NUR 550 TOPIC 1 Evidence-Based Practice Project Proposal: Identification of Nursing Practice Problem
Complete your PICOT using your approved proposed nursing practice problem. If they were approved, you may use the population and intervention developed in your Topic 1 assignment. Include any necessary revisions in this submission. Refer to the “Example PICOT” below as needed for guidance on how to complete the PICOT.
| PICOT Question | |||
| P | Population | The population of focus entails nurses working in the emergency department.
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Emergency departments are one of the high-risk and high-stress environments where workplace violence among nurses is most prevalent. Therefore, nurses here are at a disproportionate risk due to exposure to high-stress situations that may propagate violence. |
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| I | Intervention | Implementation of a structured evidence-based de-escalation training, mandatory for all nurses.
The proposed intervention for the evidence-based practice project is de-escalation training. According to Thompson et al. (2022), de-escalation training entails teaching and preparing nurses with the necessary skills to address, prevent, reduce, and manage aggressive situations that may lead to workplace violence before they escalate, reducing workplace violence incidents. It aims to minimize the risk of physical and verbal assaults by promoting communication strategies to defuse tension, reducing injuries to staff and patients, and enhancing staff confidence and perceived safety. De-escalation training aligns with the Joint Commission safety goals and supports a culture of safety and respect (Thompson et al., 2022). |
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| C | Comparison | Standard practice- emergency departments without a structured workplace violence prevention program.
Despite the high rate of workplace violence against nurses, especially those reported in high-risk departments such as the emergency and psychiatric departments, studies show that most institutions lack structured violence prevention programs (Kafle et al., 2022). Therefore, the project will compare the implementation of the proposed intervention with departments without the structured program. |
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| O | Outcome | Reduction in the workplace violence incidences reported in the department and nurses’ perceived safety.
A reduction in the cases reported on workplace violence against nurses would increase the nurses’ perception of safety, even as they work in high-stress, high-acuity environments such as the emergency department. Additionally, the outcome would mean reduced physical and emotional harm to nurses, which further translates to lower turnover rates, absenteeism, and compromised patient care. |
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| T | Timeframe | 6 months. The proposed timeframe of six months will be adequate to implement the training intervention among the nurses and assess the pre- and post-intervention workplace violence incidence rates to determine the intervention’s effectiveness. | |
| PICOT
Create a complete PICOT statement. |
In nurses working in the emergency department (P), how does the implementation of a mandatory structured de-escalation training program (I), compared to standard practice (C), lead to reduced incidence of reported workplace violence and perceived safety among nurses (I) within 6 months (T)?
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| Problem Statement
Create a problem statement for your PICOT. You will use this problem statement throughout your final written paper.
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Workplace violence in healthcare settings, particularly in emergency departments, is a pervasive and growing concern with significant implications for nurse safety, patient care quality, and workforce sustainability. Emergency departments are especially vulnerable due to high patient acuity, overcrowding, long wait times, and the frequent presence of individuals under the influence of substances or experiencing psychiatric crises (Aljohani et al., 2021). The high-stress nature of the ED contributes to an environment where verbal abuse, threats, and physical assaults are disturbingly common.
Despite the high prevalence of workplace violence against nurses, studies show that the incidents are underreported due to a culture of normalization, fear of retaliation, and lack of institutional response (Gressia et al., 2022). However, nurses exposed to violence are more likely to suffer depression, anxiety, and have an increased intention to leave the profession, low morale, which affects clinical performance and overall patient outcomes. The problem also creates a climate of fear and demoralization, reducing teamwork and communication, especially among nurses and other interprofessional team members (Goh et al., 2022). Therefore, there is a need to implement structured interventions to prevent the issue, especially in high-risk areas such as the emergency department. De-escalation training programs have been found effective in equipping nurses with communication, situational awareness, and conflict resolution skills to defuse potentially violent situations before they escalate, hence reducing the incidence of aggression towards nurses and improving their confidence in managing high-risk encounters. The lack of structured mandatory workplace prevention programs implemented in high-risk environments as standard practice creates a practice gap that presents an opportunity for the evidence-based practice project to evaluate the effectiveness of such interventions within the emergency department context. |
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References
Aljohani, B., Burkholder, J., Tran, Q. K., Chen, C., Beisenova, K., & Pourmand, A. (2021). Workplace violence in the emergency department: a systematic review and meta-analysis. Public Health, 196, 186–197. https://doi.org/10.1016/j.puhe.2021.02.009
Goh, H. S., Hosier, S., & Zhang, H. (2022). Prevalence, Antecedents, and Consequences of Workplace Bullying among Nurses-A Summary of Reviews. International Journal of Environmental Research and Public Health, 19(14), 8256. https://doi.org/10.3390/ijerph19148256
Gressia, R. G. G., Usman, S., Kamil, H., Syarif, H., & Susanti, S. S. (2022). “Why do nurses not report?”A qualitative study of underreported workplace violence (WPV) in emergency department (ED). Clinical Nursing, 32, S1-S5. https://doi.org/10.1016/j.enfcli.2022.03.007
Kafle, S., Paudel, S., Thapaliya, A., & Acharya, R. (2022). Workplace violence against nurses: a narrative review. Journal of Clinical and Translational Research, 8(5), 421–424. https://pubmed.ncbi.nlm.nih.gov/36212701/
Thompson, S. L., Zurmehly, J., Bauldoff, G., & Rosselet, R. (2022). De-escalation Training as Part of a Workplace Violence Prevention Program. The Journal of Nursing Administration, 52(4), 222–227. https://doi.org/10.1097/NNA.0000000000001135
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Evidence-Based Practice Project Proposal: Identification of Nursing Practice Problem
Rubric
View Rubric
Assessment Description
Learners will select a valid nursing practice problem for an evidence-based practice project proposal. The project will be completed in sections, beginning in NUR-550 and culminating in a final written paper detailing the evidence-based practice proposal in NUR-590.
