Develop a presentation no longer than 10-12 minutes with comprehensive speaker's notes that covers all of the major areas of your proposal. You will need to post your Evidence-Based Practice Presentation to the main forum in Topic 8 as directed by the instructor for class discussion and peer feedback. While APA format is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. Organizational Culture and Readiness Assessment The purpose of the assessment is to evaluate the strengths and weakness, in the readiness of evidence-based practice (EBP) innovation, practice change and the capacity to facilitate EBP changes in the Cuyahoga County Correctional Center (CCCC). The Organization Culture and Readiness Assessment (OCRA), will measure questions about EBP focusing on the culture and its readiness for application (Melnyk & Fineout-Overholt, 2015, p. 569). The use of the assessment scale will view what support is needed to assist in the changing attitudes, behaviors, skills and the thought processes of individuals who are responsible for caring for patient/inmates (Helfrich, Li, Sharp, & Sales, 2009). Based on the OCRA the CCCC is getting ready for EBP organizational change in some areas, but the scores of the assessment questions both can hinder and support efforts for implementation. For example, scores were noted for the nursing administrators, providers and the healthcare staff focus themselves on committing to EBP. However, mentorship from Advanced Practiced Nurses scored lower due to those currently employed and possible time constraints. However, the security rating was much lower with obligating themselves to EBP in healthcare, they are more focused on the safety of the environment but rank high on the shared responsibility of the outcome of the care, possibly due to the entire system is employed under the sheriff’s department. Another area that had interesting sores were the overall workshops, technology for implementing communication and collaboration to support EBP. The scores were higher in the EMR for medical staff interoperability for healthcare shared medical records with the county hospital. However, the ratings were much lower in the internal connection of innovation that promotes EBP between medical providers and security. Another attractive area was the extent of decision generation in this type of environment suggesting there is a lack of administration healthcare leadership in implementing EBP, which leads to decisions generated from the administration who has little to no knowledge of scientific understanding or skill that encourage EBP. The overall rating for .

1. Develop a presentation no longer than 10-12 minutes with
comprehensive speaker's notes that covers all of the major areas
of your proposal.
You will need to post your Evidence-Based Practice
Presentation to the main forum in Topic 8 as directed by the
instructor for class discussion and peer feedback.
While APA format is not required for the body of this
assignment, solid academic writing is expected, and in-text
citations and references should be presented using APA
documentation guidelines, which can be found in the APA Style
Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to
beginning the assignment to become familiar with the
expectations for successful completion.
Organizational Culture and Readiness Assessment
The purpose of the assessment is to evaluate the strengths and
weakness, in the readiness of evidence-based practice (EBP)
innovation, practice change and the capacity to facilitate EBP
changes in the Cuyahoga County Correctional Center (CCCC).
The Organization Culture and Readiness Assessment (OCRA),
will measure questions about EBP focusing on the culture and
its readiness for application (Melnyk & Fineout-Overholt, 2015,
p. 569). The use of the assessment scale will view what support
is needed to assist in the changing attitudes, behaviors, skills
and the thought processes of individuals who are responsible for
caring for patient/inmates (Helfrich, Li, Sharp, & Sales, 2009).
Based on the OCRA the CCCC is getting ready for EBP
organizational change in some areas, but the scores of the
assessment questions both can hinder and support efforts for
implementation. For example, scores were noted for the nursing
administrators, providers and the healthcare staff focus

2. themselves on committing to EBP. However, mentorship from
Advanced Practiced Nurses scored lower due to those currently
employed and possible time constraints. However, the security
rating was much lower with obligating themselves to EBP in
healthcare, they are more focused on the safety of the
environment but rank high on the shared responsibility of the
outcome of the care, possibly due to the entire system is
employed under the sheriff’s department.
Another area that had interesting sores were the overall
workshops, technology for implementing communication and
collaboration to support EBP. The scores were higher in the
EMR for medical staff interoperability for healthcare shared
medical records with the county hospital. However, the ratings
were much lower in the internal connection of innovation that
promotes EBP between medical providers and security. Another
attractive area was the extent of decision generation in this type
of environment suggesting there is a lack of administration
healthcare leadership in implementing EBP, which leads to
decisions generated from the administration who has little to no
knowledge of scientific understanding or skill that encourage
EBP. The overall rating for the CCCC is a two, which indicate
that the CCCC is getting ready for EBP implementation
(Melnyk & Fineout-Overholt, 2015, p. 569).
There are challenges and barriers to implementing EBP in the
correctional healthcare setting and can be a slower process due
to lack of time in research understanding, insufficient time
available, inadequate access to internal interoperability,
personal characteristics, lack of medical libraries and
organizational and cultural barriers. However, it is imperative
that in this different environment that manages the safe care of
patient/inmate must understand the initiative to implementing
EBP must be a strategic interconnection system that promotes
appropriate practices that support common challenges of safety
for those in the custody of the CCCC.
Evidence-Based Practice Proposal
In a complex healthcare environment, such as the Cuyahoga

