NUR 590 Review the different models and frameworks that can be used to facilitate change

Grand Canyon University NUR 590 Review the different models and frameworks that can be used to facilitate change-Step-By-Step Guide

This guide will demonstrate how to complete the NUR 590 Review the different models and frameworks that can be used to facilitate change assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for NUR 590 Review the different models and frameworks that can be used to facilitate change

Whether one passes or fails an academic assignment such as the Grand Canyon University NUR 590 Review the different models and frameworks that can be used to facilitate change depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for NUR 590 Review the different models and frameworks that can be used to facilitate change

The introduction for the Grand Canyon University NUR 590 Review the different models and frameworks that can be used to facilitate change is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for NUR 590 Review the different models and frameworks that can be used to facilitate change

After the introduction, move into the main part of the NUR 590 Review the different models and frameworks that can be used to facilitate change assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for NUR 590 Review the different models and frameworks that can be used to facilitate change

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for NUR 590 Review the different models and frameworks that can be used to facilitate change

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for NUR 590 Review the different models and frameworks that can be used to facilitate change

Review the different models and frameworks that can be used to facilitate change. Compare two and explain which is best for your evidence-based practice proposal and why. Provide rationale.

The Star Model explains how specific forms of knowledge, such as the systematic review and the clinical practice guideline, are solutions for moving research into practice. It is a model for understanding the cycles, nature, and characteristics of knowledge that are utilized in various phases of EBP in moving evidence into clinical decision making. The clinical scholar model was developed and implemented to promote the spirit of inquiry, educate direct care providers, and guide a mentorship program for EBP and the conduct of research at the point of care. It began as an interactive, outcomes-oriented educational program for nurses but has evolved into an interdisciplinary educational program for direct care providers (Melnyk, 2019). In my evidence-based practice proposal, the Star Model would be most beneficial. This model reviews current practice and applies knowledge for change. For my proposal, there is a lot of research on both patient and nurse dissatisfaction with the current bereavement process when a patient experiences a miscarriage in the ED. There is not a lot of research on implementation of better practice and protocols. Therefore, the Star Model will allow for me to take the knowledge of the subject and develop a change.

My experience with my leadership so far has been mostly positive. There was one instance that I will never forget when this executive leader, who is supposed to hold one of the highest positions in the hospital, came to visit our unit during our morning huddles. We discussed the new staffing method the hospital is about to implement, known as the NHPPD (Nursing actual Hours Per Patient Day) method. Of course, questions about patient acuities came up. Our unit is known for caring for acute medical psyche geriatric patients and is the designated acute medical-surgical- COVID unit. Our concern, of course, is patient acuities. The presenter did not answer many of our questions directly or clearly. Finally, the executive leader said, “If you are not happy with the staffing method, the door is open for you.” For us staff, it simply means shut up and suck it up, or you may be free to resign. I understand that being a leader is stressful, and you may not be able to please everybody, but still, you are being looked up to, and your knowledge, decisions, and attitude as a leader your subordinates are following as an inspiration. Patience is a virtue. A leader should be a force to calm down and bring balance. People look up to you for answers and solutions if there is an issue. Clearly, that leader did not show patience or compassion to her staff.

Resource:

Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Wolters Kluwer Health.

Sample Answer for NUR 590 Review the different models and frameworks that can be used to facilitate change

Change facilitation requires forethought and intentional planning and execution if a well-supported, sustainable change is going to be made on a larger scale – especially in healthcare. Evidence-base practice models may include theoretical models grouped into evidence-based practice/research utilization and knowledge transformation processes, strategic organizational change theory or knowledge exchange and synthesis for application and inquiry (Melnyk & Fineout-Overholt, 2019). However, it is becoming more widely acknowledged that a formalized approach must be considered to successfully implement these evidence-based models.

