Grand Canyon University NUR 590 The Ideal Model and Transtheoretical Model Paper

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. Grand Canyon University NUR 590 The Ideal Model and Transtheoretical Model Paper

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. Grand Canyon University NUR 590 The Ideal Model and Transtheoretical Model 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. Grand Canyon University NUR 590 The Ideal Model and Transtheoretical Model Paper

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

ass_4_rubric.xlsx

nur_590_ass_1hh_ebp_proposal.docx

Evidence-Based Practice Proposal Sample Paper

Grand Canyon University

December 2020

Evidence-Based Practice Proposal

Organizational Culture and Readiness Assessment

Healthcare organizations are the primary institutions mandated to facilitate the acquisition of quality care for the patient category, hence promoting community health and wellness that is vital for economic development. In the global spectrum, healthcare organizations are continuously leveraging evidence-based practices (EBP) as the primary problem-solving approach to clinical care, hence as a central concept in the planning and implementation of secure systems that aligns to the needs and wants of patients (Yoo et al., Grand Canyon University NUR 590 The Ideal Model and Transtheoretical Model Paper 2019).

The system replaced the conventional paradigm used in healthcare decision-making, indicating an additional responsibility for the healthcare professionals in accessing knowledge, its application in practice, and guiding others in the appropriate application and use for the greater patient good. Healthcare organizations must integrate research, evaluation, and effective communication strategies to ensure quality healthcare services for the respective population. Grand Canyon University NUR 590 The Ideal Model and Transtheoretical Model Paper

The respective organization is depicted as having been moderately prepared for the implementation of EBP strategies, as broadly evidenced by the prevalent individual nurse characteristics and the characteristics of the organization as defined by the healthcare environment. Specifically, the identified inadequate nursing skills and personality among the nursing staff may impede research capabilities, including the synthesis of garnered research literature. Grand Canyon University NUR 590 The Ideal Model and Transtheoretical Model Paper

There is also a lack of adequate managerial commitment and IT infrastructure that indicate the organization’s culture that is also identified as constantly diminishing the power, authority, and independence of the respective practitioners (Muntner et al., 2017). The organizational facilitator includes a dedicated and enthusiastic project leadership team that encompasses nurse managers. Elements of clinical inquiry, for instance, on the best practices in mitigating aspects of hypertension among nurses and their leaders adopt various metrics, including surveys and observation, focus groups, and structured questionnaires for the nursing cohort.

The healthcare organization should strategize for continuous education and teaching seminars to acquaint care providers with relevant skills and expertise to provide patient-centered care. It should also leverage applicable IT infrastructure and consideration all stakeholders and organizational parameters, such as inclusive decision-making. Grand Canyon University NUR 590 The Ideal Model and Transtheoretical Model Paper

Proposal/Problem Statement and Literature Review

There has been an identified continuing trend that depicts racial disparities in the incidence and prevalence of hypertension among Americans. The disease’s shortcomings have been continually recorded and evident based on the presenting symptoms and the associated complications that subsequently increase suffering and the development of other emergencies related to the disease. Grand Canyon University NUR 590 The Ideal Model and Transtheoretical Model Paper

There have been racial differences in the control rates of high blood pressure, with the most impacted being black Americans, compared to their counterparts who often present with lower figures. According to Lackland (2015), the disparities are closely linked to the distinct persons’ awareness and treatment levels that affect their access to quality care services. Modern society is increasingly being affected by multiple healthcare conditions that ultimately implicate the quality of life. Grand Canyon University NUR 590 The Ideal Model and Transtheoretical Model Paper

A higher disease burden stems from preventable causes, which significantly contribute to lifestyle complications that could otherwise have been prevented. Besides, distinction in individuals’ genetic constitution also contributes to the postulated disparities in the incidence and prevalence rates of hypertension within the community. Grand Canyon University NUR 590 The Ideal Model and Transtheoretical Model Paper

The prevalent racial disparity in hypertension and hypertension-related outcomes has been in existence for decades, where African Americans always have an earlier onset, hence have higher rates of the associated implications, such as possible disability and compromised quality of life, among others. Elements of lifestyle modification constitute the primary mitigation strategy for hypertension prevention, management, and control among the at-risk population (Yoo et al., Grand Canyon University NUR 590 The Ideal Model and Transtheoretical Model Paper 2019).

