Throughout this course, you have developed a formal, evidence-based practice proposal.
The proposal is the plan for an evidence-based practice project designed to address a problem, issue, or concern in the professional work setting. Although several types of evidence can be used to support a proposed solution, a sufficient and compelling base of support from valid research studies is required as the major component of that evidence. Proposals must be submitted in a format suitable for obtaining formal approval in the work setting. Proposals will vary in length depending upon the problem or issue addressed (3,500 and 5,000 words). The cover sheet, abstract, references pages, and appendices are not included in the word count…(Evidence Based Practice Proposal Sample for Nursing Students)
Solution
Evidence-Based Practice Proposal – Complete Proposal
Abstract
As the healthcare industry ushers in the third decade of the 21st century, the management of heart failure continues to prove to a significant health challenge. Inadequate patient knowledge and failure to adhere to medication prescribed amongst other factors also continue to increase the readmission rates for the HF patients. The purpose of this EBP is to decrease readmission rates within the acute care setting through increased knowledge and self- care for HF patient education. Organization Culture and Readiness for System-Wide Integration of Evidence-Based Practice (OCRSIEP) is the selected organization culture, and survey tool to investigate, evaluate, and identify the organization’s readiness. Orem’s Self-care Deficit Nursing Theory (SCDNT) is used to link the problem, the proposed intervention, and anticipated outcomes. A literature search from healthcare based databases like PubMed, Medline, and CINAHL yielded in over 270 articles, which were excluded to include 12 articles focusing on the management of heart failure, self-care, and patient education in the last 5 years. Pre-implementation data is collected in the form of visual and chart audits, as well as extraction from the facility’s EHR records. Implementing educational programs for chronic condition management of HF as well as evaluation of patients’ adherence to management behaviors for self-care facilitates responsible care coordination leading to low readmission rates and better patient outcomes.(Evidence Based Practice Proposal Sample for Nursing Students)
Keywords: heart failure, organization culture, patient education, self-care,
Section A-Organizations Culture and Readiness and Assessment
Organization Culture and Readiness for System-Wide Integration of Evidence-Based Practice is the selected organization culture and survey tool (Yoo, Kim, Kim, Kim, & Ki, 2019). For its involvement in the EBP, the survey tool will be of help in investigating, evaluating, and identifying the organization’s readiness.(Evidence Based Practice Proposal Sample for Nursing Students)
Level of Readiness of the Organization
Depending on Organizational Culture and Readiness Assessment results, the organization is set to participate in evidence-based practice. The nurses have pledged to initiate the evidence-based program. Physicians within the organization are also passionate about supporting the nursing staff in evidence-based practice. Furthermore, the organization provides the staff with numerous opportunities not only to learn but also to practice EBP. It is through the organization that the employees in different departments access to research and evidence-based practice libraries using the provided computers. To help other medical centers, the organizational share not only metrics but also EBP and outcomes through peer groups. To meet its goal of magnifying their nursing strength and quality, the organization is bound to support as well as drive an EBP culture.(Evidence Based Practice Proposal Sample for Nursing Students)
Summary of the Results of OCRSIEP Survey on the Assessed Organization Readiness
The OCRSIEP Survey assessed the selected organization and cultural readiness for the implementation of an EBP with the RN responses ranging from none at all at 1 to very much at 5. The others were a little at 2, somewhat three and moderately 4. Each of the respondents could have scored a maximum of 95 points where Respondent 1 had 77 with two questions not answered, and Respondent 2 had 51 with 1 question not answered. The other Respondents 3, 4, and 5 responded to all, and each scored 83, 93, and 58, respectively. The organization’s readiness was measured, ranked as getting ready in the previous six months. The statistical means of each question ranged from 1 to 4.6, and the medians ranging from 1 to 5. At the same time, the standard deviations ranged from 0.00 to 1.63. The RNS perceived the administration’s decisions as ranging from 25% to 100 %. The decisions made by staff ranged from none to 25%. This implies that the hospital management should institute measures that ensure the staff also feels they own the EBP programs initiated through frequent consultations and immediate feedback.(Evidence Based Practice Proposal Sample for Nursing Students)
