NUR-590 Benchmark – Evidence-Based Practice Proposal Project Framework or Model for Change

Sample Answer for NUR-590 Benchmark – Evidence-Based Practice Proposal Project Framework or Model for Change Included After Question

Assessment Description

Applying a model or framework for change ensures that a process is in place to guide the efforts for change. In 500-750 words, discuss the model or framework you will use to implement your evidence-based practice proposal project. You will use the model or framework you select in the Topic 8 assignment, during which you will synthesize the various aspects of your project into a final paper detailing your evidence-based practice project proposal.

Include the following:

  1. Identify the selected model or framework for change and discuss its relevance to your project.
  2. Discuss each of the stages in the change model/framework.
  3. Describe how you would apply each stage of the model or theoretical framework in your proposed implementation.
  4. Create a concept map for the conceptual model or framework you selected to illustrate how it will be applied to your project. Attach this as an appendix at the end of your paper.

Refer to the “Evidence-Based Practice Project Proposal – Assignment Overview” document for an overview of the evidence-based practice project proposal assignments.

You are required to cite minimum of four peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Complete the “APA Writing Checklist” to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as an appendix at the end of your paper.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

MBA-MSN; MSN-Nursing Education; MSN Acute Care Nurse Practitioner-Adult-Gerontology; MSN Family Nurse Practitioner; MSN-Health Informatics; MSN-Health Care Quality and Patient Safety; MSN-Leadership in Health Care Systems; MSN-Public Health Nursing

1.2 Apply theoretical frameworks from nursing and other disciplines to make decisions regarding practice and health-related problems at the individual and population level.

A Sample Answer For the Assignment: NUR-590 Benchmark – Evidence-Based Practice Proposal Project Framework or Model for Change

Title: NUR-590 Benchmark – Evidence-Based Practice Proposal Project Framework or Model for Change

Models of change are important in the implementation of new initiatives in healthcare settings. The models provide insights into the strategies that should be utilized in the implementation of change. They also provide information about the outcome data that will be used for evaluation purposes. Therefore, this section of the project examines the model of change that will be utilized in the implementation of the change.

Selected Model and Relevance

The trans-theoretical model of behavioral change will be utilized in the project. DiClemente and Prochaska developed the trans-theoretical model in the 1970s following their examination of the ways in which smokers quit smoking and the factors that influenced the process. The model examines the decision-making by individuals to embrace change and behaviors that are needed to influence the process. The trans-theoretical model recognizes the fact that behavioral change is a cyclical process.

Individuals embrace change through a series of steps that will determine the sustainability of change. The trans-theoretical model is applicable to the proposed project because it provides insights into the determinants of change. It also enables the determination of success of the strategies implemented at each stage of the project (Cavaiola & Smith, 2020). Lastly, it provides step-wise approach to implementing and determining the level of adoption of change in an organization.

Stages of the Model and Application to the Proposed Implementation

Change in the trans-theoretical model occurs in steps. The steps include precontemplation, contemplation, preparation, action, maintenance, and termination. Each of the steps of the trans-theoretical model is applicable to the proposed change initiative. The first step in the trans-theoretical model is pre-contemplation. Pre-contemplation is the phase where the people have no plans of taking action to improve their situation.

Their lack of awareness about the negative effect of their behaviors makes it hard for them to determine a need for change in their daily routines. This stage is applicable to the proposed initiative. Nurses are not aware of the need for the adoption of evidence-based strategies to reduce the rate of catheter-associated urinary tract infection (Gellman & Turner, 2019). As a result, the do not have any intentions to take action in any near future.

The second stage in the trans-theoretical model is contemplation. This is the phase where people become aware of the negative effect of their current behaviors. As a result, they are willing to take action in the near future. The adopters also explore the benefits as well as risks of changing their behaviors. There is however a high degree of ambivalence among them. The applicability of this step to the proposed initiative is that nurses will be aware about the need for evidence-based interventions to prevent and reduce the rate of catheter-associated urinary tract infections (Hagger et al., 2020). Nurses begin to explore the benefits of interventions such as meatus cleaning with 0.1% Chlorhexedine when compared to their usual practice of using normal saline. Nurses place emphasis on both the benefits as well as risks of behavior change.

