Implementation of Literature Research and Design Sam.docx

Implementation of Literature Research and Design Sampling to
Vaccines
Stephanie Dennison
Chamberlain University
NR 505: Advanced Research Methods
December 2018
Running head: VACCINATIONS
Running head: VACCINATIONS
Implementation of Literature Research and Design Sampling to
Vaccines
In this section of the paper, the author will continue to
delve into the evidence-based proposal project. The author will
discuss ten single study research articles related to the topic of
vaccines. The author will then identify the quantitative
approach and discuss the selected design further. The author
will then discuss the target population and how the research will
be gathered. The PDSA Change Model will be described in
great detail along with how it is applicable to the research.
Research Literature Support

In this section, the author will disseminate research studies
consistent with the childhood vaccination topic. For healthy
children 2 months and older (P), how does parental education
about vaccines (I) compared to no supplemental education about
vaccines (C) increase the number of vaccinated children (O) in
a six-week time period (T)? We will explore this PICOT
question and find support from previous studies.
Jin et al. (2018)published a study that aimed to review the
immunization status of cochlear implant recipients, assess if
adding a vaccine specialist made a change in vaccine
compliance, and elucidate any barriers to vaccine compliance.
This study implemented the quantitative approach. Chart
review and a telephone survey were used to obtain vaccination
status and collect data. The results were that ninety-eight
percent of children were vaccinated before surgery as opposed
to sixty-seven percent prior to the vaccine specialist
consultation. A strength of this study was the inclusion of one
hundred and sixteen children. One limitation of this study was
the fact that data was collected via a telephone survey. The
parents could have been dishonest about whether their child was
vaccinated or not.
Kaufman et al. (2017) conducted a study that aimed to define
different ways to communicate interventions for routine
vaccinations and integrate them into a hierarchy of vaccination
communication. The quantitative approach was used. Through
a targeted literature search, primary fieldwork observation, and
consultations with stakeholders data was collected including
inclusion and exclusion criteria. The results of the study were
the creation of a hierarchy that is categorized by purpose and
outlines communication interventions to address gaps in
vaccination education. A strength of the study was that data
was collected globally during the literature search. The
interventions suggested have not been reviewed for accuracy,
therefore, the hierarchy could show gaps in evidence.
Weidemann et al. (2017) set out to create a mathematical
transmission model to examine differences in childhood

vaccination efficacy. Transmission modeling was developed in
order to estimate the influenza epidemic using population
counts, contact patterns, and influenza history. They found that
the influenza vaccine had the potential to reduce influenza rates
in Germany, but not at the rate they had hoped. The
quantitative approach was applied. One limitation is that in
their study they modeled vaccines being given before influenza
season began when in reality people often get vaccines later in
the season. This could have altered the replication of the data.
The model’s stratification approach did allow for seasonal
heterogeneity during influenza season transmission.
Lasseter, Al-Janabi, Trotter, Carroll, & Christensen (2018)
surveyed people in the United Kingdom to help inform policy-
making decisions regarding vaccines. They implemented a
qualitative design utilizing face-to-face interviews and analyzed
using a thematic framework approach. They concluded through
surveying that some of the population has separate views than
the health-maximization approach for assessing benefits. The
sampling method was flawed because although 504 people were
invited to participate in the interview, there were only 21
surveyed. This is a relatively small sample size, which is a
weakness. Strength was that although the sample size was
small, they all had varying opinions on vaccines, which can
help generalize results.
Bao et al. (2018) set out to review how Rwanda has
achieved a ninety-eight percent vaccination rate, nearly
exclusively vaccinated. Two avenues of research were studied
both primary and secondary sources. They interviewed
residents of Rwanda and conducted interviews with government
officials and those responsible for the vaccine programs. The
secondary sources consisted of databases and peer-reviewed
literature. The results of the study concluded that Rwanda used
several components to achieve their vaccination success. Some
of these include political will, multilevel accountability and
effective use of funding. A strength of the study was that they
used primary and secondary sources in order to gather data.

One limitation is that with qualitative studies there is no result
verification. The answers to the survey are taken at face value
and could have been altered.
Mayer, Frontino, Melissen, Yu & PatelShori (2018) set out to
determine what factors influence a parent to bring a child in the
community to receive influenza vaccination using the
qualitative approach. This was a cross-sectional exploratory
survey. Data was collected from 349 participants in three
separate grocery store chains. They found that a swift
vaccination without an appointment were important factors in
their decision to vaccinate. One strength of the study was the
large sample size considering shoppers were chosen at random.
One limitation was the random selection of shoppers. These
shoppers could have been regulars at the store and knew the
staff, which led them to feel more comfortable which could
have swayed the results of the study for or against the
researchers.
SarveshKumar & Brundha (2018) wanted to create awareness
about vaccination for parents with children under fifteen. The
quantitative approach was implemented. Parents were given a
questionnaire that contained fourteen closed-ended questions to
answer. SPSS software analyzed the answers and organized
them into tables. They found that there was a lack of awareness
between parents about childhood vaccination, which calls for
further research. One limitation is that self-reported
vaccination status is a sensitive measure of vaccination.
Strength in the study is that the sample size was representative
of the population.
Oku et al. (2017) explored factors affecting vaccination
communication in Nigeria. A qualitative approach was used to
identify factors implementing communication interventions.
Data was collected implementing the SURE framework to
organize the identified factors. The study found that it is
pertinent for policymakers to identify barriers and facilitators
that influence the delivery of vaccination education. The
researcher’s qualitative approach was positive in that it was

flexible and they were able to go back to questions that needed
clarification. One potential limitation is that polio was still
active when everyone was surveyed and the focus was mainly
on eliminating polio as opposed to the prevention of already
eradicated disease.
After discovering that the vaccination rates in Tamil Nadu were
fifty-six percent, Murkehar et al. (2017) set out to identify why
these numbers were lower than previous rates. Cross-sectional
surveys were conducted on over three thousand participants.
The approach the researchers took was qualitative. Data were
collected from the children’s mother or caretaker. The study
found that eighty percent of children received their primary
vaccinations. This was higher than the researchers were
anticipating. They did identify a need to continue to increase
vaccine compliance through education and supervision of the
schedule. One limitation was that twenty percent of children
did not have their vaccine record, so the data was extrapolated
from the mother’s memory of which vaccines had been given.
However, the study did determine that the mother’s sensitivity
for recall was high.
Zamir & Israeli (2017) set out to learn about attitudes and
knowledge about vaccinations among mothers in low
immunization areas. The qualitative approach included focus
groups and semi-structured interviews. This is a qualitative
study as well that using focus groups and approached via
telephone in private homes in the community. The results were
that the parent’s vaccine knowledge was inefficient. There was
no haste in when vaccines should be given, if at all. One
limitation is that this study was conducted in an area that has
relatively high fertility rates, which could be seen as a possible
limitation. One positive is the inclusion of five different
communities within the population.
Research Approach
Quantitative research is a form of research that implements
rigorous control of the environment to definitively measure
phenomena (Rutberg & Bouikidis, 2018). This is the most