Project Barriers
These barriers are either human or organizational factors. Fist heavy workload makes reading time inadequate. There is also little experience of staff since most staff have little experience in participating in evidence-based practice. Additionally, the facilitation of evidence-based practice lack resources. Facilitators will assist in the implementation of new cultures for improving the treatment of lung cancer in men (Jones, & Baldwin, 2018). Facilitators include not only role modeling applications but also improved information access.(Evidence Based Practice Proposal Sample for Nursing Students)
Integrating clinical inquiry and strategies to strengthen nurses with low morale
In the formulation of evidence-based practice, nurses should follow the steps of the EBP process. These are: ask, gather, appraise, act, evaluate, and disseminate. To strengthen the morale of employees, the organization should motivate, empower, and acknowledge. There should also be transparency in the organization.(Evidence Based Practice Proposal Sample for Nursing Students)
Section B: Problem Statement and Literature ReviewProblem Statement
This EBP project is proposed to lower HF the one-month heart failure readmission rates in the acute care hospital setting by implementing a change initiative that would increase patient knowledge of HF self-care activities. The current EBP proposes to focus on measures that would decrease hospital readmissions that can be prevented by integrating the best practices in connection to HF self- care activities. This because educating the patient together with their families on how to manage effectively and early treatment would potentially lower the one-month hospital readmission rates and yield improved outcomes. As such the refined PICOT question which was “Amongst adults aged over 45 years diagnosed with heart failure (Population-P), would post-discharge HF education program hereafter abbreviated as (PHFEP) (Intervention- I) compared to conventional heart disease education (Comparison-C) decrease the rate of one-month hospital readmissions and improved quality of life for the patient (Outcome- O) within 90 days (Time –T)?’
The proposed problem state, therefore, states The EBP project is proposed to initiate measures whose successful implementation would lower the one-month hospital readmission rates for adult patients diagnosed with HF.(Evidence Based Practice Proposal Sample for Nursing Students)
As you continue, premiumacademicaffiates.com has the top and most qualified writers to help with any of your assignments. All you need to do is place an order with us. (Evidence-Based Practice Proposal – Complete Proposal)
Evidence-Based Practice Proposal – Complete Proposal
Literature Review
The proposed PICOT question helped guide a comprehensive literature search that helped to identify, analyze, and synthesize the relevant literature that supports the PHFEP initiative. The articles’ subjects, methods, key findings were then synthesized. The search from healthcare based databases like PubMed, Medline, and CINAHL yielded in over 270 articles. Search terms from the PICOT question and problem statements like self- care, education, and HF were used in the search process. The article’s meeting the inclusion criteria of being published in English and within not older than five years were synthesized. The subjects of the selected articles included Ba et al. (2020) integrative review, which sought to highlight transitional care interventions to Ziaenian & Fonarow (2016), which focused on strategies for preventing HF hospital readmission.(Evidence Based Practice Proposal Sample for Nursing Students)
From another perspective, Su et al. (2019) explored the socioeconomic predictors and their impact on HF readmissions. The methods used in the review articles also varied from Diez et al. (2019) use of randomized control trial and qualitative methodology, which was utilized by Glogowska et al. (2015) while Qaddoura et al. (2015) used systematic reviews and meta-analysis approach. At the same, these studies also emphasized the role of patient education and the need to adhere to the HF self-care practices as a way of effective management of HF (Souza et al., 2019; Toukhasati et al., 2019). The articles also had notable limitations, like the small number of participants in the RCTs makes the findings of the study less generalizable (Dies et al., 2019). Another study limitation was the inclusion of only those articles publishing English and failing to explore the gray literature databases like dissertations and non- peer-reviewed articles. The general trend in all the findings of the articles selected underpinned the fact that HF hospital readmissions were largely preventable events (Ba et al., 2020). The overall effect of these limitations is that not all research that is relevant was included in the literature review.
