Week 6: EBP Change Process Assignment COMPLETED

Week 6: EBP Change Process

Purpose

The purpose of this assignment is:

· To apply a change process using the ACE Star Model of Knowledge Transformation and a systematic review after identifying a clinical topic of concern and related nursing practice issue.

· The information from the ‘Illustration’ part of our lessons in Weeks 1-6 will mentor you through this process. Your change process is to be set up as a pilot project.

Directions

EBP Change Process (form)

1. Download the EBP Change Process form (Links to an external site.)Links to an external site. during Week 1. (Attached)

2. The use of this specific form is REQUIRED and is due at the end of Week 6.

3. A short tutorial with tips for completing this assignment may be viewed in the short video above.

4. Identify a clinical topic and related nursing practice issue you think needs to be changed.

5. Locate a systematic review on your topic from the Cochrane Database of Systematic Reviews located in the Chamberlain Library. Be sure this involves nursing actions.

6. Work through each step of the ACE Star Model as outlined on the assignment form (Star Points 1-5: Discovery, Summary, Translation, Implementation, and Evaluation). Respond to the instructions provided on the form.

7. Follow the activities and thinking of Nurse Daniel in Weeks 1-6 in the ‘Illustration’ part of each lesson. He will be working through a clinical topic and nursing practice issue to demonstrate a change (ACE Star Model and systematic review).

8. Work on a portion of the process each week, as the illustration unfolds.

9. Please reach out to your instructor for feedback or assistance with your PICOT question as needed.

10. Required and Additional Background Reading in Weeks 1 and 2 under Readings is available for more information on the ACE Star Model and the use of systematic reviews.

11. Please cite any references (in APA format) of your systematic review or other scholarly document (optional) as needed. Paraphrasing information, rather than quoting, is expected. No quotes for this assignment please!

12. For questions about this assignment, please contact your instructor.

13. Use the grading rubric as a final way to check that all components of the form have been completed. The rubric is the tool your instructor will use to assess your content.

Textbooks: 

American Nurses Association. (2015). Nursing: Scope and standards of practice. (3rd ed.). Silver Spring, MD: Author.

Week 6 Assignment: EBP Change Process form

ACE Star Model of Knowledge Transformation

Follow Nurse Daniel as your process mentor in the weekly Illustration section of the lesson. Please do not use any of the Nurse Daniel information for your own topic, nursing intervention, or change project. Nurse Daniel serves as an example only to illustrate the change process.

Name: _____________________

Star Point 1: Discovery (Identify topic and practice issue)

Identify the topic and the nursing practice issue related to this topic. (This MUST involve a nursing practice issue.)

Briefly describe your rationale for your topic selection. Include the scope of the issue/problem.

Star Point 2: Summary (Evidence to support need for a change)

Describe the practice problem in your own words and formulate your PICOT question.

List the systematic review chosen from the CCN Library databases. Type the complete APA reference for the systematic review selected.

List and briefly describe other sources used for data and information. List any other optional scholarly source used as a supplement to the systematic review in APA format.

Briefly summarize the main findings (in your own words) from the systematic review and the strength of the evidence.

Outline one or two evidence-based solutions you will consider for the trial project.

Star Point 3: Translation (Action Plan)

Identify care standards, practice guidelines, or protocols that may be in place to support your intervention planning (These may come from your organization or from the other sources listed in your Summary section in Star Point 2).

List your stakeholders (by title and not names; include yourself) and describe their roles and responsibilities in the change process (no more than 5).

What specifically is your nursing role in the change process? Other nursing roles?

List your stakeholders by position titles (charge nurse, pharmacist, etc.).-Why are the members chosen (stakeholders) important to your project?

What type of cost analysis will be needed prior to a trial? Who needs to be involved with this?

Star Point 4: (Implementation)

Describe the process for gaining permission to plan and begin a trial. Is there a specific group, committee, or nurse leader involved?

Describe the plan for educating the staff about the change process trial and how they will be impacted or asked to participate.

Outline the implementation timeline for the change process (start time/end time, what steps are to occur along the timeline).

List the measurable outcomes based on the PICOT. How will these be measured?

What forms, if any, might be used for recording purposes during the pilot change process. Describe.

What resources are available to staff (include yourself) during the change pilot?

Will there be meetings of certain stakeholders throughout the trial? If so, who and when will they meet?