appropriate approach for this design because the author is
attempting to compare two concrete measurements in a
controlled environment. The qualitative method would be more
appropriate if the author wanted to determine people’s feelings
about vaccinations. For this PICOT question, the quasi-
experimental approach is most appropriate. The quasi-
experimental approach involves an intervention, but no control
group. The author is comparing whether or not the intervention
made a difference, and there will be no randomization (Rutberg
& Bouikidis, 2018). One advantage to this design is a reduction
in the amount of time and energy spent. For randomization,
extensive pre-screening is required and since this approach does
not implement that it saves time and resources. One
disadvantage to this approach is that without randomization,
non-equivalent test groups can limit the ability to generalize
results and apply to the general population.
Sampling
The targeted population for this project is parents of
children two months and older up to age eighteen. The author
plans to use non-probability sampling because randomization
will not be implemented. In non-probability sampling, the odds
that a subject will be selected cannot be calculated. It would be
difficult to use randomization to obtain a sample representative
of the population. The author believes that diversity sampling
is important to implement in this specific study. In this
sampling, members are selected intentionally across possible
answers to capture all possible responses. One advantage to
this sampling is that this study will be broad and therefore
needs a large set of subjects. One disadvantage to this method
is that the margin of error cannot be calculated. Views also
may not be measures proportionally in diversity sampling. The
potential for selection bias can occur with non-probability
sampling because the ability to generalize is limited (El-Masri,
2017).
For a confidence level of 95%, a sample size of 300 and a
population of 500 at 50 percent, the confidence interval would

be 3.58. The sample size should be about 300 people, which
should be achievable. Inclusion criteria for this study are
parents of children 2 months to sixteen years of age. Exclusion
criteria are adults that are not parents or refuse to participate in
the supplemental education. Having a child is essential to this
research because the topic is childhood vaccinations.
In order to participate in a research study, participants want to
know that their rights will be upheld. It is important to protect
their confidentiality, anonymity, protection from harm and
obtaining informed consent. It is pertinent that the data
collected for the study is not shared with anyone that is not
apart of the study. Participants will be anonymous because
their information will not be recorded such as address and
identifiable information. Their initials and age can identify the
research participants. Informed consent requires that the
participants are given facts about the study and if they agree
they should sign a form. If the subject has any questions about
the study they should be allowed to air their concerns.
Protection from harm alludes to the fact that all participants in
the study will act ethically and make sure no intentional harm is
inflicted on the patients.
Proposed Implementation with Change Model
The PDSA model is known as the plan, do, study, act
model. This cycle is an improvement process typically used in
healthcare to influence change. The PDSA model tests small
changes in the cycle to optimize the process (Coury et al, 2017).
The PDSA model is helpful for any research study because by
following the steps you can tweak the process as needed based
on observations.
In the planning step of the cycle, this is where the author’s
solidified research approach will be applied. Inclusion criteria,
exclusion criteria, sample size, and the target population are all
identified. In this step, we will also plan which supplemental
education will be implemented in our intervention. In the do
step, we would implement the vaccine education on a small
scale, to begin with. In the study set, the author will analyze

the data from the do step and collect information about the
small-scale education. In the act phase, the intervention will be
refined and make changes based on the observations from the do
phase.
12
VACCINATIONS
An evidence-based practice environment is present when
opportunities to collaborate with scholarly colleagues, staff
development on the elements of research, and the autonomy to
change practice are available (Pryse, McDonald, & Schafer,
2014). In order to facilitate this in my future practice setting, I
will have to be involved in committees that foster growth and
scholarly application. The commitment to high-quality care and
patient safety, interprofessional teamwork, standardized
policies, and an environment that promotes continuous learning
have all been defined as fostering a positive environment for
evidence-based practice (Wilson et al., 2015). This can be
achieved by joining the American Academy of Nurse
Practitioners or working in a facility that has achieved Magnet
status. This will help the author stay involved in the latest
trends in healthcare. One barrier to implementing evidence-
based practice is difficulties understanding research findings.
If the author’s proposed evidence-based project does not result
in answers that are simple to disseminate, it may be difficult to
apply the research to the clinical setting. The author believes
that the information in this particular study should be fairly
simple to understand. The author’s goal is that the layperson
will be able to read these findings and apply them.
References
Bao, J., McAlister, H., Robson, J., Wang, A., Koswin, K.,
Sayinzoga, F., & Zlotkin, S. (2018). Near universal childhood
vaccination rates in Rwanda: how was this achieved and can it
be duplicated? Lancet Global Health, 6, 42-27.
http://dx.doi.org/https://doi-
org.chamberlainuniversity.idm.oclc.org/10.1016/S2214-
109X(18)30176-1

Coury, J., Schneider, J., Rivelli, J., Amanda, F., Petrik, A.,
Seibel, E., ... Coronado, G. (2017). Applying the Plan-Do-
Study-Act (PDSA) approach to a large pragmatic study
involving safety net clinics. BMC Health Services Research,
17(17), 1-10. http://dx.doi.org/doi-
org.chamberlainuniversity.idm.oclc.org/10.1186/s12913-017-
2364-3
El-Masri, M. (2017). Non-probability sampling. The Canadian
Nurse, 113(3), 17. Retrieved from
https://chamberlainuniversity.idm.oclc.org/login?url=https://sea
rch.ebscohost.com/login.aspx?direct=true&db=mdc&AN=29235
800&site=eds-live&scope=site
Jin, L., Tellez, P., Chia, R., Lu, D., Chadha, K., Pauwels, J., &
Kozak, F. (2018). Improving vaccination uptake in pediatric
cochlear implant recipients. Journal of otolaryngology-Head and
Neck Surgery, 47(1), 1-7. http://dx.doi.org/doi-
0308-5
Kaufman, J., Ames, H., Bosch-Capblanch, X., Cartier, Y., Cliff,
J., Glenton, C., & Hill, S. (2017). The comprehensive
'Communicate to Vaccinate' taxonomy of communication
interventions for childhood vaccination in routine and campaign
contexts. BMC Public Health, 17(1), 1-11. http://dx.doi.org/doi-
4320-x
Lasseter, G., Al-Janabi, H., Trotter, L., Carroll, E., &
Christensen, H. (2018). The views of the general public on
prioritizing vaccination programs against childhood diseases: A
qualitative study. Plos One, 13(6). http://dx.doi.org/doi-
org.chamberlainuniversity.idm.oclc.org/10.1371/journal.pone.01
97374
Mayer, D., Frontino, M., Melissen, P., Yu, D., & PatelShori, N.
(2018). Increasing childhood influenza vaccinations at the
community pharmacy in Pennsylvania: important factors to
parents and their peers- a pilot study. Innovations in pharmacy,
9(1). http://dx.doi.org/https://doi-

