Week 1 -Assignment 2 Discussion

Melynk and Fineout-Overholt (2011) note that there are seven steps to the evidence-based practice (EBP) process. The first step is to cultivate a spirit of inquiry. To encourage this spirit of inquiry, you are asked in this discussion to:

Identify a problem or issue from within your specialty area that you feel needs to be improved upon. The Doctor of Nursing Practice site (http://www.doctorsofnursingpractice.org/resources/dnp-scholarly-projects/) provides many examples of these projects. The list below may help focus your thoughts.

Educational program

Evidence-based healthcare policy change

Evidence-based clinical issue or protocol for specific disease/condition

Discuss the relevance of the issue from your perspective (not the literature at this juncture) in relation to your selected advanced role option.

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What piqued your interest about this issue or problem?

How does it relate to your area of specialization?

What gave you the idea that evidence exists to support this change? See “note” below.

Provide a rationale as to why this will be an evidence-based project to improve outcomes and not generate new evidence (research).

Please remember that the project will not be implemented during this course and no data will be collected. The outcome of this course is to complete a project proposal only.

Week 2 – Assignment 1 Discussion

Melynk and Fineout-Overholt (2011) note that there are seven steps to the evidence-based practice (EBP) process. The first step is to cultivate a spirit of inquiry. To encourage this spirit of inquiry, you are asked in this discussion to:

Briefly describe the problem or issue that you have decided to be the topic for your project proposal in order to orient your classmates and faculty

Indicate how it relates to your area of specialization

State your PICOT question. Indicate in parentheses after each segment, what part of PICOT the preceding words represent. For example: In patients recently discharged from the hospital following care for heart failure (P), do hand-off calls by the nurse to the primary care provider using the SBAR format (situation, background, assessment, recommendation) (I) compared to no calls (C) decrease readmission rates (O) over a one year period (T).

Discuss which process model resonates with you and will help keep you focused during the project. Process models included in your text (Melnyk & Fineout-Overholt, 2011) are:

Clinical scholar model

Stetler model of evidence-based practice

Iowa model of evidence-based practice to promote quality care

Model for evidence-based practice change by Rosswurm and Larrabee

Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) Model

Provide feedback to your classmates that focuses on:

The use of correct PICOT format for the question to guide the literature search.

Does the question reflect a clinical research question or one appropriate for an evidence-based practice project?

Week 3 – Assignment 1 Discussion

In this discussion, you will share your search strategies that you have employed to find evidence for your study. For this discussion:

State your PICOT question. Did using the terms used in this question lead you to useful research studies?

What MESH terms have you tried? Did they help you find additional studies? Are you finding MESH terms useful to expand or delimit your search?

Are you finding relevant articles? If not, how did you modify your search to increase productivity?

Indicate which databases you used—those you found useful and those that were not.

What levels of evidence do the studies you are finding represent?

Post any questions or concerns you may have and provide feedback and recommendations to your classmates. Working together and sharing search strategies is very helpful.

Use the Search Tracker to keep track of search terms.

Using the appropriate Rapid Clinical Appraisal (RCA) Tools, appraise one or two articles and add the information to your Evaluation Table to receive feedback from faculty. At this juncture, your table is a work in progress. You will complete it in Week 4. The RCA Tools and Evaluation Table in Word for you to complete can be found in the Week 3 Overview section.

Week 4 – Assignment 1 Discussion

Discuss your experience completing the rapid critical appraisal process.

Was it really “rapid” or was it more of a laborious process?

Did reading the abstract help you make quick decisions about including or excluding the study?

What worked best for you in terms of the approach you decided to use to complete the appraisal and Evaluation Table? What didn’t work?

Post any questions or concerns you may have and provide feedback and recommendations to your classmates. Working together and sharing search strategies is very helpful.

Week 5 – Assignment 1 Discussion

This week the discussion focuses on creating a Synthesis Table(s) as a means to summarize and organize the body of evidence from the Evaluation Table. The Synthesis tables will be included in your formal proposal in the Appendix. In the body of the paper, you will describe the “keeper” studies in narrative format.