3. County Correctional Center (CCCC) can be difficult to assess
the patients’ medical needs and implement treatment timely.
The initial time of treatment is critical and can affect healthcare
outcomes. The process in which care is delivered can have a
trickle-down effect on patient health, their families, medical
staff, medical escorts, the institution, and taxpayers. Chronic
issues can become acute concerns, which need to be evaluated
urgently, if not, patient health is jeopardized, and the quality of
health continues to diminish.
Diminished health leads to medical emergencies and an
ambulance trip to the hospital, causing decrease medical
security due to the need for a security medical escort
detainment to secure the patient at the hospital. Families are
affected by this problem which can cause stress that negatively
affects the body which can also cause acute medical concerns.
The medical staff is affected because now they have to respond
to a medical emergency that could have been prevented if
treatment delivery time was implemented sooner. The
institution is affected by increasing expenses for external
hospital travel by ambulance cost, facility operational costs, and
possible litigation disputes that are usually settled out of court
with monetary from the taxpayers.
The CCCC was built to house 1,749 inmates but often
accommodate over 50% over capacity, leaving inmates to be
placed on mats on the floors in the pods. The increased
population has led to more significant health concerns which
include increasing mental health problems. The complexity of
healthcare services is expanding in the CCCC, which is the
second largest jail in the state of Ohio. The CCCC manage over
26, 000 inmates per year, which house various level of security
that includes maximum security to minimum security such as
those who are weekenders (Cuyahoga County Sheriff, n.d.).
Security has increased obligations to maintain order and control
while the healthcare staff must face frequent medical
emergencies due to the delay in care. Delivering quality
healthcare services that include evidence-based practices, in an

4. environment that require continuous security restrictions for
safety and correctional action protocols, can be challenging. As
the focus of healthcare changes from individual hospitals to
healthcare systems, system integration and standardization in
practices, it is also essential for the nursing profession to adjust
(Warren et al., 2016). Conforming to a standard that promotes
EBP is also imperative in this correctional environment, which
can consist of innovation. For example, telemedicine, EMR, and
security cameras for all medical officers to capture activity and
recording of all inmates’ behavior.
In the process of retrieval of the patient/inmate, the pod officer
calls the dispensary to report a patient medical concern or
condition. After, the medical staff views the inmate’s medical
records, and if deemed necessary for further assessment, the
health provider writes out a ticket and give the ticket to the
medical escort so they can pick up the patient and escort the
patient to the dispensary. The card that is placed on the desk has
the patient/inmate health concern, which is often evaluated by
security staff. The medical security escorts who must retrieve
the patient/inmate with deteriorating health often there are
delays due to inadequate staffing, communication in the urgency
of the patient/inmate, judgments in healthcare status by medical
correctional officers and separation of inmates that requires
extra security for evaluation. However, time management is
vital in retrieving inmate/patients with particular kind of health
problems to accomplish the best health results and technology
that incorporates coordination of care is paramount to enhance
safe practices (Kleib, Simpson, & Rhodes, 2016).
To improve the quality care for all patient medical concerns.
The clinical care barriers to implementing care must be
demolished to create a more effective healthcare delivery
system. The actions of a team impact healing of patients and
therefore the need for different professions to honor what each
profession or service brings to the collective process of
healthcare delivery is vital (Treadwell, Binder, & Giardino,
2014). It is important to utilize the development of the PICOT

5. format to produce a question for this vulnerable population to
help guide the best evidence in care (Melnyk & Fineout-
Overholt, 2015, P. 25). For example, the (P) Cuyahoga County
Correctional Center healthcare system, (I) Correctional staff
and healthcare through process in safety standards of care, (C)
compared to coordination/ collaboration healthcare system
timely patent retrieval for health evaluation and stabilization,
(O) decrease the risk of medical emergencies, litigation, family
stress and death, and (T) while in the custody of CCCC.
Security in this healthcare environment takes precedence over
quality care delivery by the healthcare staff in the effort to
provide safety. The different points of view of priorities of
safety and bias judgments can contaminate the process of timely
exceptional care which can prolong care that exacerbates the
health of the patient/inmate. For example, in the CCCC the
primary issues that are brought to the dispensary consist of
chest pain, difficulty breathing, allergic reactions, decrease
blood glucose and mental health issues. The leading cause of
deaths of in the United States is heart disease, chronic
respiratory disease, diabetes and suicide listed as the top 10 out
of 100,000 per population according to the Health, United
States, 2015 report (Center for Disease Control and Prevention,
2016). To meet the healthcare needs of this complex population,
how patients are retrieved must be modified to promote
collaboration in the way all stakeholders view acute patient
healthcare assessments.
Communication and collaboration that promotes professional,
secure safe, timely quality care are vital when initiating
evidence-based practices. It fosters workshop that incorporates
learning of all disciplinary teams to create a healthy work
environment to establish the best practices possible when
retrieving patients/inmates for their health concerns.
Communication and collaboration combine a joint safety team
of awareness of self-deception, reflection, mindfulness,
authenticity, and truthfulness (Kupperschmidt, Klentz, Ward, &
Reinholz, 2010) to promote safe environments and safe health

