NURS 6052 EVIDENCE-BASED PROJECT, PART 4: RECOMMENDING AN EVIDENCE-BASED PRACTICE CHANGE

Sample Answer for NURS 6052 EVIDENCE-BASED PROJECT, PART 4: RECOMMENDING AN EVIDENCE-BASED PRACTICE CHANGE Included After Question

The collection of evidence is an activity that occurs with an endgame in mind. For example, law enforcement professionals collect evidence to support a decision to charge those accused of criminal activity. Similarly, evidence-based healthcare practitioners collect evidence to support decisions in pursuit of specific healthcare outcomes.

In this Assignment, you will identify an issue or opportunity for change within your healthcare organization and propose an idea for a change in practice supported by an EBP approach.

To Prepare:

  • Reflect on the four peer-reviewed articles you critically appraised in Module 4, related to your clinical topic of interest and PICOT.
  • Reflect on your current healthcare organization and think about potential opportunities for evidence-based change, using your topic of interest and PICOT as the basis for your reflection.
  • Consider the best method of disseminating the results of your presentation to an audience. 

The Assignment: (Evidence-Based Project)

Part 4: Recommending an Evidence-Based Practice Change

Create an 8- to 9-slide narrated PowerPoint presentation in which you do the following:

  • Briefly describe your healthcare organization, including its culture and readiness for change. (You may opt to keep various elements of this anonymous, such as your company name.)
  • Describe the current problem or opportunity for change. Include in this description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general.
  • Propose an evidence-based idea for a change in practice using an EBP approach to decision making. Note that you may find further research needs to be conducted if sufficient evidence is not discovered.
  • Describe your plan for knowledge transfer of this change, including knowledge creation, dissemination, and organizational adoption and implementation.
  • Explain how you would disseminate the results of your project to an audience. Provide a rationale for why you selected this dissemination strategy.
  • Describe the measurable outcomes you hope to achieve with the implementation of this evidence-based change.
  • Be sure to provide APA citations of the supporting evidence-based peer reviewed articles you selected to support your thinking.
  • Add a lessons learned section that includes the following:
    • A summary of the critical appraisal of the peer-reviewed articles you previously submitted
    • An explanation about what you learned from completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template (1-3 slides)

By Day 7 of Week 10

Submit Part 4 of your Evidence-Based Project.

A Sample Answer For the Assignment: NURS 6052 EVIDENCE-BASED PROJECT, PART 4: RECOMMENDING AN EVIDENCE-BASED PRACTICE CHANGE

Title: NURS 6052 EVIDENCE-BASED PROJECT, PART 4: RECOMMENDING AN EVIDENCE-BASED PRACTICE CHANGE

Introduction

Welcome to this presentation on recommending an evidence-based practice change.

Health care organizations should constantly evaluate their performance and intervene appropriately as situations necessitate. One of the highly recommended interventions is evidence-based practice change. Organizations adopt positive change based on current, relevant, and high-level evidence to solve clinical problems through such changes. The purpose of this presentation is to recommend an evidence-based practice change for addressing workplace incivility. It starts with an overview of the organization before describing the problem, the idea for change, and the plan for knowledge transfer. Other vital sections include an analysis of the measurable outcomes and lessons learned.

Organization’s Overview

The success of an evidence-based change project depends on the organizational policies, attitude towards change, and culture, among other factors. The organization is primarily a general health care facility dealing with inpatient and outpatient services. It is highly centralized, with each department dealing with specific functions. Regarding culture, the organization is primarily an adhocracy. Lepore et al. (2018) defined an adhocracy as a culture where the management supports individual initiatives instead of prescribed rules. Readiness for change can be determined by assessing the organization’s approach to change. It is right to deduce that the organization is highly ready for change since it embraces change. Previous change-driven projects have been a massive success, and the management commits resources to support innovation.

Current Problem

The current problem is workplace incivility. According to Shi et al. (2018), workplace incivility includes rude and discourteous behavior towards colleagues. An uncivil workplace is detrimental to patient care and nurses’ productivity since it hampers workplace relationships and nurses’ wellbeing. It is a leading cause of discomfort and nurse turnover (Shi et al., 2018). Workplace incivility is among the issues that nurse leadership cannot ignore in health care settings. It adversely affects the nursing staff, patients due to low-quality care and the organization due to reduced performance. Stakeholders involved in change-facilitation and/or affected by the problem include the management as change promoters, patients, the nursing staff, nurse leaders, and human resources experts (for awareness programs). The most significant risks include a change in the workplace culture and resistance.

Evidence-Based Idea for a Change in Practice

The evidence-based practice (EBP) approach recommends solving a clinical problem by integrating scientific evidence into clinical practice. As already mentioned, the problem of interest is workplace incivility. After generating evidence, it is crucial to appraise it to get the most relevant evidence for a clinical problem. Policy interventions and incivility awareness emerged as the most practical interventions for addressing workplace incivility. Such interventions include zero-tolerance policies, a culture of reporting, and education programs on workplace incivility. Cognitive rehearsal can also be integrated into the intervention programs to ensure that nurses are adequately prepared to identify and cope with workplace incivility. The objective is to reduce workplace incivility in the facility within six months.

