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Week 6 Assignment: EBPChange Process form

ACE Star Model of Knowledge Transformation

Follow Nurse Daniel as your process mentor in the weekly Illustration section of the

lesson.Please do not use any of the Nurse Daniel information for your own topic,

nursing intervention, or change project. Nurse Daniel serves as an example only to

illustrate the change process.

Name:_____________________

Star Point 1: Discovery (Identify topic and practice issue)

Identify the topic and the nursing practice issue related to this topic. (This MUST involve a

nursing practice issue.)

Nurses operate in different healthcare settings, including the emergency department

(EDs). In this healthcare environment, nurses perform various activities, including taking

patients’ vital signs, administer medication, assist doctors with medical procedures, and offer

education and support to patients and families. However, ED nurses encounter various

challenges, such as workplace violence, especially from violent patients (Sahebi, Jahangiri,

Sohrabizadeh & Golitaleb, 2019). It includes the physical and psychological damaging actions

that ED nurses encounter while they are on duty, such as the direct physical assaults, written or

verbal threats, and the physical or verbal harassment.

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Briefly describe yourrationale for your topic selection. Include the scope of the

issue/problem.

Studies show violence against nurses is a significant nursing practice issue experienced in

various working places besides the Emergency Department. According to the American Nurses

Association, out of four nurses, one gets assaulted at his/her workplace. In general,

approximately 25 000 workplace assaults are reported annually in the healthcare sector (Sahebi

et al., 2019). Besides, 30 percent of the ED nurses experience various forms of violence at their

workplace.

Patients are identified as the largest source of violence in nursing practice. However,

nurses do experience other forms of violence from different sources such as their colleagues,

visitors, or even an assailant. The cases concerning workplace violence in healthcare settings can

be even more since other injured or assaulted nurses fail to report the incidents to the relevant

authorities (Armstrong, 2018). For instance, many nurses do not report bullying and other forms

of verbal abuse that the experience from their patients.

Besides, workplace violence hinders the productivity of the affected nurses and also

contributes to high healthcare costs. One of them includes physical injuries. Also, this nursing

practice issue can lead to psychological problems, including stress or phobia. These negative

impacts can lower their productivity significantly. Additionally, the healthcare organization or an

employer compensates the injured nurses and incur indirect costs associated with sick leaves and

even employee resignation (Pourshaikhian et al., 2016). In that regard, it is imperative to address

the issue of workplace violence in nursing practice.

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Star Point 2: Summary (Evidence to support need for a change)

Describe the practice problem in your own words and formulate your PICOT question.

Among the emergency department nurses (P), how will the implementations of

educational and training programs on workplace violence and effective response procedures (I)

as compared to educational activity only (C) help reduce the prevalence of workplace violence

(O)?

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List the systematic review chosen from the CCN Library databases. Type the complete

APA reference for the systematic review selected.

Sahebi, A., Jahangiri, K., Sohrabizadeh, S., & Golitaleb, M. (2019). Prevalence of workplace

violence types against personnel of emergency medical services in Iran: a systematic

review and meta-analysis. Iranian journal of psychiatry, 14(4), 325.

List and briefly describeother sources used for data and information. List any

otheroptional scholarly source used as a supplement to the systematic review in APA

format.

Pourshaikhian, M., Gorji, H. A., Aryankhesal, A., Khorasani-Zavareh, D., & Barati, A. (2016). A

systematic literature review: workplace violence against emergency medical services

personnel. Archives of trauma research, 5(1). https://dx.doi.org/10.5812%2Fatr.28734

This is a systematic review that focuses on the issue of workplace violence in nursing

place. Thus, the author identifies a lack of nursing staff training initiatives, inadequate response

procedures, and unreliable violence management procedures as the leading causes of the nursing

practice issue in question.

Armstrong, N. (2018). Management of nursing workplace incivility in the health care settings: A

systematic review. Workplace health & safety, 66(8), 403-410.

https://doi.org/10.1177%2F2165079918771106

This article also focuses on the nursing practice issue. The author, therefore, aimed at

identifying ways to prevent incivility in hospitals. Thus, this research supports that the blending

https://dx.doi.org/10.5812%2Fatr.28734https://doi.org/10.1177%2F2165079918771106

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of educational training about workplace violence and sufficient responses to uncivil employee

conduct can help address the issue.

