NUR 590 Evidence-Based Practice Project Assignments
Week 2 Assignment NUR 590 Evidence-Based Practice Project Assignments
Evidence-Based Practice Proposal – Section A: Organizational Culture and Readiness Assessment and Section B: Proposal/Problem Statement and Literature Review
In order to formulate your evidence-based practice (EBP), you need to assess your organization. In this assignment, you will be responsible for setting the stage for EBP. This assignment is conducted in two parts: an organizational culture and readiness assessment and the proposal/problem statement and literature review, which you completed in NUR-550. NUR 590 Evidence-Based Practice Project Assignments
Section A: Organizational Culture and Readiness Assessment
It is essential to understand the culture of the organization in order to begin assessing its readiness for EBP implementation. Select an appropriate organizational culture survey tool and use this instrument to assess the organization’s readiness. NUR 590 Evidence-Based Practice Project Assignments
Develop an analysis of 250 words from the results of the survey, addressing your organization’s readiness level, possible project barriers, and facilitators, and how to integrate clinical inquiry, providing strategies that strengthen the organization’s weaker areas.
Include the rationale for the survey category scores that were significantly high and low, incorporating details or examples. Explain how to integrate clinical inquiry into the organization. NUR 590 Evidence-Based Practice Project Assignments
Submit a summary of your results. The actual survey results do not need to be included.
Section B: Proposal/Problem Statement and Literature Review
In NUR-550, you developed a PICOT statement and literature review for a population quality initiative. In 500-750 words, include the following:
Refine your PICOT into a proposal or problem statement.
Provide a summary of the research you conducted to support your PICOT, including subjects, methods, key findings, and limitations.
NUR 590 Evidence-Based Practice Project Assignments General Guidelines:
You are required to cite three to five sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content. NUR 590 Evidence-Based Practice Project Assignments
Prepare this assignment according to the guidelines in the APA Style Guide in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric before beginning the assignment to familiarize yourself with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center. NUR 590 Evidence-Based Practice Project Assignments
Note: After submitting the assignment, you will receive feedback from the instructor. Use this feedback to make revisions for your final paper submission. This will be a continuous process throughout the course for each section.
NUR 590 Evidence-Based Practice Project
Week 3 Assignment (NUR 590 Evidence-Based Practice Project Assignments)
Evidence-Based Practice Proposal – Section C: Solution Description
Write a paper of 500-750 words for your proposed evidence-based practice project solution. Address the following criteria:
- Proposed Solution: (a) Describe the proposed solution (or intervention) for the problem and the way(s) in which it is consistent with current evidence. NUR 590 Evidence-Based Practice Project Assignments
- Heavily reference and provide substantial evidence for your solution or intervention. (b) Consider if the intervention may be unrealistic in your setting, if it may be too costly, or if there is a lack of appropriate training available to deliver the intervention.
- If the intervention is unrealistic, you may need to go back and make changes to your problem statement before continuing. NUR 590 Evidence-Based Practice Project Assignments
Organization Culture: Explain how (s) the proposed solution is consistent with the organization or community culture and resources.
Expected Outcomes: Explain the expected outcomes of the project. The outcomes should flow from the problem statement.
Method to Achieve Outcomes: Develop an outline of how the outcomes will be achieved. List any specific barriers that will need to be assessed and eliminated. Make sure to mention any assumptions or limitations that may need to be addressed.
Outcome Impact: Describe the impact the outcomes will have on one or all of the following indicators: quality care improvement, patient-centered quality care, efficiency of processes, environmental changes, or professional expertise. NUR 590 Evidence-Based Practice Project Assignments
You are required to cite three to five 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 in the APA Style Guide in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric before beginning the assignment to familiarize yourself with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center. NUR 590 Evidence-Based Practice Project Assignments
Note: After submitting the assignment, you will receive feedback from the instructor. Use this feedback to make revisions for your final paper submission. This will be a continuous process throughout the course for each section.
