NURS 6052 Wk 10 Assignment: EBP Part 4: Recommending an Evidence-Based Practice Change

NURS 6052 Wk 10 Assignment: EBP Part 4: Recommending an Evidence-Based Practice Change

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Assignment: Evidence-Based Project, Part 4: Recommending an Evidence-Based Practice Change SAMPLE 1

Introduction and Purpose of the Presentation

vEvidence-based practice focuses on offering solutions to

vEBP integrates patient preferences, clinician’s expertise and experience, best evidence from research to offer quality care

vHospital acquired infection control is essential in health care settings

vHandwashing remains the most effective way to reduce HAIs

Nurses and organizations leverage evidence-based practice interventions to generate solution to that impact quality care delivery and better patient outcomes. Evidence-based practice (EBP) entails the integration of patient preferences, clinician’s expertise and experience, and best as well as current evidence from research to offer quality care interventions. Hospital acquired infections (HAIs) remain one of the adverse events that impacts patient care and requires stakeholders to generate better solutions (Melnyk & Fineout-Overholt, 2018). Handwashing and hand hygiene using hand rubs is considered one of the most appropriate approaches to addressing hospital acquired infections (HAIs). The purpose of this presentation is to recommend handwashing among providers like nurses and physicians as the first line of preventing and reducing the prevalence of HAIs in practice environment in our organization.

Organization’s Description, Culture & Readiness for Change

vA health system with different departments and specialties; including inpatient facilities

vOperates 24-hour with multiple facilities for different patient needs

vProfessional Magnet care provider that values continuous organizational development

vDynamic culture that values change and Innovation, Creativity

My organization is part of a national health system with different departments and care facilities across the country. These departments have inpatient and outpatient facilities for various disease conditions. The facility has critical care unit with intensive care unit (ICU) and high dependence unit (HDU). The health care system operate 24 hours to offer care diverse patient needs, including those with chronic conditions like diabetes and hypertension. The organization a professional Magnet care provider and focuses on continuous change and development. The dynamic learning organizational culture ensures that providers leverage EBP interventions to bring innovation and creativity for better patient outcomes.

Employees in the organization consider change as critical as it leads to better care delivery (Dearing, 2018). The culture embraces new ideas, learning, research, and sharing of novel concepts among all stakeholders using a collaborative approach. The facility demonstrates its commitment to change  and implementation of novel ideas to expand knowledge base, expertise and learning. Our core values are respect and dignity of diversity, teamwork and collaboration and effective communication to develop trust and reliability. Implementing change will allow the entity to offer quality care and improve patient outcomes.

Current Issue or Opportunity for Change

vHospital acquired infections prevalence and Effects

vNeed for Patient Safety and Quality Care

vTypes of hospital associated infections (Nosocomial Infections)

vHandwashing using soap and Water

vHand Hygiene using alcohol-based rubs

Hospital acquired infection or nosocomial infections are a huge issue in healthcare because of their effects on patient safety and quality of care. Hospital acquired infections (HAIs) lead to adverse impacts like increased lengths of stay at a facility, rise in cost of care, poor quality of care, increased morbidity and even mortality. The use of handwashing remains the primary and most effective strategy to prevent and reduce the prevalence of hospital associated infections. Studies have also demonstrated the efficacy of alcohol-based hand rubs and sanitizers but overwhelming evidence suggests that effective implementation of handwashing using water and soap offers the best approach to controlling and preventing the occurrence of infections in hospitals (Kakkar et al., 2018).

The opportunity for change in this case is using hand hygiene measures that include handwashing with soap and water as well as alcohol-based hand rubs to reduce and prevent infections in all areas of care provision in the facility. The implementation of this EBP is supported by more evidence from different studies as illustrated during the review of associated literature and analysis of their support for the project.

Scope of the Issue, stakeholders & change implementation Risks

vHAIs as a major issue in Health Care Settings and Impacts Quality Care Deliver

vStakeholders  impacted are Patients & Nurses, Health Care Resources

vChange Implementation Risks include resistance to new initiatives

vLimited Resources and organizational support

Hospital associated infections (HAIs) are the second most prevalent cause of death for patients. Health care workers like nurses and physicians transmit infections due to poor hand hygiene measures and intervention (Kakkar, et al., 2018). Studies and statistics from various sources in healthcare, including the World Health Organization and the Centers for Diseases Control and Prevention (CDC) show that HAIs account for 7% of all infections in healthcare. The involved stakeholders to the issue of using handwashing to reduce and prevent HAIs include patients and their families that stay for longer in healthcare facilities and use more resources, nurses and physicians as healthcare providers, and organizations in healthcare that have to use more limited resources to mitigate their effects (Halm & Sandau, 2018). The risks associated with change implementation in any organization include possible resistance, limited resources, and lack of support from the organization’s management and leadership.

