Instructions Instructions Please respond to all 6 discussion separately/INDIVID
Instructions Instructions Please respond to all 6 discussion separately/INDIVIDUALLY. Please divide the words equally between the 6 responses. Discussion #1When it comes to understanding the healthcare system at the local level, it is important to consider evidence-based practice when planning for implementation. Evidence-based practice has many benefits that are provided for patients and nursing staff. First and foremost, evidence-based practice promotes positive patient outcomes. Patient safety and satisfaction are the priority when it comes to nursing. Secondly, EBP helps reduce healthcare costs and promotes the growth of the science of nursing (ANA, 2023).
When it comes to my own change project, I will utilize EBP to help enhance my critical thinking and use scientifically supported research to help make an informed decision. EBP will help me to identify the problem, and then use that to gather the correct evidence as needed.
Role of evidence-based practice in nursing (5 benefits). Indeed.com. (2023, January 26). https://www.indeed.com/career-advice/career-development/benefits-of-evidence-based-practice-in-nursing
What is evidence-based practice in nursing?. ANA. (2023, May 5). https://www.nursingworld.org/practice-policy/nursing-excellence/evidence-based-practice-in-nursing/#:~:text=Besides%20keeping%20health%20care%20practices,of%20the%20science%20of%20nursing
Discussion #2Its vital to understand the health care system at the local level when planning an EBP implementation. Health care systems vary per facility and each has its own way of delivering holistic care and implementing evidence-based practices. Implementing evidence based practices achieves higher quality of care through knowledge, skill, experience of health service providers, collaborative decision making, and good time management (Dagne & Beshah, 2021). By understanding the health care systems at a local level, a researcher or in our case, nurses can figure out what would be the best route to implement EBP. Before EBP can be implemented its vital that key stakeholders, providers, and frontline workers are on the same page. In an article, they detail the importance these individuals have, once they identify solutions, their ownership and accountability for the quality of their health system increases thus quality of care increases (Strengthening Community Health Systems: Global health, 2023).
References:
Dagne, A. H., & Beshah, M. H. (2021). Implementation of evidence-based practice: The experience of nurses and midwives. PloS one, 16(8), e0256600. https://doi.org/10.1371/journal.pone.0256600
Strengthening Community Health Systems: Global health. U.S. Agency for International Development. (2023, May 3). https://www.usaid.gov/global-health/health-systems-innovation/health-systems/strengthening-community-health-systems
Discussion #3Evidence based practice is when nurses provide holistic, quality based care with the most up to date research and knowledge. (ANA, 2023). In order for overall health to improve within our communities, evidence based practice must be utilized, in order to do this we must first know what resources we have available to us at the local level. (Li et al., 2019). Understanding the demographics at the local level is also important. Knowing the culture outside of the current organization was key to evidence based practice implementation and if unknown would present as a barrier. (Crawford et al., 2023).
Considerations for my project, utilizing a special VATS/PICC team to insert PICC lines and do central line dressing changes, would be finding out if the other local hospitals currently use a VATS team. If so has this lowered their CLABSI rate. I would need to do my homework and research qualitative and quantitative studies on current facilities with a VATS team. I would need to know the average CLABSI rate for my hospital as well as others in the area. How much the current CLABSI’s are costing us yearly would help in the decision if a team would be feasible for the hospital.
References
American Nurses Association (ANA), 2023. What Is Evidence-Based Practice in Nursing? https://www.nursingworld.org/practice-policy/nursing-excellence/evidence-based-practice-in-nursing/
Crawford, C. L., Rondinelli, J., Zuniga, S., Valdez, R. M., Tze-Polo, L., & Titler, M. G. (2023). Barriers and facilitators influencing EBP readiness: Building organizational and nurse capacity. Worldviews on evidence-based nursing, 20(1), 27–36. https://doi.org/10.1111/wvn.12618
Li, S., Cao, M., & Zhu, X. (2019). Evidence-based practice: Knowledge, attitudes, implementation, facilitators, and barriers among community nurses-systematic review. Medicine, 98(39), e17209. https://doi.org/10.1097/MD.0000000000017209
Discussion #4The health belief model states that certain factors influence a patient’s health behaviors; a persons perceived threat to sickness or disease, belief of consequence, and barriers of action. (Al-Metwali, 2021). If a patient is worried that their central line will bring them infection, it could delay healing, cause anxiety, and may cause the patient to decline the central line that they would require for life saving medications. This would cause many more problems for the patient. Patients need to feel as though they are receiving the best care possible and should not have to worry about the complications of the medical treatment they are receiving. The VATS team would take this belief/worry of infection away for the patient.
The decision making model chooses the best alternative from the proposed set of alternatives. (Gati et al., 2019). I would utilize the clinical decision making model within the decision making model for my EBP intervention. The clinical decision making model utilizes a scientific hypothetic, quantitative approach. (Current Nursing, 2023). For my EBP project, I would show the health care establishment that I could save them money by implementing a VATS team through studies of quantitative analysis. They would see that this intervention would make the most sense because the only alternative would be to have the same or increased CLABSI incidence rate and decreased funding from Medicaid and Medicare.
