NUR 550 Benchmark – Evidence-Based Practice Project Proposal Final Paper

NUR 550 Benchmark – Evidence-Based Practice Project Proposal Final Paper

NUR 550 Benchmark – Evidence-Based Practice Project Proposal Final Paper

Evidence-Based Practice Project Proposal Final Paper

In the past and at present, various diseases have caused suffering, pain, and death among the population, prompting healthcare professionals to come up with appropriate measures or strategies that can be used to contain the spread of such diseases. Recently, the Covid-19 pandemic brought the world to a standstill resulting in various negative impacts, cutting across health and finances (Wang et al., 2021). The implication is that scientists had to work around the clock and come up with suitable vaccines in record time. During the middle of the pandemic, various measures were used, such as wearing masks in public spaces, sanitization, and handwashing, were used as short-term measures to prevent the spread of the virus; however, it has been evident that a longer-term solution lies in the use of appropriate vaccines.

 Even though vaccines for the Covid-19 virus are present and in use, a lot of effort is still needed to ensure that individuals take the vaccine. Millions of people remain skeptical regarding taking any of the Covid-19 vaccines, which has brought down the rates of vaccine use. As such, it is important to use proven and appropriate strategies that can lead to individuals taking the covid-19 vaccine. One of the strategies that have gained prominence in health promotion is health education; hence it provides a suitable route to improving the covid-19 vaccine uptake (Rutten et al., 2021). Therefore, the purpose of this project is to explore if the use of health education will increase people’s willingness to take the Covid-19 vaccines. As such, various aspects will be discussed, including the problem statement, organizational culture and readiness, literature review, the change model or framework, implementation plan, and evaluation plan.

Problem Statement

Covid-19 vaccines were made at the height of the Covid-19 pandemic to help contain the virus. Millions of people have since been vaccinated, leading to an incredible reduction in the rates of spread of Covid-19. However, it has not been easy getting so many people to get the vaccine due to a combination of reasons, ranging from conspiracy theories to being skeptical about the record times used in coming up with the vaccines. Therefore, there is a need to use various strategies, such as health education, to increase willingness to take the vaccine.

Organizational Culture and Readiness

The success of the implementation of an evidence-based practice project heavily depends on the organizational culture and readiness. As such, it is important to assess the organizational culture and readiness to determine how ready the organization is in terms of the implementation of the project (Cleary‐Holdforth et al., 2021). It is also important to use well-known and well-established assessment tools to assess the organization’s culture and readiness. As such, a tool was chosen, and the summary of results regarding the organization’s culture and readiness is presented in this section.

The Organization’s Culture and the Degree It Supports Change

            A positive organizational culture is known to foster the process of change implementation (Cleary‐Holdforth et al., 2021). Therefore, upon the assessment of the organization, it was noted that the leaders lean towards supporting EBP initiatives which are key to the improvement of the organization’s performance as well as the quality of patient care services. The organization also hopes to gain magnet status in the near future; hence the leaders support change initiatives. The organization’s aim and mission also focus on offering excellent and appropriate patient services and making the services accessible to patients as much as possible. As part of the culture, the leaders encourage the employees to gear their actions towards supporting the vision and mission of creating positive change that steers the organization forward. The organization also focuses on improving patient outcomes by encouraging various aspects, such as collaboration among staff and interprofessional teams. Based on this evidence, the organization’s culture points to an organization that is ready for change and supports EBP.

The Selected Organizational Readiness Tools and Summary of Results

            An assessment tool was used in assessing organizational readiness. The chosen tool was the System-Wide Integration of the EBP survey tool. This tool has widely been used in EBP and has shown its potential in the assessment of an organization’s ability to deal with and adapt to potential changes (Melnyk et al., 2022). This tool was used to assess the staff and the leaders’ understanding of the proposed change of introducing health education to improve the willingness to take covid-19 vaccine. The survey revealed that up to 90% of the staff and 80% of the leaders were ready for the proposed change. The implication is that a majority of the staff and leaders supported the proposed change. The implication is that the existing culture will be able to support and sustain EBP and change.

