HCA 699 Section E: Implementation Plan
HCA 699 Section E: Implementation Plan
Implementation is a crucial step in the adoption of evidence-based practice protocols in the clinical settings. It requires careful use of the available resources to ensure that the deliverables of the project are achieved. It also demands active collaboration between the adopters for its successful use in the organization. It therefore proves evident that health organizations should come up with measures that minimize the risk of resistance to adoption of the change among the adopters. Consequently, this section of the project explores the implementation plan that will be used in the evidence-based practice project.
Setting and Access to Participants
The implementation of evidence-based practice projects should be conducted in settings where the subjects are easily accessible. The implementation should also be conducted in the natural environments of the subjects to ensure objectivity of the obtained results (Harvey & Kitson, 2015). The proposed project will be implemented in the medical and surgical units for adult patients. These settings will be appropriate for the intervention since patient falls often occur in them. The units also provide care to patients who have conditions that predispose them to falls. The nurses in the unit have also been seeking for new ways of promoting patient safety. As a result, the proposed intervention is best suited, as it will address the safety needs of the patients in these units.
The implementation of the project will require approval from the management of the hospital. The approval is required to ensure that the intervention promotes patient safety and the realization of quality outcomes in the organization. The approval form that will be utilized in seeking implementation for the project will be attached in the appendix section. The potential subjects for the proposed interventions are nurses working in the medical and surgical units. The nurses are involved in the promotion of patient safety in these settings. Therefore, they will be the key stakeholders that will implement the utilization of hourly nursing rounds to reduce and prevent patient falls.
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Adequate time for the implementation of evidence-based practice project is important. It provides accurate picture on the effectiveness of the intervention in promoting the desired outcomes in healthcare. It also provides flexibility in the modification of the strategies that are used to provide the expected outcomes (Greenhalgh, 2017). Therefore, the estimated time that will be needed for the implementation of the proposed project is six months. This time is perceived adequate since it will allow the determination of the rates of patient falls in the unit that uses hourly rounds and that utilizes call lights. The timeline of all the events that will occur in the implementation of the project during the six-month period will be attached in the appendix section. The tentative timeline of events that will be undertaken during the six-month period is as follows.
|Assessment of the organization’s needs||January-February 2020|
|Determination of the resources needed for the project||February-Mid February 2020|
|Training of the nurses||Mid February-March 2020|
|Implementation and monitoring of the hourly rounds||March-June 2020|
|Data acquisition and analysis||Mid June 2020|
|Communicating project findings||End of June 2020|
Successful implementation of the proposed evidence-based practice project will require the use of significant organizational resources. One of them is the healthcare providers. Nurses will be highly utilized in the implementation of the project. They will be required to conduct hourly rounds in their units and record any incidence of patient falls. The other group of nurses will be required to utilize their normal approach to promoting patient safety using call lights. The other resource that will be needed in this project is money. Financial resources will be required for training the nurses, analyzing and presenting data. The other resource that will be utilized in the project is time. Nurses have to spend most of their time in monitoring the safety of the patients in their units. The implementation of the project will not demand a change in the existing organizational tools. Therefore, the existing structures and processes will not be altered except the introduction of hourly rounds in the medical and surgical units. The resources that will be needed for the successful implementation of the project are attached in the Appendix section.
Methods and Instruments
The data for this intervention will be obtained using questionnaires and total incidents of patient falls during the period of project implementation. Self-administered questionnaires will be given to the nurses to obtain information on their experiences with the intervention. The questions will be both open and closed-ended questions. The use of questionnaires was selected for the intervention due to a number of reasons. Firstly, they allow the acquisition of rich data from the subjects. They also facilitate objective and subjective acquisition of data related to the experiences of the participants (Howlett, Shelton & Rogo, 2020). Questionnaires were also chosen because the process of organizing and analyzing data obtained using them is easy. Lastly, it was considered cheaper when compared to other methods of data acquisition such as interviews with the subjects (Melnyk, Gallagher-Ford & Fineout-Overholt, 2016). Statistics of the incidents of patient falls reported in the medical surgical units will also be obtained. They will be analyzed to provide comparative data on whether the intervention was effective or not.
