NUR 590 Evidence-Based Practice Project Proposal: Implementation Plan
Evidence-Based Practice Project Proposal: Implementation Plan
The implementation plan of an evidence-based practice (EBP) intervention is essential to determine its effectiveness in attaining the expected outcomes. The implementation plan entails various aspects like stakeholders, the organizational setting and environment, available resources, timelines, acceptance by the various stakeholders, and sustainability of the proposed intervention (Melnyk et al., 2022). Having an effective and organized implementation plan is critical to the project’s success through attainment of better outcomes based on the formulated PICOT question. The proposed intervention of purposeful hourly rounding to reduce falls and fall-related injuries among elderly residents in long-term care facilities will entail a multifactorial strategy, and will involve identification of subjects and settings, developing a timeline for the proposed project, collecting data, engaging identified and essential stakeholders, evaluating possible organizational barriers, and the feasibility of the project. The purpose of this paper is to develop the implementation plan based on the identified components in executing the proposed EBP intervention.
Setting and Access to Potential Subjects
The setting for the proposed EBP project will be a long-term care facility, Belmont Village Senior Living, with elderly residents who are susceptible to falls. The setting is critical since most people start experiencing falls in their old age, especially from sixty years. Access to potential subjects will require approval from the management as the main participants in the EBP project will be nurses and other healthcare providers. Elderly patients or individuals will be beneficiaries of the proposed intervention. The recruitment of the subjects will be voluntary, and those joining will be dealing directly with elderly patients in various stages of living at the selected long-term care facility. Nurses will sign an informed consent form. Informed consent entails a research subject actively and independently selecting to be part of a project and allowing disclosure of their data for the project while endorsing its outcomes.
Timeline
An effective implementation plan demands effort and timeline based on the various activities and stakeholders that it incorporates to attain the expected outcomes. Timeline is important for planning and executing various steps required based on a selected change model like Kotter’s 8-step change process. While various factors can influence the project based on its scope and creep, a timeline allows project team and managers to implement all aspects of the proposed intervention and make necessary changes as deemed (Melnyk et al., 2022). The timeline for this project is three months. Based on Kotter’s 8-step change model, the team will engage in various activities to create urgency for change and raise awareness on the benefits of the proposed intervention during the first week. The timeline will also involve training nurses and other related healthcare providers on the effectiveness of the proposed intervention, collect data on any change in the pilot week, and an elaborate implementation based on the small wins gained through the execution.
Budget and Resources Needed for the Implementation
Appropriate resources are fundamental in implementing a proposed EBP, from human resources to funding to integrate all proposed aspects of the project. Resources will include personnel, particularly nurses, who will execute all aspects of the project to attain the expected outcomes. The human resource will also include other professionals to form an inter-professional team comprising physical therapists, counselors, and nurse assistants as well as physicians. Advanced practice nurses (APN) with geriatric specialty will be critical to the implementation of the proposed intervention. Three social workers will evaluate patient’s rooms and recommend modifications to reduce falls.
Financial resources are important to get sufficient human resources to implement organizational changes. Financial resources will be required to procure appropriate equipment to facilitate rounding and effective data collection, monitor patient movements like cameras, and give alerts to nurses (Perez-Alaniz et al., 2022). The team will require equipment for training projectors and whiteboards, mannequins to run simulations, and stationery for the personnel. Financial resources will also be required for trainers, and development of appropriate tools, including mobile apps to support rounding within the facility. All these resources will culminate into a budget as proposed in appendix 2.
Data Collection Design
An appropriate data collection or research design is essential when implementing evidence-based practice (EBP) projects in healthcare setting as it allows researchers to gather relevant information to solve the identified healthcare issue. As such, the project will use a qualitative design to collect data. Qualitative approach in this case will entail observation and interviews to get various perspectives of the intervention and group them based on themes in the analysis stage. Through observation and interviews while documenting the number of falls in patient charts, the project team will determine the causes of patient falls, and the effectiveness of purposeful hourly rounding to reduce prevalence. Through observations, the team will get a firsthand experience of falls and impact of purposeful hourly rounding to reduce prevalence (Anu, 2021). The proposed EBP project will highlight the benefits of hourly rounding to reduce and prevent falls and integrate the best practices in the facility to improve outcomes. As such, observation and interviews will show the effectiveness of the proposed EBP project to lower falls in the long-term care facility.
