Assignment: Evidence-based Practice Project Essay

Assignment: Evidence-based Practice Project Essay
A Sample Answer For the Assignment: Assignment: Evidence-based Practice Project Essay
Title:  Assignment: Evidence-based Practice Project Essay

Oncology nurses play a critical role in providing care to cancer patients to promote their health and wellbeing. The nature  of care that they provide predisposes them to burnout and burnout syndrome. Burnout is associated with adverse health outcomes such as decline in productivity, dissatisfaction with jobs, and increased rate of staff turnover. Therefore, this project is a proposal about the use of mindfulness-based practice in addressing the issue of burnout among the oncology nurses. Organizational culture assessment performed showed that the hospital is ready to embrace the proposed intervention. A review of existing literature revealed that the use of the intervention is highly effective in reducing the risk of burnout among oncology nurses. It is expected the intervention will result in outcomes that include reduction in costs of healthcare, improvement in the overall quality of care, improvement in satisfaction of the oncology nurses with their jobs, and decline in staff turnover rates. The intervention will be administered to oncology nurses who will be selected and placed to treatment groups based on the developed inclusion and exclusion criteria. The intervention will be administered for a period of ten months upon which data will be obtained from them for use in determination of its effectiveness.  Successful implementation of the project will be guided by Duck’s Change Curve Model, which will facilitate the management of potential barriers to the project. The project will be evaluated on metrics that include operational costs in the organization, staff turnover rates, and perceived changes in the quality of care with the use of the intervention.

Healthcare organizations adopt evidence-based practices to optimizing patient outcomes and provide quality, patient-centered care (Schaefer & Welton, 2018). Effective adoption of EBP is achieved when an organization is ready and can identify barriers and facilitators that may affect the implementation process. To help in implementing the current project, a readiness assessment was executed at The Optimal Health Center using the “Organization Culture & Readiness for System-Wide Integration of Evidence-based Practice Survey.” The assessment revealed that TOHC was ready to implement new EBP.

Project Barriers and Facilitators

Time limitation was a major barrier to implementation. Staff reported a heavy workload, which left them with no time to review new evidence. Time constraints resulted in limited experience in implementing EBP. Facilitators observed was on-site providers who are ready to champion EBP regardless of the time constraints faced (Schaefer & Welton, 2018). The management also reported that they would create an adequate system for personal and professional development.

The assessment tool had nineteen categories, and TOHC performed well in five of them. The high scores are linked to the management and providers’ commitment to using EBP (Egeland, Ruud, Ogden, Lindstrøm & Heiervang, 2016). The staff pointed out that EBP improved patient care and were visiting online databases to learn more about best practice guidelines. Survey also revealed that the center was tracking patient outcomes to evaluate if patients are receiving adequate care. The management has rolled out a clinical trial where diabetic patients are educated and offered removable subcutaneous meters. The device monitors patient sugar levels, and the data collected will be used to enhance diabetic care within the center.

The center performed poorly in seven categories, with the major contributor being lack of a tuition reimbursement program to help employees further their education (Egeland, Ruud, Ogden, Lindstrøm & Heiervang, 2016). TOHC also did not have a librarian to educate or guide staff on EBP matters.

Integration of Clinical Inquiry

To enhance integration, providers will be trained on EBP to improve their confidence and motivation. The training will help them outline areas that require improvement (Egeland, Ruud, Ogden, Lindstrøm & Heiervang, 2016). Research will then be executed on the identified weak areas and possible solutions tabled for approval. Policy to guide on implementation will then be created to help in adopting the approved solutions.

Assignment: Evidence-based Practice Project Essay Conclusion

Nurses need to assess the readiness of their organizations to embrace evidence-based practice. They need to examine the availability and adequacy of the resources that would be needed for the success of the process. They also need to ensure that the organizational culture supports the use of evidence-based practice. Therefore, I believe that my organization is ready to embrace the intervention for this project.

