In 1,250-1,500 words, discuss the implementation plan for your evidence-based practice project proposal.
In 1250-1500 words discuss the implementation plan for your evidence-based practice project proposal. When required, create the appropriate form, table, image, or graph to fully illustrate that aspect of the intervention plan and include them in an appendix of your paper. You will use the implementation plan, including the associated documents in your appendices, in the Topic 8 assignment, during which you will synthesize the various aspects of your project into a final paper detailing your evidence-based practice project proposal.
Include the following:
- Describe the setting and access to potential subjects. If there is a need for a consent or approval form, then one must be created. Include a draft of the form as an appendix at the end of your paper.
- Create a timeline. Make sure the timeline is general enough that it can be implemented at any date. Based on the timeline you created, describe the amount of time needed to complete this project. Include a draft of the timeline as an appendix at the end of your paper.
- Develop a budget and resource list. Consider the clinical tools or process changes that would need to take place. Based on the budget and resource list you developed: (a) describe the resources (human, fiscal, and other) or changes needed in the implementation of the solution; (b) outline the costs for personnel, consumable supplies, equipment (if not provided by the institute), computer-related costs (librarian consultation, database access, etc.), and other costs (travel, presentation development). Include a draft of the budget and resource list as an appendix at the end of your paper.
- Explain whether you would select a qualitative or quantitative design to collect data and evaluate the effectiveness of your evidence-based practice project proposal. Provide rationale to support your selection.
- Describe the methods and instruments (questionnaire, scale, or test) to be used for monitoring the implementation of the proposed solution. Include the method or instrument as an appendix at the end of your paper.
- Explain the process for delivering the intervention and indicate if any training will be needed.
- Discuss the stakeholders that are needed to implement the plan.
- Consider all of the aspects of your implementation plan and discuss potential barriers or challenges to the plan. Propose strategies for overcoming these.
- Establish the feasibility of the implementation plan.
Refer to the “Evidence-Based Practice Project Proposal – Assignment Overview” document for an overview of the evidence-based practice project proposal assignments.
Verified Expert Answer and Explanation
Evidence-Based Practice Project Proposal Implementation Plan
Postoperative complications following coronary artery bypass graft (CABG) surgery remain a significant concern in clinical practice. Early mobilization has emerged as a promising intervention to prevent complications and enhance recovery in CABG surgery patients. This paper presents an evidence-based practice project proposal aimed at evaluating the impact of early mobilization on postoperative outcomes in adult patients undergoing CABG surgery.
Setting And Access to Potential Subjects
The intervention will take place within the inpatient hospital setting at Baylor St. Luke’s Medical Center, focusing on adult patients who have undergone coronary artery bypass graft (CABG) surgery. The target population for this project will be patients in the first week of their postoperative period. Early mobilization will be implemented in the hospital’s cardiovascular recovery unit and continued when the patient is transferred to the cardiovascular surgical unit. To access potential subjects, patients scheduled for CABG surgery will be identified during preoperative assessments.
After surgery, patients will receive additional orientation about the intervention as soon as they are alert and oriented to person, time, place, and situation, indicating their full capacity to provide consent. Informed consent will be obtained through a consent form provided to prospective participants for this EBP project (Drisko, 2021). The consent form will outline the purpose of the project, the nature of the intervention, potential risks and benefits, confidentiality measures, and the voluntary nature of participation.
Project Timeline
The proposed EBP project will be implemented over the course of 3 months, starting in June and ending in September. The project will begin with the identification of participants scheduled for CABG surgery between June and July, with the peak season for surgeries at Baylor St. Luke’s Medical Center. Prior to surgery, identified participants will receive an email providing information about the planned intervention to prepare them for what to expect.
