Stakeholder Engagement in EBP: Pneumonia Immunization Project Report

This report details a student's evidence-based practice (EBP) project focused on pneumonia immunization, emphasizing stakeholder engagement. The project identifies key stakeholders, including older patients, nurses, clinicians, and researchers, and employs a power and influence grid for effective management. Strategies for stakeholder involvement include symbolic participation and participatory social network analysis. The report addresses potential resistance to recommendations by explaining the strength of evidence and disseminating research findings through interactive sessions. Evaluation methods involve data collection, statistical analysis using mixed logistic regression models, and mixed-method evaluations in community settings. The report also outlines strategies to overcome resistance and evaluates the impact of interventions using interrupted time series analysis, addressing the level of stakeholder engagement and improvements in evidence-based practice within the community.

Running head: EVIDENCE BASED NURSING RESEARCH
Evidence Based Nursing Research
Name of the Student
Name of the University
Author note

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Key stakeholders for your Evidence-Based-Practice project
The key stakeholders for the evidence based project are older patients/participants with
pneumonia, patients at risk of pneumonia, nurses, community people and clinicians and
academic researchers. The stakeholder identification process is based on the stakeholder
analysis, judgement of the experts and team meetings. Using the power and influence grid the
stakeholders with the greater power would be closely managed and updated continuously. I will
keep informing stakeholder with high power and low interest about the project. I will monitor the
stakeholder with low interest and low power.
Strategies
In order to involve and engage them in making changes that I have recommended, I will
opt for symbolic participation. It will have a place at a table allowing the stakeholders to hear the
plan. It will allow them to have a voice and have a meaningful engagement that also involves
shared decision making related to pneumonia immunization. With the help of the Participatory
Social Network Analysis, it would be easy to collaborate with the stakeholders and evaluate the
EBP from the communities perspective (Peters, Bhuiya & Ghaffar, 2017). This strategy better
helps to identify the stakeholders and bring together the researchers to promote the
recommendations for the immunization treatment using the conventional influenza vaccines.
Further, it would be effective to take the advantage of the stakeholder’s capability and address
the challenges (Goodman, & Sanders Thompson, 2017).
Further, with the help of the transformational leadership quality I can build a dialogue
with the stakeholders. With the help of the profile analysis meetings, it will be easy to engage the

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stakeholder while assessing their role, impact, interest and expectations in the project. It will also
help identify the level of stakeholder engagement. It would be beneficial to balance the expert
judgement with input from the stakeholders. The communication method most appropriate for
the purpose would be used along with the interpersonal skills. It will help build trust and resolve
conflict (Pandi-Perumal et al., 2015).
Resistance
Initially the level of resistance of the stakeholders will be assessed. To overcome the
resistance I would explain the strength of the recommendations. For the first recommendation,
there is a strong evidence of association with a relative risk of >5(<0.2). The resistance can be
decreased by sharing the results related to the reduction in death by PPSV23 and its implication
in taking up pneumococcal vaccine to mitigate the pneumococcal vaccine. I would also share the
strength of the second recommendations. The data from the randomised control trial could be
shared with the stakeholders through graphical illustrations and poster management. There is
more number of secondary papers that aligns with the research recommendations in the
concerned EBP. To overcome the resistance, research information would be disseminated
effectively. It may include interactive sessions, workshops, and video presentations. The strategy
is to discuss the issues identified by the stakeholders and highlights the solutions that would
mitigate any proposed risks. The key to overcome resistance as an effective leader is to harness
the resistance ad use it as the resource. The next thing would be to boost the awareness related to
change. It will reduce the worries and help return to the purpose of change again and again. It
will be useful to keep in front the positive aspects in the mind of stakeholders (Matos Marques
Simoes, & Esposito, 2014).

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Evaluation of results of interventions
The evaluation would include further collection of data from the hospitals demographic
information and dose delivered. The primary outcome would be the number of adults receiving
atleast one dose of vaccine at the clinic as per the program record. Further, record includes total
number of doses delivered. Mixed logistic regression model would be used followed by
statistical analysis. The time scale for this method is one year. For evaluating the outcomes of
the interventions in the community a mix-method evaluation will be conducted. It will include a
post intervention comparison of vaccination uptake. It may include review after uptake of
vaccine every two weeks. Randomly six interventions maybe selected and compared with the
control slum communities. The initiative may be delivered in partnership with government. A
two months span may be considered for this purpose. In conducting the investigation the errors
and flaws of other researchers in similar process will be eliminated. The patient’s reason for
immunisation, barriers to immunisation would be characterised. Surveys will be conducted to
know the reason for refusal (Taddio et al., 2015).
The key questions to be considered during evaluation are-
 Level of partnership on the continuum of the stakeholder engagement?
 Was the stakeholder engagement meaningful?
 Is there an improvement in the fit of evidence based practice in comm. unity
settings?
Another strategy to evaluate is conducting interrupted time series analysis. It is effective
in evaluating the population level health interventions after it is implemented at a clearly defined
point in time (Bernal, Cummins & Gasparrini, 2017).

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References
Bernal, J. L., Cummins, S., & Gasparrini, A. (2017). Interrupted time series regression for the
evaluation of public health interventions: a tutorial. International journal of
epidemiology, 46(1), 348-355. DOI: https://doi.org/10.1093/ije/dyw098
Bernal, J. L., Cummins, S., & Gasparrini, A. (2017). Interrupted time series regression for the
evaluation of public health interventions: a tutorial. International journal of
epidemiology, 46(1), 348-355.
Goodman, M. S., & Sanders Thompson, V. L. (2017). The science of stakeholder engagement in
research: classification, implementation, and evaluation. Translational behavioral
medicine, 7(3), 486-491. DOI: https://doi.org/10.1007/s13142-017-0495-z
Matos Marques Simoes, P., & Esposito, M. (2014). Improving change management: How
communication nature influences resistance to change. Journal of Management
Development, 33(4), 324-341. Retrieved from:
https://www.emeraldinsight.com/doi/abs/10.1108/JMD-05-2012-0058
Pandi-Perumal, S. R., Akhter, S., Zizi, F., Jean-Louis, G., Ramasubramanian, C., Edward
Freeman, R., & Narasimhan, M. (2015). Project stakeholder management in the clinical
research environment: How to do it right. Frontiers in psychiatry, 6, 71. DOI:
10.3389/fpsyt.2015.00071
Peters, D. H., Bhuiya, A., & Ghaffar, A. (2017). Engaging stakeholders in implementation
research: lessons from the Future Health Systems Research Programme experience. DOI:
https://doi.org/10.1186/s12961-017-0269-6

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Taddio, A., Shah, V., McMurtry, C. M., MacDonald, N. E., Ipp, M., Riddell, R. P., ... &
Chambers, C. T. (2015). Procedural and physical interventions for vaccine injections:
systematic review of randomized controlled trials and quasi-randomized controlled
trials. The Clinical journal of pain, 31(Suppl 10), S20. DOI:
10.1097/AJP.0000000000000264