Eight different models have been identified as key drivers for evidence-based integration and change management. These include: 1. The Stetler Model of Evidence-Based Practice, 2. The Iowa Model of Evidence-Based Practice, 3. The Model for Evidence-Based Practice Change, 4. The Advancing Research and Clinical practice through close Collaboration (ARCC) model for implementation and sustainability of EBP, 6. The Clinical Scholar Model, 7. The Johns Hopkins Nursing Evidence-Based Practice Model, and 8. The Stevens Star Model of Knowledge Transformation (Melnyk & Fineout-Overholt, 2019).

Upon comparing the Stetler Model and Johns Hopkins Model, the Stetler Model has been regularly revised, and involves integrating evidence-base practice information into practical, sustainable day to day standards for patient care. With critical thinking and utilization of both internal and external evidence to support practice change, the Stetler Model hinges on five phases, and multiple steps to identify and support use of evidence, determined by critical thinking (Melnyk & Fineout-Overholt, 2019). A “toolkit” of sorts has been developed to implement consensus guidelines and evidence-base practice change. Upon comparison, the Johns Hopkins Model supports its use by bedside registered nurses with aim to implement research results in an evidence-based practice format. The key objective is to make it easy for direct caregivers to make change at a grass-roots level, while positively impacting patient outcomes in a meaningful way. A problem-solving approach to address clinical questions, the 18-step process allows for non-randomized control trial designed evaluations and quality improvement initiatives to take place(Melnyk & Fineout-Overholt, 2019).. With mindfulness that registered nurses encounter challenges that require a fix “tomorrow”, with potential use of nonresearch evidence by use of four pathways.

For my PICOT with aim to reduce occurrence of CLABSIs in patients with a central line, I believe either model could be used to implement meaningful change. However, the Stetler model is better suited for a randomized control trial approach, which is the method I believe to be best suited to gain the most sound, valid and reliable results. By way of using critical thinking and various types of evidence (internal AND external), the Stetler model allows for easy implementation of evidence gathered by way of a toolkit and use of consensus guidelines and policy change.

References

Melnyk, B.M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing and healthcare: A guide to best practice (4th ed.). Wolters Kluwer. ISBN-13:9781496384539

Sample Answer 3 for NUR 590 Review the different models and frameworks that can be used to facilitate change

The Iowa Model for Evidence-based practice (IMEBP) implementation has been used effectively to implement hundreds of evidence-based research projects as it provides direction through decision points for priority, resources, amount of supporting evidence, research designing, piloting then integration and sustaining (Buckwater, Cullen, Hanrahan, Kleiber, McCarthy, Rakel, Steelman, Tripp & Tycker, 2017). This model thoroughly considers the creation and lifespan of implementation of EBP which is why it can commonly be seen and used in a research setting (Buckwater et al., 2017). Compared to the Johns Hopkins Nursing Evidence-Based Practice Model (JHNEBPM), there is similarity in the process of implementing and evaluating EBP research. The JHNEBPM however is more specific in applying to the nursing perspective as well as increasing the understanding that an initial exploratory inquiry is a separate step from the PET (practice question, evidence, translation) process (Melnyk & Fineout-Overholt, 2018). This model appears more organized for clinical decision making for EBP in nursing as it can be similar to the nursing process in both clinical and research settings.

It is more appropriate to use the JHNEBPM as a framework to my EBP research project as the goal is to provide change in education from nursing to a population. Since the model provides more considerations for critical thinking, more health outcomes or more types of education can be produced to achieve research goals (Melnyk & Fineout-Overholt, 2018).

References:

Buckwalter, K. C., Cullen, L., Hanrahan, K., Kleiber, C., McCarthy, A. M., Rakel, B., Steelman, V., Tripp, R. T., & Tucker, S. (2017). Iowa Model of Evidence-Based Practice: Revisions and Validation. Worldviews on Evidence-Based Nursing, 14(3), 175–182. https://doi-org.lopes.idm.oclc.org/10.1111/wvn.12223

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-Based practice in nursing and healthcare (4th ed.). p. 434-437. Wolters Kluwer Health.