Methods and Instruments
The core method to monitor the implementation will be regular fall risk assessment for all patients at the facility. Nurses and nurse assistants handling the elderly people at the facility will assess fall risk by taking a history of the person and using Timed Up and Go (TUG) tool. The TUG tool can evaluate mortality in geriatric population by assessing the physical function of the individual (Ascencio et al., 2022). Through using a standard tool, the team will have objective evaluation of whether hourly rounding reduces the risk of falls among older adults in the long-term care facilities. Patients will also complete a post-intervention interview based a questionnaire, the Activities Specific Balance Confidence Scale (ABC). The tool will have three themes that include confidence in carrying out activities, security of walking around, and fall history. If the proposed intervention, hourly rounding I effective, it will enhance self-reported score risk among the target population and reduce their susceptibility to falls.
Process of Delivering the Intervention
Delivering the intervention will be based on a systematic approach as directed by Kotter’s 8-step model. The initial step will entail creating the urgency for change through effective communication and engagement of all stakeholder. The second step will entail creating a change coalition to influence others and ensure the implementation occurs. The third aspect will entail having a strategic vision while the fourth will enlist an army of change agents to advance the proposed intervention (Melnyk et al., 2022). The fifth stage will be to address any barriers like resistance to change and ineffective communication. In the sixth step, the team will enjoy small wins while the seventh part will ensure sustenance of change through a continuous process. Lastly, the delivery will entail making hourly rounding a part of the organization’s working culture and practice for nurses. The project team will train nurses on various aspects of hourly rounding and the TUG fall risk assessment model. The training will ensure all stakeholders deliver the proposed intervention using all necessary tools and approaches.
Stakeholders
The implementation of hourly rounding in the facility will require a host of stakeholders. Stakeholders are essential in implementing organizational change, including leading entities to sustain the proposed change (Melnyk et al., 2022). The internal stakeholders in this case will include advanced practice nurses, nurses, nurse assistants, social workers, physicians, pharmacists, and the executive management. External stakeholders will include patients and their families, trainers, regulatory agencies and organizations at local, state, and federal levels. For instance, healthcare workers will implement the proposed intervention as the management offer sufficient support and resources. Pharmacists will review medication to help prevent susceptibility to falls while the organizational management team will provide resources, and work closely with the project team to implement the proposed change (Seppala et al., 2021). Nurse informaticist and other providers will help the team leverage technologies while APNs will evaluate all risks and provide effective direction to the management on the efficacy of the proposed tools and interventions. Consequently, all stakeholders will play an essential role in implementing the change project to reduce and prevent falls at the facility.
Barriers and Strategies to Addressing Them
Possible barriers in implementing the proposed approach to reduce falls may include change resistance, insufficient support from the management, insufficient resources and time from nurses and other stakeholders, and ineffective collaboration. These barriers will have a confound effect on the implementation, and require effective strategies. These include effective communication and engagement of all stakeholders (Drisko, 2020). Additionally, diversity, fostering inclusion, and constructive feedback as well as sufficient resources will help address these issues. Nurses and APNs will leverage better technologies like electronic health records (EHRs) to improve data collection and documentation.
Feasibility of the EBP Project
The availability of supportive leadership, sufficient resources, and a common approach make this project highly feasible and likely to accrue benefits not just for the entity but also patients, their families, and community because of the adverse effects emanating from falls and fall-related incidents (Tomaschek et al., 2021). The organization will also leverage its human capital, technologies, and vibrant support from all stakeholders to ensure the success of the proposed EBP project to lower falls. The organization will collaborate and implement strategic planning through centralized communication command to attain the set goals and objectives of the proposed intervention.
Conclusion
The implementation plan provides a general perspective and direction of the EBP project. As such, the proposed plan provides a systematic approach to the project’s execution to lower falls in the facility and improve patient outcomes. The proposed hourly rounding to reduce and prevent falls among older adults in long-term care facilities is feasible with possible positive effects and improve patient overall safety.
