NUR 590 Benchmark – Evidence-Based Practice Project Proposal Final Paper Essays
Sample Answer for NUR 590 Benchmark – Evidence-Based Practice Project Proposal Final Paper Essays Included After Question
NUR 590 Benchmark – Evidence-Based Practice Project Proposal Final Paper Essays
Assessment Description
For this assignment, you will synthesize the independent evidence-based practice project proposal assignments from NUR-550 and NUR-590 into a 4,500-5,000-word professional paper.
Final Paper
The final paper should:
- Incorporate all necessary revisions and corrections suggested by your instructors.
- Synthesize the different elements of the overall project into one paper. The synthesis should reflect the main concepts for each section, connect ideas or overreaching concepts, and be rewritten to include the critical aspects (do not copy and paste the assignments).
- Contain supporting research for the evidence-based practice project proposal.
Main Body of the Paper
The main body of your paper should include the following sections:
- Problem Statement
- Organizational Culture and Readiness
- Literature Review
- Change Model, or Framework
- Implementation Plan
- Evaluation Plan
Appendices
The appendices at the end of your paper should include the following:
- All final changes or revisions for the drafts that will be included in the appendices of your paper.
- 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 the final appendix at the end of your paper. In each preceding course you have been directed to the Student Success Center for assistance with APA style, and have submitted the APA Writing Checklist to help illustrate your adherence to APA style. This final paper should demonstrate a clear ability to communicate your project in a professional and accurately formatted paper using APA style.
General Requirements
You are required to cite 10-12 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.
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.
Benchmark Information
This benchmark assignment assesses the following programmatic competencies:
MBA-MSN; MSN-Nursing Education; MSN Acute Care Nurse Practitioner-Adult-Gerontology; MSN Family Nurse Practitioner; MSN-Health Informatics; MSN-Health Care Quality and Patient Safety; MSN-Leadership in Health Care Systems; MSN-Public Health Nursing
1.1: Translate research and knowledge gained from practice, while adhering to ethical research standards, to improve patient outcomes and clinical practice.
5.1: Design ethically sound, evidence-based solutions to complex health care issues related to individuals, populations, and systems of care.
Assessment Description
For professional writing in nursing and health care, APA style is expected. It is also expected for the remainder of your graduate program and in doctoral programs for nursing. Discuss what you have learned, or how you have improved, by completing the “APA Writing Checklist” and from receiving feedback from your instructors. What aspects of APA do you still struggle with? In your response to peers, provide a resource from the Student Success Center (or in addition to something in the Student Success Center) or a suggestion for an area in which someone still struggles
Assessment Description
The evidence-based practice (EBP) process is a powerful way of advancing improvements in health care. Identify three strategies that you will now incorporate into your practice based on this course. Explain your rationale.
Resources
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Translating Evidence Into Practice: How Advanced Practice RNs Can Guide Nurses in Challenging Established Practice to Arrive at Best Practice
Read “Translating Evidence Into Practice: How Advanced Practice RNs Can Guide Nurses in Challenging Established Practice to Arrive at
… Read More
https://lopes.idm.oclc.org/login?url=http://ovidsp.ovid.com.lopes.idm.oclc.org/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00000703-201711000-00004&LSLINK=80&D=ovft
Evidence-Based Practice in Nursing and Healthcare: A Guide to Best Practice
Read “Making Connections: An EBP Exemplar” in Unit 6 in Evidence-Based Practice in Nursing and Healthcare: A Guide t
… Read More
View Resource
Advanced Nursing Research: From Theory to Practice
Read Chapter 25 in Advanced Nursing Research: From Theory to Practice.
View Resource
Translating Evidence Into Practice Through Knowledge Implementation
Read “Translating Evidence Into Practice Through Knowledge Implementation,” by Campione, Wampler-Kuhn, and Fisher, from Rehab
… Read More
Benchmark – Evidence-Based Practice Project Proposal Final Paper – Rubric
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Synthesis
12 points
Criteria Description
Synthesis Paragraphs are logically sequenced, connect ideas or overreaching concepts, and are rewritten to present a fluid and cohesive paper.
-
5: Excellent
12 points
Synthesis is excellent. The paper organizes paragraphs in a logical sequence and connects ideas or overreaching concepts. The paper is well-developed, fluid, and cohesive.
-
4: Good
11.04 points
Synthesis is evident. The paper organizes paragraphs in a logical sequence and connects ideas or overreaching concepts. Overall, the paper applies transitions and the paper is fluid and cohesive.
-
3: Satisfactory
10.56 points
Synthesis is generally evident. The paper organizes most paragraphs in a logical sequence and generally connects ideas or overreaching concepts. Some paragraphs require better transitions to create a fluid and cohesive paper.
-
2: Less Than Satisfactory
9.6 points
Synthesis is sporadic. Overall, the paper fails to organize paragraphs in a logical sequence and connect ideas or overreaching concepts in a fluid and cohesive paper.
-
1: Unsatisfactory
0 points
Synthesis is not evident. The paper consists of a cut-and-paste of the previous assignments. Revision based on instructor feedback is not included.
