Evidence-Based Practice Proposal Implementation of Open Visiting Hours in the ICU
Benchmark - Evidence-Based Practice Proposal Final Paper
Throughout this course you will be developing 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 are 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; they can be between 3,500 and 5,000 words. The cover sheet, abstract, references page, and appendices are not included in the word limit.
Section headings and letters for each section component are required. Responses are addressed in narrative form in relation to that number. Evaluation of the proposal in all sections is 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: Problem Description
Section C: Literature Support
Section D: Solution Description
Section E: Change Model
Section F: Implementation Plan
Section G: Evaluation of Process
Each section (A‐G) will be submitted as separate assignments so your instructor can provide feedback (refer to applicable modules for further descriptions of each section).
The final paper will consist of the completed project (with revisions to all sections), title page, abstract, reference 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.
Use the "NUR‐699 EBP Implementation Plan Guide" and "NUR‐699 Evidence‐Based Practice Project Student Example" to assist you. Also refer to "NUR‐699 Evidence‐Based Practice Project Proposal Format."
Prepare this assignment according to the APA 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.
Attachments
NUR699.R.Evidence-BasedPracticeProjectProposalFormat_student.docx
NUR699.R.EBPStudentExample_Student.docx
NUR699.R.EvidenceBasedPracticeProposalFinalPaperOverview_student.docx
NUR699.R.EBPimplementationPlanGuide_student.docx
RUBRIC
View Rubrics
Download
Benchmark - Evidence-Based Practice Proposal Final Paper - Rubric
No of Criteria: 6 Achievement Levels: 6
Criteria
Achievement Levels
Description Percentage
No Submissions
71.00 %
Unsatisfactory
75.00 %
Less Than Satisfactory
83.00 %
Satisfactory
88.00 %
Good
92.00 %
Excellent
100.00 %
Content
55.0
Abstract Presents a complete, concise overview of all phases of the proposed project.
10.0
None
No abstract
Abstract minimally written, clearly not sufficient to provide the reader with an understanding of the project.
Abstract provides overview of part of the project, but does not cover each section.
Abstract provides a quick or too brief overview of all phases of the proposed project. Contains project title, project director's name, and affiliation.
Abstract provides a complete concise overview of all phases of the proposed project and flows well with the rest of the paper. Contains project title, project director's name, and affiliation.
Project / Content Comprehension
25.0
None
Content is incomplete or omits most of the requirements stated in the assignment criteria. Does not demonstrate an understanding of the basic principles. Does not demonstrate critical thinking and analysis of the overall program subject.
Content is incomplete or omits some requirements stated in the assignment criteria. Demonstrates shallow understanding of the basic principles. Within section revisions components may be missing details, only a surface level of evaluation is offered, methods are described but flawed or unrealistic and strategies are discussed, but incomplete.
Content is complete, but somewhat inaccurate and/or irrelevant. Demonstrates adequate understanding of the basic principles. The major sections have had revisions but some components may be missing details. Reasonable but limited inferences and conclusions are drawn but lack development. Supporting research is inadequate in relevance, quality, and/or currentness.
Content is comprehensive and accurate, and definitions are clearly stated. Sections form a cohesive logical and justified whole. All of the major sections have been revised based upon logical feedback, conclusions, and sound research. Shows careful planning and attention to details and illuminates relationships. Research is adequate, current, and relevant, and addresses all of the issues stated in the assignment criteria.
Content is comprehensive. Presents ideas and information beyond that presented throughout the course, and substantiates their validity through solid, academic research where appropriate. Research is thorough, current, and relevant, and addresses all of the issues stated in assignment criteria. Final paper exhibits process of creative thinking and development of proposal. Applies framework of knowledge and practice. All of the major sections have been revised based upon logical feedback, conclusions, and sound research. Shows careful planning and attention to how disparate elements fit together.
Sections A-G Synthesis
20.0
None
The main sections are not easily identified; some of the subconcepts do not successfully integrate to form a cohesive whole. Within section revisions methods and strategies are described poorly. Basic descriptions, connections, and alignment are not clearly presented. Logic flow is random, not easily understood.