Briefly summarize the main findings (in your own words) from the systematic review and

the strength of the evidence.

The study assessed the incidence of workplace violence among healthcare workers

operating in the emergency unit. The study was set in Iran. It employed a systematic review and

meta-analysis study design. Therefore, the researcher extracted nine articles from various

sources, including the Scopus, PubMed, Google Scholar, and Maglran databases. It had a sample

size of 1257 healthcare personnel in total. The study confirmed that the issue of workplace

violence was highly prevalent in the country. The incidence rate of verbal workplace violence

was about 73 percent. Besides, the prevalence rate for the physical and cultural workplace

violence was 36.39 % and 16.51%, respectively. The author concluded that workplace violence

in the ED department is a significant issue. Therefore, there is a need to address the problem

using various measures such as training the healthcare staff on various incivility prevention

measures.

Strengths

1. The systematic review delivers a clear and comprehensive overview of the available

evidence on workplace violence and enhances its reliability.

2. The objective of the systematic review is clearly stated.

3. A meta-analysis was conducted. This enhances the reliability of the evidence

Outline one or two evidence-based solutions you will consider for the trial project.

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1. Educating and training of ED nurses on various violence prevention methods.

2. Zero tolerance policy

Star Point 3: Translation (Action Plan)

Identify care standards, practice guidelines, or protocols that may be in place tosupport

your intervention planning (These may come from your organization or from the other

sources listed in your Summary section in Star Point 2).

OSHA workplace violence training guidelines

List your stakeholders (by title and not names; include yourself) and describe their roles

and responsibilities in the change process (no more than 5).

Nurses

These are the target population. They will be trained on various strategies to prevent violence in

the workplace. Secondly, they will be responsible for reporting any incidents that may lead to

violence in the healthcare setting.

ED nurse managers

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These healthcare professionals perform the managerial role in the ED department to ensure the

nurses finish their duties as required. In this case, they will be involved in making decisions and

designing an educational and training program that will equip ED nurses with the necessary

skills to prevent and handle various violence cases at the workplace. Secondly, they provide a

report concerning the intervention the senior management.

Nurse educators

These healthcare professionals will educate the ED nursing staff about various workplace

violence prevention methods. Therefore, they will identify the nursing staff's training needs to

ensure the training program is active.

Psychiatrist

This healthcare provider will be responsible for assessing the affected nurses and treating them to

enhance their well-being and promote their productivity.

Management Board

They include the hospital CEO and the senior managers. They are responsible for

directing all activities within the organization, including planning and financing the facility. In

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this case, they will be responsible for funding the educational and training program and

managing the daily activities to ensure the program is done successfully.

What specifically is your nursing role in the change process? Other nursing roles?

Nurses will take various roles in this change process. Mainly, they will be required to

learn about multiple violence prevention methods and report any incidents that may lead to

workplace violence. Other roles will include educating patients about risks associated with

workplace violence to avoid those violent cases that originate from the patients.

List your stakeholders by position titles (charge nurse, pharmacist, etc.).-Why are

the members chosen (stakeholders) important to your project?

Hospital CEO

This healthcare professional will be crucial in the change process. This stakeholder ensures

patient safety, promotes quality of healthcare, and creates policies. Thus, in the change process,

the hospital CEO play will participate by approving the quality improvement project and

financing it.

Nurses

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These healthcare providers will be involved in the change process since they are directly affected

by workplace violence. Thus, educating them on various measures to identify and curb the

different forms of workplace violence will improve their safety at the workplace.

Psychiatrist

This healthcare professional will play a role in the change process by identifying those nurses

affected by workplace violence in the emergency department and treat them to improve their

well-being and maintain their productivity.

ED nurse manager

This stakeholder will play an essential role in the change process. He/she will be responsible for

creating a safe working environment for their nursing staff by planning and implementing

various interventions to address the issues affecting them.

Nurse educator

This healthcare professional educates nursing staff to improve their skills and knowledge. Thus,

in this case, the nurse educator will ensure that the nurses have the skills needed to address

various forms of violence that they may encounter at their workplace.