The purpose of this assignment is to select a relevant nursing practice problem for your evidence-based practice project proposal. To identify a relevant problem, consider problems generally faced in nursing practice (coordination of health care, assessment, education, patient support, trauma prevention, recovery, health screenings, etc.). Use the “PICOT Draft” template to complete this assignment.
Use a national, state, or local population health care database to research indicators of disparity. Choose a mortality/morbidity indicator to identify a clinical problem or issue that you want to explore pertaining to a population of focus. Use this indicator to begin to formulate a PICOT (Population/Problem, Intervention, Comparison, Outcome, and Time to achieve the outcome) statement.
Refer to “Evidence-Based Practice Project Proposal – Assignment Overview,” located in Class Resources, for an overview of the evidence-based practice project proposal assignments.
You are required to cite one peer-reviewed source to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be 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.
Evidence-Based Practice Project Proposal: Identification of Nursing Practice Problem Rubric Criteria
Criteria Description
Nursing Practice Problem (relevant to nursing practice, appropriate for an evidence-based practice project proposal, supported by current research)
- Target
3.5 points
The proposed problem is highly relevant to nursing practice, strongly supported by a current research article, and excellent for an evidence-based practice project. A clear explanation for why the topic is selected and relevant to advance nursing practice is presented. The nursing practice problem is approved. No revision is needed.
- Acceptable
3.22 points
A relevant nursing practice problem for an EBP project proposal is presented and is adequately supported by a current research article. Minor revision is needed for the nursing practice problem. An explanation for why the topic is selected and its relevance to advance nursing practice is presented. The nursing practice problem is conditionally approved; final approval is contingent upon revision.
- Approaching
3.08 points
A relevant nursing practice problem for an EBP project proposal is presented and is generally supported by a current research article. Some information or revision is required. The explanation for why the topic is selected and its relevance to advance nursing practice is somewhat unclear. The nursing practice problem is conditionally approved; final approval is contingent upon revision.
- Insufficient
2.8 points
A proposed problem is presented but is not relevant to nursing practice. The nursing practice problem lacks support from current research. A new nursing practice problem must be selected.
- Unsatisfactory
0 points
A problem was not submitted.
Criteria Description
Population
- Target
2.5 points
The population is thoroughly and accurately described. No revision is needed.
- Acceptable
2.3 points
The population is described. Minor detail is needed for clarity or accuracy. Minor revision is needed.
- Approaching
2.2 points
A summary of the population is presented. More information is needed. Revision is required.
- Insufficient
2 points
The description for the population is incomplete, or the information for the population is inaccurate.
- Unsatisfactory
0 points
The population is not described.
Criteria Description
Intervention
- Target
2.5 points
The proposed intervention is clearly described and relevant to the nursing practice problem and the population. No revision is needed.
- Acceptable
2.3 points
The proposed intervention is described and adequate to the nursing practice problem and the population. Minor detail is needed for clarity. Minor revision is needed.
- Approaching
2.2 points
The proposed intervention is generally described and adequate to the nursing practice problem and the population. More information needed. Revision is required.
- Insufficient
2 points
The proposed intervention is incomplete, or the proposed intervention is not relevant to the population or problem.
- Unsatisfactory
0 points
The proposed intervention is not described.
Criteria Description
Required Sources
- Target
0.5 points
Number of required resources is met. Sources are current and appropriate for the assignment criteria and nursing content.
- Acceptable
0.46 points
Number of required sources is met. Sources are current, but not all sources are appropriate for the assignment criteria and nursing content.
- Approaching
0.44 points
Number of required sources is met, but sources are outdated or inappropriate.
- Insufficient
0.4 points
Number of required sources is only partially met.
- Unsatisfactory
0 points
Sources are not included.
Criteria Description
Mechanics of Writing (includes spelling, punctuation, grammar, and language use)
- Target
0.5 points
No mechanical errors are present. Appropriate language choice and sentence structure are used throughout.
- Acceptable
0.46 points
Few mechanical errors are present. Suitable language choice and sentence structure are used.