Star Point 5: (Evaluation)

How will you report the outcomes of the trial?

What would be the next steps for the use of the change process information?

9.2019 Update. DLP

1. Please review the infographic as way to guide you in getting started with your assignment: Developing an Assignment with Integrity (Links to an external site.)
2. View a short tutorial with tips for completing this assignment: Evidence-Based Practice Change Process Assignment Tutorial (Links to an external site.) or by reading the transcript (Links to an external site.).
3. Download the EBP Change Process form (Links to an external site.) during Week 1. The use of this specific form is REQUIRED 
4. Identify a clinical topic and related nursing practice issue you think needs to be changed. 
5. Locate a systematic review on your topic from the CCN Library databases. Be sure this involves nursing actions.
6. Work through each step of the ACE Star Model as outlined on the assignment form (Star Points 1-5: Discovery, Summary, Translation, Implementation, and Evaluation). Respond to the instructions provided on the form.
7. Follow the activities and thinking of Nurse Daniel in Weeks 1-6 in the ‘Illustration’ part of each lesson. He will be working through a clinical topic and nursing practice issue to demonstrate a change (ACE Star Model and systematic review).
8. Work on a portion of the process each week, as the illustration unfolds.

Week 6 Assignment: EBP Change Process form COMPLETED

ACE Star Model of Knowledge Transformation

Follow Nurse Daniel as your process mentor in the weekly Illustration section of the lesson. Please do not use any of Nurse Daniel’s information for your topic, nursing intervention, or change project. Nurse Daniel serves as an example only to illustrate the change process.

Name: _____________________

Star Point 1: Discovery (Identify topic and practice issue)
Identify the topic and the nursing practice matter related to this topic. (This MUST involve a nursing practice issue.)
The Royal Cornwall Hospitals NHS Foundation Trust (RCHT) in South Gloucestershire has commissioned a study targeted at lowering hospital re-admissions through the discharge process for patients over the age of 65 to increase patient safety and reduce readmissions. Hospital Readmission in healthcare affects organizational performance by creating significant barriers in the scope of nurse practice; for example, In a year, up to 28% of COPD patients discharged from the hospital are readmitted, causing relational stress in management and treatments for the subject patient by nurses. Resolutions may be as simple as changing discharge rules to reduce readmissions. The reimbursement reduction to hospitals for excess re-admissions is one component of the pay-for-performance approach (CMS.gov, 2021). Healthcare management should establish efforts and strategies to adapt to this reimbursement change to reduce patient readmissions. According to research, hospitals could save health provision costs per person by implementing evidence-based best practices from institutions with low rates of patient readmissions.
Briefly describe your rationale for your topic selection. Include the scope of the issue/problem.
Patient readmissions in hospitals are presented due to several patient concerns, such as practitioner engagement and administrative regulations on discharge. Therefore, the healthcare organization faces constraints in resource management, financial requirements, and consumer reports due to institute healthcare regimes leading to readmissions. Effective integration of a change management system within an organization that standardizes regulations and quality health care provision among practitioner and administrative sectors will help address patient readmissions.

Star Point 2: Summary (Evidence to support the need for a change)
Describe the practice problem in your own words and formulate your PICOT question.
Hospital re-admissions can be assessed as performance measures in providing quality healthcare services. The issue of hospital Readmission is a dynamic problem affected by various internal organizational factors, such as the prevalence of Chronic Diseases, Poor medical adherence from patients, and administrative regulators from the institution fostering unexpected discharges. The need for change within institutional performances will help assess the effectiveness of standardizing the discharge process for the target population to reduce hospital readmissions.

PICOT QUESTION: In admitted patients over 65 years, how will they benefit from improving the discharge process through intervention mapping compared to other interventions such as reimbursement reduction decrease, the rates of hospital readmission in less than 30 days of admission.