Nurses are the primary care persons who tend to patient needs, hence required to have adequate skills and expertise for safe practice and to convey relevant knowledge to the patient and immediate caregivers to promote best practices that reduce risk and promote wellness (Carey et al., Grand Canyon University NUR 590 The Ideal Model and Transtheoretical Model Paper 2018). Essentially, adherence to the postulated elements by the care providers and the patient group has an increased potential to lessen the identified disease impact by reducing new rates and decreasing associated mortality rates as a by-product of optimized management.

EBP has, over time, become a predominant care model with significant recognition identified explicitly for a specific role it plays in facilitating the transfer of research evidence into clinical practice. Studies postulate that most of the most impacted black Americans by the identified disease include the middle-aged and older adults, and the high rates are linked to poor adherence to medication and inadequate and compromised lifestyle attributes (Yoo et al., Grand Canyon University NUR 590 The Ideal Model and Transtheoretical Model Paper 2019).

The study subjects included underserved African American middle-aged and older adults who are identified as having hypertension as the primary condition, regardless of other presenting ailments (Adinkrah et al., 2020). The selected method included a community cross-sectional survey with about 338 individuals with hypertension, 55 years, and older. The study’s independent variables included comorbidity, age, gender, educational attainment, and knowledge adherence. The study results indicated various indicative factors as the determinants and contributors to a patient’s adherence to medication and lifestyle best recommendations for hypertension. Grand Canyon University NUR 590 The Ideal Model and Transtheoretical Model Paper

Identified predictive factors include personal beliefs, behaviors, knowledge on hypertension, and diverse demographic elements; for instance, the participants identified to have higher knowledge levels on the disease were more likely to adhere to recommendations than the other cohort. Grand Canyon University NUR 590 The Ideal Model and Transtheoretical Model Paper

The high hypertension rates among the black race are also postulated to have an approximately five-year reduced life expectancy than the whites with hypertension. According to Adinkrah et al. (2020), there was a probable chance for recall bias for the participants required to recollect medication and lifestyle-related recommendations in the survey. Grand Canyon University NUR 590 The Ideal Model and Transtheoretical Model Paper

Besides, the convenient sampling method used in obtaining data could have potentially resulted in an under or over-representation of the black Americans sampling frame. Healthcare organizations should strategize strategies to leverage research, evaluation, and elements of effective communication to improve care delivery. Grand Canyon University NUR 590 The Ideal Model and Transtheoretical Model Paper

References Grand Canyon University NUR 590 The Ideal Model and Transtheoretical Model Paper

Adinkrah, E., Bazargan, M., Wisseh, C., & Assari, S. (2020). Adherence to hypertension medications and lifestyle recommendations among underserved African American middle-aged and older adults. International Journal of Environmental Research and Public Health, 17(18), 6538. https://doi.org/10.3390/ijerph17186538
Carey, R. M., Muntner, P., Bosworth, H. B., & Whelton, P. K. (2018). undefined. Journal of the American College of Cardiology, 72(23), 2996-3011. https://doi.org/10.1016/j.jacc.2018.10.022
Lackland, D. T. (2015). Racial differences in hypertension: Implications for high blood pressure management. The American Journal of the Medical Sciences, 348(2), 135-138. https://doi.org/10.1097/maj.0000000000000308
Muntner, P., Abdalla, M., Correa, A., Griswold, M., Hall, J. E., Jones, D. W., Mensah, G. A., Sims, M., Shimbo, D., Spruill, T. M., Tucker, K. L., & Appel, L. J. (2017). Hypertension in blacks. Hypertension, 69(5), 761-769. https://doi.org/10.1161/hypertensionaha.117.09061
Yoo, J. Y., Kim, J. H., Kim, J. S., Kim, H. L., & Ki, J. S. (2019). Clinical nurses’ beliefs, knowledge, organizational readiness and level of implementation of evidence-based practice: The first step to creating an evidence-based practice culture. PLOS ONE, 14(12), e0226742. https://doi.org/10.1371/journal.pone.0226742

Grand Canyon University NUR 590 The Ideal Model and Transtheoretical Model Paper