identify an issue or opportunity for change within your healthcare organization and propose an idea for a change in practice supported by an EBP approach.

The collection of evidence is an activity that occurs with an endgame in mind. For example, law enforcement professionals collect evidence to support a decision to charge those accused of criminal activity. Similarly, evidence-based healthcare practitioners collect evidence to support decisions in pursuit of specific healthcare outcomes.In this Assignment, you will identify an issue or opportunity for change within your healthcare organization and propose an idea for a change in practice supported by an EBP approach.To Prepare:Reflect on the four peer-reviewed articles you critically appraised in Module 4, related to your clinical topic of interest and PICOT.Reflect on your current healthcare organization and think about potential opportunities for evidence-based change, using your topic of interest and PICOT as the basis for your reflection.Consider the best method of disseminating the results of your presentation to an audience.BELOW IS THE ASSIGNMENTThe Assignment: (Evidence-Based Project)Part 4: Recommending an Evidence-Based Practice ChangeCreate an 8- slide narrated PowerPoint presentation in which you do the following:Briefly describe your healthcare organization, including its culture and readiness for change. (You may opt to keep various elements of this anonymous, such as your company name.)Describe the current problem or opportunity for change. Include in this description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general.Propose an evidence-based idea for a change in practice using an EBP approach to decision making. Note that you may find further research needs to be conducted if sufficient evidence is not discovered.Describe your plan for knowledge transfer of this change, including knowledge creation, dissemination, and organizational adoption and implementation.Explain how you would disseminate the results of your project to an audience. Provide a rationale for why you selected this dissemination strategy.Describe the measurable outcomes you hope to achieve with the implementation of this evidence-based change.Be sure to provide APA citations of the supporting evidence-based peer reviewed articles you selected to support your thinking.Add a lessons learned section that includes the following:A summary of the critical appraisal of the peer-reviewed articles you previously submittedAn explanation about what you learned from completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template (1-3 slides)BELOW IS THE RESOURCESRequired ReadingsMelnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.Chapter 7, “Patient Concerns, Choices and Clinical Judgement in Evidence-Based Practice” (pp. 219-232)Hoffman, T. C., Montori, V. M., & Del Mar, C. (2014). The connection between evidence-based medicine and shared decision making. Journal of the American Medical Association, 312(13), 1295-1296. doi:10.1001/jama.2014.10186Kon, A. A., Davidson, J. E., Morrison, W., Danis, M., & White, D. B. (2016). Shared decision making in intensive care units: An American College of Critical Care Medicine and American Thoracic Society policy statement. Critical Care Medicine, 44(1), 188-201. doi:10.1097/CCM.0000000000001396Opperman, C., Liebig, D., Bowling, J., & Johnson, C. S., & Harper, M. (2016). Measuring return on investment for professional development activities: Implications for practice. Journal for Nurses in Professional Development, 32(4), 176-184. doi:10.1097/NND.0000000000000483Schroy, P. C., Mylvaganam, S., & Davidson, P. (2014). Provider perspectives on the utility of a colorectal cancer screening decision aid for facilitating shared decision making. Health Expectations, 17(1), 27-35. doi:10.1111/j.1369-7625.2011.00730.xThe Ottawa Hospital Research Institute. (2019). Patient decision aids. Retrieved from https://decisionaid.ohri.ca/.Please don’t forget to use APA format and include 4 references not more than 5 years old and please make sure to go through the rubric. CORE SKILL: turning appraised evidence into a defensible, implementable PRACTICE CHANGE PROPOSAL — and understanding that the evidence is the easy part; the implementation is where projects die.
THE STRUCTURE: (1) the clinical issue and why it matters (with data — baseline rates, cost, harm); (2) the PICO question; (3) the evidence summary and level of evidence; (4) the RECOMMENDED PRACTICE CHANGE, stated specifically enough to act on; (5) the implementation plan; (6) the EVALUATION plan.
THE EVIDENCE SUMMARY must SYNTHESIZE, not enumerate. Do not walk through four studies one at a time. Instead: what do these studies AGREE on? Where do they DISAGREE, and why (different populations? different doses? different outcome measures? different designs?)? What is the overall STRENGTH and CERTAINTY of the body of evidence, and what are its gaps? Then: is it sufficient to justify a change? The honest answer is sometimes “not yet,” and saying so when warranted is a mark of integrity, not failure.
THE PRACTICE CHANGE must be SPECIFIC. “Improve hand hygiene” is not a practice change. “Implement a unit-based hand hygiene champion program with weekly direct-observation audits and monthly feedback of unit-level compliance rates” is.
THE IMPLEMENTATION PLAN — use a named model and this section stops being guesswork: the IHI MODEL FOR IMPROVEMENT (three questions — what are we trying to accomplish? how will we know a change is an improvement? what change can we make that will result in improvement? — driven by PDSA CYCLES, small and rapid, testing on one nurse and one patient before spreading). Also: the Iowa Model, the Johns Hopkins model, the Stetler model, or ARCC. Address STAKEHOLDERS, RESOURCES (time, staff, budget, IT), TIMELINE, and TRAINING.
BARRIERS AND FACILITATORS — be concrete: staff resistance and “we’ve always done it this way”; time and workload; lack of leadership sponsorship; competing priorities and initiative fatigue; cost; EHR/IT constraints. Facilitators: leadership buy-in, unit champions and opinion leaders, making the change the DEFAULT in the workflow (a forcing function beats education every time), and rapid visible feedback on results.
THE EVALUATION PLAN — the part students consistently under-develop, and where the top band is decided. Specify: OUTCOME measures (did the patient benefit? — infection rate, readmission, fall rate), PROCESS measures (is the change actually happening? — compliance percentage), and BALANCING measures (what else did we break? — did the new protocol increase nurse workload, delay discharges, or cause an unintended harm elsewhere?). BALANCING MEASURES ARE THE SIGN OF A MATURE PLAN and almost nobody includes them. State the data source, the frequency of collection, and who is responsible.
Then: how will you SUSTAIN the change once the project attention ends? Hardwire it into policy, orientation, competencies, and the EHR — because interventions that depend on enthusiasm decay.

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