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            As part of the organizational culture and readiness assessment, it is important to identify potential weaknesses or barriers that may negatively impact the implementation process and formulate strategies to overcome them. One of the identified barriers is the potential lack of support, as shown by a few staff and leaders. It will be important to obtain their buy-in as the project progress to enhance chances of success. The individuals who have shown a willingness to support the proposed change will form an important part of the project by helping to avail the needed resources and help in times of crucial decision-making.

Strategies to Facilitate the Readiness

            It is important for the project team to help facilitate readiness. Such readiness can help in improving the chances of the project succeeding. There is a need to initiate an aggressive health education program to help improve the willingness of individuals to take the covid-19 vaccines, hence a need for change. The statistics show that many people are still hesitant regarding taking the covid-19 vaccine, facts which can be used to convince the staff to get fully involved in the health education initiative. As part of the process, the staff will also be educated on how to carry out the health education program as a way of facilitating readiness (Melnyk et al., 2022). It is also important to identify the key stakeholders who are to play key roles in the project. The identified key stakeholders include the nurse educator, nurse managers, unit leaders, nurses, physicians, patients, and their families.

The Information and Communication Technologies Needed For Implementation

            It is also important to identify various strategies that can be used to support the implementation process. Key among such is the information and communication technologies. Therefore, one of the tools to be used is electronic health records (Melnyk et al., 2022). Electronic health records are important in revealing the vaccination status of patients. In addition, this tool will also be key in revealing other patient data, such as demographic data, which form an important part of the project.

Literature Review

The following formulated PICOT question was used to guide the literature review process: PICOT statement: Among the general population and individuals at risk of covid-19, will the use of health education about covid-19 vaccination plans, as compared to no intervention, lead to a 50% increased willingness to take covid-19 vaccine within six months?

The Search Methods Used

            The search strategy forms an integral part of a good literature search as it allows the researcher to obtain the most relevant article which is in line with the issue at hand. Therefore, a search method was employed to assist with the literature review. Various databases formed the basis of the literature search. The article databases used include Google scholar, the Cochrane Database of Systematic Reviews, Ovid, the Cochrane Central Register of Controlled Trials, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Medline. Keywords used as part of the search strategy include “risk of Covid-19”, “health education,” “vaccine uptake,” and “willingness to take the vaccine.” Since the pandemic occurred within the last five-year time frame, the publication dates were not used as exclusion criteria.

The Synthesis of Literature

            The literature search yielded several research articles, and eight of the articles have been reviewed, and their relevance to the PICOT question is presented in this section. In one of the research efforts, Motta et al. (2021) carried out a research with the major aim of determining the effect of educational messages in increasing people’s willingness to take the Covid-19 vaccine. This study employed a qualitative design where a total of 7064 participants took part. As part of the intervention, the researcher sent pro-vaccine messages to the participants. The analysis of the data showed that pro-vaccine messages significantly improved the participant’s willingness to go for the covid-19 vaccine. Hence this source supports the formulated PICOT question.

            In another recent study, James et al. (2021) focused on exploring the impact of persuasive messages in improving the Covid-19 vaccine uptake. As opposed to the first study, these researchers employed a quantitative study design, and the participants were educated on the benefits of taking covid-19 vaccine. The researchers used regression analysis for data analysis and found that the use of persuasive messages resulted in the participants’ increased willingness to take the vaccine. They were also more willing to influence others to go for the vaccine. Therefore, this source also supports the PICOT question as it shows the efficacy of health education in improving the willingness to take vaccines.

            More recently, Jensen et al. (2022) carried out a study exploring the application of health education based on video messages in fighting hesitancy in taking the covid-19 vaccine. The researchers employed a quantitative research design and recruited 1620 participants to take part in the study. Upon analysis of the data, the research found that the video-based messages increased people’s confidence in the vaccine hence improving their willingness to take the Covid-19 vaccine. As such, this source also supports the PICOT question as it shows that health education was effective.

