NUR590 Evidence-Based Practice Project Proposal Presentation

NUR590 Evidence-Based Practice Project Proposal Presentation

Evidence-based Practice Project


  • By the end of the presentation, you should be able to understand
  • The problem statement and literature about the project
  • The purpose of the project
  • The level of organizational readiness
  • The change model used in the project
  • The implementation plan
  • The evaluation plan

NUR590 Evidence-Based Practice Project Proposal Presentation

Introduction – NUR590 Evidence-Based Practice Project Proposal Presentation

  • Clinical problem: Central-line Associated Blood Stream Infections (CLABSI).
  • In the ICU patients with reversible life-threatening conditions are stabilized before management in the general ward.
  • The invasive procedures such as central line catheters are used for medication and supporting patients are a risk for introduction of infections.
  • CLABSI are common causes of mortality, morbidity, increased hospital stay, poor outcomes.
  • Chlorohexidine has been used to reduce the rates of CLABSI. Healthcare workers play a major role in reducing infection rates.
  • PICOT-: In patients admitted in ICU with a central line catheter (P), how does the use of chlorhexidine (I) compared with flushing central line using normal saline (C) lead to the reduced central line-associated bloodstream infection (O) over six months (T)? NUR590 Evidence-Based Practice Project Proposal Presentation

Problem Statement

CLABSI negatively affect patient outcome leading to mortality and morbidity.

The recent increase in resistance to antibiotics caused by MRSA requires prevention strategies by healthcare workers.

Most healthcare providers understand the preventive measures, however, most of them fail to implement the guidelines into practice.

Preventive measures include the use of aseptic techniques, surveillance, and early management.

This project is aimed at improving knowledge among healthcare workers to adhere to the daily bathing of ICU patients with chlorohexidine to reduce the rate of CLABSI.

Prevalence of CLABSI

  • Cases of CLABSI are still on the rise with up to 41,0000
  • The global incidence is 3.73 per 1000 central lines (Frost et al., 2018).
  • The increasing rate is due to poor handling of patients by healthcare workers and nonadherence to protocols.
  • All healthcare workers must effectively carry out their roles to reduce the rate of CLABSI by 50%

Literature Review

  • CLABSIs are high in ICU patients who are immunocompromised and the elderly.
  • Causative agents include MRSA, gram-negative bacteria (33.9%), and Candida species (27.6%) (Haddadin et al., 2021).
  • CLABSI is defined as infection arising after 48hrs post insertion of central lines.
  • The common sign is sudden onset fever of unknown origin.
  • CLABSI increases hospital stay, increases the cost of care, increases mortality and morbidity, and leads to poor patient outcomes.
  • Cost of care per patient with CLABSI is up to $46,000 while others may exceed $ 80,000 (Haddadin et al., 2021).
  • Mortality from CLABSI ranges between 12-25%. Most common cause of HAI
  • However, centers that use preventive measures has lower mortality and reduced cost of care.

