Discuss growth opportunities for health insurance in Saudi Arabia. What challenges do you see in the future? How can health insurance in Saudi Arabia financially impact the country? What can it do for health care?

Be sure to support your statements with logic and argument, citing any sources referenced. Post your initial response early, and check back often to continue the discussion.

You are required to reply to at least two of your peers’ answer posts to this weekly discussion question and/or your instructor’s response to your posting. These post replies need to be substantial and constructive in nature. They should add to the content of the post and evaluate/analyze that post’s answer. Normal course dialogue doesn’t fulfill these two peer replies, but is expected throughout the course. Answering all course questions is also required.

 

Implementing EBP Model in Practice, Administration, or Education Setting

            To implement evidence based practice (EBP), the Iowa Model is widely considered to be one of the best models to use. It is routinely used in implementing EBP in nursing practice and education. This model consists of seven steps for implementation including: selecting a topic, forming a team, evidence retrieval, grading the evidence developing a EBP standard, implementing the evidence, and evaluation (Buckwalter et al., 2017). Due to the thorough nature of this theory, it can useful in implementing EBP interventions in nursing education and/or practice. This model is detailed in terms of the steps that it lays out and allows for a researcher to easy follow the steps to implement EBP in their respective setting. Another important step in the process of implementing EBP is evaluation, this model addresses this topic and allows the researcher to determine if the intervention was effective in practice or an educational setting (Buckwalter et al., 2017).

Introducing the Change

 This change could be introduced by two methods. First to help introduce the change a team could be formed specific to that area of practice (Buckwalter et al., 2017). This would help facilitate engagement among staff members when trying to implement EBP in a practice setting or among learners in an educational environment. The other major factor with using this model to introduce change, is the impact or magnitude of the problem being researched. If the problem lacks depth and importance, it is less likely to be implemented (Buckwalter et al., 2017).

Barriers to Change

 One possible barrier to introducing this model may be lack of support for its use in the practice or educational setting. For example, some staff members may find the IOWA Model more difficult to use compared to other models. Another possible barrier is preconceived notions that EBP research and implementation is difficult and time consuming. Lastly, another barrier to implementing change with this model is that some people may find that using this process takes time and some may not want to use this method (Buckwalter et al., 2017).

 

Lewin’s Change Management Theory is a standard theory used by nurses across specialty areas for various quality improvement plans to modify care at the bedside (Wojciechowski et al., 2016). According to new research, Lewin’s Change Management Model consists of three key phases: unfreeze, change, refreeze. These steps refer to the three-stage process of change that he describes. The first phase, unfreezing, involves preparing the team or unit to accept that change is necessary, which involves breaking down (melting) the existing status quo before introducing a new way of operating. Developing a compelling message to exhibit why there must be a change is critical. The second phase of change occurs when people begin exploring new ways of accomplishing tasks or improving the old ways. Refreezing, the third step of the model, is when the new changes have taken shape and those who are practicing the advancements are embracing the updated policies (Lewin’s Change Management Model: Understanding the Three Stages of Change, n.d.).

Healthcare systems must be adaptive to maintain equilibrium and survive as change is a constant (Wojciechowski et al., 2016). Using Lewin’s Change Model is an excellent approach to introduce best practices to guarantee willing participation and understanding from those involved. Change, in general, can be scary or unpredictable to some. People need time to understand the how and why of changes, and they also need to feel deeply connected to the group throughout the transition period (Lewin’s Change Management Model: Understanding the Three Stages of Change, n.d.). Giving time and support through a hands-on approach would ensure a smooth transition to new practices. According to Wojciechowski et al. (2016), Lewin’s change theory has a few criticisms. Lack of accountability for the cooperation of individuals or groups involved and a failure to address the complex processes of change are among the critiques. As evidenced by this study, Lewin’s model should be used in conjunction with other models to ensure a comprehensive strategy to introduce and implement change. Additional models would compensate for these shortcomings.

 

Change Agent

To purpose and use evidence-based practice in promoting positive outcomes, change is inevitable. As much as “change is vital to progress in evidence-based nursing practice, there are many complexities associated with transforming plans into action and attempts at change often fail because change agents take an unstructured approach to implementation” (Mitchell, 2013). I believe I can be a change agent by “carrying out a calculated, purposeful and collaborative effort to guide others to move from a process focus to an outcome focus” (Mitchell, 2013).

Relationship to the area of practice

I work in an acute care setting where most of the patients have a therapeutic indication for indwelling urinary catheters (IUC). We have a CQI team which I am part of, as a change agent and member of the CQI, it is my responsibility to see that to the pre-assessment and monitoring of patient on IUC. IUC must have a physician’s order, then a urinary catheter assessment bundle must be filled and signed by two registered nurses after assessing the patient and reviewing his or her chart for allergies to latex or silicone and a therapeutic/appropriate indication for the IUC.  Afterward, placement must be done by two nurses with an utmost degree of hand hygiene and sterility. After the catheter placement, a daily assessment is done by the CQI team to identify indications for continued use or discontinuation of the IUC. The CQI team always make sure CDC guideline for CAUTI prevention is followed at all time. Although this process of IUC use was resisted by many, the change was implemented and still in place.

