A. Identify a current nursing practice within your healthcare setting that requires change (alarm fatigue- nurses becoming desensitized to alarms due to the many devices with alarms that are often false).
1. Describe the current nursing practice.
2. Discuss why the current nursing practice needs to be changed.
B. Identify the key stakeholders within your healthcare setting who are part of the current nursing practice.
1. Describe the role EACH identified key stakeholder will play to support the proposed practice change (examples of key stakeholders: nurses, CNA’s, patients, family, physicians etc)
C. Create an evidence critique table (see “Sample Evidence Critique Table”).
1. Identify 5 SOURCES from scholarly peer-reviewed journals, which adhere to the following standards:
a. Each source must be published within the PAST FIVE YEARS.
b. Each source must relate to the change identified in part A.
c. Each source must be listed in the table using APA format.
2. Identify the evidence strength of each chosen source- see the description below under C3.
3. Identify the evidence hierarchy of each chosen source, using the Evidence Hierarchy Table below.
(Description here:Strength of Evidence and Evidence Hierarchy:
Level I Hierarchy: Meta-analysis, Systematic Reviews, Integrative Reviews, National Practice guidelines
This level includes; research designs of Meta-Analyses, Systematic Reviews, Integrative Reviews, and EBP Guidelines which are developed from systematic reviews and housed in national repositories. Level I Examples
Level II Hierarchy: Randomized Controlled Trial (RCT) and Experimental
This level represents evidence from studies using a true experimental design. Level II RCT Example
Level III Hierarchy: Quasi-Experimental
This level represents evidence obtained from experimental studies without randomization. Level III Quasi-Experimental Example
Level IV: Hierarchy: Non-experimental
This level represents evidence from well-designed nonexperimental designs such as retrospective, case-control, cross-sectional, cohort-comparison, prospective, descriptive and correlational single studies. Level IV Nonexperimental Examples
Level V Hierarchy: Meta-Synthesis
This level represents evidence from systematic reviews of studies using qualitative methods. Level V -Meta-Synthesis Example
Level VI Hierarchy: Single Qualitative Study
This level represents single studies using a qualitative research method. Level VI Single Qualitative Studies Examples
Level VII Hierarchy: Expert Opinions
This level represents materials from a variety of non-research based evidence and generally consists of reports of expert committees and/or opinions of authorities on the subject. The evidence from this level includes; specialists’ opinions, case studies, practice guidelines, narrative reviews, editorials, regulations, legislation, and program outcome data/QI projects)
D. Develop an evidence summary based on the findings from part C that includes EACH of the five sources used (suggested length of 1–2 pages for all sources combined).
E. Recommend a specific best practice based on the evidence summary developed in part D.
F. Identify a practice change model that is appropriate to apply to the proposed practice change. (Choose one: The Change Curve Model or Kotter and Cohen’s Model of Change)
1. Justify why you chose the practice change model.
2. Explain how to apply the identified model to guide the implementation of the proposed practice change.
G. Discuss possible barriers to successful implementation of the proposed practice change. (examples: organizational culture, nurses’ belief system related to practice and research related barriers)
H. Discuss any possible ethical implications that may arise while planning or implementing the proposed practice change. (example: Cost-benefit ratio)
Resources: ***see above regarding the 5 required peer-reviewed articles, additonal resources may be from internet sources***
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