NURS 6052 EBP Part 4 Recommending an Evidence-Based Practice Change
Sample Answer for NURS 6052 EBP Part 4 Recommending an Evidence-Based Practice Change Included After Question
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, related to your clinical topic of interest and PICOT.
- Reflect on your current healthcare organization and think about potential opportunities for evidence-based change, using your topic of interest and PICOT as the basis for your reflection.
- Consider the best method of disseminating the results of your presentation to an audience.
The Assignment: (Evidence-Based Project)
Part 4: Recommending an Evidence-Based Practice Change
Create an 8- to 9-slide narrated 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.
- Explain how you would disseminate the results of your project to an audience. Provide a rationale for why you selected this dissemination strategy.
- Describe the measurable outcomes you hope to achieve with the implementation of this evidence-based change.
- Be sure to provide 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 within the Critical Appraisal Tool Worksheet Template (1-3 slides)
By Day 7 of Week 10
Submit Part 4 of your Evidence-Based Project.
Submission and Grading Information
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A Sample Answer For the Assignment: NURS 6052 EBP Part 4 Recommending an Evidence-Based Practice Change
Title: NURS 6052 EBP Part 4 Recommending an Evidence-Based Practice Change
Change is necessary in the healthcare systems. With the advancement in the operational processes, there is always the need to adjust some of the approaches used in the healthcare. Most organizations often implement changes to ensure efficiency in the healthcare processes and also to increase revenues. With the increased demands of quality in the healthcare delivery, most healthcare institutions are always involved in the continuous change processes to ensure that they meet the ever increasing demands from the clients. Given that healthcare institutions are faced with different challenges that need to be addressed, there is always the need to initiate change processes to address such challenges/problems (Arditi, Nayak, & Damci, 2017). Different healthcare institutions are associated with different issues that either require changes in people’s behaviors or the processes or approaches in the healthcare system. Some of the challenges may include medication errors, workplace conflicts, inadequate care delivery, high costs of healthcare services, and low nurse to patient ratios. These challenges/issues often require the implementation of appropriate changes in the service delivery to ensure effective operational processes. The purpose of this paper is to examine an issue that may lead to the implementation of change processes in the healthcare system.
Executive Summary of the Issue Impacting Organization/Workplace
One of the main issues affecting my organization/workplace is workplace conflict. In most cases, conflicts among the employees and the management often impact effective operational processes. Usually, workplaces with a lot of issues experience delays in service delivery. Also, the quality of service delivery may go down. With the increasing conflicts within the work environment, people cannot reach consensus on various issues that impact healthcare processes. Workplaces with continuous conflicts often require constant changes to ensure that there is an overall improvement in the operational processes. Conflicts within the work environment may be caused by poor communication, lack of common understanding among the workforce, as well as the lack of respect among the employees and the management.
Close-mindedness, misunderstandings, as well as passive aggressive behaviors are some the other causes of workplace conflicts in my organization. In my organization, the management has been involved in implementing different change processes to address the issue of workplace conflicts. However, the approaches that have been taken often appear ineffective. For instance, the management has tried to transform communication processes to enhance understandings among the employees and the management; however, the approaches that were taken failed to produce effective outcomes.
Description of the Change Being Proposed
Changes in the organizational culture and policies is essential in addressing the workplace conflicts. Changing an organizational culture is one of the best approaches in ensuring a reduction in workplace conflicts. However, it is one of the challenging processes for the management as there is always the need to transform the mind-set of employees as well as their behaviors. Also, the organization’s culture often consists of interlocking set of roles, goals, values, processes, attitudes, communication policies, as well as assumptions. Changing an organizational culture is often a large scale undertaking that requires the organization of different resources. For instance, the organizational tools that are required in changing the minds will need to be put in place.
