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Introduction
The issue to be addressed in the paper is how post-operative education provided by a pre-recorded DVD compares with the traditional teaching of lecture and book for survival rates in the first year in the adult lung transplant recipients. The problem is that the number of complications resulting from the lack of knowledge after lung transplantation is high, which means that efficient ways to educate patients about behaviors that can improve their results must be found. Potential solutions to the problem include the usage of traditional lectures or DVDs as more innovative tools giving better results. The nursing plan would include uniting all methods making emphasis on the latter.
Change Model Overview
Before passing on to the development of an intervention plan, it is highly important to choose the most efficient framework that would allow bringing together all theoretical information and structure it. This is required for further investigation since it will be necessary to integrate new data into the existing corpus of knowledge, which is difficult if it is not systematized. The ACE Star Model of EBP was chosen due to the fact that it ensures that knowledge will be successfully translated into practice while accompanying challenges will be overcome. The model encompasses fives stages, which are (Schaffer, Sandau, & Diedrick, 2013):
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doing research;
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summarizing evidence obtained;
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translating knowledge to guidelines;
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implementing theory in practice;
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evaluating the outcome.
The popularity of the given model with nurses can be explained by the fact that it provides comprehensible guidelines on how to achieve evidence-based practice performing a sequence of clearly defined steps. This significantly facilitates the procedure and saves time.
Define the Scope of the EBP
The scope of the problem is to determine the best way to increase survival rates among lung-transplant patients during the first year and compare the efficiency of traditional lectures along with pre-recorded DVD in providing post-operative education. The statistics are currently worrying: According to a recent study, survival rates in lung transplant patient are 43.4% (for the first year) and 40.1% (for the second), while the longest recorded period is 1,083 days after the operation (Singer et al., 2014). This problem affects health care on a broader scale since such low rates undermine the reputation of transplant surgery, making a lot of patients refuse it (Yusen et al., 2013).
Stakeholders
The team will consist of:
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charge nurses;
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physicians;
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nurse educators or an education officer;
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risk manager;
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nursing assistance;
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family members.
Determine Responsibility of Team Members
The responsibilities are going to be divided as follows:
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charge nurses: providing quality patient care, controlling the patients postoperative state, admissions, discharges, and readmissions;
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physicians: evaluating possible interventions, providing practical recommendations on improving the patients condition;
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nurse educator or an education officer: developing educational programs for nurses, updating current programs, integrating new staff members into the process, teaching nurses how to instruct patients on the use of innovative methods in post-operative education;
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risk manager: identifying and eliminating risks connected with patient safety during the rehabilitation period;
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nursing assistance: helping nurses in the provision of daily care;
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family members: ensuring support to patients and helping them with post-operative education.
Evidence
Besides the evidence that will be summed up below, the given study also largely relies on EBP guidelines since they allow providing a comprehensible and exhaustive description of the indicated problem, explaining reasons for change (in the form of educational methods), performing a profound root-cause analysis, and identifying both intrinsic and extrinsic factors as well as obstacles that may hinder the introduction of the change. Therefore, the major strength of the research is its evidence-based nature that ensures the reliability of the data. Furthermore, the study is practice-oriented and will allow preventing life losses in lung transplant recipients.
Summarize the Evidence
Those researchers who address the issue under discussion try to compare the efficiency of different educational methods, delve into the peculiarities of lung transplantation and assess the quality of life of patients who experienced the given procedure. The major objectives are: 1) to determine the most efficient way of educating patients belonging to this category; 2) is to create ideal recommendations resting on patients responses related to the recovery process and possible misunderstandings that might occur when using one or another educational tool to acquire an important information about the recovery process.
The authors suggest that using patients feedbacks and problems they might face when analyzing the information about lung transplantation an educator could create an efficient program that will improve the outcomes significantly and help to avoid fatal complications. Moreover, they also suggest the usage of innovative and interactive methods to improve the efficiency of the process, which is the intervention that is going to be used within the framework of this research (Davis et al., 2014).
Develop Recommendations for Change Based on Evidence
Comparing the usage of DVD and traditional lectures, the former is recommended as it is possible to outline the increased efficiency of the more innovative tool, which contributes to the better understanding of the main information and improved results among patients who have experienced lung transplantation.
Translation
Action Plan
The action plan will include the following steps:
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create an intervention team consisting of the enumerated stakeholders;
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coach the team on post-operative education of lung transplant recepients;
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perform the assessment of the effect of the traditional education;
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introduce DVDs as an innovative educational tool;
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provide ongoing monitoring of the process of education;
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perform regular evaluations of the change resulting from the implementation of the new method and document the results.
It is now difficult to set the timeline; however, the main part of the project is to be completed in a 3-month period. Evaluation of the effect will be performed regularly and the ultimate impact will be estimated in app. 6 months.
Process, Outcomes Evaluation and Reporting
The desired outcome is to increase survival rates among lung-transplant patients during the first year and compare the efficiency of traditional lectures along with pre-recorded DVD in providing post-operative education. The results will be measured by assessment of the patients condition according to physical examination as well as by questionnaires. They will be reported to stakeholders in person at regular meetings of the team.
Identify Next Steps
On a larger scale, the plan can be implemented in the facility as a whole, as post-operative education can be based on DVDs regardless of the department if it proves to be successful. In order to ensure that the implementation becomes permanent, it is possible to set this method as a standard.
Disseminate Findings
Findings can be disseminated at an open conference for the hospital personnel to inform representatives of other departments. For outer dissemination, the findings will be placed on the Internet medical sites.
Conclusion
The problem of the research is that the lack of knowledge after lung transplantation results in high mortality rates. Potential solutions to the problem include the usage of traditional lectures or DVDs as more innovative tools giving better results. The comparative analysis of the two methods will rely on the ACE star model, which includes: 1) doing research; 2) summarizing evidence obtained; 3) translating knowledge to guidelines; 4) implementing theory in practice; 5) evaluating the outcome.
References
Davis, L., Ryszkiewicz, E., Schenk, E., Peipert, J., LaSee, C., Miller, C.,& Waterman, A. (2014). Lung transplant or bust: Patients recommendations for ideal lung transplant education. Progress in Transplantation, 24(2), 132-141.
Schaffer, M. A., Sandau, K. E., & Diedrick, L. (2013). Evidencebased practice models for organizational change: Overview and practical applications. Journal of Advanced Nursing, 69(5), 1197-1209.
Singer, J. P., Blanc, P. D., Dean, Y. M., Hays, S., Leard, L., Kukreja, J.,& Katz, P. P. (2014). Development and validation of a lung transplant-specific disability questionnaire. Thorax, 69(5), 445-450.
Yusen, R. D., Christie, J. D., Edwards, L. B., Kucheryavaya, A. Y., Benden, C., Dipchand, A. I.,& Stehlik, J. (2013). The registry of the International Society for Heart and Lung Transplantation: Thirtieth adult lung and heart-lung transplant report2013; focus theme: Age. Heart Lung Transplant, 32(10), 965-978.
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