The Process of Delivering the Intervention
The intervention will be delivered through a carefully planned process. The approval will be sought from the management of the hospital prior to its implementation. The nurses from the medical units will then be selected as the treatment group while those from adult surgical units will be placed on the control group. The nurses in the treatment group will be trained on the use of hourly rounds in detecting and preventing patient falls. The nurses on the control group will not receive any form of training. They will provide the usual care of detecting and preventing patient falls using call lights. The intervention will be implemented for a period of three months in both settings where data will then be obtained to determine the effectiveness of the intervention. The obtained data will be analyzed and results presented to the healthcare providers and management of the hospital.
Data Collection Plan
As shown earlier, the data for the intervention will be collected using questionnaires and statistics of patient falls in the adult medical and surgical units. The questionnaires will be administered to the nurses to obtain information about their subjective and objective experiences with the intervention. Data on the reported incidence of patient falls during the period of the intervention will be utilized for comparative purposes. A data analyst will be tasked with the responsibility of data management. The obtained data from the intervention will be analyzed using SPSS software version 20.0. The demographic data of the nurses will be analyzed using descriptive statistics. The data collection tools that will be utilized in this project will be attached in the Appendix section of the final paper.
Managing Any Barriers, Facilitators, and Challenges
It is expected that some barriers or challenges might affect the implementation of the proposed project. One of the challenges is the resistance of the nurses in adopting the change. The resistance could be attributed to factors such as fear of the unknown or high workload. The issue will be addressed by training them on the implementation of the intervention. Information on the significance of the project will also be provided to them (Ammenwerth & Rigby, 2016). The other challenge that might be experienced is the lack of financial support from the hospital. The issue will be addressed by ensuring that the intervention aligns with the mission and vision of the hospital.
Feasibility of the Implementation Plan
It is estimated that the implementation of the plan will cost the hospital $10, 000. This amount will be used to gather the costs incurred in training, data analysis, presentation, and purchase of training materials. It will also cover the cost incurred in hiring additional nurse should the workload in the departments increase beyond the expected level. Therefore, cost-efficient methods will be utilized to ensure that allocated resources are enough for the implementation process.
Plans to Maintain, Extend, Revise and Discontinue the Proposed Intervention
The proposed solution will be maintained if it proves effective in reducing the rates of patient falls in the hospital. This will be in comparison with the use of call lights in the inpatient units. The intervention will also be maintained if it is found to be cost effective when compared to the use of call lights. The intervention will be extended if the number of patients at a risk of falls admitted to the unit’s decline. It will be revised if it is found that the intervention that is used does not directly result in reduction in patient falls. It will be discontinued if it predisposes the nurses and patients to adverse events such as harm and increased risk of falls.
In summary, this section has described in detail the implementation plan for the project. It has explored the subjects and setting where the intervention will be implemented. It has also described the methods that will be utilized in data collection and analysis. Therefore, it is anticipated that the subjects will be ready to implement the project in their settings. Interventions that minimize threats to the implementation process will be adopted.
Ammenwerth, E., & Rigby, M. (Eds.). (2016). Evidence-based health informatics: Promoting safety and efficiency through scientific methods and ethical policy (Vol. 222). Ios Press.
Greenhalgh, T. (2017). How to implement evidence-based healthcare. John Wiley & Sons.
Harvey, G., & Kitson, A. (2015). Implementing evidence-based practice in healthcare: a facilitation guide. Routledge.
Howlett, B., Shelton, T. G., & Rogo, E. (2020). Evidence Based Practice for Health Professionals. Jones & Bartlett Publishers.
Melnyk, B. M., Gallagher-Ford, L., & Fineout-Overholt, E. (2016). Implementing the evidence-based practice (EBP) competencies in healthcare: a practical guide for improving quality, safety, and outcomes. Sigma Theta Tau.
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