Change is a critical part in the evolution of a process (Polit & Beck, 2008). Within nursing field, practice through research has enhanced by the application of evidence-based practice. The generation and eventual assessment of evidence forms a critical aspect in nursing that calls for the need to undertake changes beneficial in clinical practice.
One critical area of procedure that requires change is the Improving Hand Off communication between nurses at change of shift. This is because it is through best practices in communication that nurses can share information regarding the status of their patients. The problem of communication through the documentation of Hand Off record and passing the details over to an oncoming nurse has a lot of demerits. According to Beyea and Slattery (2006), “documentation is an important nursing role that requires improvement”. In addition to the above, the absence of verbal communication presents challenges to oncoming nurses in cases where the documentations are incomplete.
Probing questions on the state of patient’s condition by the oncoming nurse may not be answered because of the absence of the outgoing nurse. I strongly believe that this culture should be changed to allow nurses meet and discuss issues verbally during change shifts. This will provide the opportunity for exchange of ideas between the two nurses. Furthermore, because of the presence of the outgoing nurse, probing questions by the oncoming nurse will be adequately addressed. It is my belief that the change will foster an interactive culture between the nurses.
I propose to implement this change by the application new model and process to the implementation of evidence-based practice as advanced by Reavy and Tavernier (2008). The benefits of evidence-based practice have been demonstrated to be large in numbers. According to Reavy and Tavernier (2008), “beneficial outcomes of the implementation and use of evidence-based practice by staff nurses include increased ability to offer safe, cost-effective, and patient-specific interventions.” In addition to the above model, I will take a keen cognizance on the difference between Quality Improvement (QI) and research which in most cases is not always clear (Newhouse Pettit, Poe and Rocco, 2006). This is because according to Newhouse Pettit, Poe and Rocco (2006), “the consequences of misrepresenting QI as nursing research result in poorly designed and interpreted studies, potential for lack of consideration of subject rights and IRB or other regulatory sanctions for noncompliance with federal, state, and local law and institutional policies.”
According to Newhouse (2007), “the evaluation of successful change requires not only rigorous measurement but also standardized measures that drive diverse healthcare systems to common evidence-based goals.” I must therefore underline the barriers that will come my way during the implementation. These include “lack of congruence between unit policies and research evidence, resistance to take part in evidence practice, the challenges brought about by environmental factors and inadequate attendance because they also lack confidence and experience” (Leasure, Stirlen, &Thompson, 2008). Other barriers that I expect to come across in the implementation of this evidence-based practice as pointed out by include “management styles and individual learning styles” (Reavy and Tavernier, 2008). I believe by proper identification on the specific area that needs change, underlining the model I expect to apply in the implementation of the evidence-based practice, understanding the barriers I expect to come across, I have the competitive advantage of reaping the benefits that come along with this change.
Beyea, S. and Slattery, M.J. (2006). Evidence-based practice in nursing: a guide to successful implementation. New York: HCPro.
Leasure, A., Stirlen, J., & Thompson, C. (2008). Barriers and facilitators to the use of evidence-based best practices. Dimensions of Critical Care Nursing, 27(2), 74-84.
Newhouse, R. P. (2007). Accelerating improvement: Implications of the IOM report for nurse executives. Journal of Nursing Administration, 37(6), 264-268.
Newhouse, R. P., Pettit, J. C., Poe, S., & Rocco, L. (2006). The slippery slope: Differentiating between quality improvement and research. Journal of Nursing Administration, 36(4), 211-219.
Polit, D. F., & Beck, C. T. (2008). Nursing research: Generating and assessing evidence for nursing practice. Philadelphia: Lippincott Williams & Wilkins.
Reavy, K., & Tavernier, S. (2008). Nurses reclaiming ownership of their practice: Implementation of an evidence-based practice model and process. Journal of Continuing Education in Nursing, 39(4), 166-172.