NURS 6052 Assignment EBP, Part 4 Recommending an EBP 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.

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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.

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)

Risk Mitigation Plan

The proposed cultural change may be associated with different risks including loss of employees, loss of focus among the employees, as well as increased level of animosity. Cultural change may also lead to the loss of previous cultural practices that are important in determining organizational identity. Some of the risk mitigation plan that can be used in the change process may include preserving the organization’s most precious asset such as branding. In other words, the organizational branding ought to be attached to the new cultural practices. Ensuring extreme transparency and involving all the stakeholder in the change process is essential in mitigating the changes required.

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By Day 7 of Week 10

Submit Part 4 of your Evidence-Based Project.

Submission and Grading Information

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Grading Criteria

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Week 10 Assignment Rubric

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Submit your Week 10 Assignment Draft and review the originality report

Submit Your Assignment by Day 7 of Week 10

To participate in this Assignment:

Week 10 Assignment

Module 6: Changing the World Through Evidence-Based Practice (Weeks 10-11)

Laureate Education (Producer). (2018). Evidence-based Practice and Outcomes [Video file]. Baltimore, MD: Author.

Due By	Assignment
Week 10, Days 1-3	Read the Learning Resources. Begin to compose your assignment.
Week 10, Days 4-6	Continue to compose your Assignment.
Week 10, Day 7	Deadline to submit your Assignment.
Week 11, Days 1-2	Read the Learning Resources. Compose your initial Discussion post.
Week 11, Day 3	Post your initial Discussion post.
Week 11, Days 4-5	Review your Discussion posts. Compose your peer Discussion responses.
Week 11, Day 6	Post two peer Discussion responses.
Week 11, Day 7	Wrap up Discussion

Learning Objectives

Students will:

Analyze opportunities for change within healthcare organizations
Recommend evidence-based organizational changes using an evidence-based practice approach to decision making
Identify measurable outcomes addressed by evidence-based changes
Justify dissemination strategies
Analyze the impact of patient preferences on clinical decision making
Analyze decision aids

Learning Resources

Note: To access this module’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

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Patient preferences and decision making

Situation

A 70 year old male patient was referred to our home health agency for wound care. He had other diagnoses-diabetes and hypertension. He had been a smoker for the last 30 years. His blood pressure and blood sugar levels were labile. We wanted to help him quit smoking for better health outcomes because we know from scientific research that smoking can affect oxygenation and therefore interfere with wound healing(Ellis, 2018), increase blood pressure by narrowing and hardening arteries (cdc,2019). With high blood pressure, there is a potential for heart attack and stroke. Smoking can also increase blood sugar leading to complications like heart disease, nerve damage, blindness (CDC, 2019).Patient was educated on the implications of smoking on his health and was given options that would help him consider quitting smoking.

When patients are presented with choices and options, they are able to tell us their preferences. Evidence based decision making integrates research evidence, patient preferences and values, and clinical expertise (Melnyk & Fineout, 2018). After considering the options, the patient objected to the use of medication and opted to quit on his own. He did well for the first week, but on week two was found with a few packs placed on the table. Asked what went wrong, he conceded that quitting on his own was a challenge because he just enjoys smoking. Patient preferences need not just be diagnoses related; considerations should be given to their social and cultural values, personal priorities, beliefs about health religious and spiritual values (Ginex, 2018). He decided to try the nicotine patch. By the time of his discharge from the agency, he was reporting zero episodes of craving cigarettes and an aversion to the smell of the smoke, wound was healed and blood pressure was well controlled, blood sugar was still problematic but that is a scenario for another day because his dietary habits were questionable even after several interventions.

The decision tool I chose is, Quitting Smoking: Should I Use Medicine”? (The Ottawa Hospital Research, 2019).This tool provides the facts, gives options, considers patient’s feelings and then gives the patient the chance to check the facts by answering questions related to what they have learnt. This will be a quick- go- to, helpful/useful tool in my practice because it is factual, user friendly and to the point. Incorporating patient preferences/perspectives in how we provide care can lead to better clinical outcomes. Patient input in decision making helps the clinician understand the patient’s concerns and fears about their disease and their treatment plan. Hoffmann, Montori, & Del Mar(2014) note that through the shared decision making process, patients are able to implement health care decisions and live with the consequences.

