The collection of evidence is an activity that occurs with an endgame in mind. For example, law enforcement professionals collect evidence to support a decision to charge those accused of criminal activity. Similarly, evidence-based healthcare practitioners collect evidence to support decisions in pursuit of specific healthcare outcomes.
In this Assignment, you will identify an issue or opportunity for change within your healthcare organization and propose an idea for a change in practice supported by an EBP approach.
To Prepare:
Reflect on the four peer-reviewed articles you critically appraised in Module 4.
Reflect on your current healthcare organization and think about potential opportunities for evidence-based change.
The Assignment: (Evidence-Based Project)
Part 5: Recommending an Evidence-Based Practice Change
Create an 8- to 9-slide PowerPoint presentation in which you do the following:
Briefly describe your healthcare organization, including its culture and readiness for change. (You may opt to keep various elements of this anonymous, such as your company name.)
Describe the current problem or opportunity for change. Include in this description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general.
Propose an evidence-based idea for a change in practice using an EBP approach to decision making. Note that you may find further research needs to be conducted if sufficient evidence is not discovered.
Describe your plan for knowledge transfer of this change, including knowledge creation, dissemination, and organizational adoption and implementation.
Describe the measurable outcomes you hope to achieve with the implementation of this evidence-based change.
Be sure to provide Help write my thesis – APA citations of the supporting evidence-based peer-reviewed articles you selected to support your thinking.
Add a lessons learned section that includes the following:
A summary of the critical appraisal of the peer-reviewed articles you previously submitted
An explanation about what you learned from completing the evaluation table (1 slide)
An explanation about what you learned from completing the levels of evidence table (1 slide)
An explanation about what you learned from completing the outcomes synthesis table (1 slide)
Part 5: Recommending an Evidence-Based Practice Change
Create an 8- to 9-slide PowerPoint presentation in which you do the following:
· Briefly describe your healthcare organization, including its culture and readiness for change.
· Describe the current problem or opportunity for change. Include in this description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general.
· Propose an evidence-based idea for a change in practice using an evidence-based practice approach to decision making. Note that you may find further research needs to be conducted if sufficient evidence is not discovered.
· Describe your plan for knowledge transfer of this change, including knowledge creation, dissemination, and organizational adoption and implementation.
· Describe the measurable outcomes you hope to achieve with the implementation of this evidence-based change.
· Be sure to provide Help write my thesis – APA citations of the supporting evidence-based peer-reviewed articles you selected to support your thinking.
Add a lessons learned section that includes:
· A summary of the critical appraisal of the peer-reviewed articles you previously submitted.
· What did you learn from completing the evaluation table?
· What did you learn from completing the levels of evidence table?
· What did you learn from completing the outcomes synthesis table?
Written Expression and Formatting—Paragraph Development and Organization:
Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.
Written Expression and Formatting—English Writing Standards:
Correct grammar, mechanics, and proper punctuation.
Written Expression and Formatting—The paper follows correct format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.
Recommending an Evidence-Based Practice Change
The health organization is ready for change since it has adopted other changes in the past successfully. It has developed a culture of adopting changes seamlessly without major problems. The readiness for change is determined by the healthcare providers who understand that a change is necessary. The nurses have experienced challenges while dealing with the current problem and they have resolved that a change is necessary (Haque, TitiAmayah & Liu, 2016). In a recent evaluation of the state of healthcare in the facility, the nurses indicated that a change was needed. The senior management also supports the initiative as an urgent issue. The management is ready to fund all the changes requires to enhance patient care and reduce the cost of treatment. Additionally, the nurses plus the management are ready for the implications of an overhaul despite its implications.
The current problem involves an increased rate of patient falls in adult units beyond 30 falls per 1,000 patients. The patient falls result in injury, bruises, and bone fracture. The falls are as a result of patients walking out of their beds without any assistance. The stakeholders include nurses and elderly patients. The falls have reduced patient satisfaction, increased treatment cost, and lengthened patient stay (Benzer, Charns, Hamdan & Afable, 2017). It is important to note that Medicare does not reimburse the cost incurred in treating inpatient falls. Therefore, the organization is forced to take care of the extra medical cost due to patient falls. One of the risks to change implementation is resistance to change. There is a possibility that some nurses or some members of the top management may be opposed to the change since it will call for extra duties to be allocated. However, change management can be carried out by minimizing the risks.
