In 1,000-1,500 words, provide a description of the methods to be used to implement the proposed solution. Include the following:
Describe the setting and access to potential subjects. If there is a need for a consent or approval form, then one must be created. Although you will not be submitting the consent or approval forms in Topic 5 with the narrative, you will include the consent or approval forms in the appendices for the final paper.(Evidence Based Practice Proposal Sample for Nursing Students-Implementation Plan)
Describe the amount of time needed to complete this project. Create a timeline. Make sure the timeline is general enough that it can be implemented at any date. Although you will not be submitting the timeline in Topic 5 with the narrative, you will include the timeline in the appendices for the final paper.(Evidence Based Practice Proposal Sample for Nursing Students-Implementation Plan)
Describe the resources (human, fiscal, and other) or changes needed in the implementation of the solution. Consider the clinical tools or process changes that would need to take place. Provide a resource list. Although you will not be submitting the resource list in Topic 5 with the narrative, you will include the resource list in the appendices for the final paper.(Evidence Based Practice Proposal Sample for Nursing Students-Implementation Plan)
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Evidence Based Practice Proposal Sample for Nursing Students-Implementation Plan-Solution
Evidence-Based Practice Proposal: The Implementation Plan
Introduction
Heart failure is long term condition whose prevalence continues to increase in the wake of improved medical practices which have increased life expectancy. At the same time, inadequate patient knowledge and failure to adhere to medication prescribed amongst other factors also continue to increase the one-month readmission rates for the HF patients. As such, this EBP Proposal seeks to decrease readmission rates within the acute care setting through increased knowledge and self- care for HF patient education. Consequently, the fifth section of the proposal offers a description of the methods to be utilized in the implantation of the proposed solution.(Evidence Based Practice Proposal Sample for Nursing Students-Implementation Plan)
Setting and Access to Potential Subjects
Once approved, the proposed EBP project will take place in an acute care setting in a South Western hospital (SWACH). The peri-urban hospital is situated in a wealthy community. The project sample will be from HF patients discharged from the SWACH and later referred to the facility’s HF clinic for the nurse-led patient education program (Kollia et al., 2016). The target number will be about 90- 110 patients who get a primary diagnosis of HF. The patients will be recruited during their inpatient stay where the Registered nurses will explain the project to them and obtain their consent. Since the education intervention poses no harm to the patients, the nurse researcher who is also the lead change agent anticipates receiving Institutional Review Board Exempt Status.(Evidence Based Practice Proposal Sample for Nursing Students-Implementation Plan)
Time Needed to Complete the Proposed EBP Project
After the clinical practice problem is identified, a microsystem assessment of the Cardiovascular unit and initial observations of the process of discharge will be completed. Key metrics will be identified, and baseline data collected in before having the staff education will then be expected to educate the patients before the full implementation of the process. The projected time will run for nine weeks. In the first week, the nurse researcher will complete the microsystem assessment where one-month readmission rates will be linked to the understanding of the discharge instructions. This will be followed with a meeting of the project advisor to discuss the scope of the project and the process of securing IRB process in the second week where the pertinent clinical question will also be identified. By Week 3, the discharge process within the unit will be observed with care coordination meeting followed by submission and approval of IRB amongst other activities being accomplished within Week 4 and 5, respectively. In Week 5 still, the proposed intervention will be presented to the staff with nurses’ feedback and Care Coordination on discharge preparedness targeted to be accomplished within the same week. In Week 6, the implementation, the six steps of SCNDT and nurse education will occur. Week 7 will entail audit of the SCNDT and lastly audit of the patient education in Week 8. Week 9 will entail the of teach-back education for the patients.(Evidence Based Practice Proposal Sample for Nursing Students-Implementation Plan)
Resources (Human, Fiscal, And Other) Or Changes Needed