The need to nurse-led face to face patient education sessions is bound to improve HF disease management. As the articles reviewed indicate, patients with HF knowledge scores are less likely to be readmitted in hospitals compared to patients with low HF scores indicating the efficacy of the proposed education intervention. The increase in HF knowledge improves the patients’ self-care confidence and practices. All these findings support the need for a comprehensive post-discharge HF patient education applying the best practices, which would ultimately lead to reduced HF readmission rates.(Evidence Based Practice Proposal Sample for Nursing Students)
Section C Solution Description
Proposed Solution
The aging population and the rising prevalence of HF serve to increase the healthcare costs shared by the individual patient and third-party payers (Savarese & Lund, 2017). One of these interventions is HF patient education, which entails making the patients ware of HF warning signs and how to manage them before they degenerate into hospital admissions. Following the proposed EBP intervention of decreasing the one-month readmission rates in acute care settings, the intervention of increasing knowledge and self-help activities, the third section of the EBP project aims to describe the proposed solution.
Healthcare providers acknowledge that HF is a long-term condition with an increased prevalence emanating from the enhanced medical management therapies. HF remains one of the costliest cardiovascular diseases in the US and a leading cause of hospitalization. While this might be the case, Howie- Esquivel et al., 2015 note that half of the readmissions are preventable since they are caused by insufficient teaching upon discharge, not sticking to the recommended diet or medication, and inadequate or absence of follow up of the HF. Studies also point out that patient education that incorporates the family members on HF self-care practices plays a significant role in decreasing acute HF exacerbations while simultaneously improving the patient’s quality of life (Vailant-Rolussel et al., 2016). Subsequently, the proposed intervention is the implementation of an HF self-care patient education that utilizes a holistic approach in clinical decision making and early symptom recognition and management. The patient education program is cost-effective and does not cause any harm to the patient.(Evidence Based Practice Proposal Sample for Nursing Students)
Organization Culture and Expected Outcomes
The proposed patient education on self-care management practices rhymes the site of the proposed organizational culture in that the facility keeps the nurses motivated through internal and external rewards (Storkholm et al., 2019). This motivation leads the nurses to initiate, implement and sustain measures that are bound to improve patient outcomes and increase the hospital reimbursement rates after meeting the set patient safety recommendations and benchmarks as set by state nursing boards and other healthcare regulatory agencies. By focusing on measures that could lead to decreased readmissions, the change agents will target to intervene at the hospital stage before the patients’ discharge and run through the four weeks after discharge. Offering the patients, the requisite tools to partake in positive self-care behavior is bound to lead them to identify the changes in their HF condition and initiate interventions before they seek hospitalization.(Evidence Based Practice Proposal Sample for Nursing Students)
Method to Achieve Outcomes
To achieve the expected outcomes of improved quality of life, enhanced self-care HF and management practices, and decreased hospital readmissions within the one-month post-discharge, a raft of methods will be used that can best be captured in six steps. The first step will entail the assessment for a need for change in practice when the nurse researcher meets will significant stakeholders like the hospital administrators, nursing staff, educators, case, and nurse managers, among others. Step two will see the connection between the problem, the proposed intervention, and anticipated outcomes established. Step three will include the synthesis of the best available evidence within the context of HF, patient and family education, self-care readmissions, and a decrease in reimbursement. The fourth step will see the practice change designed before the patient education program is implemented, evaluated while the last but not least will have the intervention integrated and eventually maintained into the hospital’s clinical practice.(Evidence Based Practice Proposal Sample for Nursing Students)
Outcomes Impact
Mathieson, Grande, and Luker (2017) highlight some barriers to EBP project implementation. A likely barrier will be a memory, but the nurse educations will resolve this by ensuring that verbal communication is accompanied by written resources like brochures, pamphlets, and posters. Other barriers include but are not limited to inadequate knowledge on the HF disease progression, its symptoms, and recommended best self-care practices that the educational intervention will address. The study assumes that the proposed theoretical frame will be suitable to evaluate and judge appropriate teaching materials. Simultaneously, a fundamental limitation is the utilization of nursing models to the psychological and emotional aspects of self-care. The impact of expected outcomes will lead to increased knowledge self-care activities, early HF symptoms identification, and enhanced compliance with the medication regimen and recommended diet.