Organizational Culture and Readiness
10.5 points
Criteria Description
Organizational Culture and Readiness Culture, degree of readiness, challenges to implementation, strategies for implementation, stakeholder involvement, communication strategies.
-
5: Excellent
10.5 points
The organizational culture and readiness are thoroughly discussed and insight into the organization challenges is presented. Clear strategies for communication, stakeholder involvement, and the implementation of the evidence-based practice project proposal are presented. Thorough explanations and strong supporting evidence are provided.
- 4: Good
9.66 points
The organizational culture and readiness are discussed and information on the organizational challenges is presented. Strategies for communication, stakeholder involvement, and the implementation of the evidence-based practice project proposal are presented. Adequate explanations and supporting evidence are provided.
- 3: Satisfactory
9.24 points
An incomplete description of the organizational culture, readiness, and some organizational challenges is presented. Strategies for the overall implementation of the evidence-based practice project proposal are incomplete.
- 2: Less Than Satisfactory
8.4 points
The organizational culture, readiness, and some organizational challenges, are summarized. General strategies for the overall implementation of the evidence-based practice project proposal is presented, but there are inaccuracies. Some additional information is needed.
- 1: Unsatisfactory
0 points
A description of the organizational culture and readiness is not included.
Problem Statement (B)
12 points
Criteria Description
Problem Statement (C5.1a)
- 5: Excellent
12 points
The problem statement is consistent throughout the paper and concisely describes the issue using strong evidence-based support to rationalize and justify the problem.
- 4: Good
11.04 points
The problem statement is consistent throughout the paper and describes the issue using evidence-based support to rationalize and justify the problem.
- 3: Satisfactory
10.56 points
The problem statement is mostly consistent throughout the paper and, in most instances, uses evidence-based support to rationalize and justify the problem.
- 2: Less Than Satisfactory
9.6 points
The problem statement is inconsistently presented throughout the paper. Evidence-based support to rationalize and justify the problem is missing in many aspects.
- 1: Unsatisfactory
0 points
The problem statement is not used throughout the paper. In general, evidence-based support to rationalize and justify the problem is not provided.
Literature Review
10.5 points
Criteria Description
Literature Review
- 5: Excellent
10.5 points
The supporting literature from the literature review is organized and synthesized strategically throughout the paper to provide convincing evidence. The main components of the articles are used to provide substantial rationale for how the research supports the PICOT.
- 4: Good
9.66 points
The supporting literature from the literature review is used throughout most of the paper to provide evidence. The articles are used to provide general rationale for how the research supports the PICOT.
-
3: Satisfactory
9.24 points
The supporting literature from the literature review is synthesized and used throughout the paper to provide evidence. The main components of the articles are used to provide rationale for how the research supports the PICOT.
-
2: Less Than Satisfactory
8.4 points
The supporting literature from the literature review is inconsistently used in the paper to provide evidence. The articles do not provide clear rationale for how the research supports the PICOT.
-
1: Unsatisfactory
0 points
Supporting literature from the literature review is not evident. Clear rationale for how the research supports the PICOT is not presented.
Change Model or Framework
10.5 points
Criteria Description
Change Model or Framework
-
5: Excellent
10.5 points
The selected model or framework and its application for the proposed implementation are thoroughly described.
-
4: Good
9.66 points
The selected model or framework and its application for the key aspects of the proposed implementation are described.
-
3: Satisfactory
9.24 points
The selected model or framework and its general application for implementation are outlined.
-
2: Less Than Satisfactory
8.4 points
The selected model or framework and its application for implementation are incomplete.
- 1: Unsatisfactory
0 points
The selected model or framework and its application for implementation are not described.
Implementation Plan (B)
10.5 points
Criteria Description
Plan includes setting/access to subjects; timeline; budget and resources; research design; methods instruments; process for delivering intervention; stakeholders; barriers and challenges. (C5.1b)
- 5: Excellent
10.5 points
The implementation plan is thoroughly described and provides the details for the various aspects. Thorough explanations and strong supporting evidence are provided.
- 4: Good
9.66 points
The implementation plan is described and provides key information for the various aspects. Adequate explanations and supporting evidence are provided.
- 3: Satisfactory
9.24 points
The implementation plan is generally described. Information for some key aspects is presented, but there are inaccuracies. Some additional information is needed.
- 2: Less Than Satisfactory
8.4 points
The implementation plan is incomplete.
- 1: Unsatisfactory
0 points
The implementation plan is not described.
Evaluation Plan
10.5 points
Criteria Description
Evaluation Plan Plan includes expected outcomes, data collection tools, statistical test, methods applied to data collection tool, strategies for nonpositive outcomes, plans for maintaining, extending, revising and discontinuing proposed solution.
-
5: Excellent
10.5 points
The evaluation plan is thoroughly described and provides the details for the various aspects. Thorough explanations and strong supporting evidence are provided.
-
4: Good
9.66 points
The evaluation plan is described and provides key information for the various aspects. Adequate explanations and supporting evidence are provided.