The main sections are somewhat identified; some of the subconcepts branch appropriately from the main sections. Basic descriptions, connections, and alignment as well as a clear logic flow are somewhat fragmented, not easily understood.
All of the main sections are easily identified, and subconcepts branch appropriately from the main sections. Recognizes links among sections; however, some connections may be ambiguous. Basic descriptions, connections and alignment as well as basic logic flow are understandable, but are somewhat lacking in a clear progression.
All of the main sections are easily identified, and subconcepts branch appropriately from the main sections. Descriptions, connections, and alignments are provided. Logic flow is smooth and easily understood, facilitating a thorough understanding of the various sections as they interrelate.
All main sections are easily identified, and sub concepts branch appropriately from main sections. Descriptions, connections, and alignments are obvious and well supported. Logic flow is smooth and easily understood, facilitating a thorough understanding of various sections as they interrelate. Connection to extraneous materials are well documented and integrated.
Organization and Effectiveness
30.0
Appendices
15.0
None
Several of the appendices are missing. Designs are not neat or organized, and do not include all required elements. Unprofessionally developed.
Several of the appendices are missing. Design detracts from purpose. The work is not neat and includes minor flaws or omissions of required elements. Limited understanding of the topic is present as evidenced by the design.
All of the appendices have been provided. Design is fairly clean, with a few exceptions. Appearance is general, and major elements are missing. Provides minimal details. Appropriate for the audience and the content but some of the development of the material is inadequate. Basic understanding of the topic is present as evidenced by the design.
All of the appendices have been provided. Designs are appropriate and present quality products. Appearance is neat, with a few minor flaws or missing elements. Provides details with accuracy. Reveals a solid understanding of the topic as evidenced by design.
All of the appendices have been provided. They are effective and functional. The work is well presented and includes all required elements. The overall appearance is neat and professional. Gives sufficient detail with precision and specificity. Reveals a solid understanding of the topic as evidenced by the design.
Mechanics of Writing (includes spelling, punctuation, grammar, language use)
15.0
None
Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice and/or sentence construction are used.
Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, and/or word choice are present.
Some mechanical errors or typos are present, but are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used.
Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used.
Writer is clearly in command of standard, written, academic English.
Format
15.0
Research Citations (In-text citations for paraphrasing and direct quotes, and reference page listing and formatting, as appropriate to assignment and style)
15.0
None
No reference page is included. No citations are used.
Reference page is present. Citations are inconsistently used.
Reference page is included and lists sources used in the paper. Sources are appropriately documented, although some errors may be present.
Reference page is present and fully inclusive of all cited sources. Documentation is appropriate and citation style is usually correct.
In-text citations and a reference page are complete and correct. The documentation of cited sources is free of error.
Total Percentage 100
Attachments: NUR-699.R.Evidence-BasedPracticeProjectProposaalFormat_student.docx
Evidence-Based Practice Project Proposal Format
Use the following format and headings when constructing your final evidence-based practice project proposal paper.
1) Abstract (Needs to be between 120 and 350 words)
a) Contains project title, project director’s name, and affiliation.
b) Presents a complete concise overview of all phases of the proposed project.
2) Section A: Organizational Culture and Readiness Assessment
3) Section B: Problem Description
4) Section C: Literature Support
5) Section D: Solution Description
6) Section E: Change Model
7) Section F: Implementation Plan
8) Section G: Evaluation
9) Appendices
a) Critical Appraisal Checklists
b) Evaluation Table
c) Conceptual Models
d) Timeline
e) Resource List
f) Proposal Instruments
g) Data Collection Tool
h) Budget
i) Optional
i) Approval Forms
ii) Handouts
iii) Evaluation Tools
NUR699.R.EBPStudentExample_Student.docx
NUR699.EvidencebasedPracticeProposalFinalPaperOverview_student.docx
Evidence-Based Practice Proposal Final Paper Overview
1. Throughout this course you will be developing a formal, evidence-based practice proposal.
2. 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 are 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; they can be between 3,500 and 5,000 words. The cover sheet, abstract, references page, and appendices are not included in the word limit.