The evidence-based solution to patient falls is to identify high-risk patients. The high-risk patients include the elderly patients who are 65 years and beyond. They also comprise of patients who have a tendency of walking out of their beds without asking for assistance yet they are weak. High-Risk patients will be provided with companions or designated nurses. The patients will be asked to always use their companions when they want to walk out of their beds. The companions will include nurses will be on standby to help them walk around. Training the patients to use bed alarms if they need help is necessary (Haque, TitiAmayah & Liu, 2016). The bed alarms should also be positioned strategically to ensure the patients can easily use them. It is also necessary to carry out regular rounds to assess high-risk patients. The regular rounds should be carried out during the day and at night to establish if all patients are fine and whether anyone needs help.
The knowledge transfer plan will comprise of developing formal documents that will be used during the training. The formal documents will be developed by an outsourced consultant or the retirees who have experience in knowledge transfer. The plan will involve creating manual documents and sharing the documents on various platforms to ensure easy accessibility by the nurses (Narayanamurthy, Gurumurthy, Subramanian & Moser, 2018). The next step is creating training platforms to disseminate knowledge. The platforms will involve workshops where nurses will be trained. The training will also extend beyond the workshop to incorporate cross-training. It involves peer training to ensure the information is well-spread across the organization. The last step is applying the knowledge and assessing the effectiveness in implementation. The assessment will indicate if the nurses have complied with the lessons learned or whether extra training is needed.
The focus of the evidence-based change is to generate measurable outcomes in the healthcare organization. One of the major measurable outcomes is to reduce the number of patient falls. The reduction will be carried out by identifying the high-risk patients and attending to them when need be. When the falls reduce, the cost of treating injuries, bruises and fractures will also reduce. Another outcome is that patient satisfaction will increase (Bank et al., 2017). Families will also develop the confidence to bring their patients to the facility. The nurses will also keep a close eye on the high-risk patients by carrying out regular rounds. The regular rounds will result in helping patients to walk around. The measurable outcomes will show the effectiveness of the knowledge transfer plan and the evidence-based solution.
The critical appraisal process involved filling an evaluation table. I learned that the design of research affects the application to practical settings. For example, systematic reviews involve analyzing current research (Aslam & Emmanuel, 2010). The analysis was essential since it presented all the available evidence thus presenting current and best solutions to medical problems. Additionally, systematic reviews were highly preferred since they had no bias compared to other studies that used a single hospital or a specific number of patients. I also learned that risks associated with implementing research findings can limit the general worth of a study. If a study is not comprehensive, it will limit the effectiveness and applicability to practical healthcare settings.
The evidence table presented different levels of evidence. I learned that there are different levels of evidence that determine the general worth of a study. For example, the systematic review had the highest evidence level since it was comprehensive and low levels of bias. The evidence table focused on the applicability of a study to the practical healthcare settings (Aslam & Emmanuel, 2010). The sample size used in a study affects the application to general practice. If the sample size is small, there is a need to carry out further study to analyze a situation further. I also learned that evidence level I is the most preferred in the application of a study to practical settings. It involved a systematic review of the current research to present the best and current evidence of practical healthcare issues.
The synthesis table presented the sample size used in a study, the outcome, key findings and quality of a study. I learned that the quality of a study depends on the design and the applicability to practical settings (Aslam & Emmanuel, 2010). For example, a systematic review design was preferred compared to cross-sectional correlational design. I also learned that the number of patient or characteristics analyzed in the study affect the quality. If the sample size was small, it would determine if the study findings could be used in practical settings. If the study has various limitations, it can propose the need for more studies to be carried out to reveal more information. Additionally, the general worth of a study was based on the research design, the sample size and the outcome of the research.
References
Benzer, J. K., Charns, M. P., Hamdan, S., & Afable, M. (2017). The role of organizational structure in readiness for change: A conceptual integration. Health services management research, 30(1), 34-46. https://doi.org/10.1177/0951484816682396
Aslam, S., & Emmanuel, P. (2010). Formulating a researchable question: A critical step for facilitating good clinical research. Indian Journal of Sexually Transmitted Diseases and AIDS, 31(1), 47. doi:10.4103/0253718469003
Bank, L., Jippes, M., Leppink, J., Scherpbier, A. J., den Rooyen, C., van Luijk, S. J., & Scheele, F. (2017). Are they ready? Organizational readiness for change among clinical teaching teams. Advances in medical education and practice, 8, 807. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5733925/
Narayanamurthy, G., Gurumurthy, A., Subramanian, N., & Moser, R. (2018). Assessing the readiness to implement lean in healthcare institutions–A case study. International journal of production economics, 197, 123-142. https://doi.org/10.1016/j.ijpe.2017.12.028
Haque, M. D., TitiAmayah, A., & Liu, L. (2016). The role of vision in organizational readiness for change and growth. Leadership & Organization Development Journal, 37(7), 983-999. https://www.emerald.com/insight/content/doi/10.1108/LODJ-01-2015-0003/full/html