The EBP project on HF hospital readmissions rates reduction expects that a comprehensive HF self- care practice and patient education will lead to decreased hospital rates. The literature search guided through the PICOT question framework will also support the outcomes of the proposed hence the need to have implemented. Once it is successfully implanted, the HF self-care and patient education program will result in successful HF outcomes distinguishable from the decreased one moth rate during the time the proposed intervention is in progress.(Evidence Based Practice Proposal Sample for Nursing Students)
Section D Change Theory
Theoretical Framework
Dorothea Orem’s Self-care Deficit Nursing Theory (SCDNT) provides the theoretical framework for the project. SCDNT or Orem’s theory is suitable for heart failure patients since it actively encourages them to participate in their care. The patients are encouraged to be in a position to care for their daily weights, adhere to medications as well as identify worsening symptoms (Attaallah, Klymko, & Hopp, 2016). This self-care is an essential concept for the nurses while caring for heart failure patients since it captures the center of nursing philosophy and a crucial nursing practice aspect. In this model, nursing assessment, diagnosis, organization, execution, and evaluation processes. Previous studies show that applying this theory to patients with heart failure brings about affirmative therapy and clinical outcomes when self-care measures are applied and reinforced in-patient heart failure education (Parke, 2017). Reduced readmissions would reduce the financial burden resulting from heart failure patient readmission within 30 days.(Evidence Based Practice Proposal Sample for Nursing Students)
Stages in the Change Model/Framework
Orem’s theory has systematically identified steps that will not only guide adjustment but also integrate into practice. First, there will be an assessment of the need for variance in practice. Measures needed to be taken by hospitals to reduce readmission within 30 days follow the review. The hospital’s target will be to reduce hospitalization by 20% because of the current heart failure readmission rates. Possible causes for change will be discussed. Secondly, problems, interventions, as well as results, are linked. In this stage, some group members will present confirmation of suitable practices for a readmission rate reduction from seminars. (Evidence Based Practice Proposal Sample for Nursing Students)
Different groups within the hospital share practices that produce positive results. Ways to help heart failure patients identify the variance of their condition and seek intervention before requiring hospitalization are devised. The next stage synthesizes the best evidence. ProQuest and PubMed are some of the databases that will apply to a literature review within a limited period (Amoah, & Mwanri, 2016). Terms such as heart failure, readmission education, decrease reimbursement, and self-care are used. Stage 4 involves designing of practice change. The change to be proposed in the discharge process is discussed by one of the groups. The possibility of practice change implementation, together with strategies are suggested. Necessary resources are also identified. Before engaging in the last stage, change in practice is to be implemented and also evaluated. Ways of evaluating the process are formulated by the students and concerned stakeholders like the quality manager. 30-day readmission rates on heart failure patients are evaluated as they are also further educated. Lastly, the change in practice is to be integrated and maintained. They can either accept or reject it to either integrate the practice into the standards or not is made as they observe the trend of readmission rates and heart failure self-care management.(Evidence Based Practice Proposal Sample for Nursing Students)
Application of Each Stage of the Proposed Project Implementation
The steps ofDorothea Orem’s Self-care Deficit Nursing Theory (SCDNT), as the applied theoretical framework for this evidence-based project, are to be appropriately applied in the proposed implementation. Stage one, assessing the need for change practice, will help the administration recognize and report the recorded readmission rates in the hospital compared to the national average. Using guidelines of the best practice will help formulate a PICOT question to assess heart failure education’s impact on readmission rates within 30 days. Both internal and external factors that may affect the EBP project will be assessed. After applying the assessment for change practice, locating the best evidence will be useful in obtaining literature and seminar evidence concerning the best practices in lowering readmission rates. PubMed and ProQuest databases will be useful in the search process.(Evidence Based Practice Proposal Sample for Nursing Students)
In the third step, synthesizing the best evidence, the evidence will be analyzed using Melnyk and Covey’s (2016) rating system for critical consideration and hierarchy forms of evidence from books. The selected studies will summarize the evidence in a table form. Analysis of how the support of post-discharge for old heart failure patients reduces 30-day readmission will also be done. Stage 4 of designing practice change will define what would change practice and decrease the readmissi0on rate. Patients will be given further education in heart failure clinics APNs. Implementing and evaluating change in practice will also be applicable. The educational tool will be administered to a patient. Intervention data will also be collected for 30 days while at the same time noting the rate of readmission. Finally, on integration and maintaining change in practice, a decision will be made to integrate the teaching tool into the practice standards for the hospital.(Evidence Based Practice Proposal Sample for Nursing Students)
