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NR 451 Week 4 Assignment: Translation into Practice

NR 451 Week 4 Assignment: Translation into Practice

Translation into Practice: Telehealth to Improve Management of Chronic Conditions

Chronic conditions constitute a significant public health concern and burden for individuals, families, providers, and the healthcare system. The Centers for Disease Control and Prevention (CDC) (2024) postulates that six in ten Americans suffer from at least a chronic disease while 4 in every ten have comorbidities. Again, evidence projects that the prevalence of chronic conditions like diabetes and hypertension will increase by close to 100%, to 145.66 million Americans by 2050 due to the rise in the number of individuals aged 50 years and over (Ansah & Chiu, 2023). The implementation of nurse case management that leverages telehealth can improve the quality of life and reduce adverse outcomes for individuals with chronic conditions like diabetes and hypertension. This paper discusses and explores the translation of an evidence-based change project into practice that focuses on nurse case management using telehealth.

Evidence-Based Intervention

Change projects are critical for healthcare organizations, nurses, and patients as they integrate evidence-based practice interventions to improve care delivery and patient outcomes. Studies show that creating and integrating change is central to healthcare practice that responds to advanced technologies, best practice evidence, and the need to meet patient concerns. According to Barrow and Annamaraju (2022), change is inevitable in healthcare, but close to two-thirds of change projects do notsucceedd due to various reasons, including poor planning, ineffective communication, and engagement of stakeholders,s and unmotivated staff.

The specific evidence-based intervention in this change project is nurse case management which integrates telehealth to improve the management of chronic conditions among adults. The proposed intervention helps in patient monitoring, patient education, and support. As an evidence-based intervention, the proposed change will enhance access to care, especially for patients with mobility issues and location barriers (Ma et al., 2022). Leveraging telehealth tools like remote monitoring devices, video consultations, and text messages, nurses will track patient progress give prompt interventions based on specific patient needs, and personalize care plans.

Various factors influence the need for change in managing chronic conditions among adults because of the substantial burden they present on healthcare delivery. These factors include national quality standards, accreditation, reimbursement requirements, and practice guidelines. National quality standards set by agencies and organizations like the Centers for Medicare and Medicaid Services (CMS) mandate healthcare organizations to improve patient care outcomes using evidence-based practice interventions. Further, CMS reimburses healthcare organizations based on the quality standards and outcomes illustrated by patients’ feedback. Accreditation requirements by The Joint Commission, require organizations to meet certain standards to maintain their accredited status. Compliance with such standards requires changes in policies, procedures, and clinical practices (Alhawajreh et al., 2023). For instance, implementing the proposed intervention may lower readmissions and improve the quality of life for those with chronic conditions. The possible barriers or challenges to implementing this intervention include change resistance, adequate resource allocation, and support from the organizational leaders (Cheraghi et al., 2023). Effective communication, engagement of stakeholders, and getting feedback will be critical in addressing these challenges. For instance, through effective communication, the change project team will engage stakeholders to generate awareness while seeking their support, and feedback on areas for improvement.

Monitoring and evaluating the effectiveness of nurse-led case management intervention will be critical to meeting the set goals. Monitoring activities will include continuous tracking and progress reports, ascertaining implementation fidelity, and collecting and analyzing data to determine strong areas and weaknesses in the implementation process. Additionally, feedback and adjustments will be core features of monitoring. Evaluation will entail impact assessment, analysis of gaps between planned and attained results, and examination of the changes that will be attributed to the intervention. The evaluation will also entail determining the long-term sustainability of the intervention and its effects on the selected population.

Planning

Planning is important in change projects and entails having a team with each member executing interconnected roles. The three important colleague roles in this change project will include communication, process development, and long-term implementation and evaluation. Firstly, the three roles will be involved based on the activities in each role. For instance, the communication role will entail providing information and outlining the process to all stakeholders, including the targeted population and healthcare providers. Process development will focus on creating the software, integrating it, and training nurses on its work to meet patient needs (Tao et al., 2022). The preparation for the change project for the three roles will include sufficient orientation and training, the use of practical components to demonstrate the working of the proposed project, and providing information about the effectiveness of the proposed intervention.

