NUR 590 Benchmark – Evidence-Based Practice Proposal Project: Framework/Model for Change
Evidence-Based Practice Proposal Project: Framework/Model for Change
Evidence-based practice (EBP) is the foundation of continuous improvements in nursing. It requires nursing professionals to identify performance gaps and propose suitable interventions supported by scientific evidence. Common causes of gaps include workplace issues, patient safety concerns, and poor care quality. As frontline workers who interact with patients regularly, nursing professionals should implement EBP using appropriate models. According to Duff et al. (2020), EBP models provide the steps of knowledge implementation and decision points to facilitate evidence application to nursing practice. The purpose of this paper is to discuss the framework/model for implementing the EBP proposal project.
The Selected Framework/Model for Change and its Relevance
The appropriate framework/model for the proposed project is the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model. Friberg and Creasia (2023) mentioned that the JHNEBP model was created in 2002 to address gaps in evidence utilization in nursing. The model has three essential components that guide change leaders in EBP implementation: practice question, evidence, and translation (Dusin et al., 2023). The JHNEBP model is relevant to the project since it provides a step-wise approach to evidence translation (Appendix A). Its other dominant feature is the interrelationships between scientific inquiry, practice, and learning, enabling nurses to improve patient outcomes as they improve their knowledge. Importantly, the model is team-based, and the proposed project requires such an approach for successful implementation.
The Stages in the Change Framework/Model
The first step (practice question) has much to do with identifying the EBP question guided by the clinical problem. Within nursing, this question is in problem/population, intervention, comparison, outcome, and time (PICOT) format (McClinton, 2022). The evidence phase involves searching, appraising, and rating the strength of the evidence. This search is mainly in scientific journal articles from the leading nursing databases. The appraisal ensures they meet the desired qualities, particularly credibility, relevance, and purpose. The third phase, translation, involves implementing and evaluating the proposed change through an action plan (Dusin et al., 2023; Friberg & Creasia, 2023). After evaluating the outcomes, change leaders should share findings with the stakeholders.
Applying the Framework/Model in the Proposed Implementation
Applying the JHNEBP model implies following the steps of the practice question, evidence, and translation (PET). The proposed intervention is a two-weekly tailored physical exercise training program to improve functional fitness and independent living among older adults with type 2 diabetes. Following the PICOT format, the practice question is: in older adults with type 2 diabetes (P), does a twice-weekly tailored physical exercise training program (I), compared to no exercise interventions (C), improve functional fitness and independent living (O) in 8 weeks (T)?
Scientific evidence to support the intervention should be searched, appraised, and rated as the model recommends. Similarly, evidence (particularly levels 1 and 2) exploring the effectiveness of the tailored physical exercise training program in improving functional fitness will be appraised before being translated into practice (project implementation). Such evidence includes Zarco et al. (2021) and Kirwan et al. (2021) peer-reviewed articles exploring participants’ experiences and impacts of exercise programs on functional fitness and independence among older adults with type 2 diabetes. The findings will also be shared with stakeholders as the model recommends.
JHNEBP Conceptual Framework
The concept map (Appendix A) illustrates the basic steps (PET) of the JHNEBP model. It will be applied to the project to guide the phased translation of evidence into practice. As such, it will be a reference tool to ensure that the essential steps are followed and key activities are accomplished. Above all, it will be used during project evaluation to determine the project’s success and ensure its findings have been shared with the stakeholders.
Conclusion
EBP projects require a systematic implementation to ensure evidence is translated appropriately and outcomes can be evaluated. As a result, EBP frameworks/models are crucial to facilitate this organized implementation. The JHNEBP model is relevant to the current project due to its step-wise (PET) approach. Evidence will be sourced from credible sources and appraised to ensure the intervention improves outcomes as envisioned.
References
Duff, J., Cullen, L., Hanrahan, K., & Steelman, V. (2020). Determinants of an evidence-based practice environment: an interpretive description. Implementation Science Communications, 1, 1-9. https://doi.org/10.1186/s43058-020-00070-0
Dusin, J., Melanson, A., & Mische-Lawson, L. (2023). Evidence-based practice models and frameworks in the healthcare setting: a scoping review. BMJ Open, 13(5), e071188. https://doi.org/10.1136/bmjopen-2022-071188
Friberg, E. E., & Creasia, J. L. (2023). Conceptual Foundations-E-Book: the Bridge to Professional Nursing Practice. Elsevier Health Sciences.
