Planning For Implementing and Evaluation of Practice Change Essay

Application 4: Planning for Change, Implementing and Evaluating EBP Projects

Evaluating EBP Projects

Many factors influence how successfully an EBP Project is implemented and evaluated. As noted in this week’s Learning Resources, using a translation framework can facilitate effective implementation and the evaluation of outcomes.Planning For Implementing and Evaluation of Practice Change Essay

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As you complete Application 4, revisit the evidence-based practice model or framework you selected for your EBP Project (Application 2 [see attached file]). How does the model or framework facilitate the evaluation of outcomes? Would another model or framework better meet the needs of your project?

To prepare for this week’s section of Application 4:

Continue (from this week’s Discussion[ use the discussion you are currently working on for me]) to:
Identify an appropriate method for evaluating your outcomes.
Develop new practice guidelines based on the possible results of the evaluation.
Create, if appropriate, new standards of care that would be based on the new practice guidelines.Planning For Implementing and Evaluation of Practice Change Essay

This paper should be written in APA format with a minimum of 8 scholarly references. All level 1 & 2 headers must be as in the grading rubric (see attached file). The paper must also include an introduction ending with a purpose statement and a conclusion as per APA guidelines. Do not go over the required maximum of 8-page. The Paper must be cited often and throughout.

The full Application 4 is due by Wednesday 10/31/18 before midgnight of this week. Instructions for how to prepare for previous sections of this Application have been provided in Weeks 8 and 9 (see attached files on WK8 & WK9 discussions you previously did for me).

To complete: (See attached Grading Rubric)Planning For Implementing and Evaluation of Practice Change Essay

Write a 4- to 8-page paper that addresses the following:

1) Planning for EBP Change (see attached file on WK8 Discussion)

a) Analyze the impact of implementing change in your practice environment, including the factors that need to be considered regarding stakeholders and end users.

b) Summarize the methods you would use to ensure that those are adequately addressed.

2) Implementing EBP Projects (see attached file on WK9 Discussion)

a) Identify the desired outcomes of your EBP Project.

b) Describe any macro or micro systems issues that may inhibit implementation and strategies for resolving those issues.

c) Explain how resolving your EBP Project issue will improve quality and patient safety.

3) Evaluating EBP Projects (See this week Discussion you are currently working on)

a) Describe evaluation strategies.

b) Formulate new practice guidelines based on the possible results of the evaluation of outcomes.

c) Describe, if appropriate, new standards of care relevant to the new practice guidelines

Required Readings

White, K. M., Dudley-Brown, S., & Terharr, M. F. (2016). Translation of evidence into nursing and health care practice (2nd ed.). New York, NY: Springer.

Chapter 4, “Translation of Evidence to Improve Clinical Outcomes”
Chapter 5, “Translation of Evidence for Improving Safety and Quality”
Chapter 7, “Translation of Evidence for Health Policy”
Chapter 17, “Data Management and Evaluation of Translation”
Chapter 14, “Creating a Culture That Promotes Translation”
Chapter 15, “Best Practices in Translation: Challenges and Barriers in Translation”

Darling, F. (2016). Practitioners’ views and barriers to implementation of the Keeping Birth Normal tool: A pilot study. British Journal of Midwifery, 24(7), 508-519.

Sadeghi-Bazargani, H., Tabrizi, J.S., & Azami-Aghdash, S. (2014). Barriers to evidence-based medicine: a systematic review. Journal of Evaluation in Clinical Practice, 20, 793-802.

Smith, E.L., Rice, K.L., & Agrell-Kann, M. (2015). Improving quality outcomes using a champion model for ancillary nursing staff, Journal of Continuing Education in Nursing, 46(12), 539-541.

Andermann, A., Pang, T., Newton, J.T., Davis, A., & Panisset, U. (2016). Evidence for health II: Overcoming barriers to using evidence in policy and practice. Health Research Policy and Systems, 14 (17) doi 10.1186/s12961-016-0086-3

Catallo, C. & Sidani, S. The self-assessment for organizational capacity instrument for evidence-informed health policy: Preliminary reliability and validity of an instrument (2014). Worldviews on Evidence-Based Nursing, 11(1), 35–45.

