NURS 7024 – Research Analysis & Application

Fall 2020

Evidence-Based Practice Proposal

The goal of evidence-based practice is to provide high-quality, safe, and cost-effective care.  Changes in practice are driven by new problems that arise or new knowledge that becomes available. The ability to critically appraise evidence is essential for determining which evidence should be put into practice.  Barriers to implementation of practice changes include lack of knowledge and skill for accessing current research, and lack of familiarity and expertise in effecting change.  Prior to implementing a change in practice, preparing a formal, evidence-based proposal to support the change is an appropriate strategy for overcoming these barriers.  The goal of this assignment is to increase your ability to appraise and synthesize evidence to develop a logical argument to support a proposal for practice change (a project), and to provide experience in designing a detailed implementation and evaluation plan for your proposed project.    

Experientially, this assignment recreates the manuscript submission process, which allows authors to make corrections to their original manuscript and resubmit it for further consideration for publication.  It is designed to give you a sense of preparing a “final,” high-quality first draft for submission, getting back reviewer comments, and putting your nose to the grindstone again.  

The entire assignment is worth 300 points.  It will be submitted in 3 parts: 

  1. An initial draft of the Introduction section that is worth 100 points and is due by midnight on October 11, 2020.

            This draft should include the Title page, Abstract, Introduction, and References.

  • An initial draft of the Implementation section that is worth 100 points and is due by midnight on November 1, 2020.

            This draft should include the Title page (with corrections), Abstract (with corrections),    Introduction (no corrections needed), Implementation, and References (with any             formatting errors corrected).

  • A final project proposal that is worth 100 points and is due by midnight on November 11, 2020. 

Assignment Guidelines

This semester you will identify an appropriate clinical problem that you believe is significant to health care delivery and nursing practice.  Review the existing “evidence” and develop a proposal for a practice change to resolve the problem or implement the new knowledge in an appropriate clinical setting.  The proposal will be written up and submitted as a 5-8 page professional paper, not including title page, abstract, references, or attachments.  Remember, this is not a research study.  Prepare a formal written proposal for a change in practice using the following guidelines:

  • Double space all writing (do not add extra spaces except as needed at the bottom of a page to avoid single lines of text)
  • 12-point font only
  • Paginate consistently in upper right corner
  • Use running head (must include your name) in upper left corner
  • Use subheadings to structure the flow of your discussion and assist the reader to understand. At a minimum your subheadings should reflect the grading rubric.  However, because the Implementation section is such a complex part of your paper, I recommend using additional subheadings for each distinct part of the Implementation plan (example: Setting, Population, Timeline, Approval, etc.).  This will also help you group content appropriately and avoid confusion in your description of the process.
  • Professional tone – no contractions, no grammatical errors, no slang terminology
  • Do not use first person or refer to yourself as “the author” (third person).
  • Do not use quotations.  At the graduate level you are expected to paraphrase.
  • Label any attachments (i.e. Attachment A, Attachment B, etc.)
  • Proof read!! – no typographical or grammar errors
  • Rule of thumb – your goal is to ensure clarity for your reader.  Be sure everything is labeled clearly and referred to appropriately in the body of your paper.

Content of the Proposal

Title – Provide a brief title (not to exceed 12 words) in title case that describes the proposed practice change.

Abstract – Develop a non-structured abstract (not to exceed 150 words) on a separate page that summarizes the proposal (problem, solution, recommendation, anticipated outcome) for naïve readers.

Introduction – This section provides a brief synthesis of the literature (7-10 research studies).