Nurses play an important role in the provision of care that meets the needs of those in need. They work with other healthcare providers in ensuring that the best available care is given to improve their health and wellbeing. In doing this, they often end up suffering from burnout. Burnout increases the risk of them being provided with low uality care and rise in medical errors. The use of non-pharmacologucal intervetios such as mindfulness based practice is important in reducing the risk of burnout among the nurses. Therefore, this paper examines the relevant literature on the use of this intervention in reducing burnout among oncology nurses.To submit your completed Assignment for review and grading, do the following:
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Problem Statement

Oncology nurses assess, plan, implement, monitor, and evaluate plans of care to ensure that the needs of their patients are met. The nurses handle patients with dynamic needs, which are stressing and induces burnout syndrome. Burnout syndrome refers to a situation where a nurse is emotionally exhausted and has a diminished sense of individual accomplishment (Gomez-Urquiza et al.,

2016).  Research indicates that numerous oncology nurses report the burnout syndrome as they handle patients who succumb to cancer and has to come to term with the meaning of death (Cañadas‐De la Fuente et al., 2018). Additionally, the nurses have to promote recovery and help patients cope with pain, grief, and accept the approaching death. Burnout syndrome makes nurses irritable, causes sleep deprivation, and can lead to the abuse of drugs, which negatively impacts their performance. The syndrome is linked to increased sick leave and absenteeism, increased medical errors and low attention and morale to help patients (Ko, 2014). A novel approach should be devised to address burnout and optimize oncology nurses’ performance. Mindfulness practice has been proven to reduce burnout among oncology nurses. This proposal, therefore, aims at finding out whether mindfulness practice is effective and the PICOT that will guide the research is:

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Research executed indicated that mindfulness practice reduces burnout syndrome. Penque (2019) supported this notion with a quasi-experimental study that involved 61 nurses aged 21 years and older.  The main aim of the study was to establish in mindfulness-based stress reduction programs reduced burnout and enhanced work satisfaction. Findings indicated that not only did the program reduce burnout, but also enhanced psychological factors like mindfulness, self-compassion, and serenity. Similarly, a non-randomized controlled study executed by Duarte and Pinto-Gouvenia (2017) outlined that mindfulness mediated changes resulted in reduced compassion fatigue and better self-compassion, which reduced anxiety, stress, burnout and increases satisfaction with life. The study had 96 oncology nurses and used self-reported measures to assess aspects like compassion fatigue, depression, burnout, self-compassion, and mindfulness.

A systematic review by Burton et al. (2017) reported that mindfulness-based interventions improve burnout among health professionals. The articles reviewed handled interventions like telephonic mindfulness-based stress reduction (MBSR) program, traditional MBSR, mindfulness-based cognitive attitude training, and modified MBSR. Among all the article reviewed, only one had negative results. A cross-sectional survey by Vivian et al. (2019) evaluated what caused stress among nurses. Three hundred and forty nurses participated in the study, and they indicated that lack of support, death and dying, workload, and conflict with physicians were the major causes of stress. Nurses operating in critical care units reported least dispositional mindfulness creating a need to come up with interventions that address the weakness. Lastly, Flatt and Dabney (2019) executed a systematic review that revealed that mindfulness-based programs help in dealing with compassion fatigue, depression, distress, stress, and burnout.

A comparison of the articles reveals that the literature supports the use of mindfulness-based interventions. The articles indicate that MBIs make it easy for health professionals to execute their duties, and they promote physical and psychological well-being (Penque, 2019). The authors point out that clinical work is stressful, and it causes burnout. The articles align with the aim of the current proposal, which is to find out the effectiveness of mindfulness practice on reducing burnout among oncology nurses.  A striking difference observed entails the varying duration of interventions used in the various articles. Most of the interventions last between 6-8 weeks and cover varying participants (Flatt & Dabney, 2019). Although the articles involved health professionals, two articles dealt with general health practitioners while the rest specifically handled oncology nurses. A clear conclusion is that the articles generated results that were consistent with the existing literature.