Kirwan, M., Chiu, C. L., Hay, M., & Laing, T. (2021). Community-based exercise and lifestyle program improves health outcomes in older adults with type 2 diabetes. International Journal of Environmental Research and Public Health, 18(11), 6147. https://doi.org/10.3390/ijerph18116147
McClinton, T. D. (2022). A guided search: Formulating a PICOT from assigned areas of inquiry. Worldviews on Evidence-Based Nursing, 19(5), 426–427. https://doi.org/10.1111/wvn.12598
Zarco, E. P. T., Aquino, M., Petrizzo, J., Wygand, J., & McGorry, A. (2021). Perceived benefits of a guided exercise program among older adults. Gerontology and Geriatric Medicine, 7, 23337214211060147. https://doi.org/10.1177/23337214211060147
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Assessment Description
Applying a framework/model for change ensures that a process is in place to guide the efforts for change. In 500-750 words, discuss the framework/model you will use to implement your evidence-based practice proposal project. You will use the framework/model you select in the Topic 8 assignment, during which you will synthesize the various aspects of your project into a final paper detailing your evidence-based practice project proposal.
Include the following:
- Identify the selected framework/model for change and discuss its relevance to your project.
- Discuss each of the stages in the change framework/model.
- Describe how you would apply each stage of the framework/model in your proposed implementation.
- Create a concept map for the framework/model you selected to illustrate how it will be applied to your project. Attach this as an appendix at the end of your paper.
Refer to the “Evidence-Based Practice Project Proposal – Assignment Overview” document, located in Class Resources for an overview of the evidence-based practice project proposal assignments.
You are required to cite a minimum of four peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.
Complete the “APA Writing Checklist,” located in Class Resources, to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as an appendix at the end of your paper.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Benchmark Information
This benchmark assignment assesses the following programmatic competencies:
MBA-MSN; MSN
1.2 Apply theoretical frameworks from nursing and other disciplines to make decisions regarding practice and health-related problems at the individual and population level.
Benchmark – Evidence-Based Practice Proposal Project: Framework/Model for Change – Rubric
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Rubric Criteria
Total100 points
| Criterion | 1. Unsatisfactory | 2. Insufficient | 3. Approaching | 4. Acceptable | 5. Target |
|---|---|---|---|---|---|
| Selected Framework/Model for Change
Selected Framework/Model for Change |
0 points
The selected framework/model and its relevance to the project are not discussed. |
9.6 points
The selected framework/model and its relevance to the project are incomplete. |
10.56 points
The selected framework/model and its relevance to the project are summarized. More information or support is needed. |
11.04 points
The selected framework/model and its relevance to the project are discussed. Some detail is needed for clarity or support. |
12 points
The selected framework/model and its relevance to the project are thoroughly discussed. Rationale or support is provided. |
| Stages for Framework/Model
Stages for Framework/Model |
0 points
The stages in the framework/model are not discussed. |
10.4 points
The stages in the framework/model are only partially discussed. |
11.44 points
The stages framework/model are outlined. There are some inaccuracies. More information is needed. |
11.96 points
The stages in the change model or framework are discussed. Some detail is needed for clarity or accuracy. |
13 points
The stages in the change model or framework are thoroughly discussed. |
| Application of Model or Framework to Proposed Implementation
Application of Model or Framework to Proposed Implementation |
0 points
Application of each stage of the model or theoretical framework to the proposed implementation is omitted. |
12 points
Application of each stage of the model or theoretical framework to the proposed implementation is incomplete. |
13.2 points
Application of each stage of the model or theoretical framework to the proposed implementation is outlined. More information is needed. |
13.8 points
Application of each stage of the model or theoretical framework to the proposed implementation is described. Some detail is needed for clarity or support. |
15 points
Application of each stage of the model or theoretical framework to the proposed implementation is thoroughly described. |
| Concept Map for Model or Framework
Concept Map for Model or Framework |
0 points
A concept map for the selected conceptual model or framework is omitted. |
12 points
The concept map for the selected conceptual model or framework is incomplete or inaccurate. The concept map is attached, but not in an appendix. |
13.2 points
A general concept map for the selected conceptual model or framework is attached in an appendix. There are inaccuracies. |
13.8 points
A concept map for the selected conceptual model or framework is attached in an appendix. Some detail is needed for clarity or accuracy. |
15 points
A detailed and accurate concept map for the selected conceptual model or framework is attached in an appendix. |
| Application of Theoretical Framework in Decision Making (B)
Application of Theoretical Framework in Decision Making (C1.2) |
0 points
The ability to apply theoretical frameworks from nursing and other disciplines to make decisions regarding practice and health-related problems at the individual and population level is not demonstrated. |
