Evidence-Based Practice Proposal - Section D: Solution Description
Write a paper of 500‐750 words (not including the title page and reference page) paper for your proposed evidence‐based practice project solution. Address the following criteria:
Proposed Solution: (a) Describe the proposed solution (or intervention) for the problem and the way(s) in which it is consistent with current evidence. Heavily reference and provide substantial evidence for your solution or intervention. (b) Consider if the intervention may be unrealistic in your setting, too costly, or there is a lack of appropriate training available to deliver the intervention. If the intervention is unrealistic, you may need to go back and make changes to your PICOT before continuing.
Organization Culture: Explain the way(s) in which the proposed solution is consistent with the organization or community culture and resources.
Expected Outcomes: Explain the expected outcomes of the project. The outcomes should flow from the PICOT.
Method to Achieve Outcomes: Develop an outline of how the outcomes will be achieved. List any specific barriers that will need to be assessed and eliminated. Make sure to mention any assumptions or limitations which may need to be addressed.
Outcome Impact: Describe the impact the outcomes will have on one or all of the following indicators: quality care improvement, patient‐centered quality care, efficiency of processes, environmental changes, and/or professional expertise.
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.
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 LopesWrite. Please refer to the directions in the Student Success Center.
Upon receiving feedback from the instructor, refine "Section D: Solution Description" for your final submission. This will be a continuous process throughout the course for each section.
My PICOT Question:
In the surgical patients (P), how does the use of a written intra-operative checklist (I), compared with no checklist (C), affect wrong site surgery (O) over a period of 1 year.(T )
Evidence-Based Practice Proposal
Section D: Solution Description
Portia Stephens
Grand Canyon University: NUR 699
May 22, 2019
Section D: Solution Description
At Cleveland Clinic, the incidence of wrong site surgeries is less likely to occur as the organization implements strategies to prevent this occurrence and engages in ongoing education of the operating room staff and the use of a safety checklist in the operating room. Tom Miheljevic, the current CEO and President of the Cleveland Clinic Health System, in an online document refers to zero as our non-negotiable target for serious safety events in the hospital and outpatient environments (2018). This move for change has improved the culture of the organization globally where Zero is considered as something that should not occur and referred to as “Start Strong and Finish Strong”. This is combined with the Universal Protocol developed by the Joint Commission in 2004 with the idea of safety checklists, as proposed by Boston surgeon Atul Gawande in 2009 (as cited in Miheljevic, 2018). The launching of this process "start strong and finish strong" is bringing all our facilities closer to target zero every day (Miheljevic, 2018). According to Miheljevic (2018), every voice on the team is heard, caregivers, patients and family are equal partners, anyone can speak up, and anyone can stop the line with a concern.
Current research made by Geraghty et al. (2017), reported incidence of wrong-site surgery occurring in approximately 1 in every 100,000 surgical cases varying among different specialties. According to Geraghty et al. (2017), the data reported in the United Kingdom recorded about 124 cases of wrong-site surgery from April 2014 to March 2015, where this number of incidence is the highest number of documented cases in their country in a single year. In the United States, approximately 2,700 patients are harmed by wrong-site surgery each year (Collins et al., 2014). The use of a checklist greatly reduces the incidence of wrong-site surgery and is cost effective in the long-term both to the patient, the staff involved and the institution where the possibility of legal implications would exist.
The occurrence of wrong-site surgery should be eradicated or avoided as these events cause great harm not only to the safety of the patients but also to the institutional integrity of health professionals around the world. To minimize the occurrence of these avoidable events, the proposed solution or intervention needed is the implementation of a surgical safety checklist that was developed by the World Health Organization (WHO). The checklist can be in a poster format posted in the operating room, which is very cost effective, or with an electronic scheduling system using monitors to easily encourage the compliance of the surgical team in implementing the checklist.
In a complementary study made by Weiser et al. (2010), the evaluation of the checklist's effectiveness in reducing the rate of complications and deaths during emergency surgical procedures was observed. This study focused only on urgent surgery operation, within 24 hrs of assessment, rather than scheduled surgery. The initial observation revealed a significant reduction of mortality cases from 3...
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