Malterud, K., Bjelland, K., & Elvbakken, K.T. (Evidence-based medicine – an appropriate tool for evidence-based health policy? A case study from Norway. Health Research Policy and Systems, 14 (15) doi 10.1186/s12961-016-0088-1

Rehfuess, E.A., Durao, S., Kyamanywa, P., Meerpohl, J. J., Young, T., & Rohwer, A. (2016). An approach for setting evidence-based and stakeholder-informed research priorities in low- and middle-income countries, Policy & Practice, 94, 297–305 doi: http://dx.doi.org/10.2471/BLT.15.162966

Schaffer, M.A., Sandau, K.E., & Diedrick, L. (2013). Evidence-based practice models for organizational change: overview and practical applications. Journal of Advanced Nursing, 69(5), 1197-1209 (see attached file).

Erickson, K., Monsen, K.A., Artleson, I.S., Radosevich, D.M., Oftedahl, G., Neely, C., & Thorsen, D.R. Translation of obesity practice guidelines: Measurement and evaluation. Public Health Nursing, 12(3), 222–23. doi: 10.1111/phn.12169. (see attached file)

Wang, Y., Xiao, L.D., Ullah, S., Guo-Ping, H., & De Bellis, A. Evaluation of a nurse-led dementia education and knowledge translation programme in primary care: A cluster randomized controlled trial (2017). Nurse Education Today, 49, 1-7. https://doi.org/10.1016/j.nedt.2016.10.016. (see attached file)

Abdullah, G., Rossy, D., Ploeg, J., Davies, B., Higuchi, K., Sikora, L., & Stacey, D. (2014). Measuring the effectiveness of mentoring asa knowledge translation intervention for implementing empirical evidence: A systematic review. Worldviews on Evidence-Based Nursing, 11 (5) 284–300. https://doi-org.ezp.waldenulibrary.org/10.1111/wvn.12060 (see attached file)

Einarson, A., Egberts, T.c., & Heerdink, E.R. (2015). Antidepressant use in pregnancy: knowledge transfer and translation of research findings. Journal of Evaluation in Clinical Practice, 21, 579-583 doi:10.1111/jep.12338 (see attached file)Planning For Implementing and Evaluation of Practice Change Essay

PIICOT Question

In patients in extended intensive care within an urban acute care facility in Eastern United States, how does early mobilization as recommended by National Institute of Health and Care Excellence clinical guidelines on rehabilitation of patients after critical illness impact early transfers from intensive care as measured 6 months post-implementation when compared to the current standard of care including minimal mobilization of patients?

P: Adult patients

I: in extended intensive care within an urban acute care facility

I: increased mobilization of the patients

C: minimal mobilization of the patients

O: early transfers of the patients from intensive care

T: 6 months

Implementing Change Paper Crystal Powers HCS/475 – Leadership and Performance Development April, 22, 2013 Linda Hagler-Reid Implementing Change Paper This paper will explain the managers’ role within a company and their responsibility when implementing a change within a company. It’s not just the planning and organizing talking about what plans need to be placed in order to create a change in a company, but the manager must know what to expect and how to completely deal with staff to make a positive outcome for the team. In the end this paper will provide and explain the change process; assessment, planning, implementation, and evaluation.

Managers Role and Responsibilities Managers use the intellectual property within their work, this means an idea, invention or process. Staff commonly will reject a change within the work place. Studies have shown that implementing change mainly results in a positive outcome for all who may be involved. People are comfortable with routine so when a change takes place it causes fear of what may happen. Managers are placed in a role to take action or motivate staff. Choosing a good manager is crucial for a plan to succeed. A different term for managers would be a changing agent.Planning For Implementing and Evaluation of Practice Change Essay