The anticipated timeline for implementing the change project will be six months. The change project will entail diverse activities and actions that will run during the implementation. The actions will include training the nurses, including the three roles, informal and formal meetings, and feedback forums for all stakeholders. Tracking progress for the change project based on the timeline will determine its overall implementation and effectiveness (Green & Samson, 2025). Tracking progress will entail filling periodic reports in templates from the second to the last month of the implementation period. The project team will also produce monthly reports and data on the utilization of the intervention among the targeted population and make recommendations on how to fill gaps and improve delivery.

Culture of Change

The proposed change project will occur in the facilities and homes of affected patients or those with chronic conditions. The facility will set up a telehealth nursing room for teleconference with patients. The patients will also integrate communication devices, including smartphones, tablets, and laptops to access care from nurses in the facility. The change implementation will follow protocols and practices set by the organization that include a whole-of-facility approach where all departments will be integrated into the lead team and get progress reports as required (Lehman et al., 2023). Advocacy for client population involvement will entail engaging the patients and their families, collaborative approaches to develop patient-centered care plans based on their input, and providing sufficient information for their participation and feedback (David-Olawade et al., 2024). The team will also conduct surveys and collect data to determine gaps and areas for improvement. Effective stakeholder engagement and management require the implementation to develop a comprehensive approach that entails continuous communication, listening, and collaboration (Ma et al., 2022). The team will create a communication plan to encourage and embed two-way dialogue and leverage meetings, focus group discussions, and spending more time with patients to collect information on the impact of the project.

Considerations

Effective implementation of change projects involves altering one or more of an organization’s major components like policies, culture, internal processes, and even its infrastructure. As such, before implementing the proposed change project, the facility should consider its privacy policy since the project will collect data from patients, and integrate its infrastructure with third-party entities who may not have security protocols, which could increase susceptibility to unauthorized access (Tao et al., 2022). The facility should also ensure compliance with regulatory mandates based on the Privacy Rule by HIPAA requirements.

A core cost analysis before implementing the change project will be a cost-benefit analysis where the team will compare the projected or estimated costs of the project and the benefits associated with the changes (Boyles, 2023). For instance, the expected benefits from this project may outweigh the initial and long-term costs or expenses for the facility and even patients. For example, the facility will improve patient outcomes and reduce the need for emergency room visits and readmissions, especially within 30 days after discharge. Further, the facility and nurses will expand access to care and generate more patients and revenues for long-term sustainability.

The project will require financial, human, and material resources to attain its goals. The financial and material resources will entail software development and integration into the current electronic health records (EHR) system and patient charts, and training nurses to understand its working (Nilsen et al., 2020). The facility will also require financial resources to regularly update the system and ensure it is secure with limited to no possible infiltration by unauthorized entities (Harrison & Janes, 2022). Human resources will entail having additional nurses, especially specialized nurses in geriatric care with sufficient abilities to implement and use telehealth devices. Additional human resources will include system developers and information technology (IT) personnel to give input and develop a system that meets and aligns with the organizational policies regulatory mandates and compliance.

Conclusion

Translation of evidence to practice is essential as demonstrated in this paper where the facility will implement the change project to enhance access to care for adults with chronic conditions using telehealth. Nurses will implement the proposed change through effective planning, making changes to the culture, and considering various aspects that the intervention may affect. As such, the proposed change project will benefit not just patients but also the facility and nurses who will manage the intervention.

References

Alhawajreh, M. J., Paterson, A. S., & Jackson, W. J. (2023). Impact of hospital accreditation on

quality improvement in healthcare: a systematic review. PloS one, 18(12): e0294180. DOI: 10.1371/journal.pone.0294180

Barrow, J. M. & Annamaraju, P. (2022). Change Management In Health Care.

https://www.ncbi.nlm.nih.gov/books/NBK459380/

Boyles, M. (2023 March 16). How to Implement Organizational Change Successfully.

https://online.hbs.edu/blog/post/implement-organizational-change

Ansah, J. P., & Chiu, C. T. (2023). Projecting the chronic disease burden among adult

Population in the United States using a multi-state population model. Frontiers in public health, 10, 1082183. DOI: 10.3389/fpubh.2022.1082183

Centers for Disease Control and Prevention (CDC) (2024). About Chronic Diseases.

https://www.cdc.gov/chronic-disease/about/index.html

Cheraghi, R., Ebrahimi, H., Kheibar, N., & Sahebihagh, M. H. (2023). Reasons for resistance to

change in nursing: an integrative review. BMC nursing, 22(1): 310. DOI: https://doi.org/10.1186/s12912-023-01460-0

David-Olawade, A. C., Olawade, D. B., Ojo, I. O., Famujimi, M. E., Olawumi, T. T., & Esan, D.