For this discussion, include the following:

Share your approach to synthesizing the evidence. What were the variables of interest you identified?

Learning to write in a scholarly fashion requires that you are able to succinctly summarize an article in a sentence or two and cite it appropriately using APA format. In this discussion, practice summarizing 2 articles you have identified from the Synthesis Table as pertinent to your proposal. Include the level of evidence, study design, and evidence of rigor. Use appropriate APA citation in text and references. Incorporate feedback from peers and faculty in your Dropbox assignment for this week.

In addition to research studies, patient preference and clinical expertise should also be considered. Discuss how you will incorporate these important perspectives into your project proposal.

Week 6 – Assignment 1 Discussion

For this week’s discussion, please address the following:

Briefly describe the clinical issue or problem for your project, the setting, and population of interest to orient classmates and faculty

Write your clinical question

Describe the intervention you plan to test

What type of study will you conduct? Will it be experimental? Quasi-experimental? Provide a rationale for your answer.

Provide feedback on the clinical questions of your colleagues

Week 7 – Assignment 1 Discussion

This discussion will focus on the measurement tools you will use to evaluate change from the intervention. The purpose of this discussion is to fine-tune your thinking about evaluation by receiving feedback from colleagues and faculty. Include in your discussion:

Write a brief description of your project that starts by stating your clinical question and succinctly explaining your planned intervention in order to orient everyone.

Will you need to develop your own evaluation tools or are valid and reliable tools available?

If you create your own tools, what are your thoughts on pilot testing them? How will you go about this?

Will you gather baseline data? Will you use pre- and posttests? How will you measure change?

How will you identify the participants for your study? How does the sampling method chosen further define the type of study you will be doing?

How will you ensure confidentiality of study participants?

Week 8 – Assignment 1 Discussion

The discussion for this week will revolve around the analysis phase of your project. Include the following points in your discussion:

Begin with a brief description of your project that includes your clinical question, your planned intervention, the type of study you will conduct and how you plan to evaluate the outcomes.

What type of statistical analysis will be done?

What is a reasonable timeline for your project?

What expenses should be considered? Include both obvious expenses, such as materials, as well as those that are hidden, such as time, which equates to part of your salary.

Will you need to consider a funding source for your project?

Week 9 – Assignment 1 Discussion

Although you will not implement your project during this course, it is important that you understand the various steps that are necessary to do so. As you begin to formulate your strategic plan for implementing your change project, discuss the following specific to your proposed project:

Who are the stakeholders? Please identify them by role or job within the organization, not by name. Can you identify any “champions” or people within your organization that you can convert to champions?

What potential barriers do you foresee and what strategies do you envision to prevent or overcome these barriers?

What change theory will you use to guide you?

Week 10 – Assignment 1 Discussion

For this discussion question, you are asked to review the student learning outcomes for this course and discuss how you met these outcomes. The intention here is to provide you an opportunity to “reflect” on the learning achieved during this term and how you successfully met these learning outcomes. If you do not feel you successfully met the objective, discuss your plans to successfully complete the objective in the future.

By the end of the course, the student should be able to:

Demonstrate synthesis of the knowledge and skills acquired in preceding graduate nursing core and specialty curriculum content.

Evaluate current health policy and legal and ethical considerations in addressing the health promotion and disease prevention of a target population.

Integrate this synthesis in the creation of a scholarly project of either an evidenced-based practice proposal or a research proposal that generates new nursing knowledge.

Disseminate significant components of the project through a written paper and oral presentation.

Week 1 assignment 3

Evidence-Based Project Proposal

Project Overview:

Title: Evidence Based Project-Proposal

Description:

As the course progresses over the 11 weeks, learners will develop a scholarly project that demonstrates an application of evidence to practice for substantive change. This project emphasizes critical appraisal and application of evidence-based research, scholarly writing, and critical thinking. The scholarly project will be submitted as a written paper in APA format/style. In addition, learners will present a summary of the final project orally or by creating a PowerPoint presentation.