This is someone who makes sure the change process runs smoothly from one step to the next until all possible changes are put in place, then all the staff is comfortable, and it is completed. These types of people are able to motivate team members, show strong interpersonal skills, flexibility, confidence, and they have the skills to use various ideas from different types of input (Rehder, 2011). Even though managers implement change they are following orders from the leader of the company to make the changes within the team to meet the goals. Providing Information

Providing information is the key to preparing employees for the change, which in return will help prevent people from completely resisting the new plan put in place. Not all companies are ready to change completely or reshape a plan to succeed. This creates anxiety that relates changes in people. A strong tool for managers to use to divert change related anxiety is to give open communication about each person’s job within the plan and how it affects the team. The manager should answer any questions that the team may have about his place in the plan regarding the changes.Planning For Implementing and Evaluation of Practice Change Essay

This creates an outlet for people who maybe uncertain about what to expect as well as leading by example. A discussion along with proper planning should help the manager gain a positive support from the team to properly implement the changes within the company. A different tactic that a manager could use to prevent employees from feeling the change would be unfair to him is to talk of how the change will protect or raise fair treatment throughout the company. Certain training will help employees feel more confident about the changes taking place and how everyone has an important part of the plan working in a positive direction.Planning For Implementing and Evaluation of Practice Change Essay

The manager needs to show the employees he understands change is scary to have empathy for the staff. The manager should be aware of the different reactions that staff may have because this will help with the proper response to complete the change and assist in the introduction of the changes. Steps of the Change Process “Typically, the planning process has five steps: 1. Assessment of affirmative action needs; 2. Assessment of affirmative action opportunities; 3. Setting priorities and developing strategies; 4. Implementing the program and 5.

Evaluating the program (“Planning, Implementing And Evaluating An Affirmative Action Program”, 2013). ” Implementing change is easier when there is a large group, which is committed to the change and believes the change will positively improve the system (“Intellectual Property Office”, 2013). Health care teams work most effectively during influential and high level endorsement and support. Managers should know the different skills that the team members carry which allows the training within the team easier because there is open communication.Planning For Implementing and Evaluation of Practice Change Essay

By using the proper resources for the structure of planning it helps the organization of the team and last but not least each team will be able to reflect on the change while the manager evaluates the process. After the new changes are put in place it is vital for the manager or leader to complete the evaluation of the project planning in order to see how the changes put in place made the company improve. This is the time which important decisions are made based on the result of the beginning changes. Using a Pilot It is sometimes a good idea to use a small pilot or group of people to get feedback of the potential plan that may affect them.

This trial can give insight to any problems that may occur and help bring light to different strategies to make the proper changes as well as provide a learning experience not just for the manager but for the people involved. This process is to figure out the best possible method of change, and is not used to decide whether the project will be started. Sharing Results When sharing results the manager should create an audience that fits best for the job. Having communication about the results provides an opportunity to see what options work best within their learning staff and stakeholders (victorian quality council, 2006).Planning For Implementing and Evaluation of Practice Change Essay

Even the small changes benefit from an evaluation. By sharing which outcomes work for the team it creates a window that helps organize a plan and work out the kinks which can make everyone involved act in a positive manner. Having a willing team to be the only audience who critiques the project before it has a chance to use within the health care team. The opinions of other team members must be open and honest within the meeting of sharing results. This will help bring all the problems and information out in the open (victorian quality council, 2006).

This team should collaborate what works within the changes or what they do not think will be a positive change within the company. In the end a successful implementation of system change is important in the safety, quality of care to patients. This can be a difficult process for just anyone and that is why it takes a trained manager to make the change in the system a positive improvement for the company as well as the team members involved. After this is discussed the next step would be to choose the proper plan which worked for everyone.

