Evidence-Based Practice Project Proposal: Implementation Plan Paper

Evidence-Based Practice Project Proposal: Implementation Plan Paper

Evidence-Based Practice Project Proposal: Implementation Plan Paper

The implementation section of an evidence-based practice (EBP) project proposal can be challenging component of research for advanced nursing students. Many factors contribute to the challenging approach to the implementation of practice change. These include the stakeholders involved, the setting and access to research subjects as well as resources, time and sustainability of the project and it accepted (DeNisco, 2019). Developing a structured implementation plan is critical to attain the success of the EBP project. As such, the purpose of this section is to describe the implementation plan of the EBP project proposal on case management (CM) model as an effective way to reduce the length of stay, emergency visits, and readmissions for patients with chronic diseases within six to 12 months. The paper covers the setting and access to research subjects, timelines and budget, resources and research design and evaluation approaches to the project. The paper also identifies possible barriers and strategies to address them as well as examines the feasibility of the implementation.

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Setting & Access to Research Subjects

Existing research evidence shows that implementation of case management (CM) lead to improved care for patients with complicated healthcare needs that include those with chronic diseases (Hudon et al., 2018). Imperatively, the setting for this EBP project would be a hospital facility that handles patients with chronic conditions that include diabetes, hypertension, and renal disease. The setting is a patient care nursing unit in a 300-bed health care facility that handles patients with comorbidities. The subjects in the study would be nurses and physicians as well as selected patients that will receive case management (CM) interventions in the facility; both as inpatients and outpatients. However, the implementation will follow a pilot study involving five patients, three nurses and one physician. The study will obtain consent from the subjects to allow the collection of data and interviews from them. The study will also attain approval from the management to conduct these activities. Imperatively, participation in the study would be voluntary meaning that only those who wish will be permitted after getting sufficient information. The signing of the consent form will show that the participants have sufficient information on the aspects of the project.

Timelines

A structured approach to an implementation plan implores the stakeholders and project team to have a careful consideration of timelines based on the activities to be executed. The timelines must be based on issues like data gathering approaches, the study’s design, proposed interventions and education and sufficient planning of tasks to enhance optimal care outcomes in case management of patients with chronic conditions (Joo & Liu, 2018). The EBP will deploy the Iowa model to guide its implementation. The model contains several stages that require sufficient time and better organization. The proposed timeline for this project is between 6 and 12 months with the first month dedicated to planning and getting approval from relevant institutions. The timelines will be flexible and create two intervals that will enable the evaluation of the interventions using collected data and if there is need for changes to the project’s implementation. The project timelines are in appendix one.

Budget and Resources

The implementation of EBP requires resources and a budget to attain all requirements for effective execution of tasks and duties. Imperatively, a proposed budget and list of resources for the EBP has been developed. The budgetary allocation will cater for tasks and activities that include developing plans, literature for patients, communication devices and resources through the use of telehealth and telemedicine approaches, and movement of nurses, especially in management of outpatients who get their services in the facility (Melnyk & Fineout-Overholt, 2019). Resources in this case would include having financial support based on the budget and items as captured in appendix 2.

 Being a nurse-led intervention, the case management initiative will require nurse managers for respective patients, and nurses, nurse assistants and physicians who will review patients, recommend interventions and evaluate their effectiveness. The other critical resources would be integration of patients and their families and community-based volunteers who will coordinate and deliver education and health promotion interventions periodically based on their assigned patients. Through these interventions, patients, their families, and respective healthcare teams will improve adherence to medications, self-management, and have in-depth understanding of each case and effective management to reduce readmissions, length of stay, and emergency visits.

Project Design and Data Collection Tools

The project will use a non-experimental mixed method approach. The design integrates both qualitative and quantitative approaches in a single study to enable the researcher get an in-depth perspective to the research question as opposed to using either qualitative or quantitative design alone. The EBP will comprise of surveys and interviews with the gathered data informing the interventions (Melnyk & Fineout-Overholt, 2019). These interventions will be designed on baseline interviews, surveys, and even observations. Data collected from the interventions will be deployed to evaluate the overall success of the project. Using the mixed method would lead to a sequential approach to collection of data at different times during the implementation process. The process is effective as it allows the integration of both qualitative and quantitative data at different points of the study.

