Identify a practice issue which resulted in negative patient outcomes.

1. Identify a practice issue which resulted in negative patient outcomes
a. Concept exploration: What is the nature of the clinical problem? How is it defined?
b. Is the issue clinically significant and why? The literature review should support this.
c. Is the issue a priority and why?
a. Identify processes that helped to identify this clinical problem. Examples:
• Shift-to-shift report
• Nurse/student partnership
• Unit-based clinical practice committee discussion
2. Create a case-study to illustrate the problem
3. Develop a PICO question
a. Population of interest
b. Intervention of interest
c. Comparison of interest
d. Outcome of interest
4. Complete a literature review including a critical appraisal and evaluation of the evidence as it related to the chosen topic (This should include no less than three (3) evidence-based practice articles from a peer-reviewed journal). Utilize the following format to discuss the findings:
Title/Year/Author(s)
Study Question/Problem
Sample Population
Study Design
Study Findings
Conclusions/Implications for Nursing Practice

5. Locate and discuss an evidence-based guideline or practice protocol related to the topic and the identified population (Suggested databases include the Agency for Healthcare Research and Quality or Best Practice Guidelines)
6. In support of the guideline, select one scholarly article that corroborates the evidence-based guideline/protocol chosen. This article must be from a peer-reviewed, scholarly journal, not more than 5 years old. One article from the literature review may be utilized. Textbooks may not be utilized.
7. Critique the selected article utilizing the table below. Discuss the findings associated with the article by reviewing the discussion and implications/recommendations for practice and summary assessment as they relate to the case study. Describe how these findings will support the small test of change (Do NOT summarize the content of the article).

Discussion
• Are all major findings interpreted and discussed?
• Are the interpretations consistent with the results and with the study’s limitations?
• Does the report address the issue of the generalizability of the findings?
Implications/Recommendations
• Do the researchers discuss the implications of the study for clinical practice or further research-and are those implications reasonable and complete?
Summary Assessment
• Despite any identified limitations, do the study findings appear to be valid-is there confidence in the truth-value of the results?
• Does the study contribute any meaningful evidence that can be used in the nursing practice or that is useful to the nursing discipline?
8. Analyze two of the most pertinent QSEN competencies as they relate to the case study and describe how they relate to the practice issue
9. Select evidence based practice model
a. Discuss why the selection of this EBP model is most appropriate to the practice issue identified. Examples of selected models:
• Johns Hopkins Model (2005)
• Rosswurm and Larrabee Model (1999)
• Stetler Model (2001)
• Iowa Model (Titler, 2001)
10. Utilizing the Institute for Healthcare Improvement (IHI) steps for Quality Improvement, create and present a plan for a small test of change addressing the following items:
a. Forming the Team; Effective Teams
b. Setting aims
c. Establishing measures
d. Selecting changes
e. Testing changes (Plan-Do-Study-Act)
f. Implementing changes
g. Spreading changes
11. Develop a PowerPoint presentation (PPT) in the form of a scholarly presentation. Follow the instructions located in Canvas under ACON Student Resources.

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