Implementation Plan

Implementation Plan

Consider the population in which the solution is intended, the staff that will participate,
and the key contributors that must provide approval and/or support for your project to be
implemented. These stakeholders are considered your audience.
Develop an implementation plan (1,500 words). The elements that should be included in
your plan are listed below:
Method of obtaining necessary approval(s) and securing support from your organization’s
leadership and fellow staff.
Description of current problem, issue, or deficit requiring a change. Hint: If you are
proposing a change in current policy, process, or procedure(s) when delivering patient
care, describe first the current policy, process, or procedure as a baseline for comparison.
Detailed explanation of proposed solution (new policy, process, procedure, or education to
address the problem/deficit).
Rationale for selecting proposed solution.
Evidence from your review of literature in Topic 2 to support your proposed solution and
reason for change.
Description of implementation logistics (When and how will the change be integrated into
the current organizational structure, culture, and workflow? Who will be responsible for
initiating the change, educating staff, and overseeing the implementation process?)


Resources required for implementation: Staff; Educational Materials (pamphlets,
handouts, posters, and PowerPoint presentations); Assessment Tools (questionnaires,
surveys, pre- and post-tests to assess knowledge of participants at baseline and after
intervention); Technology (technology or software needs); Funds (cost of educating staff,
printing or producing educational materials, gathering and analyzing data before, during,
and following implementation), and staff to initiate, oversee, and evaluate change.

Implementation Plan

1.0 Method of obtaining necessary approval and securing support
In essence, for this project to be succeed, support from the key stakeholders including the
administration, managers and colleagues at Duke Hospital & Health Center is of great
importance. These key stakeholders are important since they have to approve and/or support the
project for it to be executed. Together with children patients suffering from Addison’s disease
and their parents, the physicians, Registered Nurses (RNs), nurse assistants and the management
of the healthcare organization comprise the audiences of this project. Support would be obtained
from these key contributors by making clear to them the basis and justification for the proposed
solution, as well as the reasons why the proposed change is vital and needed in the health care
The hospital’s managers and leadership, as well as physicians, RNs and assistants would
be informed about the value of the change and the way that Duke Hospital & Health Center is
going to benefit in consequence of the change. It is of note that the nursing process used in
diagnosing and treating patients with Addison’s disease at the hospital has to be reviewed as this
will produce results that could be assessed to bring about positive outcomes that will help get rid


of the entire condition. The formation of Evidence-Based Practice (EBP) models will help the
RNs gain a better understanding of Addison’s disease and recognize how to reduce the
continuous stubbornness of the problem (White, 2009). Moreover, engaging the elements of a
comprehensive training of RNs will allow them to have an intensive and extensive approach to
Addison’s disease. This proposed solution will reduce occurrences of death and/or insanity of the
children patients with Addison’s disease since they will be able to contain their stress and
depression. Since deaths of children at the hands of the RNs will reduce, the emotional suffering
of RNs will also reduce. Besides enlightening the management, RNs, physicians and other
healthcare workers of Duke Hospital & Health Center about the potential benefit of the proposed
change, they will also be encouraged to express any of their concerns or worries in relation to the
proposed change, and these would be addressed in a satisfactory, unequivocal and explicit
Essentially, there would be less likelihood of resistance to the proposed solution when all
their concerns regarding the proposed solution are clearly and sufficiently addressed. They are
also likely to approve and support it when they are amply involved and consulted, and when they
are well informed about the justification for the change (Holcomb, 2006). Consulting and
involving all the key stakeholders during the project would actually ensure that they all have the
feeling of involvement and ownership of the project. This is crucial since it will increase the
likelihood of them being receptive to the proposed the change.
2.0 Description of current problem

The current problem entails how children patients with Addison’s disease are treated. In
Addison’s disease, WebMD (2014) stated that the adrenal glands do not produce adequate of


cortisone hormone, or less often, aldosterone hormone; hence, it is at times called
hypocortisolism or chronic adrenal insufficiency. At my health care organization, which is
Duke’s Children Hospital & Health Center, Addison’s disease is one of the very complicated
illnesses that Registered Nurses try to treat. An effective solution needs to be developed that
would assist with suppressing the complications of this disease to children patients at the health
care organization. An Addisonian crisis is one of the most complicated conditions of Addison’s
disease and it usually arises whenever the supply of hormones becomes dangerously low, and it
crops up when the body of the victim in under intense stress (WebMD, 2014). Nearly all of the
strenuous scenarios are experienced after a patient undergoes a surgical operation. Stress impacts
adrenal glands to produce more adrenaline to help patient in coping up, but Addison’s disease
patients cannot effectively cope up with the added stress. The impacts of the problem are diverse
and a patient with this disease can die of heart attack if they are not able to control the stress
(Ross et al., 2014).
As RNs, we often suffer emotionally whenever children affected by Addison’s disease
die under our care when they are not able to cope up with depression. The stubbornness of this
disease questions the quality of care that Registered Nurses deliver to the children patients at
Duke Hospital & Health Center. Some relatives of the patients openly condemn us whenever a
patient experiences occurrences of insanity or even death. It is worth noting that the impact of
the disorder on patient outcomes is diverse given that some patients may either become insane or
die, since some of the children are not able to contain depression. In addition, the condition can
further complicate the body to cause hormonal imbalance that necessitates homeostatic
regulation to bring them to equilibrium (Holcomb, 2006).

