The impact of implementing change in my environment and factors to be considered regarding end users and stakeholders
Change is a basic component of continuous quality improvement. The necessity for safety and quality improvement initiatives inculcates health care greatly. Change in the management of any organization is of paramount importance; therefore it is coherent to measure the effectiveness of the change and its influence in the organization. Though Evidence based health care practices are available for conditions like asthma and heart failure as well as diabetes, most of the time these practices are not implemented in care delivery and variation in practice are evident. Through the implementation practices of change, health care is made safer, but safety practices are difficult to implement and need proper strategies to address the complexity of systems of care itself, the practitioners, leaders and the people’s cultures about health care. The focus on system change is much associated with enhancement of a number of improvement strategies and tools that are geared towards system improvement.
- Methods that will ensure implementation is fully done
One method that would be used is the application is the Evidence-based practice (EBP). It is basically the judicious and conscientious use of contemporary and new use of clinical expertise, best evidence and patient values to enhance coherent decisions in health care. Empirical evidence could also be use alongside evidence-based practices which include scientific methods like the description and the qualitative research methods (Houser, 2011, p. 213). Information from expert opinion leaders can be of relevant use and also information from hospital and police case reports may play a significant role in giving information, as well as scientific principles.
- The Desired Outcomes of my EBP Project
Successful implementation of system change in the Evidence-based practices is of paramount importance particularly in enhancing a monitoring program. This program will utilize key elements of retention of faculty and job satisfaction in a nursing school. To start with members within the system will fully be engaged in the improvement of various aspects of the organization. This is because people are generally symbolic resource, barrier, support and even risk in change management. Seemingly, a range of emotions could be displayed by persons who directly or indirectly are affected in the process of change; acceptance, frustration, despair, anger, elation and enthusiasm. Comprehending reasons behind occurrence of these emotions could assist to initiate change in a certain way that acknowledges, anticipates and responds to concerns (Hopp, 2012, p. 87).
- Communication
Communication is important to the organization and therefore it should take place in some certain form with all parties affected by the projected change, internal and external stakeholders, staff and consumers. At given points, stakeholders could be consulted, informed and collaborated with. Notably, in order to implement change in Evidence-based practices, commitment from the people will greatly be required. These people will in one way or another be affected by the proposed changes with two basic aspects; resistance and motivation.
- Motivation
People will be committed to change only if the change will be successful. For instance, a ‘win-win’ situation for all will pretty much help to identify useful motivators. Encouraging discussions and debates on the need for transformation by presenting data may assist in creating a sense of urgency.
- Resistance
Resistance is a universal, natural, inevitable human reaction to change where another individual presumes is a credible idea, improvement and resisting change doesn’t quite one narrow-minded or bad.
- Using a Pilot
Commencing change with a pilot is often a good idea especially in regards to a minute test of the proposed solution or option that could be undertaken in a particular area which is ready to be involved. The trial or pilot could highlight any hindrances and also provide coherent studies in relevant change strategies. Therefore, the outcomes and information accrued from a pilot could alter and re-define a certain approach that may be used in enhancing change.
With these strategies, a defined communication strategy will be enhanced that will involve all parties including stakeholders in the planning process. Staff will also be supported with opportunities and training to identify change champions (In, 2013, p. 98).
Evaluating EBP Projects
- Macro and micro systems issues which may inhibit both implementation and strategies for resolving the issues
Macro system issues are the major external issues inhibiting implementation and strategies for resolving issues while micro systems are the minor internal issues inhibiting various strategies and implementation of activities in organizations. Macro systems may include forces from above “ministry” national level or international level affecting operations of an organization in one way or another. This involvement may include change of policies of rules and regulations.
Micro system issues could probably involve forces from within the system ‘locally’. For instance, the manager giving orders different from the usual ones, or else, change in management leading to alteration of activities within the system. Micro system issues are basically minute issues within the local organization that need amendment, change or reshuffle to include or exclude part of the amendments within the structure (Hoffmann, 2009, p. 221).
