NUR 590 Week 2 DQs

Week 2 DQ 1 Do you foresee any issues with implementation of your project? Identify stakeholders who could assist in supporting you, and any theoretical frameworks (organizational change, leadership, role-specific) or models that could help you adapt.

Assessing organizations for readiness for change/new interventions is necessary for implementing successful and lasting change. Organizational readiness tools and assessments can be used for a multitude of reasons. This includes assessing the organization’s level of motivation for change, the strengths and weaknesses within an organization, and facilitators/barriers to change (Dearing, 2018). Two organizational readiness tools are the total interpretive structural modeling (TISM) tool and the organizational readiness to change assessment (ORCA).

TISM is utilized to identify contributing factors that may impact an organization’s state of readiness for a new intervention/change before implementation (Vaishnavi et al., 2019). The TISM approach for organizational readiness for change in a healthcare system has multiple steps in the process (Viashnavi et al., 2019). The steps include identifying and defining factors that impact change within an organization, interpret the relationship between each factor and the change, determine the driving power for each factor, and finalize the list of factors from most influential to least (Viashnavi et al., 2019).

The ORCA tool measures organizational readiness for new and/or evolved evidence-based practice implementations (Helfrich et al., 2009). ORCA looks at three major elements: the organization’s capacity to facilitate the change, the organizational culture to support the change, and the strength of the evidence for the proposed change/innovation (Helfrich et al., 2009).

I am selecting the ORCA tool to assess my organization, an obstetrician office. This tool would work well for this organization and my proposed intervention of EHR communication/telehealth to improve safe sleep practices and reduce SUID rates among African American infants. For example, there is quality research to support the efficacy of this intervention in clinical practice. There is also a culture of change and infant safety since guidelines and best practices are constantly changing. Lastly, with good leadership and implementation plans, the organization can facilitate this innovation.

References

Dearing, J. W. (2018). Organizational readiness tools for global health intervention: A review. Frontiers in Public Health, 6(1), 56. https://doi.org/10.3389/fpubh.2018.00056

Helfrich, C. D., Li, Y. F., Sharp, N. D., & Sales, A. E. (2009). Organizational readiness to change assessment (ORCA): Development of an instrument based in the promoting action on research in health services (PARIHS) framework. Implementation Science, 4(1), 38. https://doi.org/10.1186/1748-5908-4-38

Vaishnavi, V., Suresh, M., & Dutta, P. (2019). A study on the influence of factors associated with organizational readiness for change in healthcare organizations using TISM. Benchmarking: An International Journal, 26(4), 1290-1313. https://doi.org/10.1108/BIJ-06-2018-0161

Week 2 DQ 2 What strategies will you use in your new practice as an advance registered nurse to review and critique literature pertinent to your practice?

Advanced nurse practitioners require advanced skills when it comes to their practice. However, the one related to reading and critiquing research literature is one of the most pertinent skills that one needs to possess. One of the most important strategies that I will deploy entails identifying the issue and then rephrasing the words into my own. During this venture, I am going to consider the nature of the problem statement contained in the article. A well-written problem statement establishes the significance of an issues and its importance to nursing (Pinkowski, 2017). Moreover, the critique of the articles will entail identifying of the author has identified related studies to the topic. Articles with literature review section are valid and hence can be used to support an evidence-based project. Further, during such assessments, I will consider whether an article has focused on the fundamentals of the issue. A properly written article needs to establish what is written about the topic of examination as identified in the problem statement concepts. Moreover, it should have adopted theoretical constructs, expert consensus opinion and evidence from research studies as its sources of information.

Moreover, the theoretical frameworks of studies will also form a basis of the critique of literature materials for the present EBP project. The articles that will be obtained from varied databases such as the CINAHL need to have sound theoretical underpinnings that demonstrate the manner in which the study fits into practice. Moreover, the theoretical framework provided in an article will help to guide future research on an issue, which may directly influence the present study (Wakefield, 2015). Thus, identifying them is crucial. In addition, a research study needs to have clear research questions and hypotheses in order to guide its direction. Therefore, the identified research articles will be examined for the same.

References

Pinkowski, J. C. (2017). Educating nurses how to critique research reports. J Nurs Res Pract. 2(2):32-34.

Wakefield, A. (2015). Synthesising the literature as part of a literature review. Nursing Standard (2014+), 29(29), 44.