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Literature Review and Proposed Service Improvement Plan to Improve Service User Experience

The following structure should be considered when writing this assignment:

Introduction and Background (Maximum 300 words).

Briefly introduce and reference the key topic that has inspired your proposal for change to improve the service user experience. You will need to provide a rationale as to why you have chosen this topic and illustrate the significance of this using appropriate evidence. It will be useful to set the scene for your service user improvement by providing statistics from the literature that demonstrate the scale of the issue that you feel needs to be improved. You can also introduce the impact of the issue on patient experience.

Literature Review (Around 2900 words)
A literature review is a critical analysis of the findings of a variety of different authors on a given subject.
This section requires you to have the knowledge and skill to undertake a literature search around your chosen topic.
If you have not used the skill of undertaking a literature search for previous assignments it is strongly recommended that you visit the library for a refresher on how to go about this. You will not be able to write this section until you have undertaken a substantial literature search and read the literature that you will be critiquing. Library hosts search engines such as CINAHL Plus, Cochrane and Medline.
You will need to identify how you have undertaken the search for your literature and a summary of this will be placed within your appendix. This will include a list of the search criteria that you have used including, search engines used, key words or terms, date range (keep this contemporary), inclusion criteria (e.g. specific countries), exclusion criteria etc. You will need to demonstrate how you have used criteria to reduce the number of articles you have identified to a manageable number that address the key topic you are focusing on.
The literature that you use should include:
o published primary research
o Local and National Policy
o a range of literature from other relevant sources (articles, books and reputable websites that provide additional insight into the topic under review)
Cormack’s (2000) framework for critiquing primary research is a useful tool to support you in appraising research papers and organising your thoughts around these. You are required to use this tool to demonstrate that you have identified appropriate research literature and considered the value of this. You will be required to include a table in the appendix which shows that you have used Cormack’s framework to evaluate your chosen research papers.
Why is it important to conduct a literature search and read the literature prior to structuring this section and deciding on the key themes within it?
Only when you have read the literature will you be able to establish some prominent and emerging themes to help structure this section of the assignment. Do not pre-empt or second guess these themes before you have read the literature – otherwise your discussion will not reflect the literature or provide a logical review.
The limit of a 2900 word count for this section will require you to be succinct in your writing and you are advised to choose no more than 2 themes from the literature to structure your discussion. Any more is likely to result in a descriptive account of the literature, rather than an analytical and challenging debate of the literature.
How should research articles be discussed within this section?
The work that you have done using Cormack’s framework will be key to the discussion in this section. When reviewing research based literature you need to be able to identify whether the research had a quantitative or qualitative approach, or perhaps a mix of both.
Where possible you should make comment on the overall design of the study, the ethics associated with the study, the sample size and sampling technique, the data collection methods and in some cases it may be appropriate to discuss how the data were analysed.
A literature review is not just a summary of who said what. It is an analysis, evaluation and comparison of the findings of different authors writing about the same topic.
Application to practice is also important and you will need to demonstrate that you are able to consider the literature in the context of the practice setting. Your previous experience around your chosen topic will help to inform this.
Change Management (Around 1400 words)
You will be required to consider carefully how your proposed service user improvement could be implemented in the future (N.B. You are not expected or permitted to implement this plan as part of this assignment).
Develop an action plan using the Specific, Measurable, Achievable, Realistic, Time-bound (SMART) framework.
This action plan will be placed in your appendix and will not be included in the word count. The plan will be used within your discussion about change management in this section of the essay.
You will need to familiarise yourself with change theory.
Identify one theory of change that you will discuss in this section and make reference to the stages of this change theory as you discuss the proposed implementation of your service improvement. For example, if you choose to use Lewin’s (1947) renowned change theory, within the ‘unfreezing’ stage’ you will be required to discuss the positive driving forces that will support your proposed change (for example, involving all staff in a discussion to explore the benefits of the change, demonstrating the positive impact on patient care, positive impact on resources such as staff time, staff job satisfaction etc.). You would also discuss the negative restraining forces that could impede the change (for example, resistance to change by staff, cost, lack of education etc.) The Force Field Analysis in Lewin’s theory would inform the discussion here as you would need to consider if the factors against change outweigh the factors for change. How might you address this? Are there any of the negative drivers that can be influenced to provide a more positive impact?
Make it clear who should be involved to achieve the change and what effect the proposed change will have on stakeholders, and the multi-professional health care team. Briefly consider how leadership theory can be effectively used to enable and sustain the change in collaboration with the team from old local care/professional practices to new evidence-based practices.
Make realistic recommendations for the implementation of your service improvement that are sustainable.
State how the change will be measured for success, from a pre-change state to a post-change state.

Conclusion (Maximum 400 words)
State what has been learned during this assignment, keeping it specific to the information covered in the main body of this essay (no new material should be discussed).
Make recommendations for further self-development in terms of developing evidence-based practice through; literature searching skills; skills in the analysis and evaluation of literature; growth as a leader and growth as a change agent.
Finally make a recommendation for future research that is needed to give some specific evidence-based information for current nursing practice e.g. a gap in the existing evidence-based knowledge in the current research findings.

Summary of Literature Search
Cormack’s Critiquing Framework
Action plan using SMART goals

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