Changing an organizational culture will involve addressing the communication processes and improving the behaviors of people. In other words, the proposed change, which is the transformation of the organizational culture, will address the issues that often lead to conflicts. For example, the change process will create an environment of mutual respect and effective communication. Changes in the organizational culture may also create an environment where there is teamwork. In most cases, workplaces where people interact and operate together experience less conflicts. The change or transformation of the organizational culture may lead to strong employee relationships, which can lead to less conflicts. Changing an organizational culture may also lead to changes in policies, objectives, mission, and vision, especially if these factors are attached to the cultural practices.
Justification for the Change
Addressing the cultural change will have significant impact in the organization/workplace. Cultural change will lead to the creation of a positive environment for all the stakeholders, which will lead to increased quality in service delivery and the general patient outcomes. Organizational culture often contributes significantly to the behaviors of the people as well as the interaction processes. Therefore, whenever there is the need to resolve workplace conflict, transforming culture is necessary. Also, organizational culture often determines the value, principles, and ethical behaviours of the people. Therefore, transforming it would mean improvement on individual’s values, ethical behaviors and the development of positive principles which are necessary in resolving conflicts.
Type and Scope of the Proposed Change
Making changes to the organizational culture should incorporate making adjustments to the standards of behaviors of the people. Also, the whole process involves changes in the values and principles that people ought to adhere to. In other words, cultural change should incorporate changes in the workplace values, policies, skill, practices, attire, language, expectations, aesthetics, and tools. Cultural change should involves overall changes in behaviors. In other words, the organizational culture change should incorporate a shift in behaviors and in the ways things are supposed to be done as well as how employees are expected to behave under different circumstances (Slack & Singh, 2018). The cultural change should also involve the transformation of policies relating to human resource activities.
Stakeholders Impacted By the Change and the Identification Of The Change Management Team
Some of the stakeholders that will be impacted by the cultural change include employees and the management. In the process of change, employees will be required to transform their behaviours, which may go contrary to the normal behaviors of a person. Also, adjusting to the set standards of behaviors may become very difficult for some people. Given that the management often relates directly to the employees, they may also be impacted by the cultural change (Pitafi, Liu, & Cai, 2018). Other stakeholders that may be impacted by the change include clients/patients that often get engaged directly with the organizational employees.
The change management team will involve the management. For instance, human resource managers will be among the change management team. Also, the chief executive officer, lower level managers, nurse leaders, and some employees, especially nurses, will be part of the change management team. The above professionals understand what it takes to transform the organizational culture.
Plan for Communicating the Proposed Change
There is always the need to communicate proposed changes to ensure that everyone understand the procedures and processes required is necessary. Selecting credible leaders to communicate the change process is necessary in ensuring that every aspect of the change process is well understood and addressed by the stakeholder involved in the whole process. Keeping communication all the way to the end of the whole process is necessary in ensuring that all the stakeholders become aware of the change process (Currie et al., 2017). Delivering accurate messages to the people and ensuring that everyone captures the information being communicated is important. While communicating the processes of change, there is the need to ensure that all the messages delivered are consistent to the end.
Risk Mitigation Plan
The proposed cultural change may be associated with different risks including loss of employees, loss of focus among the employees, as well as increased level of animosity. Cultural change may also lead to the loss of previous cultural practices that are important in determining organizational identity. Some of the risk mitigation plan that can be used in the change process may include preserving the organization’s most precious asset such as branding. In other words, the organizational branding ought to be attached to the new cultural practices. Ensuring extreme transparency and involving all the stakeholder in the change process is essential in mitigating the changes required.
Conclusion
Change is necessary in the healthcare systems. With the advancement in the operational processes, there is always the need to adjust some of the approaches used in the healthcare processes. Transforming cultural practices is necessary in ensuring that there are improvements in the quality services delivery and that clients can enjoy effective services offered. Addressing the cultural change will have significant impact in the organization/workplace. Cultural change will lead to the creating of a positive environment for all the stakeholders, this will lead to the quality in service delivery and the general patient outcomes.
