Evidence-Based Practice Proposal: Section G: Evaluation of Process
In 500 words (not including the title page and reference page), develop an evaluation plan to be included in your final evidence-based practice project. Provide the following criteria in the evaluation, making sure it is comprehensive and concise:
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Upon receiving feedback from the instructor, refine “Section G: Evaluation” for your final submission. This will be a continuous process throughout the course for each section.
Evidence Based Practice Proposal- Section F Implementation Plan
This EBP project is proposed to take place in a small rural critical access hospital emergency department providing care 24 hours each day and 365 days each year. The proposed service area includes 1 county in rural Georgia and 2 adjacent counties also in rural Georgia.
The participants will be those patients > 18 years of age presenting to ED triage with possible sepsis and NEWS score of > 3. The project will compare electronic medical records (EMR) of pre- implementation (before protocol initiation) with those EMRs from post- implementation. This will involve identification, initial contact and nurse compliance with sepsis protocols. An approval form for the implementation will be obtained from administration prior to the implementation. All patients < 18 years of age will be excluded. The project sponsor will avoid any manipulation, participant’s privacy and confidentiality will be protected completely any information that is obtained will be for the purpose of selecting subjects.
The timeline for the project will be 16 months’ implementation, and data collection of EMRs for the same amount of time.
Putting evidence- based research into practice requires a number of resources for effective implementation. These resources aid the healthcare professional in getting to know the answers to important questions. There will be a need for funding resources such as education and personnel, equipment such as computers and labels, educational materials and information technology.
Methods and Instruments
Data collection will be from EMRs pre- and post- implementation by chart review. Data will be entered into a purchased and downloaded Statistical Package for the Social Sciences (SPSS) and compared.
This will be a multi-faceted project. With first step being the identification and appraisal of best available evidence pertaining to the care of patients with sepsis, severe sepsis and septic shock in the ED. Sepsis screening tools will be added to the computer system to include the NEWS score which will trigger activation of the steps included in the sepsis protocol including activation of code sepsis alert, moving the patient immediately to an ED bed, blood samples being drawn for cultures, CBC, CMP, chest radiograph, and alerting the ED physician of potential sepsis for implementation of the sepsis care bundles described in the SSC guidelines of 2012. All nurses, lab and radiology personnel, and physicians will be trained and educated on all protocol steps.
Data Collection Plan
Data collection will be from the EMRs pre-and post-implementation. Data to be collected includes, chief complaint on arrival to triage, age > 18 years, NEWS score, SIRS criteria, sepsis screening information, and nurse compliance with sepsis care protocol components. Primary data results are nurse compliance with sepsis care bundle components, secondary data to be compared are mortality rates, ICU admissions, and length of stay. All due diligence will be taken to ensure that information will be kept private and confidential. All data will be managed and maintained by the project manager. Data analysis will be entered the SPSS for statistical analysis. Utilizing a chi square test of independence to calculate screening compliance pre-and post- implementation. Secondary analysis will include examining compliance impact on the secondary data on pre-and post- protocol implementation patients whose EMR indicates a diagnosis of sepsis.
Strategies to manage barriers
There are a variety of strategies that are utilized in overcoming barriers to the implementation of evidence-based practice, there is need for formal evaluation to ascertain the impact on the proposed change, knowledge, attitude and skills of nurses are identified as the main barriers to EBP in sepsis care included in this is the lack of baseline knowledge of sepsis care, lack of triage recognition and delay of diagnosis leading to decrease protocol use and poor patient outcomes. Utilization of online systems to obtain databases with appraised evidence to enhance the awareness along with education and training on good communication. A commitment must be made to advance evidence-based practice and allocate efficient resources for implementation.
Evaluation of the feasibility of the implementation of the EBP practice focuses on the knowledge, skills, personnel cost and computer related cost. Clinician knowledge and skills indicate that they are prepared to get the research into practice. Personnel costs are justified in that there will be staff employed to ensure the effective implementation of the plan. All special lab labels will be used to identify stat lab tests for sepsis patients ensuring that results are obtained in < 1 hour as recommended in the SSC guidelines. Computer related costs will be incurred with the purchase of SPSS program, and the addition of the NEWS score trigger and are justified in their necessity for the project.
Plan to maintain, revise, extend or discontinue
Here the project team will evaluate the efficacy of the timely implementation for the ED sepsis care protocol. If the proposed ED sepsis care protocol is ascertained as ineffective, it shall be discontinued. The project manager anticipated providing the required education and training to identify the any needed revisions early to ensure implementation of the best evidence- based sepsis protocols. There will be ongoing education and updates as needed to ensure that all practitioners are using all the best evidence in practice and all protocols remain up to date. Extension of the implementation period is not anticipated now due to the extended length of the current plan, any possible need for extension will be assessed later.