Why is understanding the health care system at the local level important to consider when planning an EBP implementation? Conduct research and solicit anecdotal evidence from the course preceptor that you will take into consideration for your own change project. Planning EBP Implementation
Change theories play a significant role in implementing EBP in clinical settings. Kotter’s model for effective change comprises eight stages that healthcare organizations can follow. The phases include identifying the need for change, forming a coalition, creating a vision, communicating, removing obstacles, realizing short-term wins, building on the difference, and anchoring it into the healthcare system. Each of these stages provides an opportunity for improvements within the healthcare setting. For example, in the first stage, the organization can identify the most pressing problem and engage a team to resolve it through evidence-based practices. If the methods result in short-term improvements, it is embedded into the healthcare system to sustain organizational-wide changes (Ravi et al., 2022). Therefore, Kurt Lewin’s theory can provide a basis for change in clinical settings. Conversely, some healthcare professionals prefer Lewin’s theory of change, which includes three stages……Planning EBP Implementation…….. The first step of this theory is unfreezing the people affected by the transition to help them recognize the need for new practices. Unfreezing helps the change agent reduce the resistance related to change. The second phase of this model is the moving stage which involves a change of thoughts or behaviors. Finally, the refreezing stage occurs by forming new change behaviors to become universal processes in the unit or organization (Dahlkemper, 2021). Lewin’s theory can facilitate effective and fast change to improve outcomes. The theory that makes the most sense for my EBP is Lewin’s model. My preceptor has used this theory in similar settings with much success. The idea is practical as it ensures stakeholder support and staff involvement and emphasizes how the change will benefit the organization (Schmidt & Brown, 2021). Overall, I intend to integrate this theory into my capstone project.
One nursing theory is the application of theory of goal attainment. This theory works to identify the needs of the patient, demonstrate effective communication with the patient, and apply the theory to solve the identified problems of the patient. King’s theory offers insight for interactions with individuals. This is an important part of the medication reconciliation process as it lends to an important conversation between nurse/pharmacist and the patient. According to King, the patient is a social being who has three fundamental needs: the need for health information, the need for care that seeks to prevent illness, and the need for care when the patient is unable to help him or herself….Planning EBP Implementation….. The first two needs are influenced by an accurate medication reconciliation. The first process in nursing process is nurse meets the patient and communicates and interacts with him. Assessment is conducted by gathering data about the patient based on relevant concepts. Medication reconciliation is gathering that data. (Current Nursing, 2020, Nursing Theories, Application of Theory of goal attainment)
Another nursing theory is Virginia Henderson’s Need Theory. This theory emphasizes the importance of patient independence so that progress after hospitalization would not be delayed. She described the nurse’s role as substitutive (doing for the person), supplementary (helping the person), complementary (working with the person), with the goal of helping the person become as independent as possible. The doing for the person is giving the patient the medications while in the hospital, helping the patient is going over the medication prior to discharge. Working with the patient is happening at the TCC visit with the patient to help them be independent with knowledge of disease process and taking the correct medications. (Current Nursing, 2020, Nursing Theories, VIRGINIA HENDERSON’S NEED THEORY)……Planning EBP Implementation….. I like to incorporate both into the EBP intervention. The theory to have goal attainment to influence the patient with the nurse/pharmacist interaction can lead to a better discharge medication reconciliation process. The Virginia Henderson need theory can also be incorporated in guiding the patient every step of the way with the med rec process. My preceptor has used the goal attainment theory when working with the patent at the TCC appointment. The relationship between the provider and the patient is a strong and important one. The Virginia Henderson’s Need Theory has not been utilized as they do not see the patients on a regular basis.