PURPOSE:
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 POINTS
REQUIREMENTS
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:
o Sample size
o Inclusion criteria
o 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.

Please see attached files for directions, criteria, and grading rubric.
Also attached files will give an overview of what PICO I have been working to assist in this assignment process.

ANSWER

Research Literature, Design, Sampling, and Implementation

Research Literature Support

The identified PICO question based on week five was:

P: Among health care workers and patients,

I: Does hand washing protocol,

C. Compared to no hand washing protocol,

0: Minimize hospital acquired infections in an adult in-patient critical care department in the course of hospitalization

The systematic review of literature is meant to enable me as a researcher understand factors that other researchers found out as contributing greatly to the hand-washing related infections. Most of the literature obtained was searched from the MEDLINE (PubMed) search library.

The first article to consider is research conducted by Karaoglu and Akin (2018) whose purpose was to look at how training of workers on effective hand washing is effective in avoiding hand washing acquired infections. Researchers used a nonrandomized and quasi experimental design. Observations were made for all the five working days to evaluate how effective the training was on hand washing practices. In the study, 63 nurses working in Istanbul filled Hygiene knowledge score forms just after a hand washing training was conducted and concluded. It was observed that the actions of hand washing significantly improved after training based on the scores collected (Karaoglu & Akin, 2018). This results implies that training on hand washing practices greatly helps improve the knowledge among nurses who eventually embrace hand washing activities. One strength of this research is that it provided very reliable data since it involved a wider sampled group. The limitation was that it narrowed down to one facility which may not be a representative of many other facilities.

The next article is by Gold and Avva (2018). This research was geared to explaining how alcohol sanitizer use among healthcare workers is important in reducing infection of hands among all people. The research was also aimed at understanding the eventual effect in reducing morbidity and mortality. The target population was healthcare providers handling children. The findings showed that children are more vulnerable to infections related to hand washing practices (Gold & Avva, 2018). The strength of this research is that it explains why hand sanitizers needs to be used in hand washing practices. The limitation is it does not consider other hand washing practices yet they are the most used in smaller healthcare facilities.

Hand washing practices among healthcare providers has also been analyzed especially in the effect they have a month children. Diarrhoea among children majorly occurs as a result of unhygienic environments contributed by healthcare workers. The main objective of this research was to assess how hand washing interventions helps reduce incidents among children and even the elderly (Gold & Avva, 2018). In this research, data bases were used to seek for information regarding the subject of research. Some of the data bases used were: Cochrane Infectious Diseases specialized register, the world health organization, the grey literature among others. Some researchers and organizations were contacted as well. Data selection criteria involved randomized control trials as well as cluster randomized control trials which gave a comparison of hand washing with incidents of diarrhea among children. To collect data, three authors were chosen to review the assessed trials and gave data. The results indicated that to a large extent, hospitals are causes of infections especially owing to the unhygienic manner in which attendants serve children with meals without caring about how clean their (workers) hands were. Healthcare workers involve in shaking of hands and extend to serve these children with food which enhances chances of getting infections (Gold & Avva, 2018). This research had an advantage as it combined a lot of literature from the data base and hence the biasness was less. This research however has a limitation since it is based on opinions from reviewers and not on an in depth research individually carried out.

The next article considered is by Fox et al. (2015) whose objective was to examine a new patient hygiene protocol which has been made to help reduce hospital acquired infections as well as help nurses comply with hand washing practices. The sampling entailed use of an experimental study design in comparing two common hospital acquired infection within a twelve-month period. The compliance of nurses on hand washing practices were compared before and after the protocol was employed. The target group was nurses who work with central catheter associated blood stream infections as well as urinary tract infections (Fox et al., 2015). The results obtained showed that there were reductions in the 12-month rates if infection for the two types of infection. The reduction however showed no statistical significance. The mean nurse…