As you continue, premiumacademicaffiates.com has the top and most qualified writers to help with any of your assignments. All you need to do is place an order with us. (Evidence-Based Practice Proposal – Complete Proposal)
Evidence-Based Practice Proposal – Complete Proposal
Section E: 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 in-patient 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)
Timeline
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 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 by a meeting of the project advisor to discuss the scope of the project and the process of securing IRB approval 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 a 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 teach-back education for the patients.(Evidence Based Practice Proposal Sample for Nursing Students)
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’ recruiters will each a booklet to take home for referring to at their convenience (Kristiansen et al., 2017). Patient education will also incorporate the latest HF guidelines and tools needed to promote the self-care behaviors among 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)
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 of HF leads to a worsened quality of life, necessitating the formulation of methods and the creation of instruments like questionnaires 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)
Delivery Process for the Intervention
Considering even amongst some nursing staff, the change team will act as the principal change agents will undergo a two-week training program with each session lasting, not more than 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 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)
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 the information, which is then sent to the 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)
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 that are essential in the management of HF on a long-term basis. (Evidence Based Practice Proposal Sample for Nursing Students)
As you continue, premiumacademicaffiates.com has the top and most qualified writers to help with any of your assignments. All you need to do is place an order with us. (Evidence-Based Practice Proposal – Complete Proposal)
Evidence-Based Practice Proposal – Complete ProposalFeasibility 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 $10,000. 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 database 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, $1700, will be set aside for miscellaneous expenses.(Evidence Based Practice Proposal Sample for Nursing Students)
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 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.
Section F: Evaluation Plan
Rationale for the Methods Used in Collecting the Outcome Data
It is easier for most patients to respond to questions using a Likert scale. It is also possible to get the contributing factors to the patients’ worsening health state, such as dietary, comorbidity, and non-adherence to patient education. For instance, the nurse can give them dietary recommendations as well as common food’s specific sodium content. They are also able to assess whether the patients received full medical evaluation or not. Patients who are at high risk for readmission due to para-medical reasons like non-optimal medication are also identified with ease.(Evidence Based Practice Proposal Sample for Nursing Students)
Outcome Measures Evaluation of Project Objectives
By getting the comparison of the 30 days readmission rate for outpatients receiving additional information to in-patients getting traditional education, the extent of achievement of reduction of readmission rate will be evaluated. According to Ziaeian and Fonarow (2016), discharge education helps in reducing readmissions of heart failure patients. However, this intervention alone is not enough to reduce heart failure readmission rates. There is, therefore, a need for other interventions like discharge planning, prior scheduling of follow-up, communicating with outpatient providers, medication reconciliation, and follow-up telephone calls. Readmission is prevented since these patients receive necessary information about diet, how to adhere to medication, and also how they can manage symptoms on their own.(Evidence Based Practice Proposal Sample for Nursing Students)
Outcome Measures and Their Evaluation
The proposed EBP project outcome measure to be measured will be to measure the rates of readmission for those HF patients receiving extra education within an outpatient setting in comparison to those who received the standard education offered to in-patients. The anticipated outcome will also be to increase self- care behavior knowledge and early recognition of symptoms in need of attention by the primary care physician. The validity and reliability of the data will be premised on the fact that the data will be obtained from HF patient director of case management. Similarly, the data’s applicability will rely heavily on the director of quality who prepares reports on monthly reports, an HF subcommittee.(Evidence Based Practice Proposal Sample for Nursing Students)
