Week 6 Assignment: Evidence-Based Practice Change Process (graded)
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Due Jun 14 by 11:59pm Points 225 Submitting a file upload
Purpose
The purpose of this assignment is:

To apply a change process using the ACE Star Model of Knowledge Transformation and a systematic review after identifying a clinical topic of concern and related nursing practice issue.
The information from the ‘Illustration’ part of our lessons in Weeks 1-6 will mentor you through this process. Your change process is to be set up as a pilot project.
Course Outcomes
This assignment enables the student to meet the following course outcomes:

CO2: Proposes leadership and collaboration strategies for use with consumers and other healthcare providers in managing care and/or delegating responsibilities for health promotion, illness prevention, health restoration and maintenance, and rehabilitative activities. (PO#2)
CO8: Selects evidence for best practices when planning professional nursing care involving systems, processes, and devices for individuals, families, aggregates and communities. (PO#8)
Points
The assignment is worth 225 points.

Due Date
Submit your completed assignment by Sunday end of Week 6 by 11:59 p.m. MT.

Directions
Please do not use any of the Nurse Daniel information for your own topic, nursing intervention, or change project. Nurse Daniel serves as an example only to illustrate the change process.

Please review the infographic as way to guide you in getting started with your assignment: Developing an Assignment with Integrity (Links to an external site.)
View a short tutorial with tips for completing this assignment: Evidence-Based Practice Change Process Assignment Tutorial (Links to an external site.) or by reading the transcript (Links to an external site.).
Download the EBP Change Process form (Links to an external site.) during Week 1. The use of this specific form is REQUIRED
Identify a clinical topic and related nursing practice issue you think needs to be changed.
Locate a systematic review on your topic from the CCN Library databases. Be sure this involves nursing actions.
Work through each step of the ACE Star Model as outlined on the assignment form (Star Points 1-5: Discovery, Summary, Translation, Implementation, and Evaluation). Respond to the instructions provided on the form.
Follow the activities and thinking of Nurse Daniel in Weeks 1-6 in the ‘Illustration’ part of each lesson. He will be working through a clinical topic and nursing practice issue to demonstrate a change (ACE Star Model and systematic review).
Work on a portion of the process each week, as the illustration unfolds.

Best Practices
Please reach out to your instructor for feedback or assistance with your PICOT question as needed.
Required and Additional Background Reading in Weeks 1 and 2 under Readings is available for more information on the ACE Star Model and the use of systematic reviews.
Please see the grading criteria and rubrics on this page.
Please use your browser’s File setting to save or print this page.

Scholarly Sources and Citations
Please cite any references (in APA format) of your systematic review or other scholarly document (optional) as needed.
Paraphrasing information, rather than quoting, is expected. No quotes for this assignment please!

**Academic Integrity**

Chamberlain College of Nursing values honesty and integrity. All students should be aware of the Academic Integrity policy and follow it in all discussions and assignments.

By submitting this assignment, I pledge on my honor that all content contained is my own original work except as quoted and cited appropriately. I have not received any unauthorized assistance on this assignment.