org.chamberlainuniversity.idm.oclc.org/10.24926/iip.v9i1.977
Murhekar, M., Kamaraj, K., Elavarasu, G., Rajasekar, D.,
Boopathi, K., & Sanjay, M. (2017). Coverage of childhood
vaccination among children aged 12-23 months in Tamil Nadu.
Indian Journal of Medical Research, 145(3), 377-386.
org.chamberlainuniversity.idm.oclc.org/10.4103/ijmr.IJMRpass:
[_]1666_15
Oku, A., Oyo-Ita, A., Glenton, C., Fretheim, A., Eteng, G.,
Ames, H., & Lewin, S. (2017). Factors affecting the
implementation of childhood vaccination communication
strategies in nigeria: a qualitative study. BMC Public Health,
17(1), 1-12. http://dx.doi.org/https://doi-
4020-6
Pryse, Y., McDaniel, A., & Schafer, J. (2014). Psychometric
analysis of two new scales: the evidence-based practice nursing
leadership and work environment scales. Worldviews on
Evidence-Based Nursing, 11(4), 240-247.
org.chamberlainuniversity.idm.oclc.org/10.1111/wvn.12045
Rutberg, S., & Bouikidis, D. (2018). Focusing on the
Fundamentals: A simplistic differentiation between qualitative
and quantitative research. Nephrology Nursing Journal, 45(2),
209-213. Retrieved from
rch.ebscohost.com/login.aspx?direct=true&db=ccm&AN=12910
Sarvesh Kumar, J., & Brundha, P. (2018). Awareness about
childhood vaccination among parents with children below 15
years of age. Drug Intervention Today, 10(12), 2481-2484.
Retrieved from
rch.ebscohost.com/login.aspx?direct=true&db=a9h&AN=132447
Weidemann, F., Remschmidt, C., Buda, S., Buchholz, U.,

Ultsch, B., & Wichmann, O. (2017). Is the impact of childhood
influenza vaccination less than expected: a transmission
modeling study. BMC Infectious Diseases, 17(1), 1-14.
2344-6
Wilson, M., Sleutel, M., Newcomb, P., Behan, D., Walsh, J.,
Wells, J., & Baldwin, K. (2015). Empowering nurses with
evidence-based practice environments. Worldviews on
Evidence-Based Nursing, 12(1), 12-21.
org.chamberlainuniversity.idm.oclc.org/10.1111/wvn.12077
Zamir, C., & Israeli, A. (2017). Knowledge, attitudes, and
perceptions about routine childhood vaccinations among jewish
ultra-orthodox mothers residing in communities with low
vaccination coverage in the Jerusalem district. Maternal &
Child Health Journal, 21(5), 1010-1017.
2272-5
Week 3 08042019
Hello Professor and class
The article that I selected for this assignment is a single subject
study exploring the use of evidence-based approaches for
managing pain in palliative care (Unné & Rosengren, 2014).
According to the authors, pain is an unpleasant experience that
requires the optimal selection of adequate management
approaches that are sophisticated and flexible (Unné &
Rosengren, 2014). This objective can be attained by
incorporating the expertise of interdisciplinary teams. The study
explored the variations in the techniques of evaluating pain in a
palliative care facility located in northeast Sweden. It used
quantitative methods that involved the acquisition of empirical
and quantifiable data. This information was analyzed and
interpreted to develop generalizations regarding the pain

management approaches. The research study design used in the
article was quasi-experimental. It included different comparison
groups but did not involve random assignment (Campbell &
Stanley, 2015).
In the representation for the article, the nomenclature X
represents the intervention, O expresses the observation and
data collection, and R stands for random assignment to a study
group. Pain assessment involves the application of unique
approaches and scales such as the Numerical Rating Scale
(NRS), Visual Analogue Scale (VAS), Verbal Rating Scale
(VRS), and Edmonton Symptom Assessment System (ESAS).
The evidence-based intervention (X) used in the study involved
the use of numbers instead of descriptive words to enhance,
clarify, and unify the process of documenting pain ratings. O
included the completion of pain assessment using the
recommended evidence-based rating tools during the last days
of the patient’s life. The study team developed nine questions to
assess the experiences of physicians with managing pain in
palliative care (Unné & Rosengren, 2014). The team took two
weeks to compile the responses to questions that served as the
foundation for the improvement effort. R was not used for the
study, although the improvement project included two teams
operating in the healthcare district.
Non-probability sampling was used for the study. The sample
included two teams consisting of 22 staff members that work as
palliative care providers within the patients’ homes. This
sample was selected from a population of 125 employees
working in the healthcare district (Unné & Rosengren, 2014).
The sample was chosen from nine teams consisting of different
healthcare professionals that operated in two areas.
One of the advantages of non-probability sampling is that it is
more cost and time effective than probability sampling. The
technique is easy to use and is sufficient when working with
small populations (Sharma, 2017). The major shortcoming of
the method is that it is challenging to determine how well the
sample is representative of the population. This aspect results

from the difficulty in determining the confidence intervals and
margins of error (Sharma, 2017).
The research study groups in the article did not undergo random
assignment because the inquiry did not include experimental
and treatment groups. The two research teams that participated
in the study documented pain among the patients using the
recommended scales.
Random assignment was not used for the study. This aspect
increased the chances for biases and errors because the sample
may not be representative of the population (Nguyen, Collins,
Lamy, Devereaux, Daurès, Landais, & Le Manach, 2017). It also
made it hard to generalize and validate the findings.
References
Campbell, D. T., & Stanley, J. C. (2015). Experimental and
quasi-experimental designs for research. Ravenio Books.
Nguyen, T. L., Collins, G. S., Lamy, A., Devereaux, P. J.,
Daurès, J. P., Landais, P., & Le Manach, Y. (2017). Simple
randomization did not protect against bias in smaller
trials. Journal of clinical epidemiology, 84, 105-113.
Sharma, G. (2017). Pros and cons of different sampling
techniques. International Journal of Applied Research, 3(7),
749-752.
Unné, A., & Rosengren, K. (2014). Using numbers creates value
for health professionals: a quantitative study of pain
management in palliative care. Pharmacy, 2(3), 205-221.
Retrieved from https://www.mdpi.com/2226-4787/2/3/205/pdf
This is the respond from the professor question
Professor question: Collapse SubdiscussionJo Podjaski
Jo Podjaski
Jul 24, 2019Jul 24 at 11:26pm
Manage Discussion Entry
Yahima,
Good article. Okay, sounds like your assessment on quasi-

experimental is logical. There were different comparison groups
without random assignment. The intervention was the use of
numbers to document pain ratings. Was this the numerical pain
scale? I would assume so. The tool is the intervention and the
data collection were the EBP pain rating tools. So there was a
patient side and a provider side to this study in terms of
assessment it sounds like. The second part, the provider part,
sounds like qualitative in terms of collecting data on
experiences of providers managing palliative pain. No random
assignment either, since 2 teams were used. So they were
designated groups. Yes, then this is also non-probability
sampling because the researcher wants to only look at a certain
population. They consisted of 9 teams from a population of 125
employees, have I got this right?
Again, non-probability is easier to use since you have the set
population at hand, but there can be bias too as well as
questionable population representation.
Great discussion,
Dr. Jo
Respond
rom Week 3: Elements of Quantitative Research: Design and
Sampling
Jul 28, 2019 4:21pm
Yahima Montero
Hello professor
I really appreciate you commended in my post. Thank you so
much for your feedback and recommendations. I assessed the
study model and determined that it is quasi-experimental. The
rationale for the conclusion was that two groups participated in
the study, and the random assignment was not used. The
intervention involved using EBP tools to rate the severity of
their pain and improve pain management in palliative care. The
Numerical Rating Scale (NRS) was adopted as the EBP tool for
rating pain among the patients (Unné & Rosengren, 2014). This
approach was employed to replace the verbal description of
pain. The providers tested the EBP tools on the patients and

