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.
Communication is a key skill that leads to the translation of research evidence into practice. Constructive feedback is an evidence-based strategy of communicating observations about a staff member’s behaviors. It entails focusing on the behavior and not the person, stating observations rather than judgments, and working out with the staff how to communicate more effectively (Duffy, 2013). In the course of my field experience, I employed constructive feedback to let a nurse know that she was communicating with peers in a way that was hostile and disrespectful. The purpose of my project was to address nurse turnover by promoting collegial relationships among the staff members through a mentorship program. Hostility within the team is a barrier to successful project implementation and worsens turnover. Thus, the behavior needed to be dealt with in a positive way. In addition, two-way communication during meetings enables the transmission of valuable information from the staff and is a component of participatory change (Diedrick, Schaffer & Sandau, 2011). I needed to obtain input from the nurses as to what they thought the mentorship program should look like. I also needed feedback for monitoring and evaluation purposes. In both instances, two-way communication was helpful.
Participatory change is another evidence-based practice I employed. Knowledge and skills in mentoring are not sufficient to bring about a more collegial atmosphere in the workplace. Rather, the staff needs to be motivated to embody the attitudes and behaviors reflective of a nurturing environment. Commitment contributes to motivation and is elicited through participation because it enables collective ownership of the project (Abad-Corpa et al., 2013). During meetings, I encouraged the staff to express their thoughts and suggestions regarding the proposed project as well as take on tasks they were capable of performing. In doing so, the project became not mine but ours. A common responsibility for the outcomes motivated the staff, especially the senior nurses, to mentor newer nurses in accordance with their education and training.
Another evidence-based intervention is the use of the principles of andragogy in educating the staff. By virtue of their life experiences and engagement in professional practice, they have unique learning needs that are effectively met through adult education (Gom, 2009). I employed a workshop type of education that permitted the sharing of mentor and mentee experiences among the staff. Besides learning from others, the workshop generated best practices recommended for adoption by potential mentors in the program.
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 above evidence-based strategies help me achieve organizational and systems leadership for quality improvement and systems thinking (Essential II), interprofessional collaboration for improving patient and population health outcomes (Essential VI), and advanced nursing practice (Essential VIII) (AACN, 2006). Participatory change management requires leadership that considers organizational culture and the work environment as broad overarching factors influencing job satisfaction, commitment, and retention among the staff. The inability to recognize these factors lead to a myopic view of issues, e.g. separation from the company as an individual decision rather than a function of negative workplace attributes, and inappropriate as well as ineffective responses.
On the other hand, systems thinking allow critical analysis of the interrelationships of the work environment and employee outcomes (Clark et al., 2013). Meanwhile, communication skills promote collaboration among nurses and between nurses and other health care professionals. Collaboration is important in successfully rendering patient care and in implementing improvements therein as well as in organizational systems and processes (Chapman, 2009). Lastly, use of adult-centered education fosters advanced nursing practice. It is an effective strategy of supporting the professional development of nurses so that they can provide better nursing care.
The evidence-based strategies also assist in attaining the project objectives. Two-way communication helps create a comprehensive picture of the development and implementation of the mentorship program that supports Objective #1. It also permits the transmission of data useful in quantifying the impact of the program as stated in Objective #4. Participatory change management, on the other hand, facilitates the utilization of the staff nurses’ knowledge as a form of evidence supporting the effectiveness of mentoring and best practices therein, both of which can be validated by reviewing the evidence generated by formal research in Objective #2. Lastly, andragogy represents best practice in building staff capacity for mentorship, an intervention employed to improve recruitment and retention for the achievement of Objective #3.
References
Abad-Corpa, E., Delgado-Hito, P., Cabrera-Garcia, J., Meseguer-Liza, C., Zarate-Riscal, C.L., Carillo-Alcaraz, A., Caravaca-Hernandez, A. (2013). Implementing evidence in an onco-haematology nursing unit: A process of change using participatory action research. International Journal of Evidence-based Healthcare, 11(1), 46-55. doi:10.1111/1744-1609.12006.
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
Chapman, K.B. (2009). Improving communication among nurses, patients, and physicians. American Journal of Nursing, 109(11), 21-25. doi: 10.1097/01.NAJ.0000362013.53342.17.
Clark, J., Singer, S., Kane, N., & Valentine, M. (2013). From striving to thriving: Systems thinking, strategy, and the performance of safety net hospitals. Health Care Management Review, 38(3), 211-223. doi: 10.1097/HMR.0b013e31825ba9ab.
Diedrick, L.A., Schaffer, M.A., & Sandau, K.E. (2011). A practical communication strategy to improve implementation of evidenced-based practice. The Journal of Nursing Administration, 41(11), 459-465. doi: 10.1097/NNA.0b013e3182346e61.
Duffy, K. (2013). Providing constructive feedback to students during mentoring. Nursing Standard, 27(31), 50-56. Retrieved from http://rcnpublishing.com/doi/pdfplus/10.7748/ns2013.04.27.31.50.e7334
Gom, O. (2009). Motivation and adult learning. Contemporary PNG Studies: DWU Research Journal, 10, 17-25. Retrieved from http://search.informit.com.au/documentSummary;dn=962884090077237;res=IELI ND