Rubric
Week 6: EBP Change Process Assignment Grading Rubric
Week 6: EBP Change Process Assignment Grading Rubric
Criteria Ratings Pts
This criterion is linked to a Learning Outcome Selected Systematic Review
A systematic review from the CCN Library databases was selected, identified, and was appropriate for the selected nursing change process.
25.0 pts
One systematic review from the CCN Library databases was identified and was clearly appropriate.
22.0 pts
A systematic review was selected from the CCN Library databases and was mostly appropriate for a nursing change process.
20.0 pts
A systematic review was selected from the CCN Library databases and was fairly appropriate for a nursing change process.
10.0 pts
A systematic review was selected, but not from the CCN Library databases and/or was not appropriate for this assignment.
0.0 pts
No systematic review selected or used.
25.0 pts
This criterion is linked to a Learning Outcome Star Point 1 (Discovery)
The topic, nursing practice issue, rationale and scope of the problem were clearly identified and described.
25.0 pts
Star Point 1 elements in the first column were thoroughly addressed.
22.0 pts
Star Point 1 elements in the first column were mostly well addressed.
20.0 pts
Star Point 1 was missing one element in the first column or one lacked detail.
10.0 pts
Star Point 1 was missing more than one element in the first column and others lacked detail.
0.0 pts
The ACE Star Model Star Point 1 was not completed.
25.0 pts
This criterion is linked to a Learning Outcome Star Point 2 (Summary)
The NURSING practice problem, NURSING related PICOT question, a systematic review from any database in the Chamberlain Library, and other optional references, evidence summary, strength, and solutions, are listed and described.
35.0 pts
Star Point 2 elements in the first column were thoroughly addressed.
31.0 pts
Star Point 2 elements in the first column were mostly well addressed.
28.0 pts
Star Point 2 was missing one element in the first column or one lacked detail.
13.0 pts
Star Point 2 was missing more than one element in the first column and others lacked detail. or were inappropriate.
0.0 pts
The ACE Star Model Star Point 2 was not completed.
35.0 pts
This criterion is linked to a Learning Outcome Star Point 3 (Translation)
Care standards, practice guidelines, or protocols; stakeholders and their roles and responsibilities; the nursing role; rationale for including certain stakeholders, and cost analysis plan are addressed.
35.0 pts
Star Point 3 elements in the first column were thoroughly addressed.
31.0 pts
Star Point 3 elements in the first column were mostly well addressed.
28.0 pts
Star Point 3. was missing one element in the first column or one lacked detail.
13.0 pts
Star Point 3 was missing more than one element in the first column and others lacked detail.
0.0 pts
The ACE Star Model Star Point 3 was not completed.
35.0 pts
This criterion is linked to a Learning Outcome Star Point 4 (Implementation)
Permission process, education plan, timeline, measurable outcomes, forms, resources, and stakeholder meetings, are addressed.
35.0 pts
Star Point 4 elements in the first column were thoroughly addressed.
31.0 pts
Star Point 4 elements in the first column were mostly well addressed
28.0 pts
Star Point 4 was missing one element in the first column or one lacked detail.
13.0 pts
Star Point 4 was missing more than one element in the first column and others lacked detail.
0.0 pts
The ACE Star Model Star Point 4 was not completed.
35.0 pts
This criterion is linked to a Learning Outcome Star Point 5 (Evaluation)
Reporting results, process and next steps are addressed.
35.0 pts
Star Point 5 elements in the first column were thoroughly addressed.
31.0 pts
Star Point 5 elements in the first column were mostly well addressed
28.0 pts
Star Point 5 was missing one element in the first column or one lacked detail.
13.0 pts
Star Point 5 was missing more than one element in the first column and others lacked detail.
0.0 pts
The ACE Star Model Star Point 5 was not completed.
35.0 pts
This criterion is linked to a Learning Outcome Presentation
Information was presented clearly and thoughts were well organized and logical.
20.0 pts
Information was presented clearly and thoughts were well organized and logical throughout.
18.0 pts
Information was presented clearly and thoughts were mainly organized and logical throughout.
16.0 pts
Information was presented clearly and thoughts were somewhat organized and logical throughout.
8.0 pts
Information was not consistently clear and/or was not consistently organized and logical.
0.0 pts
Information was disorganized and difficult to understand.
20.0 pts
This criterion is linked to a Learning Outcome Mechanics/APA
The systematic review and any other scholarly resources were properly listed in APA format.
The writing includes error free grammar and spelling, and complete sentence structure.
15.0 pts
Excellent mechanics and APA formatting with minimal errors in grammar, spelling, and sentence structure.
13.0 pts
Good mechanics and formatting considering the elements listed in the first column
12.0 pts
Fair mechanics and formatting considering the elements listed in the first column
6.0 pts
Poor mechanics and formatting considering the elements listed in the first column
0.0 pts
Very poor mechanics and formatting such that information is difficult to read.
15.0 pts
This criterion is linked to a Learning Outcome Assignment Form Used
0.0 pts
0 points deducted
Correct assignment form used
0.0 pts
22.5 points (10%) deducted
Incorrect form used resulting in point deduction
0.0 pts
This criterion is linked to a Learning Outcome Late Deduction
0.0 pts
0 points deducted
Submitted on time
0.0 pts
Not submitted on time – Point deduction
1 day late =11.25 deduction; 2 days=22.5 deduction; 3 days=33.75 deduction; 4 days =45 deduction; 5 days = 56.25 deduction; 6 days =67.5 deduction; 7 days =78.75 deduction; Score of 0 if more than 7 days late
0.0 pts

Week 6 Assignment:  EBP Change Process form

ACE Star Model of Knowledge Transformation

Follow Nurse Daniel as your process mentor in the weekly Illustration section of the lesson. Please do not use any of the Nurse Daniel information for your own topic, nursing intervention, or change project.  Nurse Daniel serves as an example only to illustrate the change process.

