individual studies review expert opinion articles B u s i n e s s F i n a n c e

“Nurses should take responsibility for their personal and professional growth by
continuing their education and seeking opportunities to develop and exercise their
leadership skills” The PDSA project will provide the student the experience to initiate
and coordinate planned change in a health care organization. The purpose of this
assignment is to engage the student in analysis of an evidence-based practice scenario
within their clinical experiences. The assignment will be divided into four phases:

#1). Part I: Plan

I plan to: Here you will write a concise statement of what you plan to do
Example: “I plan to: test a process of giving out satisfaction surveys and getting
them filled out and back to us”.

I hope this produces: Here you can put a measurement or an outcome that you hope to
achieve.
Example: I hope this produces at least 25 completed surveys per week during
this campaign.

#2). Steps to execute: Here is where you will write the steps that you are going to take in this
cycle. You will want to include the following:

 Problem Identification: Identify a clinical problem that you observed in the
clinical site. Digging up clinical problems can start with observations of clinical
practice on your unit, asking staff about the problems they face when delivering
care, looking through policies and procedures and guidelines of care to assess if
there is a standard or policy to improve practice. Talking with patients about their
perceptions of the care they are receiving and asking clinical questions that
address the clinical implication of the observation. Is there a problem, a patient or
a population there is negatively affected by the present standard of practice? Once
this P factor is determined without a present resolution, then a clinical question
should be developed using the PICOT process.

 The population this could be a patient, a problem, a population, a unit, a division,
or organization problem.

 The time limit that you are going to do this project—remember, it does not have
to be long, just long enough to get your results. You may set a time limit of 1
week but find out after 4 hours that it does not work. You can terminate the cycle
at that point because you got your results.

 Review of literature: What level of knowledge is out there to address the
problem, are there any evidence-based guidelines already published. Most of the
literature reviewed should utilize systematic reviews, meta-analysis, or clinical
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guidelines. Individual studies review expert opinion articles and clinical articles
can be used as supportive literature for clinical issues with limited research.

Example:
Steps to execute

1. Problem and population same day post-surgical patients do not
answer the survey about satisfaction with services.

2. Found that if surveys are easily accessible the response may be
increased.

3. We will display the surveys at the checkout desk.

4. The checkout attendant will encourage the patient to fill out a
survey and put it in the box next to the surveys.

5. We will try this for 1 week.

#3). Part II: Do
After you have your plan, you will execute it or set it in motion. During this
implementation, you will be keen to watch what happens once you do this.
What did you observe? Here you will write down observations you have during your
implementation. This may include how the patients react, how the nurses react, how it fit
in with your organizational system. You will ask, “Did everything go as planned?” “Did I
have to modify the plan?”

Example:
What did you observe?

 We noticed that patients often had other things to attend to at this time,
like making an appointment or paying for services and did not feel they
could take on another task at this time.

 The checkout area can get busy and backed up at times.

 The checkout attendant often remembered to ask the patient if they would
like to fill out a survey.

Part III: Study
After implementation you will study the results.
What did you learn? Did you meet your measurement goals? Here you will record
how well it worked, if you met your goal.

Example: We only had 8 surveys returned at the end of the week. This process did
not work well.
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Part IV: Act
What did you conclude from this cycle? Here you will write what you came away with
for this implementation, whether it worked or not. And if it did not work, what you can
do differently in your next cycle to address that. If it did work, are you ready to spread it
across your entire practice?

Example: Patients did not want to stay to fill out the survey once their visit was
over. We need to give patients a way to fill out the survey when they have time.
We will encourage them to fill it out when they get home and offer a stamped
envelope to mail the survey back to us.
Dissemination: This section will be the materials used to disseminate your project
findings to the clinical agency.

Presentation overview of the problem, evidence, and proposed plan, results,
and recommendation. The presentation should include:

a) Actual PowerPoint slides of effective communication of
project.

b) 2-3 discussion questions prepared by students to pose to their audience to generate
discuss about the project and potential for implementation