ESSAY: Evidence-Based Practice Proposal – Section E: Implementation Plan

INSTRUCTIONS

In 1,000-1,500 words, provide a description of the methods to be used to implement the proposed solution. Include the following:

Describe the setting and access to potential subjects. If there is a need for a consent or approval form, then one must be created. Although you will not be submitting the consent or approval forms in Topic 5 with the narrative, you will include the consent or approval forms in the appendices for the final paper.

Describe the amount of time needed to complete this project. Create a timeline. Make sure the timeline is general enough that it can be implemented at any date. Although you will not be submitting the timeline in Topic 5 with the narrative, you will include the timeline in the appendices for the final paper.

Describe the resources (human, fiscal, and other) or changes needed in the implementation of the solution. Consider the clinical tools or process changes that would need to take place. Provide a resource list. Although you will not be submitting the resource list in Topic 5 with the narrative, you will include the resource list in the appendices for the final paper.

Describe the methods and instruments, such as a questionnaire, scale, or test to be used for monitoring the implementation of the proposed solution. Develop the instruments. Although you will not be submitting the individual instruments in Topic 5 with the narrative, you will include the instruments in the appendices for the final paper.

Explain the process for delivering the (intervention) solution and indicate if any training will be needed.

Provide an outline of the data collection plan. Describe how data management will be maintained and by whom. Furthermore, provide an explanation of how the data analysis and interpretation process will be conducted. Develop the data collection tools that will be needed. Although you will not be submitting the data collection tools in Topic 5 with the narrative, you will include the data collection tools in the appendices for the final paper.

Describe the strategies to deal with the management of any barriers, facilitators, and challenges.
Establish the feasibility of the implementation plan. Address the costs for personnel, consumable supplies, equipment (if not provided by the institute), computer-related costs (librarian consultation, database access, etc.), and other costs (travel, presentation development). Make sure to provide a brief rationale for each. Develop a budget plan. Although you will not be submitting the budget plan in Topic 5 with the narrative, you will include the budget plan in the appendices for the final paper.

Describe the plans to maintain, extend, revise, and discontinue a proposed solution after implementation.

ANSWER

Setting and access to potential subjects

Outpatient surgery can be tricky especially in ambulatory surgical settings where a patient is to be discharged on the same day. Such settings call for medical procedures that are fast and efficient to avoid subjecting patients to a lot of pain. Malignant Hyperthermia (MH) is a reaction which can develop in the course of a medical procedure using volatile anesthetics and hence it is a medical emergency. Previously, the use of dantrolene has been the source of many cases of morbidity and mortality. Though expensive, Ryanodex is effective in handling MH since it can be reconstituted in less than a minute and also needs less staff (Zavilla et al, 2016).

Potential subjects are people who have malignant Hypothermia. It can be as a result of heat stroke, overdose of some illicit drugs but most commonly it is as a result of use of anesthetic medications in the time of surgery. Since this is an emergency situation and any drug given is for the good of the patient, consent is not compulsory. Ryanodex will be administered in a similar fashion in the way dantrolene was being administered within the ambulatory surgical setting.

Amount of Time Needed to Complete the Project

There are five main processes that have to be followed for complete implementation of the use of ryanodex as compared to dantrolene. The five steps will inform on the timeline for full implementation of the new antidote. The first step is concurrent replacement of all the dantrolene stock from all the MH carts. The second step entails coming up with proper educational materials to help raise awareness of the shift from dantrolene to ryanodex. Educating the anesthesiology providers as well as pharmacy staff will be the third step. The fourth step is revision of the dantrolene lists from the cart to ensure complete removal. Finally, it will be paramount to replace the MH carts with ryanodex.

A gradual switch out could have been the best way to face out dantrolene and use ryanodex but this may pose great challenges with patients who already use dantrolene and hence they need enough time to be educated on the need to embrace ryanodex. However, the best technique to implement the changes was the one-time-switch-out after implementing the five steps described before. The timeline below was thus set based on each and every step that made the switch out a success…