Strategies to Take If Outcomes Provide Negative Results
It’s not always that the results of a project turn to be positive. It is, therefore, necessary to formulate strategies that would be implemented in case the outcomes are negative. If negative results are registered, the implementation plan would be revised by identifying the barriers at the patient, health providers, and system-level barriers. Possible ways of addressing the obstacles would also be devised. Among other strategies to address these barriers include the medical home establishment in outpatient clinics, partnership creation with community resources for patients with low income, and medical home establishment with heart failure patients and families (Figueroa et al., 2017). Alternatively, we would look for suitable ways of addressing the study limitations. Chamberlain et al. (2018) acknowledge that a larger sample size would be lead to an accurate measure of changing trends. Patients from several organizations would also be used. These would help to improve health outcomes.(Evidence Based Practice Proposal Sample for Nursing Students)
Implications for Practice and Future Research
Advanced Practice Nurses (APNs) are responsible for the care coordination of care for heart failure patients. They assess the patient’s needs; implement necessary educational elements for chronic condition management as well as evaluation of patients’ adherence to management behaviors for self-care. They also check the patients’ daily weights, understand dietary restrictions, and also identify worsening symptoms. Their expertise also promotes positive healthcare practices. To direct change in practice, future research should be based on existing study findings. The research should also determine whether the outcome quality of heart failure patients is improved by education led by APNs. If the education tool used is successful, its use would be continued at the project facility.(Evidence Based Practice Proposal Sample for Nursing Students)
Conclusion
Improved outcomes and reduced 30 days readmission rate will indicate better implementation of the chosen strategies. The proposed EBP project on HF hospital readmissions rates reduction expects that a comprehensive HF self- care practice and patient education will lead to decreased hospital rates. The increase in HF knowledge improves the patients’ self-care confidence and practices. Findings support the need for a comprehensive post-discharge HF patient education applying the best practices, which would ultimately lead to reduced HF readmission rates. The literature search guided through the PICOT question framework supports the outcomes of the proposed hence the need to have implemented. Guided by Orem’s theory of self-care nursing, the HF self-care and patient education program will result in successful HF outcomes distinguishable from the decreased one moth rate during the time the proposed intervention is in progress.(Evidence Based Practice Proposal Sample for Nursing Students)
As you continue, premiumacademicaffiates.com has the top and most qualified writers to help with any of your assignments. All you need to do is place an order with us. (Evidence-Based Practice Proposal – Complete Proposal)
Evidence-Based Practice Proposal – Complete ProposalReferences
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)
Amoah, D., & Mwanri, L. (2016). Determinants of hospital readmission of medical conditions in developing countries. Austin J Public Health Epidemiol, 3(5), 1049.(Evidence Based Practice Proposal Sample for Nursing Students)
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)
Attaallah, S., Klymko, K., & Hopp, F. P. (2016). Self-care among older adults with heart failure. Gerontology and Geriatric Medicine, 2, 2333721416684013.(Evidence Based Practice Proposal Sample for Nursing Students)
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.
Chamberlain, R. S., Sond, J., Mahendraraj, K., Lau, C. S., & Siracuse, B. L. (2018). Determining 30-day readmission risk for heart failure patients: the Readmission after Heart Failure scale. International journal of general medicine, 11, 127.(Evidence Based Practice Proposal Sample for Nursing Students)
Diez, N. P., Campos, R. C., Roiz, S., Salaverria, I., Subijana, E., González, M. J. E., & Sobradillo, P. (2019). Effectiveness of self-care program for hospital readmissions prevention in patients with potentially avoidable hospitalizations 🙁 AUTOCUID) randomized clinical trial. International Journal of Integrated Care (IJIC), 19.
Figueroa, J. F., Joynt, K. E., Zhou, X., Orav, E. J., & Jha, A. K. (2017). Safety-net hospitals face more barriers yet use fewer strategies to reduce readmissions. Medical care, 55(3), 229.
Glogowska, M., Simmonds, R., McLachlan, S., Cramer, H., Sanders, T., Johnson, R., & Purdy, S. (2015). Managing patients with heart failure: a qualitative study of multidisciplinary teams with specialist heart failure nurses. The Annals of Family Medicine, 13(5), 466-471.(Evidence Based Practice Proposal Sample for Nursing Students)
Greaves, C. J., Wingham, J., Deighan, C., Doherty, P., Elliott, J., Armitage, W., & Singh, S. (2016). Optimizing 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)
Howie-Esquivel, J., Carroll, M., Brinker, E., Kao, H., Pantilat, S., Rago, K., & De Marco, T. (2015). A strategy to reduce heart failure readmissions and inpatient costs. Cardiology Research, 6(1), 201.
