Throughout This Course You Will Be Developing A Formal Evidence Based
Throughout this course you will be developing a formal, evidence-based practice proposal. The proposal is the plan for an evidence-based practice project designed to address a problem, issue, or concern in the professional work setting. Although several types of evidence can be used to support a proposed solution, a sufficient and compelling base of support from valid research studies is required as the major component of that evidence. Proposals are submitted in a format suitable for obtaining formal approval in the work setting. Proposals will vary in length depending upon the problem or issue addressed, but they should be between 3,500 words.
Section headings and letters for each section component are required. Responses are addressed in narrative form in relation to that number. Evaluation of the proposal in all sections is based upon the extent to which the depth of content reflects graduate-level critical-thinking skills. This project contains six formal sections:
Section A: Problem Description
Section B: Literature Support
Section C: Solution Description
Section D: Change Model
Section E: Implementation Plan
Section F: Evaluation of Process
Paper For Above instruction
Developing an evidence-based practice (EBP) proposal is integral to advancing professional practice and improving patient outcomes in healthcare settings. This paper outlines a comprehensive, graduate-level EBP proposal tailored to address a pressing concern in a typical clinical environment, systematically adhering to the six prescribed sections. Each section demonstrates critical thinking, in-depth research, and strategic planning necessary for effective change implementation.
Section A: Problem Description
The foundation of any EBP project is a clearly articulated problem. In this scenario, the problem identified is the high rate of patient falls within a medical-surgical unit at a metropolitan hospital. Patient falls
constitute a significant safety concern, often leading to injuries, prolonged hospital stays, increased healthcare costs, and diminished patient satisfaction. Literature consistently emphasizes the importance of targeted interventions to mitigate fall risks. According to the Agency for Healthcare Research and Quality (AHRQ, 2018), falls are among the most common adverse events in hospitals, affecting approximately 3-5% of admitted patients. The problem's root causes include poor patient mobility, environmental hazards, inadequate staffing, and insufficient patient education on fall prevention. Addressing this issue aligns with the hospital's strategic goal of enhancing patient safety and quality of care.
Section B: Literature Support
An extensive review of current research validates effective strategies for fall prevention. Studies highlight multifactorial interventions, such as comprehensive risk assessments, staff education, environmental modifications, and patient engagement, as instrumental in reducing fall incidences (Oliver, Daly, Martin, & McDonald, 2010). A systematic review by Kouladjian et al. (2017) demonstrated that implementing hourly rounding protocols combined with environmental safety checks significantly lowers fall rates. Additionally, evidence suggests that patient education on fall risks and safety measures fosters greater self-awareness and compliance (Oliver et al., 2018). The literature underscores the importance of a standardized, evidence-based approach that integrates staff training, environmental safety, and patient involvement to mitigate fall risk effectively.
Section C: Solution Description
The proposed solution involves the implementation of a multifaceted fall prevention program that includes staff education on best practices, environmental safety audits, and patient-centered education initiatives. Core components comprise staff training modules on fall risk assessment, hourly rounding protocols, and environmental hazard mitigation. Patients will receive education through tailored fall prevention materials and one-on-one discussions emphasizing safety behaviors. This comprehensive approach aims to create a culture of safety, improve staff responsiveness, and empower patients to participate actively in their safety. The solution aligns with best practice guidelines provided by the Centers for Medicare & Medicaid Services (CMS, 2016) and the National Institute for Healthcare Excellence (NICE, 2017).
Section D: Change Model
The Change Model selected for this initiative is the Lewin’s Change Theory, which delineates a three-phase process: unfreezing, changing, and refreezing. The unfreezing phase involves raising
awareness among staff and stakeholders about the fall problem and preparing them for change. During the changing phase, new protocols, education, and environmental modifications will be implemented systematically. The refreezing stage aims to sustain changes by integrating new practices into organizational culture through ongoing training and policy reinforcement (Lewin, 1947). This model provides a structured yet flexible framework conducive to implementing safety culture shifts within the unit.
Section E: Implementation Plan
Implementation will proceed through a detailed plan encompassing staff training, environmental audits, patient education, and evaluation. Initially, a team comprising nursing leadership, staff nurses, and quality improvement specialists will be convened. A timeline will be established for staff education sessions, environmental modifications, and patient educational activities, scheduled over three months. Staff training will involve workshops on fall risk assessments and hourly rounding procedures. Environmental audits will identify hazards for immediate correction. Patient education will be integrated into admission procedures with standardized materials. Regular multidisciplinary meetings will monitor progress, address challenges, and adjust strategies as needed.
Section F: Evaluation of Process
Evaluation will focus on measuring the effectiveness of the intervention in reducing fall incidents, improving staff compliance, and enhancing patient safety perceptions. Data collection will involve preand post-implementation incident reports, staff surveys on adherence to protocols, and patient feedback surveys. Quantitative measures include fall rate comparisons, while qualitative data will assess staff and patient satisfaction. Continuous quality improvement cycles will facilitate ongoing assessment, and statistical analysis, such as chi-square tests, will evaluate the significance of changes. The evaluation process aims to determine the sustainability of safety practices and identify areas for further improvement.
References
Agency for Healthcare Research and Quality. (2018). Preventing falls in hospitals: A toolkit for improving quality and safety. AHRQ Publication No. 18-0022.
Centers for Medicare & Medicaid Services. (2016). Hospital-Acquired Conditions and Patient Safety Indicators.
Kouladjian, L., et al. (2017). Effectiveness of interventions to prevent falls in high-risk older adults in acute care: A systematic review. Journal of Nursing Scholarship, 49(1), 89-99.
Lewin, K. (1947). Frontiers in group dynamics. Human Relations, 1(1), 5-41.
NICE. (2017). Falls in older people: Assessing risk and prevention. National Institute for Health and Care Excellence.
Oliver, D., Daly, F., Martin, F., & McDonald, M. (2010). Risk factors and risk assessment tools for falls in hospital inpatients: A systematic review. Age and Ageing, 39(3), 230-234.
Oliver, D., et al. (2018). Patient education and engagement for fall prevention: A systematic review. Clinical Rehabilitation, 32(7), 908-917.
Kouladjian, L., et al. (2017). Effectiveness of interventions to prevent falls in high-risk older adults in acute care: A systematic review. Journal of Nursing Scholarship, 49(1), 89-99.