NUR 590 Patient care problems

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 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.

Thank you for your response. This brings to mind King James Bible/New Living Translation 2005, Luke 8:17; For all that is secret will eventually turn to light. I was in Nursing school and happen to be tutoring a nursing student that was a class or two behind me. The student was prepared to take her med-surgical exam; we had reviewed the pathophysiology so that she would be able to look at, for example, be given a scenario regarding a patient’s lab values and know if the patient was in metabolic acidosis. We reviewed the ability to think critically. Prior to her taking the test we, both felt confident that she would pass. Day later she called and asked to come over and when she arrived, she was distraught. I was dumb founded; she explained that she had taken the exam, but it did not go very well because she decided to cheat. A couple of her classmates reassured her that they had the answers to the exam; She did not even read the exam to use anything that we had reviewed as far a critically thinking and using pathophysiology, lab values, and so on to arrive at the answers. I was upset that she had taken up hours and days of my time to prepare for an exam and she just totally threw everything out the window and just put down answers. The class prior to hers had aced the exam, but the instructor and the Director of the Nursing department reviewed the class trends and knew that the class prior to her class should not have scored that many A’s. Therefore, the test was changed and the test that my friend took was different from the one the prior class had taken. On top of that she had to speak with the Director of the Nursing department and was expelled from the program. She needed to at least pass with a C to remain in the program. The class prior had students that were also expelled as well as the students that were in her class. I only knew about this as she confided in me regarding the situation; otherwise, the was emphasis in my class to make sure that all the concepts were understood; if not ask questions during/after lecture and because in clinical we were taking care of patients and need to know why we were administering some as simple as a vitamin E and the side effects. In my practice I have been conscientious regarding patient care. In the Neonatal Intensive Care everything we gave during the time I worked in the unit was doubled checked. If it did not fit into a 1cc syringe it was triple checked.

Conclusion

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.

References

Chiaranai, C., Chularee, S., & Srithongluang, S. (2018). Older people living with chronic illness. Geriatric Nursing, 39(5), 513-520. https://doi.org/10.1016/j.gerinurse.2018.02.004

Cullen, L., Hanrahan, K., Edmonds, S. W., Reisinger, H. S., & Wagner, M. (2022). Iowa Implementation for Sustainability Framework. Implementation Science, 17(1), 1-20. https://doi.org/10.1186/s13012-021-01157-5

Duff, J., Cullen, L., Hanrahan, K., & Steelman, V. (2020). Determinants of an evidence-based practice environment: An interpretive description. Implementation Science Communications, 1(1), 1-9. https://doi.org/10.1186/s43058-020-00070-0

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. https://dx.doi.org/10.4135/9781529743616

Hanrahan, K., Fowler, C., & McCarthy, A. M. (2019). Iowa model revised: Research and evidence-based practice application. Journal of Pediatric Nursing, 48, 121-122. https://doi.org/10.1016/j.pedn.2019.04.023

Assessment Description
Applying a model or framework for change ensures that a process is in place to guide the efforts for change. In 500-750 words, discuss the model or framework you will use to implement your evidence-based practice proposal project. You will use the model or framework you select in the Topic 8 assignment, during which you will synthesize the various aspects of your project into a final paper detailing your evidence-based practice project proposal.
Include the following:
1. Identify the selected model or framework for change and discuss its relevance to your project.
2. Discuss each of the stages in the change model/framework.
3. Describe how you would apply each stage of the model or theoretical framework in your proposed implementation.
4. Create a concept map for the conceptual model or framework you selected to illustrate how it will be applied to your project. Attach this as an appendix at the end of your paper.
Refer to the “Evidence-Based Practice Project Proposal – Assignment Overview” document for an overview of the evidence-based practice project proposal assignments.
You are required to cite minimum of four peer-reviewed sources to complete this assignment. Sources must be

published within the last 5 years and appropriate for the assignment criteria and nursing content.
Complete the “APA Writing Checklist” to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as an appendix at the end of your paper.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.
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. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

https://nursingassignmentgurus.com/nur-590-benchmark-ebp-proposal-project-framework-model-for-change/
Benchmark Information
This benchmark assignment assesses the following programmatic competencies:
MBA-MSN; MSN-Nursing Education; MSN Acute Care Nurse Practitioner-Adult-Gerontology; MSN Family Nurse Practitioner; MSN-Health Informatics; MSN-Health Care Quality and Patient Safety; MSN-Leadership in Health Care Systems; MSN-Public Health Nursing NUR 590 Patient care problems
1.2 Apply theoretical frameworks from nursing and other disciplines to make decisions regarding practice and health-related problems at the individual and population level.
Resources
Collapse All
Guidelines and Measures
Study “Guidelines and Measures,” located on the Agency for Healthcare Research and Quality website.
https://www.ahrq.gov/gam/index.html

Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: NUR 590 Patient care problems

________________________________________
Study Designs
Review “Study Designs,” located on the Centre for Evidence Based Medicine (CEBM) website.
https://www.cebm.ox.ac.uk/resources/ebm-tools/study-designs
________________________________________
Evidence Based Medicine: Levels of Evidence
Read “Evidence Based Medicine: Levels of Evidence,” by the University of Illinois/Chicago’s Library of the Health Sciences at Peo
… Read More
http://researchguides.uic.edu/content.php?pid=232200&sid=1921074
________________________________________
Nursing Best Practice Guidelines
Investigate the Nursing Best Practice Guidelines page of the Registered Nurses Association of Ontario (RNAO) website.
http://www.rnao.org/Page.asp?PageID=861&SiteNodeID=133
________________________________________
Use of Evidence-Based Practice Models and Research Findings in Magnet-Designed Hospitals Across the United States: National Survey Results
Read “Use of Evidence-Based Practice Models and Research Findings in Magnet-Designed Hospitals Across the United States: National Sur
… Read More
https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=142632269&site=ehost-live&scope=site
________________________________________
Updating the Stetler Model of Research Utilization to Facilitate Evidence-Based Practice
Read “Updating the Stetler Model of Research Utilization to Facilitate Evidence-Based Practice,” by Stetler, by Nursing Outlo
… Read More
https://www-sciencedirect-com.lopes.idm.oclc.org/science/article/pii/S0029655401478390
________________________________________
A Test of the ARCC Model Improves Implementation of Evidence-Based Practice, Healthcare Culture, and Patient Outcomes
Read “A Test of the ARCC Model Improves Implementation of Evidence-Based Practice, Healthcare Culture, and Patient Outcomes,” by
… Read More
https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=121082056&site=ehost-live&scope=site&custid=s8333196&groupid=main&profile=ehost
________________________________________
Critical Appraisal Tools
Read “Critical Appraisal Tools,” located on the Centre for Evidence Based Medicine (CEBM) website.
https://www.cebm.ox.ac.uk/resources/ebm-tools/critical-appraisal-tools
________________________________________
Evidence-Based Practice in Nursing and Healthcare : A Guide to Best Practice
Read Chapter 14 and review Chapter15 in Evidence-Based Practice in Nursing and Healthcare: A Guide to Best Practice.
… Read More
View Resource
________________________________________
Advanced Practice Nursing: Essential Knowledge for the Profession
Read Chapter 6 in Advanced Practice Nursing: Essential Knowledge for the Profession.
View Resource
________________________________________
Worksheet for Using Practice Guidelines
Study “Worksheet for Using Practice Guidelines,” from the “Evidence Based Medicine Toolkit,” by Buckingham, Fisher, and S
… Read More
http://www.ebm.med.ualberta.ca/CPGWorksheet.html
________________________________________
Star Model
Explore the Star Model resources, located on the UT Health San Antonio School of Nursing website.
https://www.uthscsa.edu/academics/nursing/star-model
________________________________________
Iowa Model of Evidence-Based Practice: Revisions and Validation
Read “Iowa Model of Evidence-Based Practice: Revisions and Validation,” by Buckwalter et al., from Worldviews on Evidence-Bas
… Read More
https://lopes.idm.oclc.org/log
Benchmark – Evidence-Based Practice Proposal Project: Framework or Model for Change – Rubric
Collapse All
Selected Model or Framework for Change
12 points
Criteria Description
Selected Model or Framework for Change
5. 5: Excellent
12 points
The selected model or framework and its relevance to the project are thoroughly discussed. Rationale or support is provided.
4. 4: Good
11.04 points
The selected model or framework and its relevance to the project are discussed. Some detail is needed for clarity or support.
3. 3: Satisfactory
10.56 points
The selected model or framework and its relevance to the project are incomplete.
2. 2: Less Than Satisfactory
9.6 points
The selected model or framework and its relevance to the project are summarized. More information or support is needed.
1. 1: Unsatisfactory
0 points
The selected model or framework and its relevance to the project are not discussed.
Stages for Model or Framework
13 points
Criteria Description
Stages for Model or Framework
5. 5: Excellent
13 points
The stages in the change model or framework are outlined. There are some inaccuracies. More information is needed.
4. 4: Good
11.96 points
The stages in the change model or framework are thoroughly discussed.
3. 3: Satisfactory
11.44 points
The stages in the change model or framework are discussed. Some detail is needed for clarity or accuracy.
2. 2: Less Than Satisfactory
10.4 points
The stages in the change model or framework are not discussed.
1. 1: Unsatisfactory
0 points
The stages in the change model or framework are only partially discussed.
Application of Model or Framework to Proposed Implementation
15 points
Criteria Description
Application of Model or Framework to Proposed Implementation
5. 5: Excellent
15 points
Application of each stage of the model or theoretical framework to the proposed implementation is thoroughly described.
4. 4: Good
13.8 points
General application of each stage of the model or theoretical framework to the proposed implementation is outlined. More information is needed.
3. 3: Satisfactory
13.2 points
Application of each stage of the model or theoretical framework to the proposed implementation is described. Some detail is needed for clarity or support.
2. 2: Less Than Satisfactory
12 points
Application of each stage of the model or theoretical framework to the proposed implementation is incomplete.
1. 1: Unsatisfactory
0 points
