Evidence-Based Practice Model and Change Model
Introduction
Evidence-based practice (EBP) is an essential strategy in healthcare that involves the integration of best available evidence with clinical expertise and patient values to make informed decisions about patient care. In order to effectively implement an evidence-based practice change in a clinical practice environment, it is crucial to select an appropriate EBP model and change model. This PowerPoint presentation explores one EBP model and one change model/theory from the textbook (Melnyk and Fineout-Overholt, 2015) and describes their application in implementing an evidence-based practice change in a personal clinical practice environment.
Part 1: Evidence-Based Practice Model
The chosen EBP model for this presentation is the Stetler Model of Evidence-Based Practice. This model consists of five phases: preparation, validation, comparative evaluation, translation, and evaluation. Each phase plays a crucial role in facilitating the implementation of evidence-based practice change.
1. Preparation Phase: In this phase, the healthcare professional identifies the clinical problem and formulates a focused clinical question. The question is then used to guide the search for relevant evidence.
2. Validation Phase: During this phase, the healthcare professional critically appraises and evaluates the evidence gathered from various sources. The goal is to determine the validity and quality of the evidence and select the best available evidence for implementation.
3. Comparative Evaluation Phase: In this phase, the healthcare professional compares the selected evidence with current practice and identifies the gaps and areas for improvement. This enables the development of an evidence-based practice change plan.
4. Translation Phase: The translation phase involves the implementation of the evidence-based practice change in the clinical practice environment. This includes educating and training staff, developing protocols and guidelines, and monitoring the implementation process.
5. Evaluation Phase: The final phase involves evaluating the impact of the evidence-based practice change on patient outcomes and the healthcare system. This assessment helps to determine the effectiveness of the change and identify any further improvements that may be necessary.
Application of the Stetler Model of Evidence-Based Practice in Personal Clinical Practice Environment
In the personal clinical practice environment, the Stetler Model of Evidence-Based Practice can be utilized to implement an evidence-based practice change related to the research topic from Module 1 – “Effectiveness of hand hygiene practices in reducing healthcare-associated infections.”
1. Preparation Phase: In this phase, the healthcare professional can identify the specific aspects of hand hygiene practices that need improvement and formulate a clinical question, such as “What is the most effective hand hygiene technique for reducing healthcare-associated infections?”
2. Validation Phase: During this phase, the healthcare professional can conduct a comprehensive literature search to identify relevant studies on hand hygiene techniques. The evidence can then be critically appraised and evaluated for validity and quality.
3. Comparative Evaluation Phase: In this phase, the healthcare professional can compare the selected evidence on hand hygiene techniques with the current practices in the clinical practice environment. This will help identify any gaps and areas for improvement in the existing hand hygiene protocols.
4. Translation Phase: The translation phase involves developing a plan to implement the evidence-based practice change in hand hygiene practices. This may include providing education and training to healthcare staff on the recommended hand hygiene techniques, revising existing protocols and guidelines, and conducting regular audits to monitor compliance.
5. Evaluation Phase: The final phase involves assessing the impact of the evidence-based practice change on healthcare-associated infections. This can be done by tracking infection rates and comparing them with pre-implementation data. Any necessary adjustments can be made based on the evaluation results.
Part 2: Change Model/Theory
The chosen change model/theory for this presentation is the Kotter and Cohen’s Change Model. This model consists of eight steps that guide the implementation of organizational change. The steps include creating a sense of urgency, forming a powerful guiding coalition, developing a vision and strategy, communicating the vision, empowering employees, generating short-term wins, consolidating gains and producing more change, and anchoring new approaches in the culture.
1. Create a Sense of Urgency: This step involves creating awareness among stakeholders about the need for change and the potential benefits that can be achieved through evidence-based practice.
2. Form a Powerful Guiding Coalition: In this step, a group of influential individuals is formed to provide leadership and support for the evidence-based practice change initiative. This coalition ensures that all key stakeholders are involved and committed to the change.
3. Develop a Vision and Strategy: The development of a clear vision and strategy is essential to guide the implementation of the evidence-based practice change. The vision should be aligned with the organization’s goals and values.
4. Communicate the Vision: Effective communication is vital to engage and educate employees about the evidence-based practice change. Clear and consistent communication helps to address any concerns or resistance that may arise.
5. Empower Employees: Empowering employees involves providing them with the necessary resources, knowledge, and support to implement the evidence-based practice change. This can be achieved through training programs, mentoring, and fostering a culture of continuous learning.
6. Generate Short-term Wins: Celebrating small successes along the way boosts morale and motivates employees to continue working towards the evidence-based practice change. These short-term wins demonstrate the positive impact of the change and reinforce its importance.
7. Consolidate Gains and Produce More Change: Building on the initial successes, this step aims to create momentum and sustain the evidence-based practice change. It involves identifying and addressing any barriers or challenges that may hinder progress.
8. Anchor New Approaches in the Culture: To ensure the long-term sustainability of the evidence-based practice change, it is crucial to embed the new approaches in the organizational culture. This requires ongoing monitoring, reinforcement, and integration of the change into daily practice.
Application of Kotter and Cohen’s Change Model in Personal Clinical Practice Environment
In the personal clinical practice environment, Kotter and Cohen’s Change Model can be utilized to implement the evidence-based practice change in hand hygiene practices.
1. Create a Sense of Urgency: By sharing data on the impact of healthcare-associated infections and the potential benefits of improved hand hygiene practices, a sense of urgency can be created among healthcare providers.
2. Form a Powerful Guiding Coalition: A multidisciplinary team consisting of representatives from different departments, including infection prevention, nursing, and administration, can be formed to provide leadership and support for the hand hygiene practice change.
3. Develop a Vision and Strategy: The team can develop a clear vision that emphasizes the importance of hand hygiene in preventing healthcare-associated infections. A strategy can be formulated to promote consistent hand hygiene practices.
4. Communicate the Vision: The vision and strategy can be effectively communicated to all healthcare providers through meetings, newsletters, and training sessions. Feedback and input from staff can also be encouraged to ensure everyone feels engaged in the change process.
5. Empower Employees: Training programs on proper hand hygiene techniques can be provided to empower healthcare providers. Access to hand hygiene resources, such as hand sanitizers and handwashing stations, can be enhanced to support the change.
6. Generate Short-term Wins: Tracking and publicly recognizing improvements in hand hygiene compliance can generate momentum and motivate healthcare providers to continue practicing proper hand hygiene.
7. Consolidate Gains and Produce More Change: Addressing barriers, such as lack of resources or time constraints, and continuously monitoring hand hygiene compliance can help consolidate the gains achieved and identify opportunities for further improvement.
8. Anchor New Approaches in the Culture: Embedding proper hand hygiene practices into the organizational culture can be achieved by including hand hygiene as a performance metric, conducting regular audits, and promoting a culture that values patient safety.
Conclusion
Evidence-based practice models and change models/theories are valuable tools in implementing evidence-based practice changes in clinical practice environments. The Stetler Model of Evidence-Based Practice and Kotter and Cohen’s Change Model provide structured frameworks to guide the process of implementing evidence-based practice changes and facilitating organizational change. By applying these models effectively, healthcare providers can improve patient outcomes and promote a culture of evidence-based care.
