NUR 590: Evidence Based Practice Project Proposal Implementation Plan

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My project is about the regular training of workers in a Long term care facilities or nursing home to prevent fall in an elderly.

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Solution

Section E: The Implementation Plan

The proposed evidence-based project involves regular training of workers in long-term care facilities or nursing homes to prevent falls in elderly individuals.

Setting

The proposed EBP project will be implemented in a nursing home that serves about 2 000 residents based in city. The nursing home has been selected due dramatic increase in the rate of patient falls in the facility. Approximately 80% of the nursing home’s total population constitutes elderly individuals aged 75 years and above. According to Fulmer et al. (2021), the prevalence of elderly adults in nursing homes has increased dramatically in the United States due to a substantial rise in the geriatric population in the country. Approximately 52.4 million Americans were sixty-five and above as of 2018, representing around 15.6% of the total US population (Fulmer et al., 2021).

The implementation of the proposed project will involve the management of the nursing home, nurse leaders, physiotherapists, and registered nurses. A sample size of 70 participants will be engaged during the project’s participants. However, the qualified participants will only be involved in implementing the proposed project upon written consent to participation. The project leader will obtain approval from the management of the targeted nursing home before implementing the proposed project in the institution. An approval form is included in the appendices session.

Timeline

The proposed project will be implemented within 12 months. A multidisciplinary team (MDT) will be formed in the first month of project implementation. Staff members will be trained in the second month. The MDT members will spend the third month in collecting, criticizing, and synthesizing the relevant literature to determine the efficacy of the proposed intervention in preventing fall among the geriatrics in a nursing home. The team members will then conduct the actual implementation of the proposed EBP project between fourth and ninth month. Additionally, the implementation team will modify the proposed project and issue all the participants with badges to remind them to comply with each training program component. The project team will spend tenth and eleventh month in shutting down the project. Finally, the implementation team will use an audit tool to assess the rates of staff compliance with the training program and comparison of results before and after implementation of the project in the last month. The clinical nurse leader will then be mandated to disseminate the project’s results to all the concerned parties, including the nurse administrator and the nursing home management. A timeline for the proposed project is included in the appendices.

Budget and Resources

Human resources will be required in implementing the proposed evidence-based project in the targeted nursing home. The institution will hire external quality improvement trainers who will train the multidisciplinary team members in the second month of project implementation. Training will equip the multidisciplinary team members with the knowledge and skills needed to implement the proposed project successfully. According to Lavallée et al. (2019), a multidisciplinary team enhances the successful implementation of an EBP. Thus, a multidisciplinary team, including clinical nurse leaders, registered nurses, clinical nutritionists, and physiotherapists, will implement the proposed EBP. The team members will facilitate collaboration during the implementation process, which is vital to project success Urton & Murray, 2021). The team members will play various roles during the implementation process. First, the physiotherapist will attend training on repositioning patients regularly and supporting them when leaving their beds to prevent them from falling. Clinical nutritionists will receive training regarding the nutritional needs of patients and how to meet them through proper diets. Clinical nurse leaders will supervise other staff members to ensure that the participants are required during project implementation. Registered nurses will receive training on how to provide the residents with quality and safe long-term care to prevent them from falling. According to Simmons et al. (2016), quality care promotes safety, thus reducing the rate of falls in a nursing home.

In addition to human resources, finance will be required during the implementation of the proposed project. A total of $500 000 will be needed to fund the entire process. $300 000 will be used to compensate the external quality improvement trainers who will train the multidisciplinary team members in the second month of project implementation. The remaining $200 000 will be spent to facilitate the training program of staff members during the actual implementation of the proposed plan. A budget will be included in the appendices section.

Qualitative Design

The qualitative design will be used to collect data and assess the effectiveness of the proposed evidence-based practice project. This research design is preferred due to its efficacy in evaluating intervention improvement. Hence, this design will be appropriate in assessing progress in falls among the elderly in the nursing home following regular training. Qualitative research is preferred due to its flexibility, responsivity, and openness to context, making data collection and analysis relatively simple compared to quantitative research design (Busetto et al., 2020).

Methods and Instruments

Questionnaires and interviews will be used to monitor the implementation of the proposed intervention. Closed-ended questionnaires will be handed to the participants, filling them and handing them over to the project team. The questionnaires will include questions regarding the rate of falls among the elderly adults in the nursing home before implementing the change project. Additionally, clinical nurse leaders will be interviewed to enquire about changes in fall rates among elderly patients following the implementation of the proposed project. A decline in the fall rate by 50% or more following the implementation of the proposed change will indicate that regular training effectively improves quality, safety, and effectiveness of care, hence reducing fall rates.

The Process for Delivering the Intervention

Delivering the proposed intervention will involve training staff members who provide hospice care to elderly individuals in the nursing home. Before delivering the intervention, research will be conducted to evaluate the efficacy of regular training in improving practitioners’ knowledge. A training program for all the staff members will be scheduled upon gathering adequate evidence regarding the effectiveness of this intervention. The staff members will be educated on how to provide elderly patients with quality and safe care.