-
3: Satisfactory
9.24 points
The evaluation plan is generally described. Information for some key aspects is presented, but there are inaccuracies. Some additional information is needed.
-
2: Less Than Satisfactory
8.4 points
The evaluation plan is incomplete.
-
1: Unsatisfactory
0 points
The evaluation plan is not described.
Associated Documents and Appendix
9 points
Criteria Description
Associated Documents and Appendix Appendix includes consent or approval form; timeline; budget and resource list; method or instrument; APA Writing Checklist.
- 5: Excellent
9 points
The resources are accurate and attached in the appendix. It is clearly evident by the quality of the paper that the APA Writing Checklist was effectively used in development of the paper.
- 4: Good
8.28 points
The resources are revised accordingly and attached in the appendix. It is apparent that the APA Writing Checklist was used in development of the paper.
- 3: Satisfactory
7.92 points
The resources have been revised, but there are one or two minor errors. The resources are attached in the appendix. It is apparent that the APA Writing Checklist was generally used in development of the paper, but some aspects are inconsistent with the paper format or quality.
- 2: Less Than Satisfactory
7.2 points
The required resources are attached, but an appendix has not been created. Some resources contain errors and have not been revised. The paper does not reflect the use of the APA Writing Checklist during development.
- 1: Unsatisfactory
0 points
The appendix and required resources are omitted.
Ability to Translate Research and Knowledge to Improve Patient Outcomes and Practice (B)
12 points
Criteria Description
Ability to translate research and knowledge to improve patient outcomes and practice (C1.1)
- 5: Excellent
12 points
The final paper clearly adheres to ethical research standards and demonstrates a strong ability to translate research and knowledge gained from practice to the improvement of patient outcomes and clinical practice.
- 4: Good
11.04 points
The final paper observes ethical research standards and demonstrates an ability to translate research and knowledge gained from practice to the improvement of patient outcomes and clinical practice.
- 3: Satisfactory
10.56 points
The final paper observes ethical research standards, but there are some aspects of the paper that need more detail or information. A general ability to translate research and knowledge gained from practice to the improvement of patient outcomes and clinical practice is demonstrated.
- 2: Less Than Satisfactory
9.6 points
The final paper is inconsistent in its adherence to ethical research standards. The ability to translate research and knowledge gained from practice to the improvement of patient outcomes and clinical practice is not consistently demonstrated.
- 1: Unsatisfactory
0 points
The final paper does not adhere to ethical research standards. The ability to translate research and knowledge gained from practice to the improvement of patient outcomes and clinical practice is not demonstrated.
Required Sources
7.5 points
Criteria Description
Required Sources
- 5: Excellent
7.5 points
Number of required resources is met. Sources are current, and appropriate for the assignment criteria and nursing content.
- 4: Good
6.9 points
Number of required sources is met. Sources are current, but not all sources are appropriate for the assignment criteria and nursing content.
- 3: Satisfactory
6.6 points
Number of required sources is met, but sources are outdated or inappropriate.
- 2: Less Than Satisfactory
6 points
Number of required sources is only partially met.
- 1: Unsatisfactory
0 points
Sources are not included.
Thesis Development and Purpose
10.5 points
Criteria Description
Thesis Development and Purpose
- 5: Excellent
10.5 points
Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.
- 4: Good
9.66 points
Thesis is apparent and appropriate to purpose.
- 3: Satisfactory
9.24 points
Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.
-
2: Less Than Satisfactory
8.4 points
Thesis is insufficiently developed or vague. Purpose is not clear.
-
1: Unsatisfactory
0 points
Paper lacks any discernible overall purpose or organizing claim.
Argument Logic and Construction
12 points
Criteria Description
Argument Logic and Construction
- 5: Excellent
12 points
Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.
-
4: Good
11.04 points
Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.
-
3: Satisfactory
10.56 points
Argument is orderly but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.
-
2: Less Than Satisfactory
9.6 points
Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.
-
1: Unsatisfactory
0 points
Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.
Mechanics of Writing
7.5 points
Criteria Description
Mechanics of Writing Includes spelling, punctuation, grammar, language use.
- 5: Excellent
7.5 points
Writer is clearly in command of standard, written, academic English.
- 4: Good
6.9 points
Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.
- 3: Satisfactory
6.6 points
Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.
-
2: Less Than Satisfactory
6 points
Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.
-
1: Unsatisfactory
0 points
Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.
Paper Format
7.5 points
Criteria Description
Paper Format Use of appropriate style for the major and assignment.
-
5: Excellent
7.5 points
Template is fully used. There are virtually no errors in formatting style.
-
4: Good
6.9 points
All format elements are correct.
-
3: Satisfactory
6.6 points
Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent. The organizational culture and the degree to which it supports change is thoroughly discussed. The various aspects of the culture are included. Thorough explanations and strong supporting research are provided.
-
2: Less Than Satisfactory
6 points
Template is used, and formatting is correct, although some minor errors may be present.
-
1: Unsatisfactory
0 points
Template is not used appropriately, or documentation format is rarely followed correctly.
