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In order to formulate your evidence-based practice (EBP), you need to assess your organization. In this assignment, you will be responsible for setting the stage for EBP. This assignment is conducted in two parts: an organizational cultural and readiness assessment and the proposal/problem statement and literature review, which you completed in NUR-550.
Section A: Organizational Culture and Readiness Assessment
It is essential to understand the culture of the organization in order to begin assessing its readiness for EBP implementation. Select an appropriate organizational culture survey tool and use this instrument to assess the organization\’s readiness.
Solution
Organizations Culture and Readiness and Assessment
Organization Culture and Readiness for System-Wide Integration of Evidence-Based Practice is the selected organization culture and survey tool (Yoo, Kim, Kim, Kim, & Ki, 2019). For its involvement in the EBP, the survey tool will be of help in investigating, evaluating, and identifying the organizationâs readiness.
Level of Readiness of the Organization
Depending on Organizational Culture and Readiness Assessment results, the organization is set to participate in evidence-based practice. The nurses have pledged to initiate the evidence-based program. Physicians within the organization are also passionate about supporting the nursing staff in evidence-based practice. Furthermore, the organization provides the staff with numerous opportunities not only to learn but also to practice EBP. It is through the organization that the employees in different departments access to research and evidence-based practice libraries using the provided computers. To help other medical centers, the organizational share not only metrics but also EBP and outcomes through peer groups. To meet its goal of magnifying their nursing strength and quality, the organization is bound to support as well as drive an EBP culture.
Summary of the Results of OCRSIEP Survey on the Assessed Organization Readiness
| Question | Sample Size | Mean | STD | Minimum | Maximum |
| Question 1 | 5 | 3.1 | 1.20 | 2 | 5 |
| Question 2 | 5 | 3.6 | 1.26 | 2 | 4 |
| Question 3 | 5 | 3.1 | 1.42 | 3 | 4 |
| Question 4 | 5 | 3.3 | 0.88 | 3 | 5 |
| Question 5 | 5 | 3.1 | 1.2 | 2 | 5 |
| Question 6 | 4 | 3.1 | 0.83 | 2 | 4 |
| Question 7 | 5 | 1.9 | 0.85 | 2 | 5 |
| Question 8 | 5 | 2.2 | 1.2 | 1 | 4 |
| Question 9 | 5 | 3.8 | 0.83 | 3 | 5 |
| Question 10 | 5 | 2.3 | 1.65 | 1 | 4 |
| Question 11 | 5 | 3.8 | 0.44 | 3 | 3 As you continue, thestudycorp.com has the top and most qualified writers to help with any of your assignments. All you need to do is place an order with us. (Organizations Culture and Readiness and Assessment) |
| Question 12 | 4 | 1 | 0 | 1 | 1 |
| Question 13 | 5 | 4 | 0 | 1 | 1 |
| Question 14 | 5 | 1 | 0 | 1 | 1 |
| Question 15 | 5 | 3.1 | 1.49 | 2 | 4 |
| Question 16 | 4 | 2.74 | 0.50 | 2 | 3 |
| Question 17 | 5 | 2 | 1.41 | 1 | 4 |
| Question 18 | 5 | 3 | 1.22 | 1 | 3 |
| Question 19 | 5 | 1.6 | 0.44 | 2 | 3 |
The OCRSIEP Survey assessed the selected organization and cultural readiness for the implementation of an EBP with the RN responses ranging from none at all at 1 to very much at 5. The others were a little at 2, somewhat three and moderately 4. Each of the respondents could have scored a maximum of 95 points where Respondent 1 had 77 with two questions not answered, and Respondent 2 had 51 with 1 question not answered. The other Respondents 3, 4, and 5 responded to all, and each scored 83, 93, and 58, respectively. The organizationâs readiness was measured, ranked as getting ready in the previous six months. The statistical means of each question ranged from 1 to 4.6, and the medians ranging from 1 to 5. At the same time, the standard deviations ranged from 0.00 to 1.63. The RNS perceived the administrationâs decisions as ranging from 25% to 100 %. The decisions made by staff ranged from none to 25%. This implies that the hospital management should institute measures that ensure the staff also feels they own the EBP programs initiated through frequent consultations and immediate feedback.