References

Ellis, P. (2018). The impact of smoking on wound healing: the role of the nurse. British Journal of Nursing, 27(6), S10–S14. https://doi-org.ezp.waldenulibrary.org/10.12968/bjon.2018.27.6.S10

Ginex, P. K. (2018, March 22). Integrate evidence with clinical expertise and patient preferences and values. ONS Voice. https://voice.ons.org/news-and-views/integrate-evidence-with-clinical-expertise-and-patient-preferences-and-values

Hoffmann TC, Montori VM, Del Mar C. The Connection Between Evidence-Based Medicine and Shared Decision Making. JAMA. 2014;312(13):1295–1296. doi:10.1001/jama.2014.10186

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer

The Ottawa Hospital Research Institute. (2019).Patient decision aids. Retrieved from https://decisionaid.ohri.ca/

Required Readings

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.

Chapter 7, “Patient Concerns, Choices and Clinical Judgement in Evidence-Based Practice” (pp. 219–232)

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

Note: You will access this article from the Walden Library databases.

Kon, A. A., Davidson, J. E., Morrison, W., Danis, M., & White, D. B. (2016). Shared decision making in intensive care units: An American College of Critical Care Medicine and American Thoracic Society policy statement. Critical Care Medicine, 44(1), 188–201. doi:10.1097/CCM.0000000000001396

Note: You will access this article from the Walden Library databases.

Opperman, C., Liebig, D., Bowling, J., & Johnson, C. S., & Harper, M. (2016). Measuring return on investment for professional development activities: Implications for practice. Journal for Nurses in Professional Development, 32(4), 176–184. doi:10.1097/NND.0000000000000483

Note: You will access this article from the Walden Library databases.

Schroy, P. C., Mylvaganam, S., & Davidson, P. (2014). Provider perspectives on the utility of a colorectal cancer screening decision aid for facilitating shared decision making. Health Expectations, 17(1), 27–35. doi:10.1111/j.1369-7625.2011.00730.x

Note: You will access this article from the Walden Library databases.

The Ottawa Hospital Research Institute. (2019). Patient decision aids. Retrieved from https://decisionaid.ohri.ca/

Change is necessary in the healthcare systems. With the advancement in the operational processes, there is always the need to adjust some of the approaches used in the healthcare. Most organizations often implement changes to ensure efficiency in the healthcare processes and also to increase revenues. With the increased demands of quality in the healthcare delivery, most healthcare institutions are always involved in the continuous change processes to ensure that they meet the ever increasing demands from the clients.

Given that healthcare institutions are faced with different challenges that need to be addressed, there is always the need to initiate change processes to address such challenges/problems (Arditi, Nayak, & Damci, 2017). Different healthcare institutions are associated with different issues that either require changes in people’s behaviors or the processes or approaches in the healthcare system. Some of the challenges may include medication errors, workplace conflicts, inadequate care delivery, high costs of healthcare services, and low nurse to patient ratios. These challenges/issues often require the implementation of appropriate changes in the service delivery to ensure effective operational processes. The purpose of this paper is to examine an issue that may lead to the implementation of change processes in the healthcare system.

Executive Summary of the Issue Impacting Organization/Workplace

One of the main issues affecting my organization/workplace is workplace conflict. In most cases, conflicts among the employees and the management often impact effective operational processes. Usually, workplaces with a lot of issues experience delays in service delivery. Also, the quality of service delivery may go down. With the increasing conflicts within the work environment, people cannot reach consensus on various issues that impact healthcare processes. Workplaces with continuous conflicts often require constant changes to ensure that there is an overall improvement in the operational processes.

Conflicts within the work environment may be caused by poor communication, lack of common understanding among the workforce, as well as the lack of respect among the employees and the management. Close-mindedness, misunderstandings, as well as passive aggressive behaviors are some the other causes of workplace conflicts in my organization. In my organization, the management has been involved in implementing different change processes to address the issue of workplace conflicts. However, the approaches that have been taken often appear ineffective. For instance, the management has tried to transform communication processes to enhance understandings among the employees and the management; however, the approaches that were taken failed to produce effective outcomes.