NUR 590 Evidence-Based Practice Project Assignments Week 4 Assignment – Evidence-Based Practice Proposal – Section D: Change Model
Roger’s diffusion of innovation theory is a good theoretical framework for an EBP project. However, students may also choose to use change models, such as Duck’s change curve or the transtheoretical behavioral change model. NUR 590 Evidence-Based Practice Project Assignments
Other conceptual models, such as a utilization model (Stetler’s model) and EBP models (the Iowa model and ARCC model) can also be used to apply your evidence-based proposal in clinical practice. Apply one of the above models and carry your implementation through each stage, phase, or step identified in the chosen model. NUR 590 Evidence-Based Practice Project Assignments
In 500-750 words (not including the title page and references page), discuss applying one of the change models to the implementation plan:
- Identify the selected model or theoretical framework and discuss its relevance to your project.
- Discuss each of the stages in the change model/framework.
- Describe how you would apply each stage in your proposed implementation.
In addition, create a conceptual model of the project. Although you will not be submitting the conceptual model you design in Topic 4 with the narrative, you will include the conceptual model in the appendices for the final paper. NUR 590 Evidence-Based Practice Project Assignments
You are required to cite three to five sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content. NUR 590 Evidence-Based Practice Project Assignments
Prepare this assignment according to the guidelines in the APA Style Guide in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric before beginning the assignment to familiarize yourself with the expectations for successful completion. NUR 590 Evidence-Based Practice Project Assignments
You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.
Note: After submitting the assignment, you will receive feedback from the instructor. Use this feedback to make revisions for your final paper submission. This will be a continuous process throughout the course for each section.
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NUR 590 Evidence-Based Practice Project Assignments – Week 5 Assignment
Evidence-Based Practice Proposal – Section E: Implementation Plan
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.
- Describe the amount of time needed to complete this project. Create a timeline. Ensure the timeline is general enough to 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. NUR 590 Evidence-Based Practice Project Assignments
- 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 to monitor the proposed solution’s implementation. 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. NUR 590 Evidence-Based Practice Project Assignments
Explain the process for delivering the (intervention) solution and indicate if any training will be needed.
Provide an outline of the data collection plan. Describe how data management will be maintained and by whom. Furthermore, explain 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.
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). NUR 590 Evidence-Based Practice Project Assignments
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.
Describe the plans to maintain, extend, revise, and discontinue a proposed solution after implementation.
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 in the APA Style Guide in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric before beginning the assignment to familiarize yourself with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center. NUR 590 Evidence-Based Practice Project Assignments
Note: After submitting the assignment, you will receive feedback from the instructor. Use this feedback to make revisions for your final paper submission. This will be a continuous process throughout the course for each section.
NUR 590 Evidence-Based Practice Project Assignments Week 6: Evidence-Based Practice Proposal – Section F: Evaluation of Process
In 500-750 words, develop an evaluation plan to be included in your final evidence-based practice project. Provide the following criteria in the evaluation, making sure it is comprehensive and concise:
- Describe the rationale for the methods used in collecting the outcome data.
- Describe the ways in which the outcome measures evaluate the extent to which the project objectives are achieved.
- Describe how the outcomes will be measured and evaluated based on the evidence. Address validity, reliability, and applicability. NUR 590 Evidence-Based Practice Project Assignments
- Describe strategies to take if outcomes do not provide positive results.
- Describe implications for practice and future research.
You are required to cite three to five 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 in the APA Style Guide in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric before beginning the assignment to familiarize yourself with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center. NUR 590 Evidence-Based Practice Project Assignments
Note: After submitting the assignment, you will receive feedback from the instructor. Use this feedback to make revisions for your final paper submission. This will be a continuous process throughout the course for each section.
NUR 590 Evidence-Based Practice Project Assignments: Week 7 Assignment Benchmark – Evidence-Based Practice Proposal Final Paper
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. NUR 590 Evidence-Based Practice Project Assignments
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.
You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.
