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

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

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.

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.

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.

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.