NRS-493 Topic 7 Capstone Change Project Evaluation Plan Assignment
Students must develop skills related to systematic evaluation for intervention effectiveness. The content covered this week prepares students to evaluate the effectiveness of interventions and develop communication plans for the dissemination of information related to project outcomes. Synthesis of information from the process of evaluating outcomes (whether outcomes were met or not) generates new knowledge and adds to the body of knowledge for nursing practice.
- Determine how the capstone project change proposal could be disseminated to leadership.
- Create a plan to evaluate outcomes of the proposed nursing practice intervention used in the change proposal.
- Integrate reflective practice into the practicum reflective journal.
- Demonstrate interprofessional collaboration during the creation of the capstone project change proposal.
NRS-493 Topic 7 Capstone Change Project Evaluation Plan Assignment Tasks
Capstone Change Project Evaluation Plan
Review your strategic plan to implement the change proposal, the objectives, the outcomes, and listed resources. Develop a process to evaluate the intervention if it were implemented. Write a 150-250 word summary of the evaluation plan that will be used to evaluate your intervention.
The assignment will be used to develop a written implementation plan.
APA style is not required, but solid academic writing is expected. You are not required to submit this assignment to LopesWrite.
Professional Capstone And Practicum Reflective Journal
Students are required to submit weekly reflective narratives throughout the course that will culminate in a final, course-long reflective journal due in Topic 10. The narratives help students integrate leadership and inquiry into current practice.
This reflection journal also allows students to outline what they have discovered about their professional practice, personal strengths and weaknesses, and additional resources that could be introduced in a given situation to influence optimal outcomes. Each week students should also explain how they met a course competency or course objective(s).
In each week’s entry, students should reflect on the personal knowledge and skills gained throughout the course. Journal entries should address one or more of the areas stated below. In the Topic 10 graded submission, each of the areas below should be addressed as part of the summary submission.
- New practice approaches
- Interprofessional collaboration
- Health care delivery and clinical systems
- Ethical considerations in health care
- Practices of culturally sensitive care
- Ensuring the integrity of human dignity in the care of all patients
- Population health concerns
- The role of technology in improving health care outcomes
- Health policy
- Leadership and economic models
- Health disparities.
Topic 7 DQ 1
Describe one internal and one external method for the dissemination of your evidence-based change proposal. For example, an internal method may be the hospital board, and an external method may be a professional nursing organization. Discuss why it is important to report your change proposal to both of these groups. How will your communication strategies change for each group?
Topic 7 DQ 2
In order to evaluate an evidence-based practice project, it is important to be able to determine the effectiveness of your change. Discuss one way you will be able to evaluate whether your project made a difference in practice.
Benchmark- Capstone Project Change Proposal Sample
Background of the Change Proposal
Respiratory viruses in contact with contaminated surfaces, and the absence of practical interventions for preventing transmission patterns. Despite the actual and potential ramifications of respiratory virus infections in hospitals, healthcare professionals grapple with the urge to embrace evidence-based practices for preventing viral transmission. For instance, the COVID-19 pandemic exacerbated the situation by increasing healthcare professionals’ susceptibility to respiratory viruses.
The Covid-19 pandemic necessitates implementing a contingency plan for preventing respiratory viruses and other healthcare-associated infections (HCAIs), including ventilator-associated pneumonia. In this sense, hospitals implement various strategies, including hand hygiene, personal protective equipment, staff education, and environmental hygiene. However, these strategies achieve varying effectiveness since they depend on organizational factors such as norms, leadership commitment, and change implementation. Therefore, this paper elaborates on the role of hand hygiene in preventing respiratory viruses in emergency departments and general wards.
Clinical Problem Statement
Undoubtedly, the high prevalence of respiratory viruses in emergency departments and general wards results in detrimental ramifications, including deaths, compromised quality of life for patients and healthcare professionals, lengthy hospitalization, and increased economic burden. According to Chow & Mermel (2017), respiratory viruses in hospital settings spread through direct contact with infected visitors, workers, and patients and indirectly through contact with contaminated fomites. Also, patient-to-patient contact facilitates viral transmission when practical hand hygiene protocols are lacking.
Yu et al. (2018) argue that acute respiratory infections (ARIs) pose a significant global public health problem because of their high morbidity and mortality. With the entry of Covid-19 as a new coronavirus strand, hospitals have grappled with the subsequent problems of overwhelmed emergency departments and general wards, increased workload, and compromised hygiene. As a result, hand hygiene protocols remain a profound, practical, and cost-effective strategy for preventing acute respiratory infections (ARIs) in different healthcare settings due to inconsistencies from other preventive measures.
