Running head: EVIDENCE-BASED PRACTICE PROPOSAL FINAL 1
PAPER
NUR 699 EBP Proposal-FinalPaper
Evidence-Based Practice Proposal Final Paper
Lizy Windsor
Grand Canyon University
Evidence-Based Practice Project
NUR 699
October 31, 2012
,EVIDENCE-BASED PRACTICE PROPOSAL FINAL 2
PAPER
Evidence-Based Practice Proposal Final Paper
Table of Contents
1. Abstract.....................................................................................................3
2. Section A: Organizational Culture and Readiness Assessment...............4
3. Section B: Problem Description...............................................................7
4. Section C: Literature Support.................................................................10
5. Section D: Solution Description.............................................................13
6. Section E: Change Model.......................................................................17
7. Section F: Implementation Plan..............................................................22
8. Section G: Evaluation of Process ………………………………… 29
9. Conclusion..............................................................................................35
10. References ………………………………………………………… 36
11. Appendices …………………………………………………………
i. Appendix A: Critical Appraisal Checklists................................42
ii. Appendix B: Evaluation Tables..................................................46
iii. Appendix C: Conceptual Model..................................................50
iv. Appendix D: Timeline................................................................51
v. Appendix E: Resource List.........................................................52
vi. Appendix F: Proposal Instruments.............................................53
vii. Appendix G: Budget....................................................................57
viii. Appendix H: Data Collection Tools...........................................58
ix. Appendix I: Handout tool............................................................60
x. Appendix J: Consent Form.........................................................61
,EVIDENCE-BASED PRACTICE PROPOSAL FINAL 3
PAPER
Abstract
Presented forth is a study proposed by Ms. Lizy Windsor, affiliated with Banner Good
Samaritan Medical Center, located in central Phoenix. The study is projected to present
information on capnography for use in procedural sedation in the emergency department,
applying an evidence-based approach. This study explores the organizational culture of the
facility and conducts a readiness assessment, prior to identifying the clinical issue and providing
evidence linked to the use of capnography in procedural sedation. Additionally, the study
presents the solution for the problem and provides the implementation plan, based on the
conceptual framework of the Iowa Model. The expected outcome was recognized as a
conspicuous reduction in occurrences of hypoventilation, apnea, and hypoxia during procedural
sedation in the ED, thus reducing negative patient outcomes, and improving patient safety.
Evidence generated from the pilot study could also be transferred to other areas that employ
procedural sedation, such as other emergency departments, endoscopy suites, and cardiac
catheterization suites.
, EVIDENCE-BASED PRACTICE PROPOSAL FINAL 4
PAPER
Organizational Culture and Readiness Assessment
Literature review indicates that evidence-based practice (EBP) guideline implementation
results in positive patient-outcomes (Grimshaw, et al., 2006; Soh, et al., 2011). However, often
EBP implementation is challenging secondary to a myriad of factors. According to Melnyk and
Overholt (2011), for acceptance of EBP in patient-care, impediments to EBP must be
subjugated. Additionally, employing strategies to endorse guideline observance is noted to
improve client consequences (Lugtenberg, Burgers, & Westert, 2009). Consequently, as an
initial undertaking, barriers and expediters, including organizational culture and readiness for
system-wide execution of EBP must be evaluated (Melnyk & Overholt, 2011). Accordingly,
provided forth is an analysis of the appraisal of the institution’s inclination towards EBP
implementation.
Analysis of Survey Results
The survey was performed using Appendix N in Evidence-based practice in nursing &
healthcare: a guide to best practice (Melnyk & Overholt, 2011, p.559). The findings provide an
overview of the organizational, provider, and leadership factors influencing clinical practice in
the institution, thus impacting quality improvement proposals. The overall findings demonstrate
that the facility is equipped and ready for EBP implementation, by scoring high in virtually all
categories.
