Nur 699 wk 5 EBP Section F: Implementation Plan Example

NUR 699 GC Week 5 Section F Implementation Plan

NUR 699 GC Week 5 Assignment 2

Evidence-Based Practice Proposal – Section F: Implementation Plan

Details:

In 500-750 words (not including the title page and reference page), provide a description of the methods

to be used to implement the proposed solution. Include the following:

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Describe the setting and access to potential subjects. If there is a need for a consent or approval

form, then one must be created. Although you will not be submitting the consent or approval

form(s) in Topic 5 with the narrative, the consent or approval form(s) should be placed in the

appendices for the final Nur 699 wk 5 EBP Section F: Implementation Plan Example paper.

Describe the amount of time needed to complete this project. Create a timeline. Make sure the

timeline is general enough that it can be implemented at any date. Although you will not be

submitting the timeline in Topic 5 with the narrative, the timeline should be placed in the

appendices for the final paper.

Describe the resources (human, fiscal, and other) or changes needed in the implementation of

the solution. Consider the clinical tools or process changes that would need to take place.

Provide a resource list. Although you will not be submitting the resource list in Topic 5 with the

narrative, the resource list should be placed in the appendices for the final paper.

Describe the methods and instruments, such as a questionnaire, scale, or test to be used for

monitoring the implementation of the proposed solution. Develop the instruments. Although you

will not be submitting the individual instruments in Topic 5 with the narrative, the instruments

should be placed in the appendices for the final paper. Nur 699 wk 5 EBP Section F: Implementation Plan Example.

Explain the process for delivering the (intervention) solution and indicate if any training will be

needed.

Provide an outline of the data collection plan. Describe how data management will be maintained

and by whom. Furthermore, provide an explanation of how the data analysis and interpretation

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process will be conducted. Develop the data collection tools that will be needed. Although you will

not be submitting the data collection tools in Topic 5 with the narrative, the data collection tools

should be placed in the appendices for the final paper.

Describe the strategies to deal with the management of any barriers, facilitators, and challenges.

Establish the feasibility of the implementation plan. Address the costs for personnel, consumable

supplies, equipment (if not provided by the institute), computer related costs (librarian

consultation, database access, etc.), and other costs (travel, presentation development). Make

sure to provide a brief rationale for each. Develop a budget plan. Although you will not be

submitting the budget plan in Topic 5 with the narrative, the budget plan should be placed in the

appendices for the final paper.

Describe the plans to maintain, extend, revise, and discontinue a proposed solution after

implementation.

Prepare this assignment according to the APA 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. Nur 699 wk 5 EBP Section F: Implementation Plan Example

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student

Success Center.

Evidence-Based Practice – Section F: Implementation Plan

Implementation Plan

Implementing a change within a healthcare organization encompasses many different aspects. There are different phases, different people, different obstacles or barriers, as well as different drivers. The purpose of this paper is to describe the methods used to implement the Hester Davis Scale for Falls Risk Assessment (HDS).

The HDS pilot is taking place at Kaiser Permanente, Downey Medical Center on unit 4 West (the orthopedic/medical surgical unit). The setting will be in an acute care setting on a medical surgical unit. Consent to use the falls mats and bed and chair alarms are not required, as there are no invasive interventions or treatments. Educating the patient includes explanation of the care plan interventions.

Being that this pilot is broken into phases, there is no specific timeframe to complete each phase. Phase 1, the initial roll out, was begun in December, 2015 and completed on April 4, 2016. That was four and a half months. Phase 2 began on April 5, 2016. It will be refined, as needed, based on the metrics on documentation and falls or falls with injury, as well as observation of the staff’s compliance with the use of the care plans’ interventions. Phase 3 will begin once phase 2 is complete.

During the pilot and training phases, Hester Davis will not charge for use of the HDS tool. However, there are licensing fees associated with the HDS (no discussion at this time). As for the tools to be used with the interventions, there is the falls mat, chair alarms, and bed alarms. All of the beds on the orthopedic/medical surgical unit have bed alarms. The staff must be trained the appropriate alarms to place on the beds. The chair alarms are being provided by Posey for testing purposes. Currently, KP is working with two different vendors in regards to the floor mats. There is no contract with any of the vendors, in place, at this time, so everything is currently on loan for the purpose of the pilot. Getting a contract in place with Region takes some time, so this is something that will be address at a later time. Amy Hester and her team are available by phone, and we have a standing weekly Webex meeting on Thursdays at 4 pm. Nursing staff is also needed to ensure proper roll out.

