n the Expenses worksheet, calculate row totals for each Expense item in the range F5:F9. Calculate column totals for each quarter and for the Annual Total in the range B10:F10.
April 24, 2022
Choose an ethical-legal dilemma that would cause the advanced practice nurse moral distress. The dilemma could be one you have faced in your practice.
April 24, 2022


Question description
Topic 1: Evidence-Based Change
Locate an article from a peer-reviewed nursing journal where a practice change was made based on research, preferably a change that could relate to your area of practice or organization. Note: You are seeking to find an evidence-based article that describes some change in practice that was based on research; this is all about applying research, not doing research. Thus, you are not looking for a research article, but you are looking for an article that uses evidence from research to make a change.

Describe the change made and comment on the strength of the research evidence utilized and the whether the change led to improved patient outcomes.
Note any barriers to change that were identified and how they were overcome.
End your discussion with a reflection on how this article is useful to you as you consider your role as an advanced practice nurse leading others to use the best evidence to strengthen nursing practice and improve nursing-sensitive patient outcomes.

Topic 2: Eight Steps for Successful Change: Your Personal Example

Post your personal example about change here for peer and instructor feedback.
Refer to the Practice area in Activities.

Textbook Readings
Evidence-Based Practice in Nursing and Healthcare

Chapter 14: “Creating a Vision and Motivating a Change to Evidence-Based Practice in Individuals, Teams and Organizations”

Journal Readings
Please retrieve and read the following Journal articles. Articles can be located through a search in the CINAHL database, OVID database.
Shekelle, P. G., Woolf, S. H., Eccles, M., & Grimshaw, J. (1999). Clinical guidelines: Developing guidelines. British Medical Journal, 318(7183), 593–596.
Sandstrom, B., Borglin, G., Nilsson, R., & Willlman, A. (2011). Promoting the implementation of evidence-based practice: A literature review focusing on the role of nursing leadership. Worldviews on Evidence-Based Nursing, 8(4), 212–213.
Thompson, G., N., Estabrooks, C. A., & Degner. L .F. (2006). Clarifying the concepts in knowledge transfer: A literature review. Journal of Advanced Nursing, 53(6), 691–701.
Yip, W. K., Mordiffi, S. Z., Shen, L., Ang, E. N., Zhang, X., & Majid,S. (2013). Nurses’ perception towards evidence-based practice: A descriptive study. Singapore Nursing Journal, 40(1), 34–41.
Web Resources
Continuing to educate yourself is important to being an effective change-agent. Revisit the NCQA website and review the Education and Resources for Clinicians.

Review the following website that focuses on nursing-sensitive patient outcomes.


Identify an area of change in your organization where you are currently employed, or were recently employed.
Write a brief summary about how that change is being implemented and any evidence-based practice or quality outcomes that are being measured.
Use table 14.1 Eight Steps for Successful Change, on page 321 in your textbook, to compare how change was implemented within your workplace.
Post the summary for peer and instructor feedback in Discussion Topic 2.


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