involves searching for resources necessary to implement the EBP project. Human, material, and required financial resources should all be available by the end of the second month. The training should occur in the third month. As the training takes place, all questions about the training and its implications should be answered at this stage. The main activity in the fourth month should be a detailed assessment of how nurses react to change and whether some improvements are necessary. If differently stated, it is the piloting stage before adopting the new practice in the fifth month. The last month should be for compiling a report and disseminating information for use in other practice settings. Dissemination spreads knowledge about EBP interventions on a wide scale (Derman & Jaeger, 2018). Its primary aim is to ensure that other health care organizations and providers have a reference when faced with a similar problem.
Resources Needed in the Implementation
The project requires nurse educators as change promoters, trainers on mindfulness mediation, and management as a partner. Professional assessment of the progress also requires human facilitation (external) to avoid bias. Financial resources are also required to purchase training materials, payment for the training venue, and payment for facilitators. Communication, refreshments, and training miscellaneous expenses also require some budgetary allocation. Some materials such as projectors can also be hired instead of purchasing. Generally, human and financial resources are the most needed to make the project a success.
Methods and Instruments
EBP projects require close monitoring to track and assess the outcomes of the proposed interventions. A monitoring plan represents a living document that should be updated regularly as the project’s implementation progresses. Questionnaires will be used to measure how nurses perceive the process and whether they are ready to apply the new knowledge to enable them to work more productively. Activity logs are also necessary, and data will be collected through attendance sheets. The other vital instrument is track indicators which will compare the project’s progress against the set timeline weekly. Track indicators will rate the project against expectations to determine whether any adjustments are required at some point.
The Process of Delivering the Solution
The required solution will be delivered via mindfulness meditation training of nurses. In this training, nurses will be shown how to focus on being intensely aware of what they are experiencing (sensing and feeling) at the moment without interpreting or judging the situation. Kriakous et al. (2020) supported the approach as among the most effective to enable nurses to provide diligent care amid stressful situations such as overwhelming work burden and poor shift rotation. Some of the strategies to be taught include guided imagery and breathing methods that relax the nurse’s body and mind and improve concentration (Gilmartin et al., 2017). The primary aim is to ensure that nurses are more informed about stress reduction in highly demanding situations.
Many benefits are associated with mindfulness meditation training of nurses. Firstly, mindfulness meditation helps nurses engage in peaceful balance and self-care by strengthening the brain region responsible for attention (New Jersey State Nurses Association, 2021). It also improves coping skills, relationships, self-understanding, and relaxation. According to Zeller et al. (2021), mindfulness meditation is associated with high clinical performance and excellent listening skills among nurses. Accordingly, the training is critical for creating an empowered workforce that can cope with stress, understands issues, avoids reacting, and has high resilience levels (Lin et al., 2019). The impacts are profound and justified.
The Data Collection Plan
EBP projects’ implementation should be data-centered. There should be data to evaluate whether the project’s outcomes achieve the desired outcomes. Data should be collected at every phase as described in the timeline. It should be both manual and automated as situations obligate and to enhance safety. The project manager will work alongside data analyst to manage and maintain the data. Electronic data will be stored in password protected devices and only availed when authorized by the project manager. Data analysis will be primary comparing what has been achieved against the set timelines. It will also involve an in-depth analysis of nurses’ overall behavior change against the set objectives. The difference in what is achieved compared to the expectation will inform whether the process is a success or not.
Dealing with Barriers, Facilitators, and Challenges
EBP projects are not immune to barriers and implementation challenges. Lack of resources, resistance to change, and the organizational culture are common barriers to change (Tappen et al., 2017). In the current project, potential barriers and challenges include different literacy levels among nurses, resistance to change, and abandoning of the project by the nurses. Facilitation will be managed by looking for expert trainers at a cost. The barriers and challenges can be addressed and effectively managed by creating awareness, open communication, and active engagement of nurses. The basic assumption is that the project will lead to positive outcomes.
Feasibility of the Implementation Plan
Generally, the implementation requires substantial financial services, but its overall impact makes it cost-effective. Personnel, consumable supplies, equipment to facilitate training would cost up to $7,700. Computer-related costs to support data access, data management, and communication would cost up to $1,500. Other costs such as travel, presentation, remuneration, and miscellaneous expenses would go up to $4,500. Each resource is needed to make the training effective and achieve the desired effects.
Maintaining, Extending, Revising, and Discontinuing the Training
The training will improve patient health outcomes by ensuring that nurses are physically and mentally ready to provide health care services. After implementation, progressive evaluation is necessary every three months. If nurses’ capacity to work improves, the training program should be maintained and extended to other workforces, such as new nurses joining the organization. Progressive evaluation should also guide revisions if some areas need improvement or other methods to facilitate mindfulness meditation emerge and should be included. Discontinuation is justified if there is no significant difference between the trained and untrained nurses or there are no resources to facilitate continuous training.
Conclusion
Nurses are centrally involved in health care provision, and it is vital to ensure that they offer the best care possible. EBP projects play a critical role in enhancing patient health outcomes. Training on mindfulness meditation is expected to improve overall attention, empathy, and presence of nurses with patients and their families, thus, improving patient outcomes. It will consume a substantial cost, but its implementation can be justified by improving nurses’ preparedness to address patient problems.