Proposed EBP Change Idea Using EBP Approach

vEBP Model incorporates evidence, data and clinical expertise & Patient Preferences

vDevelopment of Solutions to Patient & Healthcare Problems

vRequires application of critical Thinking and professional Expertise

vValues and Concerns by Stakeholders

The deployment of EBP approach requires stakeholders to leverage current evidence attained through the formulation of PICOT question to generate solutions. EBP implementation mandates the integration of clinical expertise, patient values and preferences to make better decisions and deploy effective interventions. Therefore, EBP focuses on provision of tenable solutions that can be implemented based on available resources. These decisions should be based on critically analyzed evidence from existing literature and studies to inform better choices (Melnyk & Fineout-Overholt, 2018).  The evidence implementation should also leverage existing organizational resources and expertise .The implication is that EBP framework requires stakeholders to incorporate organizational and patient preferences and values that will enhance overall effective outcomes to achieve set goals

Proposed Idea for Change

vHand hygiene measures among health care providers in the facility in all departments

vPatient education on the significance of hand hygiene once in the facility

vIncreased awareness and provision of sufficient information to patients and their families

vDevelopment of an organizational policy on Hand Hygiene

vInstallation of hand hygiene at strategic points in the facility

Hand hygiene measure among health care providers are an effective way of reducing and preventing the prevalence of hospital acquired infections. The appraised research articles based on their levels of evidence show that handwashing with soap and water as well as use of alcohol-based hand runs are effective approaches to reducing infections. The evidence from other organizations like Centers for Disease Control and Prevention (CDC) as well as the World Health Organization (WHO) underscore the significant role of hand hygiene measures in addressing the issue of HAIs. The proposed idea for change in this case entails implementation of a bundle of measures aimed at increasing the use of hand hygiene activities in the facility (Halm & Sandau, 2018). These include patient education on the importance of hand hygiene once in the facility, increasing awareness and providing information to patients and their families on maintenance of hand hygiene and development of an organizational policy on hand hygiene. The proposed change also entails installation of hand hygiene points at strategic places within the facility to encourage and ensure compliance.

Change is necessary in the healthcare systems. With the advancement in the operational processes, there is always the need to adjust some of the approaches used in the healthcare. Most organizations often implement changes to ensure efficiency in the healthcare processes and also to increase revenues. With

NURS 6052 Assignment Evidence-Based Project Part 4 Recommending an Evidence-Based Practice Change

the increased demands of quality in the healthcare delivery, most healthcare institutions are always involved in the continuous change processes to ensure that they meet the ever increasing demands from the clients. Given that healthcare institutions are faced with different challenges that need to be addressed, there is always the need to initiate change processes to address such challenges/problems (Arditi, Nayak, & Damci, 2017). Different healthcare institutions are associated with different issues that either require changes in people’s behaviors or the processes or approaches in the healthcare system. Some of the challenges may include medication errors, workplace conflicts, inadequate care delivery, high costs of healthcare services, and low nurse to patient ratios. These challenges/issues often require the implementation of appropriate changes in the service delivery to ensure effective operational processes. The purpose of this paper is to examine an issue that may lead to the implementation of change processes in the healthcare system.

Executive Summary of the Issue Impacting Organization/Workplace

Workplace conflict is a major issue in my organization/workplace. Conflicts between employees and management frequently have an impact on effective operational processes. Typically, workplaces with numerous issues experience service delivery delays. Furthermore, the quality of service delivery may suffer. People are unable to reach an agreement on a variety of issues affecting healthcare processes as workplace conflicts increase. Workplaces with ongoing conflicts frequently necessitate constant changes to ensure that operational processes improve overall. Conflicts in the workplace can be caused by poor communication, a lack of common understanding among employees, and a lack of respect between employees and management. Isolation, misunderstandings, and passive aggressive behavior.

Description of the Change Being Proposed: NURS 6052 Wk 10 Assignment: EBP Part 4: Recommending an Evidence-Based Practice Change

Organizational culture and policy changes are critical for resolving workplace conflicts. One of the most effective ways to reduce workplace conflicts is to change an organization’s culture. However, it is one of the most difficult management processes because there is always the need to change employees’ mindsets as well as their behaviors. Furthermore, an organization’s culture is frequently made up of a web of interconnected roles, goals, values, processes, attitudes, communication policies, and assumptions. Changing an organization’s culture is frequently a large-scale undertaking requiring the coordination of multiple resources. For example, the organizational tools required to persuade people to change their minds must be put in place.