References
Ascencio, E. J., Cieza-Gómez, G. D., Carrillo-Larco, R. M., & Ortiz, P. J. (2022). Timed up and
test predicts mortality in older adults in Peru: A population-based cohort study. BMC
Geriatrics, 22(1). DOI: 10.1186/s12877-022-02749-6.
Anu, J. A. (2021). Hourly Rounding and fall prevention among the elderly in long-term care: a
change process. Journal of Geriatric Medicine, 3(1).
DOI: https://doi.org/10.30564/jgm.v3i1.2614
Belmont Village Senior Living (2024). About Belmont Village Senior Living.
Drisko, J. W. (2020). Incorporating evidence-based practice into informed consent practice.
Families in Society: The Journal of Contemporary Social Services, 102(1), 67–77.
https://doi.org/10.1177/1044389420929625
Melnyk, B. M., & Fineout-Overholt, E. (2022). Evidence-based practice in nursing &
healthcare: A guide to best practice. Lippincott Williams & Wilkins.
Perez-Alaniz, M., Lenihan, H., Doran, J., & Hewitt-Dundas, N. (2022). Financial resources for
research and innovation in small and larger firms: Is it a case of the more you have, the
more you do? Industry and Innovation, 30(2): 189–232. https://doi.org/10.1080/13662716.2022.2036597
Seppala, L. J., Kamkar, N., van Poelgeest, E. P., Thomsen, K., Daams, J. G., Ryg, J., Masud, T.,
Montero-Odasso, M., Hartikainen, S., Petrovic, M., van der Velde, N., Petrovic, M.,
Nieuwboer, A., Vlaeyen, E., Milisen, K., Ryg, J., Kenny, R. A., Bourke, R., Hartikainen,
S., … Kobusingye, O. (2022). Medication reviews and deprescribing as a single intervention in falls prevention: A systematic review and meta-analysis. Age and Ageing, 51(9).
Tomaschek, R., Lampart, P., Scheel-Sailer, A., Gemperli, A., Merlo, C., & Essig, S. (2022).
Improvement strategies for the challenging collaboration of general practitioners and
specialists for patients with complex chronic conditions: A scoping review. International
Journal of Integrated Care, 22(3): 4. DOI: 10.5334/ijic.5970.
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Assessment Traits
Requires Lopeswrite
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 at the end 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; and (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 challenges.
- Establish the feasibility of the implementation plan.
Refer to the “Evidence-Based Practice Project Proposal – Assignment Overview” document, located in Class Resources 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,” located in Class Resources, 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.
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Evidence-Based Practice Project Proposal: Implementation Plan – Rubric
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Rubric Criteria
Total120 points
| Criterion | 1. Unsatisfactory | 2. Insufficient | 3. Approaching | 4. Acceptable | 5. Target |
|---|---|---|---|---|---|
| Setting and Access to Potential Subjects
Description of setting and access to potential subjects; consent or approval form is attached in an appendix, if needed. |
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. |
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. |
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. |
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. |
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. |
| Timeline
Description of time required; draft of timeline is attached in an appendix. |
0 points
The amount of time needed to complete this project is not described. A timeline needs to be created and attached in an appendix. Revision is needed. |
6.72 points
The amount of time needed to complete this project is only partially described. A timeline is attached but contains significant errors; the timeline is not attached in an appendix. |
7.39 points
The amount of time needed to complete this project is generally described. Some additional information is needed. A timeline is attached but requires some revision; the timeline is attached in an appendix but has formatting errors. |
7.73 points
The amount of time needed to complete this project is described and general enough to be implemented at any date. Minor revision may be needed on the timeline, or to correct formatting issues in the Appendix. Some detail is needed for clarity or accuracy. |
8.4 points
The amount of time needed to complete this project is clearly described and general enough to be implemented at any date. A well-developed timeline is attached correctly in an appendix. |
| Budget and Resource List
Description of resources or changes required; outline of cost and budget and resource list are attached in an appendix. |
0 points
Description of resources or changes needed and outline of costs are omitted. A budget and resource list need to be created and attached in an appendix. Revision is needed. |
6.72 points
Description of resources or changes needed and outline of costs are partially presented. A budget and resource list are attached but contain significant errors; the list is not attached in an appendix. |
7.39 points
Description of resources or changes needed and outline of costs are generally presented. Some additional information is needed. A budget and resource list are attached but require some revision; the list is attached in an appendix but has formatting errors. |
