Improving EMS-to-ER Communication: Evaluating the Impact of Standardized Handoff Tools on Information Accuracy

Guidelines for Evidence-Based Practice Project

The purpose of the Evidence Based Practice (EBP) Project is to use the principles and context of EBP, systems thinking, and Interprofessional Education (IPE) as an approach to propose changes in quality and safety in health care based on evidence. Applying systems thinking for quality and safety in nursing, in coordination with clinical facilitators (actively working nurses with a BSN or higher), is utilized through such activities as working directly with input from patients and/or families and interdisciplinary professional peers to improve patient outcomes within systems. Implementing input from patients, families or population of interest, and interprofessional peers is a necessary part of the EBP process. APA 7th edition professional paper formatting required, point deductions if written as a student paper.

Pre-project work:

• Identify a clinical facilitator who has at least a BSN or higher and submit the forms to your professor (see clinical facilitator forms).
• With your clinical facilitator, identify a problem related to quality and safety in the health care facility.
• With your clinical facilitator, identify patients/family population(s) who could provide input on the topic of your EBP project.
• Conduct an interview with patient(s) family, or population and gather input on the problem (see interview with a patient-family-population instructions) (due in Module #4)
• With your clinical facilitator, identify interprofessional personnel (non-nursing) to become part of the change team.
• Conduct and interview with interprofessional personnel (non-nursing) to gain input on the change team. (See interview with interprofessional team member instructions) (due in Module #4)
• Submit your topic in the form of a Problem-Intervention-Comparison-Outcome (PICO) to your professor for approval in Canvas Inbox (see instructions below about how to write a PICO question).
• Determine a title for your project that relates to the topic, DO NOT title your project “Evidence-Based Practice Project”.

The parts of the project include each of the bolded sections below and on the rubric should be identifiable sections within your paper. (See rubric

):

BACKGROUND (50 points)

• Describe your rationale for undertaking this project.
• Include any data available to support the need for the project.
• Include patient/family input on the problem (from your interview)

Describe the current evidence and make recommendations for change/improvement.  You will work with your clinical facilitator, patient/family population, interprofessional team member, and course faculty member to identify a problem and create your PICO question. Prepare the final project report using the following sections and guidelines. This section will require analysis of research to support the issue and need for this project. This may require more resources that are beyond the 5 research articles.

• Quality and safety practice/policy/procedure and outcomes/implications
• Describe your reason for including a professional outside of nursing and
  their potential contribution to the EBP project outcome.

THE QUESTION (10 points)

• Pose an answerable question in PICO format. See this link for details: 

Library LinkLinks to an external site.

THE SEARCH (20 points)

• Describe the search strategy.
• Discuss how potential, relevant research reports were identified.
• What were the inclusion and exclusion criteria?
• How many studies were included in the final appraisal of the
                 evidence?

CRITICALLY APPRAISE THE EVIDENCE (Part A and Part B: 100 points total)

A. Article Analysis Matrix. Perform a literature review of 5 articles. Develop a matrix of the evidence. At least one article should be an international research article and highlight how practice may or may not be similar to the current national practice. 

Use this template for your matrix.

Matrix for part A of Critically Appraise Evidence Example

• Name of author, date, title of study, journal
• Level of Evidence – Evidenced-Based Practice Tool KitLinks to an external site.
• Hypothesis, if there is no hypothesis, the question, if there is no question, the purpose.
• Must be specific.
• Sample: Size of sample, important demographics, inclusion and exclusion
                                  criteria
• Data Collection Instruments/Procedures including reliability and validity.
    (Was it completed or not?)
• Statistical Results/Findings
• Implications/Conclusions related to adoption to practice.