In the end result the manager should implement change but reward the team for their hard work by celebrating success. References: Rehder, S. (2011). The manager’s role in implementing change. Retrieved from http://execclub. org/? p=488 victorian quality council. (2006). Successfully inplementing change. Retrieved from http://www. health. vic. gov. au/qualitycouncil/downloads/successfully_implementing_change. pdf Intellectual property office. (2013). Retrieved from http://www. ipo. gov. uk/ Planning, implementing and evaluating an affirmative action program. (2013). Retrieved from http://www. da. ks. gov/ps/documents/aap/planning.Planning For Implementing and Evaluation of Practice Change Essay

Engage all divisions of an organisation in the strategy planning process by ensuring information flow within all visions; from to levels to lower level (upward to downward communication channel should be adopted). Managers must be fully aware of how the company operates and how change will affect operation before formulation of the strategy.
Step 2
Communicate the need and how decisions were made to fill that need. Employees and all stakeholders must understand why the strategy is being put in place and its goals. Change often causes paranoia among employees. Making them feel they are an important part of the change process and educating them about the details will help to create enthusiasm and cooperation instead of paranoia.
Related Reading: What Does Strategy Implementation Involve?
Step 3
Obtain buy-in by all key employees and stakeholders involved in implementing the strategy. No matter how brilliant top management thinks the new plan is, if the production department thinks it is unworkable, they will resist change and the plan will likely fail.
Step 4
Conduct informational sessions or training to achieve a comfort level with new strategic processes and procedures. This is the time to make any necessary changes to the plans as gaps and mistakes appear. Informational sessions often elicit helpful suggestions from staff and line employees.Planning For Implementing and Evaluation of Practice Change Essay
Step 5
Implement the new strategy with elaboration. It is important that all levels of employees are passionate about the change and feel as though they have been rewarded for their help in bringing it about. There must also be a broad understanding of when the change begins, so create a launch date or schedule that everyone knows and can easily follow
Vague strategy formulation 2. Leaders consider their job is done when they finished with the planning. 3. Left the organization during the implementation. 4. Implementation tasks and activities not defined enough detailed. 5. Top middle management conflicting goals and priorities- middle management tasks modification.
6. Inadequate leadership style: top down or laissez fair senior management, not collaborative management
Strategy Formulation
The first step in forming a strategy is to review the information gleaned from completing the analysis. Determine what resources the business currently has that can help reach the defined goals and objectives. Identify any areas of which the business must seek external resources. The issues facing the company should be prioritized by their importance to your success. Once prioritized, begin formulating the strategy. Because business and economic situations are fluid, it is critical in this stage to develop alternative approaches that target each step of the plan.
Strategy Implementation
Successful strategy implementation is critical to the success of the business venture. This is the action stage of the strategic management process. If the overall strategy does not work with the business’ current structure, a new structure should be installed at the beginning of this stage. Everyone within the organization must be made clear of their responsibilities and duties, and how that fits in with the overall goal. Additionally, any resources or funding for the venture must be secured at this point. Once the funding is in place and the employees are ready, execute the plan.Planning For Implementing and Evaluation of Practice Change Essay
Evaluation and Control
Strategy evaluation and control actions include performance measurements, consistent review of internal and external issues and making corrective actions when necessary. Any successful evaluation of the strategy begins with defining the parameters to be measured. These parameter should mirror the goals set in Stage 1. Determine your progress by measuring the actual results versus the plan. Monitoring internal and external issues will also enable you to react to any substantial change in your business environment. If you determine that the strategy is not moving the company toward its goal, take corrective actions. If those actions are not successful, then repeat the strategic management process. Because internal and external issues are constantly evolving, any data gained in this stage should be retained to help with any future strategies.
Avoiding the Implementation pitfalls
Because you want your plan to succeed, heed the advice here and stay away from the pitfalls of implementing your strategic plan.
Here are the most common reasons strategic plans fail:
Lack of ownership: The most common reason a plan fails is lack of ownership. If people don’t have a stake and responsibility in the plan, it’ll be business as usual for all but a frustrated few.
Lack of communication: The plan doesn’t get communicated to employees, and they don’t understand how they contribute.
Getting mired in the day-to-day: Owners and managers, consumed by daily operating problems, lose sight of long-term goals. _ Out of the ordinary: The plan is treated as something separate and removed from the management process.Planning For Implementing and Evaluation of Practice Change Essay
An overwhelming plan: The goals and actions generated in the strategic planning session are too numerous because the team failed to make tough choices to eliminate non-critical actions. Employees don’t know where to begin.
A meaningless plan: The vision, mission, and value statements are viewed as fluff and not supported by actions or don’t have employee buy-in.
Annual strategy: Strategy is only discussed at yearly weekend retreats. _ Not considering implementation: Implementation isn’t discussed in the strategic planning process. The planning document is seen as an end in itself.
No progress report: There’s no method to track progress, and the plan only measures what’s easy, not what’s important. No one feels any forward momentum.
No accountability: Accountability and high visibility help drive change. This means that each measure, objective, data source, and initiative must have an owner.