List the systematic review chosen from the CCN Library databases. Type the complete APA reference for the systematic review selected.
Hesselink, G., Zegers, M., Vernooij-Dassen, M., Barach, P., Kalkman, C., Flink, M., Öhlen, G., Olsson, M., Bergenbrant, S., Orrego, C., Suñol, R., Toccafondi, G., Venneri, F., Dudzik-Urbaniak, E., Kutryba, B., Schoonhoven, L., Wollersheim, H., & European HANDOVER Research Collaborative (2014). We are improving patient discharge and reducing hospital readmissions by using Intervention Mapping. BMC health services research, 14, 389. Retrieved from: https://doi.org/10.1186/1472-6963-14-389
List and briefly describe other sources used for data and information. List any other optional scholarly source used to supplement the systematic review in APA format.
McIlvennan, C. K., Eapen, Z. J., & Allen, L. A. (2015). Hospital readmissions reduction program. Circulation, 131(20), 1796–1803. Retrieved from: https://doi.org/10.1161/CIRCULATIONAHA.114.010270
Warchol, S. (2018). Organisational Strategies to Reduce Hospital Readmissions. Walden University and Doctoral Studies Collection: Retrieved from: https://scholarworks.waldenu.edu/cgi/viewcontent.cgi?article=6425&context=dissertations

Briefly summarise the main findings (in your own words) from the systematic review and the strength of the evidence.
Intervention mapping is a helpful tool for assessing and prioritising intervention methods for care providers and policymakers (Hesselink, 2014). The approach assures that patient readmissions are reduced by focusing on the quality-of-care plan discharge information. The study thoroughly examines patient discharge issues and their underlying causes. It provides a theory-based framework and tools to help care professionals choose and implement actions.

Outline one or two evidence-based solutions you will consider for the trial project.
The compared strategic method for addressing the discharge issue in the target population is the reduction of federal reimbursements. Because of high patient readmissions, hospitals are in danger of losing federal funding. The yearly cost of readmission to the US healthcare system is $17.4 billion (Warchol, 2018). The approach encourages hospitals to admit the required number of patients to provide adequate care and improve the population’s health outcomes.

Star Point 3: Translation (Action Plan)
Identify care standards, practice guidelines, or protocols that may be in place to support your intervention planning (These may come from your organization or the other sources listed in your Summary section in Star Point 2).
The guidelines for reducing hospital readmission include assessing administrative data such as the Medicaid readmission protocols and comparing them to Medicare trends to develop action plans for addressing the root concern. The collection of the evidence-based practices for patient readmission reduction strategies in a multifaceted approach will help stakeholders in the trial determine the best approach with minimal limitations to advance effectiveness. Strategic advances will be essential in forming the goals and objectives for effectively reducing readmission rates (AHRQ, 2014). The build-up of evidence-based best practices can be used to improve transitional care within the institution for Medicaid patients. Inter-professional collaboration is also a definitive guideline for the success of the trials. A cross-continuum team involving various stakeholders advances ethical practice in advancing the healthcare delivery system. The final practice guideline in reducing the readmission rates is to ensure a cost-effective strategic trial that can be assessed and funded by external local payers to advance services to targeted populations at risk of readmission.

List your stakeholders (by title and not names; include yourself) and describe their roles and responsibilities in the change process (no more than 5).
Nurse Managers; The managers will be responsible for collecting the admission and discharge data for patients older than 65.
Assistant Nurse Manager will provide Patient-centered care data and discharge recommendations.
The Patient Representative will inform the target population about the scope of intervention practice associated with reducing readmission rates.
What is explicitly your nursing role in the change process? Other nursing roles?
As a discharge nurse, the assessment of Policy regulations to standardize and reduce hospital Readmission determines their validity and ethical factors.
List your stakeholders by position titles (charge nurse, pharmacist, etc.). Why are the members chosen (stakeholders) critical to your project?
All Multidisciplinary Team Members will be involved in the success of the trial process i.e
Pharmacists: They will be responsible for enhancing medical teaching and medication adherence within the target population.
The Nurse Leader will work with the others to provide improvement proposals based on the most recent quantitative reasoning on patient-centered care and self-management.
What type of cost analysis will be needed before a trial? Who needs to be involved with this?
Cost-Benefit Analysis will be essential in determining the benefits of the proposed interventions for trial. The analysis involves tallying expenses associated with interventions and comparing them to the forecasted benefits of implementing the proposed intervention to reduce hospital re-admissions. Stakeholders involved will be nurse managers and the associative physicians, and administrative staff will be assessed on the financial aspects of losses and profit and which best approaches to minimize risk.

