: EVIDENCE-BASED PRACTICE PROPOSAL NRS 490Dana Gill final

Running Head: EVIDENCE-BASED PRACTICE PROPOSAL Evidence-Based Practice Proposal - Final Dana Gill Grand Canyon University NUR-699 Evidence-Based Practice Project March 3, 2019 2 Running Head: EVIDENCE-BASED PRACTICE PROPOSAL Table of Contents Abstract……………………………………………………………………………………. 5 Introduction……………………………………………………………………………….. 6 Section A: Organizational Culture and Readiness Assessment……….………………….. 7 Barriers and Facilitators…………………………………………………………… 8 Section B: Problem Description…………………………………………………………… 8 PICOT………………………………………………………………………………8 Purpose and Objectives……………………………………………………………..8 Identify Stakeholders/Change Agents………………………………………………9 Supportive Rational…………………………………………………………………9 Implications for Practice……………………………………………………………10 Section C: Literature Support……………………………………………………………….10 Review of the Literature…………………………………………………………….10 Review Method……………………………………………………………………..10 Summary of Results………………………………………………………………...11 Summary of Studies………………………………………………………………...11 Strengths and Weakness…………………………………………………………....14 Section D: Solution Description……………………………………………………………14 Proposed Solution…………………………………………………………………..14 Organizational Culture……………………………………………………………...15 Expected Outcomes…………………………………………………………………15 Strategies to Achieve Outcomes……………………………………………………15 Limitations………………………………………………………………………….16 3 Running Head: EVIDENCE-BASED PRACTICE PROPOSAL Barriers……………………………………………………………………………...17 Outcome Impact…………………………………………………………………….17 Section E: Change Model…………………………………………………………………17 Model for Improvement…………………………………………………………...17 Design……………………………………………………………………………..18 PDSA Cycle……………………………………………………………………….19 Conceptual Model…………………………………………………………………20 Section F: Implementation Plan…………………………………………………………...20 Setting and Time Frame…………………………………………………………...20 Resources………………………………………………………………………….21 Methods and Instruments to Monitor Implementation……………………………21 i. Pre- and Post-Implementation Surveys…………………………………...21 ii. Direct Observation………………………………………………………..21 iii. Hand Hygiene Compliance Data………………………………………….22 iv. Hand Hygiene Product Use……………………………………………….22 v. Informal Interviewing…………………………………………………….22 Delivering the Implementation…………………………………………………...22 Data Collection Plan……………………………………………………………...22 Analysis Plan……………………………………………………………………..23 Barriers, Facilitators and Challenges……………………………………………..23 Feasibility Plan…………………………………………………………………...23 Sustainability……………………………………………………………………..24 Section G: Evaluation of Progress…………………………………………………….....24 Rational for Methods………………………………………………………….....24 4 Running Head: EVIDENCE-BASED PRACTICE PROPOSAL The Extent of How Outcome Measures Achieve Project Objectives……………25 Validity, Reliability and Applicability of Evaluation and Measure……………..26 Strategies if Outcome is not Optimal…………………………………………..27 Implications for Practice……………………………………………………….27 Future Research………………………………………………………………..27 References……………………………………………………………………………..28 Appendices…………………………………………………………………………….34 a) Critical Appraisal Checklists…………………………………………………..34 b) Table of Evidence……………………………………………………………...43 c) Conceptual Model……………………………………………………………...45 d) Implementation Model…………………………………………………………46 e) Timeline………………………………………………………………………..47 f) Resource List…………………………………………………………………..48 g) Proposal Instruments…………………………………………………………..49 G(a). Hand Hygiene Knowledge Assessment…………………………49 G(b). Pre-Implementation Survey……………………………………..51 h) Data Collection Tool…………………………………………………………..54 i) Budget…………………………………………………………………………56 j) Approval Forms……………………………………………………………….57 k) Handouts………………………………………………………………………58 l) Evaluation Tools……………………………………………………………....60 1. Post-Implementation Survey……………………………………...60 5 Running Head: EVIDENCE-BASED PRACTICE PROPOSAL Abstract Healthcare acquired infections are the most common complication of hospital care in the United States, with subsequent negative implications on the healthcare system. While hand hygiene has long been considered the single most important and cost-effective way of reducing healthcare-acquired infections, compliance among healthcare professionals is low, and most efforts to improve fail. When compared to single-component hand hygiene interventions, research demonstrates that tailored multi-modal interventions are an effective way to improve compliance with hand hygiene practices among healthcare professionals. Dana Gill, this project’s director, in affiliation with Baylor Emergency Medical Center, will focus on implementing a multi-modal hand hygiene intervention, tailored to fit the specific needs of Baylor Emergency Medical Center, to determine its effect on compliance and sustainability of hand hygiene practices among