| Timeline Stage | Time Frame |
| Identify Participants | May – June |
| Preoperative Education | Prior to Surgery |
| Early Mobilization Initiation | Day 1 Postoperative |
| Monitoring and Assessment | Day 1 – Day 7 Postoperative |
| Data Collection | Throughout Implementation |
| Data Analysis | July – September |
Budget and Resource List
| Resource | Description | Cost |
| Human Resources | ||
| Nurses | Directly involved in patient care postoperative CABG surgery | Existing |
| Physical Therapist | To initiate early mobilization | Existing |
| Physical Therapy Assistants | Follow through with mobilization activities and monitor progress | Existing |
| Clinical Nursing Aides | Assist with early mobilization after initial assessment | Existing |
| Physicians | Educate patients on the importance of early mobilization | Existing |
| Fiscal Resources | ||
| Existing Staff Members | Utilization of current staff members | No additional cost |
| Clinical Tools/Process Changes | ||
| Electronic Health Record (EPIC) | Data collection and analysis | Included in existing infrastructure |
| Other Costs | ||
| Presentation Development | Printing of poster for dissemination of findings | $100 (estimated) |
Total Estimated Cost: $100
The budget and resource list for the proposed EBP project on early mobilization postoperative CABG surgery primarily utilize existing human resources within the hospital, including nurses, physical therapists, physical therapy assistants, clinical nursing aides, and physicians. The intervention will be integrated into the current postoperative protocol, minimizing fiscal costs. Essential clinical data will be gathered using the hospital’s Electronic Health Record system, “EPIC,” without additional expenses. The only direct cost incurred will be for presentation development, with the EBP project manager covering printing expenses for dissemination purposes.
Research Design
For the evaluation of the effectiveness of the evidence-based practice project proposal on early mobilization postoperative CABG surgery, a quantitative research design would be more appropriate. A quantitative approach is based on a design that provides for the measurement and analysis of numerical data, which is good for finding out how the decreases in intervention leads to the decrease in outcomes (Smith & Hasan, 2020).
In this particular scenario, the application of an experimental study design within the quantitative framework would allow for an in-depth, careful and accurate analysis of the causal relationships between early mobilization and postop complications. The effectiveness of early mobilization could be precisely measured through considerably adopting parameters like clinical outcomes, the rate of complications, and the functional status.
Qualitative research allows for more in-depth interpretations and connections. It also empowers the researchers to conduct statistical analysis so that they can highlight any significant differences or correlations that exist between various variables (Smith & Hasan, 2020). Through the use of quantitative approaches, the project can produce quantitative evidence of a high level that will support clinical decisions making and be the information landmark in creation of postoperative care best practices for CABG surgery patients. Quantitative data of trial participants can also be time-saving, steaming and replicable, thereby increasing the generalizability of the findings across different populations and healthcare conditions.
Methods and Instruments
For monitoring the implementation of the proposed solution, a combination of structured surveys, direct observation, and electronic health records (EHR) will be utilized (Chipps et al., 2020). Structured surveys will enable the systematic collection of data from participating patients regarding their experiences with early mobilization postoperative CABG surgery, including perceived benefits and challenges. Direct observation, supplemented by EHR data, will provide valuable insights into patients’ physical responses and recovery progress during early mobilization sessions.
Process for Delivering the Intervention
The process for delivering the intervention of early mobilization postoperative CABG surgery involves multiple steps and collaboration among healthcare team members. Initially, the early mobilization will be conducted by the assigned Physical Therapist for the patient, ideally starting as early as day 1 postoperative if the patient’s condition allows.
The Physical Therapist will assess the patient’s readiness and safety for mobilization and initiate appropriate activities (Linke et al., 2020). Mobilization activities will be carried out daily, with a goal of three sessions per day during the first week of the postoperative period, as tolerated by the patient. Physical Therapy Assistants will be responsible for conducting daily mobilization activities for participants within this timeframe.
Stakeholders Needed to Implement the Plan
The key stakeholders must come together to develop and implement the plan for early mobilization postoperative CABG surgery. These stakeholders include the nurses, who will help with immediate attention through sternal precautions and also provide continued assistance whenever the patient engages in mobilization activities (Berkel et al., 2020). Physical therapy assistants are in charge of assessing daily mobilization activities and tracking participants progress, which are therefore, essential (Williams et al., 2021).
The clinical nurse assistants are an integral part of the beneficial process of controlled early mobilization, which begins after the first assessment and the therapy started being administered by the physical therapist. Doctors are also stakeholders who keep patients well-informed about the early adoption of mobilization activities and are constantly monitoring the implementation of the process from the beginning to end of the activities (Berkel et al., 2020).