Description of the Change Being Proposed

Changes in the organizational culture and policies is essential in addressing the workplace conflicts. Changing an organizational culture is one of the best approaches in ensuring a reduction in workplace conflicts. However, it is one of the challenging processes for the management as there is always the need to transform the mind-set of employees as well as their behaviors. Also, the organization’s culture often consists of interlocking set of roles, goals, values, processes, attitudes, communication policies, as well as assumptions. Changing an organizational culture is often a large scale undertaking that requires the organization of different resources. For instance, the organizational tools that are required in changing the minds will need to be put in place.

Changing an organizational culture will involve addressing the communication processes and improving the behaviors of people. In other words, the proposed change, which is the transformation of the organizational culture, will address the issues that often lead to conflicts. For example, the change process will create an environment of mutual respect and effective communication.

Changes in the organizational culture may also create an environment where there is teamwork. In most cases, workplaces where people interact and operate together experience less conflicts. The change or transformation of the organizational culture may lead to strong employee relationships, which can lead to less conflicts. Changing an organizational culture may also lead to changes in policies, objectives, mission, and vision, especially if these factors are attached to the cultural practices.

Justification for the Change

Addressing the cultural change will have significant impact in the organization/workplace. Cultural change will lead to the creation of a positive environment for all the stakeholders, which will lead to increased quality in service delivery and the general patient outcomes. Organizational culture often contributes significantly to the behaviors of the people as well as the interaction processes.

Therefore, whenever there is the need to resolve workplace conflict, transforming culture is necessary. Also, organizational culture often determines the value, principles, and ethical behaviours of the people. Therefore, transforming it would mean improvement on individual’s values, ethical behaviors and the development of positive principles which are necessary in resolving conflicts.

Type and Scope of the Proposed Change

Making changes to the organizational culture should incorporate making adjustments to the standards of behaviors of the people. Also, the whole process involves changes in the values and principles that people ought to adhere to. In other words, cultural change should incorporate changes in the workplace values, policies, skill, practices, attire, language, expectations, aesthetics, and tools. Cultural change should involves overall changes in behaviors. In other words, the organizational culture change should incorporate a shift in behaviors and in the ways things are supposed to be done as well as how employees are expected to behave under different circumstances (Slack & Singh, 2018). The cultural change should also involve the transformation of policies relating to human resource activities.

Stakeholders Impacted By the Change and the Identification Of The Change Management Team

Some of the stakeholders that will be impacted by the cultural change include employees and the management. In the process of change, employees will be required to transform their behaviours, which may go contrary to the normal behaviors of a person. Also, adjusting to the set standards of behaviors may become very difficult for some people. Given that the management often relates directly to the employees, they may also be impacted by the cultural change (Pitafi, Liu, & Cai, 2018). Other stakeholders that may be impacted by the change include clients/patients that often get engaged directly with the organizational employees.

The change management team will involve the management. For instance, human resource managers will be among the change management team. Also, the chief executive officer, lower level managers, nurse leaders, and some employees, especially nurses, will be part of the change management team. The above professionals understand what it takes to transform the organizational culture.

Plan for Communicating the Proposed Change

There is always the need to communicate proposed changes to ensure that everyone understand the procedures and processes required is necessary. Selecting credible leaders to communicate the change process is necessary in ensuring that every aspect of the change process is well understood and addressed by the stakeholder involved in the whole process. Keeping communication all the way to the end of the whole process is necessary in ensuring that all the stakeholders become aware of the change process (Currie et al., 2017). Delivering accurate messages to the people and ensuring that everyone captures the information being communicated is important. While communicating the processes of change, there is the need to ensure that all the messages delivered are consistent to the end.

Risk Mitigation Plan

Conclusion

Change is necessary in the healthcare systems. With the advancement in the operational processes, there is always the need to adjust some of the approaches used in the healthcare processes. Transforming cultural practices is necessary in ensuring that there are improvements in the quality services delivery and that clients can enjoy effective services offered. Addressing the cultural change will have significant impact in the organization/workplace. Cultural change will lead to the creating of a positive environment for all the stakeholders, this will lead to the quality in service delivery and the general patient outcomes.

