Assignment Evidence-Based Capstone Project, Part 6 Disseminating.docx

Assignment: Evidence-Based Capstone Project, Part 6:
Disseminating Results
The dissemination of EBP results serves multiple important
roles. Sharing results makes the case for your decisions. It also
adds to the body of knowledge, which creates opportunities for
future practitioners. By presenting results, you also become an
advocate for EBP, creating a culture within your organization or
beyond that informs, educates, and promotes the effective use of
EBP.
To Prepare:
· Review the final PowerPoint presentation you submitted in
Module 5, and make any necessary changes based on the
feedback you have received and on lessons you have learned
throughout the course.
· Consider the best method of disseminating the results of your
presentation to an audience.
To Complete:
Create a 5-minute, 5- to 6-slide narrated PowerPoint
presentation of your Evidence-Based Project.
· Be sure to incorporate any feedback or changes from your
presentation submission in Module 5.
· Explain how you would disseminate the results of your project
to an audience. Provide a rationale for why you selected this
dissemination strategy.
FEED BACK FROM LAST POINT( The powerpoint you did last
week)

Olayemi,
-Powerpoints do not require complete sentences.
-Your outcomes, as written are not measurable. Quantify.
-This is an area you need to work on. I suggest reviewing the
literature on SMART goals.
-Number your slides.
-I did not see any synthesis. You could synthesis on your
summary slide.
-Start with a purpose statement, end with a conclusion.
- very careful about using information from previous
assignments. This information is making your SI elevate. Here
are examples from your SafeAssign report:
3 In our organization we offer patient-centered care, always
keep ourselves updated on the latest practices, practices staff
diversity and we are ready to adapt to new change. As members
of the facility we make sure that we keep ourselves updated to
ensure that the organization is able to develop and
advance. 3 The organization is ready to face and adapt to any
new changes since it is predicted that the healthcare system will
undergo change through implementing current technologies.
Evidence-Based Practice Change
Walden University
NURS 6052- Essentials of Evidence-Based Practice
November 01, 2020

ORGANIZATION CULTURE
My organization seeks diversity in their employees
Value the possibility of enhancing patient communication.
We provide patient-centered care
We treat patient based on their decisions
Members are kept updated with new technology
Readiness to face and adapt to any new changes

In our organization we offer patient-centered care, always keep
ourselves updated on the latest practices, practices staff
diversity and we are ready to adapt to new change. As members
of the facility we make sure that we keep ourselves updated to
ensure that the organization is able to develop and advance. The
organization is ready to face and adapt to any new changes
since it is predicted that the healthcare system will undergo
change through implementing current technologies.
2
CURRENT ISSUE OF INTEREST
My chosen clinical issue of interest involves UTI
Evidenced-based in treating of uncomplicated UTI
Nitrofurantoin, best practice in uncomplicated UTI treatment.
A common infection among women due to their anatomy
Treating UTI is paramount to avoid further complications.
Nitrofurantoin is the best practice in UTI treatment.

Urinary tract infection (UTI) occurs when a bacteria infect the
urethra, ureters, kidneys or bladder. UTI is one of the most
common hospital acquire infection among women due to our
anatomy, shorter urethra making it quicker for the bacteria to
travels to the bladder. Treating this infection important to avoid
further complications.
3
PICOT
Guides and clarify essential element of question
Important step towards finding the right information
P- Adult women aged 18-65 years diagnosed with UTI in ABC
clinic
I- Nitrofurantoin, 100mg orally twice daily for 7 days
C- No intervention
O- Complete UTI signs and symptoms resolution
T- One month

PICOT is used to guide and clarify the essential part of question
and its important towards finding the right information to
answer the question.
In women aged 18-65 years with uncomplicated UTI, how does
nitrofurantoin compared to no interventions affect urinary tract
within 30 days?
4
CHANGE OPPORTUNITY
Change is driven by complications experienced.
Workers have made themselves ready for change
Workers ready to apply evidence-based strategy
Workers ready to apply advanced practices that may be
implemented.

