GCU Development EBP Change Proposal Project In this assignment, students will pull together the capstone project change proposal components they have been

GCU Development EBP Change Proposal Project In this assignment, students will pull together the capstone project change proposal components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. For this project, the student will apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice

Develop a 1,250-1,500 written project that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal:

Background
Clinical problem statement.
Purpose of the change proposal in relation to providing patient care in the changing health care system.
PICOT question. FEEDBACK: You have each of the parts identified, take each part and put them into 1 cohesive statement or question.
Literature search strategy employed.
Evaluation of the literature.
Applicable change or nursing theory utilized. (Lewin’s change theory would be the theory that would be the most beneficial for my EBP, educating this population will require motivation and changing the aspects of their self-care with the education or modifying behaviors to another level, and then solidifying or freezing the new behaviors to make positive changes in self-care.)
Kritsonis, A.(2005). Comparison of change theories. International Journal of Scholarly and Academic Intellectual Diversity, 8(1): 1-7. Health Behavior: Psychosocial Theories:S. Sutton, in International Encyclopedia of the Social & Behavioral Sciences
Proposed implementation plan with outcome measures. Find this in my strategic plan
Discussion of how evidence-based practice was used in creating the intervention plan.
Plan for evaluating the proposed nursing intervention.( to evaluate my project change I would utilize the impact evaluation, this evaluation method will assess the overall effect on the participants in the project. By implementing a short evaluation checklist that will assess change in awareness of their disease process, their knowledge of how to maintain a healthy lifestyle, behavioral changes, and if the action plan was helpful in managing their disease. We will implement this evaluation process within a months’ time to ensure the participants have had ample opportunity to fully engage in their specific action plans)
Identification of potential barriers to plan implementation, and a discussion of how these could be overcome.
Appendix section, if tables, graphs, surveys, educational materials, etc. are created. SURVEY NEEDED (short evaluation checklist that will assess change in awareness of their disease process, their knowledge of how to maintain a healthy lifestyle, behavioral changes, and if the action plan was helpful in managing their disease.)

Review the feedback from your instructor on the Topic 3 assignment, PICOT Question Paper, and Topic 6 assignment, Literature Review. Use this feedback to make appropriate revisions to these before submitting.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

I found a CKD action plan but will need to develop one like it to add to this paper find it attached Running head: DEVELOPMENT EBP CHANGE PROPOSAL
PICOT Question Paper
Debra Bergland
Grand Canyon University
June 20, 2020
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DEVELOPMENT EBP CHANGE PROPOSAL
2
PICOT Question Paper
PICOT Question:
P- Population: Adults over the age of 20 that have been newly diagnosed with chronic
kidney disease.
Practice Issue: According to the Centers for Disease Control and Prevention (CDC) 37
million adults are predicted to have chronic kidney disease (CKD) and most are undiagnosed,
48% have decreased kidney function and should be on dialysis but are not aware of having CKD.
Diabetes and hypertension are the leading cause of kidney failure, both these diseases are
treatable and with appropriate treatment can retard the development of CKD, and retard endstage renal disease. Patients have reported that they have very little knowledge about CKD and
limited understanding of treatment options if diagnosed with kidney disease. Literature reviews
are done to evaluate different studies that address specific clinical issues and EBP initiatives.
One literature review indicated a problem within these communities of knowledge deficits
concerning kidney disease and most importantly lack of education for this population on how to
stop the disease from progressing. This information leads to the question, “is the lack of
awareness and education within the population of patients diagnosed with CKD not optimal, and
does this lack of knowledge contribute to the progression of ESRD.” (“Centers for Disease
Control and Prevention,” 2020)
I – Intervention: Knowledge deficit related to CKD and health education.
Nursing practice interventions would be to educate this population in the awareness of
their disease and disease process and treatment options to prevent progression to ESRD. Nursing
interventions to address the knowledge deficit would include educating the patients on the
DEVELOPMENT EBP CHANGE PROPOSAL
3
importance of controlling their blood pressure and to understand the rationale behind
medications that are prescribed.