concluded that the NRS generated sufficient, transparent, and
unified pain ratings. I agree with your statement that the second
part on data collection resembles the qualitative method.
However, I am convinced that it is a quantitative method
because it focused on generating numerical data that can only
be analyzed using quantitative methods. Two teams were used
to test the EBP tools, but randomization was not used when
selecting the members. The research teams consisted of
healthcare professionals and cannot be considered as designated
groups. Non-probability sampling was used, and it proved easy
because of the availability of a study population. However, this
technique could result in unrepresentative samples and biased
results.
Thank you
Reference
Unné, A., & Rosengren, K. (2014). Using numbers creates value
for health professionals: a quantitative study of pain
management in palliative care. Pharmacy, 2(3), 205-221.
Retrieved from https://www.mdpi.com/2226-4787/2/3/205/pdf
Running head: PROPOSAL ON EVIDENCE-BASED
PRACTICE 1
PROPOSAL ON EVIDENCE-BASED PRACTICE
2
This the week 2 assignment
This is the feedback from the professor
Yahima, You have most of the elements of the assignment. You
should follow the headings specific to the instructions, though,
it would organize the thoughts better. You have good writing
and reading flowed fairly well. You do not have a theory,
however, that is an exiting nursing theory or other discipline's

theory. I could not clearly understand your PICO. You want an
intervention that will help patients follow their treatment plans,
right? Dr. Jo
This the PICO fixed
Hello Professor and Class
The project aims at identifying the implication of utilizing
evidence-based model in the treatment procedure on patients
with chronic ailments. The researcher would be interested in
measuring the usefulness of the model on satisfaction and
decision-making process. The appropriate method to use in the
research is quantitative approach. The quantitative method is a
scientific approach that is characterized by statistical
procedures to enhance data analysis. The aim of the quantitative
approach is to explore ‘cause and effect relationship’
connecting the variables under study (Gerring, 2011). In
particular, for purposes of this research, descriptive research
design is the most feasible. The method helps in making
depiction of the participants either through observation or a
case study. Quantitative will help answer questions on what
happens following the subjection of participants to certain
conditions under study. Being action-orientated, the quantitative
approach generates outcomes that provide a particular change in
a particular field. In this research, the method will help inform
the caregivers on the need to use the EBP model based on the
findings that will show positive outcomes on patients as well as
improvements in decision-making process among the
professionals.
My PICO Question is: in patients with Diabetes, is there
reported improved decision-making and patient education when
using EBD model compared to conventional approaches in
reducing the burden of pain through enhanced professional
interactions?
Diabetes is a chronic disease that is affecting people in society.
It is caused by the reduction effectiveness of insulin in the
patient’s body. I will use self-management and literacy
techniques to help patients prevent diabetes. Some of the self-

management and literacy techniques I will apply patient
education formula will include advising them to eat healthily,
jeep the right body weight, and doing exercise regularly. In the
effort to curb diabetes from spreading will create awareness to
the community to understand its causes and risk factors. The
variables to consider include satisfaction, decision-making
process, and professional interactions. The EBP model will be
of great help to the patients in making improvements in the
prevention of diabetes, where evidence is turned into actions.
Through an improved decision-making process, professionals
from different fields will share credible information that will be
instrumental in the management of chronic ailments. Medical
professionals have a significant influence on the overall clinical
outcomes though they require proper strategies that target the
specific needs of a patient.
Reference
Creswell, J. W., & Creswell, J. D. (2017). Research design:
Qualitative, quantitative, and mixed methods approaches. Sage
publications
Brown, J. M. (2014). Evidence-based practice for nurses.
Burlington: Jones & Bartlett Publishers.
Proposal on Evidence-Based Practice
Yahima Montero
Chamberlain University
Class RN 505

Proposal on Evidence-Based Practice
Relationship between EBP and Research
Healthcare deals with many complicated health-related issues in
pursuit of the best outcomes for the patients. In the healthcare
sector, nursing is an essential aspect for all patients requiring
help regarding their health status. However, to provide this
help, health care providers need to have a foundation of
information reflecting quality care. Thus, there is a need for
evidence-based practice (EBP) that is centered on research.
According to Stavor, Zedreck-Gonzalez, & Hoffmann (2017),
EBP should be managed using specific clinical applications that
are based on up-to-date research. The process of establishing a
pool of knowledge has been given many names over the years,
such as quality care, evidence-based practice, and best
practices. However, irrespective of the term given to this
practice, the foundation of the care must be centered on
research.
The definition of EBP also encompasses various aspects such as
research, client preferences, nursing expertise, and thought
process. However, as much as all these aspects are required, the
actual caregiving in a healthcare setting requires a nurse to use
their experience in making decisions because some of the cases
they encounter are unique (Stavor et al., 2017). All in all, the
scientific data generated from the research is the foundation
upon which healthcare providers make their decisions.
Differences between EBP and Research

The primary goal of the research is to develop new knowledge
or validate an already-existing pool of knowledge (Baker et al.,
2014). Therefore, research studies are usually systematic and
scientific while trying to test hypotheses or answer particular
research questions using standard rigorous methods (Baker et
al., 2014). Despite research involving investigations,
discoveries, and exploration, it also requires the researcher to
understand Science philosophy. As Baker et al. (2014) indicate,
data generated from the research is considered valid and reliable
if the researchers used scientific methods in an orderly and
sequential manner. On the other hand, EBP does not entail
developing or validating any knowledge. Instead, it involves
translating already existing evidence and using it to enhance
clinical decision making (Baker et al., 2014). Despite most of
the evidence in EBP emanating from research; it goes beyond
research to include patients’ preferences and clinical practice.
EBP will also sometimes involve knowledge from experts and
opinion leaders where no existing knowledge is found.
Contribution of EBP to Professional Nursing
EBP has contributed massively to professional nursing. For a
start, it has changed the nature of nursing education. Today,
education institutions such as colleges and universities have
changed their curricula on the BSN program to incorporate EBP
(Balakas & Smith, 2016). Students that are pursuing a degree in
nursing, be it through RN or BSN programs, are being engaged
in coursework that teaches them how to improve their overall
knowledge and to have professional accountability (Balakas &
Smith, 2016). These programs focus on critical thinking skills
while also urging nursing students to put into perspective the
patient’s cultural, socioeconomic and clinical backgrounds in
addition to relevant scientific research.
EBP has also led to improved quality of care. As Balakas &
Smith (2016) affirm, it has led to improved patient outcomes.
Today, nurses are using available new research to minimize
complications on patients, especially with chronic illnesses
(Balakas & Smith, 2016). This helps the nurse to conduct the

