Evidence-Based Practice Implementation Project
Sample Answer for Evidence-Based Practice Implementation Project Included After Question
Assessment Description
In 1,250-1,500 words, discuss the implementation plan for your evidence-based practice project proposal. When required, create the appropriate form, table, image, or graph to fully illustrate that aspect of the intervention plan and include them in an appendix of your paper. You will use the implementation plan, including the associated documents in your appendices, in the Topic 8 assignment, during which you will synthesize the various aspects of your project into a final paper detailing your evidence-based practice project proposal.
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. Include a draft of the form as an appendix at the end of your paper.
- Create a timeline. Make sure the timeline is general enough that it can be implemented at any date. Based on the timeline you created, describe the amount of time needed to complete this project. Include a draft of the timeline as an appendix at the end of your paper.
- Develop a budget and resource list. Consider the clinical tools or process changes that would need to take place. Based on the budget and resource list you developed: (a) describe the resources (human, fiscal, and other) or changes needed in the implementation of the solution; (b) outline 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). Include a draft of the budget and resource list as an appendix at the end of your paper.
- Explain whether you would select a qualitative or quantitative design to collect data and evaluate the effectiveness of your evidence-based practice project proposal. Provide rationale to support your selection.
- Describe the methods and instruments (questionnaire, scale, or test) to be used for monitoring the implementation of the proposed solution. Include the method or instrument as an appendix at the end of your paper.
- Explain the process for delivering the intervention and indicate if any training will be needed.
- Discuss the stakeholders that are needed to implement the plan.
- Consider all of the aspects of your implementation plan and discuss potential barriers or challenges to the plan. Propose strategies for overcoming these.
- Establish the feasibility of the implementation plan.
Refer to the “Evidence-Based Practice Project Proposal – Assignment Overview” document for an overview of the evidence-based practice project proposal assignments.
You are required to cite a minimum of five peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.
Complete the “APA Writing Checklist” to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as an appendix at the end of your paper.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.
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. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
A Sample Answer For the Assignment: Evidence-Based Practice Implementation Project
Title: Evidence-Based Practice Implementation Project
Cardiovascular diseases are among the leading health challenges in the US. However, African Americans are disproportionately affected as they exhibit higher rates of morbidity and mortality than other ethnics groups. Hypertension, obesity, chronic kidney disease, and diabetes are prevalent among this population, which predispose them to heart failure. Besides, other factors such as genetic polymorphisms, neurohormonal imbalances, and socioeconomic factors also contribute to heart failure. However, despite the advancements in the management and treatment of heart failure, there seems to be inconsistency in response among the African Americans compared to other ethnic groups. It is against the backdrop of this discordance in the response to treatment and management of heart failure between African Americans and other ethnic groups that prompted this evidence-based project to determine effectiveness of the use community health workers in controlling and managing heart failure among African Americans. The outcome of the study will used to guide the development of heart failure control and management programs targeted to the African Americans.
The realization of successful EBP depends on the organizational readiness and ability to figure out facilitators and barriers to the EBP implementation (Park & Jang, 2016). Therefore, the current organization used Organization Culture & Readiness for System-Wide Integration of Evidence-based Practice Survey as tool to determine the organizational readiness for EBP. The outcome indicated that the organization was ready to adopt EBP.
Project Barriers and Facilitators
The major barriers reported included shortage of human resources resulting into heavy workload for the existing providers, hence, they lack tome to review the resources. Besides, there was inadequate access to resourceful library with nursing journals (Sadeghi‐Bazargani, Tabrizi&Azami‐Aghdash, 2014). The facilitators reported included the evidence that EBP is associated with practical issues such as cost effectiveness, ease of use, and time saving. Besides, the flexibility, ownership, and the autonomy of the innovation were also a critical facilitator.
The High Scores and Low Scores
The survey tool was equipped with 19 categories and the organization recorded high scores in seven of the categories that related to healthcare providers’ and the management commitment to utilization of the EBP. On the other hand, the low scores were reported in six categories that related to lack of resources. These included human resources such as nurses and librarian, financial resources, and fully equipped library with enough and updated journals.
Integration of Clinical Inquiry
To strengthen the organizational weak areas in EBP implementation, training programs will be conducted. The organizational will also conduct investigations on perceived weak areas and determine the best intervention to address such areas. A collaborative approach of implementation will be adopted to facilitate the dissemination of the EBP.