NUR590 Evidence-Based Practice Project Proposal Presentation References

  • Arunga, S., Mbarak, T., Ebong, A., Mwesigye, J., Kuguminkiriza, D., Mohamed-Ahmed, A. H. A., Hoffman, J. J., Leck, A., Hu, V., & Burton, M. (2021). Chlorhexidine gluconate 0.2% as a treatment for recalcitrant fungal keratitis in Uganda: a pilot study. BMJ Open Ophthalmology, 6(1), e000698.
  • Frost, S. A., Hou, Y. C., Lombardo, L., Metcalfe, L., Lynch, J. M., Hunt, L., Alexandrou, E., Brennan, K., Sanchez, D., Aneman, A., & Christensen, M. (2018). Evidence for the effectiveness of chlorhexidine bathing and health care-associated infections among adult intensive care patients: a trial sequential meta-analysis. BMC Infectious Diseases, 18(1), 679.
  • Haddadin, Y., Annamaraju, P., & Regunath, H. (2021). Central line associated blood stream infections. In StatPearls [Internet]. StatPearls Publishing.
  • Hammoudeh, S., Gadelhaq, W., & Janahi, I. (2018). Prospective cohort studies in medical research. In Cohort Studies in Health Sciences. InTech.
  • Kuriyan, A., Kinkler, G., Cidav, Z., Kang-Yi, C., Eiraldi, R., Salas, E., & Wolk, C. B. (2021). Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) to improve collaboration in school mental health: Protocol for a mixed methods hybrid effectiveness-implementation study. JMIR Research Protocols, 10(2), e26567.
  • Reynolds, S. S., Woltz, P., Keating, E., Neff, J., Elliott, J., Hatch, D., Yang, Q., & Granger, B. B. (2021). Results of the CHlorhexidine Gluconate Bathing implementation intervention to improve evidence-based nursing practices for prevention of central line associated bloodstream infections Study (CHanGing BathS): a stepped wedge cluster randomized trial. Implementation Science: IS, 16(1), 45.
  • Zamir, N., Pook, M., McDonald, E., & Fox-Robichaud, A. E. (2020). Chlorhexidine locking device for central line infection prevention in ICU patients: protocol for an open-label pilot and feasibility randomized controlled trial. Pilot and Feasibility Studies, 6(1), 26.


Assessment Description – NUR590 Evidence-Based Practice Project Proposal Presentation

The dissemination of an evidence-based practice project proposal is an important part of the final project. Dissemination of your project to a local association or clinical site/practice informs important stakeholders of evidence-based interventions that can improve clinical practice and ultimately patient outcomes.

For this assignment, develop a professional presentation that could be disseminated to a professional group of your peers.

Develop a 12-15 slide PowerPoint detailing your evidence-based practice project proposal. Create speaker notes of 100-250 words for each slide.

NUR 590 Topic 5 Evidence-Based Practice Project Proposal Implementation Plan Example

Project implementation preparation is an essential aspect of project success. An implementation plan explains the “who, what, when, how, and why” of the project (Fernadez et al., 2019). It translates strategies and objectives to tasks (Fernandez et al. ). Leaders must prepare all necessary infrastructure, including availing resources, contacting stakeholders, and preparing the necessary paperwork, such as the process map and consent.

Preparing an implementation plan helps direct resources toward goal achievement and helps avoid unnecessary problems such as time and resources wasted after deviation from the objectives. An implementation plan also helps prepare a budget and improve the leader’s efficiency in controlling project activities. This paper outlines the implementation plan for the project, which focuses on barcode medication administration to reduce medication errors in the facility.

Settings and Access to Potential Subjects

The settings of interest for implementing the project are the ICU and the HDU  in the healthcare facility. HDU and ICU patients are long-term care patients requiring a lot of nursing support, and these units report some of the highest numbers of medication errors in healthcare facilities (Alghamdi et al., 2019). Factors such as their critical condition, age, immunocompromise, nature of medications, and the hasty nature of these departments expose the patients to medication errors and the severe effects of medication errors (Zirpe et al., 2020). These patients in the critical care units are the patients of interest. The patients selected must be in a state they can give consent, or their caregivers can give consent. 

The patients of interest are patients with chronic illnesses due to the duration of management. Intensive care and critical care units have relatively longer stays than other critical care settings, such as the emergency and post-operative care settings. Consent is necessary because the technology is new in the facility, and patients can sue the facility for being denied routine care and being used in research without their consent. The consent forms the patient or their care providers must fill out are attached in the appendix.


Various activities during the project’s implementation will be time-consuming, hence the need for adequate preparation. The total time taken from implementation to evaluation is precisely six months, and the timing is dictated by the time resources and all other factors necessary for the implementation are ready. The timeline does not include the preparation phase because gathering primary resources can be affected by various issues, such as resource availability. Thus, the total time required from implementation preparation to evaluation is eight months. The timeline draft is attached in the appendix.

Budget and Resource List

The budget and resource list require an entirely new program embedded in the electronic health records that ensures that monitors and scanners can access patient data from the healthcare database. The human resources required include the executive leadership and the technical team to assist with the maintenance and technology implementation of the project. Other changes include a complete transition to computerized physician order entry to ensure all patient data is accessible in the healthcare database.

