RE: Discussion – Week 9

COLLAPSE

Several models have been created to help with disseminating evidence-based practice. The first model I am most inclined to use is the Iowa Model. Melnyk, B. & Fineout-Overholt, E. (2018) state that the purpose of this model is to guide nurses in developing questions related to clinical practice and decision making to affect improvement in patient outcomes. I like the Iowa model because its design is for nurses and clinicians in inpatient care. The model contains specific steps to identify a problem in current practice, identify measures for improvement, and then implement those improvements into practice. (Melynk, B. & Fineout-Overholt, E. (2018). One barrier to the Iowa model is that it is designed to identify an inquiry to fit the organization’s needs. (Melynk, B. & Fineout-Overholt, E. (2018). This can be a problem if your identified problem or area of interest does not align with something the facility is willing to research and implement. A way to overcome this would be to do independent research and present it to stakeholders on why your identified topic is essential to the organization. Another barrier is that stakeholder involvement is a crucial component to help with the dissemination and implementation of evidence-based practice. A way to overcome this would be by having fellow nurses collaborate with you on the topic’s importance to help influence the manager’s willingness to approve and participate in the proposed practice change.

The ARCC Model is another model I am inclined to use for disseminating evidence-based practice. The ARCC model compares a standard of practice utilized in the past or over the years to the current standard of practice in the everyday practice area and identifies improvement needs. (Melynk, B. & Fineout-Overholt, E. (2018). This model is useful because nurses are always looking to improve current practices by comparing the past with current care standards. A barrier to the ARCC model will occur if the organization has inadequate knowledge related to evidence-based practice. This can be overcome by having educated mentors present to educate staff on evidenced-based practice through various methods. Another barrier is staff expertise in carrying out the evidence-based practice. (Melynk, B. & Fineout-Overholt, E. (2018). If there are no knowledgeable mentors and clinicians available to help carry out and monitor the evidence-based practice changes, results may not occur. This barrier is overcome by making sure enough competent clinicians are involved in the process.

The Stetler Model is a strategy I least likely will use. Melynk, B. & Fineout-Overholt, E. (2018) states that the Stetler model favors individual practitioners and advanced practitioners over staff nurses or combined teams of interdisciplinary professionals. For a practice related to a hospital unit change, most of the team members involved would not be advanced practitioners, so this is why I feel like this model would not work. In conclusion, I believe the learning resources models are beneficial when it comes to implementing evidence-based practice.

Reference

Melnyk, B. M. & Fineout-Overholt, E. (2018). Evidence-based practice in nursing and healthcare: A guide to best practice (4th ed.) Philadelphia, PA: Wolters Kluwer, pp 378-427.

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C:/Users/SASHI/AppData/Roaming/PolarisOffice/ETemp/9188_7581504/fImage653148467.png Mary Hedrick

RE: Discussion – Week 9

COLLAPSE

Discussion Week 9

Evidence-based practice (EBP) is the integration of patient preferences and values, clinical expertise and rigorous research to make decisions that lead to improved outcomes for the patients as well as their families (Melnyk & Fineout-Overholt, 2019). This process begins when a problem or area of concern is recognized. The research is performed, and then the solution must be put in place. There are several strategies that were developed to disseminate the information.

I chose to use the Iowa Model for nurses as well as the Clinical Scholar Model. In the Iowa Model, the priority is given to the organization and the specific strategic plan that the hospital has chosen to use. A team approach is used. The team will include nurses, managers, interprofessional colleagues and even leaders within the organization. Proactive planning is utilized in order to prevent a relapse to the “old ways”. This would require literature to be placed around the hospital in the forms of posters and possibly some required continuing education for staff. The continuing education could verify that the education was completed.

The Clinical Scholar Model promotes the spirit of the inquiry, educates direct providers and even involves a mentorship for the designated process (Melnyk, 2019). This model began as an interactive model and promotes observation and reflection. Staff are encouraged to critically think and write researchable questions. This model also promotes sharing the findings with other organizations in hopes of inspiring positive research for others. This model would best be shared in the form of lectures. Motivational speakers could inform the staff of the importance of their questions and areas of potential research. Also, the lectures could be recorded and shared with others to continue the positive energy that surround this model.

The Iowa Model and the Clinical Scholar Model would require energetic staff that want to make a change. Some barriers may include the staff not viewing the change as important, the organization reluctant to make changes in current policies and procedures, and staff not willing to provide the continuing education needed to successfully implement and continue the proposed change. Educating the staff and having leadership in the organization that embrace change are also key to the success.

The Stetler Model would not be a beneficial model for my research. This model has been known as a practitioner-oriented model. This model is geared to more advanced practitioners that would not be inserting or maintaining the peripheral IV sites that are the basis of my research.

The Stevens Star Model would not be applicable to my area of research. This model relies on patient preferences as well as circumstances of the setting. The use of a PIV in my research would not depend on patient preference. Also, the setting would not be a factor in my area of research. Although this is a great model, I don’t think the patient satisfaction portion is applicable either.

In conclusion, the basis of EBP faces many challenges. The most important step for all is recognizing that there is a problem or issue and that there is a potential to make the problem better and safer for the staff and the patients. Also, understanding that people are resistant to change. Time and patience must be utilized throughout all phases of the EBP process.

References

Melnyk, B. M. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice (Fourth edition). Wolters Kluwer Health.