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Sample Answer 4 for NUR 590 Review the different models and frameworks that can be used to facilitate change

Two models that facilitate change and are supported by evidence-based practice are Kotter’s Change Management Model and Kurt

Lewin’s Change Model. Kotter’s Change Management Model is a standard theory used worldwide that consists of eight stages that focus on the employee’s responses when it comes to change (Kotter, 2019). These eight stages include increasing urgency, building the team, communicating, getting the vision correct, moving things, incorporating change, not giving up, and focusing on short-term goals. Using Kotter’s method allows an organization to achieve successful quantitative and qualitative results while focusing on cost-efficient approaches towards health opportunities, demand for change, and barriers. Kurt Lewin’s Change Model is a standard method that has proven effective management models for change. Lewin’s model has three phases: unfreezing, changing, and refreezing (Hussain et al., 2018). The model aids organizations in better comprehending organizational and structural change. The two different approaches provide valuable insights into how effective change management occurs. When used together, they tend to balance each other out when it comes to the weaknesses of each method one by one. In the evidence-based proposal, Kotter’s model is a better method when focusing on organizational detail.

Hussain, S. T., Lei, S., Akram, T., Haider, M. J., Hussain, S. H., & Ali, M. (2018). Kurt Lewin’s Change model: a Critical Review of the Role of Leadership and Employee Involvement in Organizational Change. Journal of Innovation & Knowledge, 3(3), 123–127. https://doi.org/10.1016/j.jik.2016.07.002

Kotter, J. (2019). John Kotter’s Eight Step Change Model. https://portal.ct.gov/-/media/SDE/Turnaround/School-Improvement-Resources/Kotters_model.pdf

Sample Answer 5 for NUR 590 Review the different models and frameworks that can be used to facilitate change

The two models that I reviewed are the Iowa Model of Evidence-Based Practice and the John Hopkins Nursing Evidence-Based Practice Model (JHNEBP).

The Iowa Model was developed by nurses in the 1990’s and then revised in 2015 due to dramatic changes in healthcare (Buckwalter et al., 2017). The revision included translation research and patient engagement (Buckwalter et al., 2017). This model is application oriented and provides a step-by-step guide to the EBP (Evidence Based Practice) process (Buckwalter et al., 2017). This model outlines a multiphase change process with feedback loops. It is widely recognized for its applicability and ease of use by interprofessional teams. It can be used by novice to expert users and can be used in a variety of settings (Buckwalter et al., 2017). Since 2001 there have been over 3900 requests to use the Iowa Model from all 50 states and 130 countries (Buckwalter et al., 2017). It is focused on triggers both problem and knowledge focused. It consists of 11 categories/steps.

These categories/steps include: (Melnyk & Fineout-Overholt, 2019).

Identify triggering issues/opportunities: Encourages clinicians to identify questions. Triggers may have data that highlights an area for improvement. Question current practice.
Clinical applications: Nurses identify clinically relevant practice questions.
State the question or purpose: Includes a clearly stated purpose. Using PPPICO (problem(patient), population, pilot area, intervention, comparison, and desired outcome)
Topic Priority: Establish whether it aligns with organizational priorities.
Form a team.
Assemble and appraise evidence.
Sufficient evidence.
Design and pilot the practice change.
Decide if the change is appropriate for practice.
Integrate and sustain practice.
Disseminate results

