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B740 : Nursing Theory
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B740 : Nursing Theory
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Course Code: B740
University: University Of Stirling
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Country: United Kingdom
Question:
1. Discuss challenges of research utilization you have faced in your nursing practice when trying to implement a practice change
I personally have not tried to change or implement a practice change in my nursing practice. However, I understand it takes a longer time for our staff, such as, Clinical Nurse Specialist or Nurse Educators to request a practice change. There are many steps and committees that one has to follow prior to implement changes.
At UCHealth, we utilize the Colorado Model @2009 that was established by UCHealth staff (Goode, Fink, Krugman, & Oman, 2011). This Colorado Model @2009 focuses and includes the patient in the center core, where patients are the main decision-maker.
2.Discuss the challenges of research utilization you have faced in your nursing practice when trying to implement change.If we know that knowledge translation is the ethically sound application of knowledge once it has been exchanged and synthesized, we must also then understand where research utilization plays in. Stetler (2001, p. 272) describes research utilization as “the process of transforming research knowledge into practice”. with the ultimate goal of decreasing ICU delirium- a condition well documented in the literature that causes increased morbidity and mortality, increased ICU and hospital length of stay, etc. Perhaps this could have been more successful if we included the nurses and nurse aids in this decision (bringing in the major stakeholders), brought forth the evidence in a clear, straightforward way (if nurses know it is hurting their patients, they will likely cooperate), and provided more follow up (the UBC checking in every other week or so to see how the implementation is going and what we can do to assist each other).
Answer:
Response to post 1
The post is well written in explicit manner about the difficulty in practice change requests to be fulfilled by the educators. The post is overall informative stating the importance of the Colorado Model @2009 in enhancing the patient centered care (Rosenthal et al., 2016). The post also gave insights of the usefulness of the evidence based practice in the addressing the patients’ needs and in shared decision making. Further, the post implicitly highlighted how the process of approval from the Colorado Multiple Institutional Review Board (COMIRB) is timing consuming. There is no strategy mentioned to speed up the process of giving accurate information to clients for research and decision making. The difference between the understanding of the importance of research utilisation in nursing practice and implementing the knowledge is clearly depicted in the post.
Response to post 2
The post explicitly discusses the challenges faced by the nurses in using the most recent evidences for improving the patient care. On the other hand it also mentions the need of rationalising every nursing action by stating that it is the “heart of the research utilization and knowledge translation”. The post highlights the need of greater acceptance of change among the professionals as also mentioned by Esmaeili, Ali Cheraghi & Salsali (2014). It was supported with the evidence of nurses refusing to participate in bathing of ventilated patients for decreasing the ICU delirium. The best part of the post is the strategy to increase acceptance of change such as UBC monitoring, and nurses awareness as it indicate knowledge of problem and solutions.
References:
Esmaeili, M., Ali Cheraghi, M., & Salsali, M. (2014). Barriers to Patient?Centered Care: A Thematic Analysis Study. International journal of nursing knowledge, 25(1), 2-8.
Rosenthal, M. B., Alidina, S., Friedberg, M. W., Singer, S. J., Eastman, D., Li, Z., & Schneider, E. C. (2016). A difference-in-difference analysis of changes in quality, utilization and cost following the Colorado multi-payer patient-centered medical home pilot. Journal of general internal medicine, 31(3), 289-296.
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