Evidence-Based Practice Proposal – Section F: Implementation Plan.

Evidence-Based Practice Proposal – Section F: Implementation Plan

Setting and Access

The author will implement this EBP project in a regional-based healthcare organization that provides inpatient care to an ethnically diverse population comprising of adults, children, and elderly patients. According to Doody & Noonan (2016), this will encourage close continuous monitoring and evaluation of outcomes. The healthcare staff involved in the project will comprise of nurses, physicians, and ward clerks working in multidisciplinary teams, but nurses will comprise the majority in the implementation teams. Since bedside shift reporting may impact a patient’s privacy, each patient will sign a consent form to demonstrate that they agree with the proposed evidence-based idea.

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Project Timeline

The implementation of this EBP project will take 12 weeks bearing in mind that the project does not have numerous facets to consider. In the initial week will be a pre-assessment to determine the knowledge of staff members on bedside shift reports. The outcomes of the initial training will inform the training needs based on identified knowledge gaps. In the second week, there will be staff training and a post-assessment to determine the grasp of relevant content. In the third week, staff will progress to form a multidisciplinary team that will oversee the implementation process within the organization.

The team will comprise of nurses, physicians, physiotherapists, radiographers, and dieticians. Each member will have specific roles and responsibilities for clear communication. In week four to week six, the members of the multidisciplinary team will search for literature that supports the proposed evidence-based idea, conduct a critical appraisal and synthesis. Week seven to week eight will be a pilot change of the proposed evidence-based idea in the pediatric and med-surge units. The pilot test will help to determine the need for any modifications before the actual implementation. Week nine to week ten will be the actual implementation of the proposed EBP change. In week ten, the multidisciplinary implementation team will develop clinical practice guidelines and policies on bedside shift reports that all staff must adhere to during sift handover.

Resources

Several resources are integral for the success of the proposed evidence-based project. A key facet of this component is human resources comprising of competent nurses, physicians, dieticians, radiographers and physiotherapists to ensure the implementation of the proposed evidence-based idea in the best way for successful outcomes (Dorvil, 2018). There will also be a need for materials on bedside shift reports for both patients and healthcare providers. Implementation will further require an EMR (Electronic Medical Record) and Whiteboards which are already available.

Methods and Instruments

The author will use a survey to conduct the pre and post-assessment of staff to determine knowledge gaps on bedside shift report. Surveys are affordable, easy to build, and implement compared to other instruments for collecting data (Ponto, 2015). The organization will hire an external quality improvement trainer to conduct training based on the identified knowledge gaps. Post-implementation, the author will collect data using incident report forms, patient and nurse satisfaction survey forms.

Delivering the Intervention

The author will deliver the intervention through a one-week training of healthcare staff, and posters. There will be four training sessions each session lasting forty-five minutes. The training will comprise of content on bedside shift report as documented in the clinical practice guidelines. On the other hand, there will be staff-specific and patient-specific posters. The latter will contain details on the roles of patients, advantages, and expectations of bedside shift report while the former will contain staff roles, expectations, requirements, and the process of bedside shift report.

Data Collection Plan

Nurses heading each inpatient unit will collect data in two phases; pre and post-implementation phases, since the data will be readily available on whiteboards and EMRs. In both phases, the nurse-in-charge will collect data on adverse events, patient outcomes, and clinical alerts such as precautions on infection control, and allergies from the communication board in each patient’s room. Data collected will also include nurses’ perceptions on the care given to patients, and treatment outcomes will be managed by a data manager and analyzed using ANOVA

Addressing Potential Barriers, Facilitators, and Challenges

Most healthcare staff perceive bedside shift report to be a time-consuming process. Since it is a new change initiative, there are high chances that there will be much resistance from staff. However, to prevent or reduce the impact of resistance from staff, there will be an open and effective communication plan, identification, and addressing the root causes of resistance (Dorvil, 2018). The proposed evidence-based project is highly feasible since currently, the organization has adequate staff, an EMR, and whiteboards. The only resource that will incur costs is hiring an external trainer.

Maintenance Plan

The implementation team will conduct ongoing quarterly meetings to evaluate whether the project attains the expected outcomes. This team will obtain feedback through questionnaires administered to nurses and patients, and reports tabled during meetings.  The team will use the outcomes to make modifications and improve outcomes.

PICO Question

In an acute care hospital (Population), does bedside shift report (Intervention) compared to traditional report at the nurses’ station (Comparison) improve quality of care, safety and nursing satisfaction (Outcome)?

Proposed solution:

Implementing bedside shift report during shift handoff on patients.

References

American Nurses Association.(2015). Code of ethics for nurses with interpretive statements. Retrieved from http://nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthicsforNurses/Code-of-Ethics-For-Nurses.html

Bressan, V., Cadorin, L., Stevanin, S., &Palese, A. (2019).Patients experiences of bedside handover: findings from a meta‐synthesis. Scandinavian Journal of Caring Sciences, 33(3), 556–568.doi: 10.1111/scs.12673

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Dorvil, B. (2018). The secrets to successful nurse bedside shift report implementation and sustainability. Nursing Management , 49(6), 20–25. doi: 10.1097/01.numa.0000533770.12758.44

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Schmidt, N., Brown, J. M. Evidence-Based Practice for Nurses. [Western Governors University]. Retrieved from Boshart, B., Knowlton, M., & Whichello, R. (2016).Re-implementing bedside shift report at a community hospital. Nursing Management (Springhouse),47(12), 52-55. doi:10.1097/01.numa.0000508265.42099.cc

Dorvil, B. (2018). The secrets to successful nurse bedside shift report implementation and sustainability. Nursing Management (Springhouse),49(6), 20-25. doi:10.1097/01.numa.0000533770.12758.44

Lincoln, N., MS, RN, APRN-BC, CCRN. (2016, July 13). Hardwiring Standardized Nursing Bedside Handoff to Improve Patient Safety and Satisfaction[Scholarly project]. In Virginia Henderson Global Nursing E-Repository. Retrieved June 13, 2019, from https://sigma.nursingrepository.org/handle/10755/616293

Natafgi, N., Zhu, X., Baloh, J., Vellinga, K., Vaughn, T., & Ward, M. M. (2017).Critical Access Hospital Use of TeamSTEPPS to Implement Shift-Change Handoff Communication. Journal of Nursing Care Quality,32(1), 77-86. doi:10.1097/ncq.0000000000000203

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Williams, C. L. (2018). A Comparison of the Risks and Benefits of Nursing Bedside Shift Report vs. Traditional Shift Report: A Systematic Review of the Literature. International Journal of Studies in Nursing,3(2), 40-43. doi:10.20849/ijsn.v3i2.382