Section B: Proposal/Problem Statement and Literature Review
Heart failure is one of the leading causes of the death globally. However, the incidences of heart failure are widespread among African Americans. It is against this backdrop that the PICOT statement in this paper is concerned with heart failure amongst African American adults and how to the use of community health workers based group education results in better control and management of the disease. According to Sharma, Colvin-Adams andYancy (2014), African Americans are affected disproportionately by heart failure compared to other racial groups, with high incidences at an early age. Moreover, it is attributed that the prevalence of heart failure in people below the age of 50 years is twenty-fold higher among African Americans than the white counterparts (Devereaux, 2019).
Intrinsically, the higher prevalence of heart failure among African Americans is due to myriad modifiable risk factors such hypertension, obesity, diabetes, and chronic kidney disease. However, Sharma, Colvin-Adams andYancy (2014) contend that hypertension is the major contributor of the condition in African American population. The study maintains that the prevalence of hypertension in African Americans is among the leading internationally and since this population is highly unlikely to exercise effective hypertension control, they are likely to suffer heart disease. Worse yet, African Americans remain at higher risk of contracting heart failure even after adjusting risk factors. Moreover, other factors that influence African Americans to heart failure include chronic kidney disease and high-density lipoproteins. However, despite the high incidences of heart failure in African Americans, the population-wide decline in heart failure and mortality remain unequal in this population. On the other side, the burden of heart failure in African American population remains high and is the major cause of differences in life expectancy between African Americans and other racial groups (Savarese& Lund, 2017). Besides, victims of heart failure who have poor self-care behaviors tend to be hospitalized or visit the ED more frequently than those trained on how to manage their condition at home. It is against this increased challenge of heart failure among African American population that this study sought to propose the use of community health workers based group education results in better control and management of the disease.
In a bid to support the PICOT statement, this study conducted an extensive literature review from several peer-reviewed journal articles. The method of finding the journal articles included relying specifically on articles that focus on heart failure among African Americans. Besides, the other criteria included selecting studies that focused on factors that predispose African Americans at risk of heart failure. Additionally, the focus was also on articles that examined the impact of community health workers in improving the health outcomes of patients with heart failure and in the management of cardiovascular diseases.
Essentially, the key findings in the articles reviewed include the revelation that African Americans are at higher risk of developing heart failure. Moreover, the studies also indicated that predisposing factors included obesity, hypertension, diabetes, poor self-care habits, and chronic kidney disease. Further, heart failure is associated with high incidences of hospitalizations and frequent visits to the Emergency Department. Importantly, the findings also reveal that community health workers have had a significant impact on improving the health outcomes of people with heart failure by helping patients manage their condition at home and providing health education. Regarding limitations, each study recorded different limitations ranging from failure to design studies to be generalizable to the population, inadequate competent community health workers, restricting participation to African Americans with heart failure, and failure by eligible patients to participate in the study.
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Evidence-Based Practice Implementation Project Conclusion
There is a consensus among studies reviewed that African Americans are affected most by the heart failure and are equally more predisposed to heart diseases than other racial groups. Therefore, it is important to implement various interventions that can address the condition such as the use community health workers based group education to enable African Americans to improve the quality of their lives.
Section C- Proposed Solution
The provision of patient-centered care is critical in promoting quality in healthcare. Patient-centeredness ensures that the patients are empowered to take responsibility for their healthcare needs. Patient-centeredness can be achieved with the use of care models that incorporate community health workers in the process. Evidence has shown that community health workers promote the provision of continuous care that improve the management of diseases affecting a population. Therefore, this research paper explores the use of community health workers in promoting the control and management of heart failure in patients from African American backgrounds.
Proposed Solution
The proposed solution for this project is the use of community health workers to improve the control and management of heart failure among African American patients. Community health workers are important in facilitating the effective management of chronic conditions, including heart failure. The effectiveness in the care they provide is attributed to the close contact they have with the patients in the community settings. According to a research by Barber et al.(2015), the community health workers are important in facilitating continuity in the provision of care. The continuity in care reduces the risk of adverse outcomes in the care process and readmission rates among the patients at risk (Barberet al., 2015). Allen et al. (2016) also identified that community health workers are important in facilitating the provision of transitional care in the community settings. They strengthen the adoption of behavioral and lifestyle interventions that increase patient adherence and empowerment in the care process. According to a research by Newman et al. (2018), community health workers are effective in promoting the management and control of conditions such as heart failure since they understand the barriers to care and ways of addressing them. They are in direct contact with patients upon discharge, hence, their ability to promote the creation of social support groups that will facilitate the management of the disease (Newmanet al., 2018).
