Presentation of an Evidence-Based Practice Change Narrative Speaker Notes

Presentation of an Evidence-Based Practice Change Narrative Speaker Notes

Slide 2: Hello and welcome to my presentation on Recommending an Evidence-Based Practice Change. In this presentation, I will describe my healthcare organization, including its culture and readiness for change. Secondly, I will describe my current problem including an opportunity for change. Here I will also include a description of the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general. Thirdly, I will propose an evidence-based idea for a change in practice using an EBP approach to decision-making. Fourthly, I will describe my plan for knowledge transfer of this change, including knowledge creation, dissemination, and organizational adoption and implementation. I will explain how I would disseminate the results of my project to an audience. I will also measurable outcomes I hope to achieve with the implementation of this evidence-based change. Lastly, I will reflect on my EBP project so far by providing a summary of the critical appraisal of the peer-reviewed articles I previously submitted and an explanation of what I learned from completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template

Slide 3: my health organization is a health institution that provides both primary and secondary care to residents of a state in the South Eastern United States. It provides both medical and surgical as well as pediatric and psychiatric care to patients. Inpatient and outpatient care is provided in this health organization that has a centralized administrative structure. The usual care for all patients begins at admission where building health history starts with the examination that includes an assessment of pain score. Usually, clinical decisions are made at the team level with various health professionals. The nursing practice in my organization to some extent encourages shared decision making as explained in an article by Kon et al. in 2016. I assessed readiness for change for my organization using the organizational readiness to change assessment (ORCA) as explained in an article by Kononowech et al. in 2021. My evidence for this change came from research studies including both systematic reviews and primary studies. A believe that these studies were valuable as reported by a stuffy by Lund et al. in 2021. My organization embraces evidence-based practice and is also a research center. Nursing administration including our chief nursing officer champions evidence-based practice and sharing in various units. This signifies the organizational capacity to help people change their attitudes, behaviors, skills, and ways of thinking and working according to Newhouse et al. (2007). My project used minimal resources and findings concerning practice assessments.

Slide 4: Management of pain starts with assessment at the first contact of all patients in the health organization. Subjective reporting of pain is the most commonly used method of pain assessment. This happens in many healthcare settings. Among pediatrics and patients in ICU, no universal method of pain assessment. This is true for my healthcare organization. Assessing pain level is important for the objective management of patient pain because pain is a major cause of patient discomfort. This is challenging for nonverbal pediatric patients as well as unconscious patients. Nevertheless, pain management occurs for all patients presenting with pain. This clinical problem offers an opportunity for change to utilize the best evidence-based methods for pain assessment so that pain management can be individualized and objective.

Slide 5: My evidence-based idea for change will endeavor to ensure that care for preverbal and nonverbal patients with pain is assessed and managed through patient-centered care. My evidence-based idea for change involves unifying pain assessment for nonverbal-based receiving care in the organization. Doing so will require that the best methods of pain assessment are used and the staff be sensitized on these methods using information-sharing techniques. Evidence-based change in practice involving pain management would include using collaborative teams for pain assessment, continuous evaluation of pain management methods, and barriers to pain assessment. For preverbal children, the existing tools for pain assessment are useful in pain monitoring but not the initial assessment. More research is required to establish the best method of pain assessment in preverbal patients.

Slide 6: My plan for knowledge transfer will start with knowledge creation. Knowledge creation started with my project but to make the findings more appropriate to my audience, I will use three strategies: message targeting, tailoring, and framing. Framing the message will involve presenting the same message from EBP in a positive manner to gain the attention of the audience. Targeting the message will involve manipulating the EBP findings using charts, graphs, and other visuals to gain the attention of the audience. Message tailoring will involve recreating the key messages in my EBP findings through personalization of the message to a specific audience. To ensure implementation of the knowledge, EBP fading dissemination discussed in the next slide will improve reach, motivation to use the findings, and compliance to apply the EBP findings.

Slide 7: Disseminating my evidence will aim at motivating practitioners to utilize the knowledge to improve care and increase practitioners’ abilities to use and apply the evidence (Brownson et al., 2018). To improve motivation, I will use a champion to influence the utilization of the evidence. The champion, in this case, will be our chief nursing officer who has constantly championed evidence-based practice in the organization. Dissemination strategies to increase abilities will be the use of organization presentations such as the use of PowerPoint presentations during continuous nursing education sessions. Publication of the new evidence in an academic journal will also be utilized. This will provide additional resources to practitioners to their already existing practice knowledge on pain management.

Slide 8: As I mentioned earlier, disseminating my evidence will aim at motivating practitioners to utilize the knowledge to improve care and increase practitioners’ abilities to use and apply the evidence. This application of this evidence is expected to reflect on the nurse satisfaction with pain assessment and care, self-efficacy in objective pain assessment among nurses, behavioral intention by nurses to use and apply evidence on pain assessment, and incidence of pain assessment during every point of care transitions.

Slide 9: Verbal pain assessment is the commonest use pain assessment method. According to Hamdan in 2019, pain assessment in nonverbal and preverbal patients can be easily ignored leading to missed pain assessment. According to Chen et al. in 2019, there are no valid pain assessment scales for preverbal patients. Therefore, existing tools such as FLACC-Revised and Pediatric Pain Profile (PPP) can be used for the observation and monitoring of pain. According to Allen et al. in 2018, An evidence-based practice change should focus on documentation of pain scores for every patient at admission, collaborative teams in pain management, tracking of progress in organization management of pain, and continuously addressing current and emerging barriers in pain assessment and management.