Monitoring Methods and Instruments

Initial baseline assessment done using questionnaires and surveys enables the evaluation of the present policies and practices in the organization concerning innovative and evidence-based practice (EBP) interventions in reducing different aspects of care associated with chronic diseases’ patients. The evaluation is essential in knowing what may be working or not and the changes needed to correct the situation. Therefore, the project will use questionnaires and surveys to understand the effectiveness of case management as a way of addressing adverse events, and reducing expenses resources used by chronically-ill patients. Data collected through these approaches would be analyzed using an appropriate statistical tool to attain meaning.

Delivery of the Intervention & Training

Training will be critical for successful implementation and adoption of the EBP project. The data collected prior to the study will determine the interventions that the team will use in the project. Staff involved in the project will implement the requisite interventions that include increasing access to health resources through telehealth and telemedicine interventions as well as increasing overall support for the inpatients and monitoring of health status regularly based on set schedules, and emotional aid. The intervention will also include increased emphasis on self-management and development of effective community alliances with all stakeholders to attain optimal outcomes (Joo & Liu, 2021). Health promotion and education will also be a critical component of the delivery as part of the interventions in the communities. Training sessions will be conducted to enhance staff education on the aspects of the implementation process. Nurse leaders will also be encouraged to increased their support for the staff and engage all stakeholders to gain knowledge and significance of case management as an effective intervention for patients with chronic conditions.

Stakeholders

Stakeholders are critical components of any EBP project because their implement, make decisions and choices and provide resources for effective execution of the initiative (Melnyk & Fineout-Overholt, 2019). The key stakeholders in this project would include nurse administrators and managers, nurses, physicians, and patients and their families. Other core stakeholders would comprise of nurse assistants and community health volunteers who will disseminate information at appropriate times during the implementation. Each of these entities and individuals will have a direct benefit from the project and the intervention used. The nurse managers and administrator will be important stakeholders because of their roles and duties in the organization like approving budgets and coordination as well as planning of the activities (Joo & Liu, 2021). These stakeholders will coordinate and collaborate with both the management and staff to ensure effective implementation of the project to attain desired outcomes.

Implementation Plan: Barriers, challenges & Proposed Strategies

The overall success of this EBP project will rely on the management of different components that include facilitators and barriers and establishment of effective strategies to respond to all situations that may interfere with the execution. Therefore, the identified stakeholders and patients as well as their families will play important roles to ensure that the project is a success. Barriers to the implementation may include insufficient levels of a positive organizational culture that embraces change, limited resources and time, inadequate knowledge and skills among nurses, and a negative attitude that may be change reluctant.

However, addressing these challenges would require deployment of effective strategies that focus on enhancing acceptance and implementation of these interventions to attain expected outcomes (Barber, 2018). Effective strategies will include providing necessary training to nurses, having responsive communication and feedback among the stakeholders, and engagement of all stakeholders for resources and skills dissemination. The strategies will also include use of appropriate change models like the Iowa EBP model alongside Lewin’s approach to change. Effective participation of all stakeholders will also lead to a reduction in any resistance.

Feasibility of the Implementation Plan

While the implementation of EBP projects may offer evidence required to adopt new ways, processes and practices of doing things, this may be hindered due to various reasons like resource availability, limited support from the management, and change resistance culture in a setting as well as timelines and need for training. However, the fit and feasibility of this EBP project is high because of the nature of the problem being handled and the status of the organization as a Magnet facility that emphasize a change culture (Joo & Liu, 2021). The facility has a shared governance culture that allows for collection and sharing of views to improve care provision. The EBP project is feasibility based on a cost-benefit analysis as the benefits of its implementation are more than the projected expenses.

Conclusion

The paper describes the implementation of the EBP project proposal based on the addressed aspects. The various components highlight and discuss aspects of the project that will lead to effective delivery and ensure it attains its core goals and objectives. The feasibility of this project and its success is high, implying that it shall lead to quality outcomes for the different stakeholders involved while providing requisite solutions to reduce length of stay, readmissions and visits to emergency rooms and departments.

References

Barber, B. (2018). Research on human subjects: Problems of social control in medical

            experimentation. Routledge.