Learners will select one of the following types of projects related to their specific advanced role specialization and target population:

Educational program

Evidence-based healthcare policy change

Evidence-based clinical issue or protocol

Overview of the Evidence Based Project (EBP):

In Week 1 of the course, students will identify an area of inquiry as a basis for practice change, and in Week 2, write their clinical question in PICOT format that will drive the literature search.

Following approval of the practice change idea and the PICOT question by course faculty, in Week 3 students will begin their literature search and rapid critical appraisal (RCA) using the RCA checklists available in Appendix D of the course text (Melynk & Fineout-Overholt, 2011) and in Word format. The Search Tracker may be useful in organizing and tracking your search.

Your evidence review will be completed in Week 4, resulting in a finished Evaluation Table containing only the “keeper” studies.

In Week 5 you will synthesize the evidence to determine best evidence for your project. Faculty will continue to serve in the role of mentor as the student progresses through the remaining steps of the project.

Weekly submissions will be used to monitor progress in the development of your proposal. It is recommended that upon receiving feedback from faculty on each section, you revise your work and add that section to build your final paper. Doing so as you proceed through the course will avoid last-minute work.

When you began your study of evidence-based practice it was contrasted with the research process. The underlying goal of EBP is to appraise research and study its application to specific patient populations in order to identify best practices. In order to accomplish this, what must be included within your project is a research study. You will most likely compare pre-intervention data with post-intervention results. In come cases, statistical analysis will be necessary. Your proposal will include plans for this study.

EBP Project Criteria

Students will prepare a formal project proposal using APA format. Below is an outline for the final paper with the weeks where this content will be covered. Each week you will turn in parts of this outline as Dropbox assignments. The week each part will be due is indicated in the outline. After receiving feedback from faculty on each part submitted, it is recommended that you begin building your paper, adding the pieces where they belong. Since you will not be implementing this project, the results section has been omitted. This outline is consistent with the format used for journal articles when reporting results of evidence-based practice projects.

Criteria and organization of final paper

Abstract

Part 1

Introduction – Week 2

Practice issue

Summarize the practice issue in need of change providing background information about the organization (setting) and the perceived significance and severity of the problem

Describe the specific aims of the project – what improved outcomes do you hope to achieve

PICOT question – State your question in PICOT format, labeling each part with P-I-C-O-T in parentheses

Significance – what is the significance of the issue in terms of poor outcomes, cost, etc.

Part 2 – Week 3. 4, & 5

Evidence review and synthesis

List the names of the databases you searched and if limited to a span of time, i.e., less than 5 years old

Summarize “keeper” studies

Summarize the synthesis of the body of evidence

Part 3 – Week 6

Purpose of the project – include intervention

Theoretical framework

Clinical questions

Part 4 – Week 7

Study design

Setting/sample

Confidentiality

Procedure/intervention

Instruments/scales and measurement of outcomes

Data collection

Part 5 – Weeks 8 & 9

Data analysis

Outcomes expected

Aligning stakeholders

Appendices

Evaluation Table – turned in Weeks 3 & 4

Synthesis Table – turned in Week 5

The paper provides evidence of synthesis of coursework, professional writing, and graduate level scholarship.

Oral or Poster Presentation

In addition to the written paper, students will present a summary of their project by submitting a professional Microsoft PowerPoint presentation.

Criteria:

Organize the presentation to include all required criteria of the EBP project proposal.

Quality of presentation is professional and provides evidence of graduate level scholarship.

This week’s Dropbox Assignment

Keep in mind that this proposal will be developed piece by piece during the course. The Dropbox assignment this week provides you an opportunity to identify the problem or issue within your specialization that is in need of improvement and receive feedback from faculty.

Review the grading criteria listed below as you begin this assignment. Note that you must pass all elements in order to move forward with your proposal development. Faculty will provide feedback either approving or asking that you resubmit prior to further development of your project.

