Among healthcare workers in acute care settings (or hospitals) (P ), does using alcohol-based hand sanitizer (I), compared to hand washing using soap and water (C ) decrease the rate of healthcare- associated infections (HAI)(O)?  That is my pico question the final template need to be fill out.

The requirement for this course is only for one (1) research article/evidence; choose the BEST evidence to use. You may submit up to 2 if necessary.

I sent you the PDF i do not know how many pages will be at the end I will pay for 2 if you need more please let me know and I will pay extra

EBP Project-Solution

Evidence-Based Practice Project Proposal – Part D: Implementation Plan

The Iowa Model

The Iowa Model provides an implementation framework for clinical and administrative evidence-based interventions. The framework effectively institutes measures that improve patient outcomes, enhance nursing practice and monitor healthcare costs. The model provides a pragmatic multiphase change process containing feedback loops that facilitate better adoption of evidence in clinical practice (Titler et al., 2015). The Iowa Model borrows from Rogers’ Diffusion of Innovation theory, implementation application science, emphasizing the use of pilot testing before full-scale change implementation (Tucker et al., 2021). It is appropriate for its ease of use and applicability in interprofessional healthcare teams, making it suitable for implementing the proposed intervention. (EBP Project Essay Example)

Application of Model

The key phases of the Iowa Model are (Hanrahan, Fowler, & McCarthy, 2019):

1. Identify triggering issues/opportunities
2. State the question or purpose
3. Form a team
4. Assemble, appraise, and synthesize body of evidence
5. Design and pilot the practice change
6. Integrate and sustain the practice change
7. Disseminate results

Identify Triggering Issues/Opportunities

In this phase, clinicians identify questions or issues as opportunities to improve practice and healthcare. The selected issue is based on current practice. The problem can be identified from existing data or scientific knowledge (Titler et al., 2015). The problem identified for the proposed project is a deficient nursing skill mix associated with adverse patient events, as evidenced by changes in rapid responses and code blues. The clinically relevant question is how a staffing model based on a nursing skill mix can help optimize patient outcomes, as evidenced by decreased rapid responses and code blues.(EBP Project Essay Example)

State the Question or Purpose

This stage entails explicitly including a well-stated purpose as effective implementation depends on a clear purpose (Bonds, 2018). Key elements to include in the purpose statement are the clinical problem, population, pilot area, intervention, comparison, and desired outcomes (Titler et al., 2015). A clear purpose guides the team to successful project completion and prevents it from drifting off target. The statement of purpose of the PICOT question for the proposed project is:

For nurses working in a medical-surgical unit, will an appropriate staffing model based on skill mix help decrease adverse patient outcomes as evidenced by changes in rapid responses and code blues over six months?(EBP Project Essay Example)

Form a Team

A team is formed to develop, execute, and evaluate the practice change after committing to addressing the identified practice problem (Titler et al., 2015). The team will be composed of stakeholders, including all nurses, unit managers, interprofessional colleagues, representatives of shared governance committees, organizational leaders, education institutions, nurses certifying bodies, and regulators. Bonds (2018) notes that the implementation team’s development should be based on considerations to maximize team members’ influence, knowledge, skills, and organizational linkages.

Assemble, Appraise, and Synthesize Body of Evidence

The developed team selects reviews, critiques, and synthesizes all available evidence (Titler et al., 2015). The team will collaborate with the nurse librarian to access all relevant documents to be used to assemble evidence. The librarian will help maximize yield from online bibliographic databases and other library resources. The team will way and appraise all evidence, identifying the strength of the recommendation and the potential benefits. The team will also determine whether the evidence is sufficient to address the practice problem.(EBP Project Essay Example)

Design and Pilot the Practice Change

This phase is critical in the EBP process to identify issues before implementing the intervention in the larger organization or scaling up. When designing and piloting the practice change, stakeholders, especially those affected directly by the project, will be involved comprehensively to help identify additional requirements and the effectiveness of the intervention in achieving the desired outcomes (Iowa Model Collaborative et al., 2017). Piloting will help determine if the change is appropriate for practice.(EBP Project Essay Example)

Integrate and Sustain the Practice Change

After successful piloting, and when the desired outcomes are achieved, the stakeholders will be engaged to facilitate the integration of the practice change. Local champions, opinion leaders, senior leadership support, and educators will help promote sustainability and continuous outcome monitoring (Klingbeil & Gibson, 2018). The practice change requires ongoing assessment with collected information incorporated into quality and performance improvement programs to promote integration into daily practice. The process of implementation will include:(EBP Project Essay Example)

1. Creating awareness and interest
2. Building knowledge and commitment
3. Promoting action and adoption
4. Pursuing integration and sustained use

Disseminate Results

Information or findings sharing and distribution is crucial for professional learning. The project outcomes will be shared within and outside the practice area using professional presentations and publications to support EBP culture, expand knowledge, and encourage practice change in other units and organizations.

