In 500-750 words, develop an evaluation plan to be included in your final evidence-based practice project. Provide the following criteria in the evaluation, making sure it is comprehensive and concise:
Describe the rationale for the methods used in collecting the outcome data.
Describe the ways in which the outcome measures evaluate the extent to which the project objectives are achieved.
Describe how the outcomes will be measured and evaluated based on the evidence. Address validity, reliability, and applicability.
Describe strategies to take if outcomes do not provide positive results.
Describe implications for practice and future research.
You are required to cite three to five sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content. Evaluation Plan Essay Paper
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Evidence-Based Practice Proposal Section F: Evaluation Plan
With the proposed solution firmly implemented, what now remains is the evaluation of the effectiveness of the change. The identified practice problem had been the rising rates of patient falls within the rehabilitation center for the elderly. This had a negative consequence in that the fall victims were getting injured and in turn spending a prolonged period within the rehabilitation center. Due to the Centers for Medicare and Medicaid Services (CMS) policy of non-reimbursement for services rendered to fall victims, the hospital was also incurring losses by having to foot this bill for fall patients (Fehlberg et al., 2017). The purpose of this paper is to describe the evaluation plan for this project at the end of the implementation phase.
Rationale for the Methods Used in Collecting Outcome Data
The outcome data in this project has been collected by using various means. The two most important are the fall risk assessment tools and the Likert-type questionnaire for the nurses implementing the change. The rationale for using the risk assessment tools is that they are the instruments that will ensure the interventions are targeted at the right patients who will then be used to correctly assess the efficacy of those interventions. If the interventions were just undertaken in a blanket fashion without having knowledge of those patients among the rest who were at higher risk of falls, it would be difficult to evaluate success. This is why it is justifiable to use this method for data collection. Evaluation Plan Essay Paper
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The other method mentioned for data collection is the questionnaire. Its use is justifiable in that it is the tool or instrument that will ensure the attitude of the implementing nurses is in sync with the spirit of the interventions. The rationale is that the nurses have the first hand information of whether the interventions are practically feasible or not. This information is absolutely necessary in determining the adoption of the interventions into the organizational culture as policy. It would therefore only make sense that the feelings, attitudes, and opinions of the nurses are captured in the data that would then be analyzed for decision making later on (Wang et al., 2018).
Outcome Measures vs Project Objectives
The main outcome measure in this case is the rate of patient falls. Across the United States the rate of patient falls annually is reported to be between 3.3 and 11.5 falls per 1,000 hospital stays. The national benchmark is 3.44 falls per 1,000 hospital stays (Venema et al., 2019). With this, the outcome measure that had been set within the PICOT statement was a fall rate of below 3.3 falls per 1,000 hospital stays. This was the set expected outcome right from the start of the project with the identification of the problem and setting of the PICOT question (Melnyk & Fineout-Overholt, 2019). Taking this outcome measure as an example, it will evaluate the achievement of the set project objectives in that an actual drop of the fall rate to below 3.3 falls per 1,000 patient stays will indicate success. However, were the fall rate to continue skyrocketing even after implementation of the change interventions, the project would then be considered a phenomenal failure.
The other outcome measures are healthcare spending and the length of hospital stay. These two also measure the achievement of the project objectives in much the same way. An increase in the length of hospital stay would be a direct consequence of a fall that injures the elderly patient and continues to keep them in hospital for a longer duration of time as they heal. If this were the case, the project objective would not have been achieved. Higher hospitalization costs, just like the length of stay, would also be a direct consequence of an increased fall rate. This is because the injuries suffered by the fall victim would require treatment and further rehabilitation adding to the cost of healthcare. As seen above, this cost resulting from fall injuries will also be shouldered by the organization itself. All this does not achieve the project objectives that were set even before the project kicked off. The evaluation of the project will take place at the end of the implementation. According to the provided timeline, this will be during the stage of confirmation as per Roger’s diffusion of innovations theory.
Measuring Outcomes and Implications for Practice and Future Research
Based on the evidence, outcomes will be measured and evaluated as has been described above. The outcomes will be placed against the expected benchmarks and deviations noted. The methods used are valid as internal consistency was assured. Outcomes can also be generalizable since reliability was determined by proper methodology and sample size (a census in this case). The results are therefore applicable to clinical practice. In the event that the interventions do not provide the expected positive results, a fresh PICOT statement will be generated and a search for evidence started again in research databases. The implications for future practice are that accidental falls will no longer be a quality issue. Further research needs to be undertaken to establish causality between cognitive impairment and falls.
References
Fehlberg, E.A., Lucero, R.J., Weaver, M.T., McDaniel, A.M., Chandler, M., Richey, P.A., Mion, L.C., & Shorr, R. I. (2017). Impact of the CMS no-pay policy on hospital-acquired fall prevention related practice patterns. Innovation in Aging, 1(3), 1-7. http://dx.doi.org/10.1093/geroni/igx036
Melnyk, B.M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice, 4th ed. Wolters Kluwer.
Venema, D.M., Skinner, A.M., Nailon, R., Conley, D., High, R., & Jones, K.J. (2019). Patient and system factors associated with unassisted and injurious falls in hospitals: An observational study. BMC Geriatrics, 19(348), 1-10. https://doi.org/10.1186/s12877-019-1368-8
Wang, Y., Kung, L., & Byrd, T.A. (2018). Big data analytics: Understanding its capabilities and potential benefits for healthcare organizations. Technological Forecasting and Social Change, 126(1), 3–13. https://doi.org/10.1016/j.techfore.2015.12.019 Evaluation Plan Essay Paper