3.0 Detailed description of proposed solution


The proposed solution encompasses several methods. One of them is to review the
nursing process being used presently in diagnosing and treating patients with Addison’s disease.
This will be geared to produce results that could be evaluated to bring outcomes that ensure the
entire condition gets eliminated. The proposed solution also requires formation of EBP models
that basically try to figure out the underlying reason for the continuous stubbornness of this
disorder. Moreover, the proposed solution engages the elements of a comprehensive training of
RNs at Duke Hospital & Health Centre to have an extensive and intensive approach to the
problem. Nonetheless, this proposed solution does not omit the traditional models of dealing
with the problem of substituting the hormones that adrenal glands are producing. Even though
Cortisol is replaced orally with hydrocortisone tablets, we as RNs ought to find ways in which it
would be administered through injection in order to enhance faster absorption of the drug into
the blood system.
The rationale for selecting the proposed solution is that it will allow the RNs at Duke
Hospital & Health Center to provide the children patients suffering from Addison’s disease with
the best possible and optimal treatment that will reduce the stubbornness of this disorder and
help the patients control stress. More importantly, the proposed solution will facilitate better
management of the disease and thereby help in reducing the incidences of insanity and death as a
result of Addison’s disease.

4.0 Evidence from literature

Ross et al. (2014) noted that Addison’s disease in known to crop up whenever the adrenal
gland is not able to produce its contents in an effective manner. It is of note that the proposed
solution entails formation of Evidence-Based Practice models aimed at gaining an understanding


of the underlying reason for the continuous stubbornness of Addison’s disease. EBP is
understood as the judicious, explicit, conscientious usage of existing best evidence in making
decisions regarding the care of individual patients (White, 2009). In essence, the practice of
evidence-based medicine implies incorporating individual clinical expertise with the finest
available external clinical evidence from systematic research. White (2009) stated that EBP is a
very helpful approach to enhancing the impact of practice in the management of Addison’s
disease, adding that nurses in the care of Addison’s disease patients should always direct
significant attention to evidence. They should honor the many dissimilar types of evidence.
Those who advocate the use of EBP in the management of Addison’s disease emphasize on the
findings of major experimental comparisons in documenting the effectiveness of treatment
against untreated control groups, against other treatment, or both. They do this given that
properly conceptualized and completed experiments – randomly controlled trials – are great way
of showing that a treatment resulted in a specific alter (Brandão Neto & Carvalho, 2014).
The proposed solution also engages the elements of an all-inclusive training of Registered
Nurses in the health care organization to have both an extensive and intensive approach to the
problem. According to White (2009), nurses should be provided with a comprehensive training
that will allow them to deliver both family-centered and patient-focused treatment of Addison’s
disease. This comprehensive training will ensure that RNs never lose their sight of the fact that
Children with Addison’s disease, are primarily individuals, and not just patients. As such, the
patient’s family has to be included at each stage of the treatment process (WebMD, 2014).

5.0 Implementation logistics


The hospital’s administration would integrate the change into the existing structure,
workflow and culture of the organization using several ways. The first one entails putting in
place principles and standards that would incorporate the change into the existing organizational
culture, workflow and structure. The other way is using enticements such as financial rewards
that are aimed at encouraging RNs and other health care workers to be amenable and open to the
change. Another equally important way is using punitive measures whereby the health care
personnel would be compelled to accept the change, and those who try to resist the change are
actually demoted or sacked. Two influential people, a Charge Nurse and a Nurse Manager would
be responsible for initiating the change process, educating all registered nurses, in addition to
supervising the process of implementation. The Charge Nurse would initiate the change process
and develop a shared vision for Duke Hospital & Health Center, whereas the Nurse Manager will
supervise the process of implementation to make sure that it is conducted effectively.

6.0 Resources required for implementation

Several resources are needed. (i) Human resources – Duke Hospital & Health Center’s
workers such as RNs, nurse assistants and physicians would be included in implementing the
change process. (ii) Tools for assessment would be required comprising questionnaires, surveys,
pretests as well as post-tests. (iii) Educational materials – pamphlets, booklets, posters, and
brochures would be required. Computers would also be utilized to create PowerPoint
presentations. (iv) Funds – the budget for the project is $61,918 bearing in mind both the
project’s scope and size.



7.0 References

Brandão Neto, R., & Carvalho, J. (2014). Diagnosis and classification of Addison’s disease
(autoimmune adrenalitis). Autoimmunity Reviews, 13(4/5), 408-411.

Holcomb, S. S. (2006). Hospital Nursing: Do the Clues Add Up to Addison’s Disease? Nursing,
36(3): 64
Ross, I., Dandara, C., Swart, M., Lacerda, M., Schatz, D., & Blom, D. (2014). 9β Polymorphism
of the Glucocorticoid Receptor Gene Appears to Have Limited Impact in Patients with
Addison’s Disease. Plos ONE, 9(1), 1-6. doi:10.1371/journal.pone.0086350
WebMD. (2014). Understanding Addison’s Disease.
z-guides/understanding-addisons-disease-basics . (Accessed September 27, 2014).
White, A. (2009). Managing Behavioral Emergencies: Striving Toward Evidence-Based
Practice. Journal of Emergency Nursing, 12:13.



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