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NUR 590 Evidence-Based Practice Project Assignments – Evidence-Based Practice Presentation
Develop a 10-15-slide presentation with comprehensive speaker’s notes that covers all of the major areas of your evidence-based practice proposal.
You will need to post a rough draft of your evidence-based practice presentation to the Main Forum in Topic 8 DQ 1 for peer feedback. NUR 590 Evidence-Based Practice Project Assignments
While APA style is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references compiled from the final project should be presented using APA documentation guidelines, which can be found in the APA Style Guide located in the Student Success Center.
This assignment uses a rubric. Please review the rubric before beginning the assignment to familiarize yourself with the expectations for successful completion. NUR 590 Evidence-Based Practice Project Assignments
You are not required to submit this assignment to LopesWrite.
NUR 590 Evidence-Based Practice Project Assignments : Benchmark – Evidence-Based Practice Project Proposal Final Paper Sample
Problem Statement
In recent years, inserting a central line has become routine for outpatient and inpatient settings. Central lines include administering medication, monitoring hemodynamic status, and providing nutritional assistance, among other things (Huybrechts et al., 2021). For the same reasons, patients in the intensive care unit (ICU) need central lines since they are in critical condition. A proper insertion process must be followed because central line insertion is typical for ICU patients. NUR 590 Evidence-Based Practice Project Assignments
Unfortunately, the central lines act as a passage of infective agents, including bacteria, viruses, and fungi. These infections are termed central-line-associated bloodstream infections (CLABSI).
This is attributed to either wrong insertion procedures, poor maintenance of catheters, and failure to monitor the central lines. Once an infective agent accesses the body, it spreads through the bloodstream to cause severe systemic infection. CLABSI leads to an increased hospital stay that in turn increases the cost of care with resultant reduced patient outcomes.
Notably, up to 41000 new CLABSI infections are reported in the United States, with an estimated annual expenditure of 2.68 billion dollars (Huybrechts et al., 2021). Furthermore, despite the achievement in treating CLABSI with antibiotics, there has been a recent increase in antibiotic resistance. As a result, most healthcare institutions focus on preventive measures to reduce the rate of CLABSI and improve patient outcomes.
The proposed preventive measures include; aseptic insertion of a central catheter; proper maintenance by either dressing, cleaning, or bathing; appropriate hand hygiene, and removal of unnecessary catheters when not in use (Karagiannidou et al., 2019). NUR 590 Evidence-Based Practice Project Assignments
Chlorhexidine has been used for bathing the central line leading to a reduced CLABSI rate. Most healthcare providers understand the importance of chlorohexidine; however, few adhere to the guidelines. Therefore, this evidence-based proposal will discuss the effectiveness of chlorhexidine compared to normal saline in reducing the rates of CLABSI.
The project aims at increasing knowledge among healthcare providers to adhere to daily bathing of central line with chlorohexidine. The PICOT question is: In patients admitted in ICU with a central line catheter (P), how does the use of chlorhexidine (I) compared with flushing central line using normal saline (C) lead to the reduced central line-associated bloodstream infection (O) over six months (T)?
Literature Review
CLABSI is defined as any infection that develops within 48 hours of central line insertion or after removal of the catheter and cannot be related to other factors apart from the central line. It is the most common form of hospital-acquired infection (HAI) among patients admitted to the ICU.
According to Haddadin et al. (2022), the annual incidence of CLABSI in the US is above 41000 cases, estimated as 0.8% per 1000 central line days. The same author states that the global incidence is estimated at 3.73% per 1000 central line days. The increasing incidences lead to an increased hospital stay, reduced quality of life, increased mortality and morbidity, and increased cost of care. NUR 590 Evidence-Based Practice Project Assignments
The estimated annual cost of care due to CLABSI has recently increased from 670 million dollars to 2.68 billion dollars (Karagiannidou et al., 2019). The increased expenditure strains the healthcare budget with an increased cost of care. However, untreated cases lead to mortality and morbidity. The global mortality rate is estimated at 12-25% (Payne et al., 2018). This rate is expected to rise if preventive measures are not adhered to.