Lack of empowerment: Although accountability may provide strong motivation for improving performance, employees must also have the authority, responsibility, and tools necessary to impact relevant measures. Otherwise, they may resist involvement and ownership. It’s easier to avoid pitfalls when they’re clearly identified. Now that you know what they are, you’re more likely to jump right over them!
Covering all your bases Planning For Implementing and Evaluation of Practice Change Essay
As a business owner, executive, or department manager, your job entails making sure you’re set up for a successful implementation. Before you start this process, evaluate your strategic plan and how you may implement it by answering a few questions to keep yourself in check.
Take a moment to honestly answer the following questions:
How committed are you to implementing the plan to move your company forward?
How do you plan to communicate the plan throughout the company?
Are there sufficient people who have a buy-in to drive the plan forward?
How are you going to motivate your people?
Have you identified internal processes that are key to driving the plan forward?
Are you going to commit money, resources, and time to support the plan?
What are the roadblocks to implementing and supporting the plan?
How will you take available resources and achieve maximum results with them?Planning For Implementing and Evaluation of Practice Change Essay
You don’t need to have the perfect answers to all these questions right now, but just make sure that you’ve given all the questions equal consideration. You don’t want to look back six months from now, and wish you had identified some big issues that are now threatening your success. If you’ve identified some red flags, assess if they’re huge obstacles or small ones. If they’re big, get them out of the way before you implement, even if it means pushing your timeline out for awhile.
Making sure you have the support
Often overlooked are the five key components necessary to support implementation: people, resources, structure, systems, and culture. All components must be in place in order to move from creating the plan to activating the plan.
People
The first stage of implementing your plan is to make sure to have the right people on board. The right people include those folks with required competencies and skills that are needed to support the plan. In the months following the planning process, expand employee skills through training, recruitment, or new hires to include new competencies required by the strategic plan.Planning For Implementing and Evaluation of Practice Change Essay
Resources
You need to have sufficient funds and enough time to support implementation. Often, true costs are underestimated or not identified. True costs can include a realistic time commitment from staff to achieve a goal, a clear identification of expenses associated with a tactic, or unexpected cost overruns by a vendor. Additionally, employees must have enough time to implement what may be additional activities that they aren’t currently performing.
Structure
Set your structure of management and appropriate lines of authority, and have clear, open lines of communication with your employees. A plan owner and regular strategy meetings are the two easiest ways to put a structure in place. Meetings to review the progress should be scheduled monthly or quarterly, depending on the level of activity and time frame of the plan.
Systems
Both management and technology systems help track the progress of the plan and make it faster to adapt to changes. As part of the system, build milestones into the plan that must be achieved within a specific time frame. A scorecard is one tool used by many organizations that incorporates progress tracking and milestones. See the section ‘Keeping Score of Your Progress’ later in this chapter for info on how to create a scorecard for your company.Planning For Implementing and Evaluation of Practice Change Essay
Culture
Create an environment that connects employees to the organization’s mission and that makes them feel comfortable. To reinforce the importance of focusing on strategy and vision, reward success. Develop some creative positive and negative consequences for achieving or not achieving the strategy. The rewards may be big or small, as long as they lift the strategy above the day-to-day so people make it a priority.
Determine your plan of attack
Implementing your plan includes several different pieces. Implementing a plan can sometimes feel like it needs another plan of its own. But you don’t need to go to that extent because I’ve done it for you! Use the steps below as your base implementation plan. Modify it to make it your own timeline and fit your organization’s culture and structure. What follows is a set of comprehensive implementation steps:
Finalize your strategic plan after obtaining input from all invested parties.
Align your budget to annual goals based on your financial assessment.
Produce the various versions of your plan for each group.
Establish your scorecard system for tracking and monitoring your plan.Planning For Implementing and Evaluation of Practice Change Essay
Establish your performance management and reward system.
Roll out your plan to the whole organization
Build all department annual plans around the corporate plan
Set up monthly strategy meetings with established reporting to monitor your progress.
Set up annual strategic review dates, including new assessments and a large group meeting for an annual plan review.
In the light of the importance of strategy implementation as a component of the
strategic management process, the high failure rate of change initiatives due to poor
implementation of new strategies and
wheat
According to existing literature about strategy implementation, it is thus obvious that strategy implementation is a key challenge for today`s organisation. Various scholars found out that most common reasons of firms bankrupting and shut-down in the world are correlated to wrong strategy implementation. The author will, therefore, scrutinize the existing studies of strategy implementation, by analyse the implementation strategy process, and critically examine barriers to strategy implementation as well as possible solutions to overcome the implementation strategy barriers. For the purpose of the class Economic in public policy management, author will evaluate the existing studies of strategy implementation if it is a true reflection of public sector, therefore, examples from public sector prospective may be used to support the literature argument.

