Sample Answer for NURS 6052 Evidence-Based Project 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.
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A Sample Answer For the Assignment: NURS 6052 Evidence-Based Project Part 4: Recommending an Evidence-Based Practice Change
Title: NURS 6052 Evidence-Based Project Part 4: Recommending an Evidence-Based Practice Change
Health organizations operate with the aim of optimizing outcomes such as safety, quality, and efficiency in addressing the needs of their organizations. Often, health organizations operate in highly dynamic and challenging environments. They experience issues such as competition from other organizations, changing consumer needs and preferences, and emerging health problems. These challenges imply that health organizations must embrace change to respond to their current and emerging needs in their markets. Change initiatives provide organizations competitive edge over others involved in the same market niche. Healthcare providers, including nurses play a crucial role in the implementation of change initiatives that address organizational needs. They select evidence-based practice interventions to ensure efficiency in the adopted strategies and realization of optimum safety and quality outcomes in service delivery. Therefore, this presentation examines an organizational issue and proposed change to address it.
The organization I work with is a tertiary hospital. The hospital leads in the region in the provision of specialized and general care to its diverse populations. The hospital has a culture that supports change. First, healthcare providers utilize teamwork in the provision of patient care services. Teamwork aims at ensuring collectivism in the realization of the organizational outcome. The organization also strives to support safety culture. This is achieved by the adoption of evidence-based interventions in the implementation of organizational strategies. Evidence-based strategies optimize outcomes such as safety, quality, and efficiency.
There is also the use of open communication among different stakeholders. Open communication ensures the prioritization of the stakeholder needs, views, and concerns. Open communication has strengthened openness and trust among the organizational employees, hence, enhanced teamwork in the provision of patient care. The organization also recognizes the vital role that rewarding performance plays in contributing to employee productivity. As a result, it undertakes biannual performance appraisals and uses them to reward employees and motivate them to explore additional ways of achieving the desired outcomes. These aspects of the organizational culture make it ready to embrace change.
The selected nursing problem in my organization is nursing shortage. The hospital currently experiences an acute shortage of nurses, which has affected the provision of patient care services to the patients. Several circumstances surround the issue of nurses shortage in the hospital. One of them is high rate of nurses’ turnover. The rate of nurses leaving their jobs intentionally has risen significantly over the past years. The rise is attributed to organizational issues such as high workload because of the few nurses, burnout, and occupational stressors associated with the challenge of balancing professional and family life demands. The other factor is unhealthy workplaces. This can be seen from violence targeted at nurses by other nurses and other healthcare providers. Most nurses report experiencing either physical or verbal violence from others, which affect their psychological and physical health, hence, their intention to leave their jobs.
The other factor is the low number of nursing students being trained among the American universities. This is attributed to the shortage of faculty staff to train a high number of nurses to address the current shortage. Lastly, more than one million nurses will be retiring in the next decade. This implies that the problem of nursing shortage will persist if no intervention is embraced (Yahya Muabbar & Zayyan Alsharqi, 2020). The affected stakeholders by the problem include nurses and patients. Nurses suffer from high workload while patients are affected by low quality nursing care being given to them. The risks of implementing change include resistance to change from the adopters, inadequate support from health organizations, and disruption of the existing systems and processes by change.
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The proposed idea to address the issue of nurses shortage in the hospital is empowering them. The hospital should implement nurse-centered interventions that address their actual and potential needs. The interventions should align with the needs and expectations of the nurses. One of the empowerment strategies that the hospital should consider is rewarding their performance. The hospital should ensure that the remuneration for the nurses aligns with the role and contributions of nurses to its success. The hospital should also implement reward schemes regularly to motivate nurses to engage in additional ways to meet the needs of their patients and theirs too. The other strategy is ensuring health and safe working environment (Challinor et al., 2020). The hospital should ensure the adoption of strict policies that condone behaviors such as violence targeted at nurses.
In addition, workplace stressors such as high workload should be addressed to prevent more nurses from leaving their jobs in the hospital. The other empowerment strategy is ensuring flexibility in the nurses’ schedules. The leadership and management should ensure that nurses have flexible schedules that help them to balance between work and family demands. There should also be programs such as counseling for nurses to help them be resilient and develop effective coping skills for managing the workplace demands. These empowerment strategies should be incorporated into the organization’s culture to ensure sustainable change (Farid et al., 2020; Gensimore et al., 2020; Lester et al., 2020; Seren Intepeler et al., 2019).
The plan for knowledge transfer will comprise several interventions. One of them will be training nurses about the selected
empowerment strategies. For example, nurses will be enrolled into training sessions where they will be informed about their role in creating safe work environments and advocating for sustainable change. Training will equip them with the competencies they need to drive excellence in nursing practice and protection of nurses’ needs and interests. The second strategy is creating discussion forums for nurses. The forums will enables them to share their issues and potential strategies that should be adopted in the organization. The third strategy for knowledge transfer will be involving nurses in assessing, planning, implementing, and evaluating the selected empowerment strategies. Their involvement will ensure the adoption of interventions that align with nurses’ expectations, hence, their sustainability (Dang et al., 2021). Lastly, best strategies will be incorporated into the organization’s culture. The incorporation will ensure the organization supports evidence-based strategies that contribute to nurses’ retention in the organization.
