When planning an EBP implementation that involves the community, it is important to understand healthcare at the local level.
Dounfo Thelusma
2 posts
Re: Topic 4 DQ 1
When planning an EBP implementation that involves the community, it is important to understand healthcare at the local level. The EBP implementation concerns a specific population so it’s important to understand what is allowed and not allowed in a culture, and what these individuals value. Evidence based research are based on focus group findings and are not always easily transferable to other populations or situations with unique cultural settings (Tacia et al, 2015). It’s also important to consider the health care system where one wants the change to be implemented. For example, what kind of resources will be available and is the health care system ready to implement a new EBP project. Looking within the local level helps to identify needs that will benefit the patients the healthcare system supports. EBP can address problems identified to the local health care system and will use current clinician’s expertise and will take into account patients values and preferences (Bardsley et al, 2016).
Bardsley, J., Eich, J., Esche, C., Kropkowski, L., McLaughlin, M., Risch, S., Warren, J. (2016). The Strengths and Challenges of Implementing Evidence-Based Practice in Health Care Systems. Worldviews on Evidence-Based Nursing, 13(1), 15-24. Retrieved from http://eds.b.ebscohost.com.lopes.idm.oclc.org/eds/pdfviewer/pdfviewer?vid=2&sid=90c9baf6-84e2-4388-846f-c4e16ae05b7d%40pdc-v-sessmgr05
Tacia, L., Biskupski, K., Pheley, A., Lehto, R. (2015). Identifying Barriers to Evidence-Based Practice Adoption: A Focus Group Study. Retrieved from https://pdfs.semanticscholar.org/e63b/5de11d04f4e0b6a7260ea4b817e4225995ea.pdf
Alyssa Camacho
3 posts
Re: Topic 4 DQ 1
It is important to understand the health care system at the local level when planning EBP implementation for a few reasons. By understanding the presence of available personnel available to implement the process. It is also important to understand the local level because it promotes critical resources such as funding, training and opportunities (Bonham, Sommerfeld, Willging, Aarons, 2014). Understanding the health care system at the local level also evaluates the willingness of the health care system to implement EBP changes.
When conducting my practice change I will evaluate the health care system at the local level and involve the community and local agency. Involving the agencies and community allows for collaboration with the health care system and the community. Understanding the health care system at the local level also provides needed information about what health care needs are lacking in the community.
Reference
Bonham, C., Sommerfeld,D., Willging, C., & Aarons, G.(2014). Organizational factors influencing implementation of evidence-based practices for integrated treatment in behavioral health agencies. Psychiatry Journal, 2014, doi:10.1155/2014/802983.
Laurintia Kadiri
3 posts
Re: Topic 4 DQ 1
Several factors go into planning an evidence-based practice (EBP) implementation, and the understanding of the health care system at the local level is one of the important factors to consider. Looking at the local level can help ask and answer questions such as what can this demographic benefit from? what needs can this implementation meet? And what resources are available to help undertake implementation? During the creation of the EBP change, patient population and demographic is already a considered factor, however, the means to successfully begin the implementation takes place at the local level. “It was clear that time poses a major barrier to nurses accessing and implementing EBP. Therefore, it is important that efforts are made to develop strategies that bring evidence into everyday practice and to the bedside of patients” (Grothier, 2018). In speaking with my preceptor and when considering my change project, timing is something to take into consideration. No better time as now with a pandemic that has already shifted the way we practice daily, to implement change, as staff throughout is receptive to new ways of performing patient care tasks. The facility we will be presenting the change project to is a teaching facility, and resources to help conduct research are readily available.
References
GROTHIER, L. (2018). What are the challenges for community nurses in implementing evidence-based wound care practice? (part 2). Wounds UK, 14(5), 34–39.
Donna Reamer
1 posts
Re: Topic 4 DQ 2
Nursing theories are a set of concepts that give a view of an observable fact or event that can be both explained and predicted.