References
Dall’Ora, C., Ball, J., Reinius, M., & Griffiths, P. (2020). Burnout in nursing: a theoretical review. Human Resources for Health, 18, 1-17. https://doi.org/10.1186/s12960-020-00469-9
Derman, R. J., & Jaeger, F. J. (2018). Overcoming challenges to dissemination and implementation of research findings in under-resourced countries. Reproductive Health, 15(1), 121-126. doi: 10.1186/s12978-018-0538-z
Gilmartin, H., Goyal, A., Hamati, M. C., Mann, J., Saint, S., & Chopra, V. (2017). Brief mindfulness practices for healthcare providers–a systematic literature review. The American Journal of Medicine, 130(10), 1219-e1. http://dx.doi.org/10.1016/j.amjmed.2017.05.041
Kriakous, S. A., Elliott, K. A., Lamers, C., & Owen, R. (2020). The Effectiveness of Mindfulness-Based Stress Reduction on the Psychological Functioning of Healthcare Professionals: a Systematic Review. Mindfulness, 1–28. Advance online publication. https://doi.org/10.1007/s12671-020-01500-9
Lin, L., He, G., Yan, J., Gu, C., &Xie, J. (2019). The effects of a modified mindfulness-based stress reduction program for nurses: A randomized controlled trial. Workplace Health & Safety, 67(3), 111-122. doi: 10.1177/2165079918801633
Miake-Lye, I. M., Delevan, D. M., Ganz, D. A., Mittman, B. S., & Finley, E. P. (2020). Unpacking organizational readiness for change: an updated systematic review and content analysis of assessments. BMC Health Services Research, 20(1), 1-13. https://doi.org/10.1186/s12913-020-4926-z
New Jersey State Nurses Association. (2021). Mindfulness: Meditation. Retrieved from https://njsna.org/mindfulness-meditation/
Nuño-Solinís, R. (2018). Are Healthcare Organizations Ready for Change? Comment on “Development and Content Validation of a Transcultural Instrument to Assess Organizational Readiness for Knowledge Translation in Healthcare Organizations: The OR4KT”. International Journal of Health Policy and Management, 7(12), 1158–1160. https://doi.org/10.15171/ijhpm.2018.95
Tappen, R. M., Wolf, D. G., Rahemi, Z., Engstrom, G., Rojido, C., Shutes, J. M., & Ouslander, J. G. (2017). Barriers and Facilitators to Implementing a Change Initiative in Long-Term Care Using the INTERACT® Quality Improvement Program. The Health Care Manager, 36(3), 219–230. https://doi.org/10.1097/HCM.0000000000000168
Zeller, J. M., Johnson, A. M., Hoffman, A., Hoyem, R. L., Alexander, M. B., Yudkowsky, R., & Hicks, F. D. (2021). Mindfulness Training to Improve Nurse Clinical Performance: A Pilot Study. Western Journal of Nursing Research, 43(3), 250-260. https://doi.org/10.1177/0193945920964938
Sample Answer 3 for NUR590 Evidence Based Practice Project Week 5 Assignment Evidence-Based Practice Proposal – Section E: Implementation Plan
Setting and Access
The setting for this project will occur at the author’s present place of work. The hospital acts as an academic health sciences center that is associated with local universities. In addition, the hospital possesses urban and suburban referral base and it has several in-patient units for critical and non-emergency cases. For the purposes of the project, the patients that will have been discharged from the hospital are going to be identified by codes such as demanded by the clinical modification as relates to the International Classification of Diseases (ICD-9-CM) : 491.x (bronchitis), 496.x as chronic airway obstruction that has not been classified, 490.x as unspecified bronchitis, and 492.x emphysema (Lewis, Bruton, & Donovan-Hall, 2014). The patients will be informed verbally that they will be participating in a research program that is intended to determine the effectiveness of the two interventions. Indeed, the verbal information relayed to the patients may not be necessary as most of them may not be worry about which intervention they will be receiving. Nevertheless, the personnel who will be participating in the program will require to provide their consent to the researchers. The personnel such as nurses are significant to the implementation of the project since data collection has to occur in the most accurate way possible. As such, committing to the project through signing forms will be significant.
Time Needed to Complete the Project
The project will run for 12 months from any specified period by the investigator and the health care setting. Three phases will be involved in the implementation of the project. In the first phase, education of the nursing personnel qualified for the study will occur. Assessment tools will be adopted to determine their knowledge of the management of the COPD exacerbations using both pharmacological and pulmonary rehab. After the recruitment and training of competent nurses has occurred, the investigators will now shift their focus to recruiting patients for the study. The patients were identified using the codes presented above and their readmissions monitored within 12 months. Those who were readmitted with COPD exacerbation from the discharged list were automatically enrolled to the program. The readmission preceded the interventions using both pharmacological and pulmonary rehab options while some of the less serious cases were only managed using pharmacotherapy.