Change in the organization is driven by some of the
complications that we have been experiencing as well as the
implementation of a new healthcare system (Ritchie & Straus,
2019). Other than the implementation of new healthcare system
our organization has been experiencing issues which requires
changes. Most of the employees are ready to apply evidence
based strategy and advanced practices.
5
RISK INVOLVED WITH IMPLEMENTING NEW CHANGES
Implementation of new changes may lead to adverse results
Changes may affect employee’s performance and commitment.
Poor change management may hinder growth
Failure to consider culture may lead to failure

Some of the risks that may arise due to implementing changes is
negative outcomes such as reduced employee commitment, poor
organization growth, and transformation period may fail. Poor
change management can lead to my organization transforming
and growing poorly after the changes have been implemented.
Failure of the organization putting into consideration their
culture during the change implementation period may lead to
failure of the process.
6
EVIDENCE-BASED IDEA PROPOSAL
Implementation of Hopkins evidence-based model is
recommended.
Model allows fast and appropriate application
Latest research and best practices.
Organization will be able to simplify the EBP process
Encourage a culture of evidence-based care (Dang & Dearholt,
2017).

An evidence-based practice that I would propose for the
organization is the Hopkin nursing evidence-based model since
this model enables fast and appropriate application of latest
research as well as best practices and simplify EBP activities.
7
EVIDENCE-BASED IDEA PROPOSAL
Steps involved in the Hopkin model include:
Practice question
Evidence
Translation
EBP model tool will assist workers
Enhance collaboration with other care providers

Hopkin nursing evidence-based practice has three steps which
are evidence, practice question, and translation. This model
helps physicians in the organization to work personally and
collaborate with other physicians to counter major issues.
8
KNOWLEDGE TRANSFER
The Plan is to create, transfer and implement knowledge
Creation process will be to develop training
Creation process will include developing training manuals
Intervention plan occur based on knowledge gained
knowledge implemented will be used to develop solutions
knowledge dissemination plan will involve training staff

In the organization knowledge transfer will involve: supporting
employee as they change to new role in the organization, collect
the require knowledge, make sure that knowledge is shared and
stored for future use and reference, the knowledge will be

shared through paired working and E-learning training ,
implementation will be carried out step by step to assist
employees to easily adapt.
9
EXPECTED RESULTS
Increased patient safety and positive health outcome.
organization will be able to have problem-solving strategies
Eliminate challenges that prevent current research

After implementing the Hopkin model the organization will
have problem solving strategy for providing care that combines
diligence to the current best practices. The expected outcome
after implementing the Hopkin model is that the organization
will be able to have problem-solving strategies, increased
patient safety and positive health outcome.

10
SUMMARY OF CRITICAL APPRAISAL
UTI occurs when organs are affected by a bacteria.
Nitrofurantoin; best practice in treating UTI.
Researchers show that nitrofurantoin prevents UTI
More effective than other antibiotics such as methane.
Nitrofurantoin is the best practice.
No negative effect caused by nitrofurantoin.

UTI occurs when urethra, ureter, kidney and bladder are
affected by a bacteria and nitrofurantoin is the best practice in
treating UTI. The difference research show that 5 days
nitrofurantoin results to positive results among females with
UTI at 28 days after completing therapy. Additionally the
research also shows that nitrofurantoin prevents UTI more than
any other antibiotic such as methane. Nitrofurantoin is the best

practice since it has no negative effect caused by nitrofurantoin.
11
APA citations
Huttner, A., Verhaegh, E. M., Harbarth, S., Muller, A. E.,
Theuretzbacher, U., &Mouton, J. W. (2015). Nitrofurantoin
revisited: a systematic review and meta-analysisof controlled
trials. Journal of Antimicrobial Chemotherapy, 70(9), 2456-
2464. DOI:https://doi.org/10.1093/jac/dkv147
Price, J. R., Guran, L. A., Gregory, W. T., & McDonagh, M. S.
(2016). Nitrofurantoin vsother prophylactic agents in reducing
recurrent urinary tract infections in adultwomen: a systematic
review and meta-analysis. American journal of obstetrics
andgynecology, 215(5), 548-560. DOI:
10.1016/j.ajog.2016.07.040
Muller, A. E., Verhaegh, E. M., Harbarth, S., Mouton, J. W., &
Huttner, A. (2017).Nitrofurantoin's efficacy and safety as
prophylaxis for urinary tract infections: asystematic review of
the literature and meta-analysis of controlled trials.
ClinicalMicrobiology and infection, 23(6), 355-362.
DOI:https://doi.org/10.1016/j.cmi.2016.08.003
Mitrani-Gold, F. S., Raychaudhuri, A., & Rao, S. (2020).
Systematic Review and Meta-analysis to Estimate the
Antibacterial Treatment Effect of Nitrofurantoin for a Non-
Inferiority Trial in Uncomplicated Urinary Tract Infection.
Journal of GlobalAntimicrobial Resistance, 22, 68-77. DOI:
https://doi.org/10.1016/j.jgar.2020.01.027

