The development of an implementation plan for the bundle of 4-6 practice change recommendations that you have selected or derived from your clinical practice guideline (SEE OTHER ATTACHMENT), which are:
-Recommendation 1.2: Perform a comprehensive pain assessment on persons screened having the presence, or risk of, any type of pain using a systematic approach and appropriate, validated tools.
– Recommendation 2.1: Collaborate with the person to identify their goals for pain management and suitable strategies to ensure a comprehensive approach to the plan of care.
– Recommendation 3.3: Teach the person, their family and caregivers about the pain management strategies in their plan of care and address known concerns and misbeliefs.
-Recommendation 5.3: Promote interprofessional education and collaboration related to the assessment and management of pain in academic institutions.
The bundle recommendations need to be incorporated into a protocol to be implemented in a clinical practice setting. The following elements need to be contained in the implementation plan which is “the assessment and Management of Pain”
One or two paragraphs at most, describing the clinical issue or problem being addressed
The 4-6 practice change recommendations derived from the selected clinical practice guideline (SEE OTHER ATTACHMENT) that you would propose to implement in a practice setting to improve patient outcomes relevant to your identified clinical problem or issue. These would be similar to an Institute for Health care Improvement “bundle” of interventions to appropriately assess and manage pain
Gap analysis: depending on your selected bundle, this information can be presented in table format. The table could include a gap analysis with these suggested columns: Selected Guideline Recommendations: Do we have a policy?- Yes/No; Are we following policy?-Yes/No, HENCE WHY WE ARE IMPLEMENTING THIS NEW BUNDLE
Selected practice change recommendations must be very specific – not general statements. Staff or other target adopters need to know precisely how their practices need to be changed and what they are expected to do. Example: “Review continued need for opioid use in postop patients, despite patient education on use of multimodal analgesia.” Identify the level of evidence supporting each recommendation. This information might also be presented in table form: Level of Supporting Evidence; Specific Practice Changes. (SEE OTHER ATTACHMENT pages 7-11)
Next, describe the following elements that need to be contained in your implementation plan:
The members of the EBP change project team and the proposed change champions. Explain why you selected these individuals for these roles and who will lead the team.
The target adopters – nurses, physicians, teams, patients, family members, pharmacists – individuals/groups whose behaviors are being targeted for change as a result of implementation of the bundle recommendations.
The key stakeholders – who needs to be involved in the implementation plan and who needs to be kept informed during the implementation process. A stakeholder analysis identifies who will support the changes, who will oppose the changes, who will be neutral, and who might actually pose a threat to the successful implementation of the practice changes.
Environment: Thus sections need to address the organization’s environmental readiness to make the required changes. This includes the existing culture and climate, leadership support, team work and interdisciplinary collaboration, resource availability, and communication channels. (this can be of any typical hospital environment)
Consider elements of the Rogers and PARIHS models in your project planning – such as strength of the evidence, unit and facility culture. The organizational assessment will lead to identification of project-specific barriers and facilitators. (this can be of any typical hospital environment)
Barriers, facilitators and strategies: Identify potential barriers and facilitators of the proposed change (individual, unit, and organizational levels as appropriate). In this case, facilitators refer to structures or processes that are in place, not individuals who function to facilitate individual-level change.
Specify the appropriate implementation strategies:
Match the selected strategies to identified barriers to the proposed practice changes.
Match the implementations strategies to the targeted adopters of each practice change recommendation
Evaluation plan: Develop an evaluation plan for your implementation project. Make sure you specify both process (formative) and outcome (summative) measures. Formative measures refer to evaluating how successful your implementation strategies were – for example, what percentage of the nursing staff completed the required online educational modules or attended staff development programs?
Summative evaluation measures refer to your expected outcomes, and would include measures such as the percentage of post-op patients that report adequate pain control on a monthly basis. Describe the sources of evaluation data – risk management reports, NDNQI report cards, staff surveys, sign-in sheets, other sources. Also think about different data collection approaches – focus groups, interviews, staff surveys.
Notes:
This is an implementation paper on a specific topic. Therefore, do NOT include any general discussions or review of the literature, and do NOT include the Clinical Practice Guideline appraisal. This paper starts with a brief introduction of the clinical problem, and then moves to the proposed practice change recommendations.
Tables or flow charts be used where possible. However, just including the tables or charts is not sufficient. Provide brief descriptions of their key content and appropriate transition paragraphs between the sections of the paper. Make sure you use section headings (APA Guidelines) to improve readability of your paper. Be succinct!
Do not include appendices. A reference list should be in correct 7th edition APA format.
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