One of the major health related issue that is prevalent in the post-operative environments is the development of respiratory infections. These include infections such as pneumonia and pulmonary complications. They occur, especially, after the administration of anesthesia, which facilitates the development of hospital-acquired infections. Nearly half of the surgical patients that require the administration of anesthesia before undergoing surgery develop pulmonary infections (Dennise, 2009). The fact that most surgical patients usually have limited mobility within the post-operative environment has been identified as the main risk factor for such infections. Due to these hospitals acquired infections, numerous surgical patients usually incur increased medical costs and prolonged medical stay.
Change Model Overview
Johns Hopkins Nursing Evidence- based practice is a very important model used in solving different problems in clinical decision making. It is supported by another tool which is easy to use in order to guide professionals in their daily chores. This model is made in such a way that it is able to fulfill the needs of practicing nurses (Agostini et al, 2013). It only involves the application of only three processes called PET namely practice questions, evidence and translation. This model is introduced to ensure that the most current research results and best practices are included when taking care of the patient. This model is therefore used as a framework for providing guidance and support in synthesis and translation of evidence into real life (Newhouse, Dearholt, Poe, Pugh, & White, 2007). This model also emphasizes that during research both internal and external factors must be looked at before introducing change. This model has three different phases where the first phase involves selection of questions that can be answered, followed by systematic review and the final phase is translation. JHNEBP feasibility of introducing and implementing proposed practice changes.
It is important for practicing nurses to use Johns Hopkins Nursing Evidence Based practices is because it is the simplest and more user friendly than other research models. This model is also easy to understand and produces more accurate result because it allows nurses to work through three processes or steps called PET (Neelam Makhija, 2007). It is also appropriate for practicing nurses to use this model because it has the capacity to generate a thorough descriptive and easy to use tool that can be used in the assessment of evidence for bedside nurse. JHNEBP model should also be used by nurses because it is an appropriate approach that helps nurses and other professional make correct decision by first identify evidences that could be there for a given practice and provide its ratings according to its scientific purpose. It also ensures that all unsound practices are eliminated to improve the quality of nursing practices and finally it improves the quality of patient care. The use of this model also ensures that nursing practices are provided at a lower cost and this improves the quality life.
Step 1: Recruit Inter-professional Team
It is vital to identify professionals only to form the team (Anne, 2007). This is because they have professional knowledge necessary in this research intervention. This team must be composed of practicing nurses, pharmacists, healthcare practitioners, researchers, clinicians and leaders. Each team member will have his or her own responsibilities designated separately. This will prevent incidences of duplication of duties and also create accountability.
Step 2: Develop and Refine the EBP Question
The development and refinement of EBP questions is very important as it highlights what should be done to change the current policies. The EBP question saying how effective the use of incentive spirometers is can be refined by saying what the effectiveness of incentive spirometers is. The second question can be refined by saying what the differences are and comparison between deep breathing and slight breathing exercises and finally the last question should be what the prevention of respiratory infections is
Step 3: Define the Scope of the EBP
EBP is only limited to the study of the prevalent of post operative environment. It is the main issue because causes the growth of many respiratory diseases such as pneumonia and pulmonary infections (Anne, 2007). This kind of infection only occurs once the patients have been given anesthesia which supports the development of hospital- acquired infections. Statistics indicates that almost all surgical patients that have been administered anesthesia before undergoing surgery, develops pulmonary infections. The effect of this problem is that it increases the cost of medication and also increases the spread of other infections in the hospitals.
Steps4 and 5: Determine Responsibility of Team Members
It is important to have clinicians in my team because they play a role in encouraging inter-disciplinary EBP. They are also required to develop the skills of EBP so that they can spread it throughout the organization (Neelam Makhija, 2007). All settings of clinicians such as acute, long term and primary care must be there in the team because there will be expected to evaluate evidences and provide recommendation for the change of current practices. Leaders that come from different disciplines must also be there the team to set the expectations that require EBP to be multi-disciplinary (Anne, 2007). Finally, researchers are also required as they will be responsible for testing the models, creating metrics to represent high quality and also to assess the outcomes of the study. Practicing nurses will ensure that they provide professional expertise required during evaluation process. They will also support in the implementation process of the recommended changes in the organization. Pharmacists will be responsible for providing advisory opinion on the impacts of such changes and also advise other members on the possible barriers that might affect the implementation of such practices.