            In another research effort, Piltch-Loeb et al. (2021) carried out a research that focused on determining the impacts of using health education passed through different chances on the willingness to take the covid-19 vaccine. Using a quantitative study design, the researchers recruited a total of 2650 participants to take part in the study. Various channels such as social media, newspapers, and national TV were used to pass information regarding the vaccine. The analysis of the data showed that the use of both social media and traditional media resulted in an increased likelihood of accepting the Covid-19 vaccine. This study supports the proposed study as it shows the importance of educating people about the vaccine using different channels.

            Li et al. (2022) also conducted a study that explored the impact of health education on Covid-19 vaccine hesitancy. The researchers employed a quantitative study design and recruited a total of 500 study subjects. While the survey was used as part of data collection, the researchers completed data analysis using regression analysis and chi-square. The analyzed data showed that the education program led to a significant lowering of vaccine hesitancy among the participants hence improving their willingness to take the vaccine.

            Another relevant research was conducted by Davis et al. (2022). This research aimed to determine if the provision of information that contrasts the high effectiveness of covid-19 vaccine with the lower effectiveness of the annual flu vaccine could improve the covid-19 uptake. The researcher recruited a total of four hundred and eighty-one research subjects to participate in the study. The analysis of the collected data showed that providing such information had a positive impact as it improved the participant’s willingness and intention to take the covid-19 vaccine.

            Argote et al. (2021) also conducted a study aimed at determining the effect of education carried out through vaccine campaigns in increasing people’s willingness to take the covid-19 vaccine. The researcher recruited a total of two thousand people to participate in the study. Vaccine survey was used as the main tool for data collection. As part of the educational initiative, the researchers provided the participants with various information regarding the effectiveness of the vaccine; analysis of the data showed that such information led to an improved willingness to take the covid-19 vaccine.

            Another relevant study was conducted by Santos et al. (2021), which focused on determining the effectiveness of messages that target behavior concerning vaccination registration as well as acceptance. The researchers used a quantitative study design and recruited a total of 9723 individuals to take part in the study. The researchers collected data through email and surveys. Upon the implementation of the program, the researchers found out that the number of individuals who were willing to register for the vaccine and take it considerably increased. Therefore, this article also supports the proposed intervention of using health education to increase people’s willingness to accept the covid-19 vaccine.

Change Model or Framework

Implementation of interventions to improve patient outcomes usually requires the implementation of various change initiatives. It is important to note that implementation of change is usually a complicated process as individuals tend to resist suggestions for change implementation. As such, it is important to use proven and effective change management strategies to minimize the potential for failures. This is where the model or framework for change comes in. Such models have steps or phases of change management that the project team can follow to ensure that the proposed change initiative is appropriately implemented (Harrison et al., 2021). There are several change management models in existence today. Therefore, it is upon the project implementers to choose the most befitting model which can help achieve the project goals.

The Selected Change Model

            The change model that was chosen for the implementation of this project is Kurt Lewin’s change model. According to Lewin, change takes place in three major phases or stages, including the unfreezing, change, and refreezing phases. In addition, Lewin argued that there are two major forces involved in the change process, the driving forces that support the change and the restraining forces which oppose the change effort. The implication is that a successful change process only occurs when the driving forces exceed the restraining forces.

The Stages in the Change Model

            As earlier stated, Lewin’s change model has three major stages or phases of change, which include unfreezing, change, and refreezing. In the unfreezing stage, the project team has to create an awareness of the need for an urgent change. As part of the plan, the change leaders used data such as organizational data to prove that there was an urgent need for change. As such, the leaders have to use effective communication to ensure that their message is home and well received (El-Sayed, 2023). The next phase is the change phase which entails the implementation of the proposed change. The change leaders use their expertise to implement the intervention and test its effectiveness. The refreezing stage is the final stage of change based on this model. This phase is characterized by change sustenance and ensuring that the implemented change becomes part and parcel of the organization’s operations and normal practice.

How Each Stage of the Model Will be Applied in the Proposed Implementation

            Lewin’s model has three major phases of change implementation; hence all three phases will be used in the implementation of the proposed project. In the first stage, the project team will take it upon themselves to inform the staff at the facility and those who visit the facility about the need to improve people’s willingness to take the covid-19 vaccine. It is important to use the current statistics on covid-19 vaccine hesitancy to convince individuals. The next phase of the project will entail educating the staff on the health education strategy to be used to convince individuals visiting the facility to take the vaccine. In the last stage of the model, the willingness to take the covid-19 vaccine will be sustained through frequent educational initiatives.