C- Comparison: A literature review showed research that looked at information about
factors that influenced patients’ self-care with CKD and health-related decision making and
compared patients that received appropriate education on self-care to those that did not receive
the education needed to understand and apply self-care. The results of the study showed
behavioral changes in those that had received the education, as patients verbalized the necessity
to follow medical instructions regarding medications to treat CKD, and verbalized a more
comprehensive understanding of the progression of the disease. The group of patients that had no
education and low health literacy was noted to be more confused about the progression of the
disease, most were concerned with if they would need dialysis, and felt controlled by the disease.
Confirming the need to implement education for this population. (Nunes , Roney, Kerr, Ojo, &
Fagerlin, 2016)
O – Desired outcomes: To improve the gap in education and knowledge base for patients
with CKD. The goal will be to improve the patient’s understanding of self-care and management
of CKD. An article by Chen et al. (2011), reviewed self-management programs from CKD
clinics, this review noted reductions in mortality and morbidity of the CKD population and
demonstrated delays in the progression to EDRD. Successful self-management patient
care education shows the need for healthcare providers to coordinate care with other members of
the multidisciplinary team in other health care agencies to ensure the implementation of
recommended diagnostic and intervention therapies, with information, education and support
needs to be individualized to the patient’s degree of kidney disease and health literacy. (“Clin
Exp Nephrol,” 2018)
DEVELOPMENT EBP CHANGE PROPOSAL
T -Timeframe: Possible weekly education within a 30-day evaluation period.
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DEVELOPMENT EBP CHANGE PROPOSAL
5
References
Cheng, S., Tsai, Y., Sun, C., Wu, W., Lee, C., & Wu, M. (2011). The impact of self-management
support on the progression of chronic kidney disease-a prospective randomized controlled
trial. Nephrology Dialysis Transplantation, 26(11), 3560-3566.
http://dx.doi.org/10.1681/ASN.2009111163
Chronic Kidney disease basics. (2020). Retrieved from
https://www.cdc.gov/kidneydisease/basics.html
Essential points from Evidence-based Clinical Practice Guidelines for Chronic Kidney Disease
2018. (2018). Retrieved from 10.1007/s10157-018-1648-1
Nunes , J., Roney, M., Kerr, E., Ojo, A., & Fagerlin , A. (2016, August ). A diagnosis of chronic
kidney disease: despite fears patients want to know early. Clin Nephrol., 88(2), 78-86.
http://dx.doi.org/: 10.5414/CN108831 PMCID: PMC5012189
FACT SHEET FOR PATIENTS AND FAMILIES
Chronic Kidney Disease — Personal Action Plan
Date:
You are in charge of managing your chronic kidney
disease (CKD) — and your Intermountain Healthcare
team is here to help you. Use these tools to develop your
own action plan and keep track of your progress at home.
Treatment guidelines
My next appointment:
Bring this Plan to your appointment.
Local resources:
Care manager or health educator:
My current lab results
eGFR (estimated Glomerular Filtration Rate)
ACR (protein in the urine)
Blood pressure
/
Local clinic phone and website:
HbA1c (if diabetic)
Lipids Panel
Other consultants or providers:
Other
My personal goals for managing my CKD are:
Patient education resources
My healthcare team’s treatment goals
Your team’s treatment goals for preventing your
CKD from progressing are:
eGFR
ACR
Blood Pressure
HbA1c (if diabetic)
Lipids
Other
My personal action plan
Besides taking your medications every day, other
activities are also important. Choose one or two goals
you will work on each week, like:
Trying food changes your dietitian marked (page 3)
Making lifestyle changes you selected (page 4)
Write the date you received each resource checked.
‰‰Understanding CKD:
‰‰Kidney Disease, High Blood Pressure,
and Urine Proteins:
‰‰Kidney Disease and Your Bones:
‰‰Kidney Disease and Potassium:
‰‰Kidney Disease and Phosphorus:
‰‰Kidney Failure: Your Options:
‰‰ Dialysis: What’s the Right Option for Me?
‰‰Kidney Transplant: Am I a Candidate?
Online resources
•• intermountainhealthcare.org/kidney
•• nationalkidneycenter.org
•• kidney.org
•• niddk.nih.gov/health-information/health?topics/
kidney-disease/pages/default.aspx
1
MEDICATION — Your healthcare provider will check the medications you take.