For further review, the articles indicate that future programs should adopt mindfulness programs to redirect negative thinking among nurses and reframe difficult situations.  Oncology nurses need these programs to ensure that organizations have nurses who can promote companionship and support each other when stressful situations occur. Time-commitment is a major barrier to the implementation of mindfulness-intervention, and researchers planning to implement them should be keen on this aspect (Vivian et al., 2019). To deal with time-constraints a brief and accessible intervention would facilitate a quicker adoption. Lastly, several assessment time points are crucial for any MBI to ensure that stronger conclusions are drawn and act as fidelity checks for the programs (Duarte & Pinto-Gouveia, 2017).

Assignment: Evidence-based Practice Project Essay Conclusion

Oncology nurses handle dynamic patients who induce stress and burnout. Burnout harms care offered because it could potentially lead to nurse irritability and substance abuse. Burnout increases absenteeism, sick leaves, and medical errors. To avoid the negative impacts, mindfulness practice can be employed since reviewed literature indicated that it reduces burnout and promotes physical and psychological wellbeing. Programs adopted should be brief and accessible and should have several assessment time points to enhance the conclusions made.

Section C: Solution Description

Implementation of evidence-based practices is among the ways in which quality in healthcare can be promoted. The healthcare providers need to explore the available interventions that can be used to promote best practices in their organizations. They also need to explore the most effective models that can be utilized to minimize the incidences of resistance to change among the adopters. They also need to review the readiness of their organizations in embracing the change. Therefore, this paper explores the proposed solution, its expected outcomes, organizational readiness, and ways of achieving and assessing the impact of the intervention.

Proposed Solution

The proposed solution for the evidence-based practice project is the use of mindfulness-based practice to reduce burnout among nurses working in an oncology unit. Mindfulness-based practice is an intervention recognized to reduce the risk of burnout syndrome among nurses. According to Luken and Sammons (2016), the use of mindfulness-based practice promotes emotional and somatic wellbeing. The research by Penque (2019) revealed the use of mindfulness-based practice reduces the risk of burnout syndrome among nurses. Its use also found to result in enhanced work satisfaction among them. The research by Duarte and Pinto-Gouveia. (2016) and Gomez-Urquiza et al. (2016) revealed the use of mindfulness-based interventions in nursing practice results in outcomes such as reduced risk of compassion fatigue, anxiety, and stress. The fore-mentioned outcomes, in turn, lead to an increase in life satisfaction among the nurses. Therefore, it proves evident that the use of the mindfulness-based practice is likely to result in enhanced life outcomes for oncology nurses.

The use of the above intervention is realistic for the oncology setting. The organization has been in a constant search of evidence-based practice interventions that can be utilized to improve the wellbeing of the nurses, while improving the quality of care given to those in need. As a result, a culture is present to adopt the use of mindfulness-based practice in the oncology setting to improve the health and wellbeing of its workforce (Penque, 2019). The nurses in the oncology unit are also ready to engage in activities that will contribute to the development of evidence-based practice in their practice. The use of the mindfulness-based practice is a new and exciting concept. Therefore, nursing engagement is high with an eagerness to pilot the practice as a way of contributing to evidence-based practice in nursing and improving their wellbeing. In addition, the institution has professionals who have been trained on the use of mindfulness-based practice in healthcare. Therefore, there is a consistent presence of available personnel to train nurses on the use of the intervention.

Organizational Culture

The proposed intervention also aligns with the culture of our organization. The mission of the institution is to promote excellence in innovation and research as a way of improving the care and experiences of the patients. The proposed intervention is an innovation and research at the same time. Therefore, its execution will underpin the realization of the organization’s mission of promoting excellence in healthcare through research and innovation. Through it, the organization provides excellent experiences to the patients seeking care in the organization. Employees in the organization are also encouraged to engage in activities that will contribute to improvement in nursing experiences and quality of care given to patients (Duarte & Pinto-Gouveia, 2016; Gomez-Urquiza et al., 2016). Undertaking this intervention fulfills the provision as it will contribute to the health and wellbeing of employees working within the institution. Lastly, the organization prioritizes the needs of the employees as a way of empowering and motivating them. These needs can be promoted with the use of the intervention. Hence, the proposed intervention aligns with the existing organizational culture.