The Implementation Plan

The implementation phase of an EBP project is perhaps the most important phase as the proposed intervention is put into use and tested. The implication is that an appropriate plan is required that details the aspect of the implementation and all activities that must be accomplished to ensure that the process is a success. As part of the plan, the project team should use appropriate and effective methods that can enhance the chances of the project’s success while incorporating ideas from different people. Considering other stakeholders’ ideas is important since it can help minimize the chances of resistance (Melnyk& Fineout-Overholt, 2019).

The Setting and Accessing the Potential Research Subjects

            It is important to obtain the research subjects from a relevant setting. Therefore, the setting for the project is a healthcare facility providing outpatient and inpatient care services to patients. Therefore, the research subjects are those who visit the facility for the services and are at risk of contracting the covid-19 virus (Dror et al., 2020). In addition, those who have not received the covid-19 vaccine will be the major target. The data obtained from these participating individuals will be used in determining the impact of the proposed health education intervention in improving people’s willingness to take the vaccine. It will not be necessary to obtain informed consent as the project will not deal with identifiable data. However, approval will have to be obtained from the facility to complete the project.

The Proposed Project Timeline

            As part of the plan, it is important to note that this project will take a total of six months. It is projected that this time will be sufficient for all the project activities. In addition, this time will also be used in implementing any corrective actions as needed to ensure that the project is a success. A detailed project timeline has been included in the appendix.

The Budget and Resource List

            Resources will be needed to help accomplish the project goals and aims. As such, both financial and human resources will be needed (Hopp & Rittenmeyer, 2021). For example, the human resources required for this project include hospital management, trainers, and nurse educators. The financial resources will be needed to help in coming up with the educational material to be used to convince people to take the covid-19 vaccine. In addition, the finance will also be used to cater for data collection, project evaluation, and monitoring of the project. A detailed project budget and resource list has been included in the appendix section.

The Selected Study Design

            A quantitative study design has been chosen for the project. The design will be used in data collection, data analysis, and even evaluation of the efficacy of the proposed health education program. It has been chosen since it supports the use of numbers as opposed to the qualitative design, which mainly uses narration (Jolley, 2020). It is also easier and simpler to collect and analyze data using quantitative design through the use of well-known statistical tools.

The Methods and Instruments

            Methods and instruments play a key role in the EBP project. As such, one of the instruments to be used in this project is questionnaires. Questionnaires will be used at different stages or parts of the project. For example, they will be used to gain an insight into the participant’s attitude towards covid-19 vaccine and their willingness to take the vaccine. They will also be used to assess the same parameters after the health education initiative. Questionnaires have been chosen since they are easier to compose and administer. The data obtained from such questionnaires are also easier to organize and analyze (Melnyk& Fineout-Overholt, 2019).

The Process of Delivering the Intervention

            The intervention should be delivered in an appropriate way to ensure that it is a success. As such, the intervention is to be delivered in stages. Stage one will entail a needs assessment. Such a needs assessment exercise will be key in exploring the participant’s willingness to take the vaccine and their knowledge regarding the same. The next phase involved educating the staff regarding the material to be used for educating the participants. The last stage involves rolling out the health education initiative to help increase individuals’ willingness to take covid-19 vaccine.

The Stakeholders Needed For the Implementation Process

            It is important to timeously identify the stakeholders since they can impact the implementation of the project. It is also key to incorporate them in the project early enough to limit the possibility of resistance (Triplett et al., 2022). As such, several stakeholders were identified to be part of the project implementation. Among the stakeholder include the nurses handling patients in the outpatient unit, the nurse educator, the nurse leader, the finance officer, and the nurse manager of the outpatient unit. The nurses attending to patients in the outpatient unit will take an active role in the whole implementation process. The nurse leader will be tasked with the project implementation coordination. As such, they will give necessary feedback regarding the challenges that have been experienced and the project milestone. The nurse educator will lead the other staff in developing the education material. Besides, the finance officer will give financial advice upon the completion of the cost-benefit analysis and after carrying out an analysis of the financial implications.