Part B

Practice Setting

The practice setting is a medical-surgical unit in a Los Angeles county hospital. Nurses are part of the interprofessional team working in the unit, and various nurse specialties are also available. Nurses in the unit provide care for patients using the nursing process of assessment, planning, intervention, implementation, and evaluation. The nurses collaborate with other professionals to promote effective care delivery to achieve the desired patient outcomes. They also coordinate with medical professionals to administer medication and educate patients regarding surgical procedures. Generally, roles include:

1. Assessing, planning, and executing care plans
2. Evaluating medical information
3. Preparing, administering, and recording prescribed medication, changing dressings, starting IVs, and inserting catheters
4. Collaborating on discharge planning with other team members
5. Answering questions and educating clients and families on surgical procedures and post-surgical care.
6. Maintaining and updating patient files, medical charts, and health records.
7. Adopting best practices, standards, and protocols.

 Approval Needed

The project needs approval from the nurse lead, the Quality Improvement Initiative Project manager, and the project manager to ensure the project meets standards and guidelines for qualifying QI initiatives and meaningful participation in qualifying quality improvement or performance improvement initiatives. The project should also be approved by the nurses, QI professionals, and the advisory board.

Affected Stakeholders

The project proposes a staffing model based on the nursing skill mix. The project setting is a medical-surgical unit that includes various professionals who will be affected by changes in staffing. Nurses will be affected the most. Physicians and other professionals working in teams with affected nurses will also be affected. Other affected stakeholders include the administration/management, the HR department, certifying bodies, educators, and patients working with the affected nurses. The project plan will be communicated through presentations, project summary reports, group video calls, informal stakeholder communications, emails, and newsletters.

Project Timeline

The project will take three months to complete, through May, June, and July.

Financial Feasibility

The project costs are estimated to be between $50,000 and $90,000. The initial project cost was $85,000, which can be more or less depending on uncertainties or issues like additional requirements midway.

Cost of Personnel

Personnel costs will include wages, salaries, benefits, and hiring and consulting costs. The personnel cost will be approximately $35,000.

Consumable Supplies

Consumer items include batteries, computer cables, calculators, envelopes, whiteboard markers, printer paper, and food supplies. Consumables will cost approximately $10,000-15,000.

Equipment Costs

Most equipments are available at the hospital. The equipment needed is available in the medical-surgical unit. The equipment will be used to determine the competency of nurses working in the unit.

Computer-Related Costs

They include a librarian consultation fee, a database access subscription, and internet purchase. Computer-related costs are projected to be around $10,000

Presentation Development

Presentation development costs are associated with the amount paid to professional presentation developers to ensure the presentation is as convincing and aesthetic as possible. Presentation developer will be paid around $1,500-$4,000.

Travel costs

Travel costs include meeting external stakeholders or performing other project-related tasks. The costs are estimated to be $3,000.

References

Bonds, R. L. (2018). SBAR tool implementation to advance communication, teamwork, and the perception of patient safety culture. Creative Nursing, 24(2), 116-123.

Hanrahan, K., Fowler, C., & McCarthy, A. M. (2019). Iowa model revised: Research and evidence-based practice application. Journal of pediatric nursing, 48, 121-122.

Iowa Model Collaborative, Buckwalter, K. C., Cullen, L., Hanrahan, K., Kleiber, C., McCarthy, A. M., … & Authored on behalf of the Iowa Model Collaborative. (2017). Iowa model of evidence‐based practice: Revisions and validation. Worldviews on Evidence‐Based Nursing, 14(3), 175-182.

Klingbeil, C., & Gibson, C. (2018). The teach-back project: a system-wide evidence-based practice implementation. Journal of Pediatric Nursing, 42, 81-85.

Titler, M. G., Kleiber, C., Steelman, V. J., Rakel, B. A., Budreau, G., Everett, L. Q., & Goode, C. J. (2015). The Iowa Model Revised: Evidence-Based Practice to promote Excellence in Healthcare.

Tucker, S., McNett, M., Mazurek Melnyk, B., Hanrahan, K., Hunter, S. C., Kim, B., … & Kitson, A. (2021). Implementation Science: Application of Evidence‐Based Practice Models to Improve Healthcare Quality. Worldviews on Evidence‐Based Nursing, 18(2), 76-84.