Purpose of the Change Proposal
This change proposal aims to present evidence-based approaches to implementing hand hygiene guidelines in hospital settings. As stated earlier, health organizations implement various preventive measures, including personal protective equipment (PPE), environmental hygiene, staff education, and hand-rub practices. However, the effectiveness of these interventions relies massively upon the institutional ability to promote behavioral change and sustain new safety interventions.
Regardless of the inconsistent result of different preventive measures, hand hygiene guidelines are now universal for preventing nosocomial infections such as acute respiratory infections (ARIs). Therefore, the change proposal aims to identify motivators and barriers to hand hygiene guidelines and support their plausibility in preventing respiratory viruses in emergency departments and general wards.
While establishing the effectiveness of hand hygiene in preventing respiratory viruses in emergency departments and general wards, it is crucial to develop a culture of clinical inquiry by defining a clinical problem, comparing alternatives, and conceptualizing questions to aid in nursing research. The PICOT format enables researchers to organize ideas by identifying the problem/population (P), defining interventions (I), comparing alternatives (C), stipulating potential outcomes (O), and setting a timeframe for intervention implementation (T). The PICOT question for this change proposal includes the following essentials:
- P: Emergency departments and general wards
- I: Hand hygiene implementation
- C: Other interventions
- O: Preventing respiratory viruses
- T: One month
These essentials narrow down to a statement PICOT question: In the emergency department and general wards (P), does hand hygiene implementation (I), compared to other approaches (C), prevent respiratory viruses (O) within one month of implementation (T)?
Literature Search Strategy
The purpose of developing a PICOT question is to guide nursing research to investigate the effectiveness and applicability of hand hygiene protocols in preventing respiratory viruses. After developing the clinical question, I searched, located, and selected credible sources to answer the question. I accessed reputable internet-based databases such as
PLOS ONE, Springer, PMC, Canadian Journal of Infection Control, JMIR Nursing, and Scholarly Commons (the University of Pennsylvania’s open-access institutional repository). I selected five scholarly sources and articles for review. The search criteria included keywords and subtitles such as hand hygiene and respiratory viruses, hand washing and nosocomial infections, and handwashing effectiveness.
After selecting the potential evidence sources for answering the PICOT question, I applied the CRAAP (Currency, Relevance, Authority, Accuracy, and Purpose) test to appraise the articles. I included sources published within the last five years
(2017-2022). Other measures such as sources’ relevance, authority, accuracy, and purpose revolved around authors’ credibility, the sources’ resonance with the clinical question, and the generalizability of the sources.
Evaluation of Literature
The sources supported the clinical question by establishing the rationale for implementing hand hygiene protocols to prevent respiratory viruses in hospitals. According to Kong et al. (2021), increased healthcare workers’ awareness of nosocomial infections and knowledge of hand hygiene protocols translate to decreased trends in Hospital-associated Infections (HAIs) during the COVID-19 pandemic (p. 383).
A study by Akram et al. (2020) supports this observation by arguing that hand hygiene and low-level disinfection of equipment behaviors among hospital staff are leading cost-effective methods of reducing hospital-acquired infections (HAIs) among patients. Hori et al. (2021) argue that hand hygiene complements other preventive measures, including personal protective equipment (PPE) and regular antibody surveillance.
Equally, a scholarly article by Bello et al. (2020) states that hand wash and alcohol hand-rub preparations effectively prevent HCAIs in intensive care units (ICUs). Finally, Sands & Aunger’s (2020) study states that hand hygiene is the simplest and most effective measure for preventing healthcare-associated infections. However, health organizations should address barriers to effectively implementing hand hygiene, including nurse workload, workplace stressors, ineffective communication, and organizational norms that compromise change implementation.
Applicable Change or Nursing Theory
Since implementing hand hygiene guidelines requires health institutions to challenge the status quo, behavioral issues, and stressors, embracing a reputable change model or theory is essential. According to Sands & Aunger (2020 NRS-493 Topic 7 Capstone Change Project Evaluation Plan Assignment), a behavior-centered design (BCD) can support organizational learning needs and new approaches for preventing HCAIs. In the same breath, it is vital to implement Kotter’s 8-step model when implementing change.
According to Carman et al. (2019), Kotter’s 8-step change model narrows to three tenets; creating a climate for change, engaging and enabling the whole organization to implement change, and sustaining change. It is possible to utilize this theory in promoting hand hygiene protocols by educating employees, encouraging preventive behaviors, and transforming organizational culture to accommodate safer procedures.
