1. What evidence-based communication skills, change processes, and interventions are you using to guide your work in the field experience? Please be complete and provide at least 2 examples of how you are using these practices.
The main process employed in change was team-based implementation. A committee consisting of staff members, this writer, and the nurse educator was formed for the project. The committee provided a venue for participants to provide input during the development of the project, and to take part in its implementation. Doing so ensured the optimization of the knowledge and skills of the committee members, so that the final project was the most appropriate to our practice setting and the most effective in meeting our need to reduce the rate of turnover (Covill & Hope, 2012; Glenn, 2010). It also elicited buy-in, support, and commitment for the project within the committee and the rest of the staff that were crucial in its success. The committee also showed how intra-professional collaboration can bring about the best outcomes in enhancing the work environment. The experience serves as springboard for future collaborations among the staff.
This writer employed open communication skills for the purpose of initiating the project and managing the change accompanying its implementation. Within the committee, brainstorming sessions were held during the conceptualization phase to facilitate the expression of ideas and flow of relevant information from the staff. Meetings were also held for purposes of decision-making, troubleshooting arising issues during implementation, and monitoring and evaluating the project outcomes. As such, my experience validated how open communication is an indispensable element to team-based project implementation (Kassean & Jagoo, 2005; Knaus, 2009). Open communication also involved being sensitive to the verbal and nonverbal communication of the rest of the staff that was useful in determining the level of acceptability of and enthusiasm for the project.
One other evidence-based intervention was piloting the project. Piloting entails small scale implementation and eliciting input for the purpose of determining any weaknesses or areas of improvement (AHRQ, 2012). Such areas are sufficiently addressed prior to implementation, which guarantees an effective and acceptable mentorship program. In my fieldwork, the committee decided to pilot the project using one mentor-mentee pair. The pair was followed for one month to determine the impact of mentorship and any problems that arose. Feedback was provided by the mentor and mentee, and some components of the project were modified before it was finalized into a document describing the mentorship program. While the committee exercised diligence during the conceptualization phase, a small-scale implementation provides additional insight on what real implementation looks like and any unexpected events requiring adaptation.
2. How does the use of these evidence-based strategies assist you in meeting a) DNP essentials (be specific as to which essentials); and b) your objectives (also please be specific)?
The use of evidence-based strategies as described above is helpful in meeting the DNP essentials and my project objectives. One DNP essential is organizational and systems leadership for quality improvement and systems thinking (AACN, 2006). A team-based approach in conjunction with open communication creates a wider perspective in that the focus is the entire nursing staff and there is a conscious attempt to influence organizational factors that contribute to the problem. Two other DNP essentials pertain to the use of clinical scholarship and analytic methods for evidence-based practice and ensuring a scientific underpinning for practice (AACN, 2006). Using strategies supported by literature and engaging the staff in the systematic analysis and resolution of the problem facilitate the fulfillment of these essentials.
On the other hand, my objectives pertain to experiencing leadership, change management, and research utilization. Promoting collaboration and using open communication allowed me to motivate and lead change in the work environment, as well as positively manage this change. Leadership is about influencing others to act in desirable ways. This was attained by using participatory leadership. Meanwhile, I experienced research utilization through the application of findings and recommendations from the literature into the project development, implementation, and evaluation phases. Guidance from available nursing knowledge guarantees the possibility of effectiveness especially when adapted into the context of the chosen practice setting.
References
Agency for Healthcare Research and Quality (2012). Chapter 4: Developing and pilot testing change: Implementing the medication reconciliation process. Retrieved from http://www.ahrq.gov/professionals/quality-patient-safety/patient-safety- resources/resources/match/match4.html#ack
American Association of Colleges of Nursing (2006). The essentials of doctoral education for advanced nursing practice. Retrieved from http://www.aacn.nche.edu/publications/position/dnpessentials.pdf
Covill, C., & Hope, A. (2012). Practice development: Implementing a change of practice as a team. British Journal of Community Nursing, 17(8), 378-383. Retrieved from http://www.magonlinelibrary.com/doi/abs/10.12968/bjcn.2012.17.8.378?url_ver=Z39 .88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed
Glenn, L. (2010). Implementing change. Journal of Community Nursing, 24(5), 10-14. Retrieved from http://www.jcn.co.uk/journal/09-2010/management/1377- implementing-change/
Kassean, H.K., & Jagoo, Z.B. (2005). Managing change in the nursing handover from traditional to bedside handover: A case study. BMC Nursing, 4(1), 1-6. doi:10.1186/1472-6955-4-1.
Knaus, M.A. (2009). Perspectives on leadership: Planning and implementing change in healthcare. Journal of the Dermatology Nurses’ Association, 1(2), 129-130. Retrieved from http://www.nursingcenter.com/lnc/journalarticle?Article_ID=857888