LESSON LEARNED FROM THE CRITICAL APPRAISAL
Nitrofurantoin is the best practice to treat UTI
Nitrofurantoin treatment has no negative effect
Women are more prone to UTI due to their anatomy

From the critical appraisal I have come to understand that
through the evidence-based research care providers are able to
understand problems better, and the evidence based model
shows how a problem is recognized, analyzed, and provides

strategies for solving a problem. Despite the preferred model
evidence-based research should show how a problem is
identified, analyzed, and strategies of how to enhance the
problem. Through carrying out an evidence-based research
clinicians will be able to understand current problems more
clearly.
13
REFERENCE
Dang, D., & Dearholt, S. L. (2017). Johns Hopkins nursing
evidence-based practice: Model and guidelines. Sigma Theta
Tau.
Ritchie, L. M. P., & Straus, S. E. (2019). Assessing
Organizational Readiness for Change: Comment on"
Development and Content Validation of a Transcultural
Instrument to Assess Organizational Readiness for Knowledge
Translation in Healthcare Organizations: The OR4KT".
International Journal of Health Policy and Management, 8(1),
55.
Melnyk, B. M., & Fineout-Overholt, E. (2018). Finding
Relevant Evidence to AnswerClinical Questions. In Evidence-
based practice in nursing & healthcare: A guide to bestpractice
(4th ed.). Philadelphia, PA: Wolters Kluwer.

FASH1139 Assignment # 3 –
Transportation and Warehousing
of Ready-Made Garments
Logistics involves the management of the supply chain from
raw materials to manufacturing to importation and distribution
of the goods. Over the past 20 years North American businesses
have ceased to be important manufacturers or producers of
clothing goods. Nowadays, Canada imports ready-made
garments (RMG) primarily from countries such as China and
Bangladesh.
Canada and the European Union recently signed and ratified a
comprehensive free trade agreement called CETA, which may
correlate to an increase in well-known fashion brands and
ready-made garments being shipped into Canada from Europe.
From a logistics point of view, CETA has encouraged Canadian
businesses to follow the transportation and storage guidelines
for clothing goods promoted by Germany. The English
translation of Germany’s transportation and storage guidelines
for shipments of ready-made garments has been posted on
Blackboard and it is also attached to this Assignment. It is
strongly recommended that you read the posted EU guidelines
and Chapters 5, 6 and 7 of the course textbook before answering
the questions contained in this Assignment 3.
Remember that your submission must be a minimum 500 words
(not including assignment questions) in order to receive a

passing mark.
_________________________________
1.
Identify the four (4) modes of transportation that are used by
exporters of ready-made garments and state the relative merits
of each mode of transportation on account of price and delivery
time in relation to the other modes of transportation. For
example, the World Bank states “air freight is typically priced 4
or 5 times that of road transport and 12-16 times that of sea
transport” per kg (i.e add/include the 4th mode and use similar
approach for delivery times). 2.
Many clothing brands cite environmental and sustainability
concerns as a reason for the company to use specific modes of
transportation. Research or use the best of your knowledge to
fill in the following blanks:
Levi Strauss claims that it has reduced its carbon footprint by
shifting from the most carbon-intensive modes of transportation
such as ________________ and _____________________ into
less intensive modes such as _____________________ and
_________________________. Also briefly describe the
relative benefits to Levi Strauss of each of the four modes of
transportation used by the company.
3.Victoria’s Secret ships silk lingerie from Asian manufacturers
to stores around the world. Explain whether you would have any
concerns (A) if the silk garments were left unprotected for a
couple of days in a New Dehli, India port on a hot summer day;
and (B) if the same unprotected shipment was left outside in
Ottawa, Canada for 7-8 hours in January.
4. Explain whether you would have any concerns about a
container shipment of wool jackets and cotton sweaters destined
for Wal-Mart stores in North America fell overboard and into
the sea (but was eventually recovered) while the jackets and