Documentation of Sources
7.5 points
Criteria Description
Documentation of Sources Citations, footnotes, references, bibliography, etc., as appropriate to assignment and style.
-
5: Excellent
7.5 points
Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.
-
4: Good
6.9 points
Sources are documented, as appropriate to assignment and style, and format is mostly correct.
-
3: Satisfactory
6.6 points
Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.
-
2: Less Than Satisfactory
6 points
Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.
-
1: Unsatisfactory
0 points
Sources are not documented.
Total 150 points
NUR 590 Benchmark – Evidence-Based Practice Project Proposal Final Paper Essays Grading Rubric
| Performance Category | 100% or highest level of performance
100% 16 points |
Very good or high level of performance
88% 14 points |
Acceptable level of performance
81% 13 points |
Inadequate demonstration of expectations
68% 11 points |
Deficient level of performance
56% 9 points
|
Failing level
of performance 55% or less 0 points |
| Total Points Possible= 50 | 16 Points | 14 Points | 13 Points | 11 Points | 9 Points | 0 Points |
| Scholarliness
Demonstrates achievement of scholarly inquiry for professional and academic topics. |
Presentation of information was exceptional and included all of the following elements:
|
Presentation of information was good, but was superficial in places and included all of the following elements:
|
Presentation of information was minimally demonstrated in all of the following elements:
|
Presentation of information is unsatisfactory in one of the following elements:
|
Presentation of information is unsatisfactory in two of the following elements:
|
Presentation of information is unsatisfactory in three or more of the following elements
|
| 16 Points | 14 Points | 13 Points | 11 Points | 9 Points | 0 Points | |
| Application of Course Knowledge
Demonstrate the ability to analyze and apply principles, knowledge and information learned in the outside readings and relate them to real-life professional situations |
Presentation of information was exceptional and included all of the following elements:
|
Presentation of information was good, but was superficial in places and included all of the following elements:
|
Presentation of information was minimally demonstrated in the all of the following elements:
|
Presentation of information is unsatisfactory in one of the following elements:
|
Presentation of information is unsatisfactory in two of the following elements:
|
Presentation of information is unsatisfactory in three of the following elements
|
| 10 Points | 9 Points | 6 Points | 0 Points | |||
| Interactive Dialogue
Initial post should be a minimum of 300 words (references do not count toward word count) The peer and instructor responses must be a minimum of 150 words each (references do not count toward word count) Responses are substantive and relate to the topic. |
Demonstrated all of the following:
|
Demonstrated 3 of the following:
|
Demonstrated 2 of the following:
|
Demonstrated 1 or less of the following:
|
||
| 8 Points | 7 Points | 6 Points | 5 Points | 4 Points | 0 Points | |
| Grammar, Syntax, APA
Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition Error is defined to be a unique APA error. Same type of error is only counted as one error. |
The following was present:
AND
AND
|
The following was present:
AND/OR
AND/OR
|
The following was present:
AND/OR
AND/OR
|
The following was present:
AND/OR
AND/OR
|
The following was present:
AND/OR
AND/OR
AND/OR
|
The following was present:
AND/OR
AND/OR
|
| 0 Points Deducted | 5 Points Lost | |||||
| Participation
Requirements |
Demonstrated the following:
|
Failed to demonstrate the following:
|
||||
| 0 Points Lost | 5 Points Lost | |||||
| Due Date Requirements | Demonstrated all of the following:
A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT. |
Demonstrates one or less of the following.
A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT. |
Also Read: DNP 801 Topic 8 DQ 2 What changes will you need to make in order to have a feasible topic for your PICOT-D?
A Sample Answer For the Assignment: NUR 590 Benchmark – Evidence-Based Practice Project Proposal Final Paper Essays
Title: NUR 590 Benchmark – Evidence-Based Practice Project Proposal Final Paper Essays
Evidence-Based Practice Project
The promotion of safety, quality and efficiency is important in nursing practice. The achievement of these care outcomes depends largely on the interventions that nurses utilize in patient care. Evidence-based interventions are effective in minimizing patient harm and enhancing quality and efficiency of care. Generally, nurses should demonstrate competencies in translating evidence into practice. Safety issues such as medication administration errors threaten the health and wellbeing of the patients. Medication administration errors have significant adverse effects on the health of the patients. They include prolonged hospital stay, unintended harm, increased costs of care, and mortality. Health information technologies are effective in preventing and reducing medication administration errors. Therefore, this project proposes the use of integrated health information systems to reduce the risk and rate of medication administration errors in critically ill patients.