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Assignment: Evidence-Based Practice Proposal – Section F: Implementation Plan
Details:
In 500-750 words (not including the title page and reference page), provide a description of the methods to be used to implement the proposed solution. Include the following:Planning For Implementing and Evaluation of Practice Change Essay
1. Describe the setting and access to potential subjects. If there is a need for a consent or approval form, then one must be created. Although you will not be submitting the consent or approval form(s) in Topic 5 with the narrative, the consent or approval form(s) should be placed in the appendices for the final paper.
2. Describe the amount of time needed to complete this project. Create a timeline. Make sure the timeline is general enough that it can be implemented at any date. Although you will not be submitting the timeline in Topic 5 with the narrative, the timeline should be placed in the appendices for the final paper.
3. Describe the resources (human, fiscal, and other) or changes needed in the implementation of the solution. Consider the clinical tools or process changes that would need to take place. Provide a resource list. Although you will not be submitting the resource list in Topic 5 with the narrative, the resource list should be placed in the appendices for the final paper.
4. Describe the methods and instruments, such as a questionnaire, scale, or test to be used for monitoring the implementation of the proposed solution. Develop the instruments. Although you will not be submitting the individual instruments in Topic 5 with the narrative, the instruments should be placed in the appendices for the final paper.Planning For Implementing and Evaluation of Practice Change Essay
5. Explain the process for delivering the (intervention) solution and indicate if any training will be needed.
6. Provide an outline of the data collection plan. Describe how data management will be maintained and by whom. Furthermore, provide an explanation of how the data analysis and interpretation process will be conducted. Develop the data collection tools that will be needed. Although you will not be submitting the data collection tools in Topic 5 with the narrative, the data collection tools should be placed in the appendices for the final paper.
7. Describe the strategies to deal with the management of any barriers, facilitators, and challenges.
8. Establish the feasibility of the implementation plan. Address the costs for personnel, consumable supplies, equipment (if not provided by the institute), computer related costs (librarian consultation, database access, etc.), and other costs (travel, presentation development). Make sure to provide a brief rationale for each. Develop a budget plan. Although you will not be submitting the budget plan in Topic 5 with the narrative, the budget plan should be placed in the appendices for the final paper.
9. Describe the plans to maintain, extend, revise, and discontinue a proposed solution after implementation.Planning For Implementing and Evaluation of Practice Change Essay
PLEASE WRITE UNDER THE FOLLOWING HEADINGS;
1. Setting and access to potential subjects. PLEASE create a consent or approval form(s)
2. Time needed to complete this project. PLEASE create a timeline.
3. Resources or changes in the implementation of the solution. PLEASE provide a resource list.
4. Methods for monitoring the implementation of the proposed solution. PLEASE develop the
instruments.
5. Process for delivering the (intervention) solution.
6. Data collection plan. PLEASE develop the data collection tools.
7. Strategies to deal with the management of any barriers, facilitators, and challenges.
8. Feasibility of the implementation plan. PLEASE develop a budget plan.
9. Proposed solution after implementation.
Prepare this assignment according to the APA 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.
You are required to submit this assignment to Turnitin.