References
Arditi, D., Nayak, S., & Damci, A. (2017). Effect of organizational culture on delay in construction. International journal of project management, 35(2), 136-147. /https://doi.org/abs/pii/S0263786316303052
Currie, D., Gormley, T., Roche, B., & Teague, P. (2017). The management of workplace conflict: Contrasting pathways in the HRM literature. International Journal of Management Reviews, 19(4), 492-509. https://doi.org/10.1111/ijmr.12107
Pitafi, A. H., Liu, H., & Cai, Z. (2018). Investigating the relationship between workplace conflict and employee agility: The role of enterprise social media. Telematics and Informatics, 35(8), 2157-2172. https://doi.org/10.1016/j.tele.2018.08.001
Slack, N. J., & Singh, G. (2018). Diagnosis of organizational culture in public sector undertakings undergoing reforms. Public Organization Review, 18(3), 361-380.: https://doi/org/10.1007/s11115-017-0383-5
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A Sample Answer 2 For the Assignment: NURS 6052 EBP Part 4 Recommending an Evidence-Based Practice Change
Title: NURS 6052 EBP Part 4 Recommending an Evidence-Based Practice Change
Heart failure (HF), especially among the elderly patients who are 65 years and above, is a complex chronic condition that contributes to increasing cost of healthcare. Patients with the condition have a high incidence of hospital readmission within 30 days after discharge than any other condition. The disease is a leading cause of hospital admissions among the elderly patients (Al-Tamimi et al., 2018). The purpose of this critical appraisal paper, part B, is to identify a best practice that emerges from the researched and reviewed literature comprising of four articles on the kind of interventions that nurses can have to reduce the prevalence of readmissions within 30 days after discharge these patients.
The reviewed literature comprises of four articles on the selected topic of heart failure among patients aged 65 years and above and the use of nurse-led educational interventions to reduce the surging prevalence. Studies consistently show that the main cause of these readmissions within 30 days after discharge is non-compliance to treatment protocols and self-management care. The provision of nurse-led multidisciplinary education can help reduce the prevalence and this emerges as the best practice based on the reviewed four articles. The first article by Awoke et al. (2019) is a quasi-experimental study that evaluates the impact of nurse-led education program to improve knowledge, and self-care management with the aim of reducing the rate of readmissions for individuals with heart failure.
The second article by Breathitt et al. (2018) is a randomized controlled trial that leverages use of tablets and nurse practitioner education to reduce the rate of readmission for patients with heart failure condition. These two articles provide level one and two evidence, implying that the best practice they recommend works in different settings and have proof of efficacy. The two articles are categorical that using nurse-led interventions alongside others can help patients with heart failure improve their self-care and compliance to treatment interventions, especially at home once discharged from hospitals.
Nurses play a critical role in management of diseases and patient care. These providers are tasked with the responsibility of ensuring that patients are free from the risk of getting readmissions upon discharge through effective compliance with treatment interventions (Melnyk & Fineout-Overholt, 2018). Nurse-led self-care management education and practices enhance information distribution to patients and their families, ensuring that patients follow the suggested or recommended treatment interventions.
The article by Clarkson et al. (2017) focuses on the impact of an inter-professional heart failure education program to mitigate heart failure readmissions. This article supports the need for a nurse-led education program through the inter-professional team to enhance adherence to treatment protocols and self-care management. The implication is that effective self-care management happens when nurses are involved since they are patient advocates, interact more with the patients than any other health professional, and are based placed to understand their needs.
The study by Rice et al. (2018) also emphasizes the role of nurse-led education to reduce hospital readmission and quality of life and lower the cost among adults with heart failure. The systematic review presents the best evidence to demonstrate the significant role that nurses play in mitigating readmissions and enhancing the quality of life for patients with heart failure condition. These articles identify a hands-on nurse-led education program through increased interactions with patients and provision of materials that allow patients to adhere to the treatment protocols and recommendations as offered by their providers.
Conclusion
Conclusively, better nurse-led interventions are a core aspect of managing heart failure and reducing readmissions. The reviewed articles show that nurse have a critical role to enhance patient education and better outcomes in heart failure condition. Their efforts improve self-care and reduce susceptibility to readmissions thus lowering the overall cost of care burden on patients, their families and the healthcare system.