  1. (2024). Nursing in the Digital Age: Harnessing telemedicine for enhanced patient care.

Informatics and Health, 1(2): 100-110. https://doi.org/10.1016/j.infoh.2024.07.003

Green, R., & Samson, L. (2025). Implementing Store-and-Forward Telehealth in a Remote

Patient Monitoring-Home Telehealth Program. Telehealth and Medicine Today, 10(1).

DOI: https://doi.org/10.30953/thmt.v10.547

Harrison, R., & Janes, G. (2022). Integrating the sciences of improvement, implementation and

managing change in nursing practice. https://doi.org/10.1111/jocn.16605

Lehman, V. E., Siegel, J. E., & Chiang, E. N. (2023). The price of practice change: assessing the

cost of integrating research findings into clinical practice. Medical Care, 61(10): 675-680. DOI: 10.1097/MLR.0000000000001873

Ma, Y., Zhao, C., Zhao, Y., Lu, J., Jiang, H., Cao, Y., & Xu, Y. (2022). Telemedicine application

in patients with chronic disease: a systematic review and meta-analysis. BMC medical informatics and decision making, 22(1): 105. DOI: https://doi.org/10.1186/s12911-022-01845-2

Nilsen, P., Seing, I., Ericsson, C., Birken, S. A., & Schildmeijer, K. (2020). Characteristics of

successful changes in health care organizations: an interview study with physicians,

registered nurses, and assistant nurses. BMC health services research, 20, 1-8.

DOI: https://doi.org/10.1186/s12913-020-4999-8

Tao, X., Zhu, W., Chu, M., & Zhang, Y. (2023). Nurse-led virtual interventions in managing

chronic diseases: a protocol for a systematic review of randomized controlled trials. BMJ

open, 13(5), e070583. DOI: 10.1136/bmjopen-2022-070583 https://pmc.ncbi.nlm.nih.gov/articles/PMC10186446/

Answers to Questions about Progress on the Translation into Practice Assignment

Flag Question 1 Answer

The selected evidence-based change intervention based on the PICOT and after revisions as recommended by the instructor is integration of nurse case management of chronic conditions among adults by leveraging telehealth.

Flag Question 2 Answer

Existing evidence helps influence change as organizations leverage telehealth to improve patient outcomes, enhance quality standards at national level, and comply with reimbursement requirements by the Centers for Medicare and Medicaid Services (CMS). For instance, The Joint Commission steps national quality standards that align with CMS requirements for facilities to get reimbursed for service provided. Under CMS reimbursement requirements, a facility should meet set quality standards that entails better patient outcomes. The article below provides the rationale for accreditation; implying that healthcare organizations can attain better outcomes when they improve care delivery and quality standards.

Alhawajreh, M. J., Paterson, A. S., & Jackson, W. J. (2023). Impact of hospital accreditation on

quality improvement in healthcare: a systematic review. PloS one, 18(12): e0294180. DOI: 10.1371/journal.pone.0294180

Flag Question 3 Answer

The three colleague roles essential to this change project include communication, development of the process, and long-term implementation and sustainability of the change project.

Flag Question 4 Answer

The change project will be set in the facility with a dedicated telehealth room for nurses to promptly consult patients and get their feedback. Patients in their homes will also set a dedicated space to interact with providers through telehealth.

Flag Question 5 Answer

My two questions concern the assignment process. Firstly, how can one integrate all the sections of the assignment paper into one paragraph on the template? Secondly, it is possible to create a comprehensive template and provide systematic rubric for each area or part?

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Translation into Practice

Assignment

Purpose

The purpose of this assignment is to explore the translation of an evidence-based change project into practice.