7.73 points
Description of resources or changes needed and outline of costs are presented. Minor revision maybe needed on the budget or resource list, or to correct formatting issues in the appendix. Some detail is needed for clarity or accuracy. |
8.4 points
A detailed description of resources or changes needed and outline of costs are clearly presented. A well-developed budget and resource list are attached correctly in an appendix. |
| Research Design
Quantitative or qualitative design to collect data and evaluate effectiveness. |
0 points
Research design is not selected. |
6.72 points
A research design is selected. It is unclear how the design will be used to collect data and evaluate effectiveness of the evidence-based practice project proposal. |
7.39 points
A research design is selected. A general explanation of how the design will be used to collect data and evaluate effectiveness of the evidence-based practice project proposal is presented. More rational is needed for support. |
7.73 points
A research design is selected. An explanation of how the design will be used to collect data and evaluate effectiveness of the evidence-based practice project proposal is presented. Adequate rationale is provided for support. |
8.4 points
A research design is selected. A thorough explanation for how the design will be used to collect data and evaluate effectiveness of the evidence-based practice project proposal is presented. Strong rationale is provided for support. |
| Methods and Instruments
Methods or instruments used for monitoring implementation. |
0 points
The methods or instruments are omitted. The methods or instruments need to be created and attached in an appendix. |
6.72 points
The methods or instruments used for monitoring the implementation of the proposed solution are only partially discussed. A methods or instruments are attached but contain significant errors; the methods or instruments are not attached in an appendix. |
7.39 points
The methods or instruments used for monitoring the implementation of the proposed solution are summarized, but more information is needed. The methods or instruments are attached but require some revision; the list is attached in an appendix but has formatting errors. |
7.73 points
The methods or instruments used for monitoring the implementation of the proposed solution are described. Minor revision may be needed for the methods or instruments, or to correct formatting issues in the appendix. Some detail is needed for clarity or accuracy. |
8.4 points
The methods or instruments used for monitoring the implementation of the proposed solution are thoroughly described. The methods or instruments are accurate and correctly attached in an appendix. |
| Process for Delivering Intervention and Needed Training
Process for Delivering Intervention and Needed Training |
0 points
The process for delivering the intervention is omitted. |
6.72 points
The process for delivering the intervention is only partially described. |
7.39 points
The process for delivering the intervention and any needed training is summarized. More information or support is needed. |
7.73 points
The process for delivering the intervention and any needed training is explained. Some detail is needed for clarity or accuracy. |
8.4 points
The process for delivering the intervention and any needed training is thoroughly explained. Strong rationale is provided for support. |
| Stakeholders for Implementation
Stakeholders for Implementation |
0 points
Stakeholders needed to implement the plan are omitted. |
6.72 points
The discussion of stakeholders needed to implement the plan is incomplete. |
7.39 points
A summary of stakeholders needed to implement the plan is presented. More information or support is needed. |
7.73 points
An adequate discussion of stakeholders needed to implement the plan is presented. Some detail is needed for clarity or accuracy. |
8.4 points
A thorough discussion of stakeholders needed to implement the plan is presented. Strong rationale is provided for support. |
| Barriers or Challenges to Plan and Strategies for Overcoming
Barriers or Challenges to Plan and Strategies for Overcoming |
0 points
Potential barriers or challenges to the implementation plan are not discussed. |
6.72 points
Potential barriers or challenges to the implementation plan are only partially discussed. |
7.39 points
Potential barriers or challenges to the implementation plan are summarized. General strategies for overcoming these are presented. |
7.73 points
Potential barriers or challenges to the implementation plan are discussed and strategies for overcoming these are proposed. Some detail is needed for clarity or accuracy. |
8.4 points
Potential barriers or challenges to the implementation plan are thoroughly discussed and clear strategies for overcoming these are proposed. Strong rationale is provided for support. |
| Evidence of Feasibility
Evidence of Feasibility |
0 points
The feasibility of the implementation plan is not discussed. |
6.72 points