- How my presumed project issue will significantly improve both quality and patient safety
Resolving the proposed Evidence-based practices in our organization will ultimately improve performance in a number of ways; its primary benefit which is improving patient care will solve specific issues and problems in a specific patient or unit. This includes; decreasing surgical infection rates as well as length of stay for admitted patients. This strategy will commence with identifying an outcome to be improved or a problem to be solved. Identification of the problem to be solved will be the very first task which includes reviewing the literature and establishing the evidence that supports a possible solution.
Resolving EBP project issues will greatly improve patient safety and quality by increasing confidence in decision making. Nurses will be well equipped with current and relevant health practices that are effective and efficient. Generally, EPB is presumed to result in better patient outcomes such as a good response to medication, surgery and other types of therapies aimed at improving patients’ health (Courtney, 2010, p. 218).
Evaluation strategies
- New practice guidelines based on the possible results of the evaluation outcome
There are five steps of evaluating evidence-based practice process which includes;
- Formulation of a clinical question – A clinical question will be formed to address current issues in the organization that need to be addressed with immediate effect. This question could be concerning patients, nurses, management or operations within the organization.
- Gathering the best evidence to answer the proposed clinical question –a proper research will be done to determine the cause, factors and alarming issues leading to this question. It is after a critically establishing the root cause and factors leading to the question that a solution will be found.
- Critical assessment of the best evidence –Determining the solution to the problem is the immediate thing to focus on. It entails a proper research on the question/issue at hand and ways to tackle it comprehensively.
- Integration of the evidence the expertise of the clinician, available health care resources’, assessment of the patient’s condition as well as the patient’s values and preferences to execute a clinical decision.
These five steps are very critical and basic in implementing practice change. Clinicians, nurses and other health professionals ought to fully understand the effectiveness of patient/clinical decisions.
- New standards of care which are relevant to the latest practice guidelines
Self reflection –In order to provide proper client care, nurses must understand the client culture/s as well as that of the nursing profession. Every person has certain beliefs, biases, and values and they affect the manner in which people respond to particular aspects. The nursing profession has got a culture and values such as empathy and respecting the choices of the client greatly influence the interaction of the nurse and the clients.
Facilitating Client Choice –Arguably clients moreover differ in their definitions of health and quality of life. The role of the physician/nurse is to help the client meet his/her health goals.
Communication –A curative client-nurse relationship is mainly based on coherent communication between the client and the nurse. Occurrence of communication barrier causes the nurse to develop a plan to restore the effective communication strategy. This includes non-verbal and verbal approaches.
Developing approaches to care –It is the duty of the nurse to work in partnership with the client to create a wide-ranging plan of care. This plan needs to also include the client’s culture and preferences (Boltz, 2012, p. 74).
Assessment –It is coherent to bring out relevant information about the client which could be accomplished by allowing the client to enough opportunity to explain. Proper assessment of the client and their current situation in regards to health is very important. This has been stressed in the new standards of care which state that proper care must be taken on the client for effective assessment.
References
Houser, J., & Oman, K. S. (2011). Evidence-based practice: An implementation guide for healthcare organizations. Sudbury, MA: Jones and Bartlett Learning.
Hopp, L., & Rittenmeyer, L. (2012). Introduction to evidence-based practice: A practical guide for nursing. Philadelphia: F.A. Davis Company.
In Thyer, B. A., In Dulmus, C. N., & In Sowers, K. M. (2013). Developing Evidence-Based Generalist Practice Skills. Hoboken, N.J: John Wiley & Sons, Inc.
Hoffmann, T., Bennett, S., & Del, M. C. (2009). Evidence-based practice across the health professions. Chatswood, N.S.W: Elsevier Australia.
Courtney, M. D., & McCutcheon, H. (2010). Using evidence to guide nursing practice. Sydney: Churchill Livingstone/Elsevier.
Boltz, M. (2012). Evidence-based geriatric nursing protocols for best practice. New York: Springer Pub. Co.