Project Barriers
These barriers are either human or organizational factors. Fist heavy workload makes reading time inadequate. There is also little experience of staff since most staff have little experience in participating in evidence-based practice. Additionally, the facilitation of evidence-based practice lack resources.
Facilitators
Facilitators will assist in the implementation of new cultures for improving the treatment of lung cancer in men (Jones, & Baldwin, 2018). Facilitators include not only role modeling applications but also improved information access.
Integrating clinical inquiry and strategies to strengthen nurses with low morale
In the formulation of evidence-based practice, nurses should follow the steps of the EBP process. These are: ask, gather, appraise, act, evaluate, and disseminate. To strengthen the morale of employees, the organization should motivate, empower, and acknowledge. There should also be transparency in the organization.
Part Two: Proposal/Problem Statement and Literature Review
This EBP project is proposed to lower HF the one-month heart failure readmission rates in the acute care hospital setting by implementing a change initiative that would increase patient knowledge of HF self-care activities. The current EBP proposes to focus on measures that would decrease hospital readmissions that can be prevented by integrating the best practices in connection to HF self- care activities. This because educating the patient together with their families on how to manage effectively and early treatment would potentially lower the one-month hospital readmission rates and yield improved outcomes. As such the refined PICOT question which was âAmongst adults aged over 45 years diagnosed with heart failure (Population-P), would post-discharge HF education program hereafter abbreviated as (PHFEP) (Intervention- I) compared to conventional heart disease education (Comparison-C) decrease the rate of one-month hospital readmissions and improved quality of life for the patient (Outcome- O) within 90 days (Time âT)?â
The proposed problem state, therefore, states The EBP project is proposed to initiate measures whose successful implementation would lower the one-month hospital readmission rates for adult patients diagnosed with HF.
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Summary of the Literature Review Articles
The proposed PICOT question helped guide a comprehensive literature search that helped to identify, analyze, and synthesize the relevant literature that supports the PHFEP initiative. The articlesâ subjects, methods, key findings were then synthesized. The search from healthcare based databases like PubMed, Medline, and CINAHL yielded in over 270 articles. Search terms from the PICOT question and problem statements like self- care, education, and HF were used in the search process. Articleâs meeting the inclusion criteria of being published in English and within not older than five years were synthesized. The subjects of the selected articles included Ba et al. (2020) integrative review, which sought to highlight transitional care interventions to Ziaenian& Fonarow (2016), which focused on strategies for preventing HF hospital readmission. From another perspective, Su et al. (2019) explored the socioeconomic predictors and their impact on HF readmissions. The methods used in the review articles also varied from Diez et al. (2019) use of randomized control trial and qualitative methodology, which was utilized by Glogowska et al. (2015) while Qaddoura et al. (2015) used systematic reviews and meta-analysis approach. At the same, these studies also emphasized the role of patient education and the need to adhere to the HF self-care practices as a way of effective management of HF (Souza et al., 2019; Toukhasati et al., 2019). The articles also had notable limitations, like the small number of participants in the RCTs makes the findings of the study less generalizable (Dies et al., 2019). Another study limitation was the inclusion of only those articles publishing English and failing to explore the gray literature databases like dissertations and non- peer-reviewed articles. The general trend in all the findings of the articles selected underpinned the fact that HF hospital readmissions were largely preventable events (Ba et al., 2020). The overall effect of these limitations is that not all research that is relevant was included in the literature review.
Conclusion
In conclusion, the need to nurse-led face to face patient education sessions is bound to improve HF disease management. As the articles reviewed indicate, patients with HF knowledge scores are less likely to be readmitted in hospitals compared to patients with low HF scores indicating the efficacy of the proposed education intervention. The increase in HF knowledge improves the patientsâ self-care confidence and practices. All these findings support the need for a comprehensive post-discharge HF patient education applying the best practices, which would ultimately lead to reduced HF readmission rates.
References
Diez, N. P., Campos, R. C., Roiz, S., Salaverria, I., Subijana, E., GonzĂĄlez, M. J. E., & Sobradillo, P. (2019). Effectiveness of self-care program for hospital readmissions prevention in patients with potentially avoidable hospitalizations đ AUTOCUID) randomized clinical trial. International Journal of Integrated Care (IJIC), 19.
Glogowska, M., Simmonds, R., McLachlan, S., Cramer, H., Sanders, T., Johnson, R., & Purdy, S. (2015). Managing patients with heart failure: a qualitative study of multidisciplinary teams with specialist heart failure nurses. The Annals of Family Medicine, 13(5), 466-471.