Stakeholders Needed to Implement the Plan

The implementation of the proposed intervention, including registered nurses, clinical nurse leaders, and the management of the targeted facility. The management will approve the project before it is implemented in the facility. The registered nurses will attend the scheduled training during the implementation process to equip them with the required knowledge and skills. Finally, the clinical nurse leader will supervise registered nurses to ensure that they comply with all the requirements of the implementation process.

Potential Barriers

Some challenges will face the implementation process. First, the staff members will be reluctant to embrace the proposed change. In most cases, employees consider change demanding and a threat to their status quo. This challenge will be addressed by convincing the staff members of the benefits of implementing the proposed intervention in the organization. Another challenge is the lack of finances to fund the implementation process. This issue can be addressed by preparing a proposal and the anticipated budget and presenting them to potential donors for funding.

The Feasibility of the Implementation Plan

The proposed plan is associated with costs and benefits. Funds will be required to facilitate the implementation process. A total of $500 000 will be needed to fund the entire process. A total of $300 000 will be used to compensate the external quality improvement trainers, while the remaining $200 000 will be spent to facilitate the training program of staff members. On the other hand, this intervention will equip the staff members with knowledge and skills to provide quality and safe care, thus preventing patient falls. Hence, the benefits of this project outdo its cost.

References

Busetto, L., Wick, W., & Gumbinger, C. (2020). How to use and assess qualitative research methods. Neurological Research and practice2, 1-10.

Fulmer, T., Reuben, D. B., Auerbach, J., Fick, D. M., Galambos, C., & Johnson, K. S. (2021). Actualizing Better Health and Health Care for Older Adults: Commentary describes six vital directions to improve all older Americans’ care and quality of life. Health Affairs40(2), 219-225.

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.

Simmons, S. F., Schnelle, J. F., Sathe, N. A., Slagle, J. M., Stevenson, D. G., Carlo, M. E., & McPheeters, M. L. (2016). Defining safety in the nursing home setting: implications for future research. Journal of the American Medical Directors Association17(6), 473-481.

Urton, D., & Murray, D. (2021). Project manager’s perspectives on enhancing collaboration in multidisciplinary environmental management projects. Project Leadership and Society2, 100008.

 

 

Appendices

Appendix A: Approval Form

Dear management,

You facility has been selected for a quality improvement project. Your staff members will be requested to participate during project implementation for educational and quality improvement purposes. This project will be implemented in an effort to improve the quality of care in a nursing home. The aim is to reduce the risk of patient falls among the geriatrics. The project will involve regular training of staff members, which will be undertaken on a monthly basis for six months. Staff members will be observed continuously during the training session. Assessment will be conducted after completion of the project to compare fall rate among the elderly patients before and after implementation of the project. Any questions, concerns, comments, or complaints regarding this project can be communicated through the Patient Care Coordinator. A copy of this informed consent form will be handled to the participants at the beginning of the project to indicate their willingness to participate in the project.

The signature below implies that one has read the consent form and is willing to participate during project implementation.

 

____________________________________________                            __________________

Your Signature                                                                                                Date

 

 

 

 

 

Appendix B

Project Timeline (12 months)

Tasks 1 2 3 4 5 6 7 8 9 10 11 12
The formation of multidisciplinary team                      
Staff members training

  • Informing them about the project
  • Highlighting project’s timeline
  • Stating project’s benefits
                     
Literature review

  • Data Collection
  • Criticizing data
  • Synthesizing data
                     
Actual implementation

  • Begin regular training of the staff members.
  • Training to be conducted monthly for the next 6 months.
  • Modify training sessions
                     
Pilot shutdown

  • Remove training materials from the site.
                     
  • Assessment of staff compliance rate
  • Comparison of results before and after the project
                     

 

Appendix C: Project Budget

 

Item Cost
External quality improvement trainers $ 300 000
Training materials $ 200 000

 

 

Appendix D: Resources

Literature Resources
1. CINAHL
2. PubMed
3. Cochrane
4. MEDLINE Human Resources
Human Resources
1.       Clinical nurse leaders
2.       Physiotherapists
3.       Registered nurses
4.       Clinical nutritionists

 

 

 

Appendix E: Survey

Appendix B: Healthcare workers pre and post knowledge assessment form

Question 1: Nurses must conduct bedside monitoring on                    basis.

  1. Daily
  2. Weekly
  • Monthly
  1. Annual

Question 2: Prevention of patient fall entails

  1. Regular bedside monitoring of patients
  2. Supporting patients when leaving their beds
  • Lowering patient’s patients as much as possible
  1. Advising patients to remain in their beds strictly?

Question 3: Was the regular staff training beneficial to you as a staff?

Yes         (    )

No           (     )

Question 4: Has the rate of patient falls reduced following the implementation of regular staff training?

Yes             (      )

No               (       )

Question 5: By what percentage has fall rate reduced?

  1. 20%
  2. 30%
  • 50%
  1. Above 50%

 

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