Changing an organizational culture entails addressing communication processes and improving people’s behaviors. In other words, the proposed change, which is a cultural transformation, will address the issues that frequently lead to conflicts. For example, the transformation process will foster mutual respect and effective communication. Changes in organizational culture may also foster a collaborative environment. Most workplaces where people interact and work together have fewer conflicts. Changes in organizational culture may result in stronger employee relationships, which may lead to fewer conflicts. Changing an organizational culture may result in changes to policies, objectives, mission, and vision, particularly if these factors are linked to cultural practices.

Justification for the Change: NURS 6052 Wk 10 Assignment: EBP Part 4: Recommending an Evidence-Based Practice Change

Addressing cultural change in the organization/workplace will have a significant impact. Cultural change will result in the creation of a positive environment for all stakeholders, which will result in improved service delivery and overall patient outcomes. Organizational culture frequently has a significant impact on people’s behaviors as well as interaction processes. As a result, whenever there is a need to resolve workplace conflict, culture must be transformed. Furthermore, organizational culture frequently determines people’s values, principles, and ethical behaviors. As a result, transforming it would imply an improvement in individual values, ethical behaviors, and the development of positive principles that are required in conflict resolution.

Type and Scope of the Proposed Change

Making changes to the organizational culture should incorporate making adjustments to the standards of behaviors of the people. Also, the whole process involves changes in the values and principles that people ought to adhere to. In other words, cultural change should incorporate changes in the workplace values, policies, skill, practices, attire, language, expectations, aesthetics, and tools. Cultural change should involves overall changes in behaviors. In other words, the organizational culture change should incorporate a shift in behaviors and in the ways things are supposed to be done as well as how employees are expected to behave under different circumstances (Slack & Singh, 2018). The cultural change should also involve the transformation of policies relating to human resource activities.

Stakeholders Impacted By the Change and the Identification

 Of The Change Management Team: NURS 6052 Wk 10 Assignment: EBP Part 4: Recommending an Evidence-Based Practice Change

Some of the stakeholders that will be impacted by the cultural change include employees and the management. In the process of change, employees will be required to transform their behaviours, which may go contrary to the normal behaviors of a person. Also, adjusting to the set standards of behaviors may become very difficult for some people. Given that the management often relates directly to the employees, they may also be impacted by the cultural change (Pitafi, Liu, & Cai, 2018). Other stakeholders that may be impacted by the change include clients/patients that often get engaged directly with the organizational employees.

The change management team will involve the management. For instance, human resource managers will be among the change management team. Also, the chief executive officer, lower level managers, nurse leaders, and some employees, especially nurses, will be part of the change management team. The above professionals understand what it takes to transform the organizational culture.

Plan for Communicating the Proposed Change

There is always the need to communicate proposed changes to ensure that everyone understand the procedures and processes required is necessary. Selecting credible leaders to communicate the change process is necessary in ensuring that every aspect of the change process is well understood and addressed by the stakeholder involved in the whole process. Keeping communication all the way to the end of the whole process is necessary in ensuring that all the stakeholders become aware of the change process (Currie et al., 2017). Delivering accurate messages to the people and ensuring that everyone captures the information being communicated is important. While communicating the processes of change, there is the need to ensure that all the messages delivered are consistent to the end.


Change is necessary in the healthcare systems. With the advancement in the operational processes, there is always the need to adjust some of the approaches used in the healthcare processes. Transforming cultural practices is necessary in ensuring that there are improvements in the quality services delivery and that clients can enjoy effective services offered. Addressing the cultural change will have significant impact in the organization/workplace. Cultural change will lead to the creating of a positive environment for all the stakeholders, this will lead to the quality in service delivery and the general patient outcomes.

Arditi, D., Nayak, S., & Damci, A. (2017). Effect of organizational culture on delay in construction. International journal of project management35(2), 136-147.

Currie, D., Gormley, T., Roche, B., & Teague, P. (2017). The management of workplace conflict: Contrasting pathways in the HRM literature. International Journal of Management Reviews, 19(4), 492-509.

Pitafi, A. H., Liu, H., & Cai, Z. (2018). Investigating the relationship between workplace conflict and employee agility: The role of enterprise social media. Telematics and Informatics, 35(8), 2157-2172.

Slack, N. J., & Singh, G. (2018). Diagnosis of organizational culture in public sector undertakings undergoing reforms. Public Organization Review18(3), 361-380.:


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