For successful implementation of the project, the hospital will have to hire another RN for the Heart Clinic besides acquiring the tools for primary HF education. The education tools will be printed in English and full-color so that the participants’ recruiter will each a booklet to take home for referring to at their convenience (Kristiansen et al., 2017). The patient education will also incorporate the latest HF guidelines and tools needed to promote the self-care behaviors among the HF patients. Optimal discharge HF education will be structured and imparted to all patients visiting the clinics who later get a primary HF diagnosis (Athar et al., 2018).(Evidence Based Practice Proposal Sample for Nursing Students-Implementation Plan)
Description of The Methods and Instruments Used to Monitor the Implementation
The model’s choice is premised on its similarities to the process of nursing. Experts have determined that inadequate knowledge on HF leads to a worsened quality of life necessitating the formulation of methods and creation of instruments like questionnaires in order to monitor the implementation of the proposed solution. In this project, a questionnaire will be developed as a tool to monitor the impact of the HF education program of the two processes of teaching and learning. The 19-item questionnaire then uses the Kolmogorov-Smirnov normality test will be used for the questionnaire score and variables age (Bonin et al., 2014). The sample characteristics will include gender, occupation, time of diagnosis, clinical diagnosis and the like.(Evidence Based Practice Proposal Sample for Nursing Students-Implementation Plan)
The Process of Delivering the Proposed HF Patient and Self- Care Solution
Considering even amongst some nursing staff, the change team who will act as the principal change agents will undergo a two-week training program with each session lasting, not more 80 minutes. The intervention will be led by an Advanced Practice Registered nurse within the SWACH outpatient HF clinic situated a few meters from this hospital’s main facility. The HF education will be offered by the clinic’s RNs on the admitted patients and then follow up by the APN for at least one month after discharge. Orem’s theory prescribes to the nursing process of assessing, diagnose, plan, implement and lastly evaluate. Grieves et al. (2016) outline the six steps that if followed, will lead to a successful implementation of the patient education. The steps will generally take the course of lesson preparation where the content will be proven to pieces, and have a variety of resources with a minimum of a written and visual text for every session. Step 2 will entail customizing the lesson to fit the specific patient’s needs as no one size fits all has over the years proven ineffective. The third step will entail having the goals in mind where the educator will actively engage the patient, and the last step will require the nurse educator to assess the lesson not based on the education materials but instead on the goals set.(Evidence Based Practice Proposal Sample for Nursing Students-Implementation Plan)
Outline of The Data Collection Plan
Pre-implementation data will be collected in the form of visual and chart audits. The patients will have to patients 18 years and above with a primary diagnosis of HF but will not count those patients admitted beyond the one-month targeted time frame. Additionally, the SPSS tool will also be used to both collect and analyze the data mined from the patient’s EHRs records. Data will be collected from the MIDAS report which identifies both primary and secondary diagnosis of HF patients daily determined that patients fail to turn up even after being called the strategy was changed to having the patient agree before or on the day they are discharged. If the patient is readmitted within one month, the electronic health record flags te information which is then sent to MIDAS report as readmission. Documentation of attendance in the proposed solution class will also be part of the patient’s electronic health record (Albano et al., 2014). It is essential to state that the collected data will be de-identified so that patient identifier information will be blacked out. Only the nurse researcher and a select few of the team will have authorized access to the collected data which will be stored in digital form using passwords. The data will then be analyzed using descriptive statistics to describe the sample and make a comparison on the impact the solution has on one-month readmission rates.(Evidence Based Practice Proposal Sample for Nursing Students-Implementation Plan)
Barriers, Challenges and Facilitators in the Implementation