correct diagnosis, offer the right treatment, and prevent other
diseases. . Another benefit of EBP is that it has led to superior
nursing skills. A nurse who has incorporated EBP in their
education and clinical experiences has advanced decision
making and critical thinking skills (Balakas & Smith, 2016).
Moreover, such a nurse is good at utilizing informatics,
operating in interdisciplinary teams, and adapting to different
situations (Balakas & Smith, 2016). Thus, EBP helps nurses to
develop satisfaction and pride in the work that they do.
MSN Specialty Program and Practice
My MSN specialty track is a family nurse practitioner who is
well versed in nursing theory, research, healthcare policies,
informatics, and professional role development. I am aiming to
work in the family practice department. In my future practice
setting, EBP will help me to improve the quality of care that I
provide to my patients. For example, I will use the available
research to conduct diagnoses and offer treatment after I have
reviewed a patient's health records to avoid misinformed
judgments and inadequate healthcare provision.
Nursing Concern
One of the concerns among many nurses is patients' refusal on
recommended treatments. When this occurs, nurses are left in a
difficult situation, worrying about the patient's health and
wondering if they have done enough to help the patient. The
nurses also face the risk of taking all the blame if the patient
who refused treatments suffers from a poor outcome. According
to Puts et al. (2015), this dilemma revolves around a patient’s
rights and the nurse’s obligations thus touching on ethical
perspectives. In this regard, ethical tension emanates when the
nurse's responsibility to provide the best possible care conflicts
with the obligation to understand and respect a patient's
autonomy (Puts et al., 2015). The law acknowledges that a
patient has the right to decide on the care they are willing to
accept (Puts et al., 2015). Thus, nurses are left in a position
where they must balance these two obligations without favoring
any of them.

Nurses respect their patients' autonomy if they involve them in
discussions about the care they are giving. Nonetheless,
providing a listing of the medical information and allowing the
patients to decide the medical care to receive is not what many
patients or nurses want (Mahal et al., 2014). Patients want the
nurses to comprehend and contextualize information and make
relevant recommendations based on the patient's goals and
medical evidence (Mahal et al., 2014). Still, the patients do not
want the nurses to make crucial decisions on their behalf. In any
case, the paternalism where health care providers make
unilateral decisions regarding the welfare of a patient in
unethical today (Mahal et al., 2014). Thus, nurses face the
challenge of trying to help their patients without being
paternalistic.
The issue of patients refusing treatments is common in most
healthcare settings. Patients, especially the elderly, are known
to decline medical advice across the healthcare sector, from
hospitals, nursing homes, to outpatient clinics. For example,
there are numerous cases of inpatients leaving healthcare
centers against medical advice, non-adherence to treatment, and
failure to make regular follow-ups.
When patients refuse to adhere to recommended treatments, the
nurses are greatly affected. As Katz et al. (2015) indicate,
healthcare providers, derive satisfaction when they give care to
a patient and improve their healthcare outcomes. If a patient
refuses treatment, it puts their health at risk, and this affects the
nurse who feels that they are powerless to help. Moreover, if a
patient refuses treatment, and there is a poor outcome, the nurse
may take all the blame and even face lawsuits for malpractice.
Hospitals are also affected if a patient refuses treatments. In
such cases, their brand may be affected if there is an
unfortunate outcome as it may appear as if the hospital is not
providing quality care.
In most cases, the consequences are dire when patients refuse
treatments entirely. For a start, the patients may develop further
complications and in worst cases, lose their lives (Katz et al.,

2015). The healthcare providers are also affected and left
wondering if they did enough to provide quality care to the
patients. In some cases, the family of the patient also sues the
healthcare provider or hospital for a failure to deliver quality
services. Such lawsuits are a financial burden to healthcare
organizations.
To solve this problem, nurses should start by understanding why
a patient has declined the available treatments. This will create
an opportunity for the nurse to intervene. Nurses can also deal
with the issue by engaging in harm reduction. As Choi et al.
(2014) indicate, this entails identifying other acceptable
treatment options that the patient could be willing to accept. For
example, if a patient wants to leave a healthcare setting AMA, a
nurse may arrange for the patient to meet up with their primary
care provider in a day or two which the patient may agree.
Purpose Statement
This proposal seeks to ascertain how educating patients on the
essence of using EBP can reduce cases of patients refusing the
recommended treatments.
PICO Question
Can educating patients on the importance of EBP reduce cases
of patients declining recommended treatments?
The implication of Expected Outcome to my Future Practice
The expected outcome is that patients will embrace EBP fully
and understand its essence in healthcare provision. Once
patients have understood the nature of EBP, likely, cases of
patients declining treatments will significantly reduce (Choi et
al., 2014). As a future family care nurse, this will be essential
in my practice knowing that my patients are confident in the
quality of care that I am giving them. Also, nurses will be in a
position to handle as many patients as possible since EBP
reduces tests and procedures done in diagnosis. Moreover,
patients will be satisfied with the care given without demanding
for additional treatments or declining the available ones.
Purpose of Conducting a Literature Review
Conducting a literature review is essential in understanding the

existing research on why patients decline treatments. In this
regard, it is necessary to contextualize the reasons given by
patients for failing to adhere to medications and ascertain what
would have been done to prevent such cases from happening.
Another essence of conducting a literature review is to get
insights on whether most patients understand what EBP is and
how it can be used to improve their health outcomes. It is highly
likely that most patients decline treatments because they do not
understand their essence. Thus, it is essential to study whether
most patients are knowledgeable about EBP.
Steps Followed to Conduct a Literature Review
I assessed the CINAHL Plus with Text database which
extensively covers matters on allied health and nursing. Also, I
used Google Scholar, which is a search engine that specializes
in academic output while also allowing a user to download a
full text. The key phrases in my search were EBP and patients
declining recommended treatments. Some of the minor phrases
that I used in my search were healthcare challenges, the use of
technology in hospitals, and problems facing nurses. One of the
specialty organizations that are relevant to this proposal is the
Nurses' Association of the American College of Obstetricians
and Gynecologists. Using information from this proposal, this
organization can improve patient care and practice by educating
women on the treatment methods availed to them.
Theoretical Framework
This proposal relies on the theory that patients decline the
availed treatments because they are not knowledgeable about
how health care providers have arrived at their decisions.
Therefore, the assumption is that most patients are not
knowledgeable about EBP and how it is used in healthcare
settings to improve outcomes. For this reason, this proposal
suggests that educating patients on EBP would help reduce
cases of declining treatments. The literature review on this
proposal studies the reasons why patients reject medications
which will then guide healthcare providers in developing
solutions that can handle this challenge.