Slide 10: Completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template enabled source evidence from different articles. I learned to systematically analyze methods and key findings,  compare different study samples, describe key study limitations and strengths for appraisal, and appraise the evidence levels of different articles. Systematic reviews provided valuable evidence that related well to my study question.

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References

Allen, E., Williams, A., Jennings, D., Stomski, N., Goucke, R., Toye, C., Slatyer, S., Clarke, T., & McCullough, K. (2018). Revisiting the pain resource nurse role in sustaining evidence-based practice changes for pain assessment and management. Worldviews on Evidence-Based Nursing, 15(5), 368–376. https://doi.org/10.1111/wvn.12318

Brownson, R. C., Eyler, A. A., Harris, J. K., Moore, J. B., & Tabak, R. G. (2018). Getting the word out: New approaches for disseminating public health science: New approaches for disseminating public health science. Journal of Public Health Management and Practice: JPHMP, 24(2), 102–111. https://doi.org/10.1097/phh.0000000000000673

Chan, A. Y., Ge, M., Harrop, E., Johnson, M., Oulton, K., Skene, S. S., Wong, I. C., Jamieson, L., Howard, R. F., & Liossi, C. (2022). Pain assessment tools in pediatric palliative care: A systematic review of psychometric properties and recommendations for clinical practice. Palliative Medicine, 36(1), 30–43. https://doi.org/10.1177/02692163211049309

Hamdan, K. M. (2019). Nurses’ assessment practices of pain among Critically Ill patients. Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses, 20(5), 489–496. https://doi.org/10.1016/j.pmn.2019.04.003

Kon, A. A., Davidson, J. E., Morrison, W., Danis, M., & White, D. B. (2016). Shared decision-making in intensive care units. Executive summary of the American college of critical care medicine and American thoracic society policy statement. American Journal of Respiratory and Critical Care Medicine, 193(12), 1334–1336. https://doi.org/10.1164/rccm.201602-0269ED

Kononowech, J., Hagedorn, H., Hall, C., Helfrich, C. D., Lambert-Kerzner, A. C., Miller, S. C., Sales, A. E., & Damschroder, L. (2021). Mapping the organizational readiness to change assessment to the Consolidated Framework for Implementation Research. Implementation Science Communications, 2(1), 19. https://doi.org/10.1186/s43058-021-00121-0

Lund, H., Juhl, C. B., Nørgaard, B., Draborg, E., Henriksen, M., Andreasen, J., Christensen, R., Nasser, M., Ciliska, D., Clarke, M., Tugwell, P., Martin, J., Blaine, C., Brunnhuber, K., Robinson, K. A., & Evidence-Based Research Network. (2021). Evidence-Based Research Series-Paper 2 : Using an Evidence-Based Research approach before a new study is conducted to ensure value. Journal of Clinical Epidemiology, 129, 158–166. https://doi.org/10.1016/j.jclinepi.2020.07.019

Newhouse, R. P., Dearholt, S., Poe, S., Pugh, L. C., & White, K. M. (2007). Organizational change strategies for evidence-based practice. The Journal of Nursing Administration, 37(12), 552–557. https://doi.org/10.1097/01.NNA.0000302384.91366.8f

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The collection of evidence is an activity that occurs with an endgame in mind. For example, law enforcement professionals collect evidence to support a decision to charge those accused of criminal activity. Similarly, evidence-based healthcare practitioners collect evidence to support decisions in pursuit of specific healthcare outcomes.

In this Assignment, you will identify an issue or opportunity for change within your healthcare organization and propose an idea for a change in practice supported by an EBP approach.

To Prepare:

Reflect on the four peer-reviewed articles you critically appraised in Module 4, related to your clinical topic of interest and PICOT.
Reflect on your current healthcare organization and think about potential opportunities for evidence-based change, using your topic of interest and PICOT as the basis for your reflection.
Consider the best method of disseminating the results of your presentation to an audience.
The Assignment: (Evidence-Based Project)

Part 4: Recommending an Evidence-Based Practice Change

Create an 8- to 9-slide narrated PowerPoint presentation in which you do the following:

Briefly describe your healthcare organization, including its culture and readiness for change. (You may opt to keep various elements of this anonymous, such as your company name.)
Describe the current problem or opportunity for change. Include in this description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general.
Propose an evidence-based idea for a change in practice using an EBP approach to decision making. Note that you may find further research needs to be conducted if sufficient evidence is not discovered.
Describe your plan for knowledge transfer of this change, including knowledge creation, dissemination, and organizational adoption and implementation.
Explain how you would disseminate the results of your project to an audience. Provide a rationale for why you selected this dissemination strategy.
Describe the measurable outcomes you hope to achieve with the implementation of this evidence-based change.
Be sure to provide APA citations of the supporting evidence-based peer reviewed articles you selected to support your thinking.
Add a lessons learned section that includes the following:
A summary of the critical appraisal of the peer-reviewed articles you previously submitted
An explanation about what you learned from completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template (1-3 slides)