One of the critical challenges identified as a hindrance to the successful implementation of this project is the lack of knowledge on HF, for example, concerning their recommended dietary intake and salt intake reduction. Wood et al. (2018) opine that there is disconnect fueled by misconceptions about HF and its symptoms that eventually lead to failure to fathom the disease and its symptoms. Another of the barriers recognized by the patients is their failure to the full gravity of their ignoring of the treatment plan. Similarly, some cultural beliefs and personal values like the concept of Karma or the patient leaving the provider to make all decisions about their care with hardly any of the input (Jaarsma et al., 2017). On the other hand, the patients recognize health awareness and adequate understanding of the effects of not adhering to the recommended treatment as primary facilitators. On the flip side also, some cultural beliefs and values motivate individuals to participate in self- care activities are essential in the management of HF on a long-term basis. (Evidence Based Practice Proposal Sample for Nursing Students-Implementation Plan)
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Feasibility of The Implementation Plan
Once the proposed budget reveals that that implantation of the intervention program is cost-effective and within the SWACH financial and material resources. The overall cost of implementing the project will not exceed 10 thousand dollars. Beginning with the cost of personnel will be capped at $4 000 since only the research assistant will have an allowance. The other members of the change team are drawn from the hospital nursing staffed volunteers. The clinic will absorb the cost of consumable supplies like educational materials and the scales for measuring weight. At the same time, fuel cards will be given to provide to the coordinator of the project and capped at $ 1500. The other participating nurses will not be given because the education will be offered at the hospital before patients’ discharge. Computer costs are projected unknot to exceed $ 2000 to cater for databases accesses and the data analyst consultation fee. Printing of some of the materials like posters will not exceed $ 500 while the PPT presentation will consume $300. The remaining amount c $ 1700 will be set aside for miscellaneous expenses.(Evidence Based Practice Proposal Sample for Nursing Students-Implementation Plan)
Plans to Maintain, Extend, Revise, and Discontinue the Proposed Solution
Upon implementation and posting, the expected outcomes will not only be maintained but also have its time extended. If the projects substantially meet some of the set targets but fall short by a few percentage points, the project will be revised to make it better. However, if no statistical significance or clinical significance is established, then the hospital management will be at liberty to discontinue the program.(Evidence Based Practice Proposal Sample for Nursing Students-Implementation Plan)
Conclusion
Contemporary healthcare requires professionally trained muse to use EBP practices to resolve clinical issues. By assessing, critiquing and analyzing relevant information, the RNs get informed. They can therefore adequately educate the HF patients of ways to manage their condition and improve their quality of life.(Evidence Based Practice Proposal Sample for Nursing Students-Implementation Plan)
References
Albano, M. G., Jourdain, P., De Andrade, V., Domenke, A., Desnos, M., & d’Ivernois, J. F. (2014). Therapeutic patient education in heart failure: do studies provide sufficient information about the educational programme?. Archives of cardiovascular diseases, 107(5), 328-339.(Evidence Based Practice Proposal Sample for Nursing Students-Implementation Plan)
Athar, M. W., Record, J. D., Martire, C., Hellmann, D. B., & Ziegelstein, R. C. (2018). The effect of a personalized approach to patient education on heart failure self-management. Journal of personalized medicine, 8(4), 39.(Evidence Based Practice Proposal Sample for Nursing Students-Implementation Plan)
Bonin, C. D. B., Santos, R. Z. D., Ghisi, G. L. D. M., Vieira, A. M., Amboni, R., & Benetti, M. (2014). Construction and validation of a questionnaire about heart failure patients’ knowledge of their disease. Arquivos brasileiros de cardiologia, 102(4), 364-373.
Greaves, C. J., Wingham, J., Deighan, C., Doherty, P., Elliott, J., Armitage, W., … & Singh, S. (2016). Optimising self-care support for people with heart failure and their caregivers: development of the Rehabilitation Enablement in Chronic Heart Failure (REACH-HF) intervention using intervention mapping. Pilot and feasibility studies, 2(1), 37.(Evidence Based Practice Proposal Sample for Nursing Students-Implementation Plan)
Jaarsma, T., Cameron, J., Riegel, B., & Stromberg, A. (2017). Factors related to self-care in heart failure patients according to the middle-range theory of self-care of chronic illness: a literature update. Current Heart Failure Reports, 14(2), 71-77.
