Theories And Models Assignments Discussion

Theories And Models Assignments Discussion

Need Help Writing an Essay?

Tell us about your assignment and we will find the best writer for your paper

Write My Essay For Me

THEORIES AND MODELS ASSIGNMENT INSTRUCTIONS
OVERVIEW
As you are preparing to implement and translate your project results into a practice setting the use of theories and models may be helpful. In this assignment you will have the opportunity to review a variety of theories and models to serve as a conceptual framework for the scholarly project (keeping in mind you will use the Iowa Model for the evidence-based project/scholarly project)Theories And Models Assignments Discussion. In addition, you will be exploring models and theories for translation and change.
INSTRUCTIONS
1. In the assigned reading, review the conceptual frameworks that are discussed. Describe how the Iowa Model of Evidence-based Practice will support your scholarly project development. Keep in mind the Iowa Model is the model you will be using for your project. It will be required you fully describe the Iowa Model for your proposal. Spending time on the development of this portion of the assignment will be most beneficial as you move forward.

ORDER A PLAGIARISM-FREE PAPER HERE

2. In the assigned reading, review the translational and major frameworks that are discussed. Review the various models and select one you believe would be one that would provide guidance and support for the translation of the potential results of your scholarly project Theories And Models Assignments Discussion.

a. Describe the phenomenon of interest/topic being considered for the scholarly project.
b. Identify the selected framework.
c. Identify the specific components/attributes of the selected framework you view as strengths of the framework.
d. Identify the specific components/attributes of the selected framework you view as limitations of the framework.
e. Develop a narrative describing step by step how the selected model would support your potential project.

3. In the assigned reading, review the Change Theory and Models for Translation and select one you believe would be one that would provide guidance and support for making a positive change in the practice setting.

a. Identify the selected change theory.
b. Develop a narrative describing why the selected theory would be effective in making a change in the practice setting.
c. Discuss feasibility issues in using the selected framework (keeping in mind change may take a period of time)Theories And Models Assignments Discussion.

4. Include three – four additional references in addition to the assigned reading.
5. Include a title page and reference list using current APA format.
6. Use current APA format throughout the assignment.
Note: Your assignment will be checked for originality via the Turnitin plagiarism tool

NOTE: TOPIC TO FOCUS: Early Implementation of Palliative care for patient with End stage COPD to prevent/decreased number of readmissions less than 30 days.

After retrieval of evidence and dissemination of recommendations, what remains for organizations is to put those recommendations into practice. This is what is known as translation into practice (Melnyk & Fineout-Overholt, 2019). Successful translation into practice requires the adoption of a conceptual framework and change model to guide the process. In nursing, a variety of models are typically used to convert study findings to execution. These models include two that stand out. The Stetler model and the Iowa model are these two models (Dang et al., 2021)Theories And Models Assignments Discussion. The Stetler model and the Iowa model both help researchers and practitioners determine the best methods for putting research-based recommendations into clinical application (Camargo et al., 2017). The purpose of this paper is to describe the Iowa Model Revised and the conceptual framework to be used in this case to translate the recommendations into practice.

A Description of How the Iowa Model will Support the Scholarly Project

The initial version of the Iowa model was released in 1994. Nevertheless, it was revised in the year 2001 to incorporate fresh terminology as well as the idea of feedback loops. The Iowa Model Revised makes use of the idea of triggers for evidence-based practice (EBP) transformation. These catalysts, which frequently originate from outside the enterprise, arouse curiosity about studying the facts surrounding a clinical problem. Prior to a complete execution of recommendations in the enterprise, the approach places an emphasis on preliminary testing or piloting of findings (Camargo et al., 2017; White et al., 2019). This is the essence of the Iowa model of EBP implementation.

Application of the Iowa Model of EBP Implementation in this Particular Scholarly Project

The topic to focus on in this project is the Early Implementation of Palliative Care for Patients with End-Stage Chronic Obstructive Pulmonary Disease (COPD), to reduce the number of readmissions within 30 days of discharge. The Iowa Model Revised has a number of steps that must be followed for successful implementation. For this project, these are described below (Hanrahan et al., 2019):

1. The trigger: The trigger for this scholarly project and the use of the Iowa model was the frequency of readmissions of patients with end-stage chronic obstructive pulmonary disease or COPD within 30 days of discharge. These are patients who have almost irreversible emphysema (dilatation of alveoli) and chronic bronchitis. End-stage COPD is stage 4 or very severe COPD in which the patients have severe productive cough, shortness of breath, and a history of smoking with a significant number of pack years. As per spirometry, end-stage COPD is a forced expiratory ratio (FEV₁/FVC) post-bronchodilator of equal to or less than 0.3 or ≤30% (GOLD, 2017; Hammer & McPhee, 2018). This means exacerbations will be frequent as will be readmissions to the hospital.
2. The question or purpose: This is the stage in which the question as to whether the project is a priority was asked (Hanrahan et al., 2019)Theories And Models Assignments Discussion. It was found that indeed it was a priority and required to be addressed. It is at this stage that an interprofessional team of stakeholders was formed to undertake the change process. With the help of the library and research databases, this group was tasked with assembling relevant evidence and then appraising it for its quality, its quantity, and its consistency. After this, the team then synthesized the evidence for presentation and reporting.

• Determination of the sufficiency of the evidence: The team found that there was overwhelming evidence that the patients with end-stage COPD were being readmitted at a very high rate within 30 days of discharge due to frequent and serous exacerbations. For instance, according to Mir et al. (2021), about 10-20% of all COPD patients get readmitted within a 30 day period after discharge from the hospital. There is therefore every reason to extrapolate that those with end-stage COPD will thus be readmitted at an even higher rate.