Take your medications every day to help keep your CKD from getting worse.
These 3 medication types reduce protein in the urine and lower blood pressure.
? ACE inhibitors
? ARBs
lisinopril (Prinivil, Zestril)
benazepril (Lotensin)
enalapril (Vasotec)
quinapril (Accupril)
? Calcium channel blockers (CCBs)
losartan (Cozaar)
candesartan (Atacand)
irbesartan (Avapro)
valsartan (Diovan)
amlodipine (Norvasc)
diltiazem (Cardizem, Cartia, Dilacor, etc.)
verapamil (Calan, Isoptin)
ramipril (Altace)
How I will remember to take this medication:
I will tell my provider if I have these side effects:
ACE / ARB: Dry, hacking cough; swelling of mouth, tongue, eyelids; dizziness, headache, drowsiness, weakness
CCB: Headache, flushed skin, ankle swelling
? Diuretics — This medication type helps kidneys get rid of extra fluid and sodium through your
urine. It is often combined with an ACE or ARB in one pill.
hydrochlorothiazide (HCTZ)
losartan/HCTZ combination
lisinopril/HCTZ combination
chlorthalidone (Thalitone)
furosemide (Lasix)
How I will remember to take this medication:
I will tell my provider if I have these side effects: Dizziness, lightheadedness, headache, or blurred vision
? Statins — This medication type helps prevent heart attacks and strokes and lowers cholesterol.
atorvastatin (Lipitor)
rosuvastatin (Crestor)
lovastatin (Altoprev, Mevacor)
pravastatin (Pravachol)
simvastatin (Zocor)
How I will remember to take this medication:
I will tell my provider if I have these side effects:
? Pain Relievers — I will NOT take more than 81 mg per day of aspirin unless the doctor who
manages my CKD says it’s okay. I will also NOT take NSAIDs (such as Advil).
? Supplements (For some patients, supplements help manage anemia and protect bones.)
Elemental iron
Calcium carbonate, 1,200–1,500 mg
Take 3 times a day, and not at same time as calcium.
Take 1 time a day, and not at the same time as iron.
Don’t take at the same time as thyroid medications, antacids, or copper supplements.
Take only on an empty stomach, at least 2 hours before or after eating/drinking: bran, fiber, grains, nuts,
soy, and vegetables; tea, coffee, and caffeine; red grape juice and wine; dairy and egg.
Vitamin D
Take 1 time a day.
How I will remember to take these medications:
I will alert my provider if I have these side effects: Stomach upset, pain; constipation, diarrhea,
nausea, vomiting
Possible problems with taking my medications as prescribed:
Things that will help me take my medications as prescribed:
2
KIDNEY HEALTHY EATING PLAN —
Choose 1 or 2 things to work on each week.
My Plan Week
To lower the amount of sodium (salt) in my food, I will:
Limit my sodium intake to
each for 2 snacks per day).
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
per day (less than 500 mg per meal and 250 mg
Take the salt shaker off the kitchen table.
Read food labels to see which are high in sodium (more than 150 mg per serving).
Rinse canned foods before cooking and eating them.
Remove one, high-salt item from my diet this week.
At restaurants, ask for food with no added salt.
To lower the amount of protein in my food, I will:
Limit daily protein to
grams each day.
(Read food labels and use the chart below for help with non-labeled foods.)
Food Type
Grams of Protein
Food Type
Grams of Protein
meat, seafood, chicken
7 g per ounce
cheese
7 g per ounce
milk
8 g per 8-ounce cup
legumes
7 g per ½-cup serving
egg
6 g per egg
nut butter
7 g per tablespoon
To make sure I get enough to eat, I will:
Contact a dietitian for personalized diet help at
.
Eat regular meals each day.
To lower the amount of potassium in my food, I will:
Eat these foods ONLY in small portions and never more than once a day:
Starch: potatoes
Vegetables: cooked spinach, winter squash, tomatoes/tomato-based sauces, avocado
Fruits: bananas, oranges/orange juice, cantaloupe, honeydew melon
Avoid salt substitutes. Use herbs for flavoring instead.
Have no more than 1 dairy serving product a day.
Not eat or drink any herbal supplement without first talking with my kidney doctor.