Another necessary change is the fiscal scheduling policy due to the expected change in workload due to the added activity. Screens and monitors are also necessary, along with electricity sources. The cost for personnel and non-personnel items are as follows: personnel $500000 (including personnel training), consumable supplies $2000, computer-related costs $30000, equipment $1000000, and other costs (utility $1000) hence a total of $1533000. These costs are manageable by the healthcare facility, and donors can be contacted to help outsource the remaining amount in case of inefficiencies.

Research Design

A quantitative design is the best approach to data collection and evaluating the effectiveness of the evidence-based practice project proposal. The data will be collected from the healthcare database using numerical methods. Other interventions, such as determining the nurse’s attitude/perception towards the new technology, will only help improve and facilitate its implementation. The data will be evaluated based on changes in medication administration errors. Bloomfield and Fisher (2019) note that quantitative research designs best analyze research studies utilizing statistical data. 

The objective is to observe the medication administration errors and determine any statistical significance between the pre-implementation and post-implementation of the project. Data will be extracted from the database and categorized into categories such as prescription, transcription, and administration errors pre-and post-implementation of the BCMA. The differences between the data will be statistically analyzed to determine the project’s effectiveness in improving care outcomes/reducing medication administration errors (Bloomfield & Fisher, 2019). Thus, a quantitative research design for this study utilizing numerical data is integral.

Methods and Instruments

Various methods will be used to monitor the implementation of the proposed solution. The project will be monitored through advanced reporting, entailing objectives achieved/tasks completed, challenges, and any disruptive innovation employed to facilitate implementation. The selected method is the critical path method. Olivieri et al. (2019) note that the critical path method of monitoring project implementation entails outlining the critical tasks and their schedule and order of priority.

The method also entails a column outlining how the project tasks interdepend on each other and the tasks that come before and after. The sequence helps monitor activities and prepare to facilitate the activities. The project management team will tick activities as they are completed until the last task is completed. A critical path method is simple to create and use, and thus, the best method to use in monitoring project implementation.

The Process of Delivering the Intervention

The process will begin with writing a comprehensive proposal to the healthcare organization and obtaining internal and external approval for the project. The next step will be gathering resources such as modification of electric sources, equipment purchase (monitors and scanners), integration into the health information system, and system checks to ensure they are ready for the work. Another intervention will include nurses’ training on their proper use.

After setting the basic infrastructure, the nurses will utilize the technologies to administer medications and record the number of mediation administration events daily for six months. The data from the healthcare dashboard on the number of medication errors will be evaluated at the end of the project. Differences in medication administration errors and other categories before and after BCMA implementation will be analyzed using an ANOA test for statistical significance.


The stakeholders required for this project are patients, nurses, healthcare leaders, and financiers. This project is resource-intensive, and having financiers, especially donors because the project is not projected to produce profit, is integral. Patients’ consent to enrollment in the program will be helpful as it will set the ethical and legal framework for the project. A patient representative will help in the conviction process and ensure patients feel represented and valued.

Healthcare leaders will be responsible for controlling project resources, including human and fiscal resources hence their significance (Cortellazo et al., 2019). The nurses are the primary healthcare providers involved in the project and will be responsible for its implementation by administering medications utilizing the new technology. They will also assist in other vital processes, such as data collection and project evaluation. Their participation in ongoing surveys will help improve the project and enhance its success.

Barriers and Challenges to the Implementation Plan

The project could face various barriers that, include inadequate resources. Dhir et al. (2019) note that resource misappropriation is a significant barrier to project success. Budgeting and mobilizing all resources before the commencement of the project will ensure its smooth running without delays caused by resource misappropriation. Current technologies are expensive, and the technical skills required to embed the technologies into healthcare databases and ensure safe data transfer are also expensive.

The project’s budget is also relatively high, hence the need to reach out to financial institutions and healthcare donors, including the government, for assistance with the project. Lack of clarity and role confusion are other barriers that prevent or delay project implementation (Krupp et al., 2021). Developing clear roles and promptly communicating the information on roles to the stakeholders will enhance their understanding and promptness in implementing activities.