References

Arditi, D., Nayak, S., & Damci, A. (2017). Effect of organizational culture on delay in construction. International journal of project management, 35(2), 136-147. /https://doi.org/abs/pii/S0263786316303052

Currie, D., Gormley, T., Roche, B., & Teague, P. (2017). The management of workplace conflict: Contrasting pathways in the HRM literature. International Journal of Management Reviews, 19(4), 492-509. https://doi.org/10.1111/ijmr.12107

Pitafi, A. H., Liu, H., & Cai, Z. (2018). Investigating the relationship between workplace conflict and employee agility: The role of enterprise social media. Telematics and Informatics, 35(8), 2157-2172. https://doi.org/10.1016/j.tele.2018.08.001

Slack, N. J., & Singh, G. (2018). Diagnosis of organizational culture in public sector undertakings undergoing reforms. Public Organization Review, 18(3), 361-380.: https://doi/org/10.1007/s11115-017-0383-5

Health organizations operate with the aim of optimizing outcomes such as safety, quality, and efficiency in addressing the needs of their organizations. Often, health organizations operate in highly dynamic and challenging environments. They experience issues such as competition from other organizations, changing consumer needs and preferences, and emerging health problems. These challenges imply that health organizations must embrace change to respond to their current and emerging needs in their markets.

Change initiatives provide organizations competitive edge over others involved in the same market niche. Healthcare providers, including nurses play a crucial role in the implementation of change initiatives that address organizational needs. They select evidence-based practice interventions to ensure efficiency in the adopted strategies and realization of optimum safety and quality outcomes in service delivery. Therefore, this presentation examines an organizational issue and proposed change to address it.

The organization I work with is a tertiary hospital. The hospital leads in the region in the provision of specialized and general care to its diverse populations. The hospital has a culture that supports change. First, healthcare providers utilize teamwork in the provision of patient care services. Teamwork aims at ensuring collectivism in the realization of the organizational outcome. The organization also strives to support safety culture. This is achieved by the adoption of evidence-based interventions in the implementation of organizational strategies. Evidence-based strategies optimize outcomes such as safety, quality, and efficiency. There is also the use of open communication among different stakeholders.

Open communication ensures the prioritization of the stakeholder needs, views, and concerns. Open communication has strengthened openness and trust among the organizational employees, hence, enhanced teamwork in the provision of patient care. The organization also recognizes the vital role that rewarding performance plays in contributing to employee productivity. As a result, it undertakes biannual performance appraisals and uses them to reward employees and motivate them to explore additional ways of achieving the desired outcomes. These aspects of the organizational culture make it ready to embrace change.

The selected nursing problem in my organization is nursing shortage. The hospital currently experiences an acute shortage of nurses, which has affected the provision of patient care services to the patients. Several circumstances surround the issue of nurses shortage in the hospital. One of them is high rate of nurses’ turnover. The rate of nurses leaving their jobs intentionally has risen significantly over the past years. The rise is attributed to organizational issues such as high workload because of the few nurses, burnout, and occupational stressors associated with the challenge of balancing professional and family life demands.

The other factor is unhealthy workplaces. This can be seen from violence targeted at nurses by other nurses and other healthcare providers. Most nurses report experiencing either physical or verbal violence from others, which affect their psychological and physical health, hence, their intention to leave their jobs. The other factor is the low number of nursing students being trained among the American universities. This is attributed to the shortage of faculty staff to train a high number of nurses to address the current shortage. Lastly, more than one million nurses will be retiring in the next decade. This implies that the problem of nursing shortage will persist if no intervention is embraced (Yahya Muabbar & Zayyan Alsharqi, 2020). The affected stakeholders by the problem include nurses and patients. Nurses suffer from high workload while patients are affected by low quality nursing care being given to them. The risks of implementing change include resistance to change from the adopters, inadequate support from health organizations, and disruption of the existing systems and processes by change.

The proposed idea to address the issue of nurses shortage in the hospital is empowering them. The hospital should implement nurse-centered interventions that address their actual and potential needs. The interventions should align with the needs and expectations of the nurses. One of the empowerment strategies that the hospital should consider is rewarding their performance. The hospital should ensure that the remuneration for the nurses aligns with the role and contributions of nurses to its success. The hospital should also implement reward schemes regularly to motivate nurses to engage in additional ways to meet the needs of their patients and theirs too.

