Your introduction section should smoothly transition into your problem statement. It should flow logically from the information you provided. This section of the paper will provide information about the clinical problem using the Johns Hopkins Question Development Tool (Appendix B) as the guide. The clinical problem should address a nursing sensitive issue and discuss why the issue/problem is important to nursing and to healthcare. There should also be a synopsis of what current practice is related to the practice concern. Explain your approach to the problem and how your intervention will address it.

Problem Background

The background of the problem is a review of information on why the problem is a pressing concern and summarizes for the reader what is known about the problem being investigated. This is accomplished with a general review of foundational research literature and data from credible sources that report findings related to the topic of interest.

Stakeholders

What persons/groups or individuals might be impacted by your project? Ensure you think “outside the box” and consider both internal and external persons/groups, as well as entities.

PICOT Question

A well-developed clinical question using the PICO(T) components will then be developed. The PICO should be concise, relate to nursing practice and be a nursing sensitive issue. It should be written so the terms used in the PICO help guide the search strategies. The Question Development tool will also be used to identify the proposed search terms, the databases to be searched and any specific search strategies used. Search strategies can include applying limiters such as language, years to search, peer reviewed, articles limited to certain countries, etc. Search strategies can also include using Boolean search terms AND, OR and NOT to help refine the search. In this section the student will also address how the clinical question was or was not revised to reflect the current evidence. The last part of the question development tool is to identify the outcome measurement plan with very specific information and metrics related to who, what, where, how often type questions.

Review of Literature

The next area of the paper will address the literature review and provide a discussion of the evidence-supported interventions. A summary of the literature search parameters and identification of research and non-research sources of evidence will be provided with a synthesis and summary of the evidence to support the chosen intervention. The literature support must directly relate to the intervention stated in the PICO. Once the research articles have been identified a summary of the information from the studies should be provided using the Johns Hopkins Individual Evidence Summary Tool (Appendix G) as a guide. The EBP questions that will be identified in the literature review summary table will include the complete article information, author, date, name, type of evidence, sample size and setting of the study, a summary of the findings that help support the clinical question, what outcome measurements were used and any limitations of the study. Synthesize at least 8-10 (no more than 5 years old) primary research studies and/or systematic reviews; do not include summary articles. This section is all about the scientific evidence rather than someone else’s opinion of the evidence. Do not use secondary sources; you need to get the article, read it, and make your own decision about quality and applicability to your question even if you did find out about the study in a review of the literature. The studies you cite in this section must relate directly to your PICOT question. This is a synthesis where you address the similarities, differences, and controversies in the body of evidence.

SECTION III: INTERVENTION DESCRIPTION

Proposed Intervention

Restate the proposed intervention from the PICO in this section of the paper. A discussion of why this intervention is an important solution to the clinical problem should be addressed.

Setting

Identify the setting where the project will be implemented including information as to the organizational culture related to supporting evidence practice change, along with readiness to change.

Barriers

In your proposal you will address potential barriers to the project and strategies for overcoming these barriers. In the final project you will describe what barriers were encountered during the practicum project. Along with the barriers provide information as to how the barriers were overcome and what solutions were provided to ensure project success.

Outcomes

Address the benefits of the change in this section as well as the expected outcomes along with the detailed steps of how these outcomes will be measured.

Action Plan

SECTION IV: JOHN HOPKINS NURSING EVIDENCE-BASED PRACTICE MODEL

Introduction to Model

The guiding model for the practicum project and practice change will be the Johns Hopkins Nursing Evidence-Based Practice Model. You will need to give a thorough description of the model including the 19 steps.

Use of Model to Support Project

This section should include a discussion of how the model was used to support the project.

SECTION V: IMPLEMENTATION

Project implementation is a key step for the MSN-AT student. Based on the evaluation of the evidence the MSN-AT student will provide a practice recommendation, which includes an outline of the steps needed to successfully implement the project including the process for implementing the proposed intervention/solution and the feasibility and fit for the unit/organization chosen. The implementation section should also include a review of your action plan, which identifies all of the resources, support, and approvals needed, along with the implementation start and finish date/timeframe. Exactly, step-by-step, what will you do to implement your project? Provide as much detail as possible. Referring back to the John Hopkins change model what will you do at each step?

SECTION VI: TRANSLATION TO PRACTICE AND EVLATUATION

Data Collection to Support Outcomes

The data collection section will include information about the baseline data description used to identify the clinical problem. Describe the type and source of information findings. Include in the discussion how the data was used to determine the full extent of the problem. The data collection can be from internal and external sources. Include information as to how the data was collected, what restrictions may be placed on sharing the data, and how the data was used to provide outcome measurement.

Evaluation

In this phase of the project the student will evaluate how effective the chosen intervention was in providing an improvement in outcomes. Included in this section will be stakeholder input as to the overall effectiveness of the change. The paper will address the impact the practice change had on the nursing problem as well as how it affected the system where the change occurred. Specific measurable criteria will be identified and show how the change improved outcomes. A review of any changes made based on feedback will also be provided as well as strategies for solutions that did not solve the problem. A thorough discussion of how this change impacts on nursing and any impact on future research will be provided. Additionally, in this section a cost analysis/benefit summary will be provided. This analysis will delineate the cost of the project versus the proposed benefits. Include a description of the budget including the specific monetary costs of any resources needed, development and implementation cost, as well as the cost over time to continuing implementing this intervention. The expected benefits should include quality indicators such as a reduction in hospital costs, length of stay, as well as non-monetary benefits such as improved quality of life and the like.

Dissemination

The final step of the practicum project will involve dissemination of the project. The dissemination portion will discuss how the results of the project will be shared with the stakeholders and what the plan for sustainability of the project entails.

Conclusions and Contributions to the Profession of Nursing

Conclusions should relate directly to your purpose and project question. They are generalizations that loop back to the existing literature on your topic. For each conclusion you make, cite the sources that support or contradict your findings. The conclusion should represent the contribution your practice project has made to the body of scientific knowledge on this topic and they should be related to the significance of the study, which is always, in some way, to improve nursing practice. Conclusions indicate what is now known regarding nursing practice when your results and results from prior literature are considered together.

Remember this is a reference list rather than a bibliography. If there is not a citation for a reference, it should not be here. PLEASE make sure your references and your citations throughout the paper are in APA format. You can go from an A paper to a B paper on APA errors alone. Take the time to make sure they are correct.

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NOTE: Order these appendices in the order in which they were referred to in the paper.

Appendix F

Appendix G

Appendix H

Tables

Table 1 (Sample)

Budget

Table 2

[Table Title]

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For more information about all elements of APA formatting, please consult the APA Style Manual, 6th Edition.

Series 1 Category 1 Category 2 Category 3 Category 4 4.3 2.5 3.5 4.5 Series 2 Category 1 Category 2 Category 3 Category 4 2.4 4.4000000000000004 1.8 2.8 Series 3 Category 1 Category 2 Category 3 Category 4 2 2 3 5