Star Point 4: (Implementation)
Describe the process for gaining permission to plan and begin a trial. Is there a specific group, committee, or nurse leader involved?
The Process of obtaining the relevant permission to adopt the trial is important as it enhances the integrity of healthcare practice. The institution executives will be introduced to the associative issue affecting performance and healthcare provision, i.e., high readmission rates for patients above 65 years within 30 days of discharge. Executives should approve a change proposal for modifying organizational processes. The trial participants, i.e. stakeholders and patients, should be well informed on the scope of interventions to ensure a code of conduct is maintained.
Describe the plan for educating the staff about the change process trial and how they will be impacted or asked to participate.
The staff will be requested to engage by attending training, advocating alternative modifications, and proposing intervention strategies. Seminars and associative briefs will be used to engage with staff on strategic interventions for reducing discharge rates in the institution. Their suggestions will be utilized to enhance other areas of practice.

Outline the implementation timeline for the change process (start time/end time, what steps are to occur along the timeline).
Step 1: Obtain Evidence-Based Best Practice Interventions and perform outcome analysis: 10 Days
Step 2: Staff training on best practices to enforce organizational change: 2 months
Step 3: Cost-benefit analysis by nurse managers to identify the rationale for intervention: 2 days
Step 4: The integration of guidelines and protocols involved in implementing the intervention: 2 days
Step 5: Collect and Summarize Associative outcomes for the trial adoption in reducing readmission rates for the target population: 5 days
Step 6: Report on change process to determine the effectiveness and associative gaps for continuous research: 1 day.

List the measurable outcomes based on the PICOT. How will these be measured?
Outcome Measures Associated with discharge and the Readmission Rates.
The study was statistically based, and it utilized and integrated material from other intervention study authors. Data on 30-day readmission rates for chronic disease patients were examined. Throughout the study process, clinical advice and quality-improvement data were identified.

What forms, if any, might be used for recording purposes during the pilot change process. Describe.
The applicable forms for utilization during the pilot stage include Records for patient handovers and sub-optimal hospital discharge documents, Financial and Utilization forms, Organizational Change processes and other EHRs assessing admissions of the target population within the healthcare center.

What resources are available to staff (including yourself) during the change pilot?
The resources available to staff to support the intervention mapping method in addressing readmission issues include government grants to help establish interventions for at-risk patients and associative equipment such as reporting sheets to map discharge rates in adopting interventions.

Will there be meetings of specific stakeholders throughout the trial? If so, who and when will they meet?
Meetings are essential for each stakeholder. i.e., administrative nurses, Nurse managers, and executive representatives to report on the progress of each sequential step of implementing the interventions for the target population. Participants also Report on identified risks and barriers and form solutions that address them and advance the scope of organizational change to meet the intended objectives.

Star Point 5: (Evaluation)
How will you report the outcomes of the trial?
The findings and results will be assessed by the applicable stakeholders who participated in the study to determine the validity and reliability of the data; the report on validity and reliability will be drafted describing outcomes of the trial with gaps in the research included for further research.
What would be the next steps for using the change process information?
The change information derived from the outcomes is applicable in the healthcare organizational process in advancing quality through policy regulations and administrative actions to enhance health outcomes for admitted patients. The study also presents a comprehensive approach to resource management, which will benefit the institution financially and provide quality healthcare to target populations.

References
AHRQ. (2014). Hospital Guide to Reducing Medicaid Re-admissions. Agency for Healthcare Research and Quality. Retrieved from: https://www.ahrq.gov/sites/default/files/publications/files/medreadmissions.pdf
CMS.gov. (2021). Hospital Readmissions Reduction Program (HRRP). Centers for Medicare and Medicaid. Retrieved from: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/Readmissions-Reduction-Program

ADDITIONAL INSTRUCTIONS FOR THE CLASS

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• Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two-sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses.

• Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

• APA Format and Writing Quality

Familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition.

• Use of Direct Quotes

I discourage over-utilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source. Evidence-Based Practice Change Process

• LopesWrite Policy

For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for tips on improving your paper and SI score. Week 6: EBP Change Process

• Late Policy

The university’s policy on late assignments is a 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading. EBP Change Process

• Communication

Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours. Week 6: EBP Change Process

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We will process your orders through multiple stages and checks to ensure that what we are delivering to you, in the end, is something that is precise as you envisioned it. All of our essay writing service products are 100% original, ensuring that there is no plagiarism in them. The sources are well-researched and cited so it is interesting. Our goal is to help as many students as possible with their assignments, i.e. our prices are affordable and services premium.