Expected Outcomes

The expected outcomes for the proposed intervention can be varied. The main outcome includes a reduction in the rate of stress and anxiety among oncology nurses. However, it is also expected the intervention will result in an improvement in overall job satisfaction among oncology nurses and a decline in their intent to leave the organization (Luken & Sammons, 2016). Lastly, the quality of care is expected to improve as evidenced by the outcomes of reduced medical errors and subjective satisfaction of patients with nursing care.

Method to Achieve Outcomes

Two groups of oncology nurses will be recruited for the project. One group will receive the intervention while the other group, the control, does not. The intervention group will enroll in a mindfulness-based program where they will practice yoga, meditation, and mindfulness techniques (Slatyer, Craigie, Rees, Davis, Dolan, & Hegney, 2018). The period of the classes will be two and a half hours every week for the duration of the intervention. They will also have a retreat after five months of the intervention. Data will be obtained throughout the interventional phase to determine its impacts. Participants in the control group will not be given any additional program assistance and continue with usual work-life routine. One of the anticipated barriers is the lack of time for the oncology nurses to participate in the program. This barrier will be addressed by delivering the intervention after the end of their shifts. They will also be provided with incentives such as snacks to keep them in the intervention.

Outcome Impact

The outcome will have a significant impact on the quality of the care offered in the institution. Reduced rate of burnout among the oncology nurses will increase their attention in the provision of care. It will also reduce the risk of medical errors in addition to reducing job dissatisfaction among oncology nurses (Duarte & Pinto-Gouveia, 2016). Accordingly, these outcomes will result in an improvement in the quality of care in the institution. There is also anticipated decline in the cost incurred in the organization. The decline is attributed to reduced rates of staff turnover and medical errors alongside the costs related to re-hospitalizations due to low quality of care.

Assignment: Evidence-based Practice Project Essay Conclusion

The proposed intervention aims at incorporating the use of mindfulness-based practice in reducing burnout among oncology nurses. It is expected that the intervention will result in improved job satisfaction, uality of care, hiring of new nurses, and reduce the cost of operations. The outcomes of the project will be achieved through the administration of the intervention to one group of the oncology nurses. Data will be obtained from them to determine the effectiveness of the intervention.

Evidence-based practice (EBP) is highly recognized as an effective way of promoting quality in healthcare. It is critical that health care institutions support interventions that aim at facilitating the successful integration of EBP into practice. The leadership approaches utilized in an organization should underpin the realization of the goals of EBP. Most importantly, the right model of implementing change should be embraced since EBP is a change agent in itself (Cawsey, Deszca & Ingols, 2016). This assignment examines how the Duck’s Change Curve Model will be used in implementing the EBP project.

Selected Model

The model of change that would be utilized in this project is the Duck’s Change Curve Model. This model delineates a five-stage model of how people respond emotionally to a change agent. According to this model, organizational change occurs in a predictable and manageable manner. It occurs in series of five steps that are summarized in the change curve and include stagnation, preparation, implementation, determination, and fruition (Bregman & Manton, 2017).

Steps and their Application to Proposed Implementation

The first step in the Duck’s Change Curve Model is stagnation. This stage occurs due to the lack of effective leadership, low level of knowledge and awareness among the adopters, and ineffective collaboration from the stakeholders involved. Often, the adopters of the change agent feel hopeless and do not see any sense of adopting the change.

Open communication is an important strategy that is utilized in this phase to facilitate effective implementation of a project. The adopters are encouraged to share their concerns, experiences, and needs openly as a way of raising the need for a change among them. During this phase, individuals are also provided with adequate information to raise the need for the intervention for their mental health and wellbeing (Schein & Schein, 2018). Leaders should be readily available to respond to any concerns raised by the nurses working in the oncology unit, specifically during this phase.