  • Synthesize 7-10 research articles (you can also include review or non-research sources, but they won’t count as research studies) to describe the problem that the proposed change will address and the solution to the problem (evidence that the practice change will be effective).  This is the rationale for why the change is important.  Your goal is to synthesize evidence (use only content from the Results section of the articles, not the Introduction or Discussion) to develop a clear and convincing argument that change is needed.  Be sure you provide evidence to support both your problem statement (i.e. why this matters) and your solution (change in practice).  Evidence that supports the problem is likely to come from observational studies and evidence that supports the practice change must come from intervention studies.  In most cases, 3-4 paragraphs should be sufficient.  You must cite at least 7 research studies from peer-reviewed journals, but you are not limited to only 10 articles.  If you wish to include more than 10 research articles you may do so, but do not feel compelled to provide an exhaustive review of the literature. 
  • This section of your proposal should include:
    • A synthesis of the literature (2-3 paragraphs should be sufficient in most cases) that includes
      • Problem and clinical significance (why change is needed) in 1-2 paragraphs
      • Evidence from at least one intervention study that supports the change in practice (why change will be effective) in 1-2 paragraphs
    • A context for the proposed change (no more than 1 paragraph) that includes
      • Identification (1-2 sentences only) of the specific setting (name it) where the change will occur and the current practice (what you’re doing right now) in that setting
      • Clear statement (1-2 sentences only) of the change that is being proposed (similar to the purpose statement in a research article).  Make it clear that you’re recommending this new practice.
  • Define the concepts or issues you are addressing as needed.  Do not assume the reader has a clear understanding of them.  Remember, you are the “expert.”
  • Do not cite secondary sources.  Secondary citations will not be accepted, and you will lose points accordingly.

Implementation – This section describes the implementation plan in a logical and chronological (step-by-step) sequence.  It must be evidence-based and should include sufficient detail to allow duplication of your project in another setting.  Use future tense to describe what will occur if the proposal is approved.

  • First, provide a background for the change by describing each of the following with individual sub-headings
    • Setting (where the change will occur) – This includes both the physical plant and personnel.
    • Population (the patients/clients who will be affected by or involved in the change)
    • Timeline (series of target dates for each step/event needed to implement and evaluate the change) – Identify each step and the target date in chronological order.  There should be a target date that corresponds to each section (step) of the implementation process, beginning with approval.
  • Second, describe in chronological order the process for implementing the new practice in detail.  Points to consider and describe with individual subheadings include
    • Approval for the proposal
    • Communication needed for clinicians or staff involved in the change
    • Education needed for clinicians or staff involved in the change
    • New practice as a series of activities in chronological order
  • As needed, provide justification of any new costs (i.e. how the additional expense will be covered).
  • Third, describe the Evaluation Strategy last. This is how you will know if your proposed change is successful.  It does not have to be complicated but it must be clear and appropriate.  Include a specific and measurable goal (target) for comparison that you identify based on your clinical judgment or the evidence you used to support the change.  Remember, you are describing program evaluation, not clinical or patient assessment.   
  • As needed, describe any evaluation tools and provide evidence that they are appropriate.  You may attach your tools as Appendices to assist with the description (optional). 
  • As needed, explain how ethical issues will be addressed.  Remember that YOU ARE NOT CONDUCTING A RESEARCH STUDY.  If you propose use of consents or IRB approval, you must have a clear and clinically compelling reason to do so.

References – Use APA format for all references and in-text citations.

  • Only credible references may be used. Peer reviewed articles are preferred.  Electronic references (websites) from credible sites (.gov, .org, .edu) or textbooks may be used sparingly. 
  • Proprietary documents (clinical standards, procedures, etc.) may be used as necessary to provide a foundation for your proposal.  However, they do not take the place of credible references that provide authority for your work.

I will do my best to provide feedback on each part of the assignment before the next part is due.  You are expected to make corrections based on my feedback before submitting the next paper.  The exception to this is the Introduction that does not need to be corrected prior to submitting the draft Implementation paper.  You will resubmit it (in its original form) with the draft Implementation only to provide context for your plan.  Also, if you fail to synthesize at least 7 research articles for the draft Introduction, you are expected to make the correction for the final proposal paper, but not for the draft Implementation paper.  

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