Problem Statement
Critically ill patients are increasingly predisposed to errors in the care process, including medication administration errors. Medication administration errors refer to faults in the process of medication administration, leading to difference between the drugs that was given or what was supposed to be administered (Alotaibi & Federico, 2012). Medication administration errors often occur in the care of critically ill patients due to factors such as multiple medication administration, complex care needs of the patients, unpredictability in health status, and distractions (Barakat & Franklin, 2020). Medication administration errors have adverse effects on patient health such as causing unintended harm, prolonged hospital stay, increased costs of care, and high operational costs in healthcare due to rise in resource utilization (Devin et al., 2020). Nurses contribute to the majority of medication administration errors due to their primary role in medication administration (Alomari et al., 2020). The project site has witnessed a rise in the rate of medication administration errors. Despite it, it has not examined the potential interventions such as the use of integrated health information systems to address the problem. The existing evidence shows that integrated health information systems are highly effective in preventing and reducing medication errors (Jheeta & Franklin, 2017). Therefore, there is a need for its use in the project site to promote safety, quality and efficiency in patient care, hence, the focus of the project.
Organizational Culture and Readiness Assessment
Organizational culture has a direct effect on the success of implementation of evidence-based interventions. The organization has positive culture that will support the proposed project. Firstly, there is the utilization of effective leadership styles in undertaking the organizational tasks. The leaders and managers encourage the use of teamwork and interdisciplinary collaboration in the provision of patient care. The organization also has mission and vision statements that support innovation in the provision of patient care. The employees also have a high level of responsibility and accountability in undertaking their assigned tasks. They play a proactive role in the examination of the needed interventions that would drive excellence in patient care. The organization also supports open communication. Employees have the freedom to express themselves on issues affecting patient care and their roles in the organization (Bouckenooghe et al., 2019). The above aspects of organizational culture support the proposed change initiative.
Organizational Readiness Assessment
The organizational readiness and assessment tool by the Capacity Building Center for States was used in undertaking organizational readiness assessment. The tool provides insights into the readiness of an organization to make and implement change in its systems and processes. The assessment showed that the organization is ready to implement the change. The readiness could be seen from its scores of ‘strongly agreed’ and ‘partially agreed’ in the assessment. The organization had the highest scores in areas that included the availability of resources, supportive structures, leadership, staff capacity, and climate. It scored moderately in receptivity to change, compatibility, and simplicity of management (Capacity Building Center for States, n.d.).
The assessment revealed a number of strengths, weaknesses and opportunities to be explored in the organization. One of the strengths was the presence of adequate resources that would facilitate the successful implementation of the change. The organization also had the strength of effective leadership that drove the needed excellence in strategy execution for the realization of organizational mission and vision. The staffs also had the needed competencies to support excellence in their service provision. One of the weaknesses identified from the assessment is the lack of effective management in the organization. The successful implementation of the change requires simplistic management systems (Capacity Building Center for States, n.d.). However, the existing management approaches are inflexible in facilitating changes in organizational systems.
The potential barrier identified from the assessment, which might affect the implementation of change is staff shortage. Staff shortage may make it difficult to implement change due to high workload facing the existing staffs. Stakeholders however recognize the need for change in their practice, hence, their readiness to embrace change. The organization also had adequate resources to implement the change. The timing of the change is appropriate, as there have been an increase in the rates of medication errors in the institution.
Recommended Care Process and Systems
The recommended care system for use to promote safety, quality and cost-effectiveness for the organization is integrated health information technology. Integrated health information technology has the potential of eliminating and reducing the risk of medication administration errors in the organization. The integrated systems will enable healthcare providers to have expanded access to patient data for accurate decision-making. The integrated system will also guide the healthcare providers in determining suitability of various medications to the needs of the patients. The recommended change in organizational processes entails training the healthcare providers about the use of integrated health information systems (Bouckenooghe et al., 2019). Training will equip them with the competencies they need in providing high quality, efficient ad safe care.
Strategies to Facilitate Readiness of the Organization
Training will be provided to the healthcare givers in the organization to facilitate readiness. Training will ensure that the staffs have the required knowledge and skills, which will minimize incidences of resistance to change. The second strategy is active stakeholder participation. Healthcare providers will play an active role in the entire project processes to ensure their empowerment to support and sustain the change. Openness and transparency in communication will also be promoted. Open and transparent communication will strengthen the trust that the staffs have towards one another for the successful implementation of the change (Doll et al., 2017).
Stakeholders and Team Members
The implementation of the project will involve nurses, nurse managers, physicians, pharmacists, and information technology experts. Nurses will provide crucial insights into the system requirements that must be considered for the efficient use of the integrated system. They will also be the direct users of the integrated systems in medication administration. Nurse Managers will oversee the implementation process of the change. They will ensure the use of the right strategies in the implementation. Physicians and pharmacists are also involved in medication processes such as prescription and dispensing. They will provide information about the system needs that require prioritization. Information technology experts will provide the technical support needed for the successful implementation of the change in the organization.
Information and Communication Technologies
Integrated electronic health records will be needed for the implementation of the change initiative. The existing electronic health records system will have to be improved or upgraded to provide enhance efficiency in storage and access to patient data. The enhanced efficiency will facilitate accurate decision-making and easy identification of risk factors that could predispose patients to harm.
Literature Review
PICOT Statement
The use of health information technology can reduce and prevent the prevalence of medication administration errors 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
Different strategies for searching the articles that support the EBP project were used. They included using institutional library to get databases of journals and their published peer-reviewed articles. The databases included Embase, CINAHL, and PubMed. The search terms included medication administration errors, health information systems for medication administration errors, prevention of medication administration errors, integration of health information technology and effectiveness of integrated health information technology in medication administration errors.