Implementation Plan Feasibility

Feasibility studies help bring light to the implementation plan, outline challenges and opportunities, increase insight for decision-making, show the need for the project, improve team member focus, and enhance project success. Feasibility is based on technological, legal, operability, reasonable period, and economic feasibility. For technological feasibility, the organization has a robust database and healthcare information systems to facilitate the project.

In addition, the project is legally and operationally abiding and acceptable and recommended by agencies such as the Joint Commission and the Agency for Healthcare Research and Quality as the best evidence-based practice in medication administration error prevention (Call et al., 2019). The plan will also be implemented and evaluated in six months, allowing the facility to collect adequate data for project evaluation. The project is resource-intensive but will eliminate significant healthcare costs attributed to medication administration errors and other costs, such as lawsuits by patients involved in these medication errors. Thus, the project’s implementation plan is feasible.


The implementation plan entails extensive preparation plans such as a consent form, implementation monitoring method, budget, resource list, and outline of the intervention process. Preparing a project implementation plan is crucial in predicting problems and mitigating them for the success of any healthcare project. Critical care units are sensitive areas that consider patient conditions and the effects of errors on patient safety and outcomes. Barcode medication administration errors target to reduce administration errors. The implementation plan is feasible for the organization, and the project’s implementation will depend highly on the preparation phase. The project will run for six before evaluation to allow adequate time for data collection.

NUR590 Evidence-Based Practice Project Proposal Presentation References

Alghamdi, A. A., Keers, R. N., Sutherland, A., & Ashcroft, D. M. (2019). Prevalence and nature of medication errors and preventable adverse drug events in pediatric and neonatal intensive care settings: a systematic review. Drug Safety, 42(12), 1423–1436.

Bloomfield, J., & Fisher, M. J. (2019). Quantitative research design. Journal of the Australasian Rehabilitation Nurses Association, 22(2), 27–30.

Call, R. C., Ruskin, K. J., Thomas, D. A., & O’Connor, M. F. (2019). Human Factors and the Impact on Patient Safety: Tools and Training. International Anesthesiology Clinics, 57(3), 25-34.

Cortellazzo, L., Bruni, E., & Zampieri, R. (2019). The role of leadership in a digitalized world: A review. Frontiers in Psychology, 10, 1938.  .

Dhir, S., Kumar, D., & Singh, V. B. (2019). Success and failure factors that impact on project implementation using agile software development methodology. In Software engineering (pp. 647–654). Springer, Singapore.

Fernandez, M. E., Ten Hoor, G. A., Van Lieshout, S., Rodriguez, S. A., Beidas, R. S., Parcel, G., Ruiter, R. A. C., Markham, C. M., & Kok, G. (2019). Implementation mapping: using intervention mapping to develop implementation strategies. Frontiers in Public Health, 7, 158.

Krupp, A., Di Martino, M., Chung, W., Chaiyachati, K., Agarwal, A. K., Huffenberger, A. M., & Laudanski, K. (2021). Communication and role clarity inform TeleICU use: a qualitative analysis of opportunities and barriers in an established program using AACN framework. BMC Health Services Research, 21(1), 1-10.

Olivieri, H., Seppänen, O., Alves, T. D. C., Scala, N. M., Schiavone, V., Liu, M., & Granja, A. D. (2019). A survey comparing critical path method, last planner system, and location-based techniques. Journal of Construction Engineering And Management, 145(12), 04019077.

Zirpe, K. G., Seta, B., Gholap, S., Aurangabadi, K., Gurav, S. K., Deshmukh, A. M., Wankhede, P., Suryawanshi, P., Vasanth, S., Kurian, M., Philip, E., Jagtap, N.,& Pandit, E. (2020). Incidence of Medication Error in Critical Care Unit of a Tertiary Care Hospital: Where Do We Stand? Indian Journal of Critical Care Medicine: Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine, 24(9), 799.

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