DeNisco, S. M. (2019). Advanced Practice Nursing: Essential Knowledge for the Profession:

Essential Knowledge for the Profession. Jones & Bartlett Learning.

Halcomb, E. J. (2019). Mixed methods research: The issues beyond combining methods. Journal

of Advanced Nursing, 75(3), 499–501. https://doi.org/10.1111/jan.13877

Hudon, C., Chouinard, M. C., Aubrey-Bassler, K., Burge, F., Doucet, S., Ramsden, V. R., … &

Pluye, P. (2018). Case management in primary care for frequent users of healthcare services with chronic diseases and complex care needs: an implementation and realist evaluation protocol. BMJ open, 8(11), e026433. http://dx.doi.org/10.1136/bmjopen-2018-026433

Joo, J. Y., & Liu, M. F. (2018). Experiences of case management with chronic illnesses: a

qualitative systematic review. International Nursing Review, 65(1), 102-113. DOI:10.1111/inr.12429

Joo, J. Y., & Liu, M. F. (2021). Understanding Nurse-led Case Management in Patients with

Chronic Illnesses: A Realist Review. Western Journal of Nursing Research, 43(2), 182-195. https://doi.org/10.1177/0193945920943827

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 DOI: http://dx.doi.org/10.1017/S1463423618000488

Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing and

healthcare: A guide to best practice (4th ed.). Wolters Kluwer. ISBN-13:

9781496384539

Appendices

Appendix 1: Certificate of ConsentI have read the Research Participant Informed Consent Form in its entirety, and all my questions
have been answered to my satisfaction. I voluntarily consent to participate in the research study.
Participant Name Printed

Participant Name Signature and Date
_______________________________________________Date__________________________
_
Statement by the Principal Researcher

I confirm that the participant was given opportunities to ask questions and seek clarification
about the study. All the participant’s questions have been answered, and the participant has
willingly consented to be a part of the study without pressure or coercion.
Principal Researcher Name

——————————————————————————————————————–
Principal Researcher Signature
_______________________________________________Date__________________________

Appendix 2: Timelines

Time	Task Name	Sub-Task	Status	Assigned	Start Date	End Date	Duration
First Month/Week	Creation of multidisciplinary team	Training			Week 1	Week 2	2 Weeks
Second Month Week 3	Collection of resources	Resources of allocation			Week 3	Week 4	2 Weeks
3rd Month Week 1	Identification of Barriers	Identification of barriers			Week 2	Week 2	1 Week
3rd Month Week 2	Stakeholder Engagement	Stakeholders Engagement			Week 2	Week 3	1 Week
4 Month-9 Month	Implementation	Implementation			Week 3	Week 4	6 months
Tenth Month	Review & Implementation	Review & Implementation			Week 1	Week 4	4 Weeks
Twelfth Month	Evaluation	Evaluation and completion

Appendix 3: Budget and Resources

a). Budgetary Estimates:

Item	Cost (U.S. $)
Trainer’s Fee	2,000
Training Facilitation	5,000
Production of Materials: Training manual, demonstration and equipment, engagement of stakeholders	10,000
Education campaign and awareness	5,000
Telehealth & Telemedicine Devices	5,000
Community Health Volunteers’ Logistics & Communication	15,000
Total	$42,000

 b). Required Human Resources

1). Nurse manager

2). Nurse administrator

3). Physicians

4). Nurses

5). Nurse Assistants

6). Nurse Informaticists

7). Health technology experts

8). Community health volunteers

Appendix 4: Monitoring Method; Survey Questionnaire Tool

Date:			Department:
Supervisor’s Name:

Please rate the following items on a scale from 1 to 5, with 1 being “strongly disagree” and 5 being “strongly agree.”

I am satisfied with the level of work that is expected of me each day.
	1	2	3	4	5
The training I received adequately prepared me for this position.
	1	2	3	4	5
My work environment is comfortable, allowing me to do my job without difficulty.
	1	2	3	4	5
The equipment I use functions well and makes my job stress-free.
	1	2	3	4	5
My supervisor is always available to answer any questions that I may have during the workday.
	1	2	3	4	5
I am made to feel as though I am a part of the team.
	1	2	3	4	5
Hard work and attention to detail are properly rewarded.
	1	2	3	4	5
The pay and benefits offered by this company are reasonable.
	1	2	3	4	5
I look forward to coming to work every day.
	1	2	3	4	5
I believe that there are ample opportunities for promotions within this company.
	1	2	3	4	5
I would recommend family and friends to apply for work here.
	1	2	3	4	5
I plan to be working here five years from now.
	1	2	3	4	5

 

What could be done to make working for the Happy Customer Call Center more pleasant?