6. stability in patients/inmates.
Literature Support
The retrieval of patient/inmates in the Cuyahoga County
Correctional Center (CCCC) must be done through a
collaborative effort, which includes the medical staff and the
correctional security staff. A concerted and coordinated effort
will minimize potential health crisis and lower taxpayer cost. It
is implemented evidence-based practice (EBP) in the CCCC that
will link strategies and decrease barriers in the CCCC
environment, which is the second largest jail in Ohio and
manage a population of over 26,000 inmates and the population
continues to increase. The full services provided by the CCCC
which includes medical, mental health, social services, and
pharmacy must work as one team that support professional
quality services that enhance the lives of many while in the
custody of CCCC. EBP is about finding evidence and linking it
to clinical decisions and practice changes that support timely
quality care.
Center for Disease Control and Prevention
This official database, which is listed under Health and Human
Services, serves as a national agency that helps to improve the
overall health of the public. Based on the Center for Disease
Control and Prevention (CDC) website they focus on identifying
health problems, and actively investigate diseases through
epidemiologic and laboratory studies and data collection,
analysis, and circulation by working with partners at the local,
state and national level to improve health policies. The CDC
website also noted being responsible for overseeing
environmental health concerns, conducting research for disease
prevention, conducting research and training programs for
occupational safety to ensure safe and healthy working
condition in the effort to prevent and control diseases (Center
for Disease Control and Prevention, 2017).
The CDC mission will help support the capstone project by
bringing awareness to various chronic illness that has led to
death in the United States, which are often seen in many

7. patients/inmates at the CCCC. The information will help with
my capstone project.
The terms used to retrieve this information was CDC Mission
Statement. The electronic data based used Google
Cuyahoga County Sheriff
The Cuyahoga County Sheriff Department (CCSD), developed a
website, which speak of being able to provide superior care and
manage over thousands of inmates annually. Also, the CCSD
has two locations available for services that included a Euclid
jail site and Cleveland jail site. The CCSD Cleveland location
consists of two large jails that are combined which is their
largest location; Jail I and Jail II structured area is over one
million square feet. The CCSD official site has clearly noted in
large letters listed under the Cuyahoga County Sheriff logo.
“Together we thrive” (Cuyahoga County Sherriff, n.d.). This
newsletter written by the CCSD will support a joint
collaborative effort to accommodate the many patients/inmates,
who reside at the CCCC, to support health services during their
length of stay at the CCCC, which will support the capstone
project.
The terms used to retrieve this information was Cuyahoga
County Sheriff’s Department corrections (609,000). The
electronic data based used Google
Online Journal of Issues in Nursing
Authors, Manal Kleib, the founder of the Nursing Informatics
Association of Alberta, Nicole Simpson, holds the background
in clinical practice, research and education, and Beverly
Rhodes, program director and president of Nursing Informatics
Association of Alberta, (2016). These authors wrote the
scholarly article, “Information and Communication Technology:
Design, Delivery, and Outcomes from a Nursing Informatics
Boot Camp,” a level IV peer viewed article. Based on their
research they suggest information technology (IT) and
educational classes (EC) can improve the outcome of patients
and organizations with the use of IT and EC. The authors also
believe that IT and EC can produce opportunities for