Kollia, Z. A., Giakoumidakis, K., & Brokalaki, H. (2016). The effectiveness of nursing education on clinical outcomes of patients with heart failure: A systematic review.(Evidence Based Practice Proposal Sample for Nursing Students-Implementation Plan)
Kristiansen, A. M., Svanholm, J. R., Schjødt, I., Jensen, K. M., Silén, C., & Karlgren, K. (2017). Patients with heart failure as co-designers of an educational website: implications for medical education. International Journal of Medical Education, 8, 47.(Evidence Based Practice Proposal Sample for Nursing Students-Implementation Plan)
Wood, R. L., Migliore, L. A., Nasshan, S. J., Mirghani, S. R., & Contasti, A. C. (2019). Confronting Challenges in Reducing Heart Failure 30‐Day Readmissions: Lessons Learned With Implications for Evidence‐Based Practice. Worldviews on Evidence‐Based Nursing, 16(1), 43-50.(Evidence Based Practice Proposal Sample for Nursing Students-Implementation Plan)
Question
In 1,000-1,500 words, provide a description of the methods to be used to implement the proposed solution. Include the following:(Evidence Based Practice Proposal Sample for Nursing Students-Implementation Plan)
Describe the setting and access to potential subjects. If there is a need for a consent or approval form, then one must be created. Although you will not be submitting the consent or approval forms in Topic 5 with the narrative, you will include the consent or approval forms in the appendices for the final paper.(Evidence Based Practice Proposal Sample for Nursing Students-Implementation Plan)
Describe the amount of time needed to complete this project. Create a timeline. Make sure the timeline is general enough that it can be implemented at any date. Although you will not be submitting the timeline in Topic 5 with the narrative, you will include the timeline in the appendices for the final paper.(Evidence Based Practice Proposal Sample for Nursing Students-Implementation Plan)
Describe the resources (human, fiscal, and other) or changes needed in the implementation of the solution. Consider the clinical tools or process changes that would need to take place. Provide a resource list. Although you will not be submitting the resource list in Topic 5 with the narrative, you will include the resource list in the appendices for the final paper.
Describe the methods and instruments, such as a questionnaire, scale, or test to be used for monitoring the implementation of the proposed solution. Develop the instruments. Although you will not be submitting the individual instruments in Topic 5 with the narrative, you will include the instruments in the appendices for the final paper.
Explain the process for delivering the (intervention) solution and indicate if any training will be needed.(Evidence Based Practice Proposal Sample for Nursing Students-Implementation Plan)
Provide an outline of the data collection plan. Describe how data management will be maintained and by whom. Furthermore, provide an explanation of how the data analysis and interpretation process will be conducted. Develop the data collection tools that will be needed. Although you will not be submitting the data collection tools in Topic 5 with the narrative, you will include the data collection tools in the appendices for the final paper.(Evidence Based Practice Proposal Sample for Nursing Students-Implementation Plan)
Describe the strategies to deal with the management of any barriers, facilitators, and challenges.
Establish the feasibility of the implementation plan. Address the costs for personnel, consumable supplies, equipment (if not provided by the institute), computer-related costs (librarian consultation, database access, etc.), and other costs (travel, presentation development). Make sure to provide a brief rationale for each. Develop a budget plan. Although you will not be submitting the budget plan in Topic 5 with the narrative, you will include the budget plan in the appendices for the final paper.(Evidence Based Practice Proposal Sample for Nursing Students-Implementation Plan)
Describe the plans to maintain, extend, revise, and discontinue a proposed solution after implementation.(Evidence Based Practice Proposal Sample for Nursing Students-Implementation Plan)
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Evidence Based Practice Proposal: Implementation Plan
You are required to cite five to 10 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. An abstract is not required.(Evidence Based Practice Proposal Sample for Nursing Students-Implementation Plan)
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.(Evidence Based Practice Proposal Sample for Nursing Students-Implementation Plan)