Application of each stage of the model or theoretical framework to the proposed implementation is omitted.
Concept Map for Model or Framework
15 points
Criteria Description
Concept Map for Model or Framework
5. 5: Excellent
15 points
A detailed and accurate concept map for the selected conceptual model or framework is attached in the Appendix.
4. 4: Good
13.8 points
A concept map for the selected conceptual model or framework is attached in the Appendix. Some detail is needed for clarity or accuracy.
3. 3: Satisfactory
13.2 points
A general concept map for the selected conceptual model or framework is attached in the Appendix. There are inaccuracies.
2. 2: Less Than Satisfactory
12 points
The concept map for the selected conceptual model or framework is incomplete or inaccurate. The concept map is attached, but not in the Appendix.
1. 1: Unsatisfactory
0 points
A concept map for the selected conceptual model or framework is omitted.
Application of Theoretical Framework in Decision Making (B)
10 points
Criteria Description
Application of Theoretical Framework in Decision Making (C.1.2)
5. 5: Excellent
10 points
The author has clearly demonstrated the ability to effectively apply theoretical frameworks from nursing and other disciplines to make decisions regarding practice and health-related problems at the individual and population level.
4. 4: Good
9.2 points
The ability to apply theoretical frameworks from nursing and other disciplines to make decisions regarding practice and health-related problems at the individual and population level is adequately demonstrated.
3. 3: Satisfactory
8.8 points
The ability to apply theoretical frameworks from nursing and other disciplines to make decisions regarding practice and health-related problems at the individual and population level is generally demonstrated. There are some gaps or inaccuracies.
2. 2: Less Than Satisfactory
8 points
The ability to apply theoretical frameworks from nursing and other disciplines to make decisions regarding practice and health-related problems at the individual and population level is not consistently demonstrated. There are significant gaps and inaccuracies.
1. 1: Unsatisfactory
0 points
The ability to apply theoretical frameworks from nursing and other disciplines to make decisions regarding practice and health-related problems at the individual and population level is not demonstrated.
Required Sources
5 points
Criteria Description
Required Sources
5. 5: Excellent
5 points
Number of required sources is met, but sources are outdated or inappropriate.
4. 4: Good
4.6 points
Number of required resources is met. Sources are current, and appropriate for the assignment criteria and nursing content.
3. 3: Satisfactory
4.4 points
Number of required sources is met. Sources are current, but not all sources are appropriate for the assignment criteria and nursing content.
2. 2: Less Than Satisfactory
4 points
Sources are not included.
1. 1: Unsatisfactory
0 points
Number of required sources is only partially met.
Thesis Development and Purpose
7 points
Criteria Description
Thesis Development and Purpose
5. 5: Excellent
7 points
Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.
4. 4: Good
6.44 points
Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.
3. 3: Satisfactory
6.16 points
Thesis is apparent and appropriate to purpose.
2. 2: Less Than Satisfactory
5.6 points
Thesis is insufficiently developed or vague. Purpose is not clear.
1. 1: Unsatisfactory
0 points
Paper lacks any discernible overall purpose or organizing claim.
Argument Logic and Construction
8 points
Criteria Description
Argument Logic and Construction
5. 5: Excellent
8 points
Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.
4. 4: Good
7.36 points
Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.
3. 3: Satisfactory
7.04 points
Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.
2. 2: Less Than Satisfactory
6.4 points
Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.
1. 1: Unsatisfactory
0 points
Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.
Mechanics of Writing (includes spelling, punctuation, grammar, language use)
5 points
Criteria Description
Mechanics of Writing (includes spelling, punctuation, grammar, language use)
5. 5: Excellent
5 points
Writer is clearly in command of standard, written, academic English.
4. 4: Good
4.6 points
Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.
3. 3: Satisfactory
4.4 points
Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.
2. 2: Less Than Satisfactory
4 points
Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.
1. 1: Unsatisfactory
0 points
Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.
Paper Format (Use of appropriate style for the major and assignment)
5 points
Criteria Description
Paper Format (Use of appropriate style for the major and assignment)
5. 5: Excellent
5 points
All format elements are correct.
4. 4: Good
4.6 points
Template is fully used; There are virtually no errors in formatting style.
3. 3: Satisfactory
4.4 points
Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.
2. 2: Less Than Satisfactory
4 points
Template is used, and formatting is correct, although some minor errors may be present.
1. 1: Unsatisfactory
0 points
Template is not used appropriately or documentation format is rarely followed correctly.
Documentation of Sources
5 points
Criteria Description
Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)
5. 5: Excellent
5 points
Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.
4. 4: Good
4.6 points
Sources are documented, as appropriate to assignment and style, and format is mostly correct.
3. 3: Satisfactory
4.4 points
Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.
2. 2: Less Than Satisfactory
4 points
Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.
1. 1: Unsatisfactory
0 points
Sources are not documented.