8 points
The ability to apply theoretical frameworks from nursing and other disciplines to make decisions regarding practice and health-related problems at the individual and population level is not consistently demonstrated. There are significant gaps and inaccuracies. |
8.8 points
The ability to apply theoretical frameworks from nursing and other disciplines to make decisions regarding practice and health-related problems at the individual and population level is generally demonstrated. There are some gaps or inaccuracies. |
9.2 points
The ability to apply theoretical frameworks from nursing and other disciplines to make decisions regarding practice and health-related problems at the individual and population level is adequately demonstrated. |
10 points
The ability to effectively apply theoretical frameworks from nursing and other disciplines to make decisions regarding practice and health-related problems at the individual and population level. |
| Required Sources
Required Sources |
0 points
Sources are not included. |
4 points
Number of required sources is only partially met. |
4.4 points
Number of required sources is met, but sources are outdated or inappropriate. |
4.6 points
Number of required sources is met. Sources are current, but not all sources are appropriate for the assignment criteria and nursing content. |
5 points
Number of required resources is met. Sources are current, and appropriate for the assignment criteria and nursing content. |
| Thesis, Position, or Purpose
Communicates reason for writing and demonstrates awareness of audience. |
0 points
The thesis, position, or purpose is not discernible. No awareness of the appropriate audience is evident. |
5.6 points
The thesis, position, or purpose is discernable in most aspects but is occasionally weak or unclear. There is limited awareness of the appropriate audience. |
6.16 points
The thesis, position, or purpose is adequately developed. An awareness of the appropriate audience is demonstrated. |
6.44 points
The thesis, position, or purpose is clearly communicated throughout and clearly directed to a specific audience. |
7 points
The thesis, position, or purpose is persuasively developed throughout and skillfully directed to a specific audience. |
| Development, Structure, and Conclusion
Advances position or purpose throughout writing; conclusion aligns to and evolves from development. |
0 points
No advancement of the thesis, position, or purpose is evident. Connections between paragraphs are missing or inappropriate. No conclusion is offered. |
6.4 points
Limited advancement of thesis, position, or purpose is discernable. There are inconsistencies in organization or the relationship of ideas. Conclusion is simplistic and not fully aligned to the development of the purpose. |
7.04 points
The thesis, position, or purpose is advanced in most aspects. Ideas clearly build on each other. Conclusion aligns to the development of the purpose. |
7.36 points
The thesis, position, or purpose is logically advanced throughout. The progression of ideas is coherent and unified. A clear and plausible conclusion aligns to the development of the purpose. |
8 points
The thesis, position, or purpose is coherently and cohesively advanced throughout. The progression of ideas is coherent and unified. A convincing and unambiguous conclusion aligns to the development of the purpose. |
| Evidence
Selects and integrates evidence to support and advance position/purpose; considers other perspectives. |
0 points
Evidence to support the thesis, position, or purpose is absent. The writing relies entirely on the perspective of the writer. |
4 points
Evidence is used but is insufficient or of limited relevance. Simplistic explanation or integration of other perspectives is present. |
4.4 points
Relevant evidence that includes other perspectives is used. |
4.6 points
Specific and appropriate evidence is included. Other perspectives are integrated. |
5 points
Comprehensive and compelling evidence is included. Multiple other perspectives are integrated effectively. |
| Mechanics of Writing
Includes spelling, capitalization, punctuation, grammar, language use, sentence structure, etc. |
0 points
Errors in grammar or syntax are pervasive and impede meaning. Incorrect language choice or sentence structure errors are found throughout. |
4 points
Frequent and repetitive mechanical errors are present. Inconsistencies in language choice or sentence structure are recurrent. |
4.4 points
Occasional mechanical errors are present. Language choice is generally appropriate. Varied sentence structure is attempted. |
4.6 points
Few mechanical errors are present. Suitable language choice and sentence structure are used. |
5 points
No mechanical errors are present. Skilled control of language choice and sentence structure are used throughout. |
| Format/Documentation
Uses appropriate style, such as APA, MLA, etc., for college, subject, and level; documents sources using citations, footnotes, references, bibliography, etc., appropriate to assignment and discipline. |
0 points
Appropriate format is not used. No documentation of sources is provided. |
4 points
Appropriate format is attempted, but some elements are missing. Frequent errors in documentation of sources are evident. |
4.4 points
Appropriate format and documentation are used, although there are some obvious errors. |
4.6 points
Appropriate format and documentation are used with only minor errors. |
5 points
No errors in formatting or documentation are present. Selectivity in the use of direct quotations and synthesis of sources is demonstrated. |
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