NR 451 Week 6 Discussion Implementing Change Despite Resistance Recent

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Implementing Change Despite Resistance

Change can be difficult to implement Now that you are almost finished with your change project, if you were to implement your project in your clinical practice, what type of resistance do you expect from staff? List at least three ways that you can lessen the resistance you may encounter to help ensure the success of your project

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Change in any setting is difficult, we go through changes every day, new laws, new way of doing things, new technology and so forth. Some embrace change as inevitable and others just refuse to change. My mother is an avid reader and has literally hundreds of books, trust me I know I have moved her twice in the past 10 years and know all the books she has. I bought my mother a nook several years ago and taught her how to use it. Instead of embracing this new-found way of reading thousands of books that are stored in one place, she chose to hide the nook and claim it was lost. Recently she started having trouble with her eye site and could not read regular print books so I searched her apartment and found the nook, I charged it and set the font to large type and re-oriented her to its use. Again, she stashed it away saying it would not charge. Now I know that was not true, she just will not change to use of new technology, she will not learn to use a computer or tablet, she has no interest in doing that. Change scares her and that is the bottom line. As nurses, we are a lot like my mother, afraid of change, and this fear holds us back in our practice and in safe quality care and positive outcomes for our patients.

There are several major barriers to the advancement of EBP which would bring about change in nursing. These include:

Lack of knowledge and skill
Low comfort level with search techniques
Perceived lack of time-REAL LACK OF TIME
Challenges with critically appraising research
Lack of organizational/administrative support
Educational programs that continue to teach research the “traditional way” with focus on producing instead of using evidence
Negative attitudes-skeptics and fear

I had one negative encounter with implementation of change early after I earned my masters’ degree. My barrier with leadership and their lack of knowledge and insecurity with staff effecting change. I was basically told after my presentation of my idea for change that I was hired as a staff nurse and nothing more. Their insecurity with staff effecting change that could improve patient outcomes along with their lack of knowledge in nursing research became the barriers to positive patient outcomes. In the past year, the culture at that facility has changed and nursing research that includes the staff has been implemented.

Tell the class about the barriers you may encounter in your practice if you were to attempt to implement a change? It could be from staff or leadership or both.

Feeg, D. V., Suny Downstate Medical Center Department of Nursing , Nursing Research and Evidence-Based Practice
Conference, May 26, 2010; Strategies for Overcoming Barriers in Implementing Evidence-Based Practice; retrieved from
http://www.downstate.edu/icl/Feeg-Downstate2010Presentation-BarrierstoEBP.pdf

NR 451 Week 6 Discussion Implementing Change Despite Resistance Recent Grading Rubric Guidelines

Performance Category	10	9	8	4	0
Scholarliness Demonstrates achievement of scholarly inquiry for professional and academic decisions.	Provides relevant evidence of scholarly inquiry clearly stating how the evidence informed or changed professional or academic decisions Evaluates literature resources to develop a comprehensive analysis or synthesis. Uses valid, relevant, and reliable outside sources to contribute to the threaded discussion	Provides relevant evidence of scholarly inquiry but does not clearly state how the evidence informed or changed professional or academic decisions. Evaluates information from source(s) to develop a coherent analysis or synthesis. Uses some valid, relevant, reliable outside sources to contribute to the threaded discussion.	Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions. Information is taken from source(s) with some interpretation/evaluation, but not enough to develop a coherent analysis or synthesis. Little valid, relevant, or reliable outside sources are used to contribute to the threaded discussion. Demonstrates little or no understanding of the topic.	Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions. Information is taken from source(s) without any interpretation/evaluation. The posting uses information that is not valid, relevant, or reliable	No evidence of the use of scholarly inquiry to inform or change professional or academic decisions. Information is not valid, relevant, or reliable
Performance Category	10	9	8	4	0
Application of Course Knowledge – Demonstrate the ability to analyze, synthesize, and/or apply principles and concepts learned in the course lesson and outside readings and relate them to real-life professional situations	Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources; Applies concepts to personal experience in the professional setting and or relevant application to real life.	Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources. Applies concepts to personal experience in their professional setting and or relevant application to real life Interactions with classmates are relevant to the discussion topic but do not make direct reference to lesson content	Posts are generally on topic but do not build knowledge by incorporating concepts and principles from the lesson. Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life Does not demonstrate a solid understanding of the principles and concepts presented in the lesson	Posts do not adequately address the question posed either by the discussion prompt or the instructor’s launch post. Posts are superficial and do not reflect an understanding of the lesson content Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life	Posts are not related to the topics provided by the discussion prompt or by the instructor; attempts by the instructor to redirect the student are ignored No discussion of lesson concepts to personal experience in the professional setting and or relevant application to real life
Performance Category	5	4	3	2	0
Interactive Dialogue Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days. *(5 points possible per graded thread)*	Exceeds minimum post requirements Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts three or more times in each graded thread, over three separate days. Replies to a post posed by faculty and to a peer Summarizes what was learned from the lesson, readings, and other student posts for the week.	Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days Replies to a question posed by a peer Summarizes what was learned from the lesson, readings, and other student posts for the week.	Meets expectations of 2 posts on 2 different days. The main post is not made by the Wednesday deadline Does not reply to a question posed by a peer or faculty	Has only one post for the week Discussion posts contain few, if any, new ideas or applications; often are a rehashing or summary of other students’ comments	Does not post to the thread No connections are made to the topic
	Minus 1 Point	Minus 2 Point	Minus 3 Point	Minus 4 Point	Minus 5 Point
Grammar, Syntax, APA Note: if there are only a few errors in these criteria, please note this for the student in as an area for improvement. If the student does not make the needed corrections in upcoming weeks, then points should be deducted. Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition	2-3 errors in APA format. Written responses have 2-3 grammatical, spelling, and punctuation errors. Writing style is generally clear, focused, and facilitates communication.	4-5 errors in APA format. Writing responses have 4-5 grammatical, spelling and punctuation errors. Writing style is somewhat focused.	6-7 errors in APA format. Writing responses have 6-7 grammatical, spelling and punctuation errors. Writing style is slightly focused making discussion difficult to understand.	8-10 errors in APA format. Writing responses have 8-10 grammatical, spelling and punctuation errors. Writing style is not focused, making discussion difficult to understand.	Post contains greater than 10 errors in APA format. Written responses have more than 10 grammatical, spelling and punctuation errors. Writing style does not facilitate communication. The student continues to make repeated mistakes in any of the above areas after written correction by the instructor
	0 points lost				-5 points lost
Total Participation Requirements *per discussion thread*	The student answers the threaded discussion question or topic on one day and posts a second response on another day.				The student does not meet the minimum requirement of two postings on two different days
Early Participation Requirement *per discussion thread*	The student must provide a substantive answer to the graded discussion question(s) or topic(s), posted by the course instructor (not a response to a peer), by Wednesday, 11:59 p.m. MT of each week.				The student does not meet the requirement of a substantive response to the stated question or topic by Wednesday at 11:59 pm MT.

Also Read: NR 451 Week 6 Capstone Project Milestone 3 Educating Staff: Implementing Change Guidelines Purpose Set 2-(Promoting Breastfeeding) Recent