Steps 6and 7: Conduct Internal/External Search for Evidence and Appraisal of Evidence
Qualitative research was conducted and its findings were found to be the appropriate evidence. The types of evidence received were qualitative evidence (Neelam Makhija, 2007). The importance of qualitative research is that it ensures that the available data are examined in more details. It also does not inhibit the interview to be done on a specific question and therefore can be redirected in real time. The use of this research method is that research framework can easily be re-evaluated when new information emerges and finally, it is more compelling and therefore provide more vivid findings.
Steps 8 and 9: Summarize the Evidence
It is clear that for over 20 years, different studies indicate that there is inconsistent use of best practice. The evidence indicates that most registered nurses have not been able to follow clinical best practices guidelines. It is therefore important for registered nurse to use multiple sources to find solutions to their practicing problems. It is also critical to know that all patients who have not gone through surgery before being treated with anesthesia have high possibility of contracting respiratory diseases (Anne, 2007). The evidence is that all the patients who have undergone such processes have contracted respiratory diseases.
Step 10: Develop Recommendations for Change Based on Evidence
Based on the findings of this research, it is recommended for any patient before being administered with anesthesia to go through surgery to prevent the patient from contracting other additional respiratory diseases. It is also appropriate to develop policies and procedures that are followed by nurses to ensure that patients get quality care without discrimination and victimization.
Steps 11, 12, 13, 14: Action Plan
Steps 1: Determine fit, feasibility and appropriateness of recommendation 3 week
Step 2: create action plan 1 week
Step 3: secure support and resources to implement action plan 6 months
Step 4 : Implement action plan 4 weeks
Step 5:Evaluate outcomes 2 weeks
Step 6: Report outcomes to stakeholders 1week
Step 7: identify next step 1week
Step 8: Disseminate findings 3weeks
Steps 15and 16: Evaluating Outcomes and Reporting Outcomes
The outcomes were evaluated through allowing all the patients to undergo breathing test, early mobilization and airway clearance (Mueenudheen et al, 2012). The desired outcomes are to ensure that all the patients have no respiratory problems. These outcomes can be measured through the use of incentive spirometer and thoracic expansion exercises. I will report the findings to stakeholders through the internet and intranet (Anne, 2007). The findings will also be reported via social media and other media such as radio and TV.
Steps 17: Identify Next Steps
The plan will be implemented by ensuring that all the stakeholders are involved. This will encourage the professionals to have the desire and morale to implement the plan on a larger scale. For effective implementation, it is important to communicate the plan to all the stakeholders. This implementation process will be applicable to other units because all implementation process requires those (Hall et al, 2012). For the implementation process to become permanent, policies must be developed to guide and support the change. It is also important to develop a culture that supports the use of best nursing practices.
Step 18: Disseminate Findings
Once the result have been received, it is important for all the stakeholders to receive the result of the research. This can be done through face to face communication where all the employees are called in a meeting and the findings read to all the nurses and other staff. The findings can also be disseminated through writing where the organization writes a memo to all staff explaining the result of research (Agostini et al, 2013). This will ensure that everybody in the organization acquire the information about the best clinical practice which has been adopted by the organization. The employees can also be communicated through intranet. This method of communication is cost effective and efficient as it takes a very shorter time and also ensures that everybody in the organization accesses the results and findings of the research. External stakeholders will be communicated to through the use of different communication media such as radio, TV and even internet (Anne, 2007). The uses of these kinds of media ensure that the information reaches everybody and this therefore ensure clear communication between the organization and its stakeholders.
Evidence based practices is important in providing guidance to nurses during their clinical decision making. This process involves identifying, evaluating and implementation of best evidence generated by nurses in order to improve patient care. This practice require introduction of existing evidence supported by clinical expertise to provide solutions to various health care questions through the use of qualitative approaches. The use of EBP allows professionals to use current and previous findings, medical procedures and other important sources of information to select appropriate information while providing the distinction between high and low quality results. This therefore ensures that only best clinical practices with good evidence are implemented to improve the quality of nursing and this can be achieve through passing through rigorous research.
References Agostini, P et al (2013) Effectivenessof incentivesp...
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