 

Are there any changes in procedure that you would like to recommend in order to make operations flow more smoothly?

 

Are there any other comments you would like to share?

Appendix 5: APA checklist

Running Head-No running Head	ü
Page numbering	ü
Title of document appears at the top of first page	ü
Introduction paragraph or section not labeled	ü
Double line Spacing	ü
Margins 1 inch	ü
Paragraph formatting left aligned with a ragged right edge	ü
Punctuation after quotations	None
Section Heading- Level 1 headings centered and in bold, title case Level 2-flush left bolded and in title case Level 3-flush left, bolded in title case and italicized	ü
Reference page-start on a new page titled “References,” title centered and bolded	ü

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Assessment Description
In 1,250-1,500 words, discuss the implementation plan for your evidence-based practice project proposal. When required, create the appropriate form, table, image, or graph to fully illustrate that aspect of the intervention plan and include them in an appendix of your paper. You will use the implementation plan, including the associated documents in your appendices, in the Topic 8 assignment, during which you will synthesize the various aspects of your project into a final paper detailing your evidence-based practice project proposal.

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. Include a draft of the form as an appendix at the end of your paper.
Create a timeline. Make sure the timeline is general enough that it can be implemented at any date. Based on the timeline you created, describe the amount of time needed to complete this project. Include a draft of the timeline as an appendix at the end of your paper.
Develop a budget and resource list. Consider the clinical tools or process changes that would need to take place. Based on the budget and resource list you developed: (a) describe the resources (human, fiscal, and other) or changes needed in the implementation of the solution; (b) outline 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). Include a draft of the budget and resource list as an appendix at the end of your paper.
Explain whether you would select a qualitative or quantitative design to collect data and evaluate the effectiveness of your evidence-based practice project proposal. Provide rationale to support your selection.
Describe the methods and instruments (questionnaire, scale, or test) to be used for monitoring the implementation of the proposed solution. Include the method or instrument as an appendix at the end of your paper.
Explain the process for delivering the intervention and indicate if any training will be needed.
Discuss the stakeholders that are needed to implement the plan.
Consider all of the aspects of your implementation plan and discuss potential barriers or challenges to the plan. Propose strategies for overcoming these.
Establish the feasibility of the implementation plan.
Refer to the “Evidence-Based Practice Project Proposal – Assignment Overview” document for an overview of the evidence-based practice project proposal assignments.

You are required to cite a minimum of five peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Complete the “APA Writing Checklist” to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as an appendix at the end of your paper.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

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. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

Evidence-Based Practice Project Proposal: Implementation Plan – Rubric
Collapse All

Setting and Access to Potential Subjects 8.4 points
Criteria Description
Description of setting and access to potential subjects; consent or approval form is attached in an appendix, if needed.

5. 5: Excellent 8.4 points
The setting and access to potential subjects are clearly described. A well-developed and accurate consent or approval form is attached correctly in an appendix.

4. 4: Good 7.73 points
The setting and access to potential subjects are described. A consent or approval form is needed and attached in an appendix. Minor revision may be needed on the form or to correct formatting issues in the appendix. Some detail is needed for clarity or accuracy.

3. 3: Satisfactory 7.39 points
The setting and access to potential subjects are generally described. Some additional information is needed. A consent or approval form is attached but requires some revision; the form is attached in an appendix but has formatting errors.

2. 2: Less Than Satisfactory 6.72 points
The setting and access to potential subjects are only partially described. A consent or approval form is attached but contains significant errors; the form is not attached in an appendix.

1. 1: Unsatisfactory 0 points
The setting and access to potential subjects are not described. A consent or approval form needs to be created and attached in an appendix. Revision is needed.

Timeline 9.6 points
Criteria Description
Description of time required; draft of timeline is attached in an appendix.

