Evidence based practice frame work and model for change

The EBP being done is the use of Silver alginate in the changing of central line dressings in the NICU. Comparing the use of this versus the normal dressing changes being done to prevent CLABSI.
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.
Discuss each of the stages in the change model/framework.
Describe how you would apply each stage of the model or theoretical framework in your proposed implementation.
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 a 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.

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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.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

MBA-MSN; MSN-Nursing Education; MSN Acute Care Nurse Practitioner-Adult-Gerontology; MSN Family Nurse Practitioner; MSN-Health Informatics; MSN-Health Care Quality and Patient Safety; MSN-Leadership in Health Care Systems; MSN-Public Health Nursing

1.2 Apply theoretical frameworks from nursing and other disciplines to make decisions regarding practice and health-related problems at the individual and population level.

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Solution

Evidence-Based Practice FrameWork and Model for Change

Evidence-based practice (EBP) assists medical practitioners in making the best choices for their care delivery based on the most up-to-date validated practical knowledge available. Although EBP is being used in a growing number of settings, it is still in its early stages. Practitioners must adjust their practices in order to enhance patient care by adopting EBP. An Evidence‐based practice model of change, like Roger’s Diffusion of Innovation Theory, may help steer the project by establishing a platform for transition to take place. This paper seeks to discuss this change model, the stages of the model, and how it applies to the EBP project of using Silver alginate in the changing of central line dressings in the NICU versus the normal dressing changes being done to prevent CLABSI.

Roger’s Diffusion of Innovation Theory

Founded by Everett Rogers, diffusion of innovation theory is a social science paradigm that describes how an innovation or idea tends to spread through time across a group or social structure, eventually being accepted as a normal way of life (Zhang, Yu, Yan, & Spil, 2015). Adoption requires the individual who is accommodating the spread to think that the thought or action is unique.

Rogers outlines five phases in this model that may be used to reduce the skepticism associated with a new concept, idea, or innovation. These phases are as follows:

  • Knowledge- discovering the presence of innovation and attempting to get information about the innovation.
  • Persuasion- the creation of a favorable attitude toward the idea or innovation
  • Decision- determining whether to accept or reject the idea or innovation
  • Implementation- applying the innovation or idea in a real-world situation
  • Confirmation- seeking support for the idea (Singer, 2016).

Each person adopts change at their own pace and, as a result, may be categorized into one of many adopter categories based on how long it takes them to accept a new idea or innovation (Hanrahan et al., 2015). The adopter may be classified into three types, which are as follows:

  • Innovators- Those who wish to be the first to experiment with the new idea
  • Early adopters or leaders- non-leaders who are keen to experiment with innovation before the rest
  • Late majority- the group of people who are skeptical of the novel innovation but eventually accept them when many others have tried them, and the group of people who prefer old techniques (LaMorte, 2019).

Aspects that impact the adoption of an invention that correspond to the five adopter types include.

  • Relative advantage- the extent to which an invention or concept is considered to be superior to what is presently being used or done.
  • Compatibility- the degree to which an invention or concept is well-matched with the ideals or requirements of the individual who is implementing the change.
  • Complexity- difficulty with which a change is understood or implemented is referred to as its complexity.
  • Trialability- the degree to which innovation has been tried or tested before being implemented
  • Observability- the degree to which an outcome may be noticed (Hanrahan et al., 2015).

Application to the EBP Project

CLABSI prevention in the neonatal intensive care unit (NICU) is not easy, but it may be accomplished with more efficiency if current techniques are modified. For the Evidence‐based project to successfully apply the phases of Roger’s Diffusion of Innovation theory, every participant will have to be evaluated for his or her willingness to change. It is possible to undertake the required interventions to guarantee continued prospects in preventing CLABSI in the NICU based on the person’s level of acceptance of the idea (Zhang et al., 2015). The willingness of nurses to accept change is critical to the successful implementation of the EBP.

During the knowledge phase, every nurse is given detailed training on the use of silver alginate in changing central line dressings in the NICU, as well as the impacts of this approach. Some workers’ resistance to change might be attributed to a lack of sufficient training on a new innovation (Hanrahan et al., 2015). In order to effectively use silver alginate in the changing of central line dressings, the dissemination of information and knowledge about this practice tailored to the culture of the healthcare organization must first be performed.

Participants will identify their sentiments or attitudes about the proposed silver alginate intervention during the persuasion stage (Singer, 2016). Comprehensive education on silver alginate is offered via handouts in the manner that is most appropriate for every person to guarantee that they comprehend the advantages and disadvantages of the change or, more specifically, that every person will recognize the relative advantage of using silver alginate in the changing of central line dressings in the NICU and its compatibility with the practice standards, as well as the benefits and drawbacks of the change. Teaching people how the intervention may help prevent CLABSI may look complicated at first, but with detailed illustrations, people can easily learn.

After the persuasion phase is completed, the choice is made whether to proceed with the new innovation or to reject it entirely. It is essential that each participant is engaged in the development of the implementation plan, and that they make frequent check-ins to confirm that they are utilizing Silver alginate for central line dressing changes instead of standard dressing changes in order to avoid CLABSI (Sreeramoju, 2017).

When nurses have accomplished their goal of decreasing CLABSI in the NICU, they have hit the confirmation stage, and each of them will keep gaining more knowledge about new approaches that are related to the change. Following the conclusion of a project or program, the following-up process continues.

Conclusion

The Diffusion of Innovation theory developed by Rogers is an ideal theoretical model for adopting the use of silver alginate in the changing of central line dressings in the NICU in order to prevent CLABSI. Spreading information across a timeframe using proper communication means will help the idea become more widely accepted and used.

References

Hanrahan, K., Wagner, M., Matthews, G., Stewart, S., Dawson, C., Greiner, J., … Williamson, A. (2015, January). Sacred cow gone to pasture: A systematic evaluation and integration of evidence-based practice. Worldviews on Evidence-Based Nursing12(1), 3-11.

LaMorte, W. W. (2019). Behavior change models: Diffusion of Innovation Theory. Retrieved from https://sphweb.bumc.bu.edu/otlt/mph-modules/sb/behavioralchangetheories/behavioralchangetheories4.html

Sreeramoju, P. (2019, February). Reducing infections “together”: a review of socioadaptive approaches. In Open forum infectious diseases (Vol. 6, No. 2, p. ofy348). US: Oxford University Press.

Singer, L. (2016, December). On the Diffusion of Innovations: How new ideas spread. https://leif.me/on-the-diffusion-of-innovations-how-new-ideas- spread/

Zhang, X., Yu, P., Yan, J., & Spil, I. A. (2015, February 21). Using diffusion of innovation theory to understand the factors impacting patient acceptance and use of consumer e-health innovations: a case study in a primary care clinic. BMC Health Services Research15https://doi.org/10.1186/s12913-015-0726-2