Evidence-Based Practice Proposal Paper

Write a paper of 500-750 words for your proposed evidence-based practice project solution. Address the following criteria:

Proposed Solution: (a) Describe the proposed solution (or intervention) for the problem and the way(s) in which it is consistent with current evidence. Heavily reference and provide substantial evidence for your solution or intervention. (b) Consider if the intervention may be unrealistic in your setting, if it may be too costly, or if there is a lack of appropriate training available to deliver the intervention. If the intervention is unrealistic, you may need to go back and make changes to your problem statement before continuing.
Organization Culture: Explain the way(s) in which the proposed solution is consistent with the organization or community culture and resources.
Expected Outcomes: Explain the expected outcomes of the project. The outcomes should flow from the problem statement.
Method to Achieve Outcomes: Develop an outline of how the outcomes will be achieved. List any specific barriers that will need to be assessed and eliminated. Make sure to mention any assumptions or limitations that may need to be addressed.Evidence-Based Practice Proposal Paper

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Outcome Impact: Describe the impact the outcomes will have on one or all of the following indicators: quality care improvement, patient-centered quality care, efficiency of processes, environmental changes, or professional expertise.
You are required to cite three to five sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.

Note: After submitting the assignment, you will receive feedback from the instructor. Use this feedback to make revisions for your final paper submission. This will be a continuous process throughout the course for each section.

Introduction

This paper describes the implementation of a HAPU prevention bundle as the proposed intervention for decreasing LOS of elderly inpatients in acute care settings. It also discusses the consistency of the aforementioned intervention with the organizational culture, the expected outcomes, impact and method of achieving outcomes.

Proposed Solution

HAPUs are underrated yet they have a high prevalence. Their incidence in acute care settings ranges between 0.4-12% and the prevalence ranges from 12-18%. In settings with chronic care patients, it ranges from 2.2-23.9% and 53.2% respectively (Padula et al., 2016). The prevalence of HAPUs I the US   is 13.3 million, accounting for approximately $2.2-3.6 billion every year. HAPUs also increase the workload of nurses and decrease their morale. Those with stage II to IV HAPUs have a low QoL, may experience moderate to very severe pain or secondary bacterial infections with high morbidity and mortality (Padula et al., 2016).Evidence-Based Practice Proposal Paper

This EBP proposes the use of HAPU care bundles as the most efficient and effective intervention for reducing los of elderly inpatients in acute care settings. According to Lavallée et al. (2019), care bundles describe a set of EBP supported solutions meant for a particular population of patients and healthcare setting, whose collective adoption leads to improved outcomes in comparison to individual implementation. According to Barakat-Johnson et al., (2019), a HAPU bundle comprises of more than three independent interventions that require a multidisciplinary approach to implement. The proposed HAPU bundle comprises the following elements: repositioning, skincare, patient and staff education, and risk assessment. This intervention is realistic and appropriate for implementation in the healthcare organization since nurses who comprise the majority of the health workforce have some knowledge on how to conduct evidence-based research. However, they will require more training to improve their knowledge, understanding, and skills on the same.

Consistency of the Proposed Solution with the Organizational Culture

The healthcare organization is an urban medical clinic providing acute care services to more than 40,000 residents. The organization has embraced a patient safety and learning culture that is illustrated in its mission, vision, and goals. The organization’s philosophy is anchored on practices, processes, conventions, and values that encourage staff to develop competence and knowledge through continuous learning to influence each other.

The organization’s leadership embraces the transformational leadership style, which integrates other stakeholders in decision-making processes. This leadership style has prompted the implementation of other quality improvement projects to improve care outcomes. Padula et al. (2016) emphasize that the implementation of HAPU bundles requires a multidisciplinary approach to improve the chances for more successful outcomes. This healthcare organization embraced a culture of working in interprofessional teams, which improves the responsiveness of healthcare providers increases patient satisfaction rates, and reduces patient-safety and quality-related issues.

Expected Outcomes

After implementing the proposed solution (HAPU bundles), it is anticipated that patient los will reduce significantly. Patient los describes the duration of hospitalization and evidenced by hospital admission data. Los is an important aspect used to gauge the efficiency of a healthcare organization.Evidence-Based Practice Proposal Paper

Method to Achieve Outcomes

There will be an initial training session to identify potential gaps in knowledge about the proposed intervention. Internal and external quality improvement experts will do the training. There will be a specific schedule for training based on the work schedules of all healthcare providers. A quality improvement committee will oversee the implementation of the proposed intervention. This committee will comprise of stakeholders from different healthcare professionals and a representative from the organization’s leadership with well-defined roles and responsibilities (Frank et al., 2017). In this case, the committee will comprise of a nurse, nutritionist, clinical nurse leader, a physiotherapist.

Nurses will reposition patients and ensure skincare. Nutritionists will ensure that patients receive adequate hydration and nutritional status and the physiotherapist will conduct mobility exercises. The role of the CNL will be to ensure that all members adhere to the HAPU intervention bundle and to ascertain that nurses document care appropriately as needed. This committee will also oversee the monitoring and evaluation process post-implementation to determine the attainment of the project goals and objectives and potential area for adjustments.

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Outcome Impact

After implementing the proposed intervention, patient los will decrease. This implies that there will be increased efficiency in the services offered in the med-surge units evidenced by a short duration of los and early discharge (Qaseem et al., 2015). Ultimately, the incidence, prevalence, and HAPUs healthcare-related costs will also decrease which will guarantee an improvement in the quality of patient care as well as patient safety.

Conclusion

This EBP proposes the use of HAPU care bundles as the most efficient and effective intervention for reducing los of elderly inpatients in acute care settings. The organization embraces a patient safety and learning culture illustrated in its mission, vision, and goals.  Besides the organization’s philosophy is anchored on practices, processes, conventions, and values that encourage staff to develop competence and knowledge through continuous learning to influence each other, which is consistent with the proposed intervention. The expected outcome is that the patient los will reduce significantly increasing the efficiency of the care provided to patients.Evidence-Based Practice Proposal Paper

 References

Barakat-Johnson, M., Lai, M., Wand, T., & White, K. (2019). A qualitative study of the thoughts and experiences of hospital nurses providing pressure injury prevention and management. Collegian, 26(1), 95-102.

Frank, G., Walsh, K. E., Wooton, S., Bost, J., Dong, W., Keller, L., & Brilli, R. J. (2017). Impact of a PIP bundle in the solutions for patient safety network. Pediatric quality & safety, 2(2).

Lavallée, J. F., Gray, T. A., Dumville, J., & Cullum, N. (2019). Preventing pressure ulcers in nursing homes using a care bundle: A feasibility study. Health & social care in the community, 27(4), e417-e427.

Padula, W. V., Gibbons, R. D., Valuck, R. J., Makic, M. B. F., Mishra, M. K., Pronovost, P. J., & Meltzer, D. O. (2016). Are evidence-based practices associated with effective prevention of hospital-acquired pressure ulcers in US academic medical centers?. Medical care, 54(5), 512.

Qaseem, A., Mir, T. P., Starkey, M., & Denberg, T. D. (2015). Risk assessment and prevention of pressure ulcers: a clinical practice guideline from the American College of Physicians. Annals of internal medicine, 162(5), 359-369.Evidence-Based Practice Proposal Paper