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.
Jones, G. S., & Baldwin, D. R. (2018). Recent advances in the management of lung cancer. Clinical Medicine, 18(Suppl 2), s41. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334032/
Kollia, Z. A., Giakoumidakis, K., & Brokalaki, H. (2016). The effectiveness of nursing education on clinical outcomes of patients with heart failure: A systematic review.
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.
Linn, A. C., Azollin, K., & de Souza, E. N. (2016). Association between self-care and hospital readmissions of patients with heart failure/Associação entre autocuidado e reinternação hospitalar de pacientes com insufi ciência cardíaca/Asociación entre la auto-atención y reingresos hospitalarios de pacientes con insufi ciencia cardíaca. Revista Brasileira de Enfermagem, 69(3), 469.(Evidence Based Practice Proposal Sample for Nursing Students)
Mai Ba, H., Son, Y. J., Lee, K., & Kim, B. H. (2020). Transitional Care Interventions for Patients with Heart Failure: An Integrative Review. International Journal of Environmental Research and Public Health, 17(8), 2925.
Mathieson, A., Grande, G., & Luker, K. (2019). Strategies, facilitators, and barriers to implementation of evidence-based practice in community nursing: a systematic mixed-studies review and qualitative synthesis. Primary health care research & development, 20.
Melnyk, B. M., & Covey, S. R. (2016). Improving healthcare quality, patient outcomes, and costs with evidence-based practice. Reflections of Nursing Leadership, 42(3), 1-8.
Parke, H. (2017). Educational Intervention to Improve Self-Efficacy and Self-Care in Patients with Heart Failure.
Qaddoura, A., Yazdan-Ashoori, P., Kabali, C., Thabane, L., Haynes, R. B., Connolly, S. J., & Van Spall, H. G. C. (2015). Efficacy of hospital at home in patients with heart failure: a systematic review and meta-analysis. PloS one, 10(6).
Savarese, G., & Lund, L. H. (2017). The global public health burden of heart failure. Cardiac failure review, 3(1), 7.
Sousa, J. P., Neves, H., Lobão, C., Gonçalves, R., & Santos, M. (2019). The effectiveness of education on symptoms recognition in heart failure patients to manage self-care: a systematic review protocol-L’efficacia dell’istruzione sul riconoscimento di sintomi in pazienti affetti da insufficienza cardiaca ai fini Del self-care: UN protocollo di revisione sistematica. Professional infermieristiche, 72(1)(Evidence Based Practice Proposal Sample for Nursing Students)
Storkholm, M. H., Savage, C., Tessma, M. K., Salvig, J. D., & Mazzocato, P. (2019). Ready for the Triple Aim? Perspectives on organizational readiness for implementing change from a Danish obstetrics and gynecology department. BMC health services research, 19(1), 517.
Su, A., Al’Aref, S. J., Beecy, A. N., Min, J. K., & Karas, M. G. (2019, July). Clinical and socioeconomic predictors of heart failure readmissions: A review of contemporary literature. In Mayo Clinic Proceedings (Vol. 94, No. 7, pp. 1304-1320). Elsevier.
Toukhsati, S. R., Jaarsma, T., Babu, A. S., Driscoll, A., & Hare, D. L. (2019). Self-Care Interventions That Reduce Hospital Readmissions in Patients with Heart Failure; Towards the Identification of Change Agents. Clinical Medicine Insights: Cardiology, 13, 1179546819856855.
Vaillant-Roussel, H., Laporte, C., Pereira, B., De Rosa, M., Eschalier, B., Vorilhon, C., & Dubray, C. (2016). Impact of patient education on chronic heart failure in primary care (ETIC): a cluster-randomized trial. BMC family practice, 17(1), 80.
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.
Yoo, J. Y., Kim, J. H., Kim, J. S., Kim, H. L., & Ki, J. S. (2019). Clinical nurses’ beliefs, knowledge, organizational readiness, and level of implementation of evidence-based practice: The first step to creating an evidence-based practice culture. PloS one, 14(12), e0226742. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6932768/
Ziaeian, B., & Fonarow, G. C. (2016). The prevention of hospital readmissions in heart failure. Progress in cardiovascular diseases, 58(4), 379-385.(Evidence Based Practice Proposal Sample for Nursing Students)
Ziaeian, B., & Fonarow, G. C. (2016). The prevention of hospital readmissions in heart failure. Progress in cardiovascular diseases, 58(4), 379-385.