The other strategy is ensuring health and safe working environment (Challinor et al., 2020). The hospital should ensure the adoption of strict policies that condone behaviors such as violence targeted at nurses. In addition, workplace stressors such as high workload should be addressed to prevent more nurses from leaving their jobs in the hospital. The other empowerment strategy is ensuring flexibility in the nurses’ schedules. The leadership and management should ensure that nurses have flexible schedules that help them to balance between work and family demands. There should also be programs such as counseling for nurses to help them be resilient and develop effective coping skills for managing the workplace demands. These empowerment strategies should be incorporated into the organization’s culture to ensure sustainable change (Farid et al., 2020; Gensimore et al., 2020; Lester et al., 2020; Seren Intepeler et al., 2019).

The plan for knowledge transfer will comprise several interventions. One of them will be training nurses about the selected empowerment strategies. For example, nurses will be enrolled into training sessions where they will be informed about their role in creating safe work environments and advocating for sustainable change. Training will equip them with the competencies they need to drive excellence in nursing practice and protection of nurses’ needs and interests. The second strategy is creating discussion forums for nurses.

The forums will enables them to share their issues and potential strategies that should be adopted in the organization. The third strategy for knowledge transfer will be involving nurses in assessing, planning, implementing, and evaluating the selected empowerment strategies. Their involvement will ensure the adoption of interventions that align with nurses’ expectations, hence, their sustainability (Dang et al., 2021). Lastly, best strategies will be incorporated into the organization’s culture. The incorporation will ensure the organization supports evidence-based strategies that contribute to nurses’ retention in the organization.

Three dissemination strategies will be adopted. The first one is publishing an article about the results of empowering nurses on the hospital’s nursing staffing levels. Publishing an article will be an effective approach to reaching a large nursing audience. It will also be used in other organization as an evidence-based intervention to address nurses’ shortages. The second dissemination strategy will be presenting results in nursing conferences. The conferences will provide opportunities to share knowledge with other nurses on the effectiveness of the intervention and how to improve it further. The last strategy will be developing new guidelines in the hospital to guide employee management (Dang et al., 2021). The empowerment strategies that prove effective will be incorporated into human resource policies, hence, sustainability in the use of best practices in the hospital.

Several outcomes will be used to assess the effectiveness of nurses’ empowerment in addressing the issue of nursing shortage in the organization. One of them will be the rate of nurses’ turnover. The rates will be compared before the intervention and after it to determine its impact on nursing workforce. The other measure will be nurses’ level of job satisfaction. Surveys, interviews and questionnaires will be administered to determine the satisfaction of nurses with the adopted empowerment interventions.

An increase in their level of satisfaction will translate into the success of the intervention. Information about nurses’ intent to leave their jobs will also be obtained before and after the empowerment interventions. A reduction in their intention to leave their jobs will translate into project success. The costs incurred by the organization in hiring, training, and retaining nurses will also be compared before and after empowerment interventions to obtain a true picture of its impacts (Blouin & Podjasek, 2019; Cao et al., 2019).

I learned several things from conducting the evaluation table using the peer-reviewed articles. One of them is the importance of evidence-based data in nursing practice. I learned that nurses should make their decisions based on the best available evidence. The use of evidence-based data ensures optimum outcomes such as safety, quality, and efficiency. The other lesson learnt is the need for nurses to be competent in article critique. This will help them to determine the level of evidence in each article and relevance to their practice. I also learnt that evidence-based data is important in improving patient and nursing outcomes. This could be seen from the enhanced outcomes in the articles included in the review. Organizations influence the use of evidence-based data in their process. Therefore, they should ensure that their culture supports new practices to enhance performance and care outcomes in addressing the needs of different populations.

References

Blouin, A. S., & Podjasek, K. (2019). The Continuing Saga of Nurse Staffing: Historical and Emerging Challenges. JONA: The Journal of Nursing Administration, 49(4), 221. https://doi.org/10.1097/NNA.0000000000000741

Cao, Y., Liu, J., Liu, K., Yang, M., & Liu, Y. (2019). The mediating role of organizational commitment between calling and work engagement of nurses: A cross-sectional study. International Journal of Nursing Sciences, 6(3), 309–314. https://doi.org/10.1016/j.ijnss.2019.05.004

Challinor, J. M., Alqudimat, M. R., Teixeira, T. O. A., & Oldenmenger, W. H. (2020). Oncology nursing workforce: Challenges, solutions, and future strategies. The Lancet Oncology, 21(12), e564–e574. https://doi.org/10.1016/S1470-2045(20)30605-7

Dang, D., Dearholt, S. L., Bissett, K., Ascenzi, J., & Whalen, M. (2021). Johns Hopkins Evidence-Based Practice for Nurses and Healthcare Professionals: Model and Guidelines, Fourth Edition. Sigma Theta Tau.

