Choose a nursing problem from your current practice setting, and identify a possible solution to that problem.

NRS 433V Week 5 – Evidence-Based Practice Presentation – Healthcare Associated Infections [12 Slides + Speaker Notes]

The proposed solution in this evidence-based practice proposal is the reduction of nurse-to-patient ratio as a way of preventing and reducing rates of falls among adult patients. The need for the solution is attributed to the high risk of falls among patients admitted in hospitals. The falls could be attributed to the use of medications, patient’s age, and environmental factors such as inadequate monitoring from the nursing staff. The proposed solution aligns with current evidence. According to Aase and Schibevaag (2016), health organizations should prioritize the provision of care that promote safety, quality, cost-effectiveness, and efficiency. They should explore innovative ways in which issues facing them can be addressed. The proposal seeks to promote patient safety and cost effectiveness in care, hence, aligning with evidence. The practice of nursing in the modern world is highly dependent on the use of evidence-based practices. The proposed intervention is realistic in our setting. The rates of patient falls have risen significantly over the past few months. The hospital has been looking for effective ways of addressing the issue. As a result, it will adopt the intervention since it seeks to address its critical issues. The hospital also champions the use of evidence-based practices in the provision of care. The management understands the fact that evidence-based practice result in optimum outcomes of care. The proposed solution aligns with the organizational culture. The leadership of the organization understands and supports evidence-based practice. They encourage the staffs on a regular basis to explore innovative ways in which enhanced outcomes of care can be achieved. It is expected that the project will result in the reduction of falls among adult patients in the medical wards. It is also expected that it will result in improvement in quality of care. This will be seen in the reduction in rates of patient falls as well as other adverse events such as medication errors.

Daniel Duck developed the Duck curve model to guide in facilitating the understanding of the emotional response of the adopters of change to a change. According to Duck, organizational change occurs in a manner that is manageable as well as predictable. The predictable nature of the change makes it easy to be tracked in the change curve. The first stage of change in the Duck’s change curve model is stagnation. The adopters in this stage do not perceive any challenge of threat in their existing behaviors. They do not understand the manner in which their circumstances contribute to the reported adverse events. Preparation is the second step in the model of change by Duck. According to Duck, this stage is characterized by the adopters of the proposed change being aware of its need. The third step in the model of change by Duck is implementation. This is the stage where the organization puts strategies into action for the change to be possible. It can be seen through the adoption of interventions such as re-designing of the existing organizational structures, hiring of new staffs, and selection of training to be provided to the staffs based on the identified needs. The fourth step in the model is determination. The adopters in this stage have understood the need and realities associated with the change. As a result, they behave in manners that support the change. The last step in Duck’s change curve model is fruition. This is the step where the success of the change initiative has been achieved. The existing organizational processes have been transformed.

The setting for the proposed intervention will be our hospital. The hospital is tertiary institution where patients of all ages receive specialized and outpatient care for their diverse health needs. This setting is appropriate for the proposed intervention because of its large workforce and patients it serves. The subjects for the intervention will be the registered nurses working in adult medical and surgical units. The proposed project will be undertaken within a period of six months. It is expected that this duration will allow for the determination of the effect of the intervention on patient falls. The successful implementation of the proposed project will require optimum use of the allocated resources. The resources will be utilized based on the identified needs in the implementation process. A regular audit will be performed throughout the implementation phase to ensure that the allocated resources are utilized in an efficient manner.  The resources will include qualified health workforce, money, and trainers of trainees. The data for the project will be obtained using surveys and statistics of patient falls in the hospital.

Open and closed ended questionnaires will be administered to the registered nurses to determine their experience with the intervention. The intervention will be delivered in the adult medical and surgical wards. The hospital for the project has two adult medical and two adult surgical wards. One of the adult medical and one adult surgical ward will be selected for the intervention. The nurse-patient ratio in these wards will be reduced. The remaining two wards will remain with the normal nurse-to-patient ratio. The nurses in the wards where the intervention will be used will be trained on ways of preventing patient falls while the other wards will not receive any training. The nurses in the wards where the project was implemented will be administered with questionnaires. The questionnaires will contain both open and closed ended questions. The aim will be to obtain information about their subjective experiences with the project. The other set of data will be that on the number of patient falls reported in these units and those that did not receive the intervention. Training the implementers, coming up with a budgetary allocation for unforeseen challenges and providing support in the form of coaching and monitoring closely the implementation of the project will be used to address unforeseen barriers. The project will require $80, 000 for it to be undertaken to the end.

This is a CLC assignment.

Choose a nursing problem from your current practice setting, and identify a possible solution to that problem.

Conduct a search of the literature related to this problem.

Analyze and critically appraise evidence-based literature to support the solution to the identified problem. A minimum of (5) articles must be identified. This may include guidelines from the National Guideline Clearinghouse, Joanna Briggs Institute, or a review from the Cochrane Database of Systematic Review.

Prepare a 10-minute (8-10 slides; no larger than 5 MB) PowerPoint presentation related to the problem, evidence appraisal, and practice implications.

Include the following components into the presentation:

1. Present the nursing practice problem with the PICOT question.
2. Discuss your appraisal of the literature that addresses the problem.
3. Present the proposed practice changes from an integration of the findings.

While APA format is not required for the body of this assignment, solid academic writing is expected and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.