The rationale behind the change from a process focus to an outcomes focus.

Shifting from process to outcome focus especially on the nursing and care of patients is imperative. While a process focus will only explain whether the “procedures, activities or services have been performed rightly and implemented as intended, an outcome focus will explain the results and determines whether the intended outcomes are achieved” (Center for Disease Control and Prevention, n.d). Outcomes focus thus helps to determine the degree to which the nursing care rendered helps to meet the goal and provide evidence-based practice for use thus improves patient care, safety, and recovery.

 1. Is there an abstract with a list of keywords preceding the research paper?  

• Cover page?
• Page numbers?
• Indented paragraphs?
• 1” margins?
• A total of 5 pages, not including the cover page, abstract and references page?

 2. Introduction: Is the thesis clear?  What is it?  

 Does it appear soon enough in the paper?

• What questions does the thesis promise to answer? There are usually three, sometimes two, sometimes four or more.
• 1
• 2
• 3

1. Introduction: Is there some background given in the introduction that gives you some idea of why this topic is important or timely or relevant?  What is it?
2. Introduction: Is there an engaging first sentence?  
   • Is it an interesting fact, 
   • alarming statistic, 
   • question, 
   • quote, 
   • story
3. Introduction: Is there any terminology you need defined sooner to better understand the discussion that follows?
4. Body: In which paragraphs has each of the thesis questions been answered?

• 1
• 2
• 3

1. Body: Evidence: Has evidence been given to back up the claims made the research paper?  Since the research paper is required to have four sources, you should find at least four different sources cited in APA style as in-text citations (also called parenthetical citations).

 i.   

 ii.   

 iii.   

 iv.   

Body: Evidence: What type of evidence is each of the above – data, studies, expert opinion?          

1. Body: Evidence: Is there enough evidence given to be convincing?  Could it be improved? 

 i.  How? 

updated statistics, any statistics, an explanation for conflicting statistics

a quote from an expert, 

a more credible source, a primary source, 

a case history or example

1. Body: Evidence: Are the in-text citations done properly in APA style? 
   • Were you able to easily match up the in-text citation with the first word(s) in the References page?
2. Body: Evidence: In each paragraph, does the writer explain how each piece of evidence is pertinent to the thesis?   If not, where? 
   • Remember paragraph structure:

 i.   Topic sentence

 ii.  Support sentences

 iii.  Closing sentence to help integrate the information in the support sentences with the topic sentence and with the paper’s thesis.

1. Body: Evidence: Are there any in-text (parenthetical) citations missing for quotations, expert opinion or data?  Where?  

 i.  Were there any citations given for paraphrasing? Where?

                           ii.   Are there any claims made that don’t have evidence for them? That are based solely on the writer’s opinion? 

1. Body: Evidence: Are the cited sources credible and convincing?  
   • Do any of the quotations or opinions or data need a signal phrase 

 i.  to explain who the author is and why the author is credible 

 ii.  or where the data comes from?  

1. Body: Is there a logical progression of ideas? 
   • Did each idea help support the thesis, or is something missing that would help you better understand the writer’s points?
   • Are there transitions missing that would help you understand how an idea, paragraph or sentence is connected to the one before it? Where?
2. Body: Are there any sentences that are too long and convoluted to be easily understood? Where could they be broken down into more than one sentence?
3. Are there any personal pronouns (“I, me, mine, you/your”)? Where?
   • If “you/your/yours“ is used, is it being used strategically to directly address the reader? 
   • Is it always clear who” they” are or what “it is? If not, where? 
4. Conclusion: Is there a conclusion? 
   • What does the conclusion do? What type of conclusion is it? 
     • Does it ask something of the reader? Of some other group or institutions? 
     • Does it make a recommendation or give advice? 
     • Does it inform the reader of proposed or possible solutions to a problem? 
     • Is it a call to action? Tor awareness, education? 
     • Does it speculate about the future? 
     • Or does it make an observation based on what has been learned in the course of reading the research paper?  
5. Conclusion: Are you left with any questions about the subject/argument?
6. No more than 20% of the paper is quotes (80/20 rule).
7. References: Is there a References page in proper APA style?
   • Is the heading bold and centered?
   • Is the list alphabetized?
   • Are hanging indents used?
   • Are there at least four sources?
   • Are about half of them primary? 
   • Are the names of the publications included in primary source citations?
   • Is each electronically accessed source followed by a doi: or URL?

you may work off the essay provided. add to it. this needs to be done within 4 hours!