Appendix A
Data Collected from the OCRSIEP Survey
Question
Sample Size
Mean
STD
Minimum
Maximum
Question 1
5
3.1
1.20
2
5
Question 2
5
3.6
1.26
2
4
Question 3
5
3.1
1.42
3
4
Question 4
5
3.3
0.88
3
5
Question 5
5
3.1
1.2
2
5
Question 6
4
3.1
0.83
2
4
Question 7
5
1.9
0.85
2
5
Question 8
5
2.2
1.2
1
4
Question 9
5
3.8
0.83
3
5
Question 10
5
2.3
1.65
1
4
Question 11
5
3.8
0.44
3
3
Question 12
4
1
0
1
1
Question 13
5
4
0
1
1
Question 14
5
1
0
1
1
Question 15
5
3.1
1.49
2
4
Question 16
4
2.74
0.50
2
3
Question 17
5
2
1.41
1
4
Question 18
5
3
1.22
1
3
Question 19
5
1.6
0.44
2
3
Appendix B
Conceptual model: Orem’s theory of self-care nursing.
Appendix CProject Budget
Project Budget
Projected Cost
Staffing 50 hours per meeting times 4 for planning, research and resources
Cost of personnel & Research Assistant(Evidence Based Practice Proposal Sample for Nursing Students)
$ 3, 000
$1,000
Direct expenses
3. Speakers travel
4. Cost of consumable supplies
5. Printing, materials, & Computer costs
$ 1,500
$1,500
$1,500
Miscellaneous
$ 1, 500
Expenses total
$10,000
Appendix DProject Timeline
Activity
Week 1
Week 2
Week 3
Week 4
Week 5
Week 6-10
Week 10
Week 11
Complete the microsystem assessment
Define scope and IRB approval
Conduct Data collection
Collect nurses’ feedback and Care Coordination
Implementation
Audit of the SCNDT
Audit of the Patient Education
Monitoring and Evaluation
As you continue, premiumacademicaffiates.com has the top and most qualified writers to help with any of your assignments. All you need to do is place an order with us. (Evidence-Based Practice Proposal – Complete Proposal)
Evidence-Based Practice Proposal – Complete Proposal
Question
Throughout this course, you have developed a formal, evidence-based practice proposal.
The proposal is the plan for an evidence-based practice project designed to address a problem, issue, or concern in the professional work setting. Although several types of evidence can be used to support a proposed solution, a sufficient and compelling base of support from valid research studies is required as the major component of that evidence. Proposals must be submitted in a format suitable for obtaining formal approval in the work setting. Proposals will vary in length depending upon the problem or issue addressed (3,500 and 5,000 words). The cover sheet, abstract, references pages, and appendices are not included in the word count.
Section headings for each section component are required. Evaluation of the proposal in all sections will be based upon the extent to which the depth of content reflects graduate-level critical thinking skills.
This project contains seven formal sections:
Section A: Organizational Culture and Readiness Assessment
Section B: Proposal/Problem Statement and Literature Review
Section C: Solution Description
Section D: Change Model
Section E: Implementation Plan
Section F: Evaluation of Process
Each section (A-F) will be submitted as a separate assignment in Topics 1-6 so your instructor can provide feedback (refer to applicable topics for complete descriptions of each section).
The final paper submission in Topic 7 will consist of the completed project (with revisions to all sections), title page, abstract, compiled references list, and appendices. Appendices will include a conceptual model for the project, handouts, data and evaluation collection tools, a budget, a timeline, resource lists, and approval forms, as previously assigned in individual section assignments.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
Read More:
https://premiumacademicaffiliates.com/evidence-based-practice-proposal-implementation-plan/
https://premiumacademicaffiliates.com/evidence-based-practice-proposal-evaluation-of-process/
More Solved Essays Articles
Write From Scratch