Resources Needed to Complete the Project
The pulmonary rehabilitation project will require significant investment in strategies that matter. One of the most important resource will be an exercise facility within the hospital compound. Secondly, the neuromuscular electrical stimulation tools with a frequency of either 15 Hz (low frequency) or 75 Hz (high frequency) NMES will be necessary for the project (McNamara et al., 2018). The above devices will handle both critical and non-severe exacerbations. Moreover, the pulmonary rehabilitation will require respiratory muscle training. To this end, threshold or resistive muscle training devices such as Threshold™ Inspiratory Muscle Trainer and PowerBreathe will be acquired by the hospital. Further, human resources will be required for the project. Nurses and physiotherapists will be required in order for all the facets of the project to be successfully implemented.
Methods and Instruments
The project is going to adopt the use of sequential mixed methods research study model. The collection of quantitative data on COPD exacerbation readmissions will be conducted before the qualitative one. Moreover, the investigator will conduct a biostatistician to make a determination of appropriate sample size as well as provide answers to questions concerning the knowledgeability of frontline nurses and physiotherapists concerning certain pulmonary rehabilitation exercises. A shortened version of the Beeckaham et al. (2010) tool will be used to determine the knowledgeability of the personnel concerning the chosen pulmonary rehabilitation techniques. Moreover, observational survey will be used to determine the rate and incidences of COPD exacerbations and their effects on readmission rates.
Delivering the Intervention
The intervention is going to be delivered by a team of physiotherapists and nurses will be responsible for the project. The physiotherapy team will implement the pulmonary rehabilitation phase of the project. The implementation of the exercise will require specific tailored programs that only they can provide. The physiologists are going to be assessed for competence regarding the pulmonary rehabilitation program (Sundh et al., 2017). The nurses will be responsible for the pharmacotherapy section. They will also be assessed for the competence on the drugs necessary for the various COPD conditions. Moreover, the nurses will also be responsible for making observations and collecting data by looking at various parameters.
Data Collection Plan
The inclusion criteria for the study will involve patients between the ages of 30-50 years who will give a verbal consent to the investigator. The data on the identification tags will be collected upon the discharge of various patients. The collection of that data is important as it will help highlight the readmission numbers of patients with COPD exacerbation, which data will be collected as well. The collection of the readmission data will be conducted until the 11th month of the project. A Person Chi-square method will then be used to make a determination of any statistically significant reduction in the readmission rates of the patients with COPD exacerbation (Meharry, McVay, Milligan, Marshall, & Anderson, 2017). The results of the analysis from the Chi-square method will occur founded on the readmission data when both pulmonary rehabilitation and pharmacotherapy and pharmacological intervention were used. On the other hand, the Braden scale that is modified is going to be employed to gather data on the competence of both the physiotherapists and the nurses regarding their respective interventions.
Management of Barriers
The absence of research on the application of pulmonary rehabilitation techniques may affect the implementation of the project. The lack of such research has made it difficult for investigators to design pulmonary rehabilitation strategies. Therefore, in order to successfully implement the project, the Braden scale will be used to determine the physiologists with the right competence for the job (Ansari, Hosseinzadeh, Dennis, & Zwar, 2016). Financial barriers may also arise. The investigators alongside the researchers may choose to approach donors so as to ensure that adequate funding is provided.
Feasibility of the Implementation Plan
The successful implementation of the project will require additional financial backing. A gym will have to be furnished through additional costs from donors. Professionals reveal that such a gym will cost at least $30 000. Moreover, the physiologists and nurses will have to be hired specifically for the project. However, it should be generally manageable.
Plans to Maintain, Extend, Revise and Discontinue Proposed Solution
The project is going to focus in the implementation of the pulmonary rehabilitation program. To this end, a few exercises will be incorporated. The project will be assessed for effectiveness by looking at the exercises. If the exercises are effective, the project will be integrated into COPD management and extended to certain settings. However, it will be revised by introducing a few more exercises if it is partially effective. Lastly, the project will be discontinued if it does not produce desired results and if the costs become significantly higher than the projections.
References
Ansari, S., Hosseinzadeh, H., Dennis, S., & Zwar, N. A. (2016). Activating primary care COPD patients with multi-morbidity (APCOM) pilot project.
Lewis, A., Bruton, A., & Donovan-Hall, M. (2014). Uncertainty prior to pulmonary rehabilitation in primary care: A phenomenological qualitative study in patients with chronic obstructive pulmonary disease. Chronic respiratory disease, 11(3), 173-180.
McNamara, R. J., Spencer, L., Dale, M., Leung, W. M., & McKeough, Z. M. (2018). Alternative exercise and breathing interventions in COPD: a critical review. EMJ Respiratory, 6(1), 117-127.
Meharry, R., McVay, G., Milligan, M., Marshall, S., & Anderson, D. (2017). A pilot project to improve pulmonary rehabilitation adherence and outcomes in the COPD population: Glasgow City’s Community Respiratory Team.
Sundh, J., Lindgren, H., Hasselgren, M., Montgomery, S., Janson, C., Ställberg, B., & Lisspers, K. (2017). Pulmonary rehabilitation in COPD–available resources and utilization in Swedish primary and secondary care. International journal of chronic obstructive pulmonary disease, 12, 1695.