The John Hopkins Nursing Evidence-Based Practice Model (JHNEBP) is also a model that guides bedside nurses in translating evidence into practice. It was developed by Hospital leadership to accelerate the transfer of new knowledge into practice (Melnyk & Fineout-Overholt, 2019). Bedside nurses evaluated and piloted the model. This model is an open system which can be influenced by both internal and external factors (Melnyk & Fineout-Overholt, 2019) The model starts with an inquiry (question) which leads to a PET (Practice, Question, Evidence and Translation) process (Melnyk & Fineout-Overholt, 2019). Within each phase there are 19 prescriptive steps (Melnyk & Fineout-Overholt, 2019). The process is linear and may be interactive as the process evolves (Melnyk & Fineout-Overholt, 2019) There are ten tools to support the critical steps and online learning modules. The tools were developed by bedside nurses and contain check box formats, definition, and guidelines for use (Melnyk & Fineout-Overholt, 2019). It is simplified and easy to understand. This model may appeal to Nurse Educators as it has been applied in academic settings. The JHNEBP Model provides a structure for EBP education with mentoring, program planning, execution, and outcomes data collection (Friesen et al., 2017).

In comparing the two models both seem similar in many ways. Both seem widely used and easy to use. The one that I would choose for my EBP project would be the Iowa Model of Evidence- Based Practice because it talks more about using a pilot unit. For my project I would like to pilot two units to evaluate and then disseminate to the rest of the organization. A number of clinically important topics have been addressed using the Iowa Model, for example prevention of catheter associated urinary tract infections. This was appealing to me since my project goal is to reduce CAUTI (Catheter Associated Urinary Tract Infection) rates and use through patient/family education and empowerment. This model also talks about patient engagement which applies to my project as well (Melnyk & Fineout-Overholt, 2019).

References:

Buckwalter, K.C., Cullen, L., Hanraham, K., Kleiber, C., McCarthy, A.M., Rakel, B., Steelman, V., & Tripp, R.T. (2017). Iowa model of evidence-based practice: Revisions and validation. Worldview on Evidence-Based Nursing, 14 (3), 175-182. https://doi-org.lopes.idm.oclc.org/10.111/wvn.12223.

Friesen, M.A., Brady, J.M., Milligan, R., & Christensen, P.(2017). Findings from a piot study bringing evidence-based practice to the bedside. Worldview on Evidence-Based Nursing, 14 (1), 22-34. https://doi-org.idm.oclc.org/10.111/wvn.12195.

Melnyk, B.M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing and healthcare: A guide to best practice (4th ed.). Wolters Kluwer. ISBN-13:9781496384539

Sample Answer 6 for NUR 590 Review the different models and frameworks that can be used to facilitate change

Different models provide varying strengths, which can be utilized for a wide range of purposes (Melnyk & Fineout-Overholt, 2019). Depending on the change initiative and challenges faced, specific models or frameworks will be a better fit than others. When selecting a model to guide the evidence-based practice (EBP) process, it is crucial to choose a model that supports the change proposal and organization. Two models include the Promoting Action on Research Implementation in Health Services (PARIHS) framework and the Advancing Research and Clinical practice through close Collaboration (ARCC) model.

The PARIHS framework has the purpose of putting complex evidence into practice (Melnyk & Fineout-Overholt, 2019). This framework emphasizes the importance of achieving significant and planned behavior change. According to the PARIHS framework, this organizational behavioral change is necessary, in order to implement research-based evidence into practice. To achieve successful implementation (SI), three elements are needed: evidence, context, and facilitation.

The goal of the ARCC model is to promote system-wide implementation and sustainability of EBP, within healthcare institutions and clinical settings (Melnyk & Fineout-Overholt, 2019). By doing this, the likelihood of achieving quality outcomes is achieved. To get from the current state of EBP to the goal of system-wide EBP, potential barriers must be addressed. EBP mentors, who are typically healthcare providers with advanced knowledge and skills in EBP, are developed and placed within the system. Doing this helps to remove common barriers, enhance the EBP implementation, and improve patient outcomes. The ARCC model’s purpose and interventions align well with my proposal, so I believe this is the best model for my specific project. Creating system-wide EBP and developing EBP mentors, to overcome barriers, would be very beneficial for the implementation of my EBP proposal.

References

Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing and healthcare: A guide to best practice (4th ed.). Wolters Kluwer.