Course Outcomes

This assignment enables the student to meet the following course outcomes:

  • CO 2: Proposes leadership and collaboration strategies for use with consumers and other healthcare providers in managing care and/or delegating responsibilities for health promotion, illness prevention, health restoration and maintenance, and rehabilitative activities. (PO 2)
  • CO 7: Integrates the professional role of leader, teacher, communicator, and manager of care to plan cost-effective, quality healthcare to consumers in structured and unstructured settings. (PO 7)
  • CO 8: Selects evidence for best practices when planning professional nursing care involving systems, processes, and devices for individuals, families, aggregates, and communities. (PO 8)

Due Date

Students?must?complete the Week 4 Translation into Practice Assignment and submit it to the Dropbox by Sunday?at?11:59?p.m.?MT.

Late Assignment Policy

Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction as noted in the rubric below.

Total Points Possible

This assignment is worth a total of 175 points.

Preparing the Assignment

Follow these guidelines when completing each component of the assignment. Contact your course faculty if you have questions.

Directions

Complete the Evidence Summary template by following the steps below.

  1. Download the Week 4 Translation into Practice template Download Week 4 Translation into Practice templateOpen this document with ReadSpeaker docReader. Use of this template is required. If the template is not used, a 10% deduction will be applied. See the rubric. Save the template and include your name in the file name.
  2. Complete the Translation into Practice template building on your selected nursing clinical practice problem and Week 2 Evidence Summary assignment.
  3. Correctly cite and reference information from at least two scholarly sources that help support the assignment.?Sources should be no more than five years old unless they are historical references.
  4. Follow rules of grammar, spelling, word usage, and punctuation consistent with formal, scientific writing.
  5. Abide by Chamberlain University’s academic integrity policy.

Include the following sections (detailed criteria listed below and in the grading rubric). Answer the questions under each section with explanation and detail.

Section 1: Evidence-Based Intervention

  1. Describe the specific evidence-based intervention to be implemented in the change project.
  2. Describe factors that influence the need for this change, such as national quality standards, reimbursement, accreditation, or practice guidelines. Cite the scholarly source(s) that help support this discussion.
  3. Describe the potential barriers or challenges to implementing the intervention and how they will be addressed.
  4. Summarize how the intervention will be monitored and evaluated for effectiveness.

Section 2: Planning

  1. Discuss what three colleague roles are most important to your change project and explain how they will be involved.
  2. Explain how you will prepare them for the change project.
  3. Explain the anticipated timeline and actions (meetings, education, etc.) for implementing the change project.
  4. Discuss how you will track the progress of the change project using the timeline.

Section 3: Culture of Change

  1. Summarize and describe the setting where the change project will occur. Do not list specific organization names.
  2. Does your organization have defined protocols/practices for implementing a change project? If so, briefly describe. If not, what would you recommend?
  3. Describe how you will advocate for the client population involved in the change.
  4. Describe the communication and engagement strategies you will employ to involve the stakeholders and develop support for the change project.

Section 4: Considerations

  1. Discuss the current policies or procedures that should be considered within your organization before implementing the change project.
  2. Explain the type of cost analysis needed before implementing the change project and who should be involved. You are not required to perform an actual cost analysis for your project.
  3. Describe the possible financial, human, and material resources required to implement the change project.

Submit the completed Translation into Practice template to the Week 4 Dropbox by Sunday at 11:59 p.m. MT. This assignment will automatically be run through TurnItIn.

Rubric

NR451 W4 Translation into Practice Assignment Rubric

NR451 W4 Translation into Practice Assignment Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeEvidence-Based Intervention4 Required Criteria

Answer the questions with explanation and detail.

1. Describe the specific evidence-based intervention to be implemented in the change project.

2. Describe factors that influence the need for this change, such as national quality standards, reimbursement, accreditation, or practice guidelines. Cite the scholarly source(s) that help support this discussion.

3. Describe the potential barriers or challenges to implementing the intervention and how they will be addressed.

4. Summarize how the intervention will be monitored and evaluated for effectiveness.

35 ptsExcellentAll requirements met.

32 ptsVery Good3 requirements met.

28 ptsSatisfactory2 requirements met.

