Recommending an Evidence-Based Practice Change

The collection of evidence is an activity that occurs with an endgame in mind. For example, law enforcement professionals collect evidence to support a decision to charge those accused of criminal activity. Similarly, evidence-based healthcare practitioners collect evidence to support decisions in pursuit of specific healthcare outcomes.

identify an issue or opportunity for change within your healthcare organization and propose an idea for a change in practice supported by an EBP approach.

To Prepare:

Reflect on the four peer-reviewed articles you critically appraised in Module 4, related to your clinical topic of interest and PICOT.
Reflect on your current healthcare organization and think about potential opportunities for evidence-based change, using your topic of interest and PICOT as the basis for your reflection.
Consider the best method of disseminating the results of your presentation to an audience.
The Assignment: (Evidence-Based Project)

Part 4: Recommending an Evidence-Based Practice Change

Create an 8- to 9-slide narrated PowerPoint presentation in which you do the following:

Briefly describe your healthcare organization, including its culture and readiness for change. (You may opt to keep various elements of this anonymous, such as your company name.)
Describe the current problem or opportunity for change. Include in this description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general.
Propose an evidence-based idea for a change in practice using an EBP approach to decision making. Note that you may find further research needs to be conducted if sufficient evidence is not discovered.
Describe your plan for knowledge transfer of this change, including knowledge creation, dissemination, and organizational adoption and implementation.
Explain how you would disseminate the results of your project to an audience. Provide a rationale for why you selected this dissemination strategy.

Sample Solution

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Clinical Field Experience A: Making Connections, K-3

T​‌‍‍‍‌‍‍‌‍‌‌‍‍‍‌‍‌‌‌‍​he ability to effectively integrate all disciplines in student learning, while recognizing developmental milestones, is complex. Use this field experience to observe and collaborate with your mentor regarding the many facets to teaching in a K-3 classroom. Observe an inclusive K-3 early childhood or elementary site, focusing on ELA, social studies, and art lessons, and paying close attention to the relationship between reading and writing. Discuss with the mentor teacher how he or she purposefully integrates reading and writing into lessons. Using any remaining field experience hours, assist the teacher in providing instruction and support to the class. In 250-500 words, summarize and reflect upon your observations, discussion, and instructional support. Include the following: How did your field experience teacher integrate reading and writing? What was done for reading? What was done for writing? How were they connected to each other during instruction? What was done for social studies and art? Were they integrated into other curriculum? If they were not observed, how could you incorporate social studies and art into the lesson? What support and/or accommodations did you observe for children with exceptionalities? How will this observation and research inform your own future teaching practice? APA format is not required, but solid academic writing is expected.​‌‍‍‍‌‍‍‌‍‌‌‍‍‍‌‍‌‌‌‍​This assignment uses a rubric. Review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

Sample Solution

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A process in control may produce unacceptable output.

  1. A process in control may produce unacceptable output.

True _ False_

  1. Special cause variation may fall within the control limits.

True _ False_

  1. A process is capable if the variations fall within the control limits. True _ False_
  2. If X bar chart is in control then R chart may be out of control.

True _ False____

  1. Control charts are used to determine if there are unexpected changes in the process.

True _ False_

  1. For defective unit quality control, an nP chart can be used when the sample size is constant.

True _ False_

  1. A standard Six Sigma Process has a 4.5 Sigma performance

True _ False____

  1. A process is capable if the process mean exceeds the goal

True _ False_

  1. A histogram shows the trendline of a process

True _ False____

  1. A Fishbone diagram is used to organize data in categories

True _ False____

B. Please answer the following multiple choice questions (each worth 4 points)):

    1)   Which of the following tools is used to identify process frequency distribution?

A) Matrix diagram
B) Histogram
C) Pareto Chart
D) Check sheets
E) Process map

2) Which of the following tools is used to organize ideas.
A) Matrix diagram
B) Histogram
C) Affinity Diagram
D) Check sheets
E) Process map

    3)  Which of the following tools is used to analyze cycle time

A) Control Chart
B) Fishbone diagram
C) Pareto Chart
D) Process map
E) Root Cause Analysis

    4)  Which of the following is true of common cause variation?

