nursing outcome

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AdvocatingforChangeAssignment1.docx

Project #3 Advocating for Change (50 points)

PPT

Needs Assessment: Think about a problem you have observed in practice or in clinical rotations. Are the patient or staff satisfaction scores in a certain area low? Does a certain unit have a higher-than-average infection rate? What are some of the possible solutions? Why is it important to evaluate the need for change and not just stick with the “it’s the way we always have done it” mentality?

With this mindset, work with your group of four to select a topic from your pool of previous research to expand upon for this assignment. You may use your evidence-based practice research from Clinical II or your staff presentation project from Clinical III. If you want you can do something very different.

PICO: Form a PICO question that you will use for your change project. Include each element of the PICO question. This format provides guidance as you work. It is an anchor to check that your work/presentation/proposal is remaining on topic.

P

I

C

O

Population or Problem

Intervention or Exposure

Comparison

Outcome

What are the characteristics of the  Population or patient?

What is the  Problem, condition or disease you are interested in?

How do you wish to  Intervene - what do you want to do with this patient – management strategy, treatment, diagnostic test, observation, etc.?

What is the  Comparison or alternative to the intervention - placebo, different drug or therapy, surgery, no intervention, etc.?

What are the possible  Outcomes – positive and negative potential consequences: success, morbidity, death, complications, etc.?

Because this is based on previous research, you should already have an answer to your PICO question. This is merely an exercise is professionally structuring a question that is clearly relevant to your research and presentation. Here is an image I took from the internet: https://libguides.murdoch.edu.au/systematic/PICO. Please note how simple yet specific you can be when creating a PICO question for nursing research. Also, feel free to do a google search of “PICO questions.” You may very well find an example that works better for you and your given topic. I like the one below because it is clean and easy to follow.

Evidence: Based on work you have already done, what does the literature say about the potential to improve outcomes? This can largely be a copy-paste from your earlier work. Show me the research. Please edit the unnecessary components, i.e., do NOT copy/paste the entire EBP paper. Keep it relevant to the needs assessment and PICO. Consider adding to the previous research by adding some additional statistics here. When you advocate for change in your presentation, you need the evidence to back up your position. Note: remember that your references will also need to be copy-pasted at the end.

Intervention(s): Specifically, what do you propose should be done about the issue? What is the best intervention? Of course, this is based on your evidence in the previous section. In this section, add the cost (money, time, other resources) and the benefits (money, time, or other resources saved). Maintain awareness of cultural variations here if it pertains to your intervention.

Strategic Plan: Assess the readiness of the health care facility, organization, staff, etc. to support, learn about, and implement your plan. Use a SMART goals format as a basis for your plan. Remember to include a “who” component in the SMART goals. This is the number one forgotten item in my opinion. Nothing will happen if it’s nobody’s job to make it happen. Here’s a great graphic that explains the SMART structure. Again, there are many great examples to google. In this case, be aware that there is one formula that has “attainable” and “realistic” listed as the A and the R. These seem redundant to me. I like “relevant” because it brings you full circle to your purpose and your PICO. Use the SMART plan you make to flesh out a plan to propose to your audience. Who, what, when, where, and (most importantly) why?

Planning for new objectives? Here is how to create SMART goals

Evaluation: How will you and the person or people funding or otherwise providing for your venture know that it has been successful? What outcome measures will you use? Make a specific and measurable evaluation plan with timelines.

Next Steps: What do you recommend for the facility, department, etc. after the initial evaluation? You may project your assumptions here.

Advocating for Change Presentation

In Person or a Zoom meeting, your group will present your program, quality improvement initiative, or other project for approval. Choose your most appropriate audience and address them in your opening. “Ladies and gentlemen of the board” for example. Choose the person or group most relevant to your project. If you don’t know who that is, look it up. Example: It is inappropriate to ask a CEO or hospital board about enforcing 15-minute breaks on the unit. That audience would be a shift supervisor or floor manager. Find out whose role it would most likely be to hear your initiative.

Then, use the elements of your paper to convince the audience to support your proposed change. Speak extemporaneously, do not read from the paper except perhaps in the case of verifying a specific statistic. Each member of the group should speak for an approximately equal amount of time. Include some visual aids (pie chart, photo of tunneling bedsores, whatever makes an impact) but sprinkle those in rather than relying on them. For the most part, I want to see your faces, not a slideshow. This is about engaging and convincing an audience. Start from the top and work your way down. Keep in mind that your audience has no idea who you are or what you are talking about so lay it all out clearly.

1. Introduce yourselves

2. Illustrate problem and why it’s a problem (needs assessment)

3. State your question (PICO)

4. Discuss your findings (evidence)

5. Propose your idea (intervention)

6. Detail with specifics how it will be implemented (strategic plan/SMART goals)

7. Outline your measurable evaluation criteria with timelines (evaluation)

8. Project future plans (next steps)

9. Thank the audience and wrap it up.

Schedule In-Person Meeting Directions:

You will need to schedule an in-person or zoom meeting with me. You may use my “schedule a meeting”. If you need to schedule a meeting outside of the available timeslots, please send an email and I will work with you if I am able to, give me a couple of times to work for your group, and I will see what I can do. I am not opposed to doing this when you are here on campus with your Clinical group. Do not wait till the last minute to set up a meeting time. You want to get this done in the scheduled time frame.

Hot tips:

People respond to these three things: Facts and figures, higher powers, and personal connections.

Align the values of the organization with your project if possible.

Tell them how it will make or save money.

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