Synthesis of Literature
Article 1
The article by Alotaibi and Federico (2012) discusses the impacts of health information technology on patient safety. The authors review evidence show the effectiveness of these health information technologies 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.
Article 2
The second article by Barakat and Franklin (2020) conducted a qualitative study that focused on the effects of using barcode medication administration (BCMA) on nursing practice activity and workflow. They found that BCMA increased the nursing workflow, patient verification and efficiencies in medication administration. 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 such as bundles of care in reducing medication errors in pediatric wards in their quantitative research. The study showed that the use of health information technology could reduce medication errors by over 60%. The article supports the PICOT question by showing the effectiveness of health information technologies in preventing medication administration errors.
Article 4
The fourth study by Devin et al. (2020) examined the effects of health information technologies in reducing prescribing errors in hospitals using a qualitative study approach. The results of their investigation showed 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) explored the experience of nurses working with health information technology over time in their facilities by using a longitudinal qualitative study. The results showed that personal and organizational issues impact the adoption of HIT. 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 annotated literature review by Naidu and Alicia (2019) evaluated 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. The analysis showed that adherence with best practice interventions in use of e-MAR enhance patient safety and reduces reported medication administration errors. 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 observational study by Jheeta and Franklin (2017) examined the ways in which hospital electronic prescribing and medication administration system can enhance medication administration safety. The results of the study showed that implementation of these interventions help 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 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). Most of the articles demonstrate the effectiveness of having protocols and policies that supplement the use of technology to prevent errors in care. 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, 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) do 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.
Model for Change
Selected Model
The trans-theoretical model of change will be utilized in the implementation of the evidence-based proposal project. Prochaska and DiClemente developed the model to enable organizations determine the factors that influence behavioral changes in organizations. The model also guides the strategies that organizations utilize in implementing the desired change. The trans-theoretical model is applicable for the proposed project because it will promote the gradual, systematic implementation of change. It will also provide accurate information about the success of the adopted strategies and the needed revisions for the realization of its objectives (Singh & Ramdeo, 2020).
Stages of Change and their Application
The first stage in the trans-theoretical model of change is pre-contemplation. Pre-contemplation is the stage where the adopters of change are not aware of the need for change and not willing to take action in the near future. The applicability of this step to the proposed project is that the nurses and other healthcare providers are not aware of the enhanced benefits associated with integration of health information technology on the safety of patient care. As a result, they are not willing to change their conventional ways of medication administration in the organization (Singh & Ramdeo, 2020).
The second stage in the model is contemplation. The adopters of the change are willing to change their behaviors in this stage. They understand the negative effect of their current behaviors and are stimulated to adopt change initiatives to improve themselves (Hodges, 2020). The applicability of this step to the project is that nurses and other healthcare providers will be aware of the negative effect of their behaviors on patient safety. As a result, they contemplate on adopting integrated health information systems to ensure the minimization of medication errors (Singh & Ramdeo, 2020). They also weigh the benefits and risks of adopting the integrated systems for medication administration.
The third step in the model is preparation. The adopters of change are ready to implement the change within a near future in this step. They understand the benefits and risks of the change in their routines. They also begin initiating small steps that would contribute to their desired change in behaviors. The applicability of this step in the proposed project is that nurses and other healthcare providers begin utilizing integrated health information systems in the provision of patient care. They consider the gradual implementation of the system in the organization, with a focus placed on its strengths and weaknesses that must be addressed prior to organization wide implementation of the integrated systems (Singh & Ramdeo, 2020).
The fourth step in the model is action. This is a stage where the adopters have used the change for some time and willing to maintain it in undertaking their routine. The adopters continually modify their behaviors to underpin the success of the change. The application of this step to the proposed project is that nurses and other healthcare providers would have witnessed the benefits of the proposed change (Lynda et al., 2021). As a result, they modify their behaviors to ensure the optimum realization of the goals of the change.
The fifth step in the model is maintenance. The adopters in this phase have sustained the desired change in behaviors. They also intend to maintain the change in behaviors to minimize and prevent the risk of relapse in behaviors. Nurses and other healthcare providers in the organization have understood the benefits of the integrated systems based on their experiences with it. They have also used the system for a long time and are willing to sustain its use in patient care. As a result, they engage in activities that would prevent relapse to their conventional methods of medication administration, which were associated with high rates of medication errors. The last stage in the model is termination. Termination is the stage where the adopters are no longer willing to relapse to their old ways of patient care. The nurses and other healthcare providers have not willing to use the conventional methods in this stage (Singh & Ramdeo, 2020). As a result, the change is incorporated into the organizational culture for its sustained and consistent use in patient care.
Project Implementation
Setting and Access to Potential Subjects
The setting where the project will be implemented will be a hospital setting. The potential subjects for the project will comprise of the critically ill patients. The setting will be appropriate for the project, as it has a high number of critically ill patients that require different forms of treatment. Consent will not be sought from the potential subjects. However, approval will be sought from the institution prior to undertaking the project.