Proposed Implementation and Outcome Measures
The proposed change proposal targets establishing the effectiveness of hand hygiene guidelines after a month of implementation. The prerequisite activities for implementing the proposal include staff education, behavior monitoring, promoting preventive behaviors through creating awareness and availing necessary resources, including sanitizers. The outcome measures for the project include reducing mortality and morbidity of respiratory viruses among patients and healthcare professionals, bolstering employees’ knowledge of handwashing essential, including the six steps of handwashing as proposed by the World Health Organization (WHO), reduced readmissions for patients with respiratory viruses and shorted hospitalization.
Evidence-based Practice in Intervention Plan
The rationale for developing this change proposal obtains backing from evidence-based practice and insights from scholarly literature. It is essential to note that many scholarly studies support the plausibility of implementing hand hygiene protocols in preventing respiratory viruses and other nosocomial infections. According to Andriani & Nadjib (2018), hand hygiene is still the most profound way of reducing HCAIs since it entails washing hands with anti-bacterial and non-anti-bacterial soaps and alcohol-based sanitizers. Despite the simplicity and effectiveness of hand hygiene, employees’ compliance with these guidelines is relatively low. As a result, it is essential to address barriers by implementing and sustaining change. Eventually, the prevailing disparities in compliance with hand hygiene protocols validate the rationale of this change proposal.
Plan for Evaluation
Within one month of implementing hand hygiene protocols in emergency departments and general wards, it will be essential for the project implementation team to emphasize progress-focused and summative evaluations to assess the level of compliance and behavioral transformation. Progress-focused evaluations are frequent assessments (often weekly) that identify areas of improvement, employees’ opinions and views, and alignment of the project with set objectives. On the other hand, a summative evaluation will reveal the project’s impact on set outcome measures, including reducing HCAIs mortality and morbidity rates, employees’ familiarity with hand hygiene protocols, and behavioral modification to sustain change.
Barriers and Solutions to Implementation Challenges
As stated earlier, health organizations need help implementing hand hygiene despite its simplicity and effectiveness in preventing respiratory viruses in healthcare settings. Sands & Aunger (2020) identify organizational norms, nurses’ cognitive workload, ineffective communication, stress, and busyness as barriers to effectively implementing hand hygiene guidelines. While hospitals grapple with increased workload and overwhelmed units because of the Covid-19 pandemic, it is possible to address barriers to the practical implementation of hand hygiene by educating healthcare professionals, enhancing communication openness, modifying behaviors, enhancing communication, setting objectives, and increasing interactions between healthcare professionals.
Respiratory viruses are a class of healthcare-associated infections (HCAIs) that result in mortalities, lengthy hospitalization, increased care costs, and compromised quality of life (QoL). Although hand hygiene protocols present a simple and effective way of preventing HCAIs, organizational factors such as inconsistent behaviors, norms, increased workload, busyness, and workplace stressors affect its implementation.
Therefore, this change proposal elaborates on evidence-based practices for promoting hand hygiene protocols and expounds on insights from the current literature. Also, the proposal presents an ideal change implementation and management theory that focuses on transforming behaviors and sustaining safer approaches.
- Akram, H., Andrews-Paul, A., & Washburn, R. (2020). Assessing hand hygiene and low-level disinfection of equipment compliance in an acute care setting: Mixed Methods Approach. JMIR Nursing, 3(1). https://doi.org/10.2196/18788
- Andriani, Y., & Nadjib, M. (2018). The importance of hand hygiene practice implementation in reducing healthcare-associated infections: A systematic review. KnE Life Sciences, 4(9), 135. https://doi.org/10.18502/kls.v4i9.3565
- Bello, S., Bamgboye, E. A., Ajayi, D. T., Ossai, E. N., Aniwada, E. C., Salawu, M. M., & Fawole, O. I. (2020). Hand Wash versus hand-rub practices for preventing nosocomial infection in hospital intensive care units: A systematic review and meta-analysis. Canadian Journal of Infection Control, 82–90. https://doi.org/10.36584/cjic.2020.009
- Carman, A. L., Vanderpool, R. C., Stradtman, L. R., & Edmiston, E. A. (2019). A change-management approach to closing care gaps in a federally qualified Health Center: A rural Kentucky case study. Preventing Chronic Disease, 16. https://doi.org/10.5888/pcd16.180589
- Chow, E. J., & Mermel, L. A. (2017). Hospital-acquired respiratory viral infections: Incidence, morbidity, and mortality in pediatric and adult patients. Open Forum Infectious Diseases, 4(1). https://doi.org/10.1093/ofid/ofx006
- Hori, H., Fukuchi, T., Sanui, M., Moriya, T., & Sugawara, H. (2021). Comprehensive infection control measures prevent hospital-acquired severe acute respiratory syndrome coronavirus 2 infections: A single-center prospective Cohort Study and seroprevalence survey. PLOS ONE, 16(10). https://doi.org/10.1371/journal.pone.0257513