Methods used to monitor the implementation are documentation in the HDS in EPIC/Health Connect (KP’s electronic medical records), Stat It reports (Risk Management Falls metrics) and observation. Health Connect/EPIC is where staff documents their assessments on their patients. Monitoring 4 West staff documentation randomly will provide information about HDS documentation, as well as the care plan interventions (use of bed or chair alarms and floor mats). Nur 699 wk 5 EBP Section F: Implementation Plan Example. Stat It reports are generated and sent every time a UOR (Unusual Occurrence Report) is completed after a fall. Monitoring these and reaching out to the unit, if a fall occurs on the unit will give more detailed information about the fall. Lastly, random observations will show who is actually using the interventions recommended in the care plans Nur 699 wk 5 EBP Section F: Implementation Plan Example.

Initially, the champions will be trained on proper documentation in the HDS and the correct interventions set forth in the care plans. A computer generated training program has been put in place in KP Learn (a computer program that is used for training purposes). The staff is asked to review the education and the champions will walk the floor to assist the staff with training, as well. Staff have been introduced to the chair alarm and the fall mats, are aware about where they are stored and have been taught how and when to use both.

The CIS (Clinical Information Specialist), Stella, is responsible for monitoring of all falls within the medical center and creating a spreadsheet that provides detailed information that could have contributed to the fall. As for the Stat It reports, these are generated when a fall takes place and will be monitored by Risk Management and the Improvement Advisor, overseeing the project. Both of the reports are shared and discussed during the weekly Webex among all the key stakeholders.

Through training of the champions, the department administrators are hoping to mitigate any barriers. Through the weekly Webex meetings, potential barriers or challenges are addressed and answers are provided by Amy Hester and her team on how to address those potential barriers. The most important aspect of any change process is to be honest and forthcoming with information.

This implementation plan is feasible. At this time, the increased costs are associated with the nursing staff champions. These individuals are hourly staff and for every hour they are training rather than working the floor, those are additional fees. Being that the champions have a huge role, their hours and fees associated with the trainings have been pre-approved. Nur 699 wk 5 EBP Section F: Implementation Plan Example.

The pilot is just that: a practice of the change project. So, based on the information found during the process, these small tests of change will be re-evaluated and changes will be made based on the information. In order to sustain the changes, a dashboard will be created in Health Connect/EPIC to see if everyone on the unit, then the floors, are documenting on HDS. The dashboard will advise the managers and charge nurses as to who is documenting properly.

References

Agency for Healthcare Research and Quality (ahrq). (2014). Never Events. Retrieved from https://psnet.ahrq.gov/primers/primer/3/never-events

Brown, C.G. (2014). The Iowa model of evidence-based practice to promote quality care: An illustrated example in oncology nursing. Clinical Journal of Oncology Nursing, 18(2): 157-9. Retrieved from http://search.proquest.com/openview/68c6cc558c8cabfd155e5c10648895fc/1?pq-origsite=gscholar&cbl=33118

Cummins, R. (2015). Patient falls: First predict, then prevent. University of Mississippi Medical Center. Retrieved from https://www.umc.edu/News_and_Publications/Press_Release/2015-02-23-00_Patient_falls__First_predict,_then_prevent.aspx

Dupins, K. (2014). Falls and frailty: Finding who is at risk and keeping them safe. UAMS Journal. Retrieved from http://journal.uams.edu/article/falls-and-frailty-finding-whos-at-risk-and-keeping-them-safe/

Hester, A.L. and Davis, D.M. (2013). Validation of the Hester Davis scale for falls risk assessment in neurosciences population. Journal of Neuroscience, 45(5): 298-305. Retrieved from http://journals.lww.com/jnnonline/Abstract/2013/10000/Validation_of_the_Hester_Davis_Scale_for_Fall_Risk.8.aspx Nur 699 wk 5 EBP Section F: Implementation Plan Example