Evidence Centered Patient Safety Initiative Capstone Project

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Abstract

In order to gather the challenges, it is necessary to rehabilitate organizations into learning institutions at the first step, so as to make them superlative. To make a change from a traditional to a learning organization, the main factor is leadership, which brings to light the goals and the main insights of the organization, assists workers to achieve their aims and helps them put up a learning condition which is inventive (Diab, Safan & Beeker, 2017). In the most recent proposal, an outline of an organization’s assessment on how ready they are to adopt evidence-based practice in the healthcare sector is presented. This project will be carried out in hospital environments with the respondents being healthcare professionals. The study will employ the Prevention Program Assessment tool to check their preparedness for change and thereafter get into a training period of 25 weeks. The outcomes will be analyzed qualitatively and quantitatively and finally highlight the drawbacks and future implications.

Introduction

We are living in a century which requires us to speed up the rate of progress in healthcare. Nowadays, advancements in healthcare organizations are not constant. Therefore, it is very critical for the success of an organization that it has an ability to change the usual ways of practice. Change comes under different attributes either in political, social or financial frameworks. The success of an organization is revealed by its tendency to change (Diab, Safan & Bakeer, 2017). When an organization progresses from its current state to some forward and desirable state, this is said to be organizational change. Organizational change management consists of preparation and application of positive and negative changes in the organization. This has to be done in such a way so that there is a decrease in employee resistance and cost to the organization along with strengthening of tolerability of change exertion. Therefore, it is advisable for people to get ready for change in order to reduce resistance to change (Vakola, Oreg & Armenakis, 2013). Change is more likely to take place if those that embrace it are more than the ones opposed. This is observed in the model for individual and organizational change. The willingness of an individual to pursue therapy change informed the transtheoretical model in psychotherapy. In an effort to prepare the stakeholders to prepare for change, the transtheoretical model emphasizes the need to remove obstacles to the change initiative and fan the urge for change by introducing motivators for the same. The motivators may be either psychological or structural (Howley, 2012). The guidelines below could help to pick out the best approach for change: It breaks down from the status quo to the future state in five stages:

1. Craft the change

2. Plan change

3. Put change into effect

4. Manage change

5. Sustain and maintain change (Cavarec, 2014).

Failure by the top management to support nursing staff at lower levels could be one of the barriers to change. Poor pay and lack of rewards, including poor facilities, equipment and resources, lack of clear information about the need for change and failure to provide training programs for the staff for their development constitute a raft of factors that impede change. Consequently, there is likely to be lack of commitment, dissatisfaction and lack of motivation among the nursing fraternity to inspire them to take part in change (El-Sayed, Seada & El-Guindy, 2017).

Managing change is, clearly, a complex process. It is also hard to characterize and initiate in a world that is changing fast, and full of diversity among people. There are varied cultures, ecologies and organizational missions. Since leaders have an obligation to make the right decisions and implement their conclusions, the guidance provided by theories of change is, undoubtedly, useful to them. Leaders can make use of models of change to prepare their organizations to embrace fresh methods of adopting change and achieving their objectives. Change management could be a more intricate skill than conventional science. The fact that there is ambiguity in the current research on change underscores the fact. Thus, insights about practice are invaluable to such leaders (Howley, 2012).

Literature Review

According to Jones et al (2005), the perception of employees to an organizational culture is strong according to their human way of seeing things. Therefore, an open relations values will be linked to increased levels of preparedness for change which would predict the success of implementing change.

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Analysis disclosed that pre-implementation levels of preparedness for change brought a positive impact on the satisfaction of employees, given that the system is error free and user friendly. In another research by Ingersoll et al (2000), the relationship between organizational commitment, organizational culture, and organizational preparedness in a number of employees taking part in a hospital-wide redesign process were determined. Results showed that when change is taken positively, employees might put in more effort and commit themselves to the institution’s work. According to Treuer et al (2018), the preparedness of the organization as a whole for change will depend on how much they modify their organizational climate and style of leadership.

Problem Statement

The research was conducted to assess the following problem statement: “What is the level of readiness of my organization’s staff for evidence-based practice?” In order to determine how ready, the organization was for incorporation of evidence into practice in the organization, this study sought the opinions of nurse managers and staff nurses regarding the implementations of EBP changes. It also looked into the barriers that deter the incorporation of practice changes.

Methodology

Instrument. Change readiness assessment seeks to examine the level of readiness three main items: the circumstances; individual approach; and possible resources in a system. This is done at all levels (Diab et.al, 2017). The Prevention Program Assessment tool will be used to evaluate how ready the healthcare employees are to implement evidence-based practice. The major goal of developing this tool was to assess the preparedness of organizations for evidence-based interventions in programs related to prevention of chronic diseases, including asthma, obesity, and diabetes, among others. The tool can be very useful to public health practitioners who may want to know how ready their organizations are for kicking off evidence-based programs. The tool comprises 23 questions under four categories, i.e. awareness, adoption, implementation and awareness). These are meant to guide the user on evaluation of the preparedness of a given organization to apply evidence-based practice for both private and public health sectors. The Prevention Program Assessment tool employs 4 basic stages for the readiness assessment (Stamatakis et al, 2012).

1. Awareness: Assessing community awareness and organizational awareness, recognizing the availability and need of sources of EBIs

2. Adoption: Analyzing the level of evidence use in decision making

3. Implementation: Implementation and adaptation of the intervention to fulfill community needs

4. Maintenance: Availability of resources and activities for continuing support of the innovation

The four stages herein outlined make the Prevention Program Assessment Tool a worthwhile tool to use. The tool caters for both the senior and junior staff, and thus very appropriate for the project. It is good to use the tool both at the beginning of the training (pre-intervention) and after the training (post-intervention). The training will cover among other things: division of labor, discipline, decision making, leadership with fairness, sustainable employment, comprehensive instructions, remunerations and performance appraisals. The four stages cover a period of 6 months, after which the preparedness for change is evaluated using the Program Assessment tool (Cavarec, 2014).

The tool has been tested by interviewees sampled to represent study areas in prevention of chronic diseases. The degree of readiness was measured using the confirmatory factor analysis (CFA). The CFA was first tried out on the initial four-factor approach to organization preparedness. It was thus adapted several times, using a number of indices used to examine model fit. These include comparative fit index, chi-square/degrees of freedom, associated 90% confidence interval, and root means square error of approximation. CFA was the most appropriate for the 5-point scale of adoption and implementation. Its use considerably improved the awareness and maintenance scales. The maintenance scale was further divided into four and five item scales. The four-point scale represents the evaluation maintenance, whereas the five-point scale represents resource maintenance. The final scales managed to exhibit a good fit, with factored loadings between 0.6 and 0.4. The readiness scale was also found to be a good one, with ranges from 0.47 to 0.71 (Stamatakis et.al, (2012).

Subjects. This undertaking will be performed within healthcare centers and hospitals. Potential participants in the venture are hospital managers and RNs (registered nurses). Convenient sampling will be used for sample selection. Participants will have to sign a consent form before appearing for data collection.

Procedure. A non-randomized sample of registered staff nurses and nurse managers from acute and critical care.....

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