Systematic Approach To Change: The Stetler Model
The indigenous condition in Canada was a malleable asset in most of its history in the eyes of upper-class Canadians, stripping away from their past and their culture, to later incorporate into mainstream Canadiana, through violent and destructive means. For protagonist Saul Indian Horse, it’s no different. From cover to cover, he faces the power of white supremacy breaking him down, with his passion for hockey providing resilience in the bigotry. Despite that, his relationship with the sport recedes with age, following in tandem with the depths of his negative emotions, soon separating himself from hockey. Indian Horse's account of experiences on and off the rink emphasizes the motif of hockey, his relations regarding it ebbing and flowing,
This evidence proves that
Outcome three in the Doctor of Nursing Practice (DNP) program has prepared me to use analytic methods to appraise critically existing literature and other evidence to determine and implement the best evidence for practice.(Raup, King, Hughes & Faidley, 2010). For example, at the start of the DNP program, I lacked experience in research and understanding of the literature review, now I have the ability to develop, direct and evaluate quality improvement methodologies to promote safe, timely, effective, efficient, equitable, and patient-centered care. Technology and the database research assisted me in forming my question, proposal, and project by providing evidence-based data and available resources. Two key examples that facilitated my growth
Dorothea Orem’s SCDNT appears to be consistent with current nursing standards. Over 400 nursing articles were noted during a literature search by Biggs (as cited in Smith & Parker, 2015). According to McEwen and Wills (2104), SCDNT has been used to formalize care for inpatients and ambulatory care, as well as in community based programs, mother-baby and community nursing. While the use of SCDNT in current nursing practice is a strength, it bears noting that Biggs (as cited in Smith & Parker, 2015) observed an area of weakness that SCDNT has not always resulted in further development of nursing practice.
Nursing practice requires both critical thinking and clinical reasoning. Critical thinking is the process of deliberate higher level thinking to define a patient’s problem, examine the evidence-based practice in caring for the patient’s, and make options in the delivery of optimal care. Critical thinking involves the demarcation of statements of fact, judgment, and opinion. The progression of critical thinking requires the nurse to think imaginatively, use reflection, and engage in logical thinking (Alfaro-LeFevre, 2013). Critical thinking is a vital skill needed for the recognition of patient’s problems and the execution of interventions to endorse effectual care outcomes (Bittencourt & Crossetti, 2012).
• Assessment: Nurses often feel uninformed when changes are made. Not being made aware of important changes can affect patient care. • Nursing Diagnosis: Communication breakdown due to ineffective delivery of new changes related to patient care. • Goal setting: Implement an education book that is placed near the nurse 's station and nurses are responsible to read the changes and sign off when they have read it. • Evaluation: Nurses are better informed and are up to date with new
In my opinion, the presented evidence in regard to the claim and reasons are valid. Not only is the used evidence valid, but it is relevant and sufficient as well. As previously stated,
The achievement of the Millennium Development Goals set out by the United Nations is a worldwide ambition and one which calls the nurse workforce to action. These goals and indeed many other health related goals are only achievable if we have well informed health policies and well managed and led action plans. The reality is that the habits of practice rather than those informed by best evidence still persistently get in the way of achieving our goals. Poorly informed decision making is one of the main reasons services can fail to be delivered in an optimal way and can also contribute to variations in practice which make services less efficient, ineffective and inequitable.
The “Evidence-Based Practice: Step by Step” articles, by the American Journal of Nursing explains how quality of care is improve though evidence based practice. By preforming the step method of approach, nurses can gain the ability to conduct an effective search for data to improve patient conditions. In order to apply the steps of evidence based practice, the article follows a case scenario of a nurse named Rebecca, though some of the following steps. The articles stated that there are seven steps in the process, beginning with step zero, which states that the nurse must have a “spirit of inquiry” in order to determine that there is a need for an intervening question. This is necessary, because nurses become complacent with outdated methods
In the clinical setting, the nurses’ expertise can be used to make clinical assessments and recommendations for routine care at a lower cost than a physician visit. This would increase the number of patients seen and increase the quality of the care provided. The advance practice nurse would be able to hone in on preventative measures and increase patient education. The advance practice nurse can also make recommendations about practice changes needed to facilitate better health outcomes through the use of evidence-based practice. Nursing leaders are aware of how important nursing science is to provide needed evidence to transform practice, even though, finding the time and resources to support any research activity is often challenging (Stone, 2017).
Advance Practice Nurses advocate for health promotion, educate patients and the public on the prevention of illness and injury, provide care and assist in cure, participate in rehabilitation, and provide support. No other health care professional has such a broad and far-reaching role. The key factor in caring for the patient’s physical, emotional and spiritual needs in today’s society is for nurses to apply their evidence -based knowledge and skills in providing holistic care . Nurses must be able to bring analysis and utilize their critical thinking skills to address each patient’s problem based on scientific disciplines and nursing theoretical models to help their patients achieve their highest level of
ANNOTATED BIBLIOGRAPHY Berman, A., Kozier, B., Snyder, S., & Frandsen, G. (2015). Kozier & Erb 's fundamentals of nursing: Concepts process and practice (10th ed.). Hoboken, NJ: Pearson Education.
In current business environment, change is a common element that is continuously occurring irrespective of an organisations size, industry and age. As the world is changing, organisations must also change quickly to stay competitive. According Kotter (1996), organisations that handle change well thrive whilst those that do not either fail or struggle to survive. In this literature, the change that organisation XYZ underwent will be linked to Kurt Lewins 3-step model of change namely unfreeze, change and refreeze. In addition, will be the discussion of other key change management models such as Kotters 8 step model and Procsi model.
The TCM was comprised of an advanced practice nurse implemented intervention in hospital, up to 2 months post-discharge follow-up including hospital and home visits by the advanced practice nurse, at least one follow-up visit with a physician, telephone outreach and phone availability every day of the week. TCM was demonstrated to have significantly decreased (all cause) re-hospitalization or death, lower mean re-hospitalization rates per person and result in consistently fewer re-hospitalizations compared to the other two models on the study (Naylor et al., 2014). Using randomized controlled trials, the TCM answers its research questions using a positivist and post-positivist perspectives. In positivist perspective, inquiry is based upon scientific observation; and ideas only deserve incorporation into knowledge if they can be put to the test of empirical experience (Crotty, 1998). Assuming a positivistic standpoint is not only about implementing certain approaches to the design of research studies, but also, as Crotty (1998) describes, positivist perspective implies that the results of research will tend to be presented as objective facts and established truths.
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