Farid, M., Purdy, N., & Neumann, W. P. (2020). Using system dynamics modelling to show the effect of nurse workload on nurses’ health and quality of care. Ergonomics, 63(8), 952–964. https://doi.org/10.1080/00140139.2019.1690674

Gensimore, M. M., Maduro, R. S., Morgan, M. K., McGee, G. W., & Zimbro, K. S. (2020). The Effect of Nurse Practice Environment on Retention and Quality of Care via Burnout, Work Characteristics, and Resilience: A Moderated Mediation Model. JONA: The Journal of Nursing Administration, 50(10), 546. https://doi.org/10.1097/NNA.0000000000000932

Lester, P. E., Dharmarajan, T. S., & Weinstein, E. (2020). The Looming Geriatrician Shortage: Ramifications and Solutions. Journal of Aging and Health, 32(9), 1052–1062. https://doi.org/10.1177/0898264319879325

Seren Intepeler, S., Esrefgil, G., Yilmazmis, F., Bengu, N., Gunes Dinc, N., Ileri, S., Ataman, Z., & Dirik, H. F. (2019). Role of job satisfaction and work environment on the organizational commitment of nurses: A cross-sectional study. Contemporary Nurse, 55(4–5), 380–390. https://doi.org/10.1080/10376178.2019.1673668

Yahya Muabbar, H., & Zayyan Alsharqi, O. (2020). The Impact of Short-Term Solutions of Nursing Shortage on Nursing Outcome, Nurse Perceived Quality of Care, and Patient Safety. American Journal of Nursing Research, 9(2), 35–44. https://doi.org/10.12691/ajnr-9-2-1

Healthcare team and health institutions have been of the headline news as front foot soldiers and war front in the fight against the devastating pandemic scourge. The COVID effects indicate they may last for quite a while before a sigh of relief by human race. This is due to the burden of exhaustion, disruption and loss of every aspect of family dynamic not to mention the economic cloud of uncertainty the pestilence still exact. The initial cases of infection made every COVID case be handled with such disdain and depersonalization that many “initial-case-infected” people felt excluded, prejudiced and outrightly discriminated.

My topic of choice to help me view this health scare, exhaustion and prejudice is stigma associated with illness. However, stigma is such a broad and I considered narrowing it down to stigma associated with mental illness. As a clinical issue, stigma affects not only the patient but also the health care givers, significant others and the general population at large. This discordance do have ramifications on care delivery and of course interrupts quality of care and the wellness of the population. As psychiatric nurse student, this topic has a profound meaning and bearing in my discharge of duties to help guard myself appropriately and be of much benefit to patients, healthcare team and nursing discipline as a profession at large. Provision of effective education and support to persons undergoing stigmatization is critical in the holistic care and individual wellness.

As a society, we are faced by myriad of determinants of health that can bolster or effectively deny access to care, pinning down specific obstacles to any individual attainment of health can be daunting more so the ones dealing with stigma against their illness. Stigma can easily give rise to branding persons or communities and stereotyping societies in very negative ways. The COVID-19, HIV-AIDS, Malaria, Tuberculosis are ailments that have seen stereotyped conversations and prejudicial treatment to members of society that arise from such singled out geographical areas.

I utilized nursing CINHAL – EBSCO and medline with full text databases to search for my topic. Having settled on stigma, there were too many articles that filtered under the “stigma keyword” choice. Quite a few were very shallow in information, others with diverses analysis. My boolean operators to narrow and refine my search under stigma were; nursing and allied health journals, from year 2018 to 2023, including “AND” subject terms of “mental health, mental illness”, refined to peer-reviewed journals, full text and those that have PDF format availed for access. I encountered major problem while choosing the year range (2018 to 2023), it kept defaulting to only single year 2021. This resulted very few articles listed. I would browse through the article for its layout format, read the abstract, introduction, conclusion parts as I eyeballed the methodology to access validity and acceptability of the article. Most of the articles had PICOT design P-mental health patients, I-issue of concern/Stigma or intervention, C-control group with no interventions introduced, O- results after intervening, T- duration/period of study test.