1. Piloting: The Iowa Model Revised is unique in that it requires the implementation to start at a smaller scale (piloting) before it can be generalized to the whole organization or network (Hanrahan et al., 2019). During this piloting, important data that will be used for evaluation is collected.
2. Appropriateness or Otherwise of the Change for Adoption into Practice: It is after piloting phase that the data obtained is assessed to see if the change is indeed worthwhile. If the piloting results show that the change has an impact, then it will be rolled out and disseminated in the whole organization and/ or healthcare network. Another particularity of the Iowa Model Revised at this stage is that it has feedback loops that come into effect should the results of the piloting indicate that the change was not sufficient to impact practice. If this were to be the case, the feedback loops would lead to a redesign of the change initiative, reassembly, or a look at other triggers (Hanrahan et al., 2019)Theories And Models Assignments Discussion. This means the process would need to be started all over again.

Review of Models for Evidence Translation

The phenomenon of interest in this scholarly work is the 30-day readmission rate after hospital discharge among patients with stage 4 COPD or end-stage COPD. This rate was found to be quite high and this served as the trigger for the investigation. The aim is to see if the introduction of early palliative care interventions can prevent or reduce the frequency of these readmissions in these end-stage COPD patients.

As already stated in detail above, the model of change implementation chosen for this scholarly project has been the Iowa Model Revised. The steps of this model with regard to this particular scholarly project have been analyzed in detail above. One of the reasons as to why this model was chosen is the fact that it gives the opportunity for piloting before resources are committed to the full-scale implementation in the whole organization.

The specific attributes or components of the specific selected model (Iowa) that could be considered as strengths are quite a number. These include the fact that the Iowa Model Revised does not just start but must be kicked off by a suitable “trigger.” Also, when it is determined that the project should be a priority the model takes a systematic approach to implementation. Last but not least the piloting consideration is a big strength since the organization can be saved of resources if the piloting determines that the project is not feasible or impactful.

A number of limitations can also be identified from the Iowa framework or model. They include that inherent errors or mistakes made during piloting would be transferred to the general project at full-scale; the interprofessional team may have members that are not quite committed or well-versed with the research process; and the process take quite long to finish due to the need for piloting. These are just some of the weaknesses or drawbacks that can be identified in the Iowa framework. The step by step description of how the Iowa Model Revised would support this project has already been done in the preceding paragraphs Theories And Models Assignments Discussion.

Review of Models for Change or Change Theory

The Rogers Diffusion of Innovation Theory was chosen as the most suitable nursing change theory for the conceptual framework. This theory not only blends with the Iowa Model Revised, but also explains how various categories of employees in the target population adopt change. These have been described as the innovators, early adopters, early majority, late majority, and laggards (Dearing & Cox, 2018). An evidence-based change model like Rogers Diffusion of Innovation Theory helps with the project’s trajectory by offering a framework for transformation. It acts as the plan for carrying out the project.

The Rogers Diffusion of Innovation conceptual framework has five stages namely knowledge, persuasion, choosing, implementation, and confirmation (Dearing & Cox, 2018). A number of feasibility issues will affect the adoption of the change, given that the process will stretch over a long period of time. These include compatibility, complexity, relative advantage, observability of the results or outcomes, and trialability or how strongly testing has been done before implementation.

Conclusion

There is a significant clinical practice problem of frequent hospital readmissions within 30 days of discharge for patients with end-stage COPD. This scholarly project is attempting to address this by introducing early palliative care. The EBP implementation model chosen is the Iowa Model Revise; while the change theory to serve as the conceptual framework during implementation is Rogers Diffusion of Innovations theory

ORDER NOW

References

Camargo, F.C., Iwamoto, H.H., Galvão, C.M., Monteiro, D.A.T., Goulart, M.B., & Garcia, L.A.A. (2017). Models for the implementation of evidence-based practice in hospital-based nursing: A narrative review. Texto Contexto Enfermagem, 26(4), 1-12. https://doi.org/10.1590/0104-07072017002070017

Dang, D., Dearholt, S.L., Bissett, K., Ascenzi, J., & Whalen, M. (2021). Johns Hopkins evidence-based practice for nurses and healthcare professionals: Model and guidelines, 4^th ed. Sigma Theta Tau International.

Dearing, J.W. & Cox, J.G. (2018). Diffusion of innovations theory, principles, and practice. Health Affairs, 37(2), 183-190. http://dx.doi.org/10.1377/hlthaff.2017.1104

Global Initiative for Chronic Obstructive Lung Disease [GOLD] (2017). Pocket guide to COPD diagnosis, management, and prevention: A guide for health care professionals. https://goldcopd.org/wp-content/uploads/2016/12/wms-GOLD-2017-Pocket-Guide.pdf

Hammer, D.G., & McPhee, S.J. (Eds). (2018). Pathophysiology of disease: An introduction to clinical medicine, 8^th ed. McGraw-Hill Education.

Hanrahan, K., Fowler, C., & McCarthy, A.M. (2019). Iowa model revised: Research and evidence-based practice application. Journal of Pediatric Nursing, 48(0), 121-122. https://doi.org/10.1016/j.pedn.2019.04.023

Melnyk, B.M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice, 4^th ed. Wolters Kluwer.

Mir. W.A.Y., Siddiqui, A.H., Paul, V., Habib, S., Reddy, S., Gaire, S., & Shrestha, D.B. (2021) Palliative care and chronic obstructive pulmonary disease (COPD) readmissions: A Narrative Review. Cureus 13(8), e16987. https://doi.org/10.7759/cureus.16987 Theories And Models Assignments Discussion