Evidence-Based Program Planning: A Case Study

Evidence-Based Practice Proposal Final Paper Usha Kizhakkedan Grand Canyon Final Paper of Evidence Based Proposal NUR-699 Dr. Debbie Long June 1, 2016 Table of Contents Part 1: Organizational Culture and Readiness Assessment 4 • Introduction to Evidence-Based Practice 4 • Barriers to Evidence-Based Practice 4 • Facilitators of Evidence-Based Practice 5 • Integration of Clinical Enquiry 5 • The Survey 6 Part 2: Problem Description 7 • Description 7 • Identification of change agents in the Health care system 8 • PICOT question 8 • Purpose and Objectives 9 • Rationale 10 • Literature support 10 • Research Method 10 Part 3: Literature Support 11 • Research Questions 11 • Search Method 12 • Organization of Literature 12 • Framework 12 • Nursing Rounds- Patient and Family Satisfaction: 13 • Communication: 15 • Management of Pain, Use of Call Lights and Cases of Patient falls 15 • Data Collection 16 Part 4: Solution Description 16 • Objectives 17 • Change Methodology 17 • Implementation Plan 18 • Evaluation 19 Part 5: Change Model 19 • Change Model 20 • Implementing Change 21 • Rationale 22 Part 6: Implementation Plan 22 • Staff Education 23 • Client feedback 23 • Timeframe 23 • Hiring Process 24 • Implementation 24 • Data collection and Evaluation 24 • Progression 24 • Resource Management 24 • Budget Plan 25 • Outcomes and its impact 25 • Summary 26 Part 7: Evaluation of Process 26 • Objectives 26 • Methodology 27 • Procedure 27 • Collection and Analysis of data

The program implements some effective program evaluations in order to identify if the residents or homeless people of Miami-Dade county are receiving services but the agency has no measurement of the success of the clients it serves(New

According to Stevens (2013), the call to develop and implement evidence-based practice (EBP) within all healthcare disciplines is fueled by legislative demands for improvement in standard medical metrics such as mortality and morbidity. However, increasing demands by the public for evidence related to the metrics and outcomes of such concepts as quality of life illustrate what may be more important to the client (Stevens, 2013). This client-directed focus has resulted in patient-centered outcomes research (PCOR) (Stevens, 2013). "The Patient-Centered Outcomes Research Institute (PCORI) helps people make informed health care decisions, and improves health care delivery and outcomes, by producing and promoting high integrity, evidence-based information

Clegg and Smart (2010) noted that the term outcome measurement process is often interchangeable with achievement, goal, objective and indicator. Furthermore, Clegg and Smart (2010) went on to identify these terms, goals, outcomes present as essential elements to assist in identification of relevant data for program evaluation. Definitions of terms recognizes that goals are a broad statement of the ultimate aims of the program, outcomes are the changes in the lives of recipients, organization communities and those impacted by the program, and indicators indentifies specific, measurable information that can be collected or tracked to show that outcomes have occurred (Clegg & Smart, 2010).

The evaluation designs for generalist practice are broken down into five parts that is discussed in this chapter. These techniques are helpful when working with client systems. The first one is the single-subject design. This design determines whether or not an intervention is successful. (Kirst-Ashman & Hull, 2015) It focuses on families, a group or a large system. Next is the goal-attainment scaling, it is a method used when achievement of the goal is sufficiently important to be used as the primary outcome criterion. (Kirst-Ashman & Hull, 2015) Next is the task-achievement scaling, it is a method of evaluating the degree to which an identified set of tasks has been accomplished. (Kirst-Ashman & Hull, 2015) Next is the client satisfaction

Evidence-based practice is a form of critical thinking at that specific moment when you’re on the job in that specific situation. The first source that I found stated that evidence based practice combines the evidence found with what you know and joins them both to give proper healthcare (Evidence-Based Practice for Health Professionals 2014). The second source I found stated that evidence based practice which is used as EBP for short sometimes is a combination of your clinical knowledge, ethical standards for your patients, and the evidence used into making your final decision to take care of that patient (http://guides.mclibrary.duke.edu). For example, in an emergency a patient comes in the emergency room claiming that he has bad reflux.

