W5 Midterm Reflection Math 110 B033 Spring 2022

5122 1101 Am W5 Midterm Reflection Math110 B033 Spring 2022

Discuss an Evidence-Based Practice (EBP) initiative implemented in a health care setting—using fictitious names for people and places—and evaluate whether it was successful or not sustainable, providing a rationale. Additionally, choose one of four models of organizational change (e.g., Melnyk, 2019) to use in an advanced nursing role aimed at enhancing the sustainability of EBP initiatives. Your response should include an analysis of the initiative’s success, reasons for sustainability or lack thereof, and how the selected change model can support ongoing improvement.

Paper For Above instruction

Implementing evidence-based practice (EBP) initiatives has become central to advancing healthcare quality and patient outcomes. A typical scenario involves the introduction of a hand hygiene protocol in a hospital to reduce nosocomial infections. In our fictitious case, Green Valley Medical Center launched an EBP initiative aimed at improving hand hygiene compliance among nursing staff to curb the spread of infections like MRSA. The initiative included staff training, visual reminders, and real-time feedback on compliance rates. Over time, data showed an initial improvement, with hand hygiene compliance rising from 60% to 85%. However, sustainability became an issue as compliance rates gradually declined once the initial enthusiasm waned, stabilizing around 70% after six months. This underscores a common challenge: maintaining long-term adherence to EBP changes.

The success of this initiative was observed in the short term, as infection rates temporarily declined, signaling that the implemented strategies had immediate effects. However, the decline in compliance rates reveals a lack of sustainability. Several factors contributed to this outcome. Firstly, staff motivation waned when feedback was not consistently provided, and ongoing reinforcement was absent. Additionally, shifts in leadership priorities and limited integration of hand hygiene into the organizational culture hindered long-term adherence. This aligns with broader evidence suggesting that without continuous reinforcement, behavioral changes tend to regress to pre-intervention levels (Lohsami & Ramezani, 2020).

To enhance sustainability, applying an organizational change model can be instrumental. Among the various models, Melnyk's (2019) strategies emphasizing transformational leadership and participatory approaches are particularly relevant. Melnyk advocates for embedding evidence-based practices into organizational culture through leadership support, staff engagement, and continuous quality improvement. This approach involves creating a shared vision, fostering open communication, and empowering staff at all levels to take ownership of EBP initiatives. These elements are crucial for fostering the intrinsic motivation necessary for sustained change (Melnyk et al., 2019).

Implementing Melnyk’s model involves several strategic steps. First, securing strong leadership commitment is essential to prioritize and allocate resources toward EBP sustainability. Leaders should model desired behaviors and recognize staff contributions, fostering a culture of accountability and continuous improvement. Second, engaging frontline staff in the development and refinement of hand hygiene protocols ensures that interventions are tailored to real-world challenges, increasing buy-in and adherence. Third, establishing ongoing education and feedback mechanisms maintains awareness and motivation, preventing regression. Additionally, integrating hand hygiene as a core value through organizational policies and routines reinforces its importance (Melnyk, 2019).

Moreover, combining Melnyk’s approach with other frameworks such as Kotter’s 8-step change model can provide a comprehensive strategy for sustainability. Kotter’s model emphasizes creating a sense of urgency, building guiding coalitions, and generating short-term wins, which can energize staff and embed the change into the organizational fabric (Kotter, 1996). For example, highlighting infection reduction statistics can motivate staff, while forming interdisciplinary teams can foster collective responsibility. Continuous evaluation and celebrating progress help sustain momentum, ensuring that hand hygiene becomes a long-lasting practice rather than a temporary project.

In conclusion, while the initial implementation of the hand hygiene initiative at Green Valley Medical Center demonstrated promising short-term results, its long-term sustainability was compromised by factors such as waning engagement and organizational culture barriers. Applying a comprehensive change model, such as Melnyk’s approach, can promote embedding EBP into routine practice by focusing on leadership, staff involvement, ongoing education, and organizational culture change. Sustained improvements require persistent effort, strategic planning, and a supportive environment that values continuous quality improvement. Future initiatives should incorporate these elements from the outset, ensuring long-term adherence and improved patient outcomes.

References

• Hoppe, B., & Knafl, K. (2021). Applying organizational change theories to nursing practice. Nursing Management, 52(4), 31-38.
• Kotter, J. P. (1996). Leading Change. Harvard Business Review Press.
• Leeman, J., Wangen, M., & Escoffery, C. (2022). Selecting evidence-based interventions to reduce practice gaps. Practical Implementation Science.
• Lohsami, M., & Ramezani, N. (2020). Strategies for sustaining behavioral change in healthcare settings. Journal of Nursing Education and Practice, 10(3), 45-52.
• Melnyk, B. M. (2019). Strategies to promote sustainability of evidence-based practice changes. Worldviews on Evidence-Based Nursing, 16(5), 387-389.
• Melnyk, B. M., et al. (2019). Implementing Evidence-Based Practice in Healthcare: A Guide for Professional Practitioners. Springer Publishing.
• Prior, L., & Popay, J. (2020). Embedding change in healthcare organizations: Challenges and strategies. Implementation Science, 15, 17.
• Fixsen, D. L., Naoom, S. F., Blase, K. A., Friedman, R. M., & Wallace, F. (2005). Implementation Research: A synthesis of the literature. Tampa, FL: University of South Florida, Louis de la Parte Florida Mental Health Institute, The National Implementation Research Network.
• Wierzba, T. F., & Cohen, M. L. (2022). Organizational change models in healthcare: Application and outcomes. Healthcare Management Review, 47(2), 134-142.
• Schein, E. H. (2010). Organizational Culture and Leadership. Jossey-Bass.