For this week’s assignment discuss the following:

State your idea for your evidence-based project proposal including the rationale as to how it reflects an EBP project vs. a research project

Very briefly describe the issue you will address, the intervention that you feel has research evidence (this may change later after you complete the literature search), and the expected outcomes

Discuss how this project is relevant to your role specialization

Week 2 assignment 2

Evidence Based Project Proposal

For this week’s Dropbox assignment, you will submit Part 1 of the project proposal in a one-page APA formatted paper (excluding the cover page and reference page). Be sure to reflect on feedback from faculty and classmates from this week’s discussion. Include:

Part 1: Introduction

Summarize the practice issue in need of change providing background information and the perceived significance of the problem

Describe the specific aims of the project – what improved outcomes do you hope to achieve

State your question in PICOT format, labeling each part with P-I-C-O-T in parentheses

Discuss the significance of the issue in terms of poor outcomes, cost, etc

Week 3 assignment 2

Evidence Based Project Proposal

This week you will begin the submission of Part 2 of the project proposal written in APA format. In a one-page APA paper, write a narrative that describes your search of the literature for evidence, which includes:

List of the names of the databases you searched

If limited to a span of time, i.e., less than 5 years old

Using the appropriate Rapid Clinical Appraisal Tools, appraise one or two articles and add the information to your Evaluation Table to receive feedback from faculty. At this juncture, your table is a work in progress. You will complete it in Week 4.

You will also turn in the Evaluation Table with two studies appraised (see below) and the Search Tracker for feedback on your search strategies.

After receiving feedback from faculty, add what you have completed this week to Part 1 to begin to build your project proposal paper. Keep this in mind when completing this assignment, using a professional writing style in your narrative

Week 4 assignment 2

Evidence Based Project Proposal

This week you will submit the completed Evaluation Table that includes only your “keeper” studies. This will be added to your final paper as an Appendix. You will also turn in the Search Tracker so faculty can see the steps you took to locate the evidence. This will not become a part of your paper, but it is for feedback only should faculty deem that necessary.

Week 5 assignment 2

Evidence Based Project Proposal

For this week’s Dropbox assignment, you will complete Part 2 of your project proposal, the evidence review and synthesis section. This section consists of narrative descriptions of each study that forms the body of evidence. The length of this section will vary based on the number of studies that you include. The paper should be written in a scholarly fashion using APA format. For each article include in the narrative:

Authors’ names, date of publication (included in the citation).

Quality and level of evidence

How significant (or not) the evidence is and why you think so. How are these articles relevant to change practice or policy for your specific practice site and population? If a study is not significant and you have included it, mention how your clinical expertise was involved in this decision.

Your summary the synthesis section should clearly indicate the intervention you plan to use in your project proposal. You will discuss this in greater detail in the next section, but do leave the reader with the understanding of the intervention you chose.

You will also turn in your completed Synthesis Table(s) that will become part of your Appendix in your final paper.

Week 6 assignment 2

Evidence Based Project Proposal

For your Dropbox assignment this week, you will write Part 3 of your project proposal. In a one- to two-page paper in APA format, include:

Your clinical question

How the clinical question indicates the type of study that will be done (quasi-experimental vs. experimental). Describe the type of study.

Theoretical framework(s) chosen including a rationale for your choice

Week 7 assignment 2

Evidence Based Project Proposal

For your Dropbox assignment this week, you will write Part 4, the Methods section of your project proposal that consists of plans for conducting the study of the intervention and methods of evaluation. Use the titles of each bullet point in your paper.

In a two- to three-page APA formatted paper:

Study design: Briefly describe the study design indicated by the question (experimental, quasi-experimental, descriptive).

Setting/sample: Briefly describe the setting for the study, who your study participants will be, and how these participants will be chosen. Will random sampling or a sample of convenience be used?

Confidentiality: How will you protect the confidentiality of your participants?

Procedures/intervention: Discuss the intervention you will implement and the procedures you will use in enough detail that others could replicate the study.