Applying evidenced-based practice has three steps. Step one is making sure the research is creditable. Going into detail about step one should model a social work practice. In a social work practice, you always want to make sure you are looking for clarity and in some cases it helps to paraphrase it or reword it differently. As a social worker you have to be non-judgmental and try to understand every perspective. You have to be unbiased when it comes to wording and how it affects the meaning of the conversation. Also, making sure the research on the surveys or interviews are fair and represent the entire population. The second step is when you match your outcome of the research in your own “practice wisdom." As a social worker you want to compare the research you made with prior experience. You want to have different perspective and information that help you understand the client better. Lastly, the last step is to ask questions to the clients about their significance of what they have accomplished by working with you. Just asking what the client has learned can help

In our research, we have compared three very different tools for ranking evidence based practice methods. Each of these tools could be effectively utilized in any healthcare facility or healthcare organization.

According to the QSEN Institute (2014), evidence-based practice is knowing how to identify gaps in existing evidence-based guidelines and finding ways to fix these disparities. Because the prison facility does not currently educate directly on the importance of proper and frequent hand washing, a lack in this evidence-based practice of hand washing education was identified and selected for implementation.

I work in ICU unit as a registered nurse, where we provide care for patients with life threatening medical conditions. Working in ICU require a careful assessment and monitoring of patient progress in order to dictate sudden changes in the patients’ medical condition that might require emergency intervention. Evidence base practice is very important for our daily patient care. According the article published for the April issue of the journal critical care nurse, it encourages nurses to critically evaluate and apply evidence to daily practice to improve patient outcomes and to stop using practice intervention that are based solely on tradition. “It is well established that evidence-based practice (EBP) is associated with higher quality care

4. Outcomes – Focusing on the right case management behavior to impact positively the lives of the clients is what ClientTrack solutions do. Measuring the outcomes of the organization evaluate the program effectiveness, improve services, and strengthen fundraising by showcasing evidence of the impact of the programs the organizations provides for the community (Benefits...ClientTrack, 2013).

I have been working in community based services for three years now and one of the topics that I thought would be interesting to research would be the efficiency of evidence based practices within a community setting. I have myself been trained in several evidenced based practices which I have implemented with families. However, it has been a common experience among my colleges that many of these practices do not fit well within CBHI services. I would like to explore the issue and propose date to my field placement on how to better implement these evidenced based mental health practices within the community. I realized that this is a broad topic but I will work on refining this idea as I believe it will be valuable for my clients.

Nursing is a practice that keeps evolving. A policy, according to Yoder-Wise (2014), “is just a plan for action related to an issue that affect a group’s well-being” (p.179). Nurse Managers and coordinator find ways to keep up to date with the standard of practice or evidence-Based practice. In my current work area, nurses are kept up to date with the use of online classes that are compiled by the company. The online class is a short power point with voice with a test at the end. This is required by all nurses. This online system allows nurses to learn at location of their convenience. If the nurses have any questions, they are able to refer to the power point and consult their administrator. This strategy allows nurses to review and understand

According to Melnyk, Fineout-Overholt, Gallagher-Ford and Kaplan (2012) evidence-based practice (EBP) is a problem-solving technique to help in the making of clinical decisions in regards to healthcare to provide the best scientific solution to a clinical problem. This process involves clinical expertise, patient values, preferences and the best research evidence to date. The findings of an EBP project alone does not make the final decision, but the findings can help support new interventions to patient care and patient processes (---------------). If I was approach by a colleague who wanted me to co-author a manuscript and I was passionate about the project and potential benefits to patient care I would willingly accept to join their team.

During MP’s comprehensive assessment, the five-step evidence-based model was followed to ensure an inviting, non-threatening atmosphere as the foundation of a patient-centered interview process (Bush, 2016). Due to the impact that social determinants can have on one’s health and well-being, the necessity of evaluating MP’s determinants, as well as his understanding of the determinants was imperative. With open-ended, focused questions; active listening skills; and summarization, the following social determinants were assessed: economic stability, education, social & community context, health & health care, and neighborhood & built environment (U.S. Department, 2018).