sweaters were being shipped overseas from a port near
Shanghai, China.
5.
Formaldehyde is a toxic chemical that is alarmingly used by
many clothing exporters to give their wares a fresh, unwrinkled
appearance and to prevent mildew during shipping. Phthalates
is a chemical used to make plastic more flexible and resilient; it
carries a strong, plastic smell and is found in many clothes with
plastic logos and also in many new models of shoes. Explain
your concerns, if any, in respect of clothing goods that contain
formaldehyde or phthalates; and whether you should have any
concerns if your shipment of ready-made clothing goods shares
a container or is stored in a warehouse in close proximity to
ready-made garments that contain formaldehyde or phthalates.
European Union Guidelines
for Ready-made garments, clothing
(edited by Professor Aldo Forgione)
General: Ready-made garments are mass-produced finished
textile products of the clothing industry. They are made from
many different fabrics and yarns. Their characteristics depend
on the fibers used in their manufacture.
Risk factors and loss prevention:
Temperature
Odor
Humidity/Moisture
Contamination
Ventilation

Shrinkage / Shortage / Theft
Self-heating / Combustion
Insect infestation / Diseases
Truck transport generally: When transported by truck, outer
clothing is often carried as hanging garments, while other
clothing items are generally transported in folding cartons and
primarily containerized. Hanging garments must be inserted into
tight-fitting individual dust covers, sealed at the bottom. When
outer clothing is shipped in folding cartons, it is essential, in
particular for higher quality goods, for the folding cartons to be
lined with tissue paper or the like, the individual items to be
secured and interlayers used. The cartons often consist of wet
strength corrugated board.
Container transport: Standard containers are suitable for
transporting ready-made garments, subject to compliance with
limits for water content of goods, packaging and flooring.
Garment containers are best suited to transporting items of
clothing, as they provide maximum protection against creasing,
dust and dirt. Garment containers have bars for hanging up
items of clothing on coat-hangers. The bars are generally
anchored in perforated rails in the walls. The coat-hangers are
secured by special clips. A horizontally openable curtain is
located between the door and the inside. The wooden floor is
impregnated and lined with floor covering (carpet).
Cargo handling: In damp weather (rain, snow), the cargo must
be protected from moisture, since garments are strongly
hygroscopic and readily absorb moisture. For long-distance
road transport, trucks with air suspension should generally be
used.The holds/containers must be dry and clean. The stowage
space must be away from heat sources. In particular, holds must
be free of oily patches.
Cargo securing: The cargo must be stowed in such a way that

the boxes or cartons do not slip and become damaged during
transport. Where garments are shipped hanging, the shipping
container must be carefully inspected for cleanness,
leakproofness and the ability to secure individual coat-hangers
firmly. The coat-hangers must be secured on the bars with
retaining clips.
Figure 1
Figure 2
Figure 3
Figure 4
Risk factors and loss prevention
Light: Extended exposure to light puts natural and manmade
fibers at risk due to photomechanical degradation processes;
natural silk, jute and ramie are particularly sensitive.
Humidity/Moisture: Ready-made garments require particular
temperature, humidity/moisture and possibly ventilation
conditions.
Designation
Humidity/water content
Relative humidity
45 - 70%
Water content
8 - 12% (woolen fabric)
7.85 - 8.50% (cotton fabric)

Maximum equilibrium moisture content
70%
A relative humidity of 45 - 70% is deemed optimal. Specified
humidity levels can be maintained in airtight packaging by
using desiccants. Excessively high humidity levels and
seawater, rain and condensation water may cause mustiness,
mildew stains and mold growth and increase levels of insect
infestation. Rust stains may arise as a result of the corrosion of
metal strapping. Natural fibers converted into woven fabrics
have a high swelling index, caused by their histological
microstructure. Thus, for instance, modified cotton may absorb
up to 25% of its own weight of water without feeling damp.
This has a significant effect on the physical characteristics of
the fibers, such as strength, elongation, creasing tendency and
electrical conductivity. If contact with chloride solutions, e.g.
seawater, is suspected, a seawater test using the silver nitrate
method must be performed.
Temperature: Ready-made garments require particular
conditions. Favorable travel temperature range: 10 - 30°C with
Optimum travel temperature: 20°C …Ready-made garments are
best stored at 20°C ± 5°C. Transient temperature variations
within the range of 10 - 30°C do not impair quality.
Excessively low temperatures result in loss of strength.
Excessively high temperatures result from solar radiation, for
example, or from stowage too close to heat sources and not only
lead to an increase in the risk from pests and microorganisms,
but also have a significant impact on the physical characteristics
of the fibers, which may no longer comply with tolerance limits
with regard to strength, elongation, shrinkage, crease tendency,
electrical conductivity and brittleness. Synthetic materials may