18 ptsNeeds Improvement1 requirement met.

0 ptsUnsatisfactoryNo requirements met.

35 pts
This criterion is linked to a Learning OutcomePlanning4 Required Criteria

Answer the questions with explanation and detail.

1. Discuss what three colleague roles are most important to your change project and explain how they will be involved.

2. Explain how you will prepare them for the change project.

3. Explain the anticipated timeline and actions (meetings, education, etc.) for implementing the change project.

4. Discuss how you will track the progress of the change project using the timeline.

40 ptsExcellentAll requirements met.

36 ptsVery Good3 requirements met.

33 ptsSatisfactory2 requirements met.

20 ptsNeeds Improvement1 requirement met.

0 ptsUnsatisfactoryNo requirements met.

40 pts
This criterion is linked to a Learning OutcomeCulture of Change4 Required Criteria

Answer the questions with explanation and detail.

1. Summarize and describe the setting where the change project will occur. Do not list specific organization names.

2. Does your organization have defined protocols/practices for implementing a change project? If so, briefly describe. If not, what would you recommend?

3. Describe how you will advocate for the client population involved in the change.

4. Describe the communication and engagement strategies you will employ to involve the stakeholders and develop support for the change project.

40 ptsExcellentAll requirements met.

36 ptsVery Good3 requirements met.

33 ptsSatisfactory2 requirements met.

20 ptsNeeds Improvement1 requirement met.

0 ptsUnsatisfactoryNo requirements met.

40 pts
This criterion is linked to a Learning OutcomeConsiderations3 Required Criteria

Answer the questions with explanation and detail.

1. Discuss the current policies or procedures that should be considered within your organization before implementing the change project.

2. Explain the type of cost analysis needed before implementing the change project and who should be involved. You are not required to perform an actual cost analysis for your project.

3. Describe the possible financial, human, and material resources required to implement the change project.

30 ptsExcellentAll requirements met.

25 ptsSatisfactory2 requirements met.

15 ptsNeeds Improvement1 requirement met.

0 ptsUnsatisfactoryNo requirements met.

30 pts
This criterion is linked to a Learning OutcomeFormat4 Required Criteria

1. Answer all questions/criteria with explanation and detail.

2. Answers are written using professional language.

3. Information is appropriate for healthcare professionals.

4. Scholarly sources pertain to the topic and are no more than five years old unless they are historical references.

10 ptsExcellentAll requirements met.

9 ptsVery Good3 requirements met.

8 ptsSatisfactory2 requirements met.

5 ptsNeeds Improvement1 requirement met.

0 ptsUnsatisfactoryNo requirements met.

10 pts
This criterion is linked to a Learning OutcomeCitation and Reference FormationUse the current APA format to format citations and references and is free of errors. 10 ptsExcellent0-1 error(s).

9 ptsVery Good2-3 errors.

8 ptsSatisfactory4-5 errors.

5 ptsNeeds Improvement6-7 errors.

0 ptsUnsatisfactoryMore than 7 errors.

10 pts
This criterion is linked to a Learning OutcomeWriting RequirementsCommunicate with minimal errors in English grammar, spelling, syntax, and punctuation. 10 ptsExcellent0-1 error(s).

9 ptsVery Good2-3 errors.

8 ptsSatisfactory4-5 errors.

5 ptsNeeds Improvement6-7 errors.

0 ptsUnsatisfactoryMore than 7 errors.

10 pts
This criterion is linked to a Learning OutcomeTemplate Used 0 ptsNo Points DeductedCorrect template used.

0 ptsPoints Deducted (-10%)17.5 points deducted (10%) for incorrect or no template used.

0 pts
This criterion is linked to a Learning OutcomeLate Deduction 0 ptsNo Points DeductedSubmitted on time.

0 ptsPoints Deducted (-5% per day)Not Submitted on Time – Points Deducted (5% deduction per day) 1 day late = 8.75 deduction; 2 days late = 17.5 deduction; 3 days late = 26.25 deduction; 4 days late = 35 deduction; 5 days late = 43.75 deduction; 6 days late = 52.5 deduction; 7 days late = 61.25 deduction; Score of 0 if more than 7 days late

0 pts

Total Points: 175

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