Several microorganisms are known causes of CLABSI. They range from bacteria, viruses and fungi, with the commonest cause being bacteria. Staphylococci, including Staphylococci aureus and coagulase-negative staphylococci, are the leading causes of CLABSI.
Enterococci, aerobic gram-negative bacilli, and yeast follow in that order (Haddadin et al., 2022). Notably, infections of the hemodialysis catheter are caused disproportionately by staphylococcus aureus. On the other hand, infections among patients with cancer are caused mainly by gram-negative bacilli. Yeast and gram-negative bacilli are common in femoral veins catheters, while candida infections are common in central lines for parenteral nutrition.
Various risk factors exist that increase the likelihood of a certain population to develop CLABSI, unlike others. These factors are related to either patient, healthcare providers, and catheter-related. CLABSI rate is increased among either immunocompromised patients, those with severe illness, granulocytopenia, or those with existing distant infections (Zerr et al.2020). NUR 590 Evidence-Based Practice Project Assignments
Likewise, failure to adhere to aseptic procedures during central line insertion and catheter maintenance while in place increases the risks of disease. In addition, failure to monitor catheters and prolonged use of central line catheters increase the risk of infection. Furthermore, the site of the central line also determines the risk of infection.
The rate of infection increases in the following sites in descending manner; femoral catheters more than the internal jugular vein and lowest in the subclavian vein catheters. Preventive measures are required to reduce the rate of CLABSI while eliminating risks. NUR 590 Evidence-Based Practice Project Assignments
Prevention of CLABSI requires the use of evidence-based practice (EBP). These practices have been used in various settings with a resultant decrease in the CLABSI rate. According to Urbancic et al. (2018), these measures include correct insertion practice, good maintenance, and monitoring for the need for a catheter. When inserting a catheter, aseptic techniques should be used.
This requires insertion by trained personnel, adhering to hand hygiene, preparation of insertion site skin with 0.5% chlorhexidine, and using sterile barrier precautions during insertion. Maintenance of the central line requires bathing and dressing of the central line, preferably with Chlorhexidine, to reduce infection rate and educate both patients, healthcare providers, and relatives about the importance of daily bathing and the technique of bathing. Finally, monitoring of the central line should be done by healthcare providers. NUR 590 Evidence-Based Practice Project Assignments
The caregivers should assess the need for central lines in every patient and promptly remove those not needed by the patients. Consequently, prolonged stay of the central line increases the likelihood of new CLABSI. None of the preventive measures of CLABSI is superior to either. However, the use of chlorhexidine has been used by various centers with a positive result achieved.
Chlorhexidine gluconate is a disinfectant and antiseptic agent with bactericidal properties against antimicrobial agents, including aerobic and anaerobic agents. When applied to the skin, Chlorhexidine prevents skin colonization with germs and disease-causing microorganisms, reducing the infection rate (Payne et al., 2018).
It is effective against broad-spectrum bacterium and has a fast onset of action after application. Notably, various studies have been done in multiple settings to assess the effectiveness of chlorhexidine in preventing CLABSI.
Several authors and researchers have done studies involving the use of Chlorhexidine to support its effectiveness and citing reasons why it should be used in clinical practice.
To begin with, a study by Reynolds et al. (2021) sought to evaluate the effectiveness of implementing the practice of daily bathing with chlorohexidine in combination with a multifaceted program to reduce CLABSI. A qualitative-clustered randomized study was done. The involved nurses were given training regarding the proper technique of bathing central lines with chlorohexidine, and they were encouraged to adhere to daily bathing.
The champion nurses then observed nurses as they bathed central lines. Findings from the study indicated a 24% reduction in the CLABSI rate among patients bathed daily. Likewise, another study conducted by Urbancic et al. (2018) in the Australian tertiary ICU showed a decrease in methicillin-resistant staphylococcus aureus (MRSA) and minimal CLABSI reduction.