Potential Barriers and Strategies for Overcoming Them

            The implementation of evidence-based practice projects may face various barriers which can be difficult to overcome. However, it is important to identify such barriers in time and come up with potential solutions for them. Among the identified potential barriers is insufficient support from the organization (Cullen et al., 2020). In some cases, the leaders may fail to offer adequate or needed support to make the implementation process a success. One of the strategies for overcoming this barrier is ensuring that the project’s objectives and goals are well aligned with the organizational goals, vision, and mission to help trigger support from the leaders. Another potential barrier is less interest or lack of interest by the staff. Some staff may resist vaccine education due to having a contrary opinion hence putting less effort into the proposed intervention. One of the strategies that can be used to help overcome this barrier is the use of effective and open communication, which will encourage them to share their views and how they can be incorporated to better participate in the project (Cullen et al., 2022).

Evaluation Plan

Evaluation is another important phase of the evidence-based practice project cycle. This is one of the last phases where the project team explores the efficacy of the implemented intervention. In addition, as part of the evaluation phases, the project team also found out how effective the methods used in the project were or have been. Therefore, it is important to measure the outcomes and compare them with the expected outcomes to determine the effectiveness of the implemented project. Therefore, this section discusses the evaluation plan.

The Expected Outcomes

            As earlier indicated, this evidence-based practice project deals with the application of a health education program on covid-19 vaccine to help increase the willingness to take the vaccine among people at risk of covid-19 virus. As such, among the expected outcomes is enhanced willingness by the participants to take covid-19 vaccine. Another expected outcome is a willingness to turn up for the education to receive appropriate education regarding covid-19 vaccine (James et al., 2021). It is also expected that the education initiative will lead to an actual increase in the covid-19 vaccine uptake.

Data Collection Tools

            It is also important to use the most appropriate tools to collect data for analysis and evaluation. Therefore, among the tools that will be used for data collection is questionnaires. The questionnaires will play a major role in determining the level of knowledge of the target population regarding the covid-19 vaccine and their attitude toward taking the vaccine. Similar data will also be collected after implementing the program to help determine the efficacy of the health education program. This tool is also important since it supports the use of the selected quantitative study approach. Questionnaires are also known to be valid and reliable since they have been used in obtaining similar data in research efforts similar to the proposed study. The same set of questions will be used before and after the intervention, which makes it a reliable tool (Yaddanapudi& Yaddanapudi, 2019).

The Chosen Statistical Test

            Statistical tests play a significant role as part of the analysis as they give values for the measurements used in determining the effectiveness of the project. As such, paired T-test will be used as part of the analysis. This test is appropriate since it helps measure the difference in willingness to take the vaccine before and after the implementation of the proposed health education program. The test will be key in revealing if the use of the health education intervention has led to a significant difference which is a key measure of the success of the intervention.

Strategies to be Taken If the Outcomes Do Not Provide Positive Results

            It is important to put in place plans to follow if the project fails to yield positive results as expected. As such, in the case that the project results are not positive, then one of the strategies that will be used is a re-examination of the intervention used to explore if it was correctly implemented. Such a strategy will be key to enabling the project team to identify what went wrong and how to improve them for success (Melnyk& Fineout-Overholt, 2022). The strategy of extending the project timeline will also be used to allow the project team to take corrective measures

Plans to Maintain, Extend, Revise, and Discontinue the Proposed Solution

            It is important to have an appropriate plan in place for maintaining, extending, revising, and discontinuing the proposed solution. As part of the plan, the proposed solution will be maintained if the outcomes are positive and enhance clinical outcomes. In addition, the project will be maintained in the case where it is cost-effective. On the other hand, an extension will be sought if the conclusions are found to be inconclusive (Linsley et al., 2019). Such an extension may help in obtaining additional data, which can then be used for further project evaluation. The proposed solution will also be revised if the strategies do not align with the outcomes. Finally, discontinuation is considered if it turns out that the projec