NRS 493 Discuss one way you will be able to evaluate whether your project made a difference in practice

My evidence base practices proposal is on shortage of nursing in long term care. After meeting with staff and administration it was determined that the facility nurses were very upset due to contracted 90 days nurses receiving a higher pay rate and less required work than the staff nurses. Most facilities are offering incentives for their employees. It was discovered that this facility is offering outside help an increase incentive. The staff and administration must address the issue to come to a resolution to provide a medium to ensure that employees are benefited as well. In Doing research for this project, I have found several discoveries and one that I have chosen to weigh in on is. The owner of the Aperion chain of nursing homes must evaluate the risk and benefits of loosing values employers who have dedicated their talent, time, and hearts to this establishment. Most Business owners weigh in on the financial aspect of their establishment occasionally forgetting about the staff that is employed that is the reason behind the business thriving. In providing my change proposal I must provide information’s to how the employees are feeling and the progress they have provide to the facility to make it strive. While providing this information I am in hopes that my proposal will assist in providing information to the owner of the establishment that will assist in not preserving quality of care to his establishment. Establishing an administrative atmosphere that is committed to the preservation of capable employees is the initial move in decreasing workers turn over. The facility uses a tool called Relias learning for education purpose in training staff. It offers a guide for retention of staff this is something that needs to be presented to administration to review.

[1] https://www.aamc.org/news-insights/medical-burnout-breaking-bad

Hunt SR, Probst JC, Haddock KS, Moran R, Baker SL, Anderson RA, Corazzini K. Registered nurse retention strategies in nursing homes: a two-factor perspective. Health Care Manage Rev. 2012 Jul-Sep;37(3):246-56. doi: 10.1097/HMR.0b013e3182352425. PMID: 22037647.·

Initiating an evidence-based practice can be a challenging process for nurses since it’s difficult to ensure that the PICOT problem is addressed according to plan. However, nurses must be knowledgeable about change proposal implementation and the importance of assessing if the expected outcome was achieved (Ginex, 2018). One final important step in the implementation of an evidence-based project is to monitor and analyze the results. This will identify crucial areas that need adjustment for a successful outcome. Evaluating the outcomes of an evidence-based project can be done through feedback or audit assessments as well as patient outcomes (American Association of Nurse Anesthesiology, n.d.).

This writer will use a premortem to determine the project outcome to ensure the successful implementation of the change project with the use of the SBAR tool to improve communication through a standardization process. One meaningful way of evaluating a change project outcome is through a premortem (Ginex, 2018). Using a premortem evaluation tool, the writer will be able to identify outcomes, barriers, and risks associated with the successful implementation of an SBAR evidence-based project. This premortem tool will also provide insight into the evidence-based intervention to determine if using a standardized communication tool improve communication and collaboration of patient care information during handoff. Some stakeholders including the preceptor will be allowed to view the project and identify all possible reasons for failure. The writer will also use supporting feedback to modify the change project to improve user satisfaction.

Reference

American Association of Nurse Anesthesiology, . (n.d.). Step 5 – Evaluate the Outcomes. In American Association of Nurse Anesthesiology. Retrieved from https://www.aana.com/practice/evidence-based-practice/step-5—evaluate-the-outcomes

Ginex, P. (2018, April 19). Use These Methods to Evaluate EBP Outcomes and Disseminate Results. In ONS Voice. Retrieved from https://voice.ons.org/news-and-views/use-these-methods-to-evaluate-ebp-outcomes-and-disseminate-results

Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS NRS 493 Discuss one way you will be able to evaluate whether your project made a difference in practice:

The purpose of an evidence-based change proposal is to address the needs of a facility and to introduce evidence-based solutions aimed at improving the quality of care offered to patients, optimizing treatment outcomes, and minimizing financial burden. The goals of my change proposal focused of Urine Culture Stewardship, is to Decrease in the number of urine cultures ordered, decrease the number of Asymptomatic-Bacteriuria cases treated inappropriately, decrease the costs associated with the overtreatment of ASB. In order to evaluate an evidence-based practice project, it is important to be able to determine its effectiveness. To evaluate the effectiveness of change, it is important to apply an evaluation method to measure the change.

NRS 493 Discuss one way you will be able to evaluate whether your project made a difference in practice

A summative evaluation involves making judgments about the efficacy of a program or course at its conclusion. In addition, summative evaluations, or assessment of learning is the assessment of participants where the focus is on the outcome of a program. A summative evaluation involves collecting and analyzing data with the intention of identifying the effects and outcomes of an intervention (Bin Mubayrik, 2020). By utilizing a summative evaluation, I will be able to determine if my change proposal was successful in achieving the intended objectives.