 

Name: _____________________

 

Star Point 1:  Discovery (Identify topic and practice issue)

Identify the topic and the nursing practice issue related to this topic. (This MUST involve a nursing practice issue.)

Creation of a safety culture focusing on system improvement among nurses to reduce the increasing nurse errors in healthcare settings.

Briefly describe your rationale for your topic selection. Include the scope of the issue/problem.

The public health sector is faced with increasing medical errors among nurses and health practitioners in hospitals, which has been described as a leading cause of death among patients. These medical errors are categorized as omission and commission errors. Omission errors include not taking actions such as missed care or not strapping patients into a wheelchair properly. Commission errors include the wrong step taken by nurses, including administering a wrong medication that instigates allergies or not labelling laboratory specimen appropriately. These errors are fatal; making them a severe nursing and patient issue that requires change and effective intervention. Nurses thus can develop corrective measures to prevent increased medical errors by creating a culture that improves healthcare systems and eliminating these errors.

 

Star Point 2:  Summary (Evidence to support need for a change)

Describe the practice problem in your own words and formulate your PICOT question.

Nurse-related deaths are increasingly happening in our hospitals due to omission and commission medical problem. Hence, urgent intervention and change in the hospital cultures is necessary to eliminate active, adverse, latent, and medical errors for patient safety and maximized effectiveness among nurses.

Population/Patient Problem – Admitted patients/Deaths resulting from omission and commission errors

Intervention – Introducing a safety culture that improves medical systems

Comparison – Increased nurses related errors

Outcome – Reduced medical errors and deaths among patients

Time – Admitted time

PICOT Question: Introducing a safety culture that improves medical systems to reduce nurse-related errors and admitted patient deaths.

List the systematic review chosen from the CCN Library databases. Type the complete APA reference for the systematic review selected.

Ammouri, A.A., Tailakh, A. K., Muliira, K., J.K., Geethakrishnan, R., & AlKindi, S. (2015). Patient safety culture among nurses. International Nursing Review, Vol 62(1), pp; 102-110.

List and briefly describe other sources used for data and information. List any other optional scholarly source used as a supplement to the systematic review in APA format.

Flynn, F., Evanish, J. Q., Fernald, J. M., Hutchinson, D. E., & Lefaiver, C. (2016). Progressive Care Nurses Improving Patient Safety by Limiting Interruptions During Medication Administration. Critical Care Nurse, Vol 36(4), pp; 19-35.

Authors in the article argue that the presence of increased interruptions during medication administration by nurses to patients makes them susceptible to errors, hence proposing the implementation of EBP to limit interruptions and improve patient safety.

Moulton, S. H.-A. (2017). Complications: acknowledging, managing, and coping with human error. Translational Andrology and Urology, Vol 6(4), pp; 773-782.

Authors in this article acknowledge the presence of human error in medication administering due to the imperfect nature among humans. They recommend having hospital systems and cultures that recognize the faults in healthcare settings instead of covering due to shame and fear of exposure.

Rodziewicz, T. L., & Hipskind, J. E. (2020). Medical Error Prevention. Stat Pearls Publishing LLC.

The authors show different types of errors potentially experienced in healthcare settings. They also recommend a safety culture in hospitals among health practitioners to improve systems.

Briefly summarize the main findings (in your own words) from the systematic review and the strength of the evidence.

Authors contend that hospitals are faced with increasing medical errors among nurses and health practitioners. Patient safety is crucial for providing quality healthcare, and nurses play a vital role in realizing this mandate. They find that nurses with higher experience understood the vitality of a culture of patient safety. They conclude that a safety culture should include lifelong learning, continuous improvements, teamwork, increased communication and feedback on errors, and efficient management support.

Evidence strength is at level 5, as it is based on a cross-sectional and descriptive design, which provides for high-quality research. The authors researched four significant hospitals in Oman and interviewed 414 RN, which shows an extended research.

Outline one or two evidence-based solutions you will consider for the trial project.

Education and training on the Joint Commission Patient Safety Goals (JCPSG), different types of errors and evidence-based prevention strategies.

Conducting team building to facilitate teamwork, cooperation, and support open and blame-free communication channel.

Star Point 3:  Translation (Action Plan)

Identify care standards, practice guidelines, or protocols that may be in place to support your intervention planning (These may come from your organization or from the other sources listed in your Summary section in Star Point 2).