To lower the amount of phosphorus I get, I will:
Limit phosphorus in my diet to no more than 1,000 mg daily.
Have no more than 1 dairy serving a day.
Eat these foods only occasionally (no more than once a week): peas and beans,
nuts, organ meats (liver, kidney, etc.), colas, and chocolate.
Take Tums (a phosphorus binder) if my healthcare provider recommends it.
Possible problems for meeting my eating plan goals are:
Things that will help me meet my eating plan goals are:
3
LIFESTYLE —
Choose just 1 or 2 lifestyle goals to work on each week.
To increase my physical activity, I will:
Week 1 Week 2 Week 3 Week 4
Exercise at least 3 nonconsecutive days a week
(for example, Monday, Wednesday, and Friday).
Start exercise slowly, and progress gradually.
Find an exercise partner.
Make sure that my breathing is not so hard that I can’t talk to
my exercise partner.
Take walks, go swimming, bicycle, ski, or sign up for an
aerobic dance class.
Use low weights and high repetitions.
Exercise mornings or evenings, at least 1 hour after a meal or
1 hour before bedtime.
Other:
To reduce stress, I will:
Change my expectations.
Learn to say no.
Practice gratitude and joy.
Week 1 Week 2 Week 3 Week 4
To quit smoking, I will:
Week 1 Week 2 Week 3 Week 4
Identify a support program or team; call
.
Talk with my doctor about medications that will help me succeed.
Set a quit date.
Possible problems for meeting my lifestyle goal(s) are:
Things that will help me meet my lifestyle goal(s) are:
WATCH FOR SYMPTOMS
I will call my healthcare provider if:
My weight goes up suddenly
Week 1 Week 2 Week 3 Week 4
.
I get more tired or worn out than usual.
My ankles swell.
I get more lightheaded than usual when standing up.
I have unpleasant changes after taking new medications.
Submit
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© 2015 Intermountain Healthcare. All rights reserved. The content presented here is for your information only. It is not a substitute for professional medical advice, and it should
not be used to diagnose or treat a health problem or disease. Please consult your healthcare provider if you have any questions of concerns. More health information is available at
intermountainhealthcare.org. Patient and Provider Publications FS472 – 12/15
Course Code
NRS-493
Class Code
NRS-493-O502
Criteria
Content
Percentage
80.0%
Revisions Incorporated as Directed by Instructor 5.0%
Background
5.0%
Clinical Problem Statement
5.0%
Purpose of Change Proposal
5.0%
PICOT Question
5.0%
Literature Search
5.0%
Evaluation of Literature
5.0%
Change or Nursing Theory
5.0%
Implementation Plan and Outcome Measures
10.0%
Use of Evidence-Based Practice in Intervention
Plan
10.0%
Plan for Evaluating Proposed Nursing
Intervention
10.0%
Potential Barriers and Plan to Overcome Barriers 10.0%
Organization and Effectiveness
15.0%
Thesis Development and Purpose
5.0%
Argument Logic and Construction
5.0%
Criteria 3Mechanics of Writing (includes spelling,
punctuation, grammar, language use)
5.0%
Format
5.0%
Paper Format (use of appropriate style for the
major and assignment)
2.0%
Documentation of Sources (citations, footnotes,
references, bibliography, etc., as appropriate to
assignment and style)
3.0%
Total Weightage
100%
Assignment Title
Benchmark – Capstone Project Change Proposal
1: Unsatisfactory (0.00%)
Revision is omitted.
Background of clinical problem omitted.
Clinical problem statement omitted.
Purpose of the change proposal in relation to providing
patient care in the changing health care system is omitted.
PICOT questions is omitted.
Literature search strategy employed omitted.
Evaluation of literature omitted.
Change or nursing theory omitted.
Implementation plan and outcome measures are omitted.
Use of evidence-based practice in intervention plan omitted.
Plan for evaluating proposed nursing intervention omitted.
Potential barriers and plan to overcome barriers are omitted.
Paper lacks any discernible overall purpose or organizing
claim.
Statement of purpose is not justified by the conclusion. The
conclusion does not support the claim made. Argument is
incoherent and uses noncredible sources.
