Abby and Grace are planning to implement the EBP on patient education on self-care among diabetic patients. The team has been seeking Chloe’s guidance and an experienced EBP mentor who insists on the importance of assessing the EBP’s progress frequently. Given her experience with EBPs, Chloe furnished the team with an EBP implementation Plan. The multi-step plan has stages and checkpoints where EBP is evaluated against set objectives.
Preliminary Checkpoint A
The EBP is based on the Advancing Research and Clinical practice through close Collaboration (ARCC) Model. The model has been widely used to help nurses translate research findings to clinical practice (White & Spruce, 2015). There are eleven checkpoints in the model to guide the implementation of EBP from the beginning to the end. Checkpoint one is the identification of the PICOT question (Melnyk et al., 2017). The question is the effectiveness of education programs on self-care on diabetes management and reducing diabetic foot ulcers among elderly diabetic patients.
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Preliminary Checkpoint B
The second preliminary step in the ARCC model is forming a team. With the help of the mentor, the team of three is responsible for developing, implementing, and evaluating the EBP. The team will recruit an interdisciplinary team, including pharmacists, physicians, and nurses, to educate the patients.
The primary stakeholders are individuals that will be affected or those that will influence the implementation of the EBP. Active stakeholders are the ones who make the project happen; in this case, the four individuals responsible for planning the EBP. Other key stakeholders include endocrinology physicians, nurses, and administrators who interact with patients. Passive stakeholders such as the management, finance, education departments, mid-level managers, support staff, and staff from other departments who will not be actively involved in the project can still influence the outcome of the project.
The next step is seeking IRB approval, as Chloe advised. Chloe explained that an IRB ensures that the subjects involved in research are safe. The team decided to submit its implementation plan to the hospital’s IRB for approval, even though EBP is not a research study.
Checkpoint 5- Actual Implementation
Purpose of the Project
A clearly defined purpose sets the tone for the implementation. The team defines the project’s purpose as the effectiveness of educational programs on self-care practices among elderly diabetic patients to enhance compliance and reduce diabetic foot ulcers. The team must collect baseline data from internal and external sources. The team takes one month to collect and evaluate the baseline data.
In the next step, the team meets with the implementation group. The EBP team discusses the purpose, baseline data, challenges, and opportunities to help the implementation group achieve their goals. This stage will take on month as the EBP team must educate the implementation group and develop an implementation plan. During this stage, the team will identify and seek human, fiscal, and other resources needed. In the end, the team will come up with the actual implementation guide, which will be printed as posters.
In the third month, the team will begin the implementation of EBP. The team will engage in patient education on self-care among elderly diabetic patients. The first week of implementation will be a learning curve, and the EBP team will meet every day to review the team progress and make the necessary changes. The team will evaluate EBP implementation every month. The team will have a checklist with various aspects of self-care practices for elderly diabetic patients such as good nutrition and keeping glucose levels optimal (Cheng et al., 2017).
The EBP team will gather all data from the primary and passive stakeholders on the implementation and all their encounters with the patients. The data will be used to evaluate the EBP at the end of the seven months of implementation. Patient data on re-hospitalization and foot ulcers will also be used to evaluate the success of the EBP against the progress of patients who did not take part in the EBP. The team will use the data to evaluate the EBP to find out if it was successful or not. The data will be a source of lessons for the team and other stakeholders on implementing EBP better in the future.
References
Cheng, Q., Lazzarini, P. A., Gibb, M., Derhy, P. H., Kinnear, E. M., Burn, E., & Norman, R. E. (2017). A cost ‐ effectiveness analysis of optimal care for diabetic foot ulcers in Australia. International wound journal , 14 (4), 616-628.
Melnyk, B. M., Fineout ‐ Overholt, E., Giggleman, M., & Choy, K. (2017). A test of the ARCC© model improves implementation of evidence ‐ based practice, healthcare culture, and patient outcomes. Worldviews on Evidence ‐ Based Nursing , 14 (1), 5-9.
White, S., & Spruce, L. (2015). Perioperative nursing leaders implement clinical practice guidelines using the Iowa Model of Evidence-Based Practice. AORN journal , 102 (1), 50- 59.