3. Section headings and letters for each section component are required. Responses are addressed in narrative form in relation to that number. Evaluation of the proposal in all sections is based upon the extent to which the depth of content reflects graduate-level critical-thinking skills.
4. This project contains six formal sections:
a) Section A: Organizational Culture and Readiness Assessment
b) Section B: Problem Description
c) Section C: Literature Support
d) Section D: Solution Description
e) Section E: Change Model
f) Section F: Implementation Plan
g) Section G: Evaluation of Process
5. Each section (A – G) will be submitted as separate assignments so your instructor can provide feedback (refer to each Module and the Course Assignment Matrix).
6. The final paper will consist of the completed project (with revisions to all sections), title page, abstract, reference 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.
7. Use the EBP Implementation Plan Guide and the Evidence-Based Practice Project Student Example to assist you.
NUR699R.EBPimplementationPlanGuide_Student.docx
EBP Implementation Plan Guide
PICOT Question
Topic 1
Preliminary Checkpoint • Identify a health care issue you want to see change.
• Understand the culture of the organization in its readiness for EBP implementation.
• Develop PICOT question.
• Build EBP knowledge and skills. Notes:
Topic 2
Checkpoint 1 • Define project purpose.
• Who are the stakeholders for your project?
• Identify active (on the implementation team) and supportive (not on the team, but essential to success) roles.
• Identify project team roles and leadership.
• Begin acquisition of any necessary approvals for project implementation and dissemination (e.g., system leadership, unit leadership, ethics board [IRB]).
• Feasibility: Briefly integrate the evidence with stakeholder influence to inform evidence-based recommendations.
• Hone PICOT question. Notes:
Topic 3
Checkpoint 2 • Conduct literature search and retain studies that meet criteria for inclusion.
• Connect with librarian.
• Critically appraise literature.
• Summarize evidence with focus on implications for practice. Notes:
Topic 4
Checkpoint 3 • Begin formulating a detailed plan for implementation of evidence.
• Include who must know about the project, when they will know, how they will know.
• Connect the evidence and the project.
• Identify and address known barriers and facilitators of project.
• Define post-project outcome indicators of a successful project. Notes:
Topic 5
Checkpoint 4 • Define baseline data collection source(s) (e.g., existing data set, electronic health record), methods, and measures.
• Identify resources (human, fiscal, and other) necessary to complete project.
• Gather outcome measures.
• Write data collection protocol.
• Write the project protocol (data collection fits in this document).
• Finalize any necessary approvals for project implementation and dissemination (e.g., system leadership, unit leadership, IRB). Notes:
Topic 6
Checkpoint 5 • Finalize protocol for implementation of evidence.
• Complete final data collection for project evaluation.
• Include specific plan for how the evaluation will take place: who, what, when, where and how, and communication mechanisms to stakeholders. Notes:
Topic 7
Checkpoint 6 • Complete proposal.
• Develop proposal presentation. Notes:
Topic 8
Checkpoint 7 • Present proposal.
• Review proposals, addressing new questions generated from process of the peer review. Notes:
Adapted from Melnyk, B. M., & Fineout-Overholt, E. (Eds.). (2010). Evidence-based practice in nursing & healthcare: A guide to best practice (2nd ed.). Philadelphia, PA: Lippincott Williams & Wilkins
All the Professor comments are for you to include in the final paper.
0Files BROWSE FROM MY COMPUTERMore options for File Upload
Evidence Based Practice Proposal
Student’s Name
Institutional Affiliation
Evidence Based Practice Proposal
Abstract
Being admitted to the Intensive Care Unit (ICU) creates a crisis situation not only to the patients but also to family members. Fear, unfamiliar environment, lack of awareness about the condition and hopelessness are some of the factors that cause a crisis in both patients and family members. Addressing the needs of the needs of patients and relatives, and the responsiveness of health practitioners in these units determines the quality of care. Visiting patients in ICU has been mentioned to be an effective way of addressing the clients’ needs by helping them adapt with the crisis.
Keywords: Intensive Care Units, Critical Care Units, Visiting Hours, Clinicians.
