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Posted: June 14th, 2023
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Using your readings as guides, describe the context for your implementation proposal (see project below). What are some of the aspects about the particular context that will be important to your project and how will you address them? If you do not know much about your context yet—how will you go about finding more information?
Papers on Specific Context Attributes - peruse and pick 3 relevant to your project's context to read fully and discuss. If you already know important context factors relevant to your project (eg, staffing, geography, state or national policy), you may also do a literature search for papers on those factors (must be implementation science papers) and read 3.
ARTICLES TO CHOSE FROM (ONLY PICK 3)
Leadership
Shuman, C. J., Liu, X., Aebersold, M. L., Tschannen, D., Banaszak-Holl, J., & Titler, M. G. (2018). Associations among unit leadership and unit climates for implementation in acute care: a cross-sectional study. Implementation Science, 13(1), 1-10.
Shuman, C. J., Ehrhart, M. G., Torres, E. M., Veliz, P., Kath, L. M., VanAntwerp, K., ... & Aarons, G. A. (2020). EBP implementation leadership of frontline nurse managers: validation of the Implementation Leadership Scale in acute care. Worldviews on Evidence‐Based Nursing, 17(1), 82-91.
Clavijo-Chamorro, M. Z., Romero-Zarallo, G., Gómez-Luque, A., López-Espuela, F., Sanz-Martos, S., & López-Medina, I. M. (2021). Leadership as a Facilitator of Evidence Implementation by Nurse Managers: A Metasynthesis. Western Journal of Nursing Research, 01939459211004905.
Sandström, B., Borglin, G., Nilsson, R., & Willman, A. (2011). Promoting the implementation of evidence‐based practice: A literature review focusing on the role of nursing leadership. Worldviews on Evidence‐Based Nursing, 8(4), 212-223.
Patterson, A. E., Mason, T. M., & Duncan, P. (2017). Enhancing a culture of inquiry: The role of a clinical nurse specialist in supporting the adoption of evidence. JONA: The Journal of Nursing Administration, 47(3), 154-158.
Climate/Culture
Ehrhart, M. G., Shuman, C. J., Torres, E. M., Kath, L. M., Prentiss, A., Butler, E., & Aarons, G. A. (2021). Validation of the Implementation Climate Scale in Nursing. Worldviews on Evidence‐Based Nursing.
Williams, N. J., & Beidas, R. S. (2018). Navigating the storm: How proficient organizational culture promotes clinician retention in the shift to evidence-based practice. PLoS One, 13(12), e0209745.
Ost, K., Blalock, C., Fagan, M., Sweeney, K. M., & Miller-Hoover, S. R. (2020). Aligning organizational culture and infrastructure to support evidence-based practice. Critical Care Nurse, 40(3), 59-63.
EBP Competencies
Shuman, C. J., Ploutz-Snyder, R. J., & Titler, M. G. (2018). Development and testing of the nurse manager EBP competency scale. Western Journal of Nursing Research, 40(2), 175-190.
Melnyk, B. M., Gallagher‐Ford, L., Zellefrow, C., Tucker, S., Thomas, B., Sinnott, L. T., & Tan, A. (2018). The first US study on nurses’ evidence‐based practice competencies indicates major deficits that threaten healthcare quality, safety, and patient outcomes. Worldviews on Evidence‐Based Nursing, 15(1), 16-25.
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My project is a continuation (or cycle 2) of another student’s project. The student sent a document to patients regarding palliative care. My survey will be looking at the “provider side”. So, I will send out the provider survey in the fall and await their answers to the questions I provided in the survey below and make changes and update to the first student’s educational document.
(It would also be favorable to survey the providers of the palliative care clinic in future projects to measure their satisfaction and determine if there is improvement in time spent providing basic information/education during the first visit.)
Project
Provider Survey
1. When your patients come in initially, what is their baseline knowledge of palliative care?
2. How do you attempt to educate your patients regarding palliative care?
3. Do you feel the “Welcome Letter” (see attached), that is sent to all new patients prior to
their first appointment, helps patients understand palliative care?
4. Based on your interactions with new patients, have any mentioned the "Welcome Letter"
during their appointment? Furthermore, has it impacted their knowledge of palliative care
prior to their initial appointment?
5. Do you feel like any additional information should be added to the “Welcome Letter”?
6. In October 2022 one of the DNP students initiated a FAQ page to add to the Welcome
Letter. Since 10/22 till now do you feel there has been a decrease in time spent during
NP visits explaining PC to new patients?
7. Do you have any additional suggestions to improve the process for educating new
patients?
Educational document
Frequently Asked Questions
Is Palliative Care right for me?
Palliative care may be right for you if you have a serious illness (as listed on page 1) and you have experienced:
• symptoms from your illness that make it difficult for you be active and do the things you enjoy
• troublesome side effects from treatment
• frequent emergency visits
• difficulty making decisions or coping with the stress of your illness
You may receive palliative care at the same time as other treatments meant to cure you.
What can I expect from Palliative care?
You can expect a team that provides expert management of your symptoms (such as pain, shortness of breath, anxiety, fatigue, constipation, loss of appetite and difficulty sleeping) and extra time for communication about your goals and treatment options. Palliative care may improve your ability to go through medical treatments and carry on with your daily life.
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Do I have to give up my own doctor?
No, the palliative care team is here to provide you with an extra layer of support and will work in partnership with your primary doctor.
Questions to Consider Before Your First Appointment
Your Palliative care team may ask you some questions to help develop the best plan for you
• What is important to me?
• What are some of my goals?
• How do I like to make decisions about my care? Do I like to make them independently with the help of a provider, or by my friends and family?
Questions that I have for my first appointment:
___________________________
The context for the implementation proposal in this project is focused on palliative care and the education provided to patients by healthcare providers. Understanding the baseline knowledge of patients regarding palliative care and how healthcare providers educate them is crucial for developing effective educational materials and improving the overall patient experience. The project aims to assess the impact of a "Welcome Letter" sent to new patients prior to their first appointment and gather feedback from healthcare providers on its effectiveness.
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To address the context of the project, it would be important to explore the existing literature on palliative care, patient education, and effective communication strategies in healthcare. This would provide insights into evidence-based practices and strategies for educating patients about palliative care. Additionally, understanding the role of leadership in promoting evidence-based practice and implementing educational initiatives would be beneficial. Exploring articles such as "Promoting the implementation of evidence-based practice: A literature review focusing on the role of nursing leadership" and "Leadership as a Facilitator of Evidence Implementation by Nurse Managers: A Metasynthesis" would provide valuable information.
Moreover, the project involves surveying healthcare providers, so it would be important to consider the organizational culture and climate within the palliative care clinic. Research articles like "Validation of the Implementation Climate Scale in Nursing" and "Aligning organizational culture and infrastructure to support evidence-based practice" would offer insights into creating a supportive culture and environment for implementing evidence-based practices and educational initiatives.
To gather more information about the context, a comprehensive literature search should be conducted, focusing on palliative care, patient education, leadership, and organizational culture in healthcare. This would involve accessing relevant databases and academic journals to find articles that specifically address the factors relevant to the project. By critically reviewing and analyzing these articles, a deeper understanding of the context and important factors can be obtained, which can then be incorporated into the project's implementation proposal.
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