even develop permanent creases.
Ventilation: Ready-made garments require particular
conditions. Recommended ventilation conditions: air exchange
rate: 6 changes/hour, if the dew point of the external air is
lower than the dew point of the hold air.
Self-heating / Spontaneous combustion: The goods are liable to
catch fire due to the structure of the processed natural and
manmade fibers and the surface treatment or finishing which
they have undergone. Smoking must therefore be strictly
prohibited during loading/unloading of the holds/containers.
CO2 should preferably be used to extinguish fires.
Odour:
Active behavior
Ready-made garments may release a slightly unpleasant odor.
Since they are generally treated with impregnating and finishing
agents, they should as a precaution not be stowed together with
odor-sensitive goods. Odor tainting may also be caused by
insecticides (risk of moth infestation).
In the case of workwear, an unpleasant odor may be caused by
certain finishing substances used to improve wearability or to
provide resistance to rotting, mold and pests.
Passive behavior
Ready-made garments are highly sensitive to foreign odors. The
modified fabric surface and high pore volume allow unpleasant
odors to be very readily absorbed, which may indirectly result
in depreciation.
Contamination
Active behavior
Ready-made garments are a very clean cargo.
Passive behavior
Dust, colorants, ores, dirt, rust or leakages of accompanying
cargo (acids, molasses, glue, fats/oils, lubricants etc.) may

contaminate the cartons or the goods themselves and lead to a
reduction in utility value. Garment containers and special truck
bodies must be leakproof and possibly lined with carpet, to stop
dust, dirt and other foreign bodies from penetrating or being
swirled up, as, despite the protective covers on the garments,
even the smallest foreign bodies may trigger pilling of the
surface of the fabric.
Mechanical influences: Garments are sensitive to mechanical
stresses. Excessively thin plastic covers may tear if stowed too
tightly and form chafing points, which cause undesirable pilling
or snagging of the surface of the fabric. This impairs the
appearance of the surface (depreciation). The coat-hangers must
therefore be properly secured (clips) and the items of clothing
adequately wrapped to protect them from rubbing
together/chafing.
Shrinkage / Shortage / Theft: Ready-made garments are very
valuable and are therefore at acute risk of theft. Containers
should be stowed such that the doors of adjacent containers face
towards each other. The use of special seals is recommended.
RF Insect infestation / Diseases: The goods themselves are
seldom subject to insect infestation. However, when damp they
very rapidly succumb to attack by mold and rot-causing
bacteria, especially in conjunction with any finishes that may
have been applied. Mildew stains of a gray-green or brown-
black color develop and produce a musty odor. The risk of
insect infestation is lower for clothing made from polyester
fibers than for clothing made from natural fibers.
Storage/Holds: The holds/containers must be pest-free, since
many insects which are normally typical pests of foodstuffs and
animal feed may also damage textiles, especially if they seek
out these materials for metamorphosis. In their search for
breeding grounds or pupation sites, they penetrate boxes and
cartons and even bite through metal foils and plastic films and

may thereby cause considerable destruction. For instance, a
consignment of pullovers from East Asia displayed eating
damage caused by red-legged ham beetles, which had hatched
out of a consignment of copra transported in the same hold and
multiplied considerably in number. In their search for new
breeding grounds, the beetles had got into wooden boxes and
thence through metal foils, cartons and finally through plastic
bags into the woolen goods. As this environment did not appeal
to them, they tried to chew their way back out and, in so doing,
caused considerable destruction to the pullovers. Larvae from
the yellow mealworm also migrated during transport from an
accompanying cargo of flour and rolled oats into a consignment
of pullovers, for pupation. Therefore, do not stow in a
hold/container together with foodstuffs and animal feed or
hides/furs.
5

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Assignment Evidence-Based Capstone Project, Part 6 Disseminating.docx