B. Summarize your literature review.

• Make a determination of whether sufficient evidence exists to support either current practice or a need to change the practice. 
• How much variation was there in the outcome(s) studied across the studies/reports?
• What findings are supported by more than one study/ report?
• Note the level of evidence from the various studies/reports and the findings associated with them.
• Of the consistent findings, how many of the studies/reports have a treatment effect that was clinically significant?
• Your conclusions: Is the evidence picture sufficiently complete (i.e., knowledge regarding benefits and risks)
• How does the literature apply or relate to the professional nurse?
• How does the literature support diversity, equity, and inclusion or the healthcare team or the patient population.

PROPOSE A CHANGE IN CLINICAL PRACTICE (50 points)

• Assess the environment for change. Consider:

• The population in your specific setting and patient preferences and values
• Clinical expertise and preferences
• Available resources for implementing the change.

• Create a Change Team. With input from your interview with an interprofessional (non-nurse) team member, discuss who will be part of the team to implement the change and why you have chosen these individuals by answering the questions listed below. Be sure to include the professionals both inside and outside of nursing. Address the following interprofessional education (IPE) competencies. See the Core Competencies for Interprofessional Collaborative Practice at: Core CompetenciesLinks to an external site.
• How would you create a climate of mutual respect and shared values for your team?
• How would you decide upon each of your professional roles and responsibilities to create an effective team?
• How would your team communicate with one another in planning the team project?
• How would you incorporate your leadership skills to support collaborative practice and team effectiveness?

Develop a Change Strategy.  Use the following table to identify 2-3 objectives for the project that you could use to implement the change.  These objectives must be measurable and specific.  In the second column, state the specific methods or plans to meet the objectives.  Specify who will be responsible and the timetable to implement each objective.  In the last column, specifically state measurable outcomes of how you will evaluate whether or not you have successfully met the objective.  (Add additional rows to this chart, if needed). 

DEVELOP AN EVALUATION PLAN TO MEASURE EFFECTIVENESS OF THE CHANGE (20 points)

From the last column of the above table, copy and paste the measurable objectives. Complete the rest of the columns. Add additional rows to this table if necessary.

RESOURCES (10 points)

• Discuss the resources; you need for the first year of the change in practice.
• Project costs of additional supplies, equipment, and personnel as appropriate.
• Project costs savings to the health care facility.
• Use an Excel spreadsheet for this purpose if appropriate.

Diversity, Equity, and Inclusion (10 points)

• Discuss DEI within the proposed clinical change, are there concerns, potential for bias, or steps to increase or improve DEI.

MUST include a CONCLUSION to summarize main ideas (10 points)

• All professional papers need to have a conclusion that highlights the main topics and ideas of the paper and what we want the reader to leave remembering. This is the last section before the reference page.

APA Format (20 points) General APA FormatLinks to an external site. with APA 7^th edition professional paper.

• All papers must be written in APA 7th edition format for a professional paper and NOT a student paper. Significant point deduction if written as a student paper.
• Points will be deducted for grammar, incomplete or lack of in-text citations of paraphrased work, improper page formatting, inaccurate formatting of reference page, or the use of more than one direct quote.
• All sections of the project must be written in your own words and not pulled directly from resources, even if cited as a quote, these sections will not count within the grade for that section of the project. Projects can have up to one direct quote of one sentence or phrase. Significant point deductions for papers with copied and pasted text from other sources or papers. Any section of the paper that is copied from another source will not only receive APA deductions but zero or minimal points for that section of the project.
• All projects will be submitted via Turn It In which compares your project against published works, journals, other student work, etc.—as a source to review for plagiarism. The originality report will be used to consider these factors. Plagiarism is considered academic misconduct and can result in course or program failure. If you have any questions about what is considered plagiarism, please contact your course instructor and also use the APA resources.
• Each bold blue section should be an identifiable header within your paper.

Required Submission to ePortfolio:

Submission of the EBP project, to the ePortfolio, is a requirement for this course. 

Assignments turned in late without prior approval from the instructor will receive a deduction in points as follows:
•    10% for every day late
•    >3 days late = 0 points on assignment