RESPOND TO EACH DISCUSSION BOARD QUESTION
1.Having a good understanding of the health care system at the local level will be the first exposure to evidence-based practice implementation, so is very important. Local organizations are the ones that will trial new ideas and plans from research and will provide input for changing EBP techniques to get them to a final plan which can then be retried. Once the technique or practice change is perfected to its final state, it can be pushed to other organizations and reviewed to become the new EBP technique for that topic.
My topic is cyberbullying in adolescent students. When reviewing this topic with my preceptor, our biggest consideration is working with the public and private schools and their school district policies on acquiring evidence from their students. Also, my population is adolescents so there needs to be consent for participation in a student from parents of the adolescents.
2. Understanding the health care system at the local level is important to consider when planning an Evidence Based Practice implementation because it is important to know what is offered locally before change is implemented. By knowing the needs of the community the researcher can know what needs in the community are needed and where changes can be made to make the community better for the patient. The first step towards making a change in the community is knowing the community. A big focus in this border town community is diabetes prevention and early treatment. Unhealthy lifestyle behaviors and risk factors, poor delivery of clinical and community preventive services, and environments not conducive to health increase the risk of disease and injury and contribute to the leading causes of death (Ockene, J. K., Edgerton, E. A., Teutsch, S. M., Marion, L. N., Miller, T., Genevro, J. L., Loveland-Cherry, C. J., Fielding, J. E., & Briss, P. A.,2007). While speaking with my mentor we discussed the importance of promoting a healthy diet in the community along with exercise to promote disease prevention. We have been giving vaccines and felt that this would be a good opportunity to discuss within the community healthy habits of health. For my project a healthy diet along with exercise will help to prevent aggravating comorbitities and help to promote a more positive outcomes .
3.It is essential to understand the dynamics of local healthcare organizations, such as primary care offices and community health centers, when considering planning for an evidence-based protocol (Damshroder, et al., 2009).
Local health organizations identify gaps in care, guiding community health organizations to meet patients’ needs by using evidence-based practices.
After speaking with my preceptor, we discussed the community’s healthcare needs and how my change project for a virtual support group would fit in. We also addressed the staff and office along with current protocols.
The five-step process that can be used in any setting for EBP implementation is called (CFIR) Consolidated Framework for Implementation Research. The CFIR consists of the intervention, the inner and outer environment, the individuals involved, and the implementation of the new process
4. The first change theory is Lewin’s Change Theory. This theory is very widely used in nursing. This theory has three stages the unfreezing stage, moving stage, and refreezing stage. The theory has driving and resistant forces and for the theory to be successful the driving forces must overcome the resistant forces. The other change theory is Rogers’ Change Theory. This theory has 5 stages, and they are awareness, interest, evaluation, implementation, and adoption. (Oguejiofo,2017) It is successful when nurses who ignored the proposed change earlier adopt it because of what they hear from nurses who adopted it initially. Both theories are widely used in nursing and both require nurses that want the change or who are willing to make the change. My mentor has used the Lewins change theory recently. The prison already has hourly rounding, but she just introduced new paperwork that must be signed every hour. The unfreezing period she just explained how the new way will be better and she showed the nurses how it will be easier because the techs can also sign the sheet. The moving stage she let the nurses tell her how they feel about the whole situation and letting them express what they think will work. The final stage is refreezing and during this stage she went around for the first week making sure the nurses get this in their daily habit. I believe this theory makes more sense to my EBP because there are a lot of nurses that will be the driving force to make this happen and less people being the resistant force. So, it will be more likely to succeed.