The Roper-Logan-Tierney Model of Nursing is the model most used in the United Kingdom. It is based on the patient’s activities of daily living and meant to promote maximum independence through complete assessment upon admission and continued evaluation throughout the hospital stay. If deficits are identified, interventions in those areas are given to further support independence. This theory works well with my change project because the heart failure (HF) patient is assessed on admission, provided education and interventions during admission if necessary, and discharged to home with the goal of managing their HF at home without being readmitted to the hospital within 30 days.
The Orem Model of Nursing is considered a “grand nursing theory” with concepts that can be applied to all aspects of nursing. This theory promotes self-care as much as able believing that patients will recover more quickly and holistically if able to care for themselves making transition from hospital to home much smoother. This model can be used with my change project because the goal of the project is to educate and promote self-care during admission so patient will be able to manage their HF once discharged without being readmitted to the hospital within 30 days.
Both of these theories are currently being used by my preceptor at this facility.
Nursing Theory. (2016). Retrieved from http://nursing-theory.org
April Toepfer
2 posts
Re: Topic 4 DQ 2
Rogers Five-Stage Change Theory includes Stage 1: impart knowledge in terms of the reason for the change, how it will occur, and who will be involved, Stage 2: Persuade employees to accept change by relaying essential information and note the attitudes, both favorable and unfavorable, are formed, Stage 3: Decide whether to ultimately adopt the change by analyzing data and implementing a pilot study or trial of the new processes triggered by the change, Stage 4: Implement the change on a more permanent or established basis as the organization evolves to accommodate the change, Stage 5: Confirm adoption of the change by the employees responsible for and affected by the change.
Lewin’s Change Theory is a three-step model based on the premise that behavior is a dynamic balance of forces working in opposition. Driving forces facilitate change by pushing employees in a desired direction, and inhibiting forces hamper change because they push employees in the opposite direction Step 1 is the process of altering behavior to “unfreeze,” or agitate the status quo (Equilibrium state). Step 1 is necessary if resistance is to be overcome and conformity achieved. Step 2, “change,” involves movement of the employees to a new level of equilibrium. It helps employees to view change, and to facilitate consistency among management and employees. Step 3 is “refreezing,” or attaining equilibrium with the newly desired behaviors and desired outcomes can be integrated into the organization (Current Theories).
I really like Rogers Five-Stage Change theory the best. It seems more specific to a certain group or department within an organization. It will fit best with my project. My project focuses on a very specific group.
Current theories of change management. Retrieved from: https://www.nursingworld.org/~49379b/globalassets/catalog/sample-chapters/npdsamplechapter.pdf
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Beatrice Nnabuenyi
1 posts
Re: Topic 4 DQ 2
The two most important change theories prevalent in nursing practice include Lewin’s change theory and transtheoretical model of change. Lewin’s change model is a three stage model that includes unfreezing, change, and refreezing. The core concepts of this model are driving forces, restraining forces, and equilibrium. Lewin stated for this model that it is important to understand the “refreezing” process as without this, changes revert back to previous ways. In the transtheoritical model of change, the focus is intentional change. Specifically, this model helps to explain differences in success during treatment for a range of psychological and physical health problems. Some of the core concepts are: the process of change, decisional balance, self efficacy, decisional balance, and temptation. The stages of change for this model include precontemplation, contemplation, preparation, action, maintenance and relapse.
These two models of change are similar in that both pertain specifically to human systems and focus on important steps of change to bring in new habits for better outcomes. However, they also have some differences. The transtheoretical model pertains specifically to health care and health problems. The stages for this model are also more in-depth than those of Lewin’s model of change. While collaborating with my preceptor, he made me aware that he utilizes the transtheoretical model in practice as a nurse. He stated that the stages of change, such as contemplation, allows her to understand the perspectives of patients and how she can plan care and education to their specific needs to allow for successful change and better patient outcome.
http://currentnursing.com/nursing_theory/transtheoretical_model.html
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