NUR 590 Benchmark – EBP 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.
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.
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.
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.
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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.
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:
Identify the selected model or framework for change and discuss its relevance to your project.
Describe how you would apply each stage of the model or theoretical framework in your proposed
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.
NUR 590 Topic 3 DQ 1
Discuss the significance of frameworks or models in guiding research or evidence-based practice projects. How can choosing an incorrect framework or model create bias in research?
The present day’s health practice depends largely on continuous change for progressive improvement. Evidence-based practice (EBP) projects play an instrumental role in integrating current, relevant scientific knowledge to improve clinical outcomes. However, the outcomes are not standard and require guidance. Models are used to guide evidence-based practice (EBP) projects, and it is important to choose the most appropriate model.
Concerning the significance of models in guiding EBP projects, it is important to consider that change integration should be systematic. Time and resources to be used and who to involve should be defined in precision. Moullin et al. (2020) explained that change implementation frameworks provide change leaders with a structure for describing, guiding, analyzing, and implementing evaluation efforts. Doing so facilitates the advancement of generalizable implementation of scientific knowledge. Generally, a model that guides an EBP project shows how the main processes follow each other. The overall approach is well defined, and critical elements such as the problem focus, significance, outcome, timeline, implementation, and evaluation are outlined in precision.
Failing to choose the correct model has huge implications and can create bias in research. In agreement with Wyant (2017), organizations and change leaders must select the EBP model that best fits their care context. Choosing an incorrect model leads to a situation where the model used does not align with improvement goals and does not address priority clinical problems. Implementation and evaluation are done wrongly, and outcomes are misinterpreted. Eventually, outcomes and data may be highly opinionated as change leaders try to force favorable results after using a lot of time and resources. To avoid bias and implement change appropriately, change leaders should do an in-depth study of models and choose the most appropriate as clinical problems necessitate.
Moullin, J. C., Dickson, K. S., Stadnick, N. A., Albers, B., Nilsen, P., Broder-Fingert, S., … & Aarons, G. A. (2020). Ten recommendations for using implementation frameworks in research and practice. Implementation Science Communications, 1(1), 1-12. https://doi.org/10.1186/s43058-020-00023-7
Wyant, T. (November 21, 2017). Adopt an evidence-based practice model to facilitate practice change. ONSVOICE. https://voice.ons.org/news-and-views/adopt-an-evidence-based-practice-model-to-facilitate-practice-change
The models or framework could help nurses and other healthcare providers to translate the research findings into clinical practice while improving patient outcomes. Numerous evidence-based practice models are available to help nurses organize and systemically track progress in the implementation of evidence into practice. These models provide a step-by-step guide on how to take a clinical problem and match it with an intervention based on research to make an organizational or departmental change to practice (Brown.C. G.2014). Use of an established framework for implementation provides a structure to implementation efforts and increase the likelihood of project success and sustainability over time. Failure to utilize these approaches has the potential to create a secondary gap in knowledge translation within clinical settings (Tucker et al 2021).
Brown. C .G(2014). The lowa model of Evidence-Based Practice to promote Quality care An Illustrated Example in Oncology Nursing. Clinical Journal of Oncology Nursing vol (18) https://cjon.ons.org/files/987UI80063M01166.
Tucker. S, McNett. M, Mazurek. M. B, Hanarahan. K, Hunter. S.C, Kim. B, Callen. L & Kitson. A (2021). Implementation science: Application of Evidence-Based practice Models to Improve Healthcare Quality. Worldviews on Evidence-Based Nursing. 18:76-84. https://doi.org/10.1111/wvn.12495.
A framework is fashioned from the existence of a method and a model. It contains a structure that outlines the indication of how the results were generated, even though it does not show the complete detail of the research. Most of the frameworks have one or more models that are based on the modelling techniques of the research and the project. With the different frameworks methods, the user has more freedom on the user of the framework and can use the models and techniques, which are there in the research. The model is also still slightly different from the framework, although it seems the same as the framework. A model is used to elaborate or show the mechanism and the operation of several processes of processing things. On the other side, a framework shows an empirical relationship between all the aspects of an inquiry in the scientific theory or any further research (Hogg et al., 2007). It also elaborates on the hinders of the approach and other genera aspects which coordinates the framework.
A model is defined as something, which is used to represent any other thing or phenomenon. It primarily replaces the original product. The model has two main types, the physical and conceptual models. The physical model can be seen or touched; it is a material existing thing. While the conceptual model is the existence of something just as an idea or an imagination in ounce’s mind. The framework or model can create bias in research, mainly if not used in the right way of concept concerning the research being done (Younas & Maddigan, 2019). Although this method of analysis is highly reliable in any project, it needs a further reach to the project’s information to save on time and resources used. In addition, the data must be in plenty and well understood to come out with the right thing needed by the research. With this, you avoid the bias in research projects that lead to destruction and waste of resources and time.
Hogg, W., Rowan, M., Russell, G., Geneau, R., & Muldoon, L. (2007). Framework for primary care organizations: The importance of a structural domain. International Journal for Quality in Health Care, 20(5), 308–313. https://doi.org/10.1093/intqhc/mzm054
Younas, A., & Maddigan, J. (2019). Proposing a policy framework for nursing education for fostering compassion in nursing students: A critical review. Journal of Advanced Nursing, 75(8), 1621–1636. https://doi.org/10.1111/jan.13946s