References
Al-Metwali, BZ, Al-Jumaili, AA, Al-Alag, ZA, Sorofman, B. Exploring the acceptance of COVID-19 vaccine among healthcare workers and general population using health belief model. J Eval Clin Pract. 2021; 27: 1112–1122. https://doi.org/10.1111/jep.13581
Current Nursing, 2023. Nursing theories. OPEN ACCESS ARTICLES ON NURSING THEORIES AND MODELS. https://currentnursing.com/theory/decision_making_models.html
Gati, I., Levin, N., Landman-Tal, S. (2019). Decision-Making Models and Career Guidance. In: Athanasou, J.A., Perera, H.N. (eds) International Handbook of Career Guidance. Springer, Cham. https://doi.org/10.1007/978-3-030-25153-6_6
Discussion #5Two nursing theories that I choose are Neuman’s system model and Dr. Benner’s model (from novice to expert). According to the article “Neuman’s system model” Neuman’s theory focuses on the response of the patient system to actual or potential environmental stressors and the use of primary, secondary, and tertiary nursing prevention intervention for retention, attainment, and maintenance of patient system wellness. In Neuman’s Systems Model there are six steps. First is the assessment of the patient, which looks at: actual and potential stressors; condition and strength of basic factors and energy sources; characteristics of flexible and normal lines of defense, lines of resistance, degree of reaction and potential for reconstitution; interaction between the patient and his or her environment; life process and coping factors for optimal wellness; and the perceptual difference between the caregiver and the patient. Second, the nurse makes a diagnosis by interpreting the data collected. The data includes health-seeking behaviors, activity intolerance, ineffective coping, and ineffective thermoregulation. The third step in the nursing process is to set goals. The ultimate goal is to keep the client system stable. From the goals, a plan is created, which focuses on strengthening lines of defense and resistance. That plan is implemented using primary, secondary, and tertiary preventions. Finally, the nursing process is evaluated to determine whether or not balance was restored, and a stable state maintained (Neuman’s system model, 2016).
Based on the article “From novice to expert” Benner’s model is one of the most useful frameworks for assessing nurses’ needs at different stages of professional growth. There are six steps. Stage 1 Novice: This would be a nursing student in his or her first year of clinical education. Stage 2 Advanced Beginner: Those are the new grads in their first jobs; nurses have had more experiences that enable them to recognize recurrent, meaningful components of a situation. They have the knowledge and the know-how but not enough in-depth experience. Stage 3 Competent: These nurses lack the speed and flexibility of proficient nurses, but they have some mastery and can rely on advance planning and organizational skills. Stage 4 Proficient: At this level, nurses are capable of seeing situations as “wholes” rather than parts. Stage 5 Expert: Nurses who are able to recognize demands and resources in situations and attain their goals (Benner’s from novice to expert).
For my specific EBP intervention the theory that makes most sense is Neuman’s theory because it focuses on the patient’s environment and primary preventions and this is the theory my preceptor used to prevent the CLABSI in our organization. After following the CLABSI prevention guidelines there is decrease in the rate of CLABSIs in our organization.
References
Benner’s from novice to expert. (2019, September 17). Nursing Theory. https://nursing-theory.org/theories-and-models/from-novice-to-expert.php
Neuman’s systems model. (2016, June 6). Nursing Theory. https://nursing-theory.org/theories-and-models/neuman-systems-model.php
Discussion #6Nursing and theories go hand in hand because nursing theories guides all the nurses’ interventions and actions throughout the entire practices to better the patient’s outcome as well as their satisfactions, thereby reduces litigation and great outcomes.
Comparison of Change Theories:
Lewin’s Change Theory: This is a well-known model that focuses on the three-step process of unfreezing, changing, and refreezing (Shirey, 2018). Unfreezing entails raising awareness and motivation for change, implementing the change, and then refreezing to ensure the change is permanent. The concept addresses the relationship between a person and their surroundings.
Kotter’s Eight-Step Change Model: This model offers an extensive structure for managing organizational change. It starts with instilling a sense of urgency and progresses through steps like forming a coalition of support, collaborating the vision, encouraging staff members, and anchoring the change in the company’s culture (Haas et al., 2019). This theory demonstrates the significance of effective management and active participation by all parties involved.
Contrast of Change Theories: Even though both schools of thought acknowledge the necessity for shifts, their approaches differ. Lewin’s theory emphasizes individual drives and external variables, whereas Kotter’s theory requires an additional organizational viewpoint, highlighting managerial behavior and involvement of stakeholders. Lewin’s model is frequently used for small- and medium- modifications, whereas Kotter’s model is better suited for larger organizational adjustments.
Selection of Theory for Implementing EBP Intervention
Kotter’s Eight-Step Change Model appears to be more appropriate to execute a specific EBP action. EBP programs frequently entail organizational-level modifications that necessitate effective management, the participation from various stakeholders, and the creation of an environment of support (Haas et al., 2019). Kotter’s model offers an organized strategy to promote encouragement, integrating an organization, and integrating modifications in the institution’s fabric. The eight-step procedure ensures that every critical component of the transformation is addressed in a systematic manner.
Preceptor’s Use of Change Theories and Outcomes:
My preceptor has used Kotter’s Eight-Step Change Model to put several EBP interventions in place at our healthcare organization. The measures taken have been successfully conveyed and backed by instilling an atmosphere of sense of urgency and enlisting the help of a directing alliance. Staff members became empowered because of their participation in the change process, which resulted in greater acceptance and long-term viability of the interventions. Overall, using Kotter’s model aided in the seamless shift to evidence-based practices and optimized the outcomes for patients.
References
Haas, M. R. C., Munzer, B. W., Santen, S. A., Hopson, L. R., Haas, N. L., Overbeek, D., Peterson, W. J., Cranford, J. A., & Huang, R. D. (2019). #DidacticsRevolution: Applying Kotter’s 8-Step Change Management Model to Residency Didactics. The western journal of emergency medicine, 21(1), 65–70. Retrieved from https://doi.org/10.5811/westjem.2019.11.44510
Shirey M. R. (2018). Lewin’s Theory of Planned Change as a strategic resource. The Journal of nursing administration, 43(2), 69–72. Retrieved from https://doi.org/10.1097/NNA.0b013e31827f20a9