References
Baker, K. M., Clark, P. R., Henderson, D., Wolf, L. A., Carman,
M. J., Manton, A., & Zavotsky, K. E. (2014). Identifying the
differences between quality improvement, evidence-based
practice, and original research. Journal of Emergency
Nursing, 40(2), 195-197.
Balakas, K., & Smith, J. R. (2016). Evidence-based practice and
quality improvement in nursing education. The Journal of
Perinatal & Neonatal Nursing, 30(3), 191-194.
Choi, M., Kim, H. S., Chung, S. K., Ahn, M. J., Yoo, J. Y.,
Park, O. S., ... & Oh, E. G. (2014). Evidence‐based practice for
pain management for cancer patients in an acute care
setting. International Journal of Nursing Practice, 20(1), 60-69.
Katz, I. T., Dietrich, J., Tshabalala, G., Essien, T., Rough, K.,
Wright, A. A., ... & Ware, N. C. (2015). Understanding
treatment refusal among adults presenting for HIV-testing in
Soweto, South Africa: a qualitative study. AIDS and
Behavior, 19(4), 704-714.
Mahal, B. A., Aizer, A. A., Ziehr, D. R., Hyatt, A. S., Sammon,
J. D., Schmid, M., ... & D'Amico, A. V. (2014). Trends in
disparate treatment of African American men with localized
prostate cancer across National Comprehensive Cancer Network
risk groups. Urology, 84(2), 386-392.
Puts, M. T., Tapscott, B., Fitch, M., Howell, D., Monette, J.,
Wan-Chow-Wah, D., ... & Alibhai, S. M. (2015). A systematic
review of factors influencing older adults’ decision to accept or
decline cancer treatment. Cancer Treatment Reviews, 41(2),
197-215.
Stavor, D. C., Zedreck-Gonzalez, J., & Hoffmann, R. L. (2017).
Improving the use of evidence-based practice and research
utilization through the identification of barriers to
implementation in a critical access hospital. JONA: The Journal
of Nursing Administration, 47(1), 56-61.
This the week one

This the professor feed back and my answer
Yahima, Great week in the TDs. Your posts are informative
with good ideas and encouraging. Dr. Jo You will need to
change the focus of your PICO. Your population are patients
with chronic illnesses and you want them part of their own
decision making, right? You think that would increases their
self-management? EBP is typically not for patients, but nurses
bring this to the patient in terms of education and practice. Can
you re-work you PICO to be on education to patients?
Jo Podjaski , Jul 16 at 5:50pm
Hello Professor I really appreciated your feedback and
recommendation. You are correct the population selected was
patients with chronic illness, i focused on diabetes patients . In
week 2 post I fixed the PICO question , please let me know if
this is ok, or I need to resubmit it in week 1. Please advise.
Thank you so much :)
Week 1 submission
rom Week 1: Identification of Area of Interest
Jul 10, 2019 4:55am
Yahima Montero
Hello Professor and Class
The current dynamics in the clinical practice necessitate for the
formulation of approaches that enhance access to quality
services. A number of models have been developed to help in
coming up with effective interventions. Evidence-based practice
models will have a considerable role in making improvements
toward the provision of quality nursing care services. The
significance of the models is to ensure that caregivers utilize
theoretical and practical evidence in the recommendation of the
right and appropriate interventions to diverse health conditions.
At the same time, the model has significant in stimulating
improvements to clinical work climate as well as the
relationship between nurses and patients. At the same time, it is
essential for close collaboration between health care providers,

research institutions, and government. Such a move is helpful to
enable the sharing of knowledge, capacity, and resources. The
nature of services reflects the interests, needs, and values of
stakeholder involvement in the provision of services.
As rightly put in other studies, evidence-based models propose
interventions after a thorough consideration of the research
findings on a particular health condition. The models are built
on the need to recommend the right interventions and nursing
management practices. In turn, health facilities will record
reduced re-admission rates, improved quality care, and enviable
nurse-patient relationship. The evidence-based model should be
encouraged among the health providers and policy-makers to
improve nursing outcomes. Policymakers should facilitate the
adoption of the new practices and models to ensure better
outcomes and healthy population. It would be helpful to
consider models that ensure the satisfaction of caregivers and
patients as well as enhance the decision-making process. The
current nursing practices should value the significance of a
quality system that addresses emerging challenges.
In modern clinical practice, it has become increasingly
important for health care providers to integrate approaches that
enhance the quality of services. The field is utilizing data from
research studies to help in making the right interventions in
attending to the needs of the patients. The approach is
instrumental in different disciplines such as social work,
education, nursing, and psychology, among others. EBP allows
caregivers to utilize their competence and skills to identify
patients’ needs and make appropriate decisions (Dang &
Dearholt, 2017).
The significance of EBP is seen in the reduced number of deaths
and improvements in the health sector. In fact, there is better
cooperation and coordination of health activities that enhance
quality services. The approach also allows better interpretation
of concepts and formulation of national policies in the sector
(Brown, 2014). Furthermore, there is improved health awareness
and literacy that lead to the adoption of healthy behaviors. EBP

model has been instrumental in the development of innovative
and sustainable initiatives that contribute to the attainment of
positive health outcomes. The attainment of value-based care is
not possible without innovative measures that appreciate the
realities in society. Thus, it is critical for the government to
formulate an appropriate policy framework that covers different
aspects of the health sector. The intention is to improve access
to care at friendly costs.
The model considers that qualitative research process including
legal and ethical aspects have been considered when integrating
It is assumed that caregivers provide the right diagnosis that is
not only unique but also assesses the risks and benefits of the
interventions. It is assumed that the model will contribute to the
reduction of health care costs have reduced significantly with
the governments working in close collaboration with
educational institutions and non-state actors to engage in
scientific researches.
In sum, based on the information above, EBP has great
significance for an individual pursuing the MSN program.
Evidence-based nursing model is necessary for the clinical
practice. This is necessitated by the understanding the current
dynamics require better methods that cross extensive
boundaries. It is also important that there is uniformity in
global health care. In turn, patients show improved and quality
outcomes toward their satisfaction. Nursing professionals will
find the model appropriate as they seek measures to address the
challenges facing the sector. Continuous reforms in the health
sector should explore divergent views on politics, economics,
health risks, and citizens’ welfare. It is also prudent to promote
better utilization of the resources as a means to promote
efficiency and reduce healthcare costs. The benefits of the
model to health professionals and the public are evident. There
is close cooperation between researchers and medics in
formulating health policies and interventions.
PICOT: Does patients with chronic illnesses find evidence-
based models useful in the satisfaction, decision-making

process, and treatment of their conditions after one year of
treatment?
References
Brown, J. M. (2014). Evidence-based practice for nurses.
Burlington: Jones & Bartlett Publishers.
Dang, D., & Dearholt, S. L. (2017). Johns Hopkins nursing
evidence-based practice: Model and guidelines. Sigma Theta
Tau.
Week 5: Research Literature, Design, Sampling, and
ImplementationPurpose:
This assignment provides the opportunity for the student to
continue development of a MSN EBP scholarly project that
started with the identification of a nursing concern and
PICOT/PICo question from Week 2. The focus of this
assignment is to discuss the research-based literature support
for the selected concern, identify an appropriate research
design, explain the sampling method, and discuss
implementation through the use of a change model.
Course Outcome:
This assignment enables the student to meet the following
course outcome:
CO #1. Integrate evidence-based practice and research to
support advancement of holistic nursing care in diverse
healthcare settings. (PO # 1)
CO #2. Integrate knowledge related to evidence-based practice
and person-centered care to improve healthcare
outcomes. (PO #2, 5)