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What type of cost analysis will be needed prior to a trial? Who needs to be involved with

this?

The training costs will be obtained first before the trail. The nurse educators, the ED unit

manager and the senior hospital management personnel will team up to determine the costs.

Star Point 4: (Implementation)

Describe the process for gaining permission to plan and begin a trial. Is there a specific

group, committee, or nurse leader involved?

The ED nurse supervisors or managers and the management board will be involved in the initial

phase of the implementation process. Thus, a nurse will be present the idea to the ED nurse

manager to inform him about the significance of the nursing practice issue. Then the nurse

manager will communicate with senior management staff to approve the proposed evidence-

based approach.

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Describe the plan for educating the staff about the change process trial and how they will

be impacted or asked to participate.

First, the nursing staff will be informed about the need for the education program. Secondly, the

nursing educator will assess the nursing staff's training needs and design a training program.

Thirdly, the venue and duration of the training program will be decided by the ED nurse manager

in collaboration with the senior management staff. The ED nurse managers and supervisors will

then explain to staff how their work schedule will be modified to accommodate the training

program. Lastly, the training materials such as writing materials will be acquired, and then the

program will get initiated.

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Outline the implementation timeline for the change process (start time/end time, what steps

are to occur along the timeline).

The training program will run for two weeks (1st to 16th August) and will be done during

evening hours

1 -2nd August- Communication: Informing to the ED nurses the need for the desired change.

3rd-5th August- Acquisition of the training materials

6th – 14th August- Training of the nursing staff

15th-16th august- Evaluation of the training program to ensure the outcome measures are

obtained

16th August- reporting of the project outcomes

List the measurable outcomesbased on the PICOT. How will these be measured?

By the end of the training program, the ED nursing staff is expected to identify potential violence

incidents, address them like reporting the cases they encounter, understand their responsibilities

regarding the prevention of workplace and behave civilly at the workplace; and understand the

consequences of workplace violence.

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Evaluation

These outcomes can be measured by evaluating the nursing staff's knowledge of workplace

violence, how well communicate or interact with other colleagues, their patients, and families.

Lastly, a decline in the rate of the violence cases reported after the intervention will imply that

the outcomes have been achieved.

What forms, if any, might be used for recording purposes during the pilot change process.

Describe.

Monitoring and evaluation forms will be used to record the purpose of the trail. Thus, at the end

of the trial, the project will be evaluated to determine whether expected outcomes were achieved.

What resources are available to staff (include yourself) during the change pilot?

Nurses

Nurse educators

Hospital hall

Financial resources

Time

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Will there be meetings of certain stakeholders throughout the trial? If so, who and when

will they meet?

Yes. The meetings will involve the nurse educators, unit managers, and the hospital CEO to

ensure training program run smoothly by ensuring there is enough supply of training materials.

Star Point 5: (Evaluation)

How will youreport the outcomes of the trial?

The outcomes of the trail will be communicated through the emergency unit and general hospital

meetings, posters, and newsletters.

What would be the next steps for the use of the change process information?

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The report will be presented to the relevant leaders, including the ED unit nurse managers and

senior management board, to assess the change process information and decide whether to

implement the evidence-based interventions to enhance employee safety in the ED department.

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References

Armstrong, N. (2018). Management of nursing workplace incivility in the health care settings: A

systematic review. Workplace health & safety, 66(8), 403-410.

https://doi.org/10.1177%2F2165079918771106

Pourshaikhian, M., Gorji, H. A., Aryankhesal, A., Khorasani-Zavareh, D., & Barati, A. (2016). A

systematic literature review: workplace violence against emergency medical services

personnel. Archives of trauma research, 5(1). https://dx.doi.org/10.5812%2Fatr.28734

Sahebi, A., Jahangiri, K., Sohrabizadeh, S., & Golitaleb, M. (2019). Prevalence of workplace

violence types against personnel of emergency medical services in Iran: a systematic

review and meta-analysis. Iranian journal of psychiatry, 14(4), 325.

https://doi.org/10.1177%2F2165079918771106https://dx.doi.org/10.5812%2Fatr.28734