The institution’s Mission Statement proclaims, “We exist to make a difference in
people’s lives through excellent patient care” (Banner Health, 2012, para 3). Consequently, by
revealing its singular commitment in attaining excellent care to everyone in the establishment,
the organization is successful in sustaining its promise of best practice. Policies, procedures, and
guidelines should reflect incorporation of current evidence (Squires, Moralejo & LeFort, 2007),
which is evident in the facility. In safeguarding the philosophy of the institution, the leadership
PAPER
NUR 699 EBP Proposal-FinalPaper
Evidence-Based Practice Proposal Final Paper
Lizy Windsor
Grand Canyon University
Evidence-Based Practice Project
NUR 699
October 31, 2012
,EVIDENCE-BASED PRACTICE PROPOSAL FINAL 2
PAPER
Evidence-Based Practice Proposal Final Paper
Table of Contents
1. Abstract.....................................................................................................3
2. Section A: Organizational Culture and Readiness Assessment...............4
3. Section B: Problem Description...............................................................7
4. Section C: Literature Support.................................................................10
5. Section D: Solution Description.............................................................13
6. Section E: Change Model.......................................................................17
7. Section F: Implementation Plan..............................................................22
8. Section G: Evaluation of Process ………………………………… 29
9. Conclusion..............................................................................................35
10. References ………………………………………………………… 36
11. Appendices …………………………………………………………
i. Appendix A: Critical Appraisal Checklists................................42
ii. Appendix B: Evaluation Tables..................................................46
iii. Appendix C: Conceptual Model..................................................50
iv. Appendix D: Timeline................................................................51
v. Appendix E: Resource List.........................................................52
vi. Appendix F: Proposal Instruments.............................................53
vii. Appendix G: Budget....................................................................57
viii. Appendix H: Data Collection Tools...........................................58
ix. Appendix I: Handout tool............................................................60
x. Appendix J: Consent Form.........................................................61
,EVIDENCE-BASED PRACTICE PROPOSAL FINAL 3
PAPER
Abstract
Presented forth is a study proposed by Ms. Lizy Windsor, affiliated with Banner Good
Samaritan Medical Center, located in central Phoenix. The study is projected to present
information on capnography for use in procedural sedation in the emergency department,
applying an evidence-based approach. This study explores the organizational culture of the
facility and conducts a readiness assessment, prior to identifying the clinical issue and providing
evidence linked to the use of capnography in procedural sedation. Additionally, the study
presents the solution for the problem and provides the implementation plan, based on the
conceptual framework of the Iowa Model. The expected outcome was recognized as a
conspicuous reduction in occurrences of hypoventilation, apnea, and hypoxia during procedural
sedation in the ED, thus reducing negative patient outcomes, and improving patient safety.
Evidence generated from the pilot study could also be transferred to other areas that employ
procedural sedation, such as other emergency departments, endoscopy suites, and cardiac
catheterization suites.
, EVIDENCE-BASED PRACTICE PROPOSAL FINAL 4
PAPER
Organizational Culture and Readiness Assessment
Literature review indicates that evidence-based practice (EBP) guideline implementation
results in positive patient-outcomes (Grimshaw, et al., 2006; Soh, et al., 2011). However, often
EBP implementation is challenging secondary to a myriad of factors. According to Melnyk and
Overholt (2011), for acceptance of EBP in patient-care, impediments to EBP must be
subjugated. Additionally, employing strategies to endorse guideline observance is noted to
improve client consequences (Lugtenberg, Burgers, & Westert, 2009). Consequently, as an
initial undertaking, barriers and expediters, including organizational culture and readiness for
system-wide execution of EBP must be evaluated (Melnyk & Overholt, 2011). Accordingly,
provided forth is an analysis of the appraisal of the institution’s inclination towards EBP
implementation.
Analysis of Survey Results
The survey was performed using Appendix N in Evidence-based practice in nursing &
healthcare: a guide to best practice (Melnyk & Overholt, 2011, p.559). The findings provide an
overview of the organizational, provider, and leadership factors influencing clinical practice in
the institution, thus impacting quality improvement proposals. The overall findings demonstrate
that the facility is equipped and ready for EBP implementation, by scoring high in virtually all
categories.
The institution’s Mission Statement proclaims, “We exist to make a difference in
people’s lives through excellent patient care” (Banner Health, 2012, para 3). Consequently, by
revealing its singular commitment in attaining excellent care to everyone in the establishment,
the organization is successful in sustaining its promise of best practice. Policies, procedures, and
guidelines should reflect incorporation of current evidence (Squires, Moralejo & LeFort, 2007),
which is evident in the facility. In safeguarding the philosophy of the institution, the leadership