Three dissemination strategies will be adopted. The first one is publishing an article about the results of empowering nurses on the hospital’s nursing staffing levels. Publishing an article will be an effective approach to reaching a large nursing audience. It will also be used in other organization as an evidence-based intervention to address nurses’ shortages. The second dissemination strategy will be presenting results in nursing conferences. The conferences will provide opportunities to share knowledge with other nurses on the effectiveness of the intervention and how to improve it further. The last strategy will be developing new guidelines in the hospital to guide employee management (Dang et al., 2021). The empowerment strategies that prove effective will be incorporated into human resource policies, hence, sustainability in the use of best practices in the hospital.
Several outcomes will be used to assess the effectiveness of nurses’ empowerment in addressing the issue of nursing shortage in the organization. One of them will be the rate of nurses’ turnover. The rates will be compared before the intervention and after it to determine its impact on nursing workforce. The other measure will be nurses’ level of job satisfaction. Surveys, interviews and questionnaires will be administered to determine the satisfaction of nurses with the adopted empowerment interventions. An increase in their level of satisfaction will translate into the success of the intervention. Information about nurses’ intent to leave their jobs will also be obtained before and after the empowerment interventions. A reduction in their intention to leave their jobs will translate into project success. The costs incurred by the organization in hiring, training, and retaining nurses will also be compared before and after empowerment interventions to obtain a true picture of its impacts (Blouin & Podjasek, 2019; Cao et al., 2019).
I learned several things from conducting the evaluation table using the peer-reviewed articles. One of them is the importance of evidence-based data in nursing practice. I learned that nurses should make their decisions based on the best available evidence. The use of evidence-based data ensures optimum outcomes such as safety, quality, and efficiency. The other lesson learnt is the need for nurses to be competent in article critique. This will help them to determine the level of evidence in each article and relevance to their practice. I also learnt that evidence-based data is important in improving patient and nursing outcomes. This could be seen from the enhanced outcomes in the articles included in the review. Organizations influence the use of evidence-based data in their process. Therefore, they should ensure that their culture supports new practices to enhance performance and care outcomes in addressing the needs of different populations.
References
Blouin, A. S., & Podjasek, K. (2019). The Continuing Saga of Nurse Staffing: Historical and Emerging Challenges. JONA: The Journal of Nursing Administration, 49(4), 221. https://doi.org/10.1097/NNA.0000000000000741
Cao, Y., Liu, J., Liu, K., Yang, M., & Liu, Y. (2019). The mediating role of organizational commitment between calling and work engagement of nurses: A cross-sectional study. International Journal of Nursing Sciences, 6(3), 309–314. https://doi.org/10.1016/j.ijnss.2019.05.004
Challinor, J. M., Alqudimat, M. R., Teixeira, T. O. A., & Oldenmenger, W. H. (2020). Oncology nursing workforce: Challenges, solutions, and future strategies. The Lancet Oncology, 21(12), e564–e574. https://doi.org/10.1016/S1470-2045(20)30605-7
Dang, D., Dearholt, S. L., Bissett, K., Ascenzi, J., & Whalen, M. (2021). Johns Hopkins Evidence-Based Practice for Nurses and Healthcare Professionals: Model and Guidelines, Fourth Edition. Sigma Theta Tau.
Farid, M., Purdy, N., & Neumann, W. P. (2020). Using system dynamics modelling to show the effect of nurse workload on nurses’ health and quality of care. Ergonomics, 63(8), 952–964. https://doi.org/10.1080/00140139.2019.1690674
Gensimore, M. M., Maduro, R. S., Morgan, M. K., McGee, G. W., & Zimbro, K. S. (2020). The Effect of Nurse Practice Environment on Retention and Quality of Care via Burnout, Work Characteristics, and Resilience: A Moderated Mediation Model. JONA: The Journal of Nursing Administration, 50(10), 546. https://doi.org/10.1097/NNA.0000000000000932
Lester, P. E., Dharmarajan, T. S., & Weinstein, E. (2020). The Looming Geriatrician Shortage: Ramifications and Solutions. Journal of Aging and Health, 32(9), 1052–1062. https://doi.org/10.1177/0898264319879325
Seren Intepeler, S., Esrefgil, G., Yilmazmis, F., Bengu, N., Gunes Dinc, N., Ileri, S., Ataman, Z., & Dirik, H. F. (2019). Role of job satisfaction and work environment on the organizational commitment of nurses: A cross-sectional study. Contemporary Nurse, 55(4–5), 380–390. https://doi.org/10.1080/10376178.2019.1673668
Yahya Muabbar, H., & Zayyan Alsharqi, O. (2020). The Impact of Short-Term Solutions of Nursing Shortage on Nursing Outcome, Nurse Perceived Quality of Care, and Patient Safety. American Journal of Nursing Research, 9(2), 35–44. https://doi.org/10.12691/ajnr-9-2-1
A Sample Answer 2 For the Assignment: NURS 6052 Evidence-Based Project Part 4: Recommending an Evidence-Based Practice Change
Title: NURS 6052 Evidence-Based Project 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.