NUR-590 Topic 6: Evaluating Practice Change
NUR-590 Topic 6: Evaluating Practice Change
NUR-590 Topic 6: Evaluating Practice Change
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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 project will make use of the trans-theoretical model of behavioral change. In the 1970s, DiClemente and Prochaska developed the trans-theoretical model after studying how smokers quit smoking and the factors that influenced the process. The model investigates individuals’ decisions to embrace change as well as the behaviors required to influence the process. The trans-theoretical model acknowledges behavioral change as a cyclical process. Individuals embrace change in a series of steps that determine how long the change will last. Because it provides insights into the determinants of change, the trans-theoretical model is applicable to the proposed project. It also enables the success of the strategies implemented at each stage of the project to be determined (Cavaiola & Smith, 2020). Finally, it provides a step-by-step approach to implementing and determining the level of change adoption in an organization.
Stages of the Model and Application to the Proposed Implementation
The trans-theoretical model evolves in stages. Precontemplation, contemplation, preparation, action, maintenance, and termination are among the steps. Each of the trans-theoretical model’s steps is applicable to the proposed change initiative. Pre-contemplation is the first step in the trans-theoretical model. People are in pre-contemplation when they have no plans to take action to improve their situation. Their lack of awareness about the negative consequences of their behaviors makes determining the need for change in their daily routines difficult. This stage pertains to the proposed initiative. Nurses are unaware of the importance of implementing evidence-based strategies to reduce the prevalence of catheter-associated urinary tract infection (Gellman & Turner, 2019). As a result, they have no plans to take action in the near future.
Contemplation is the second stage of the trans-theoretical model. This is the stage at which people become aware of the negative consequences of their current actions. As a result, they are eager to act in the near future. Adopters also consider the advantages and disadvantages of changing their behaviors. However, there is a lot of ambiguity among them. This step is relevant to the proposed initiative because it raises nurses’ awareness of 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 investigate the advantages of interventions such as meatus cleaning with 0.1% chlorhexedine over their standard practice of using normal saline. Nurses emphasize both the benefits and risks of behavior change.
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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.
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.