NUR 590 Week 4 Assignment Evidence-Based Practice Proposal – Section D: Change Model

NUR 590 Week 4 Assignment Evidence-Based Practice Proposal – Section D: Change Model

NUR 590 Week 4 Assignment Evidence-Based Practice Proposal – Section D: Change Model

Roger’s diffusion of innovation theory is a particularly good theoretical framework to apply to an EBP project. However, students may also choose to use change models, such as Duck’s change curve model or the transtheoretical model of behavioral change. Other conceptual models, such as a utilization model (Stetler’s model) and EBP models (the Iowa model and ARCC model) can also be used as a framework for applying your evidence-based proposal in clinical practice. Apply one of the above models and carry your implementation through each of the stages, phases, or steps identified in the chosen model.

Patient care problems require practical and sustainable solutions. Such solutions are evidence-based, and their implementation should be supported by leaders, staff, and the target patient groups. Models of change provide change proponents with a systematic approach to change implementation. Most recommend a stepwise approach to change implementation involving problem identification, searching for solutions, and implementing the findings (Duff et al., 2020). They ensure that nurses and other change leaders work towards tangible results. The purpose of this assignment is to describe the selected model for change and its application in the proposed project.

The use of nursing theories is critical to patient care because of the different purposes that they serve. Nursing theories assist in informing every interaction between nurses and patients. Through defining the features of the nurse-patient interaction, these theories shape how nurses develop relationships with patients (Wei et al., 2019). The purpose of most nursing theories is to help nurses identify care needs among patients, articulate what they can do for patients and why they do it, and determine the kind of information to collect to develop care plans. Through theories, nurses can comprehend and evaluate health situations, explain and anticipate certain responses from patients and map out objectives and anticipated outcomes (Bahabadi et al., 2020). These theories also help nurses determine the interventions to deliver, best practices, and selection of productive areas for research. The implication is that nursing theories are fundamental to quality care provision as they help nurses to possess background propositions to offer the best care.

The Selected Model and Relevance

The Iowa model will guide the project implementation process. It promotes evidence-based practice (EBP) in health practice and ensures that organizational change addresses priority patient care concerns (Duff et al., 2020). Its central components include: improving patient outcomes based on scientific evidence, enhancing nursing practice, and helping to monitor healthcare costs. Hanrahan et al. (2019) asserted that utilizing the Iowa model improves nurses’ capacity to utilize EBP in healthcare delivery and work in teams to achieve better outcomes. The proposed project involves utilizing case management in chronic disease management for patients visiting the emergency department. The Iowa model is relevant to the project since it will ensure that the solutions are evidence-based and can achieve the targeted outcomes.

Stages of the Iowa Model

The Iowa Model for EBP integration into practice has eight steps. As Green (2020) explained, the first step involves identifying the trigger necessitating practice change. The second step is determining whether the problem is a priority based on its effects on patient care, health processes, practitioners’ health, and other elements. Next, the change leader identifies a team to help in evaluating and implementing the EBP change. Such a team allows interdisciplinary stakeholders to solve a problem together hence better results. The fourth step is gathering and analyzing appropriate research to guide practice change.

After gathering research (step 4), the next step is to critique and synthesize the research from the highest level of evidence possible. The primary purpose of this step is to evaluate whether the change is scientifically possible (Cullen et al., 2022). The sixth step involved deciding whether there is adequate research to implement a practice change. Next, a pilot program is conducted (step 7), and the results are evaluated (step 8). The changes are then introduced into practice based on the evaluation results. The revised model advises change proponents to disseminate results (Cullen et al., 2022). Dissemination helps health professionals to adopt similar interventions in other settings to improve patient care.

Applying Each Stage of the Iowa Model

Applying the Iowa model in the proposed implementation would first involve identifying the trigger. Currently, a problem-focused trigger has been identified- chronic illnesses for patients visiting the emergency department. The second step would involve determining its priority level. It is a priority requiring immediate intervention since chronic diseases increase the spending of hospital resources by increasing unplanned admissions and emergency department visits (Chiaranai et al., 2018). The interprofessional team for developing, evaluating, and implementing the change would involve the management, departmental leaders, the change proponent, and nurses. Evidence should be sourced from current and scholarly literature supporting the application of case management in chronic diseases management. The research would be further critiqued and synthesized to determine whether there is adequate research to implement case management. A pilot program would then follow to evaluate the effectiveness of case management before full adoption. The concept map (Appendix A) illustrates the application of the Iowa model in the project.


Change models guide nurses in implementing EBP in health practice. They emphasize implementing evidence-based change to improve patient care and other critical health outcomes. The Iowa model is appropriate for the proposed project. It will ensure that an interdisciplinary team works together to implement the proposed change.


Chiaranai, C., Chularee, S., & Srithongluang, S. (2018). Older people living with chronic illness. Geriatric Nursing39(5), 513-520.

Cullen, L., Hanrahan, K., Edmonds, S. W., Reisinger, H. S., & Wagner, M. (2022). Iowa Implementation for Sustainability Framework. Implementation Science17(1), 1-20.

Duff, J., Cullen, L., Hanrahan, K., & Steelman, V. (2020). Determinants of an evidence-based practice environment: An interpretive description. Implementation Science Communications1(1), 1-9.

Green, C. (2020). Application of the Iowa Model, an evidence-based practice model, when initiating clinical project pilots to evaluate how self-care techniques affect simulated nursing performance. SAGE Publications Ltd.

Hanrahan, K., Fowler, C., & McCarthy, A. M. (2019). Iowa model revised: Research and evidence-based practice application. Journal of Pediatric Nursing48, 121-122.

In 500-750 words (not including the title page and references page), discuss applying one of the change models to the implementation plan:

Identify the selected model or theoretical framework and discuss its relevance to your project.

Discuss each of the stages in the change model/framework.

Describe how you would apply each stage in your proposed implementation.

In addition, create a conceptual model of the project. Although you will not be submitting the conceptual model you design in Topic 4 with the narrative, you will include the conceptual model in the appendices for the final paper.

You are required to cite three to five sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

NUR 590 Week 4 Assignment Evidence-Based Practice Proposal – Section D: Change Model
NUR 590 Week 4 Assignment Evidence-Based Practice Proposal – Section D: Change Model

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.

You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.

Also Read: NUR 590 Week 3 Assignment Evidence-Based Practice Proposal – Section C: Solution Description

Note: After submitting the assignment, you will receive feedback from the instructor. Use this feedback to make revisions for your final paper submission. This will be a continuous process throughout the course for each section.

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Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.

Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.

One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.

I encourage you to incorporate the readings from the week (as applicable) into your responses.

Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately.

In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.

Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).

Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

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Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).

Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.

I highly recommend using the APA Publication Manual, 6th edition.

Use of Direct Quotes

I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.

As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.

It is best to paraphrase content and cite your source.

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Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.

Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?

Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.

Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.

If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.

I do not accept assignments that are two or more weeks late unless we have worked out an extension.

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