Needs Assessment
This project utilized the Organizational Culture and Readiness for System-Wide Integration of Evidence Based Practice (OCRSIEP) survey tool to assess the readiness level of the organization to implement an EBP (Brown, 2014). The OCRSIEP tool contains 19 items that addresses a number of aspects of practitioner’s perspectives on the organization’s readiness to implement an EBP (Eberhart, 2014). The ability of the tool to assess various aspects of the practitioner’s perceptions is the reason why it was considered important.
Results
Answers to the tool’s items range from “None at all” to “Very Much” depending on how the EBP has been incorporated into the mission of the organization and practiced. Eight nurses were assessed where 6 of them recorded the commitment to EBP to be “a little”, that of physician and administration to be “very much”. The practitioners recorded “a little” to “somewhat” on the number of nurses who possesses the necessary knowledge and skills in relation to evidence based practice. Additionally, they also recorded “a little” to “somewhat” nurses who possess the required knowledge and skills in generating and translating findings from a review. They also recorded “moderately” to “very much” commitment in practitioners to incorporate the evidence based practice into practice.
Based on the findings, the organization demonstrates a higher level of readiness to implement the evidence based practice. The commitment and passion in both nurses and practitioners is evidence enough that the hospital is ready. On the other, the hospital’s access to research institutes and a number of physicians dedicated to EBP is an added advantage.
Barriers
Some of the barriers include:
* Insufficient time.
* Insufficient resources (Scurlock-Evans, Upton & Upton, 2014).
Facilitators
* Good leadership and project management.
* Increased awareness.
To implement open visiting hours in the ICU, it is important to incorporate an evidence based practice. The assessment demonstrates that the organization is ready to adopt an EBP.
Problem Description
Being admitted to the Intensive Care Unit (ICU) creates a crisis situation not only to the patients but also to family members. Fear, unfamiliar environment, lack of awareness about the condition and hopelessness are some of the factors that cause a crisis in both patients and family members. Addressing the needs of the needs of patients and relatives, and the responsiveness of health practitioners in these units determines the quality of care. Visiting patients in ICU has been mentioned to be an effective way of addressing the clients’ needs by helping them adapt with the crisis. However, for long time, clinicians who work in these critical units have been behaving as if the units were designed for them and not for patients and family members (Levy & De Backer, 2013). Additionally, the hospital policies and space restrictions have been considered to be the barriers to ICU visitations (Haghbin et al., 2011). Moreover, the attitudes of the clinicians have also contributed to these barriers where clinicians have argued that visiting hours are burdensome. On their defence they also argue that prolonged time in ICU exposes family members to anxieties due to frequent interruptions from the healthcare team.
Those who are opposed to visiting hours in ICU argue that it poses harmful impacts on the patients. In their defence they claim that visitations from family members to critical units increase heart rates resulting in premature atrial and ventricular contractions as well as an increase in blood pressure. However, there is no literature supporting these claims. Moreover, the available literature suggests that ICU visitations help patients to rest by reducing stress.
The disagreement on ICU visiting hours has been contributed by the claims that they interfere with the work of clinicians in the units making patient care more difficult. On the contrary, studies have demonstrated that family members facilitate patient-staff communication by training patients on how to communicate with the nurses (Berwick & Kotagal, 2004). Moreover the available literature has shown that family members provide an effective feedback to patients as compared to the clinicians which improve the working conditions. The literature also suggests that if the presence of family members interferes with the workflow of nurses, they can be asked to temporarily leave the bedside in a polite manner (Noordermeer et al., 2013).
PICOT
Population- adult critical-care patients
Intervention- scheduled visiting hours
Comparison- unscheduled visiting hours
Outcomes- improved patient outcomes
Time- one year
“In adult critical care patients (P), how does scheduled vising hours in ICU (I) improve patient outcomes (Outcomes) within a year (T)?”
Objectives
* Improve communication between the hospital staff and family members.
* Improve an understanding of the nature of a family member’s condition to enhance shared decision-making.
* Improve patient and family members’ outcomes.
* Ensure there is a closer contact between the family members and their patient.
Stakeholders
* Patients
* Nurses
* Family members
* Clinicians
* Hospital management.