The proposed intervention is consistent with evidence-based practice since it focuses on the promotion of continuity of care. It emphasizes the provision of high quality care that extends beyond the clinical settings. It also focuses on the patient-centeredness in care provision and promotion of patient safety. These aspects are the basis of evidence-based practice, hence, its promotion by the intervention. The intervention is realistic in the organization since it uses community health workers as vital workforce to promote continuity of care. It also supports the provision of patient-centered care that extend beyond the hospital setting. The staffs in the organization work in collaboration with the community health workers in management of cases. Therefore, it makes the intervention applicable to the organization.
Organizational Culture
The proposed solution is consistent with the culture of our organization. Firstly, there is the use of active collaboration in the provision of care. The use the proposed intervention relies mainly on the use of collaboration in the provision of supportive care to patients with heart failure. The organization also supports interventions that would result in evidence-based practice. This is attributed to the fact that evidence-based practice contribute to outcomes that include quality, safe, efficient, and cost-effective care (Johnson &Rossow, 2018). The proposed intervention aims at promoting evidence-based practice, hence, alignment with the organizational culture. Lastly, there is an increased focus on the provision of patient-centered care to the patients in the organization. This extends to ensuring that their needs are met after their discharge from the hospital. Therefore, there is alignment with the organization’s culture since the intervention supports provision of patient-centered care.
Expected Outcomes
One of the expected outcomes is promoting effective management of heart failure among African American patients with heart failure. This outcome will be achieved with the adoption of interventions that increase their adherence to medications and lifestyle changes by the patients. The second expected outcome is that the intervention will result in better control of the symptoms of heart failure. Lastly, it is expected that the intervention will result in the reduction of mortalities associated with heart failure in the population.
Method to achieve Outcomes
The intervention will be administered to the African American patients post-discharge to the community settings. The community health workers will be used as agents to promote change where they will educate these patients on the needed lifestyle and behavioral modifications. They will also follow them up to determine whether they are adhering to the prescribed interventions for their optimum health. The intervention will be administered for ten months after which data will be obtained to determine its effectiveness. One of the barriers that might be experienced is the community health workers not being interested on the intervention. The other one will be the participants pulling out from the intervention. These barriers will be addressed through the use of active participation, education, and communicating the importance of the intervention to the involved stakeholders. It is assumed that the intervention will result in positive outcome. It is also assumed that the participants will be willing to take part in the intervention.
Outcome Impact
The intervention will result in the improvement in the quality of care offered to the patients with heart failure. It will result in the provision of continuous, patient-centered care, hence, improvement in quality of care. It will also result in improvement in the efficiency of processes. It will strengthen the collaboration between the hospital staffs and community health workers in the provision of patient care. This will reduce the resources used such as time and finances that are incurred in performing follow-up to the patients (Johnson &Rossow, 2018).
Section D: Change Model to Apply to the EBP Project
The Trans-theoretical Model of behavioral changewhich was established in 1970s by Prochaska and DiClementewill be used in this project. This model details how people make decisions for behavior change. The presumption in this model is that behavioral change is a slow and continuous process through improvement in behaviors(Haghiet al, 2018). Essentially, the clinical issue in this project relates to heart failure among African American adults and how community health workers (CHWs) can control and manage the condition. In turn, this model is relevant to the topic because it acknowledges that change occurs in an orderly manner and not radically. For change to be effective, the staffs, especially CHWs must first be made aware of the need for change, applicable behaviors they need to acquire, and how to maintain the needed change. As such, this model is effective because it exhausts all possible stages of change, which ultimately ensures behavioral change.
Stages of Change in the Model
According Abdi, Eftekhar, Mahmoodi, Shojaeizade & Sadeghi (2015), this model has several steps includingprecontemplation, contemplation, preparation, action, maintenance, and termination, which are detailed below
Precontemplation
This is the first stage. It assumes that affected people are yet to establish intentions to embrace change in the near future. They do not consider their behaviors as problematic and so, they underrate the need for behavioral change.
Contemplation
At this second stage, people begin to portray the intention for behavior change in the near future. They are already aware that their behavior is problematic and marred by adverse outcomes on others. However, they are still reluctant in changing their behavior.