Surface errors are pervasive enough that they impede
communication of meaning. Inappropriate word choice or
sentence construction is used.
Template is not used appropriately or documentation format
is rarely followed correctly.
Sources are not documented.
Total Points
300.0
2: Less Than Satisfactory (75.00%)
Revision is incomplete. Many aspects are still incomplete,
inaccurate, or unclear.
Background of clinical problem is incomplete.
Clinical problem statement is incomplete.
Purpose of the change proposal in relation to providing
patient care in the changing health care system is incomplete.
Topic is presented but criteria is incomplete.
Topic is presented but criteria is incomplete.
Evaluation of literature is incomplete.
Change or nursing theory is incomplete.
Implementation plan and outcome measures are presented is
incomplete.
Use of evidence-based practice in intervention plan is
incomplete.
Plan for evaluating proposed nursing intervention is
incomplete.
Potential barriers and plan to overcome barriers are
incomplete.
Thesis is insufficiently developed or vague. Purpose is not
clear.
Sufficient justification of claims is lacking. Argument lacks
consistent unity. There are obvious flaws in the logic. Some
sources have questionable credibility.
Frequent and repetitive mechanical errors distract the
reader. Inconsistencies in language choice (register), sentence
structure, or word choice are present.
Template is used, but some elements are missing or
mistaken; lack of control with formatting is apparent.
Documentation of sources is inconsistent or incorrect, as
appropriate to assignment and style, with numerous
formatting errors.
3: Satisfactory (79.00%)
Most key aspects were revised. Some aspects are still vague
or contain minor inaccuracies.
Background of clinical problem are summarized. There are
minor omissions or inaccuracies. Some support or
information is needed.
Clinical problem statement is summarized. There are minor
omissions or inaccuracies. Some support or information is
needed.
Purpose of the change proposal in relation to providing
patient care in the changing health care system is
summarized. There are minor omissions or inaccuracies.
Some support or information is needed.
Topic and most criteria are presented. There are minor
omissions or inaccuracies. Some support or information is
needed.
Topic and most criteria are presented. There are minor
omissions or inaccuracies. Some support or information is
needed.
Evaluation of literature is summarized. There are minor
omissions or inaccuracies. Some support or information is
needed.
Change or nursing theory is summarized. There are minor
omissions or inaccuracies. Some support or information is
needed.
Implementation plan and outcome measures are
summarized. There are minor omissions or inaccuracies.
Some support or information is needed.
Use of evidence-based practice in intervention plan is
summarized. There are minor omissions or inaccuracies.
Some support or information is needed.
Plan for evaluating proposed nursing intervention is
summarized. There are minor omissions or inaccuracies.
Some support or information is needed.
Potential barriers and plan to overcome barriers are
summarized. There are minor omissions or inaccuracies.
Some support or information is needed.
Thesis is apparent and appropriate to purpose.
Argument is orderly, but may have a few inconsistencies. The
argument presents minimal justification of claims. Argument
logically, but not thoroughly, supports the purpose. Sources
used are credible. Introduction and conclusion bracket the
thesis.
Some mechanical errors or typos are present, but they are
not overly distracting to the reader. Correct sentence
structure and audience-appropriate language are used.
Template is used, and formatting is correct, although some
minor errors may be present.
Sources are documented, as appropriate to assignment and
style, although some formatting errors may be present.
4: Good (89.00%)
The key aspects were revised. The revision generally
improves the accuracy and clarity of the project.
Background of clinical problem are presented. Minor aspects
are unclear or require support.
Clinical problem statement is presented. Minor aspects are
unclear or require support.
Purpose of the change proposal in relation to providing
patient care in the changing health care system is presented.
Minor aspects are unclear or require support.
Topic and criteria are presented. Minor aspects are unclear or
require support.
Topic and criteria are presented. Minor aspects are unclear or
require support.
Evaluation of literature is presented. Minor aspects are
unclear or require support.
Change or nursing theory is presented. Minor aspects are
unclear or require support.
Implementation plan and outcome measures are presented.
Minor aspects are unclear or require support.
Use of evidence-based practice in intervention plan is
presented. Minor aspects are unclear or require support.
Plan for evaluating proposed nursing intervention is
presented. Minor aspects are …
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