A) It is uncontrollable.
B) It is centered around the mean.
C) It is inherent in the process.
D) All of the above.
E) None of the above

    5)  A true 3 Sigma Process is equivalent to  _________industry standard Sigma Process.

A. 3.4
B. 1.5
C. 3.0
D. 4.5
E. 6.0

C. Please respond to the following questions. Each question is worth 10 points:

1)  97. 
  1. Please create a process map for withdrawing cash from an ATM machine as described below:
    Janet needed some cash and walks up to an ATM machine. She inserts her debit card. The machine returns the card and the monitor reads: “could not read the card try again”. Janet recognizes that she has entered the card in the wrong direction. She takes the card and turns it around and insert the card again. The machine keeps the card and the monitor reads: “enter pass code”. Janet enters a 4 digit code. The monitor reads: “ error, try again”.
    Janet enters the code again. The monitor displays: Withdrawal? Yes No
    Janet selects Yes. Displays shows:
    “ $100, $200, $300, $400, $______”.
    Janet selects $200. The machine pushes out 10 $20 bills. Monitor then displays “Receipt? Yes No”. Janet selects No. Monitor displays “Take your cash” .
    The machine returns the card. Display changes to “Thank You”.
    Janet takes the cash and her card and walks away. . 2)
  2. A customer relationship manager decided to track customer complaints as part of his ongoing customer satisfaction improvement program. After collecting data for 3 months, their check sheet appears as follows: Type of Problem Frequency
    (number of times)
    Call went to voice mail 18
    Items damaged when received 15
    Literature not in the box 7
    Parts missing 13
    Billing error 6
    Unit not working 2
    Delivery was late 3

Construct a Pareto chart including the cumulative % frequency. What is the cumulative percentage of the two highest priority issues?

  1. A Black Belt consultant in the ABC Corporation reported the Sigma Performance of a manufacturing line as 3.1. Using Z score table calculate the % defective units coming off the production line
  2. A procurement manager has been tracking delivery performance of her suppliers. Based on the following data

a. Calculate sigma performance of these suppliers using Z Score tables and rank order them
b. Comment on the performance of these suppliers

Supplier A B C
Number of deliveries 25 54 70
Number of late deliveries 3 10 12
.

  1. A project manager at Global Design Corporation has collected the following data on the size of software programs and the length of programming time. The company is bidding on a new system that is estimated to consist of 300,000 lines of code. Use the data to find the correlation function of coding time to the program size and estimate the number of days it would take to code the system.

Module Size in 1000 lines of code (KLOC) Number of days to code
1 160 70
2 158 66
3 150 70
4 135 59
5 178 72
6 170 63
7 158 69
8 138 65
9 200 72
10 195 68
11 189 65
12 173 68
13 159 70
14 163 55
15 150 66
16 140 65
17 206 73
18 144 64
19 157 70
20 183 74
21 195 75
22 190 77
23 182 69
24 152 65
25 174 69

  1. A project manager has developed the following data on a project tasks and durations by weeks.
    a. Please create an AON diagram, identify the critical path and the expected project duration.
    b. What is the chance of completing the project one week earlier than expected?
    c. The customer has asked for a 99% confidence on the project completion date. Calculate the number of additional weeks the project manager needs to make that commitment. Time estimation in weeks Task Predecessor optimistic Most likely Pessimistic
    A 3 4 5
    B A 1 8 15
    C A 2 4 6
    D A 4 8 12
    E B 7 9 11
    F C,B 2 5 8
    G E,D 6 8 10
    H F,G 4 7 10

Sample Solution

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Regression Towards the Mean

Look at the attached scatterplot below that compares Per Capita Meat Consumption and Colon Cancer incidence per country. Now that you are equipped with the concept of correlation, do you think that we can make a statistically significant inference about the relationship between meat consumption and colon cancer?

Consider the following points in answering this question:

Do we need to survey more countries to make a conclusion?
How strong is the correlation? What do you think the r^2 would be if you ran a linear regression?
Are there any other factors we should take into consideration besides meat consumption?

Sample Solution

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