Strengths and Barriers to Program Implementation

 As you design your program, it is important to anticipate potential issues related to program implementation. Careful forethought can help you to minimize unnecessary stumbling blocks during implementation.
 

There are strengths and barriers associated with every program. What do you see as the key factors to be aware of for your program? Brainstorm key terms such as community, culture, environment, organization, client, bias, and ethics. Give consideration to the factors you come up with (along with those in the Learning Resources) as you proceed with this Discussion.
 

To prepare:

• Review      the information presented in the Learning Resources. What are some of the      factors (e.g., community, organization, environmental, ethical) that you      consider strengths or facilitators for your program (breast cancer in      African American women in the USA)?
• Which      ones do you think may pose a challenge for your program(breast cancer in      African American women in the USA)?
• How      do these barriers need to be addressed in your program design? 
• How      might the strengths be leveraged to help overcome the barriers?

   

By tomorrow Wednesday 01/02/19 2 pm post a minimum of 550 words essay in APA format with a minimum of 3 scholarly references from the list of required readings below. (Also see attached file on the previous paper regarding the program on the issue of breast cancer in African American women in the USA). Include the level one header as numbered below:

Post a cohesive scholarly response that addresses the following:

1) Analyze two or more community, client, organization, and/or environmental forces that may facilitate your program and two or more that may pose a challenge for your program (breast cancer in African American women in the USA).

2) Propose a strategy for addressing one of the barriers as a part of your program design (breast cancer in African American women in the USA)?

3) Ask questions of your colleagues regarding how you might address the other challenge.

Required Readings

Hodges, B. C., & Videto, D. M. (2011). Assessment and planning in health programs (2nd ed.). Sudbury, MA: Jones & Bartlett Learning.

• Chapter 4, “Program Planning: The Big Picture”

• Chapter 5, “Social Marketing, Program Planning, and Implementation”

• Chapter 8, “Identifying Strategies and Activities”

• Chapter 9, “Program Implementation”

Chapter 4 outlines the program planning steps and emphasizes the importance of including your target population and additional stakeholders in the design process. Chapter 5 reemphasizes this focus on the target audience as the authors discuss the use of marketing principles in relation to program development and implementation. Chapter 8 discusses the importance of utilizing strategies that are aligned with the theoretical foundations of a program and presents recommendations for developing suitable activities. In Chapter 9, the authors note that even implementation requires planning; they provide guidance for implementation planning and advise how this can also support evaluation.

Kettner, P. M., Moroney, R. M., & Martin, L. L. (2017). Designing and managing programs: An effectiveness-based approach (5th ed.). Thousand Oaks, CA: Sage.

Review Chapter 6, “Selecting the Appropriate Intervention Strategy”

Chapter 8, “Designing Effective Programs”

Review Chapter 6, which discusses the connection between the program hypothesis and service decisions. Chapter 8 addresses how to design elements of a program systematically in order to promote consistency and attend to the necessary details.

Breslau, E.S., Weiss, E.S., Williams, A., Burness, A., & Kapka, D. (2015). The implementation road: Engaging community partnerships in evidence-based cancer control interventions. Health Promotion Practice, 16(1), 40–54 doi: 10.1177/1524839914528705

Buck, H.G., Kolanowski, A., Fick, D., & Baronner, L (2016). Improving rural geriatric care through education: A scalable, collaborative project. The Journal of Continuing Education in Nursing, 47(7), 306-313 doi:10.3928/00220124-20160616-06 

KIDASA Software. (n.d.). Gantt charts. Retrieved December 12, 2011, from http://www.ganttchart.com/Examples.html

This site provides examples of different forms of Gantt charts.

Minb, A., Patel, S., Bruce-Barrett, C., O-Campo, P. (2015). Letting youths choose for themselves: Concept mapping as a participatory approach for program and service planning. Family Community Health, 38(1), 33–43 doi: 10.1097/FCH.0000000000000060

Soong, C.S., Wangm M.P., Mui, M., Viswanath, K., Lam, T.H., & Chan, S.SC. (2015). A “community fit” community-based participatory research program for family health, happiness, and harmony: Design and implementation. JMIR Research Protocols, 4(4), 1–10 doi:10.2196/resprot.4369

Witherspoon, B., Braunlin, K., & Kumar, A.B. (2016). A secure, social media-based “case of the month” module in a neurocritical care unit (2016). American Journal of Critical Care, 25(4), 310–317 doi: http://dx.doi.org/10.4037/ajcc2016203

Required Media

Laureate Education (Producer). (2011). Design and evaluation of programs and projects [Video file]. Baltimore, MD: Author.