Yet, in another study by Zerr et al. (2020), participants were grouped into cases and controls among pediatric patients undergoing hematopoietic stem cell transplantation. The cases or study groups received daily bathing with Chlorhexidine, unlike the controls who were not bathed.
Blood cultures were collected from the groups, and results were compared. The findings revealed an increased rate of CLABSI among the controls compared to the study group. Similarly, Giri et al. (2021) did another study at Duke University medical center.
They aimed at ascertaining the relevance of using chlorohexidine for allogeneic transplant patients. The results showed a decrease in CLABSI rate among the study group by 15.6%. These two studies are relevant in ensuring adherence to daily bathing is mandatory (Giri et al., 2021). NUR 590 Evidence-Based Practice Project Assignments
Furthermore, in a prospective crossover study by Lowe et al. (2017), the researchers aimed at comparing the effectiveness between soap and chlorohexidine in reducing CLABSI. While the study group received daily bathing with chlorhexidine, the controls were bathed with non-medicated water and soap.
After eight months of follow-up of the patients and comparison of laboratory culture, the study group had a 55% reduction in the rate of CLABSI. On the other hand, the control group had a reduced rate of 36%. The reduced CLABSI leads to improved patient outcomes and a reduction in the cost of care.
Nonetheless, it is estimated that effective preventive measures can save healthcare from losses. For instance, according to Reagan et al. (2019), proper use of chlorohexidine to bathe the central line leads to reduced HAI with resultant decreased cost of care. The same study revealed that up to $815,301 was saved. Therefore, reduction of the healthcare burden requires proper use of preventive measures.
Organizational Culture and Readiness.
Assessment of the organizational culture and readiness is an essential element before implementing a project. Organizational readiness assesses the commitment and the willingness of members of an organization to accept and implement change within an organization. In centers where the readiness is high, the implementation of the project will also be possible.
This is because members will be ready to use their resources, committing to ensure that change is achieved. In addition, members will likely cooperate, initiate change, and exert persistence resulting in effective implementation of the evidence-based project (EBP). Therefore, before implementing this project, I assessed Houston`s Methodist culture and readiness.
Like other best healthcare providers in the US and globally, Houston Methodist has a culture of incorporating EBP into the care of patients while improving interdisciplinary collaboration. The administration hires and retains healthcare providers with advanced skills and knowledge to provide cost-effective care while improving patient outcomes.
Furthermore, improved interprofessional collaboration through enhanced communication and consultation improves patient care. Therefore, guided by the advanced culture and eagerness to improve, there is a need for periodic knowledge advancement regarding current issues and coming up with better strategies to enhance care while improving patient satisfaction.
In addition, the leadership of the facility is also commendable. Decentralized leadership of the organization involves employers in daily activities to ensure that patients receive the best care. As a result, Staff members are involved in various researches to come up with new innovative techniques that improve patient care.
According to Puchalski Ritchie & Straus (2019), leadership that appreciates the contribution of other employers is likely to succeed because every member will be dedicated with improved satisfaction and are likely to offer positive contributions. Furthermore, the organization is guided by Christian principles and teachings that emphasize protecting human life.
This culture encourages members to provide quality care while improving patient outcomes and their quality of life. NUR 590 Evidence-Based Practice Project Assignments
Apart from good leadership, the organization is guided by its mission, values, and beliefs. The organization’s mission states its commitment to provide high-quality, cost-effective health care that delivers the best value to the people they serve in a spiritual environment of caring in association with internationally recognized teaching and research.
Best value and quality care can be achieved by implementing evidence-based practice (EBP). EBP aims at improving clinical decision-making while ensuring that best practice is provided to patients. Guided by the mission, the organization is likely to accept the implementation of an EBP process that improves patient care, improves the quality of care, enhances the patients` experience, reduces the burden of care through cost reduction, and reduces mortality rate.
The beliefs of Houston Methodist are grounded on Christian teachings as guided by the Texas Annual Conference of the United Methodist Church. It strives to provide quality healthcare services. The
