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.

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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.

Criterion

1. Unsatisfactory

2. Insufficient

3. Approaching

4. Acceptable

5. Target

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

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

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

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

8.8 points

9.2 points

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

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.