5. 5: Excellent 9.6 points
Budget and Resource List 9.6 points
Criteria Description
Description of resources or changes required; outline of cost and budget and resource list are attached in an appendix.

Research Design 8.4 points
Criteria Description
Quantitative or qualitative design to collect data and evaluate effectiveness.

Methods and Instruments 8.4 points
Criteria Description
Methods or instruments used for monitoring implementation.

Process for Delivering Intervention and Needed Training 8.4 points
Criteria Description
Process for Delivering Intervention and Needed Trainin
Stakeholders for Implementation 8.4 points
Criteria Description Stakeholders for Implementation

Barriers or Challenges to Plan and Strategies for Overcoming 8.4 points
Criteria Description
Barriers or Challenges to Plan and Strategies for Overcoming

Evidence of Feasibility 8.4 points
Criteria Description Evidence of Feasibility

Required Sources 6 points
Criteria Description Required Sources

Thesis Development and Purpose 8.4 points
Criteria Description
Thesis Development and Purpose

Argument Logic and Construction 9.6 points
Criteria Description
Argument Logic and Construction

Mechanics of Writing 6 points
Criteria Description
Mechanics of Writing Includes spelling, punctuation, grammar, language use.

Paper Format 6 points
Criteria Description
Paper Format Use of appropriate style for the major and assignment.

Documentation of Sources 6 points
Criteria Description
Documentation of Sources Citations, footnotes, references, bibliography, etc., as appropriate to assignment and style

Evidence-Based Practice Project Proposal: Implementation Plan – Rubric

Collapse All

Setting and Access to Potential Subjects 8.4 points
Criteria Description
Description of setting and access to potential subjects; consent or approval form is attached in an appendix, if needed.

5. 5: Excellent 8.4 points
The setting and access to potential subjects are clearly described. A well-developed and accurate consent or approval form is attached correctly in an appendix.

4. 4: Good 7.73 points
The setting and access to potential subjects are described. A consent or approval form is needed and attached in an appendix. Minor revision may be needed on the form or to correct formatting issues in the appendix. Some detail is needed for clarity or accuracy.

3. 3: Satisfactory 7.39 points
The setting and access to potential subjects are generally described. Some additional information is needed. A consent or approval form is attached but requires some revision; the form is attached in an appendix but has formatting errors.

2. 2: Less Than Satisfactory 6.72 points
The setting and access to potential subjects are only partially described. A consent or approval form is attached but contains significant errors; the form is not attached in an appendix.

1. 1: Unsatisfactory 0 points
The setting and access to potential subjects are not described. A consent or approval form needs to be created and attached in an appendix. Revision is needed.

Timeline 9.6 points
Criteria Description
Description of time required; draft of timeline is attached in an appendix.

5. 5: Excellent 9.6 points
Budget and Resource List 9.6 points
Criteria Description
Description of resources or changes required; outline of cost and budget and resource list are attached in an appendix.

Research Design 8.4 points
Criteria Description
Quantitative or qualitative design to collect data and evaluate effectiveness.

Methods and Instruments 8.4 points
Criteria Description
Methods or instruments used for monitoring implementation.

Process for Delivering Intervention and Needed Training 8.4 points
Criteria Description
Process for Delivering Intervention and Needed Training
Stakeholders for Implementation 8.4 points
Criteria Description Stakeholders for Implementation

Barriers or Challenges to Plan and Strategies for Overcoming 8.4 points
Criteria Description
Barriers or Challenges to Plan and Strategies for Overcoming

Evidence of Feasibility 8.4 points
Criteria Description Evidence of Feasibility

Required Sources 6 points
Criteria Description Required Sources

Thesis Development and Purpose 8.4 points
Criteria Description
Thesis Development and Purpose

Argument Logic and Construction 9.6 points
Criteria Description
Argument Logic and Construction

Mechanics of Writing 6 points
Criteria Description
Mechanics of Writing Includes spelling, punctuation, grammar, language use.

Paper Format 6 points
Criteria Description
Paper Format Use of appropriate style for the major and assignment.

Documentation of Sources 6 points
Criteria Description
Documentation of Sources Citations, footnotes, references, bibliography, etc., as appropriate to assignment and style.