In mechanically ventilated patients in the ICU (P), does an oral care protocol using chlorhexidine mouthwash (I) compared to routine oral care (C) reduce the incidence of ventilator-associated pneumonia (O) over six months (T)?

PICOT: In mechanically ventilated patients in the ICU (P), does an oral care protocol using chlorhexidine mouthwash (I) compared to routine oral care (C) reduce the incidence of ventilator-associated pneumonia (O) over six months (T)?

We are not going to touch other parts of our paper. We are just adding this part to that paper and writing conclusion for whole paper.

Clinical implications summarize what you will need to do, or what you think needs to happen, based on the literature you have reviewed and critiqued. This is also where you will identify any gaps in the literature that you think need to be studied further. 

You will then develop an implementation plan for your project. Remember, this paper is built on previous sections of the project that you have already submitted so you will include your background and literature review. Make sure that you review the instructor’s feedback and edit your previous sections based on that feedback. 

This is your final paper, so put all of the previous sections into this one paper for a final draft. 

Clinical Implications and Implementation Plan (100 points)

Purpose/Objective of this assignment: To recommend changes to practice based on the literature and grading of the evidence, assess potential barriers to using the change in practice, and develop an evaluation plan.

Assignment Requirements: Write a  2 to3 page section,  is to be added to the literature review, applying the  key findings  for recommendations in changes to nursing practice, with proper citations, to answer the PICOT question.

· Develop a logical transition from the Literature Review to this section, including the PICOT question.

· Briefly identify the key findings about the clinical problem as applicable to nursing practice.

· Discuss the clinical implications of these findings. What is the supporting evidence regarding practice change? Support recommendations for practice change with clear arguments, using rationale/support for the changes based on the literature review findings.

· Develop a plan for making the change in practice in a clinical setting.

· Identify the data to be collected for evaluation and when it will occur.

· Identify the comparison group.

· Identify how you will collect data and what statistical test you will complete with the data (review stats, must be an appropriate test)

· Discuss  relevant barriers  related to successful implementation of the evidence-based change,  and how you will manage them.

· Identify any relevant  ethical considerations  related to the clinical problem, the research reviewed (methodology, participants’ human rights, etc.), and the implementation of the change

· Briefly discuss gaps in the literature regarding the clinical problem and make recommendations for further research.

· Paper will utilize all appropriate APA 7th Ed guidelines for intro, conclusion, citations, references, document organization, formatting, academic language, and grammar.  First person is not appropriate in this paper.

· Include a Summary/Conclusion for  entire project.

· Some suggestions:

· 1. When you note you’ll train or educate the staff, how would you do this? Via a required teaching session? A staff meeting?

· 2. For ethical considerations, think about principles of autonomy, justice, beneficence, and nonmaleficence. Also discuss specific populations that are more vulnerable if your population includes children, the elderly, those with mental health disorders- populations more at risk for medical abuse and that need further protection. All research and EBP implementation has some ethical considerations to think about.

· 3. Identify your variables- what is your dependent and independent variable for your project?

· 4. What are the appropriate statistical tests to use to show your outcomes? 

· 5. Think about the data collection- how will you collect it and discard of it? How will you maintain patient privacy?

· 6. What barriers would you anticipate? Financial? Staff compliance?

· 7. Remember you will NOT be completing an RCT- you are doing a pre and post intervention comparison. So you’ll discuss how you’d collect data pre implementation and compare it to that post intervention. with EBP, it would be unethical to withhold a practice determined as best practice from a group. 

· 8. When you discuss your inclusion criteria, also make sure to include the exclusion criteria (often opposite your inclusion criteria). 

·  

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