Theory into Practice Plan, Implementation, Evaluation
The purpose of this paper is to provide an introduction, purpose, and rational for selecting a nursing theory. I will describe the theory by identifying the purpose, concepts/definitions, relationships/structure, and assumptions. I will use the Chinn & Kramer evaluation criteria to critique this chosen theory. Finally I will describe a plan for implementing the theory into my practice setting, identifying any barriers and challenges.
Introduction and Rationale for Theory
In order to effectively guide practice, it is essential that nurses understand and critique different theories to evaluate them for use in practice. Planning For Implementing and Evaluation of Practice Change Essay
To provide guidance and direction, ten carative factors are identified that result in the satisfaction of human needs. The first three factors; acting from a humanistic-altruistic set of values, enabling and sustaining faith and hope, and cultivating a sense of sensitivity to self and others form the foundation of caring from which the other seven carative factors are built (“Jean Watson – philosophy and science of caring,” 2010). This theory explains, describes, guides, and supports nursing practice. It gives language to the unspoken beliefs and perspectives of the nursing profession. This allows the nursing professionals to better envision, realize, and articulate their unique role in healthcare (Green & Robichaux, 2009). Human caring is the basis of therapeutic relationships between human beings (Wade & Kasper, 2006) Critical Appraisal of Theory It is important to critically appraise the theory. I have used Chinn and Kramer’s approach to evaluate Jean Watson’s Theory of human caring. This evaluation criteria reflects on the clarity, the simplicity of the theory, asks how general, how accessible, and how important this theory to the nursing profession is. The Human Caring Theory is written logically as it identifies the ten carative factors and four concepts of the caring model. However, her concepts have been described as complex because of their Planning For Implementing and Evaluation of Practice Change Essay

Contemporary nursing practice is a diverse and challenging field. Nurses are increasingly involved in complex decision-making as their roles expand in the health system (Cherry and Jacob, 2016). Underlying any care decision is the need to identify the source of the problem and then to develop a suitable approach to addressing this problem. To assist in decision-making, it is recommended that nurses adopt frameworks or models of problem-solving and care planning (Johansen and O’Brien, 2016). The assessment, planning, implementing and evaluating approach, also known as APIE (Yura and Walsh, 1967), is a commonly used approach to care planning in nursing practice. This approach encourages a systematic and rigorous approach to patient care, incorporating a holistic perspective of the care process. The aim of this paper is to evaluate the individual components of the APIE and the approach in its entirety with respect to nursing practice.Planning For Implementing and Evaluation of Practice Change Essay

Assessing
The first stage of the APIE is ‘assessing’, which entails a thorough analysis of the presenting complaint and the overall account of the individual patient (Hill, 2015). The assessing process is not a list of presenting problems, but a more systematic integration of quantitative and qualitative data. Quantitative data include the physiological status of the patient, including routine observations (temperature, weight, blood pressure, pulse) and more specific assessments, such as physical examination and interpretation of investigations (Lewis et al., 2016). While quantitative data alone can provide a clue as to the diagnosis of the patient, the holistic nature of nursing care demands consideration of subjective wellbeing and qualitative aspects of the patient, including ideas, expectations and concerns. These should be elicited to provide a basis for reassuring the patient or addressing emotional and psychological support needs early during the consultation (Hill, 2015).Planning For Implementing and Evaluation of Practice Change Essay

The assessing process can be considered a fundamental part of patient care planning and forms the main data collection phase of the nurse-patient interaction (Lewis et al., 2016). Nurses use multiple techniques and approaches to collect data, including history taking, examination and ordering investigations, all of which may inform the decision-making process. Therefore, the initial stage of the APIE can be considered a valid approach to gathering data to inform care planning of the individual patient.Planning For Implementing and Evaluation of Practice Change Essay