The second stage in the Duck’s Change Curve Model is preparation. The main aim in this stage to create a basis for successful implementation of an EBP project. The nurses working in the oncology unit will be provided with training on the use of mindfulness-based interventions. Team members who will lead the implementation process will be selected, trained, and informed about their roles and responsibilities in the implementation process. During this phase, it is imperative that the hospital demonstrate commitment towards the implementation of the project. The facility should provide the resources that are needed as they align with the organization’s mission and the goals of the project (Bregman & Manton, 2017). The support from the healthcare providers and the health care institution are critical during this stage.

The third stage in the Duck’s Change Curve Model is implementation. A majority of the nurses working in the oncology unit and other interested stakeholders are enthusiastic about the project. While some nurses remain skeptical about the proposed project, is it critical to utilize teamwork and communication to assure the success of the project? Those that are hesitant during the implementation phase should be provided with adequate information related to the intervention so that they can make an informed decision regarding the change. There is a need to focus on ensuring that there is minimal conflict of interest that might hinder successful implementation of the project (Schein & Schein, 2018). Open communication is essential during this phase to assure the success of the intervention.

The fourth stage of the Duck’s Change Curve Model is determination. This is the stage where the adopters of the change agent have begun to accept the integration of the change into practice and discover the need for the change in their daily activities. The team members supporting the proposed change will strive towards ensuring that there is a strong focus on the vision of the project and provide incentives that will ensure sustenance of the project. The nurses in the oncology setting will be provided with adequate time to practice mindfulness interventions (Cawsey et al., 2016). They will be assisted in overcoming their identified barriers.

The last step in the Duck’s Change Curve Model is fruition. The oncology nurses would now feel confident with the use of the proposed interventions. They would successfully utilize mindfulness interventions in their daily practice. The outcomes of the intervention would be evident, as seen from aspects such as their level of satisfaction with their jobs, quality of care, and retention rates. A focus will be placed on ensuring long-term use of the interventions by providing nurses with opportunities that will promote their continued growth in use of the interventions. There will also be the adoption of interventions that prevent stagnation in the future (Schein & Schein, 2018).

Assignment: Evidence-based Practice Project Essay Conclusion

The five stages delineated below are essential when creating a project that is rooted in evidence that will ultimately change practice. The use of Duck’s Change Curve Model can potentially lead to successful change adoption and would be used in the implementation of the EBP project that has been created for oncology nurses.

Implementation of evidence-based practice in the clinical settings is a carefully thought process that incorporates the views of all the organizational stakeholders. The personnel to be affected by the change are actively involved to ensure that their needs are prioritized. The estimate of the resources that are needed for the process is also developed. The project leaders are also expected to come up with deliverables that would be utilized in the evaluation of the project. Therefore, this paper explores the implementation plan that would be utilized in putting the proposed intervention into practice.

Setting

The planned project will be conducted at The Optimal Health Center, which is an inpatient facility where the project leader is currently employed. The hospital functions similarly to a center for research and has strong ties with surrounding universities. The hospital also has an oncology unit where providers assume responsibility for cancer cases ranging from moderate to severe.

The potential subjects for the project will include staff nurses who are employed on the oncology unit at the hospital. Oncology nurses who have worked in the unit for at least six months would be included in this project. It is assumed that these nurses have experienced the work-related challenges that increase their risk of burnout in the organization. Oncology nurses who are not on any other form of cognitive behavioral therapy will also be included. This will ensure that the obtained results are not due to the influence of other interventions. The exclusion criteria will include nurses who have worked in the unit for less than six months, those who are on cognitive behavioral therapy, and those who decline to participate in the intervention. The consenting process for nurse participants will occur through a verbal consenting process. The other nursing personnel who will participate in other phases of the project, such as data collection and implementation of the mindfulness practice, will provide written consent (Brothers & Wilfond, 2018). The presence of the written consent form from the second group of stakeholders will ensure commitment, which will then lead to accurate collection of data. The permission to undertake this intervention will be sought from IRB board. This will ensure that the project aligns with the ethical principles of evidence-based research and interventions.

