Week 9: Part 7: Finalized Copy of the Change Project Proposal
Step 1 Prepare a finalized copy of your change project proposal. This finalized copy should include the following:
- Background (summary of interview with nurse administrator/leader)
- Research question –
- Literature review (summary of the four approved research articles)
- Stages of project implementation based on the selected change theory
Include any suggested revisions, edits, or constructive critiques that your instructor, preceptor, and/or interviewee has provided.
Step 2 Save and submit your assignment.
When you have completed your assignment, save a copy for yourself in an easily accessible place and submit a copy to your instructor.
Cite all sources in APA format.
Quality improvement measures that have been implemented in the institution are the use of EHR to reduce cases of medical errors and readmissions. QIM measures are followed while putting effort into keenness within the organization (Dixon et al., 2016). QIM helps increase the best health outcomes, whereby patient outcomes are the organization’s top priority. These measures have been in place for quite a while due to improving health outcomes. The QIM initiatives in place have ensured better patient outcomes and have reduced medical errors. Having the same agents in the outpatient services for a long time has helped the facility be a better environment for patients. The promotion of patient safety has had an impact. It has brought the question of accepting the idea of change like EHR and other factors hence rolling back the advances of reducing adverse effects on better patient outcomes (Øyri et al., 2020). There is a need for socio-technical probabilistic risk approaches to review past errors.
The clinical research question is where the PICOT approach derives the question. The question entails patient (P), intervention (I), comparison(C), outcome (O), and time (T).This format allows the construction of a researchable and answerable question (Fandino, 2019). In this case, the PICOT consists of; the impact population (P) suggested interventions (I) comparison to other alternatives, (C) patient outcomes (O), and time required to facilitate change in inpatient care (T).in summary, the research question is; Among patients in the acute care environment, how does EHR reduce medical errors compared to the usual practice in a given month. P-patient in an acute care setting, I-use of EHR, C-normal medication practice, O-reduced medical errors, T-one month. The PICOT question examines the quality improvement measure, the EHR system. It also helps analyze the reduction of medical errors in a month. Tracking and monitoring patient safety demonstrate the effectiveness of EHR (Panagioti et al., 2019).
In summary, the articles chosen focused on colonoscopy and all its components. Colonoscopy is an essential process of checking any abnormalities in the colon that could be possible signs of colon cancer (Gandhi et al., 2018). Two quantitative and two qualitative studies are needed to reflect the factors and concepts of colonoscopy. Data from various samples are analyzed to find the relationship between patients’ health issues, medications, and sociodemographic features with inadequate bowel preparation. In Lee’s case study, the research compares how adequate is high volume split colonoscopy (HVSP) versus low split colonoscopy (LSVP) preparations with enough bowel cleaning and enhanced adenoma detention being the desired outcome (Lee et al.,2020).
Poola’s article describes colonoscopy as the process of analyzing the whole colon. It seeks to detect issues that cause inadequate bowel preparations for inpatient colonoscopies (Poola et al., 2020). It also evaluates the duration of the colonoscopy, cecal intubation, and the overall patient stay. The Bucci article assesses the effectiveness of the same-day regimen for colonoscopy. The authors analyzed the sanitation, compliance, and effects of the procedure about split regimen through the systematic literature research (Bucci et al., 2019). The articles prove colonoscopy is the best tool in colon cancer detection. There are three types of colonoscopy: low-volume split, high-volume split, and same-day regimens, and they are suitable detectors of different colon conditions.
Stages of Implementation
Kurt Lewin came up with a change theory with three stages, effective in change implementation. The stages that Kurt came up with include; unfreezing, changing, and refreezing (Hussain et al., 2018). Unfreezing is a process that involves finding a way to make it easier for people to let go of older ways of doing things or patterns. In unfreezing, there are three ways to make it successful. They include; driving forces in that direction, decreasing the resistance forces, and combining the two.
On the other hand, the second stage changes, which entails going to a new level and includes; feelings, thoughts, and behavior. In evolution, there is analyzing alternatives, demonstrating change benefits and decreasing forces that negatively affect. The third stage is refreezing, which entails implementing and stabilizing a new occurrence to the system. It allows for the standard operating procedure, which means it is permanent (Udod and Wagner, 2018). in slip bowel preparation Kurt’s change theory is the most productive.
Bucci, C., Zingone, F., Schettino, P., Marmo, C., & Marmo, R. (2019). Same-day regimen as an alternative to split preparation for colonoscopy: A systematic review with meta-analysis. Gastroenterology Research and Practice, 2019, 1-8. https://doi.org/10.1155/2019/7476023
Dixon-Woods, M., & Martin, G. P. (2016). Does quality improvement improve quality?. Future Hospital Journal, 3(3), 191.
Fandino, W. (2019). Formulating a good research question: Pearls and pitfalls. Indian journal of anaesthesia, 63(8), 611.
Gandhi, K., Tofani, C., Sokach, C., Patel, D., Kastenberg, D., & Daskalakis, C. (2018). Patient characteristics associated with quality of colonoscopy preparation: A systematic review and meta-analysis. Clinical Gastroenterology and Hepatology, 16(3), 357-369.e10. https://doi.org/10.1016/j.cgh.2017.08.016
Hussain, S. T., Lei, S., Akram, T., Haider, M. J., Hussain, S. H., & Ali, M. (2018). Kurt Lewin’s change model: A critical review of the role of leadership and employee involvement in organizational change. Journal of Innovation & Knowledge, 3(3), 123-127. Available at: https://www.sciencedirect.com/science/article/pii/S2444569X16300087
Lee, J. G., Telford, J. J., Galorport, C., Yonge, J., Macdonnell, C. A., & Enns, R. A. (2020). undefined. Journal of the Canadian Association of Gastroenterology, 4(5), 207-213. https://doi.org/10.1093/jcag/gwaa031
Øyri, S. F., Braut, G. S., Macrae, C., & Wiig, S. (2020). Hospital managers’ perspectives with implementing quality improvement measures and a new regulatory framework: a qualitative case study. BMJ open, 10(12), e042847.
Panagioti, M., Khan, K., Keers, R. N., Abuzour, A., Phipps, D., Kontopantelis, E., … & Ashcroft, D. M. (2019). Prevalence, severity, and nature of preventable patient harm across medical care settings: systematic review and meta-analysis. bmj, 366.
Poola, S., Jampala, N., Tumin, D., & Ali, E. (2020). Factors influencing inpatient colonoscopy bowel preparation quality. Minerva Gastroenterologica e Dietologica, 66(3). https://doi.org/10.23736/s1121-421x.20.02657-4
Udod, S., & Wagner, J. (2018). Common change theories and application to different nursing situations. Leadership and influencing change in nursing. Available at: https://leadershipandinfluencingchangeinnursing.pressbooks.com/chapter/chapter-9-common-change-theories-and-application-to-different-nursing-situations/