CO #4. Develop knowledge related to research and evidence-
based practice as a basis for designing and critiquing research
studies. (PO 1, 2, 3, 5)
CO #5. Analyze research findings and evidence-based practice
to advance holistic nursing care initiatives that
promote positive healthcare outcomes. (PO 1, 2, 5)
Due Date Sunday 11:59 PM MT at the end of Week Five
Total Points Possible: 250 pointsRequirements
Description of the Assignment: This continues the development
of a MSN EBP scholarly project by requiring the student to
identify the additional elements of the process. The required
elements are noted to be:
· Research Literature Support (NOTE: ten research-based
references related to PICOT/PICo question are required)
· Research Approach and Design
· Sampling
· Intervention
Criteria for Content
1. Research Literature Support: In this section, comprehensive
research literature support for the identified nursing concern
and PCIOT/PICo question is to be provided. A minimum of 10
(ten) research-based references are required. The use of a
systematic research review article as a reference is NOT
allowed. All research studies are to be consistent with the
selected concern and PICOT/PICo question. The PICOT/PICOT
question is restated before presenting the research literature
support. For each research-based reference the following
information is to be discussed:
· Purpose of the research study
· Research approach that was used
· Data collection methods used
· Results of the research study
· One strength of the research study
· One limitation of the research study.

2. Research Approach and Design: In this section, the student
will identify the research approach that he/she plans on using
for the EBP project as being either quantitative or qualitative.
In addition, if the selected approach is quantitative, the student
needs to identify if the design is experimental, quasi-
experimental, or descriptive. If the selected approach is
qualitative, the student needs to identify if the design is
phenomenological, ethnography, grounded theory, or historical.
A description of the selected design is to be provided as well as
rationale for its selection. In addition one advantage and one
disadvantage to the selected design is to be identified and
discussed. Required content includes:
· Identification of the research approach that the student plans
on using as either quantitative or qualitative
· Identification of selected quantitative research design by
indicating if the design is experimental, quasi-experimental, or
descriptive
· Identification of the selected qualitative design by indicating
if the design is phenomenological, ethnography, grounded
theory, or historical
· Description of the selected design
· Rationale for the selected design
· Identification of one advantage of the selected design
· Identification of one disadvantage of the selected design
· Provide scholarly reference(s) to support information about
the selected research approach/design
3. Sampling: In this section, the student will identify the
sampling method to be used in order to obtain the necessary
participants for the proposed EBP project. Discussion of
participants’ rights as research subjects is also included.
Required content includes:
· Describe the target population
· Identify the sampling method as being either probability or
nonprobability
· Provide a complete description of the sampling procedure
including:

· Sample size
· Inclusion criteria
· Exclusion criteria
· Identify one advantage to the selected sampling procedure
· Identify one disadvantage to the selected sampling procedure
· Explain how participants’ rights will be protected including
confidentiality, anonymity, protection from harm, and informed
consent
· Provide scholarly reference(s) to support information about
the selected sampling method
4. Proposed Implementation with a change model: In this
section, the student will apply the PDSA Change Model as the
method to implement the proposed EBP practice
solution/change. The required content includes:
· Describe the PDSA Change Model
· Explain why this change model is best suited for
implementation of your evidence-based nursing practice
solution/change
· Apply each step of the PDSA Change Model to implementing
the proposed practice solution/change
· Explain how to overcome one barrier to the use of the EBP
results from this project
· Explain how an environment that supports EBP can be fostered
in your future practice setting
· Include a scholarly reference(s) for the PDSA Change Model
Preparing the Assignment
Criteria for Format and Special Instructions
1. The additional sections to the proposal are not to exceed 15
(fifteen) pages. Be sure that all literature review articles are on
your reference page. Points will be lost for not meeting these
length requirements.
2. Title page, running head, body of paper, headings, and
reference page(s) must follow APA guidelines as found in the
6th edition of the manual.

3. Required textbook for this course, dictionary and
Chamberlain College of Nursing lesson information may NOT
be used as scholarly references for this assignment. For
additional assistance regarding scholarly nursing references,
please see “What is a scholarly source” located in the Course
Resources tab. Be aware that information from .com, .edu, and
library websites may be incorrect and should be avoided.
Please contact your faculty member for guidance concerning the
acceptability of a website as a scholarly source. References are
current - within a 5-year time frame unless a valid rationale is
provided and the instructor has approved the use of the older
reference.
4. This assignment is the required submission to Turn It In™
(TII) for NR 505. To prepare for the final submission, students
are encouraged to submit their assignments early. A similarity
score of 24% or less is required for the final submission. Any
other level of similarity index requires the student to revise the
assignment before the due date and time. To allow sufficient
time for revision, early submission of the assignment to
TurnItIn™ is highly encouraged. The final submission will be
graded by faculty. If the final TurnItIn™ report indicates that
plagiarism has occurred, the Academic Integrity policy will be
followed. Similarity scores of 25% or higher result in the
implementation of the Academic Integrity Policy located in the
Chamberlain College of Nursing Student Handbook.
Directions and Assignment Criteria
Assignment Criteria
Points
%
Description

75
30
The required content is:
· Restate PICOT/PICo Question
· A minimum of 10 (ten) research-based references are required.
· The use of a systematic research review article is not allowed.
· All research studies are to be consistent with the selected
concern and PICOT/PICo question.
· For each research-based reference the following information is
to be discussed:
Research Approach
40
16
· Identify if the research approach is quantitative or qualitative
· Identification of selected quantitative research design
(experimental, quasi-experimental, or descriptive )
· Identification of the selected qualitative design
(phenomenological, ethnography, grounded theory, historical)
· Identify a rationale for the selected design
· Identification of one advantage to the selected design
· Identification of one disadvantage to the selected design
· Use scholarly reference(s) to support information about
research approach/design
Sampling
40
16
· Describe the target population for your project

nonprobability
including:
· Sample size
consent
sampling method
Proposed Implementation with a Change Model
35
14
solution/change
Paper Specifications
10
4
The additional sections do not exceed 15 (fifteen) pages
Scholarly nursing references related to the content are presented
A dictionary, required textbook for this course and Chamberlain
College of Nursing lesson information, may NOT be used as

scholarly references for this assignment.
References are current - within a 5-year time frame unless a
valid rationale is provided and the instructor has approved
them.
APA Format (6th edition)
25
1
Title page, body of paper, and reference page must follow APA
guidelines as found in the 6th edition of the manual.
One deduction for each type of APA style error
Citations in Text
10
4
Ideas and information that come from readings must be cited
and referenced correctly.
Writing Mechanics
15
6
Rules of grammar, spelling, word usage, and punctuation are
followed and consistent with formal written work as found in
the 6th edition of the APA manual.
Total
250
100 %
Chamberlain College of Nursing NR505 Advanced
Research Methods: Evidenced Based Practice
Chamberlain College of Nursing NR505 Advanced
Research Methods: Evidenced Based Practice
NR505_W4_Assignment_Refinement for Nursing Concern
Research_V1
W5 Assignment Research
Lit Design Sampling Implementation Rev. 07/27/2017