8. improvements in practice and can influence the quality and
safety of patient care. While this study only implemented views
of the nursing profession, it recognizes the variations of
utilizing IT along with EC to the differences in practice. The
authors of this article believe IT and EC will promote the
efforts in developing competencies to enable a comprehensive
understanding of collaborative preparation with the use of IT to
form quality, and safety policies practice in the environmental
development in the effectiveness of care (Kleib, Simpson, &
Rhodes, 2016). This article will help stimulate collaborative
training with the use of IT and EC, which will support change
and the capstone project.
In the electronic search for this article the terms used was
nursing information and communication information technology
excluding jail including or prison and health disparities (242).
Database search was CINAHL and GCU Library Resources.
Online Journal of Issue in Nursing
Betty Kupperschmidt, a nursing Associate Profession teaching
at the University of Oklahoma focuses on educating
administration and clinical theory. Emma Kientz, a nurse
master, and a creator of healthy work environments for student
and faculty at the University of Oklahoma. Jackye Ward, Vice-
President of Patient Care Services and Chief Nursing Officer at
the Valley View Regional Hospital, an acute care hospital that
holds 168 beds, located in Oklahoma, and Becky Reinholz, an
ICU nurse and the creator of an agency-wide Change Nurse
Development Program, (2010). Based on their research, healthy
work environments are beneficial for providers, recruitment,
retention, and quality and safety of patient care. These authors
also noted healthy environments correlated with employee
engagement that includes management trust, employees who are
respectful and administrative support that encourages
communication and collaboration skills to produce a physically
safe environment. This peer review article focuses on nursing
communication skills that have no bearing on security
communication tactics of enforcement to ensure a safe

9. environment. However, the authors use a Parse’s nursing theory
to promote their research, which emphasize on positive
collaborative interaction to improve the quality of the work
environment. The article promotes an individual responsibility
as professionals to become skilled communicators to promote
relationships of respect with all member of the team
(Kupperschmidt, Klentz, Ward, & Reinholz, 2010). This article
will help with team building and environmental change, which
will be an asset to all employees working at the CCCC and it
will help with the capstone project.
In the electronic search for this article, the terms used health
work environment, professional communication, and skilled
communicator (22). Database search was CINAHL and GCU
Library Resources.
American Association of Managed Care Nursing
Janet Treadmill has her doctorate in nursing who is also, a
Director of Providers and Care Coordination for Texas
Children’s Health Plans and focus on preventive population
health management. Brenda Binder who has her doctorate in
nursing is the Director of Graduate Nursing, as well as Interim
Associate Dean at Texas Woman's University who is also an
Associate Professor. Angelo Giardino, a Professor of Pediatrics
and Section Chief of Academic General Pediatrics at Baylor
College of Medicine who focuses on enhancing complex care
clinic and primary care practices is a board member for various
regional and national boards. These three authors wrote an
article on “An Integrative Review of Interprofessional
Collaboration”. The authors of this article focus on clinical
practice sites that are team based. These professional authors
believe there can be an interprofessional collaboration that
thrives from the professional experience of education to achieve
interdependency that promotes the wonders of interprofessional
collaboration. The authors used Dr. Jean Watson, a nursing
theorist who developed the theory of Human Caring which was
noted for promoting caring environments to offer the potential
for self and group development that support and cultivate

10. quality health. Although this article focuses on the profession of
nursing it incorporates the act of enhancing groups and
environments through professional collaboration at all levels,
which will help support the capstone project (Treadwell,
Binder, & Giardino, 2014).
The electronic search keywords used for this article were
interprofessional communication, health care, transform
(1,530,000). The Database searches were Google and American
Association of Managed Care Nursing.
Worldviews on Evidence-Based Nursing
Joan Warren, Maureen McLaughlin, Joan Bardsley, Joanne Eich,
Carol Ann Esche, Lola Kropkowski and Stephen Risch are all
healthcare system nursing leaders who collaborated to
implement evidence-based practices (EBP) to support improving
system performance. These authors’ goals are to link evidence
to practice and find ways to overcome barriers that impede
implementation to embrace Magnet principles by creating an
online plan for free EBP education competencies to promote
best-shared practices. Also, the authors aim is to encourage
Magnet conferences to help lead, mentor and educate nurses for
implementing EBP. Although the authors are nursing scholars,
they understand the challenges faced in teaching to bring
positive practice changes with the use of education, and
innovation. This article will help support positive practice
change at the CCCC with the use of educational competencies.
In the electronic search for this article, the terms used for
this article was evidence-based practice, healthcare system
organizational readiness (2,228). The database used was
CINAHL and GCU Library Resources.
In conclusion, the right to health is an essential human right
with does not depend on the legal status of individuals. The
patients/inmates must receive the quality of healthcare at CCCC
that support their right to have medical and mental health
treatment that support failing health. It is vital as professional
participants in healthcare to have the same concern and render
the same care for all life and contribute to serve better the

11. health of those in the custody of CCCC to decrease health
disparities.
Solution
Description
There can be many challenges and barriers when implementing
change. However, building a healthy environment that supports
security safety and safe healthcare practice that ensure timely
retrieval of acute patient/inmate while in the custody of CCCC
must be developed. Standards that require a rethinking of
values, processes and a group effort on collective views of
experiences within each group must be implemented as a
foundation for shared learning and understanding through
interprofessional communication and collaboration will support
safe, and timely quality care.
Proposed