Guidelines for Evidence Based Practice Project

R470 Clinical Nursing Capstone

The purpose of the Evidence Based Practice (EBP) Project is to use the principles and context of EBP, systems thinking, and Interprofessional Education (IPE) as an approach to propose changes in quality and safety in health care based on evidence. Applying systems thinking for quality and safety in nursing, in coordination with clinical facilitators (actively working nurses with a BSN or higher), is utilized through such activities as working directly with input from patients and/or families and interdisciplinary professional peers to improve patient outcomes within systems. Implementing input from patients, families, or population of interest, and interprofessional peers is a necessary part of the EBP process. APA 7th edition professional paper formatting required, point deductions if written as a student paper. Pre-project work:

• Identify a clinical facilitator who has at least a BSN or higher and submit the forms to your professor (see clinical facilitator forms).
• With your clinical facilitator, identify a problem related to quality and safety in the health care facility.
• With your clinical facilitator, identify patients/family population(s) who could provide input on the topic of your EBP project.
• Conduct an interview with patient(s) family, or population and gather input on the problem (see interview with a patient-family-population instruction/separate attachment).
• With your clinical facilitator, identify interprofessional personnel to become part of the change team.
• Conduct and interview with interprofessional personnel to gain input on the change team. (see interview with interprofessional team member instructions/separate attachment)
• Submit your topic in the form of a Problem-Intervention-Comparison-Outcome (PICO) to your professor for approval in Canvas Inbox (see instructions below about how to write a PICO question).

The parts of the project include:

BACKGROUND (70 points)

• Describe your rationale for undertaking this project
• Include any data available to support the need for the project
• Include patient/family input on the problem

Describe the current evidence and make recommendations for change/improvement.  You will work with your clinical facilitator, patient/family population, interprofessional team member, and course faculty member to identify a problem and create your PICO question. Prepare the final project report using the following sections and guidelines.

• Quality and safety practice/policy/procedure and outcomes/implications
• Describe your reason for including a professional outside of nursing and their potential contribution to the EBP project outcome.

THE QUESTION (10 points)

• Pose an answerable question in PICO format. See this link for details:

THE SEARCH (50 points)

• Describe the search strategy
• Discuss how potential, relevant research reports were identified  What were the inclusion and exclusion criteria?
• How many studies were included in the final appraisal of the evidence?

CRITICALLY APPRAISE THE EVIDENCE (100 points)

1. Article Analysis Matrix. Perform a literature review of 5 articles. Develop a matrix of the evidence. At least one article should be an international research article and highlight how practice may or may not be similar to the current national practice.

Use this template for your matrix

• Name of author, date, title of study, journal
• Level of Evidence – Evidence-Based Practice Tool Kit
• Hypothesis, if there is no hypothesis, the question, if there is no question, the
• Must be specific
• Sample: Size of sample, important demographics, inclusion and exclusion

criteria

• Data Collection Instruments/Procedures including reliability and validity (was it completed or not?)
• Statistical Results/Findings
• Implications/Conclusions related to adoption to practice

Author, date,     Level of            Hypothesis        Design  Sample Data     Stats/ Conclusions title, journal           Evidence           Question or       Size,     Collection Findings           Implication Purpose       demographic

Example:   Level 3 Determine survey 20 nursing Explain Review Value of the Smith, 2011 EBP usefulness of units, Data significant implications in NSG EBP in cost 200 nursing gathering Statistical and Administration containment surveys process findings Conclusion to

JONA,                                                                                                             nursing

practice.

1. Summarize your literature review – Make a determination of whether sufficient evidence exists to support either current practice or a need to change the practice (15 points)

• How much variation was there in the outcome(s) studied across the studies/reports?
• What findings are supported by more than one study/report?
• Note the level of evidence from the various studies/reports and the findings associated with them.
• Of the consistent findings, how many of the studies/reports have a treatment effect that was clinically significant?
• Your conclusions: Is the evidence picture sufficiently complete (i.e. knowledge regarding:

benefits and risks)

PROPOSE A CHANGE IN CLINICAL PRACTICE (50 points)

• Assess the environment for change. Consider:
  • The population in your specific setting and patient preferences and values o Clinical expertise and preferences o Available resources for implementing the change
• Create a Change Team. With input from your interprofessional team member, discuss who will be part of the team to implement the change and why you have chosen these individuals by answering the questions listed below. Be sure to include the professionals both inside and outside of nursing. Address the following interprofessional education (IPE) competencies. See the Core Competencies for Interprofessional Collaborative Practice at: Core Competencies
  • How would you create a climate of mutual respect and shared values for your team? o How would you decide upon each of your professional roles and responsibilities to create an effective team?
  • How would your team communicate with one another in planning the team project? o How would you incorporate your leadership skills to support collaborative practice and team effectiveness?

Develop a Change Strategy.  Use the following table to identify 2-3 objectives for the project that you could use to implement the change.  These objectives must be measurable and specific.  In the second column, state the specific methods or plans to meet the objectives.  Specify who will be responsible and the timetable to implement each objective.  In the last column, specifically state measurable outcomes of how you will evaluate whether or not you have successfully met the objective.  (Add additional rows to this chart, if needed).

DEVELOP AN EVALUATION PLAN TO MEASURE EFFECTIVENESS OF THE CHANGE (50 points)

From the last column of the above table, copy and paste the measurable objectives.  Complete the rest of the columns. Add additional rows to this table if necessary

RESOURCES (50 points)

• Discuss the resources; you need for the first year of the change in practice.
• Project costs of additional supplies, equipment, and personnel as appropriate.
• Project costs savings to the health care facility.
• Use an Excel spreadsheet for this purpose if appropriate.

MUST include a CONCLUSION to summarize main ideas (20 points)

• All professional papers need to have a conclusion that highlights the main topics and ideas of the paper and what we want the reader to leave remembering.

APA Format (50 points) General APA Format with APA 7^th edition.

• All papers must be written in APA 7th edition format for a professional paper and NOT a student paper. Significant point deduction if written as a student paper.
• Points will be deducted for grammar, incomplete or lack of in-text citations of paraphrased work, improper page formatting, inaccurate formatting of reference page, or the use of more than one direct quote.
• All sections of the project must be written in your own words and not pulled directly from resources, even if cited as a quote, these sections will not count within the grade for that section of the project. Projects can have up to one direct quote of one sentence or phrase. Significant point deductions for papers with copied and pasted text from other sources or papers. Any section of the paper that is copied from another source will not only receive APA deductions but zero or minimal points for that section of the project.
• All projects will be submitted via Turn It In which compares your project against published works, journals, other student work, etc—as a source to review for plagiarism. The originality report will be used to consider these factors. Plagiarism is considered academic misconduct and can result in course or program failure. If you have any questions about what is considered plagiarism please contact your course instructor and also use the APA resources.

Required Website (must be used as a resource):

• Quality and Safety Education for Nurses: QSEN Website Safety Information

Recommended Resources:

• What is Evidence-Based Practice? (2018). Duke University Medical Center. Available online:
• Definition of EBP
• Arnold and Wade. (2015). A Definition of Systems Thinking. Procedia Computer Science, 44,

669-678. doi: org/10.10.1016/jprocs.2015.03.050: Systems Thinking

• Interprofessional Education Collaborative. (2011). Core Competencies for Interprofessional

Collaborative Practice. Available online: Core Compentencies

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