NURS 6052 EVIDENCE-BASED PROJECT, PART 4: RECOMMENDING AN EVIDENCE-BASED PRACTICE CHANGE

Introduction

This presentation will describe my healthcare organization, including the organizational culture and readiness for change. I will also identify an opportunity for change in the organization and discuss the circumstances surrounding the need for change and the scope of the issue. Besides, I will propose an evidence-based intervention to promote a change in practice that will help address the opportunity for change. In addition, I will describe the plan for knowledge transfer of the proposed change and dissemination strategies for the project’s results. Lastly, I will discuss the lessons learned from the appraisal of the peer-reviewed articles in the previous assignment.

Healthcare Organization and Culture

Our healthcare organization is an outpatient psychiatric facility. It offers extensive mental health and psychiatric services in child, adolescent, and adult behavioral health. Services offered include treatment and psychotherapy for psychiatric disorders, substance abuse disorders, addiction, sexuality issues, life transitions, and family issues.

The organization has a clan culture characterized by collaborative teamwork, and all employees feel like equals. Since there are few employees (10 medical and 7 non-medical staff), the organization is non-hierarchical. There is a strong focus on mentorship, and employees are encouraged to give honest and open feedback.

The organization has a high level of readiness to change. Employees have a high individual and shared commitment to implement changes in the organization and ensure change is effective. In addition, employees have a strong belief in their shared ability to execute change.

Current Opportunity for Change

Healthcare providers attend to numerous patients with Alzheimer’s disease (AD). The AD patients usually present with cognitive decline caused by the disease process as demonstrated by increasing memory loss, shortened attention span, difficulty with language, difficulty organizing thoughts and thinking logically, inability to learn new things, poor judgment, and impaired reasoning ability (Bradfield & Ames, 2020). Although patients are prescribed medications to slow the progression of the disease, the medications do not reverse the cognitive decline. Improving AD patients’ cognitive functioning is an opportunity for change. We need to identify new evidence-based approaches to improve cognitive function in AD patients, particularly in the early stages of the disease. This would help lower the disease morbidity caused by cognitive decline and improve their quality of life.

Stakeholders involved include patients, who are the most affected by the cognitive decline, and the mental healthcare providers responsible for providing the best available interventions in helping patients live a near to normal life. No potential risks will be associated with change interventions in the organization.

EBP Best Practice Recommendation

Cognitive training is my recommended EBP best practice approach to address the cognitive decline in AD patients. Bahar‐Fuchs et al. (2019) define cognitive training as a non-pharmacological treatment approach that centers on guided practice on tasks targeting specific cognitive functions, such as attention, memory, and problem-solving. It entails guided cognitive exercises to improve various cognitive functions and improve performance in untrained cognitive tasks.

Various studies have established that cognitive training improves working memory, global cognition, learning, attention, and memory. It also improves psychosocial functioning, depressive symptoms, and visuospatial skills (Kallio et al., 2017).

Butler et al. (2018) showed that cognitive training enhanced cognitive performance in healthy older adults. Thus, it should be included in the preventative care of elderly persons to lower their risk of declined cognitive function.