References
Al-Tamimi, M. A. A., Gillani, S. W., Abd Alhakam, M. E., & Sam, K. G. (2021). Factors
Associated With Hospital Readmission of Heart Failure Patients. Frontiers in pharmacology, 2726. https://doi.org/10.3389/fphar.2021.732760
Awoke, M., Baptiste, D., Davidson, P., Roberts, A., & Dennison-Himmelfarb, C. (2019). A
quasi-experimental study examining a nurse-led education program to improve knowledge, self-care, and reduce readmission for individuals with heart failure. Contemporary Nurse, 55(1), 15–26. https://doi.org/10.1080/10376178.2019.1568198
Breathitt, K., Maffett, S., Foraker, R. E., Sturdivant, R., Moon, K., Hasan, A., Abraham,
- W. (2018).Pilot randomized controlled trial to reduce readmission for heart failure using novel tablet and nurse practitioner education. The American Journal of Medicine, 131(8) 8, 974–978. https://doi.org/10.1016/j.amjmed.2018.02.017
Clarkson, J. N., Schaffer, S., & Clarkson, J. J. (2017). The effect of an inter-professional heart
failure education program on hospital readmissions. Journal for Healthcare Quality, 39(2), 78–84. https://doi.org/10.1097/JHQ.0000000000000027
Melnyk, B. M. & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare:
A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.
Rice, H., Say, R., & Betihavas, V. (2018). The effect of nurse-led education on hospitalization,
readmission, quality of life and cost in adults with heart failure: A systematic review. Patient Education and Counseling, 101(3), 363–374. https://doi.org/10.1016/j.pec.2017.10.002.
Grading Rubric Guidelines DQ
| Performance Category | 10 | 9 | 8 | 4 | 0 |
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| Performance Category | 5 | 4 | 3 | 2 | 0 |
| Interactive Dialogue
Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days. (5 points possible per graded thread) |
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Summarizes what was learned from the lesson, readings, and other student posts for the week. |
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| Grammar, Syntax, APA
Note: if there are only a few errors in these criteria, please note this for the student in as an area for improvement. If the student does not make the needed corrections in upcoming weeks, then points should be deducted. Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition |
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per discussion thread |
The student answers the threaded discussion question or topic on one day and posts a second response on another day. | The student does not meet the minimum requirement of two postings on two different days | |||
| Early Participation Requirement
per discussion thread |
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A Sample Answer 3 For the Assignment: NURS 6052 EBP Part 4 Recommending an Evidence-Based Practice Change
Title: NURS 6052 EBP Part 4 Recommending an Evidence-Based Practice Change
Health care organizations should constantly evaluate their performance and intervene appropriately as situations necessitate. One of the highly recommended interventions is evidence-based practice change. Organizations adopt positive change based on current, relevant, and high-level evidence to solve clinical problems through such changes. The purpose of this presentation is to recommend an evidence-based practice change for addressing workplace incivility. It starts with an overview of the organization before describing the problem, the idea for change, and the plan for knowledge transfer. Other vital sections include an analysis of the measurable outcomes and lessons learned.
The success of an evidence-based change project depends on the organizational policies, attitude towards change, and culture, among other factors. The organization is primarily a general health care facility dealing with inpatient and outpatient services. It is highly centralized, with each department dealing with specific functions. Regarding culture, the organization is primarily an adhocracy. Lepore et al. (2018) defined an adhocracy as a culture where the management supports individual initiatives instead of prescribed rules. Readiness for change can be determined by assessing the organization’s approach to change. It is right to deduce that the organization is highly ready for change since it embraces change. Previous change-driven projects have been a massive success, and the management commits resources to support innovation.