(AR) Rev. 1/10/18 (AR)
4
Grading Rubric
Assignment Criteria
Exceptional
100%
Outstanding or highest level of performance
Exceeds
88%
Very good or high level of performance
Meets
80%
Competent or satisfactory level of performance
Needs Improvement
38%
Poor or failing level of performance
Developing
0%
Unsatisfactory level of performance
Content Possible Points = 200 Points
75 Points
66 Points
60 Points
29 Points
0 Points
Presentation of information was exceptional and included all of
the following elements:
· Restate the PICOT/PICo question

to be discussed:
Presentation of information was good, but was superficial in
places and included all of the following elements:
to be discussed:
Presentation of information was minimally demonstrated in the
all of the following elements:
to be discussed:

Presentation of
information in ONE or TWO of the following elements fails to
meet expectations:
to be discussed:
Presentation of information unsatisfactory in THREE or more
of the following elements:
to be discussed:

Research Approach and Design
40 Points
35 Points
32 Points
15 Points
0 Points
· Identification if the research approach as quantitative or
qualitative
(experimental, quasi-experimental, or descriptive)
qualitative

qualitative
Presentation of information in one, two or three of the
following elements fails to meet expectations:
qualitative

Presentation of information unsatisfactory in four or more of
qualitative
Sample
40 Points
35 Points
32 Points
15 Points
0 Points
nonprobability
including:
· Sample size

consent
sampling method
nonprobability
including:
· Sample size
consent
sampling method
nonprobability
including:
· Sample size

consent
sampling method
Presentation of
information in one,two or three of the following elements fails
to meet expectations:
nonprobability
including:
· Sample size
consent
sampling method
Presentation of information is unsatisfactory in four or more of
nonprobability
including:
· Sample size

consent
sampling method
35 Points
31 Points
28 Points
13 Points
0 Points
solution/change
solution/change

solution/change
Presentation of information in one or two of the following
elements fails to meet expectations:
solution/change
Include a scholarly reference(s) for the PDSA Change Model
Presentation of information is unsatisfactory in threeor more of
solution/change

Paper Specification
10 Points
9 Points
8 Points
4 Points
0 Points
This section included all of the following:
· The added sections do not exceed 15 (fifteen) pages
· Scholarly nursing references related to this content are
presented
· A dictionary, required textbook for this course and
Chamberlain College of Nursing lesson information, were NOT
used as scholarly references.
· References are current – within a 5-year time frame unless a
valid rationale was provided and the instructor approved them.
This section included three of the following:
presented
This section included only two of the following:

presented
This section included only one of the following:
presented
This section included none of the following:
presented
Total Content Points __________out of 200
Format
Possible Points = 50 Points
APA Style
25 Points
22 Points
20 Points
10 Points
0 Points

APA guidelines, as per the 6th edition of the manual, are
demonstrated for the
· title page,
· body of paper (including margins, headings, font etc), and
· reference page
One deduction for each type of APA format error
0 to 1 APA error are present
· title page,
· reference page
2 - 3 APA errors are present
· title page,
· reference page
4 – 5 APA are present
· title page,
· body of paper (including margins headings, font etc), and
· reference page
6 – 7 APA are present
· title page,

· body of paper (including margins headings, font etc), and
· reference page
8 or greater APA errors are present
Citations
10 Points
9 Points
8 Points
4 Points
0 Points
There were 0-1 errors in the crediting of ideas, and information
that contributed to knowledge, and APA formatting.
that contributed to knowledge and APA formatting.
There were 8 or greater errors in the crediting of ideas, and
information that contributed to knowledge and APA formatting.
Writing Mechanics
15 Points
13 Points
12 Points
6 Points
0 Points
1–2 errors or exceptions to the rules of grammar, spelling, word
usage, punctuation and other aspects of formal written work as
found in the 6th edition of the APA manual

3 – 4 errors or exceptions to the rules of grammar, spelling,
word usage, punctuation and other aspects of formal written
work as found in the 6th edition of the APA manual
9 or greater errors or exceptions to the rules of grammar,
spelling, word usage, punctuation and other aspects of formal
written work as found in the 6th edition of the APA manual
Total Points
_____of 250 points
In this section, comprehensive research literature support for
the identified nursing concern and PCIOT/PICo question is to
be provided. A minimum of ten (10) research-based references
are required. The use of a systematic research review article as
a reference is NOT allowed. For each research-based reference
the following information is to be discussed:
-Purpose of the research study
-Research approach that was used
-Data collection methods used
-Results of the research study
-One strength of the research study
-One limitation of the research study.
Research Approach and Design:

research approach EBP project either quantitative or
qualitative.
If the selected approach is quantitative, need to identify if the
design is experimental, quasi-experimental, or descriptive.
If the selected approach is qualitative, need to identify if the
design is phenomenological, ethnography, grounded theory, or
historical. A description of the selected design is to be provided
as well as rationale for its selection. In addition one advantage
and one disadvantage to the selected design is to be identified
and discussed. Required content includes:
-Identification of the research approach that the student plans
on using as either quantitative or qualitative
-Identification of selected quantitative research design by
indicating if the design is experimental, quasi-experimental, or
descriptive
-Identification of the selected qualitative design by indicating if
the design is phenomenological, ethnography, grounded theory,
or historical
-Description of the selected design
-Rationale for the selected design
-Identification of one advantage of the selected design
-Identification of one disadvantage of the selected design
-Provide scholarly reference(s) to support information about the
selected research approach/design
Sampling
identify the sampling method to be used in order to obtain the
necessary participants for the proposed EBP project. Discussion
of participants' rights as research subjects is also included.
Required content includes:
-Describe the target population
-Identify the sampling method as being either probability or
nonprobability
-Provide a complete description of the proposed sampling
procedure including:
Sample size
Inclusion criteria

Exclusion criteria
-Identify one advantage to the selected sampling procedure
-Identify one disadvantage to the selected sampling procedure
-Explain how participants' rights will be protected including
consent
-Provide scholarly reference(s) to support information about the
selected sampling method
In this section, the student will apply the PDSA Change Model
as the method to implement the proposed EBP practice
solution/change. The required content includes:
-Describe the PDSA Change Model
-Explain why this change model is best suited for
solution/change
-Apply each step of the PDSA Change Model to implementing
-Explain how to overcome one barrier to the use of the EBP
-Explain how an environment that supports EBP can be fostered
-Include a scholarly reference(s) for the PDSA Change Model

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