Plan for Knowledge Transfer

EBP change projects would not be fruitful if the proposed changes are not implemented and knowledge shared. An effective way of knowledge creation is to continue searching and appraising evidence to ensure that changes are based on scientific evidence. Consultative forums and nursing education programs would also be effective in sharing knowledge and generating new ideas. The best way to adopt and implement changes is to share the EBP results with the management to facilitate appropriate practice changes. Dissemination is vital for ensuring that the EBP results reach a wider nursing audience. A policy brief and posting the results on the organization’s education would ensure that information reaches all the organization’s members. Other strategies can be chosen later to share knowledge externally.

Measurable Outcomes

The primary objective of the EBP change project is to reduce workplace incivility. It will lead to better health outcomes, achieved through EBP and shared decision-making (Hoffman et al., 2014). As a result, a combination of incivility awareness programs and policy interventions will promote a more civil workplace in six months. Shi et al. (2018) found workplace incivility a leading cause of anxiety and burnout. The proposed changes will address this problem and others stemming from workplace incivility, like reduced esteem and negative perception of the nursing profession. Reducing workplace incivility is also expected to improve the nurses’ wellbeing and confidence. Doing so will reduce medication errors and improve patient satisfaction since patients will be served better.

Lessons Learned

Research appraisal is a rigorous process which involves systematically evaluating research evidence to determine its relevance and value (Melnyk & Fineout-Overholt, 2018). After the appraisal, four articles were found relevant to workplace incivility prevention. Shi et al. (2018) recommended the importance of informed and resilient nurses to cope with workplace incivility. Armstrong (2018) recommended the need for improving nurses’ ability to recognize and manage workplace incivility, justifying awareness programs. also advised health care managers to improve nurses’ skills. The last article emphasized the need for awareness. According to Kile et al. (2019), awareness programs should be intensified in health care settings to reduce workplace incivility.

The evaluation analyzes articles about workplace incivility from multiple dimensions. It is tedious to analyze articles from multiple dimensions including research methodology, sample size, design, and outcomes. Also, research evidence should be sourced from credible sources with high-level evidence. Systematic reviews are highly reliable since they comprehensively select, analyze, and appraise evidence from multiple data sources. Also, reading the entire article can be time-consuming when searching for evidence. Therefore, it is crucial to rely on the abstract as the guide. Other vital observations include the importance of searching via keywords and in-depth understanding of research databases and the type of articles found in each.

Conclusion

It is crucial to conclude the presentation by summarizing the key findings. One of the major findings is that EBP change promotes positive change in health care by proposing evidence-based interventions for addressing clinical problems. Workplace incivility can be addressed using the same approach where research is sourced from current and relevant evidence. Suitable interventions for addressing workplace incivility include policy changes to promote a new workplace culture and increased awareness on workplace incivility to enable nurses identify and cope with the problem. It is also crucial to share EBP results with other health care providers and the larger nursing profession hence the need for dissemination.

References

Abdollahzadeh, F., Asghari, E., Ebrahimi, H., Rahmani, A., & Vahidi, M. (2017). How to prevent workplace incivility?: Nurses’ perspective. Iranian Journal of Nursing and Midwifery Research, 22(2), 157-163. https://doi.org/10.4103/1735-9066.205966
Armstrong, N. (2018). Management of nursing workplace incivility in the health care settings: A systematic review. Workplace Health & Safety, 66(8), 403-410. https://doi.org/10.1177%2F2165079918771106
Hoffman, T. C., Montori, V. M., & Del Mar, C. (2014). The connection between evidence-based medicine and shared decision making. Journal of the American Medical Association, 312(13), 1295–1296. doi:10.1001/jama.2014.10186
Kile, D., Eaton, M., deValpine, M., & Gilbert, R. (2019). The effectiveness of education and cognitive rehearsal in managing nurse‐to‐nurse incivility: A pilot study. Journal of Nursing Management, 27(3), 543-552. https://doi.org/10.1111/jonm.12709
Lepore, L., Metallo, C., Schiavone, F., & Landriani, L. (2018). Cultural orientations and information systems success in public and private hospitals: preliminary evidences from Italy. BMC Health Services Research18(1), 1-13. https://doi.org/10.1186/s12913-018-3349-6
Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Wolters Kluwer.
 Shi, Y., Guo, H., Zhang, S., Xie, F., Wang, J., Sun, Z., … & Fan, L. (2018). Impact of workplace incivility against new nurses on job burn-out: A cross-sectional study in China. BMJ Open, 8(4), e020461. doi:10.1136/ bmjopen-2017-020461