The current problem is workplace incivility. According to Shi et al. (2018), workplace incivility includes rude and discourteous behavior towards colleagues. An uncivil workplace is detrimental to patient care and nurses’ productivity since it hampers workplace relationships and nurses’ wellbeing. It is a leading cause of discomfort and nurse turnover (Shi et al., 2018). Workplace incivility is among the issues that nurse leadership cannot ignore in health care settings. It adversely affects the nursing staff, patients due to low-quality care and the organization due to reduced performance. Stakeholders involved in change-facilitation and/or affected by the problem include the management as change promoters, patients, the nursing staff, nurse leaders, and human resources experts (for awareness programs). The most significant risks include a change in the workplace culture and resistance.
The evidence-based practice (EBP) approach recommends solving a clinical problem by integrating scientific evidence into clinical practice. As already mentioned, the problem of interest is workplace incivility. After generating evidence, it is crucial to appraise it to get the most relevant evidence for a clinical problem. Policy interventions and incivility awareness emerged as the most practical interventions for addressing workplace incivility. Such interventions include zero-tolerance policies, a culture of reporting, and education programs on workplace incivility. Cognitive rehearsal can also be integrated into the intervention programs to ensure that nurses are adequately prepared to identify and cope with workplace incivility. The objective is to reduce workplace incivility in the facility within six months.
EBP change projects would not be fruitful if the proposed changes are not implemented and knowledge shared. An effective way of knowledge creation is to continue searching and appraising evidence to ensure that changes are based on scientific evidence. Consultative forums and nursing education programs would also be effective in sharing knowledge and generating new ideas. The best way to adopt and implement changes is to share the EBP results with the management to facilitate appropriate practice changes. Dissemination is vital for ensuring that the EBP results reach a wider nursing audience. A policy brief and posting the results on the organization’s education would ensure that information reaches all the organization’s members. Other strategies can be chosen later to share knowledge externally.
The primary objective of the EBP change project is to reduce workplace incivility. It will lead to better health outcomes, achieved through EBP and shared decision-making (Hoffman et al., 2014). As a result, a combination of incivility awareness programs and policy interventions will promote a more civil workplace in six months. Shi et al. (2018) found workplace incivility a leading cause of anxiety and burnout. The proposed changes will address this problem and others stemming from workplace incivility, like reduced esteem and negative perception of the nursing profession. Reducing workplace incivility is also expected to improve the nurses’ wellbeing and confidence. Doing so will reduce medication errors and improve patient satisfaction since patients will be served better.
Research appraisal is a rigorous process which involves systematically evaluating research evidence to determine its relevance and value (Melnyk & Fineout-Overholt, 2018). After the appraisal, four articles were found relevant to workplace incivility prevention. Shi et al. (2018) recommended the importance of informed and resilient nurses to cope with workplace incivility. Armstrong (2018) recommended the need for improving nurses’ ability to recognize and manage workplace incivility, justifying awareness programs. also advised health care managers to improve nurses’ skills. The last article emphasized the need for awareness. According to Kile et al. (2019), awareness programs should be intensified in health care settings to reduce workplace incivility.
The evaluation analyzes articles about workplace incivility from multiple dimensions. It is tedious to analyze articles from multiple dimensions including research methodology, sample size, design, and outcomes. Also, research evidence should be sourced from credible sources with high-level evidence. Systematic reviews are highly reliable since they comprehensively select, analyze, and appraise evidence from multiple data sources. Also, reading the entire article can be time-consuming when searching for evidence. Therefore, it is crucial to rely on the abstract as the guide. Other vital observations include the importance of searching via keywords and in-depth understanding of research databases and the type of articles found in each.
It is crucial to conclude the presentation by summarizing the key findings. One of the major findings is that EBP change promotes positive change in health care by proposing evidence-based interventions for addressing clinical problems. Workplace incivility can be addressed using the same approach where research is sourced from current and relevant evidence. Suitable interventions for addressing workplace incivility include policy changes to promote a new workplace culture and increased awareness on workplace incivility to enable nurses identify and cope with the problem. It is also crucial to share EBP results with other health care providers and the larger nursing profession hence the need for dissemination.