The feasibility of the implementation plan is only partially discussed. |
7.39 points
The feasibility of the implementation plan is outlined. More information or support is needed to demonstrate the feasibility of the plan. |
7.73 points
The feasibility of the implementation plan is discussed. Some detail is needed for clarity or accuracy. |
8.4 points
The feasibility of the implementation plan is thoroughly discussed. Strong rationale is provided for support. |
| Required Sources
Required Sources |
0 points
Sources are not included. |
6.72 points
Number of required sources is only partially met. |
7.39 points
Number of required sources is met, but sources are outdated or inappropriate. |
7.73 points
Number of required sources is met. Sources are current, but not all sources are appropriate for the assignment criteria and nursing content. |
8.4 points
Number of required resources is met. Sources are current and appropriate for the assignment criteria and nursing content. |
| Thesis, Position, or Purpose
Communicates reason for writing and demonstrates awareness of audience. |
0 points
The thesis, position, or purpose is not discernible. No awareness of the appropriate audience is evident. |
6.72 points
The thesis, position, or purpose is discernable in most aspects but is occasionally weak or unclear. There is limited awareness of the appropriate audience. |
7.39 points
The thesis, position, or purpose is adequately developed. An awareness of the appropriate audience is demonstrated. |
7.73 points
The thesis, position, or purpose is clearly communicated throughout and clearly directed to a specific audience. |
8.4 points
The thesis, position, or purpose is persuasively developed throughout and skillfully directed to a specific audience. |
| Development, Structure, and Conclusion
Advances position or purpose throughout writing; conclusion aligns to and evolves from development. |
0 points
No advancement of the thesis, position, or purpose is evident. Connections between paragraphs are missing or inappropriate. No conclusion is offered. |
7.68 points
Limited advancement of thesis, position, or purpose is discernable. There are inconsistencies in organization or the relationship of ideas. Conclusion is simplistic and not fully aligned to the development of the purpose. |
8.45 points
The thesis, position, or purpose is advanced in most aspects. Ideas clearly build on each other. Conclusion aligns to the development of the purpose. |
8.83 points
The thesis, position, or purpose is logically advanced throughout. The progression of ideas is coherent and unified. A clear and plausible conclusion aligns to the development of the purpose. |
9.6 points
The thesis, position, or purpose is coherently and cohesively advanced throughout. The progression of ideas is coherent and unified. A convincing and unambiguous conclusion aligns to the development of the purpose. |
| Evidence
Selects and integrates evidence to support and advance position/purpose; considers other perspectives. |
0 points
Evidence to support the thesis, position, or purpose is absent. The writing relies entirely on the perspective of the writer. |
4.8 points
Evidence is used but is insufficient or of limited relevance. Simplistic explanation or integration of other perspectives is present. |
5.28 points
Relevant evidence that includes other perspectives is used. |
5.52 points
Specific and appropriate evidence is included. Other perspectives are integrated. |
6 points
Comprehensive and compelling evidence is included. Multiple other perspectives are integrated effectively. |
| Mechanics of Writing
Includes spelling, capitalization, punctuation, grammar, language use, sentence structure, etc. |
0 points
Errors in grammar or syntax are pervasive and impede meaning. Incorrect language choice or sentence structure errors are found throughout. |
4.8 points
Frequent and repetitive mechanical errors are present. Inconsistencies in language choice or sentence structure are recurrent. |
5.28 points
Occasional mechanical errors are present. Language choice is generally appropriate. Varied sentence structure is attempted. |
5.52 points
Few mechanical errors are present. Suitable language choice and sentence structure are used. |
6 points
No mechanical errors are present. Skilled control of language choice and sentence structure are used throughout. |
| Format/Documentation
Uses appropriate style, such as APA, MLA, etc., for college, subject, and level; documents sources using citations, footnotes, references, bibliography, etc., appropriate to assignment and discipline. |
0 points
Appropriate format is not used. No documentation of sources is provided. |
4.8 points
Appropriate format is attempted, but some elements are missing. Frequent errors in documentation of sources are evident. |
5.28 points
Appropriate format and documentation are used, although there are some obvious errors. |
5.52 points
Appropriate format and documentation are used with only minor errors. |
6 points
No errors in formatting or documentation are present. Selectivity in the use of direct quotations and synthesis of sources is demonstrated. |
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