Frameworks and models guide the design and conduct of research and evidence-based practice (EBP) projects. They inform the theoretical and empirical thinking of research and guide the interpretation of findings. Frameworks organize, explain, and describe information and the scope and relationships between concepts, including some delineating research processes (Moullin et al., 2020). On the other hand, models are specific in scope and are more often prescriptive, and can be used to delineate a series of steps in the research or EBP process.

Frameworks and models are graphical or narrative depictions of the factors, concepts, or variables of a phenomenon. In the case of EBP projects, the phenomenon of interest is implementation. Implementation frameworks can offer a structure for describing and guiding the EBP process of translating effective interventions and research evidence into practice. They can also be used to analyze what influences EBP implementation outcomes and evaluate implementation efforts (Huybrechts et al., 2021). Thus, concepts within the EBP implementation framework may include the implementation process, factors affecting the implementation process (determinants or barriers and facilitators), implementation strategies, and implementation outcomes.

Nevertheless, selecting an incorrect model or framework can negatively affect the viability and success of the research efforts. This leads to specification errors in research methods and data analyses, incorrect conclusions, and weakened reviews of research funding applications (Moullin et al., 2020). Moreover, a wrong model or framework can result in poorly articulated assumptions that guide the constructs or processes that will be involved, operationalized, measured, and analyzed. Therefore, it can create bias in research. The poor use of models and frameworks goes beyond research proposals and EBP projects and can delay or misguide the progress of implementation science.

References

Huybrechts, I., Declercq, A., Verté, E., Raeymaeckers, P., & Anthierens, S. (2021). The Building Blocks of Implementation Frameworks and Models in Primary Care: A Narrative Review. Frontiers in public health, 9, 675171. https://doi.org/10.3389/fpubh.2021.675171

Moullin, J. C., Dickson, K. S., Stadnick, N. A., Albers, B., Nilsen, P., Broder-Fingert, S., … & Aarons, G. A. (2020). Ten recommendations for using implementation frameworks in research and practice. Implementation science communications, 1, 1-12. https://doi.org/10.1186/s43058-020-00023-7

APA Writing Checklist

Use this document as a checklist for each paper you will write throughout your GCU graduate program. Follow specific instructions indicated in the assignment and use this checklist to help ensure correct grammar and APA formatting. Refer to the APA resources available in the GCU Library and Student Success Center.

☐ APA paper template (located in the Student Success Center/Writing Center) is utilized for the correct format of the paper. APA style is applied, and format is correct throughout.

☐ The title page is present. APA format is applied correctly. There are no errors.

☐ The introduction is present. APA format is applied correctly. There are no errors.

☐ Topic is well defined.

☐ Strong thesis statement is included in the introduction of the paper.

☐ The thesis statement is consistently threaded throughout the paper and included in the conclusion.

☐ Paragraph development: Each paragraph has an introductory statement, two or three sentences as the body of the paragraph, and a transition sentence to facilitate the flow of information. The sections of the main body are organized to reflect the main points of the author. APA format is applied correctly. There are no errors.

☐ All sources are cited. APA style and format are correctly applied and are free from error.

☐ Sources are completely and correctly documented on a References page, as appropriate to assignment and APA style, and format is free of error.

Scholarly Resources: Scholarly resources are written with a focus on a specific subject discipline and usually written by an expert in the same subject field. Scholarly resources are written for an academic audience.

Examples of Scholarly Resources include: Academic journals, books written by experts in a field, and formally published encyclopedias and dictionaries.

Peer-Reviewed Journals: Peer-reviewed journals are evaluated prior to publication by experts in the journal’s subject discipline. This process ensures that the articles published within the journal are academically rigorous and meet the required expectations of an article in that subject discipline.

Empirical Journal Article: This type of scholarly resource is a subset of scholarly articles that reports the original finding of an observational or experimental research study. Common aspects found within an empirical article include: literature review, methodology, results, and discussion.

Adapted from “Evaluating Resources: Defining Scholarly Resources,” located in Research Guides in the GCU Library.

☐ The writer is clearly in command of standard, written, academic English. Utilize writing resources such as Grammarly, LopesWrite report, and ThinkingStorm to check your writing.

NUR 590 Patient care problems