References

Preventing CAUTI: Focus on Culturing Stewardship. (2022, May 29). Retrieved from https://www.ahrq.gov/hai/cauti-tools/phys-championsgd/section7.html

Bin Mubayrik, H. F. (2020). New Trends in Formative-Summative Evaluations for Adult Education. https://journals.sagepub.com/doi/full/10.1177/2158244020941006

Urine culture stewardship programs are a novel strategy to reduce the rate of CAUTI in hospital settings, emphasizing the effectiveness of implementing a urine culture stewardship program by decreasing inappropriate culturing. Healthcare professionals have difficulty making a difference between asymptomatic bacteriuria (ASB) from catheter-associated urinary tract infections. Indwelling catheters are used often during hospitalizations. Urinalysis and cultures sent a reflexive response to fever and may result in overdiagnosis of catheter-associated urinary tract infections, which contribute to unnecessary and excessive antibiotic use. To reduce CAUTI, the Agile Implementation (AI) model tool was used and its methodology includes a strategic approach that engages stakeholders to develop implementation, evaluation, and termination plans to recognize the effectiveness of services and outcomes in a medical setting. Inappropriate culturing practice as a reflexive response to fever was identified as the root cause of overdiagnosis of CAUTI. A research study found evidence-based practice strategies to guide urine culture practice. CAUTI incidence rates were the primary outcome monitored. The outcomes analyzed were the number of urine cultures with reflex to culture and total antibiotic use. A termination plan would be performed immediately for any unintended consequences identified and reevaluated at 30 and 90 days post-implementation for ongoing effectiveness. For the first 30 days, indications for ordering culture were monitored for educational gaps. Implementation of the AI model to change urine culture practices led to a significantly reduced in the number of urine cultures ordered and was sustained to be applied to other medical settings (Page et al., 2020). The appropriate and inappropriate use of urine cultures to determine if treatment with antibiotics is required and to distinguish between CAUTI and CA-ASB include signs and symptoms compatible with UTI (microbiology and pyuria) (CDC, 2019).

References:

CDC. (2019). Strategize Initiatives | Urine Culture Stewardship | HAI | CDC. https://www.cdc.gov/hai/prevent/cauti/indwelling/strategize.html

Page et al. (2020). Changing the culture of urine culturing: Utilizing Agile Implementation to improve diagnostic stewardship in the ICU. AJIC. https://oce-ovid-com.lopes.idm.oclc.org/article/00000545-202011000-00016/HTM L

Assessing the effectiveness of a project is vital. This is because this assessment justifies whether there is a return on the resources being spent on the project, or whether this is needed to re-evaluate the project, and possibly look for alternative solutions that will address the clinical problem in question (Galas et al., 2018). Furthermore, assessing the effectiveness of a project will lead to the understanding as to whether or not there are gaps in the implementation that will ultimately lead to the failure of the project (Rogers, 2020). Therefore, it’s vital to ensure that there is an adequate monitoring and evaluation plan in place that will guarantee that the project is assessed to identify its successes and failures.

The first step of my evaluation will be the establishment of measurable goals, targets or outcomes. Thus far in the course, we have already developed our expected outcomes. The next step will entail making these outcomes measurable. For instance, one of my expected outcomes is to reduce the rate of smoking in patients. To make this outcome measurable, I will adjust this to mean reducing the rate of smoking in patients by 45% within 4 months of the administration of the intervention. This will ensure that when that period lapses, I have a benchmark through which I can ascertain whether the project was successful or not. After establishing. This benchmark, my second step will be to evaluate the potential data collection mechanisms. This is because these data collection mechanisms will play an important role when it comes to gathering the data needed to assess the effectiveness of the project. For instance, in order to assess the rate of smoking, we will give the participants a digital log-book in their phones. They will be required to fill this logbook in order to assess whether they have smoked. This logbook will potentially have a reminder system that will ensure that the participants are reminded every hour to fill a logbook on whether they have smoked in the past hour or not.

Last but not least, we will evaluate this data statistically and the goal of the analysis is to establish whether there is any correlation between the outcomes and the intervention administered. This also means that before the invention begins, we will need baseline data that will point us towards whether or not there has been any changes following the administration of the intervention.

In order for the project to gain any validation, these evaluation techniques are vital, as they will also communicate to stakeholders whether the project is worth their support.

References

Galas, A., Pilat, A., Leonardi, M., & Tobiasz-Adamczyk, B. (2018). Research Project Evaluation-Learnings from the PATHWAYS Project Experience. International journal of environmental research and public health, 15(6), 1071. https://doi.org/10.3390/ijerph15061071

Rogers G. (2020). Using Telemedicine for Pediatric Preanesthesia Evaluation: A Pilot Project. Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses, 35(1), 3–6. https://doi.org/10.1016/j.jopan.2019.07.001

NRS 493 Discuss one way you will be able to evaluate whether your project made a difference in practice