NURS 4020 Assessment 3: Evidence-Based Practice (EBP) Change Proposal

Assessment Brief: Improving Patient Outcomes Through EBP

Course Code: NURS 4020 – Quality Improvement & Safety in Nursing

Assessment Title: Assessment 3 – Evidence-Based Practice (EBP) Change Proposal

Level: BSN (Bachelor of Science in Nursing)

Length: 2,000 – 2,500 words (excluding references and appendices)

Format: APA 7th Edition

1. Assignment Overview & Context

In the current healthcare landscape, the gap between published research and bedside practice often results in suboptimal patient outcomes. As a baccalaureate-prepared nurse, you are expected to not only identify clinical problems but also to lead the integration of evidence into practice.

This assessment requires you to develop a comprehensive Evidence-Based Practice (EBP) Change Proposal. You will identify a specific safety or quality issue within your current clinical setting (or a setting of your choice), formulate a PICO(T) question, synthesize relevant research, and propose a strategy to implement a practice change. This proposal serves as a blueprint for organizational improvement, adhering to models such as the Iowa Model or the Johns Hopkins Nursing EBP Model.

2. Learning Outcomes (CLOs)

• Analyze the role of the nurse leader in fostering a culture of safety and quality improvement.
• Construct a PICO(T) question to address a specific clinical practice gap.
• Synthesize current, peer-reviewed evidence to support a proposed practice change.
• Develop an implementation strategy that addresses organizational barriers and stakeholder engagement.

3. Task Instructions

You are to write a formal paper proposing a practice change. Your proposal must follow the structure outlined below:

Part 1: Introduction and Problem Identification (Approx. 250 words)

Provide a clear introduction to the clinical problem. Why is this issue significant? Include background data (e.g., incidence rates, costs, impact on patient safety) to justify the need for change. Conclude this section with your formally stated PICO(T) question.

Part 2: Review of the Evidence (Approx. 750 words)

Conduct a literature review using at least five (5) current peer-reviewed articles (published within the last 5 years).

• Summarize the key findings of each study.
• Critique the strength and quality of the evidence (e.g., Level I vs. Level III evidence).
• Synthesize the findings: What does the collective evidence say about your proposed intervention compared to the current practice?

Part 3: Proposed Practice Change & Implementation Plan (Approx. 750 words)

Based on your evidence synthesis, clearly describe your proposed intervention.

• The Solution: Detail the new protocol or practice change.
• Implementation Model: Identify an EBP model (e.g., Iowa, ARCC, Johns Hopkins) to guide your process.
• Stakeholders: Who needs to be involved? (e.g., nurse managers, pharmacists, IT).
• Timeline: Provide a realistic timeline for piloting and rolling out the change.

Part 4: Evaluation and Sustainability (Approx. 250 words)

How will you measure success? Define specific outcome measures (e.g., “Fall rates will decrease by 10% within 6 months”). Discuss how you will sustain this change over time.

Part 5: Conclusion (Approx. 150 words)

Summarize the proposal and reiterate the potential impact on patient care and safety.

4. Formatting & Submission Guidelines

• Font/Spacing: Times New Roman, 12pt, Double-spaced.
• Margins: 1-inch margins on all sides.
• Headings: Use APA Level 1 and Level 2 headings to organize the paper.
• Citations: All in-text citations and the reference list must strictly adhere to APA 7th Edition standards.
• File Name: LastName_NURS4020_Assessment3.docx

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5. Grading Rubric

Criteria	Needs Improvement (0-69%)	Competent (70-89%)	Exemplary (90-100%)
Problem & PICO(T) Question (15%)	Problem is vague; PICO(T) components are missing or malformed.	Problem is identified; PICO(T) is present but may lack specificity in one area (e.g., Timeframe).	Clear, compelling problem statement supported by data; PICO(T) is flawlessly formatted and clinically relevant.
Evidence Synthesis (30%)	Fewer than 5 sources used; relies on non-scholarly sources; simple summary without synthesis.	5 sources used; summarizes findings adequately but lacks critical appraisal of evidence strength.	Synthesizes high-quality evidence; critiques study limitations/strengths; clearly connects evidence to the proposed change.
Implementation Strategy (30%)	Strategy is unrealistic or missing key stakeholders; no EBP model mentioned.	Plan is feasible; references an EBP model generally; identifies main stakeholders.	Detailed, actionable plan applying a specific EBP model; addresses organizational barriers and stakeholder buy-in comprehensively.
Evaluation Plan (15%)	Outcomes are not measurable (e.g., “Patients will feel better”).	Measurable outcomes identified but lack a timeline or data collection method.	Specific, measurable metrics (KPIs) provided with a clear plan for data collection and analysis.
Mechanics & APA (10%)	Frequent errors distract from the content; significant APA violations.	Occasional grammatical errors; minor APA formatting issues.	Professional, scholarly tone; free of errors; flawless APA 7th formatting.

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6. Implementing hourly rounding requires a structured approach to shifting unit culture, rather than simply mandating a new checklist. The evidence suggests that when nurse leaders engage staff in the design of the rounding log—incorporating the “4 Ps” (Pain, Potty, Positioning, Possessions); adherence rates improve significantly compared to top-down implementation strategies. Furthermore, utilizing the Iowa Model of Evidence-Based Practice allows the team to pilot the intervention on a single unit, gathering data on call-light usage and fall rates before scaling the protocol hospital-wide. This phased rollout ensures that unforeseen barriers, such as workflow interruptions during peak medication administration times, are addressed proactively.

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7. Recommended Study Resources

1. Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-based practice in nursing & healthcare: A guide to best practice (5th ed.). Wolters Kluwer.(The foundational text for EBP methodology and the ARCC model).
2. Tucker, S., McNett, M., & Mazurek Melnyk, B. (2021). Implementation science: Application of evidence-based practice models to improve healthcare quality. Worldviews on Evidence-Based Nursing, 18(2), 76–84.https://doi.org/10.1111/wvn.12495
3. Dang, D., & Dearholt, S. L. (2018). Johns Hopkins nursing evidence-based practice: Model and guidelines (3rd ed.). Sigma Theta Tau International.(Essential for understanding the PET—Practice Question, Evidence, Translation—process).
4. Lehane, E., Leahy-Warren, P., O’Riordan, C., Savage, E., Drennan, J., O’Tuathaigh, C., … & Hegarty, J. (2019). Evidence-based practice education for healthcare professions: An expert view. BMJ Evidence-Based Medicine, 24(3), 103–108.https://doi.org/10.1136/bmjebm-2018-111019
5. Hulse, B., Davis, C., & Kring, D. (2020). The effect of purposeful hourly rounding on patient satisfaction and call light use. Medsurg Nursing, 29(2), 117–120.