Taking extra time with patients to confirm their identity, prescriptions, and possible dangers or risks

Labeling all medications and laboratory results safely and double-checking even those in syringes

Double-checking and confirming with other medical practitioners while passing on the information

Using devices such as alarms to ensure adequate medical equipment heading

List your stakeholders (by title and not names; include yourself) and describe their roles and responsibilities in the change process (no more than 5).

Nurses form a more substantial part as they are in direct contact with patients who mostly facilitate omission and commission errors; hence, they are essential targets in this change process.

Physicians will require undergoing the training and education program to learn on possible errors in their field.

Laboratory Technicians are also primary targets as they are susceptible to omission, commission, medical, and active errors as they hold patient’s medical results.

What specifically is your nursing role in the change process? Other nursing roles?

Partaking in the educational, training, and team-building program.

List your stakeholders by position titles (charge nurse, pharmacist, etc.).–Why are the members chosen (stakeholders) important to your project?

Nurses – Major stakeholders

Physicians – Play crucial roles in administering quality healthcare

Laboratory technicians – Handles patients’ medical results crucial in determining their treatment plans and medication

What type of cost analysis will be needed prior to a trial?  Who needs to be involved with this?

Analysis of morbidity rates caused by nurse-related errors prior to and after the implementation of the project.

 

Star Point 4: (Implementation)

Describe the process for gaining permission to plan and begin a trial.  Is there a specific group, committee, or nurse leader involved?

 

Healthcare practitioner teams (nurses, physicians, and laboratory technicians) must be informed.

The hospital’s committee of top executives and BOM must be notified, as they are sponsors of the project.

Describe the plan for educating the staff about the change process trial and how they will be impacted or asked to participate.

 

The education plan will include communicating the project’s objectives, which involves understanding Joint Commission Patient Safety Goals (JCPSG) patient safety guidelines, different types of errors, and evidence-based prevention strategies.

Mixed learning methods will be integrated, which will include in-classroom lectures and interactive learning.

The involved stakeholders will learn safety guidelines; understand the need for a safety culture characterized by teamwork, cooperation, open and blame-free communication channel.

Outline the implementation timeline for the change process (start time/end time, what steps are to occur along the timeline).

 

The project will take five months beginning 1 August 2020 and ending on 1 November 2020.

Milestones

In-classroom training on JCPSG – 1 month

Demonstrations and interactive learning – 2 month

Training – 2 months

List the measurable outcomes based on the PICOT.  How will these be measured?

 

Reduced number of nurse-related deaths and errors

Increased error reporting and communication

What forms, if any, might be used for recording purposes during the pilot change process. Describe.

 

Monitoring rate of nurse-related errors

Measuring reported cases of errors and patient deaths

What resources are available to staff (include yourself) during the change pilot?

 

Machines, laboratory equipment medical reports to ensure all source of errors are identified and learned

Will there be meetings of certain stakeholders throughout the trial?  If so, who and when will they meet?

Meetings will be held bi-monthly to monitor and follow up on learning outcomes among stakeholders. Mandatory meetings will be held at the opening and closing of the project.

 

Star Point 5: (Evaluation)

How will you report the outcomes of the trial?

 

Project outcomes will be reported in written reports from the head of teams and individual reflections on the project, highlighting learning outcomes. The report outcomes will be disseminated using oral and poster presentation to ensure all essential aspects are captured and communicated on the clinical issue identified.

What would be the next steps for the use of the change process information?

 

JCPSG copies will be made available and accessible to all physicians, nurses, and medical practitioners for reference.

Follow up meetings will be scheduled monthly for the next five months to evaluate the effectiveness of the change process among involved stakeholders.

Clinical safety guidelines on error prevention strategies will be created, made available to all medical practitioners, and placed in hospitals as posters.

 

 

 

References

Ammouri, A.A., Tailakh, A. K., Muliira, K., J.K., Geethakrishnan, R., & AlKindi, S. (2015). Patient safety culture among nurses. International Nursing Review, Vol 62(1), pp; 102-110.

Flynn, F., Evanish, J. Q., Fernald, J. M., Hutchinson, D. E., & Lefaiver, C. (2016). Progressive Care Nurses Improving Patient Safety by Limiting Interruptions During Medication Administration. Critical Care Nurse, Vol 36(4), pp; 19-35.

Moulton, S. H.-A. (2017). Complications: acknowledging, managing, and coping with human error. Translational Andrology and Urology, Vol 6(4), pp; 773-782.

Rodziewicz, T. L., & Hipskind, J. E. (2020). Medical Error Prevention. StatPearls Publishing LLC.