Preparation
This is the third stage in the model where people are ready to embrace behavioral change and begin to seek steps to realize the desired change.
Action
This is the fourth stage which is characterized by sustenance of behavior change by the people who recently embraced the change. They adjust their behavior to ensure they embrace change and enhance their new behaviors.
Maintenance
This is the fifth stage which is characterized by effort by those who have adopted change to continue with new behaviors. They strive to implement relevant intervention to prevent relapse.
Termination
This the last stage in the model. It is characterized by unwillingness of people to embrace their old behaviors. The relapse is entirely ruled out at this stage and the people are willing to seek more ways to achieve the benefits of the new behavior change.
Application of these Stages on Project Implementation
Precontemplation Stage
Here, CHWs have no intention to take action to control and manage heart failure among African American adults. They do not acknowledge that heart failure may cause adverse outcomes on the survival of African Americans.
Contemplation Stage
Here, CHWs starts to acknowledge the essence of examining survival rate African American adults with heart disease and taking initiative to manage and control the condition. They contemplate engaging in research on this area in the near future (Hayden, 2019). However, they are still hesitating for change.
Preparation Stage
The CHWs are ready to engage in research to find out how to control and manage heart failure. They initiate actions including critical evaluation of studies on the heart failure among African American adults.
Action Stage
At this stage, CHWs keep exploring the issue through further research.
Maintenance Stage
CHWs are willing to focus on future researches on the issue to enhance its applicability in the clinical practice. CHWs execute their research findings in the clinical practice and delve on their effectiveness routinely(Hayden, 2019).
Termination Stage
This stage is implementation of research findings in clinical practice by the CHWs and also maintaining the culture of EBP in caring from African American adults with heart failure.
Section E: Implementation Plan
Description of the Methods to be used to Implement the Proposed Solution
The Setting and Access Potential Subjects
This evidence-based project will be conducted among African American adults with heart failure in different community settings within the United States. The program will be implemented by the community health workers (CHWs) through group-based education interventions to ensure better control of and management of heart failure among African American adults. The potential study subjects will be reached through different techniques such as door-to-door visitation by the CHWs, using snowball by informing community members about the characters required for the intervention, requesting from different health facilities to refer patients with required characteristics, asking the patients who have been identified to refer other patients, and using the feedback from surveys to identify the potential subjects.
Amount of Time Needed for the Project
Fundamentally, the burden of heart diseases is severe and requires patients to take more tasks for their self-management. Therefore, there is need to provide proper time for patient education, which is a crucial intervention for managing heart failure. This project supports the provision of an effective supportive-educational intervention to promote self-care behaviors among African American adults with heart failure. As such, setting ample time for patient education can help in effective management of the condition and prevention of the aggravation of the disease. Although group education will be offered for the patients, a consideration will also be taken to ensure individualized educational interventions that not only offer support but also consider needed cultural aspects. Consequently, at least eight weeks will be required to complete this project.
Throughout this course, you have developed a formal, evidence-based practice proposal.
The proposal is the plan for an evidence-based practice project designed to address a problem, issue, or concern in the professional work setting. Although several types of evidence can be used to support a proposed solution, a sufficient and compelling base of support from valid research studies is required as the major component of that evidence. Proposals must be submitted in a format suitable for obtaining formal approval in the work setting. Proposals will vary in length depending upon the problem or issue addressed (3,500 and 5,000 words). The cover sheet, abstract, references pages, and appendices are not included in the word count.
Section headings for each section component are required. Evaluation of the proposal in all sections will be based upon the extent to which the depth of content reflects graduate-level critical thinking skills.
This project contains seven formal sections:
1.Section A: Organizational Culture and Readiness Assessment
2.Section B: Proposal/Problem Statement and Literature Review
3.Section C: Solution Description
4.Section D: Change Model
5.Section E: Implementation Plan
6.Section F: Evaluation of Process
Each section (A-F) will be submitted as a separate assignment in Topics 1-6 so your instructor can provide feedback (refer to applicable topics for complete descriptions of each section).
The final paper submission in Topic 7 will consist of the completed project (with revisions to all sections), title page, abstract, compiled references list, and appendices. Appendices will include a conceptual model for the project, handouts, data and evaluation collection tools, a budget, a timeline, resource lists, and approval forms, as previously assigned in individual section assignments.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center