- Approaching
0.44 points
Occasional mechanical errors are present. Language choice is generally appropriate. Varied sentence structure is attempted.
- Insufficient
0.4 points
Frequent and repetitive mechanical errors are present. Inconsistencies in language choice or sentence structure are recurrent.
- Unsatisfactory
0 points
Errors in grammar or syntax are pervasive and impede meaning. Incorrect language choice or sentence structure errors are found throughout.
Criteria Description
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.
- Target
0.5 points
No errors in formatting or documentation are present.
- Acceptable
0.46 points
Appropriate format and documentation are used with only minor errors.
- Approaching
0.44 points
Appropriate format and documentation are used, although there are some obvious errors.
- Insufficient
0.4 points
Appropriate format is attempted, but some elements are missing. Frequent errors in documentation of sources are evident.
- Unsatisfactory
0 points
Appropriate format is not used. No documentation of sources is provided.
Total10 points
Rubric Criteria
Criteria Description
Nursing Practice Problem (relevant to nursing practice, appropriate for an evidence-based practice project proposal, supported by current research)
- Target
3.5 points
The proposed problem is highly relevant to nursing practice, strongly supported by a current research article, and excellent for an evidence-based practice project. A clear explanation for why the topic is selected and relevant to advance nursing practice is presented. The nursing practice problem is approved. No revision is needed.
- Acceptable
3.22 points
A relevant nursing practice problem for an EBP project proposal is presented and is adequately supported by a current research article. Minor revision is needed for the nursing practice problem. An explanation for why the topic is selected and its relevance to advance nursing practice is presented. The nursing practice problem is conditionally approved; final approval is contingent upon revision.
- Approaching
3.08 points
A relevant nursing practice problem for an EBP project proposal is presented and is generally supported by a current research article. Some information or revision is required. The explanation for why the topic is selected and its relevance to advance nursing practice is somewhat unclear. The nursing practice problem is conditionally approved; final approval is contingent upon revision.
- Insufficient
2.8 points
A proposed problem is presented but is not relevant to nursing practice. The nursing practice problem lacks support from current research. A new nursing practice problem must be selected.
- Unsatisfactory
0 points
A problem was not submitted.
Criteria Description
Population
- Target
2.5 points
The population is thoroughly and accurately described. No revision is needed.
- Acceptable
2.3 points
The population is described. Minor detail is needed for clarity or accuracy. Minor revision is needed.
- Approaching
2.2 points
A summary of the population is presented. More information is needed. Revision is required.
- Insufficient
2 points
The description for the population is incomplete, or the information for the population is inaccurate.
- Unsatisfactory
0 points
The population is not described.
Criteria Description
Intervention
- Target
2.5 points
The proposed intervention is clearly described and relevant to the nursing practice problem and the population. No revision is needed.
- Acceptable
2.3 points
The proposed intervention is described and adequate to the nursing practice problem and the population. Minor detail is needed for clarity. Minor revision is needed.
- Approaching
2.2 points
The proposed intervention is generally described and adequate to the nursing practice problem and the population. More information needed. Revision is required.
- Insufficient
2 points
The proposed intervention is incomplete, or the proposed intervention is not relevant to the population or problem.
- Unsatisfactory
0 points
The proposed intervention is not described.
Criteria Description
Required Sources
- Target
0.5 points
Number of required resources is met. Sources are current and appropriate for the assignment criteria and nursing content.
- Acceptable
0.46 points
Number of required sources is met. Sources are current, but not all sources are appropriate for the assignment criteria and nursing content.
- Approaching
0.44 points
Number of required sources is met, but sources are outdated or inappropriate.
- Insufficient
0.4 points
Number of required sources is only partially met.
- Unsatisfactory
0 points
Sources are not included.
Criteria Description
Mechanics of Writing (includes spelling, punctuation, grammar, and language use)
- Target
0.5 points
No mechanical errors are present. Appropriate language choice and sentence structure are used throughout.
- Acceptable
0.46 points
Few mechanical errors are present. Suitable language choice and sentence structure are used.
- Approaching
0.44 points
Occasional mechanical errors are present. Language choice is generally appropriate. Varied sentence structure is attempted.
- Insufficient
0.4 points
Frequent and repetitive mechanical errors are present. Inconsistencies in language choice or sentence structure are recurrent.
- Unsatisfactory
0 points
Errors in grammar or syntax are pervasive and impede meaning. Incorrect language choice or sentence structure errors are found throughout.
Criteria Description
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.
- Target
0.5 points
No errors in formatting or documentation are present.
- Acceptable
0.46 points
Appropriate format and documentation are used with only minor errors.
- Approaching
0.44 points
Appropriate format and documentation are used, although there are some obvious errors.
- Insufficient
0.4 points
Appropriate format is attempted, but some elements are missing. Frequent errors in documentation of sources are evident.
- Unsatisfactory
0 points
Appropriate format is not used. No documentation of sources is provided.
Total10 points