Develop a proposed evidence-based change-project plan specific to the environment you are using to implement your change project. Your environmental assessment will include a work breakdown structure, a budget plan, and a measurement tool.

This week, you will design a plan that is at least four pages in length and includes all the information listed in the instructions below to discuss the elements of your proposed plan.

• Develop an environmental assessment of your change project area and its readiness for the specific change project you are going to implement. 
  • Include a work breakdown structure. For example, you could create a (timeline/task list/Gantt chart)—a hierarchical definition of the planned tasks and activities of a project that normally begins with the highest-level activities and works downward into the individual tasks.
  • Include a proposed project budget (table or spreadsheet) for the project that addresses the needed personnel, equipment, and supplies that may have associated costs. Click this link for a sample budget template .
  • Include your measurable evaluation methods (indicators/metrics). Include the actual measurement tool you will use and describe any of the following that are applicable to your project: cost savings, improved efficiencies, access to care (visits/procedures/admissions), patient/family satisfaction, associate satisfaction, associate engagement, retention, clinical outcomes, injury prevention, and risk reduction.

The project will take place in Sanitas medical center where patients will fill out a questionnaire

There is no budget needed, please address this in the paper. 

The measurable tool is the DSMQ, which I have attached.

Please review the attachments.

Your written assignment for this module should be a 2-3 page paper (not including title page and reference page).

A 78-year old woman is admitted to a Medical unit directly from her physician’s office for evaluation and management of congestive heart failure. She has a history of systemic hypertension.

The initial assessment completed by the RN of the assigned patient reveals a pulse rate that is rapid and very irregular. The patient is restless, her skin is pale and cool, she states she is dizzy when she stands up and she is slightly short of breath and anxious. Her BP is 106/88. Her ECG monitor pattern shows uncontrolled atrial fibrillation with a heart rate ranging from 150 -170 beats/min. Her respirations are 20/min and her O2 saturation is 90%.

1. Given the findings, what should be the first action of the practical nurse?
2. What additional data would the practical nurse collect?
3. Discuss the potential complications of cardioversion and patient preparation for an elective cardioversion. Because the length of time the patient has been in atrial fibrillation is unknown, what adverse reaction may occur?

Later that evening the patient calls the nurse because she feels “like something terrible is going to happen.” She reports chest pain, has increased shortness of breath, and has coughed up blood-tinged sputum.

1. Based on these symptoms, what might you suspect is happening?
2. What is the first thing the practical nurse should do and what further information would you expect to be collected?

You should include a minimum of 3 references. Include a title page, in-text citations, and a reference page in APA format.