Timeline
The estimated duration needed for the implementation of the project is one year.
Budget and Resource List
The successful implementation of the project will require a change in the clinical systems and processes. One of the required changes will be the integration of the existing electronic health records. Integration will be needed to facilitate the efficiency in patient care and undertaking of processes such as medication administration. Nurses and physicians will be able to review the patient’s medical histories prior to making a decision to administer specific medications for disease management. The existing healthcare processes must also be transformed to ensure that they enhance the creation of culture of patient safety in the organization.
Human, financial, and material resources will be needed for the successful implementation of the evidence-based practice project. The human resources that will be needed will include skilled healthcare providers, trainers of trainees, and information technology experts. Financial resources will be needed for system upgrade, purchase of the required materials and remunerating the participants. The materials that will be purchased for the successful implementation of the project will include writing materials, projectors, integrated health information system, and stationeries. The other cost will gather for the training, coaching and mentoring, data collection and analysis, and presentation of findings to the institutional stakeholders. The estimated budget of the project will be $48000
Design
Quantitative design will be used in the collection of data for the evidence-based practice project. Quantitative design will be appropriate for the project because it does not focus on the experiences and emotional insight of the participants. Instead, it focuses on determining the quantity of the data that will be obtained from the project. The project also does not focus on the generation of theories for use in nursing. It focuses on determining the effectiveness of the existing best practice interventions in improving the outcomes of care in patients. This focus makes it essential to adopt quantitative approach since it will guide the evaluation of the practice intervention in patient care. The project also aims at obtaining numerical data for easy organization and analysis. The collection of numerical data will also make it easy for data analysis and inferences made from the results (Dingwall & Staniland, 2020). Consequently, it makes it important to use quantitative design since it focuses on numerical data and use of mathematical analyzes to determine the effect of an intervention.
Methods and Instruments
Monitoring of the implementation of the proposed project will be done on a regular basis. Questionnaires and organizational statistics will be used for monitoring the outcome data in the implementation of the solution. Organizational statistics on medication errors will be obtained for comparison before and after the implementation of the solution. Healthcare providers will be given self-administered questionnaires that will obtain their insights into the effectiveness of the project. Questionnaires are appropriate for the project since administering them is inexpensive. It also requires less time to administer them when compared to other methods such as focused interviews (Dingwall & Staniland, 2020). The questionnaires will also enable the acquisition of numerical data that can be analyzed with ease.
Process of Delivering the Intervention
The project will be delivered using a number of planned processes. One of them will be needs assessment. Needs assessment will be performed to determine the knowledge and skills of the healthcare providers on the use of integrated healthcare records. The other process that will be utilized in the project is the active stakeholder involvement in strategy development. Active involvement will ensure that the diverse views and needs of the stakeholders are incorporated into the developed plan of the project. Training will be provided to the staffs prior to the implementation of the project. Training will aim at equipping the staffs with the desired knowledge and skills needed for using the integrated health records (Lehane et al., 2019). Coaching, mentorship and supervision will be provided to ensure the correct and consistent use of the system in patient care.
Stakeholders
The stakeholders that will be needed for the implementation of the project will include nurse managers and nurse leaders, nurses, physicians, and information technology personnel. Nurse leaders and managers will oversee the implementation of the project. They will provide the adopters the support that they need in ensuring the effective use of the system in patient care. Nurses and physicians will be involved in the direct use of the integrated system. As a result, they will be involved in all the processes of project assessment, planning, implementation, monitoring and evaluation. Information technology personnel will provide the technical assistance needed in the use of the integrated systems.
Potential Barriers or Challenges
One of the potential barriers that may be experienced in the implementation of the project is stakeholder resistance. Stakeholders such as the healthcare providers may not be willing to implement the use of the integrated health records in their practice. This barrier will be addressed by training them and encouraging their active involvement in the entire project initiatives (Shayan et al., 2019). The other challenge that may be experienced is inadequate support from the organization. The hospital may not be willing to provide adequate financial support for the project due to resource constraints. Interventions such as ensuring feasibility of the project and aligning it with institutional mission and vision will be adopted to address the challenge (Baatiema et al., 2017). The proposed project is feasible in the organization due to the existence of robust health information systems used in patient care and healthcare providers trained in use of healthcare technologies. The project also aligns with the mission of the organization by ensuring safety, quality and efficiency in patient care.
Evaluation Plan
Expected Outcomes
A number of outcomes are expected from the proposed evidence-based practice project. One of the outcomes is the reduction in the rates of medication errors reported among critically ill patients. Evidence shows that the use of integrated health information technology is highly effective in reducing the risk and rate of medication errors (Ratwani et al., 2018; Alotaibi & Federico, 2017). The other anticipated outcome of the project is the reduction in healthcare costs that critically ill patients incur in the hospital. The reduction of medication errors with the adoption of integrated health information technology is anticipated to lower the costs incurred by critically ill patients in the institution (Bolandianbafghi et al., 2017). The last outcome is the consistent use of the integrated health information technology by the healthcare providers in the institution. Consistent use is anticipated to result in continuous improvement in the safety, quality and efficiency of patient care in the hospital.