Jones, G. S., & Baldwin, D. R. (2018). Recent advances in the management of lung cancer. Clinical Medicine, 18(Suppl 2), s41. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334032/
Linn, A. C., Azollin, K., & de Souza, E. N. (2016). Association between self-care and hospital readmissions of patients with heart failure/Associação entre autocuidado e reinternação hospitalar de pacientes com insufi ciĂȘncia cardĂaca/AsociaciĂłn entre la auto-atenciĂłn y reingresos hospitalarios de pacientes con insufi ciencia cardĂaca. Revista Brasileira de Enfermagem, 69(3), 469.
Mai Ba, H., Son, Y. J., Lee, K., & Kim, B. H. (2020). Transitional Care Interventions for Patients with Heart Failure: An Integrative Review. International Journal of Environmental Research and Public Health, 17(8), 2925.
Qaddoura, A., Yazdan-Ashoori, P., Kabali, C., Thabane, L., Haynes, R. B., Connolly, S. J., & Van Spall, H. G. C. (2015). Efficacy of hospital at home in patients with heart failure: a systematic review and meta-analysis. PloS one, 10(6).
Sousa, J. P., Neves, H., LobĂŁo, C., Gonçalves, R., & Santos, M. (2019). The effectiveness of education on symptoms recognition in heart failure patients to manage self-care: a systematic review protocol-Lâefficacia dellâistruzione sul riconoscimento di sintomi in pazienti affetti da insufficienza cardiaca ai fini Del self-care: UN protocollo di revisione sistematica. Professional infermieristiche, 72(1)
Su, A., AlâAref, S. J., Beecy, A. N., Min, J. K., & Karas, M. G. (2019, July). Clinical and socioeconomic predictors of heart failure readmissions: A review of contemporary literature. In Mayo Clinic Proceedings (Vol. 94, No. 7, pp. 1304-1320). Elsevier.
Toukhsati, S. R., Jaarsma, T., Babu, A. S., Driscoll, A., & Hare, D. L. (2019). Self-Care Interventions That Reduce Hospital Readmissions in Patients with Heart Failure; Towards the Identification of Change Agents. Clinical Medicine Insights: Cardiology, 13, 1179546819856855.
Yoo, J. Y., Kim, J. H., Kim, J. S., Kim, H. L., & Ki, J. S. (2019). Clinical nursesâ beliefs, knowledge, organizational readiness, and level of implementation of evidence-based practice: The first step to creating an evidence-based practice culture. PloS one, 14(12), e0226742. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6932768/
Ziaeian, B., & Fonarow, G. C. (2016). The prevention of hospital readmissions in heart failure. Progress in cardiovascular diseases, 58(4), 379-385.
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Question
In order to formulate your evidence-based practice (EBP), you need to assess your organization. In this assignment, you will be responsible for setting the stage for EBP. This assignment is conducted in two parts: an organizational cultural and readiness assessment and the proposal/problem statement and literature review, which you completed in NUR-550.
Section A: Organizational Culture and Readiness Assessment
It is essential to understand the culture of the organization in order to begin assessing its readiness for EBP implementation. Select an appropriate organizational culture survey tool and use this instrument to assess the organization\’s readiness.
- Develop an analysis of 250 words from the results of the survey, addressing your organization\’s readiness level, possible project barriers and facilitators, and how to integrate clinical inquiry, providing strategies that strengthen the organization\’s weaker areas.
- Make sure to include the rationale for the survey category scores that were significantly high and low, incorporating details or examples. Explain how to integrate clinical inquiry into the organization.
- Submit a summary of your results. The actual survey results do not need to be included.
Section B: Proposal/Problem Statement and Literature Review
In NUR-550, you developed a PICOT statement and literature review for a population quality initiative. In 500-750 words, include the following:
- Refine your PICOT into a proposal or problem statement.
- Provide a summary of the research you conducted to support your PICOT, including subjects, methods, key findings, and limitations.
General Guidelines:
You are required to cite three to five sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.
Prepare this assignment according to the 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.
You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.
Note: After submitting the assignment, you will receive feedback from the instructor. Use this feedback to make revisions for your final paper submission. This will be a continuous process throughout the course for each section.