Time Needed to Complete the Project

This project is expected to extend over a ten-month period. The project roll-out will occur in three phases in order to ensure the comprehensiveness and effectiveness of the intervention. The first phase will encompass educating the nurses that will be conducting the data collection as well as those that will be delivering the intervention piece of the project. The nurses that will be delivering the intervention will complete pre-assessments to determine their knowledgeability related to various mindfulness practices. Based on the results of the assessment, recruitment will be done, and training will be conducted to increase the competence of the nurses who will oversee the implementation of mindfulness practices at the hospital (Segal, 2019).

The second phase will entail recruiting the oncology nurses from the facility into the project. The recruited nurses will then be trained about the application of various mindfulness practices at the hospital under the guidance of trained professionals. The final phase of the project will include the deployment of mindfulness practices to the nurses with the integration of ongoing, recurrent data collection.

Requisite Project Resources

The mindfulness project will require an extensive investment from multiple key stakeholders. The most significant resource that will be required by the project includes a resting or relaxation room for subjects that is fully equipped with facilities that can facilitate the mindfulness-based programs. The room should be fitted with timers to establish the amount of time required for a practice to be conducted. The extra store room in the oncology unit will be used for this purpose. It will be transformed into a new unit where oncology nurses will perform mindfulness-based practice after their shifts.

The instructors that will be necessary for this project form one of the most important stakeholder groups required for mindfulness projects. The acquisition of mind-body practitioners will involve various steps, most of which require financial support from the institution (Williams, Simmons, & Tanabe, 2015). The organization will need to create a marketing plan that will allow for the successful recruitment of mind-body experts, and the mindfulness program organizers will have to stipulate the behavioral competence of qualified instructors, which will involve conducting interviews. Further, given the nature of the nursing profession, the instructors may decide to adopt a web-based programs such the Mind Mood Balance program. In order to ensure that the utilization of a web-based program occurs seamlessly, the instructors and the nurses may require access to laptops and/or phones.

Methods and Instruments

             A pre-post data collection methodology will be utilized in this project. The collection of parameters such as emotional distress, wellbeing, compassion, and empathy before enrollment into the program and after completion of the intervention (Parson’s et al., 2017). A biostatistician will be consulted to conduct a power analysis in order to determine the appropriate sample size for the program. The adoption of the Beckham et al. (2010) tool will be used to determine the level of knowledge that the instructors have regarding various mindfulness-based programs. A survey will be conducted to determine the improvement or otherwise in the parameters identified above.

Delivering the Intervention

The first step in the delivery of the intervention will be selecting oncology nurses who will receive the intervention and those who will not. The second step will be providing training to the instructors who will deliver the program. The third step will be the trainers training the oncology nurses on the use of mindfulness based program. The next step will be the oncology nurses in the intervention group being followed up for a period of five months, upon which they will be taken for a retreat where they will share their experiences with the program. The intervention will be completed at the eighth month where data from both groups will be obtained, analyzed, and presented. This will be followed by the determination of whether the intervention is effective for clinical use or not. The usage of the Mindful Mood Balance program will entail three modules. Each of these modules will run for one hour, and during this time, the health care professionals will be doing meditation (Felder et al., 2016). Other instructors can use the resting room to deliver their mindfulness-based programs as well. The nurses will require training regarding how to implement any of the mindfulness-based programs that are going to be adopted.

Data Collection

The project will include the following inclusion criteria: nurse working on the oncology unit that provides verbal consent that must manifests some of the symptoms of burnout, such as lack of empathy, gratitude, self-compassion, and stress (Holtschneider & Park, 2018). A survey will be conducted to see how many nurses have manifestations of burnout and the severity of these symptoms. The collection of the same data after the implementation of the mindfulness-based program will be analyzed using Pearson Chi-square method to determine if the programs were successful in reducing the incidence of nurse burnout. Moreover, a modified Braden scale will be adopted to determine the competence of the instructors concerning the mindfulness program that is being implemented.

Please be sure to read all comments and make all corrections to documents. Please add the conceptual model for the project. In addition, please make sure the reference section is correct as noted on comments of instructor on the paper.
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