Clinicians need to understand the importance of visiting hours in intensive care units to both patients and their family members. Moreover, the visitors should be aware of the care provision, geographical space and rights of the patient. Therefore, implementing visiting hours in intensive care units will not only improve the quality of care but also family members’ outcomes. With the increasing need to address all the needs of the patients and family members, visiting hours in ICUs will be a starting point. Therefore, reviewing the available literature is necessary for the development of EBP that will facilitate the implementation of visiting hours in critical units.
Solution Description
Clinicians have been behaving as if intensive care units (ICU) were designed for them and not for patients and their relatives. Throughout the world, determining the appropriate visiting hours in critical care units has been a challenge. Studies have demonstrated that besides the challenges, clinicians are willing to provide patients and their loved ones with more time for family visits. However, although other studies have demonstrated that visiting hours as a quality indicator and an unmet need for relatives, ICU clinicians have posed a lot of questions in relation to the impact these visiting hours might have to the staff, workflow and patients as well.
Interventions
Limited Visits: This intervention is believed to be more beneficial to the health facility and care staff. This method is the most common one since it is believed that it increases the resting time for patients and gives the care givers more control by preventing overcrowding in a room. Moreover, most ICU caretakers believe that family visits in critical care units cause psychological stress to the patients and interferes with the staff care. This may endanger patient safety. However, these claims are not supported by some of the available evidences. Therefore, limiting the number of visits presents as the best intervention strategy.
Open visits: This strategy enables family members to visit their patients any time of the day. There is evidence showing that the presence of family members around their ailing loved ones is beneficial. Being present during the hour of need demonstrates a respect to the rights of the patient and their family members. Presences of relatives tend to improve patient outcomes as well of the family members and friends because it promotes patient care.
Their nursing staff is willing to incorporate these interventions into the practice. Moreover, they will not have any financial costs to the institution.
Organizational Culture:
The organization has always desired to improve the quality of care it offers to its patients in critical care units. Moreover, it demonstrates higher readiness level to implement an EBP in into its care delivery. Also, the proposed interventions support community beliefs that being near their loved ones helps them emotionally since it makes them belief that they are cared for.
Outcomes:
i) Improve the quality of care- the quality of care in ICU has been a concern to patients, family members as well as the clinicians. Therefore, introducing visiting hours will guarantee a patient-centred care approach by addressing some of their psychological needs.
ii) Improved patient outcomes and those of their relatives- Besides the quality of care, patient and family members’ outcomes is another concern for clinicians. Not allowing relatives to be around their ailing loved ones may have equal reactions from both sides lowering their satisfaction levels.
Methodology:
The best method to implement this EBP into practice is by first considering the individual differences between the patients and their loved ones (age, culture, personality and illness related aspects). The next step is to involve all parties involved to discuss the best options (determine frequency, time of the day and duration of visits). After this has been done, it intervention will be implemented and monitored objectively by all parties. However, for effective implementation of this strategy the following limitations need to be addressed, lack of awareness in family members, hospital policies and the physical structure of the critical care units.
Outcome impact:
* Visiting hours creates a familial environment for patients and reinforces the trust in the concerned family members and friends resulting in improved working communications with the hospital staff. Moreover, this will result in an improved quality of care.
Change Model
The reception for a change in any organization varies among different groups of people. In the organization, people will have mixed reactions towards the change that is being introduced in regard to the level and speed at which it is being introduced. Rodger’s diffusion of innovation theory addresses the various reactions to new changes and its stages. This change model will utilize Rodgers theory to examine each phase and its effects especially in the implementation of an evidence-based practice.
The primary focus of the innovation theory is on how ideas spread among the various groups of peop...
👀 Other Visitors are Viewing These APA Essay Samples:
-
Views on Nurse Fatigue: Description
5 pages/≈1375 words | 4 Sources | APA | Health, Medicine, Nursing | Research Paper |
-
The Evaluation of Evidence-Based Initiative
2 pages/≈550 words | 4 Sources | APA | Health, Medicine, Nursing | Research Paper |
-
Describe Psychiatric Shortage in Rural Canada
20 pages/≈5500 words | 10 Sources | APA | Health, Medicine, Nursing | Research Paper |