Evidence-based practice is essential to providing safe, quality care to a diverse population in the acute care setting as well as in the community. Understanding the health care system at the local level is essential to consider when planning the implementation of evidence-based practice (EBP) because it helps those implementing changes understand and execute the move in an area of greatest need. Franklin and Hopson (2007) write that implementing evidence-based practice change in the community setting is challenging. Interventions that work in research or acute care setting are often very challenging to implement locally in the community setting due to the struggle with “building partnerships between clinical practitioners and researchers” (Franklin & Hopson, 2007, p. 379). Maintaining the effectiveness and reliability of interventions once moved to the community setting is difficult thus careful attention to the specific needs of the local community health care system is imperative (Franklin & Hopson, 2007).

Information from my course mentor that I will consider for my project is to ensure that I am following the hospital’s shared governance model to allow other nurses on the unit to have a voice in the project change (T. Brock, personal communication, August 20, 2019). The hospital where I am implementing my project change is a Magnet culture and uses a shared governance model when considering implementation of evidence-based practice change. My practice change does not only affect me, so it is imperative to share accountability and partnership with my unit manager, peers, and unit-based council members when implementing a project change on the unit for effective outcomes (T. Brock, personal communication, August 20, 2019).

Reference

Franklin, C., & Hopson, L. M. (2007). Facilitating the use of evidence-based practice in 

community organizations. Journal of Social Work Education, (3), 377-404. Retrieved 

from https://search-ebscohost-com.lopes.idm.oclc.org/login.aspx?

direct=true&db=edsgao&AN=edsgcl.170506618&site=eds-live&scope=site

Lewin’s Change Theory has three concepts that includes “driving forces,” “restraining forces,” and “equilibrium.” As the driving force implies, there are forces that push or cause things to change, shifting the equilibrium. Restraining forces fight against the driving forces which also causes shifts in equilibrium. Equilibrium can be described when no changes occur due to equal amount of force applied. There are three stages in his theory and that is “unfreezing,” “change,” and “refreezing.” Unfreezing is getting out of the rut of behaviors that are not healthy or productive. This requires fortitude to break out of the individual mindset and group conformity. This can be accomplished by either increasing the driving forces that direct behaviors away from the current norm or by decreasing the restraining forces that negatively affect movement away from equilibrium. A third alternative would be a combination of both. The change stage is producing growth and moving to a new level. It is evidenced by new thought, feeling and/or behavior changes. The refreezing stage is making the new patterns set as the new normal. Once they are “frozen,” it helps to prevent falling back into old unhealthy patterns (Change Theory, 2011).

Imogene King: Goal Attainment Theory has an emphasis on interaction theory vs systems theory. The concepts are based on an open system framework that honors nursing as a major system within the health care system, and places high emphasis on interpersonal processes. In the conceptual framework are three systems; the Personal (individual), Interpersonal (individuals interacting with each other) and the Social where groups of people in a community or society share common goals, interests, and values and is studied as a whole vs isolated parts. The practice of nursing is differentiated from other healthcare professions in that interpersonal systems are in place and this is reflected in the nurse-client relationship. The individual is viewed as a spiritual being, rational thinker, and records own history through own language, and expresses individual needs, wants, and goals. Humans have three fundamental needs: access to health information, illness prevention, care in times of illness. Health is dependent on continuous adjustment to stressors in the internal and external environments with use of ones resources to achieve maximum potential (Gragera, 2013).

Theory for EBP Project

The Goal Attainment Theory seems to be the best fit for the Capstone project. Results of screening and referrals develop into IHPs and IEPs that are tailored to the individual’s needs. This would seem to fit best with engaging the entire intraprofessional team in working with the student and the family in implementing interventions.

Theory Used by Mentor 

“I suppose I engage some level of nursing theory with each response in the work setting, protocol development, policy revision, and the like. When looking at the two theories you shared, I would probably most closely align myself with Imogene King’s Goal Attainment Theory. Nursing is a major system within the health care system, with vast and significant impact on individuals, families/groups, and communities (local, regional, national, and world)” (P. Anderson, personal communication, August 19, 2019).

“I’ve consistently landed on the historical (and I think still relevant) dimensions of health: physical, social, emotional, intellectual, spiritual. The individual, embracing, reflecting, and continuously balancing these five dimensions, can engage in self-responsibility and decision-making relative to the three fundamental needs identified in King’ theory:  health information, illness prevention, and care in times of illness ~ expressing needs, wants, and goals” (P. Anderson, personal communication, August 19, 2019).

Change Theory. (2011). Retrieved from http://currentnursing.com/nursing_theory/change_theory.html

Gragera, Jen. Imogene King: Goal Attainment Theory. (2013). Retrieved from https://www.slideshare.net/jen316/imogene-king-23548267

 

This assignment will incorporate a common practical tool in helping clinicians begin to ethically analyze a case. Organizing the data in this way will help you apply the four principles of principlism.

Based on the “Case Study: Healing and Autonomy” and other required topic study materials, you will complete the “Applying the Four Principles: Case Study” document that includes the following:

Part 1: Chart

This chart will formalize principlism and the four-boxes approach by organizing the data from the case study according to the relevant principles of biomedical ethics: autonomy, beneficence, nonmaleficence, and justice.

Part 2: Evaluation

This part includes questions, to be answered in a total of 500 words, that describe how principalism would be applied according to the Christian worldview.

Remember to support your responses with the topic study materials.

APA style is not required, but solid academic writing is expected.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

 

Using resources such as the CDC, state and county health department websites, and various local resources, identify an opportunity for improved health behavior in an individual client. Your paper should be 1 – 2 pages in length in addition to the cover page and reference page. You should use a minimum of three references to support your work.

Be sure to cover the following:

• Identify an opportunity to for improved health behavior in an individualized client.
• Identify short and long term goals for the achievement of the overall health goal.
• Using Healthy People 2020, identify which problem you are working on improving.
• Recognize local resources to aid in the resolution of the identified problem.
• Assist in the evaluation in the response to interventions.

     

Spelling, grammar, APA format, and minimum   of 3 references

1

 

Identify an opportunity for improved health   behavior in an individualized client.

1

 

Using Health People 2020, identify which   problem you are working on improving.

2

 

Identify short and long term goals for the   achievement of the overall health goal.

2

 

Recognize local resources to aid in the   resolution of the identified problem.

2

 

Discuss measurements that can be used to   determine the responses to interventions.

2

 

10

 

In this assignment, you will propose a quality improvement initiative from your place of employment that could easily be implemented if approved. Assume you are presenting this program to the board for approval of funding. Write an executive summary (750-1,000 words) to present to the board, from which the board will make its decision to fund your program or project. Include the following:

1. The purpose of the quality improvement initiative.
2. The target population or audience.
3. The benefits of the quality improvement initiative.
4. The interprofessional collaboration that would be required to implement the quality improvement initiative.
5. The cost or budget justification.
6. The basis upon which the quality improvement initiative will be evaluated.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.