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Name: NURS_6052_Module06_Week10_Assignment_Rubric

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Part 4: Disseminating Results Create a, 8-9-slide narrated PowerPoint presentation of your Evidence-Based Project: Briefly describe the following: your healthcare organization and culture, current opportunity for change, scope of issue, and EBP best practice recommendation. Explain how you would plan knowledge transfer and dissemination. Describe measurable outcomes with the implementation of EBP best practice. Summarize lessons learned.	Points Range: 81 (81%) – 90 (90%) The narrated presentation accurately and completely summarizes the evidence-based project. The narrated presentation is professional in nature and thoroughly addresses all components of the evidence-based project. The narrated presentation accurately and clearly describes in detail the healthcare organization and culture, current opportunity for change, scope of the issue, and EBP best practice recommendation. The narrated presentation accurately and clearly describes how to plan for knowledge transfer, disseminate the results of the project to an audience, citing specific and relevant examples. The narrated presentation clearly and accurately describes measurable outcomes with the implementation of the EBP best practice and summarizes lessons learned. The narrated presentation fully integrates at least two outside resources and two or three course-specific resources that fully support the presentation.	Points Range: 72 (72%) – 80 (80%) The narrated presentation adequately summarizes the evidence-based project. The narrated presentation is professional in nature and adequately addresses the components of the evidence-based project. The narrated presentation accurately describes in detail the healthcare organization and culture, current opportunity for change, scope of the issue, and EBP best practice recommendation. The narrated presentation accurately describes how to plan for knowledge transfer, disseminate the results of the project to an audience, citing specific and relevant examples. The narrated presentation accurately describes measurable outcomes with the implementation of the EBP best practice and summarizes lessons learned. The narrated presentation integrates at least one outside resource and two or three course-specific resources that may support the presentation.	Points Range: 63 (63%) – 71 (71%) The narrated presentation vaguely, inaccurately, or incompletely summarizes the evidence-based project. The narrated presentation may be professional in nature and somewhat addresses the components of the evidence-based project. The narrated presentation inaccurately or vaguely describes the healthcare organization and culture, current opportunity for change, scope of the issue, and EBP best practice recommendation. The narrated presentation inaccurately or vaguely describes how to plan for knowledge transfer, disseminate the results of the project to an audience, citing specific and relevant examples. The narrated presentation vaguely or inaccurately describes measurable outcomes with the implementation of the EBP best practice and summarizes lessons learned. The narrated presentation minimally integrates resources that may support the presentation.	Points Range: 0 (0%) – 62 (62%) The narrated presentation vaguely and inaccurately summarizes the evidence-based project or is missing. The narrated presentation is not professional in nature and inaccurately and incompletely addresses the components of the evidence-based project or is missing. The narrated presentation vaguely and inaccurately describes the healthcare organization and culture, current opportunity for change, scope of the issue, and EBP best practice recommendation, no examples are provided, or it is missing. The narrated presentation vaguely and inaccurately describes how to plan for knowledge transfer, disseminate the results of the project to an audience, citing no specific and relevant examples. The narrated presentation vaguely or inaccurately describes measurable outcomes with the implementation of the EBP best practice and summarizes lessons learned. The narrated presentation fails to integrate any or presents minimal resources to support the presentation.
Written Expression and Formatting—Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.	Points Range: 5 (5%) – 5 (5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.	Points Range: 4 (4%) – 4 (4%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment is stated yet is brief and not descriptive.	Points Range: 3.5 (3.5%) – 3.5 (3.5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60–79% of the time. Purpose, introduction, and conclusion of the assignment is vague or off topic.	Points Range: 0 (0%) – 3 (3%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time. No purpose statement, introduction, or conclusion was provided.
Written Expression and Formatting—English Writing Standards: Correct grammar, mechanics, and proper punctuation.	Points Range: 5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors.	Points Range: 4 (4%) – 4 (4%) Contains a few (one or two) grammar, spelling, and punctuation errors.	Points Range: 3.5 (3.5%) – 3.5 (3.5%) Contains several (three or four) grammar, spelling, and punctuation errors.	Points Range: 0 (0%) – 3 (3%) Contains many (five or more) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
Total Points: 100

Name: NURS_6052_Module06_Week10_Assignment_Rubric

NURS 6052 Assignment EBP, Part 4 Recommending an EBP Change