please see attached, 10 point strategic plan for quality improvement - this assignment also requires an annotation bibliography of 5 articles included in the assignment

The 10 Strategic Points

Title of Project

1. Title of Project

Implementing a nurse-driven mobility protocol in a long-term acute care facility (do not change)

Background

Theoretical Foundation

Literature Synthesis

Practice Change Recommendation

1. Background to Chosen Evidence-Based Intervention:

List the primary points for six sections.

1. 1. 1. Background of the practice problem/gap at the project site

      2. Significance of the practice problem/gap at the project site

      3. Theoretical Foundations (choose one nursing theory and one evidence-based change model to be the foundation for the project): Virginia Henderson – nursing theory / Kurt Lewin’s Change Model – evidence-based change model- provide a brief description of each model ( do not change)

      4. Create an annotated bibliography using the "Preparing Annotated Bibliographies (APA 7th)" located in the Student Success Center. https://www.gcumedia.com/lms-resources/student-success-center-content/documents/writing-center/preparing-annotated-bibliographies-apa7-mla8-turabian9.pdf utilizing the five (5) original research articles article to use are at the end of this paper that support the evidence-based intervention. This will be the foundation of the Literature Synthesis you will have to do in DNP-820A.

      5. Practice Change Recommendation: Validation of the Chosen Evidence-Based Intervention ( discuss benefit of nurse-driven mobility protocol)

      6. Summary of the findings written in this section. (well written paragraph)

Problem Statement

1. Problem Statement:

Describe the variables/groups to project, in one sentence.

Pls provide one well written paragraph to lead into the purpose statement

A well-written problem statement begins with the big picture of the issue (macro) and works to the small, narrower, and more specific problem (micro). It clearly communicates the significance, magnitude, and importance of the problem and transitions into the Purpose of the Project with a declarative statement such as: “It is not known if and to what degree/extent...” or “It is not known how/why and….”

( this is the purpose statement)

It is not known if the implementation of a nurse-driven mobility protocol would impact mobility status among adult patients in a long-term acute care facility. (don’t change this statement)

PICOT to Evidence-Based Question

1. PICOT Question Converts to Evidence-Based Question:

(P) Among adult patients in a rural long-term care facility (I) how does the translation of Black et al’s research on nurse-driven early mobility protocol implementing the Johns Hopkins’ Activity and Mobility Promotion Program (C) compare to current practice (O) impact mobility status (T) over a period of eight weeks?

Must keep this statement – do not change

Evidence-Based Question:

Provide the templated statement

To what degree does the translation of Black et al. research on nurse-driven early mobility protocol implementing the Johns Hopkins’ Activity and Mobility Promotion Program impact mobility status when compared to current practice among adult patients in an urban long-term acute care hospital in Virginia over eight weeks?

Must keep this statement -do not change

Sample

Setting

Location

Inclusion and Exclusion Criteria

1. Sample, Setting, Location

Identify sample, needed sample size, and location (project phenomena with small numbers and variables/groups with large numbers).

1. 1. 1. Sample and Sample Size: Population- all patients presently-inpatient total census up to (52) and number based on G*power analysis or sample size calculator. Explain potential bias and mitigation of sample size.??? Help with question

      2. Setting: long-term acute care facility

      3. Location: urban / rural then what state:
urban / Virginia

      4. Inclusion Criteria

• Who can participate- all patients currently on census

1. 1. 1. Exclusion Criteria

• Who cannot participate- no exclusion criteria

Define Variables

1. Define Variables:

   1. 1. Independent Variable (Intervention): nurse-driven protocol; pre- post knowledge assessment

Dependent Variable (Measurable patient outcome):

JH-HLM scale

Project Design

1. Project Design:

This project will use a quality improvement approach. You must be able to explain and cite the difference between research and quality improvement (one paragraph each).

1. 1. 1. Quality Improvement

      2. Research

      3. Summarize

(please fill in)

Purpose Statement

1. Purpose Statement:

Provide the templated statement.

The purpose of this quality improvement project is to determine if the implementation of the Johns Hopkins’ Activity and Promotion toolkit of implementing a nurse-driven early mobility protocol would impact mobility status among adult patients admitted to a long-term acute care hospital. The project is to be piloted over an eight-week period in an urban Virginia long-term acute care hospital.

Do not change

Data Collection Approach

1. Data Collection Approach:

   1. 1. You will need data on your participants demographic information (example: age, gender, educational background, ethnicity…..etc.). What instrument would you use to measure this? (Will you use a pre-made Likert Scale? An Excel Spreadsheet?) ( what is the easiest – pls explain)

      2. You also need data on the measurable patient outcome. What instrument will you use (survey, electronic health records, instrument) to obtain this data and how is it determined to be valid and reliable. ( pls explain this, data will extracted from the EHR of each pt , identifying pre/post intervention

      3. For the instruments used to measure data provide the reliability and validity (psychometric studies) for each. ( pls help with this)

      4. Describe the step -by-step process you will use to collect the data, explain where the data will come from, and how you will protect the data and participants. (see above section)- data is collected by physically examining each patients chart identifying their current score ( the JH score is already in place but not the nurse driven intervention ) see above in the variables section

Protocol: 1. Staff education assessment of mobility function (survey) – poster presentation – post education assessment

2. Physical therapist – to perform initial eval (done within 48 hrs of admission) to identify mobility/functional status using the Johns Hopkins Highest Level of Mobility (JH-HLM) scale (number is identified) 1- 8

1= lowest, 8-highest walk up to 250 ft.

3. All patients are assigned a color coded arm band that determines mobility / activity level.

3. staff’s documents score number in activity section of the EHR – this is done per shift (shifts7a-7p, 7p-7a)-

4. nurse to carry out assist patient according to their score twice daily – activity is documented each shift in the EHR- nursing staff should aim to progress the patient to next level of the score card- once the activity level changes- nurses can change the armband to new designated activity level

5. physical therapy continues to eval pts per their schedule per CMS guidelines to justify therapy services are being rendered.

That may need to be cleaned up a little (hope you get the jest of it)

1. 1. 1. Discuss potential ethical issues pertaining to your project. Ethical Considerations in Human Research Protection (i.e. confidentiality vs anonymity of the data, informed consent, and potential conflict of interest.) ( this project should not have any ethical issues it non discriminatory ) pls elaborate

      2. Discuss how you will adhere to the principles of the Belmont Report (respect, justice, and beneficence) in the project design, sampling procedures, within the theoretical framework, clinical problem, and clinical questions. ( pls provide explanation here)

Data Analysis Approach

1. Data Analysis Approach:

How will you analyze the participants’ descriptive, demographic information? What statistical analysis will be used to prepare the results?

What type of data analysis will be needed to analyze the measurable patient outcomes? What statistical test will be used? (i.e. chi-square, paired t-test, Wilcoxon…) in this section determine a test that’s easy to use for this type of project)

Will you use Intellectus, Laerd Statistics, or a statistician? ( pls help / and explain)

Discuss the potential Bias and Mitigation of the data. (pls explain)

References

Include references here used in the strategic plan