“Designing Effective Programs” (featuring Dr. Donna Shambley-Ebron, Dr. Debora Dole, and Dr. Rebecca Lee)

You may view this course video by clicking the link or on the course DVD, which contains the same content. Once you’ve opened the link, click on the appropriate media piece.

In this week’s videos, Dr. Donna Shambley-Ebron, Dr. Debora Dole, and Dr. Rebecca Lee share experiences related to designing effective programs.

Mr. P is a 76-year-old male with cardiomyopathy and congestive heart failure who has been hospitalized frequently to treat CHF symptoms. He has difficulty maintaining diet restrictions and managing his polypharmacy. He has 4+ pitting edema, moist crackles throughout lung fields, and labored breathing. He has no family other than his wife, who verbalizes sadness over his declining health and over her inability to get out of the house. She is overwhelmed with the stack of medical bills, as Mr. P always took care of the financial issues. Mr. P is despondent and asks why God has not taken him.

Question

Considering Mr. P’s condition and circumstance, write an essay of 500-750 words that includes the following:

· Describe your approach to care.

· Recommend a treatment plan.

· Describe a method for providing both the patient and family with education and explain your rationale.

· Provide a teaching plan (avoid using terminology that the patient and family may not understand).

·  

In a short essay (500-750 words), answer the Question at the end of Case Study 1. Cite references to support your positions.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

You are required to submit this assignment to TURNITIN

In patients with central lines, what is the effectiveness of daily chlorhexidine bath compared to weekly or as needed dressing changes to reduce infection?

Formulate a research question that you would like answered for your Literature Review Paper.

Conduct a literature search for your research question using the Individual Literature Search Worksheet Preview the documentprovided. Document your systematic search on the form, covering all steps listed below

STEP 1: Think About the Best Way to Search

STEP 2: Plan Your First Search

STEP 3: Begin Your Search

STEP 4: Refine Your Search

STEP 5: Refine Your Search Again

STEP 6: Search another Database

STEP 7: Reflection

Submit your detailed literature review worksheet.

Remember: Read through the articles carefully. Eliminate those not appropriate. It is suggested that you create a summary table. There is an example in the course text to help you organize your thoughts. Synthesize twelve or more full text research articles, beyond your textbooks, that are relevant to your research. Summarize what the studies reveal about your selected topic. Are there consistencies? Are there inconsistencies or “gaps?” Be sure to keep the table of information you developed and the twelve or more articles as you build on the course assignments. The table itself will not be part of the content in your paper; it may be included as Appendix A.

Quality Improvement and Patient Safety Initiatives

The vice president of nursing, Dr. Sasha Mendez, has had a lot of complaints from patients and their families about the difficulties they experience navigating the system at her organization; e.g., going from the E.R. to admissions. Dr. Mendez’s nursing specialty area is psych/mental health. As such, she is very concerned about the stress this is causing the patients.

What are the macro systems that are affecting patient satisfaction at Dr. Mendez’s facility? What micro systems should she also analyze to look at how the patient moves through—from entry, to possible admission, to possible discharge? How do these systems relate? What impacts each system?

The concepts presented in Week 8 serve as a foundation for this week as you continue to look at factors within an organization’s environment that are barriers and facilitators for implementing change. In this Discussion, you examine the macro and micro systems within the organization (of your practicum setting) and identify changes that may need to take place to facilitate quality improvement and achievement of patient safety outcomes.

To prepare:

• Reflect on the issue you have been addressing      through your EBP Project.
• Identify the macro and micro systems that      influence the issue. Review the McClusky and Middleton (2010) article for      an example of this process (See attached file).
• Determine the desired outcomes of resolving the  EBP Project issue and how resolving it will improve quality and patient     safety. (Note: Next week you will evaluate these outcomes. You may      want to view the Week 10 Discussion as you prepare.)
• What procedures/processes would need to be      modified to achieve the desired outcomes?