Instruments/scales and measurement of outcomes: Describe the instruments you will use to measure changes and whether they are quantitative, qualitative, or of a mixed design. If they have been tested previously, include reliability and validity data.

Data collection: Explain plans for data collection including:

Methods of collection, i.e., interviews, paper and pencil testing, etc.

Testing frequency. Will you gather baseline data prior to the intervention? Will you employ repeated measures such as pre- and posttests?

Week 8 assignment 2

Statistical Analysis

For this week’s Dropbox assignment, you will begin to develop Part 5 of your project proposal: Analyzing change. In your discussion, include the following points:

State your clinical question.

Briefly state the intervention you will implement. While these two items are not typically included in Part 5, doing so will help orient faculty so appropriate feedback can be provided.

What outcomes will be analyzed and how they will be analyzed?

Describe the statistical analysis you will do relating this to the data collection tools you plan to use.

Indicate the types of demographic data you plan to report on your participants as well.

Briefly discuss the outcomes expected should this project be implemented.

After receiving feedback from faculty, incorporate the appropriate content into your project proposal.

Week 9 assignment 2

Evidence Based Project Proposal

For your Dropbox assignment, you will write another part of your Methods section (Part 4) that you began in Week 7. In a paragraph or two in APA format include the following:

Identify your stakeholders by job title and how their participation was key to the project.

Briefly discuss potential barriers to project implementation that stakeholders may present. Include strategies to prevent or address these barriers.

After receiving feedback from faculty, incorporate this paragraph into the Methods section of your paper after the “Procedures/intervention” section and before the “Instruments/scales and measurement of outcomes” section.

Week 10 assignment 2

Evidence-Based Project

Overview/Description:

Learners will develop a scholarly project that will demonstrate an application of evidence to practice for a substantive change. This project emphasizes application of evidence-based methodology, scholarly writing, and critical thinking. The scholarly project will be submitted as a written paper in APA format/style. In addition, learners will present a summary of the final project orally and/or with a PowerPoint presentation.

Learners will select one of the following projects related to their specific advanced role specialization that addresses a health promotion and disease prevention of a target population:

Educational program

Evidence-based healthcare policy change

Evidence-based clinical issue or protocol

Criteria for scholarly EBP project proposal

Over the past 11 weeks, students have developed a proposal for an evidence-based project in their area of specialization. This final paper is the culmination of this scholarly activity. All papers must be written using APA format and a professional writing style. The proposal should include the following sections and content.

Abstract

Part 1 – Introduction – Week 2

Introduction

Practice issue

Summarize the practice issue in need of change providing background information about the organization (setting) and the perceived significance and severity of the problem

Describe the specific aims of the project – what improved outcomes do you hope to achieve

PICOT question – State your question in PICOT format, labeling each part with P-I-C-O-T in parentheses

Significance – what is the significance of the issue in terms of poor outcomes, cost, etc.

Part 2 – Evidence review and synthesis – Week 3, 4, & 5

List the names of the databases you searched and if limited to a span of time, i.e., less than 5 years old

Summarize “keeper” studies

Summarize the synthesis of the body of evidence

Part 3 – Purpose of the project – Week 6

Purpose of the project – include intervention

Theoretical framework

Clinical questions

Part 4 – Methods – Week 7

Study design

Setting/sample

Confidentiality

Procedure/intervention

Aligning stakeholders

Instruments/scales and measurement of outcomes

Data collection

Part 5 – Data analysis – Weeks 8 & 9

Outcomes to be analyzed and how they will be analyzed

Outcomes expected (hypothesized)

Appendices

Evaluation Table – turned in Weeks 3 & 4

Synthesis Table – turned in Week 5

Oral and/or PowerPoint Presentation

Students will present a summary of their project using Microsoft PowerPoint.

The presentation for onground campus students will be done orally in a 20-minute presentation

Online campus students will include speaker notes in their PowerPoint slides and will defend their presentation in a discussion board.

Criteria:

Assemble the presentation to present all required criteria sections of the EBP project.

Quality of presentation is professional and provides evidence of graduate level scholarship.