Applying a change Model to the Implementation Plan

Applying a change Model to the Implementation Plan

2. apply a change model to the implementation plan. Include the following:
3. Apply the Iowa model of E-BP, and carry your implementation through each of the stages, phases, or steps identified in the chosen model.
This is the PICOT Question for this capstone project. PICOT (P) For post-operative patients, (I) can standardized hourly rounding by a medical team be a better deterrent (C) compared to bed alarms or other tools that are readily available within a hospital (O) and designed to reduce patient fall risk (T) during hospitalization.

 

Applying the Iowa Model to the Implementation Plan

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Selected Evidence-Based Practice Model

            Numerous conceptual and theoretical models used in the implementation of evidence-based research findings to clinical practice in healthcare organizations exist.  In an organizational context, leadership has to decide the most recommended evidence-based changes to make and the approach of doing it. Most of these models are a representation of methodological approaches and tend to break the entire procedure into simpler and smaller steps. As supported by Nilsen (2015), the use of these models tends to increase the chances of success, a complete implementation process, improves the allocation of resources and provides an avenue of evaluating outcomes. Applying a change Model to the Implementation Plan.

The Iowa evidence-based practice model is a perfect example of such a model. This model has been used in different organization and education settings and proven effective in facilitating the implementation of evidence-based practice. For the implementation of the findings of this EBP project, the Iowa model was the preferred model to explore new strategies that could influence a reduction in falls among post-operative patients during hospitalization. This was the model of choice since it emphasizes on multidisciplinary collaboration, incorporates organizational change and utilizes inputs from the implementation team (White & Spruce, 2015).  Post-operative care involves numerous disciplines which collaborate to ensure timely and full patient recovery. Therefore, since this model is highly dependent on collaboration, it is the most reasonable choice. It is also worth mentioning the Iowa model can easily be understood and interpreted thus user-friendly (Schaffer, Sandau & Diedrick, 2013). Since it allows trial runs of a proposed evidence-based practice change before the actual implementation, the chances of failure are significantly reduced. Applying a change Model to the Implementation Plan.

Applying the Iowa Model To The Implementation Plan

The Iowa model will promote the implementation of fall reduction strategies in the surgical unit. The model’s algorithm has three decision-making points, the initial being determining if the subject should be a priority for the organization (Brown, 2014). While some subjects may be triggered by problems, others may be triggered by problems. For this healthcare organization, implementing new evidence-based fall reduction strategies is the organization’s priority which was triggered by an increase in fall incidences among post-operative patients. The falls resulted in prolonged hospital stays, poor health outcomes and significant financial loses.

The next step is the formation of a multidisciplinary team which should comprise of specific stakeholders from every discipline and any other interested stakeholder. When initiated by frontline practitioners in the surgical unit rather than the organization’s leadership, it is inarguable that the change process will be more successful (White & Spruce, 2015). In this case, the team will comprise of the nurse manager, direct patient care nurses, physiotherapist, nutritionist, nurse practitioner, and surgeon.

The team’s first assignment will be searching for evidence. Therefore, they will need to decide on the keywords to use in scientific databases regarding fall reduction strategies for post-operative patients. After collecting enough evidence, the team will have to critique and synthesize it. Therefore, should the team have inadequate skills or experience in conducting literature searches and assessing the strength of evidence found, it will be vital to ask for the assistance of someone in the organization (Nilsen, 2015). Applying a change Model to the Implementation Plan. The team will likely find guidelines, systematic reviews and pre-appraised researches that discuss fall prevention and fall-reduction strategies for different patient populations. Based on the evidence found, the team will be able to identify the potential gaps in knowledge that exist.

The next point would be deciding if the evidence found is adequate to guide evidence-based practice. Based on the team’s judgment, if the evidence found will be considered sufficient, they should progress to pilot an evidence-based change. On the other hand, in case of lack of a solid research base, the team can progress to use other types of available scientific evidence such as expert opinions and case studies. Otherwise, the implementation team may consider conducting the unavailable research.

If the implementation team progresses with the adoption of new fall-reduction strategies, the next stage is piloting the change in actual practice.  In this phase, there are six steps to follow.  The initial is determining the expected outcomes. The project aims at reducing the fall risks of post-operative patients during hospitalization through standardized hourly rounding by a medical team. Therefore, the most expected outcomes to measure will be; fall incidences, post-operative recovery duration, and length of stay (Pelt, et al., 2014). Secondly, baseline data should be obtained and the outcomes measured before the implementation of the change Applying a change Model to the Implementation Plan.

The third stage is the development of written policies and guidelines which define the new fall-reduction strategies and protocols for post-operative patients. In the surgical unit, the team can consider testing the new fall-risk reduction strategy for two weeks or one month. However, this requires that all personnel directly or indirectly involved with the care of post-operative patients are included and the expectations are well communicated. Next is evaluating the new strategy by making a comparison between the outcome measures and the baseline data that was initially obtained Applying a change Model to the Implementation Plan. This helps to establish if the new fall reduction strategy for post-operative patients (standardized hourly rounding by a medical team) positively influences fall incidences (Morgan, 2019).  Lastly, the protocols and guidelines developed should be modified based on the outcomes.

Conclusion

In today’s highly diverse healthcare environment, the significance of utilizing evidence-based practice in clinical settings to improve care outcomes cannot be overemphasized.  Nurse leaders are responsible for ensuring that quality care is provided in cost-effective ways and that the goals of care are adequately addressed. For the implementation plan of this EBP project, the Iowa EBP model that promotes quality care is the best guide to ensuring success in implementation. The model will particularly be helpful in the implementation of evidence-based strategies that would ensure a reduction in the fall risks of post-operative patients during hospitalization. Applying a change Model to the Implementation Plan

 

References

Brown, C. G. (2014). The Iowa Model of Evidence-Based Practice to Promote Quality Care: An Illustrated Example in Oncology Nursing. Clinical Journal of Oncology Nursing18(2).

Morgan, K. (2019). Improving Nurse Responsiveness through Advanced Call Bell Implementation & Hourly Rounding.

Nilsen, P. (2015). Making sense of implementation theories, models and frameworks. Implementation Science10(1), 53.

Pelt, C. E., Anderson, A. W., Anderson, M. B., Van Dine, C., & Peters, C. L. (2014). Postoperative falls after total knee arthroplasty in patients with a femoral nerve catheter: can we reduce the incidence?. The Journal of arthroplasty29(6), 1154-1157.

Schaffer, M. A., Sandau, K. E., & Diedrick, L. (2013). Evidence‐based practice models for organizational change: overview and practical applications. Journal of Advanced Nursing69(5), 1197-1209.

White, S., & Spruce, L. (2015). Perioperative nursing leaders implement clinical practice guidelines using the Iowa Model of Evidence-Based Practice. AORN Journal102(1), 50-59. Applying a change Model to the Implementation Plan.

 

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