Post your PowerPoint presentation

By tomorrow Tuesday 10/23/18, in APA format and include 3 scholarly references from the list of required readings below, develop a 5-slide Microsoft PowerPoint presentation for the business unit team and leadership within the organization, sharing your issue, strategies for resolving the issue, and how it will improve quality and patient safety. 

Note: The purpose of the presentation is to persuade the business unit team and leadership to accept your recommendations.

Required Readings

Brooks, P., Spillane, J.J., Dick, K., & Stuart-Shor, E. (2014). Developing a strategy to identify and treat older patients with postoperative delirium. AORN Journal, 99(2), 256-276. (see attached file).

Jarden, R.J. & Sutton, L.J. (2014). A practice change initiative to improve the provision of enteral nutrition to intensive care patients. British Association of Critical Care Nurses, 20(5), 242-254.

McCluskey, A. & Middleton, S. (2010). Delivering an evidence-based outdoor journey intervention to people with stroke: Barriers and enablers experienced by community rehabilitation teams. BMC Health Services Research, 10(18). doi: 10.1186/1472-6962-10-18. Retrieved from https://bmchealthservres.biomedcentral.com/articles/10.1186/1472-6963-10-18. (see attached file).

Murfet, G.O., Allen, P., & Hingston, T.J. (2014). Maternal and neonatal health outcomes following the implementation of an innovative model of nursepractitioner-led care for diabetes in pregnancy. Journal of Advanced Nursing, 70(5), 1150-1163 (see attached file).

PIICOT Question

In patients in extended intensive care within an urban acute care facility in Eastern United States, how does early mobilization as recommended by National Institute of Health and Care Excellence clinical guidelines on rehabilitation of patients after critical illness impact early transfers from intensive care as measured 6 months post-implementation when compared to the current standard of care including minimal mobilization of patients?

P: Adult patients 

I: in extended intensive care within an urban acute care facility

I: increased mobilization of the patients 

C: minimal mobilization of the patients

O: early transfers of the patients from intensive care

T: 6 months

Throughout this course you will be developing a formal, evidence-based practice proposal.

The proposal is the plan for an evidence-based practice project designed to address a problem, issue, or concern in the professional work setting. Although several types of evidence can be used to support a proposed solution, a sufficient and compelling base of support from valid research studies is required as the major component of that evidence. Proposals are submitted in a format suitable for obtaining formal approval in the work setting. Proposals will vary in length depending upon the problem or issue addressed; they can be between 3,500 and 5,000 words. The cover sheet, abstract, references page, and appendices are not included in the word limit.

Section headings and letters for each section component are required. Responses are addressed in narrative form in relation to that number. Evaluation of the proposal in all sections is based upon the extent to which the depth of content reflects graduate-level critical-thinking skills.

This project contains seven formal sections:

1. Section A: Organizational Culture and Readiness Assessment
2. Section B: Problem Description
3. Section C: Literature Support
4. Section D: Solution Description
5. Section E: Change Model
6. Section F: Implementation Plan
7. Section G: Evaluation of Process

Each section (A-G) will be submitted as separate assignments so your instructor can provide feedback (refer to applicable modules for further descriptions of each section).

The final paper will consist of the completed project (with revisions to all sections), title page, abstract, reference list, and appendices. Appendices will include a conceptual model for the project, handouts, data and evaluation collection tools, a budget, a timeline, resource lists, and approval forms.

Use the “NUR-699 EBP Implementation Plan Guide” and “NUR-699 Evidence-Based Practice Project Student Example” to assist you. Also refer to “NUR-699 Evidence-Based Practice Project Proposal Format.”

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

NUR699.R.Evidence-BasedPracticeProjectProposalFormat_student.docxNUR699.R.EBPStudentExample_Student.docxNUR699.R.EvidenceBasedPracticeProposalFinalPaperOverview_student.docxNUR699.R.EBPimplementationPlanGuide_student.docx