Potential Barriers or Challenges to the Plan
Several types of possible hurdles or difficulties could be realized in a course of the EBP execution on the early mobilization issue after the open-heart surgery. These include worker burn-out and resistance by the clinic personnel, and the challenge of inadequate pain control that could prevent follow-up physical therapy after surgery if the patient is in severe pain (Naghibi et al., 2021). To overcome these barriers, techniques like, availing personnel and listening to their ideas before the commencement of the initiative may resolve their concerns and receive support of the plan (Crawford et al., 2023).
Putting forth engaging, prudent interventions that address the needs of the postoperative CABG surgery patients can soothe pain and get them into movement. Moreover, training and engaging of the participants and who are linked with the project can assist in reducing reluctance to change by way of creating knowledge and support to the value of mobilization early (Crawford et al., 2023). Through pre-emptively tackling these limitations and implementing these tailored approaches, we can ensure the best outcome for patients keeping in mind the quality of care given.
Feasibility of the Implementation Plan
The conduct has been reasonable and attainable due to a number of factors behind the plan of early mobilization after open-heart surgery (CABG). The incorporation of diverse stakeholders thus airs physicians, clinical nurse assistants, physical therapy assistants, and nurses further contributes to comprehensive care and teamwork themes throughout the implementation.
Plans for coping with potential obstacles are designed by input from staff and sources of guidance, efficient treatment of pain, and conducting training for people and stakeholders to overcome problems and facilitate the deliveries (Berkel et al., 2020). For instance, the use of resources through the staff members as well as the infrastructure like the existing Electronic Health Record system eliminates the financial need caused by additional personnel.
Conclusion
The proposed evidence-based practice project on early mobilization postoperative CABG surgery holds promise for improving patient outcomes and enhancing recovery. Through rigorous evaluation and continuous quality improvement efforts, this project has the potential to inform best practices and enhance the standard of care for CABG surgery patients. Generally, the integration of stakeholders’ participation, targeting chosen strategies, and utilization of resources leads to improved success of a proposed plan to allow early mobilization after coronary artery bypass graft surgery.
References
Berkel, C., Rudo‐Stern, J., Abraczinskas, M., Wilson, C., Lokey, F., Flanigan, E., … & Smith, J. D. (2020). Translating evidence‐based parenting programs for primary care: Stakeholder recommendations for sustainable implementation. Journal of Community Psychology, 48(4), 1178-1193. https://doi.org/10.1002/jcop.22317
Chipps, E., Tucker, S., Labardee, R., Thomas, B., Weber, M., Gallagher‐Ford, L., & Melnyk, B. M. (2020). The impact of the electronic health record on moving new evidence‐based nursing practices forward. Worldviews on Evidence‐Based Nursing, 17(2), 136-143. https://doi.org/10.1111/wvn.12435
Crawford, C. L., Rondinelli, J., Zuniga, S., Valdez, R. M., Tze‐Polo, L., & Titler, M. G. (2023). Barriers and facilitators influencing EBP readiness: Building organizational and nurse capacity. Worldviews on Evidence‐Based Nursing, 20(1), 27-36. https://doi.org/10.1111/wvn.12618
Drisko, J. W. (2021). Incorporating evidence-based practice into informed consent practice. Families in Society, 102(1), 67-77. https://doi.org/10.1177/1044389420929625
Linke, C. A., Chapman, L. B., Berger, L. J., Kelly, T. L., Korpela, C. A., & Petty, M. G. (2020). Early mobilization in the ICU: a collaborative, integrated approach. Critical care explorations, 2(4), e0090. https://doi.org/10.1097/CCE.0000000000000090
Naghibi, D., Mohammadzadeh, S., & Azami-Aghdash, S. (2021). Barriers to evidence-based practice in health system: a systematic review. Evidence Based Care, 11(2), 74-82. https://doi.org/10.22038/ebcj.2021.60075.2561
Smith, J. D., & Hasan, M. (2020). Quantitative approaches for the evaluation of implementation research studies. Psychiatry research, 283, 112521. https://doi.org/10.1016/j.psychres.2019.112521
Williams, N. J., Candon, M., Stewart, R. E., Byeon, Y. V., Bewtra, M., Buttenheim, A. M., … & Beidas, R. S. (2021). Community stakeholder preferences for evidence-based practice implementation strategies in behavioral health: a best-worst scaling choice experiment. BMC psychiatry, 21, 1-12. https://doi.org/10.1186/s12888-021-03072-x
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