Data Collection Tool
Questionnaires would be effective for the collection of data in this project. Questionnaires are appropriate, as they will enable the acquisition of extensive data related to the project from the participants. Questionnaires also provide highly reliable and valid results. The high reliability of questionnaires is attributable to their ability to measure similar variables in a consistent manner across the participants of the project. The validity of questionnaires can be seen from the fact that they can accurately measure the intended outcomes of the proposed evidence-based practice project. They also provide data that reflects the true experiences or perceptions of the participants. The applicability of questionnaires for the project is seen from its use in scientific studies, including nursing (Gray & Grove, 2020).
Statistical Test
The most appropriate statistical test that would be used in the project is t-test. T-test refers to a statistical computation that compares the mean of two samples. The test is largely used in cases where the mean and standard deviation of the population data is unknown. T-test is applicable for the project, as it will provide an accurate insight into the effectiveness of the project intervention before and after its implementation (LoBiondo-Wood & Haber, 2018). It will also provide a true picture of the effect size of the intervention.
Methods
One of the methods that would be applied to the data collection tool is checking for completeness of the data. The data contained in the questionnaires should be complete for accurate analysis. The second method will be data extraction for analysis. Data will be extracted and entered into a computation software for analysis. Data analysis and interpretation will then be done to develop conclusions on the effectiveness of the intervention.
Strategies if Outcomes do not Provide Positive or Expected Results
It is anticipated that positive outcomes would be achieved following the implementation of the evidence-based practice project. However, a number of interventions will be adopted should it not provide the expected results or positive outcomes. One of the strategies would be investigating the factors that contributed to the project failure. A root cause analysis will be performed to guide the identification of project issues that led to the failure and interventions needed to improve its outcomes. The second strategy would be prolonging the project duration; as new strategies are being implemented. Prolonging the duration will enable the team to implement new strategies, which may transform the outcomes of the project.
Plans to Maintain, Extend, Revise, and Discontinue the Proposed Solution
The outcomes of the project will guide the decisions to be made by the team involved in the process. For example, the project will be maintained if the analysis of data shows it to have positive effects on the organizational indicators of safety, quality and efficiency. It will also be maintained if the analysis shows it to be highly feasible with a positive adoption response from the healthcare providers. The project will be extended if the project outcomes cannot be determined if effective or not. Extension will enable further determination of the effectiveness of the project in achieving its objectives. The project will be revised if found that its strategies do not align with its mission. It will be discontinued if found to increase the rates of medication errors among critically ill patients in the hospital.
Conclusion
Medication errors have adverse effect on the health of the patients. It predisposes them to unintended harm. It also increases the costs incurred by prolonging the hospital stay by patients. It also increases the operational costs in healthcare due to increased resource utilization in caring patients affected by the errors. Integrated electronic health records are effective in reducing and preventing medication administration errors. The reviewed evidence supports the use of the technology in promoting safety of patient care. Therefore, it is anticipated that enhanced care outcomes will be achieved with the use of the proposed intervention.
References
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Härkänen, M., Vehviläinen-Julkunen, K., Murrells, T., Rafferty, A. M., & Franklin, B. D.
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Appendices
Appendix I: Project Timelines
| Nov-Dec 2021 | Jan-Feb 2022 | Mar-Sept 2022 | Oct 2022 | Nov 2022 | |
| Assessment | |||||
| Planning | |||||
| Implementation and monitoring | |||||
| Evaluation | |||||
| Communication of feedback |
Appendix II: Budget
| Item | Cost ($) |
| Purchase of materials | 12000 |
| Remuneration of staffs | 10000 |
| Training | 10000 |
| Data collection, analysis and presentation | 3000 |
| System upgrade | 5000 |
| Miscellaneous | 8000 |
| Total | 48000 |
Appendix III: Questionnaire
- Gender (Tick where applicable)
- Male [ ] b) Female [ ]
- What is your age bracket ( Tick where applicable)
- Below 21years [ ]
- Between 21-30 years [ ]
- Between 31-40 years [ ]
- Over 40 years [ ]
- For how long have you worked in your role as a healthcare provider?
- Below 1-3 Years [ ]
- Between 3-5 Years [ ]
- More than 5 Years [ ]
- The following are statements relate to your experiences with the project. Please tick the response, which matches your opinion. Key: 1=(SD)- Strongly disagree, 2=( D)- Disagree, 3=(UD)-Undecided, 4=(A)- Agree, 5=(SA)- Strongly agree).
| Statement | SA
5 |
A
4 |
UD
3 |
D
2 |
SD
1 |
|
| 1 | The project was adequately implemented to meet our needs | |||||
| 2 | The project met the critical needs of the organization | |||||
| 3 | We were adequately involved in the project initiatives | |||||
| 4 | The strategies utilized in the project were effective |
- What do you think can be done to improve the success of a similar project in the future?
Appendix IV: Concept Map