The third stage of the model is preparation. This is the phase where the adopters of change are ready and willing to take actions related to the change within a short period. The adopters implement small steps that would contribute to the desired behavioral change. They believe that the change will have benefits to them and their daily routines (Gellman & Turner, 2019). Nurses are ready to adopt the proposed initiative in this step. They start implementing the initiative in small scale to determine its effect on patient outcomes. Nurses believe that the implementation of the initiative would result in positive outcomes in care.

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The fourth step in the model is action. This step is characterized by the recent change in behavior of the adopters. The adopters intend to continue implementing the change initiative. They modify their practices and behaviors to support the change. Nurses in this stage have considered the use of the initiative in their daily routines. They have realized the benefits of the intervention in reducing the risk and rate of catheter-associated urinary tract infections (Anisman, 2021). As a result, they are willing to explore additional ways in which the success of the change initiative can be achieved.

Maintenance is the fifth stage in the trans-theoretical model. The adopters of the change have sustained their behaviors that support the change. They work towards adopting behaviors that will prevent relapse. The nurses in this step have sustained the use of the initiative in patient care. They explore ways in which they can prevent the use of normal saline prior to insertion of urinary catheter. Termination is the last phase where the adopters do not have any intention to relapse to their traditional behaviors. The change has been incorporated into the organizational culture (Cavaiola & Smith, 2020). In this case, the use of the proposed initiative has been incorporated into the organizational culture, hence, the strengthening of excellence in patient care.

Framework

Conclusion

In summary, the trans-theoretical model will be used in the implementation of the project. The model is appropriate because it will facilitate sustainable change in the organization. The trans-theoretical model has steps that will guide the implementation process. Therefore, a focus will be placed on ensuring that the needs of the stakeholders are met at each stage for the successful implementation of the project.

References

Anisman, H. (2021). Health Psychology: A Biopsychosocial Approach. SAGE.

Cavaiola, A. A., & Smith, M. (2020). A Comprehensive Guide to Addiction Theory and Counseling Techniques. Taylor & Francis Group.

Gellman, M. D., & Turner, J. R. (2019). Encyclopedia of Behavioral Medicine. Springer New York.

Hagger, M. S., Cameron, L. D., Hamilton, K., Hankonen, N., & Lintunen, T. (2020). The Handbook of Behavior Change. Cambridge University Press.

I foresee some potential concerns with implementing educational sessions for orthopedic patients and families with low health literacy before surgery to promote a positive outcome. Ost et al. (2020) purport that implementing evidence-based practice at the system level continues to be difficult even though healthcare organizations are aware of its advantages but do not consistently make it the standard of care. There may be a need for more organizational readiness. If the organization is not ready for change, implementing the educational sessions to improve health literacy may fail. This could be due to a lack of support from leadership, a lack of resources, or a lack of understanding of the need for change. There can be a need for patient families’ engagement. If patients and families are not engaged in the sessions, they may not learn the information they need for a successful post-op recovery. This could be due to a lack of interest, a lack of understanding, or a lack of trust in the healthcare providers. Lastly, resources such as staff, materials, or space for the educational sessions could be inadequate due to limiting number of patients participating in the sessions or the quality of the information provided. 

To help create or sustain a higher level of readiness to change within the organization, it is essential to obtain buy-in from leadership. The support of leadership is essential for any change initiative to be successful. This means the organization’s leaders must be dedicated to the educational sessions and willing to provide resources and assistance. Through the institution’s shared governance council, I plan to present the proposed project to gain the support of the leaders and the interdisciplinary team. Medeiros (2020) emphasized that “shared governance councils are the venues where data are presented, actions are created, and plans are implemented that embody the motto data drives practice” (p. 8). Nursing staff must understand the importance of change and the benefits of the sessions. The author recommended that this be accomplished by presenting at staff meetings, unit councils, newsletters, and emails.  Patients must be able to attend the workshop regardless of their language or cultural background. This requires the information to be translated into several languages or use translators, and the instruction needs to be culturally responsive. 

I would assess the literature on health literacy and patient education to ensure the change is based on current evidence. This will ensure that the educational sessions are based on the most recent research and best practices. I would seek advice from professionals in health literacy and patient education within the institution. These professionals can advise on the educational sessions’ planning and implementation. I can also pilot the session on a limited group of patients. This will help in identifying potential session issues and making necessary adjustments.