Planning
Only once a systematic and comprehensive assessment phase is complete is it possible to engage in effective care planning. Planning involves formulating suitable interventions and strategies to address the presenting problem, with consideration of the biological elements of the condition as well as the preferences of the patient (Doenges et al., 2016). Furthermore, care planning should include clear goal setting to ensure that the plan can be successfully implemented. These goals should be patient-centred, recordable, observable, directive, understandable, credible and time-related regarding available resources (Hayes and Llewellyn, 2010).Planning For Implementing and Evaluation of Practice Change Essay

However, planning within the problem-solving APIE approach may be limited without consideration of additional models of nursing, including the activities of living model by Roper, Logan and Tierney (1985) and the self-care model of nursing by Orem (1985). These models provide a deeper context for applying the principles of the APIE, taking into account the necessity to generate patient-centred care planning and goals that are achievable and measurable with respect to the status of the patient (Flagg, 2015). Similarly, planning should take into consideration the ability of the patient to self-care, a crucial aspect of everyday function and wellbeing (Orem, 1985). Accordingly, nurses have a duty to support and promote patients in self-care activities and should facilitate these activities wherever possible as part of the care planning process.Planning For Implementing and Evaluation of Practice Change Essay

Care plans should include highly structured and clear stages and steps that may be taken to achieving a specific goal, which may be followed by patients, nurses and other care professionals, as needed (Blais et al., 2006). Nurses may involve other members of the care team in decision-making at this point in order to maximise the potential benefits to the patient. Furthermore, a combination of personal experience and evidence-based guidance can be used to inform the optimal planning approach, suggesting that nurses need to apply critical thinking and a combination of intuition and guidelines in formulating appropriate care goals (Blais et al., 2006).Planning For Implementing and Evaluation of Practice Change Essay

Implementing
As with the planning phase, implementing appropriate care plans requires input not only from the nurse, but also the patient. Nurses need to ensure that the actions needed to address the patient’s needs are appropriate and practicable, including the direct delivery of interventions and referral of the patient to specialist care, as needed (Locke and Latham, 2013). However, the APIE approach focuses more precisely on the role of nurse-led interventions and overlooks the importance of supportive nursing roles during the implementation process.Planning For Implementing and Evaluation of Practice Change Essay

In addition to nurse-led interventions, patients should be supported and educated to promote self-care (Wilkinson and Whitehead, 2009). Furthermore, careful consideration of available resources and support is needed to ensure that the care plan is suitable for the individual patient and their environment (e.g. hospital or community settings). Self-care ranges from the simple act of a patient managing their own medication to more complex processes, whereby patients are responsible for symptom identification and changes to lifestyle/behaviours. The Nursing and Midwifery Council (2018) publishes a code for nurses, which includes the role of the nurse in supporting self-care in a sensitive and compassionate manner. Therefore, to ensure adherence to practice standards and professional codes of conduct, the implementing process in the APIE scheme should balance the need for nurse-led therapies and strategies to promote individual wellbeing and empowerment in self-care.Planning For Implementing and Evaluation of Practice Change Essay

Furthermore, the APIE problem-solving approach emphasizes the need for suitable implementation of a plan, but wider roles of nurse and the patient need to be considered to deliver personalised care. This includes the core components of respect and dignity of the patient, which should be preserved at all times, as well as the delivery of culturally-sensitive care (NMC, 2018). Indeed, nurses who are compassionate and considerate of other cultures and patient beliefs are more likely to develop strong therapeutic relationships, which have been shown to promote adherence to treatment plans and improve outcomes (Hagerty and Patusky, 2003).

Evaluating
The APIE approach culminates in an evaluation of the implementation of the care plan, which is essential in ensuring goals of care have been met, while allowing adjustment of the care plan where needs remain unmet. This evaluation process was initially conceptualised as a single assessment during patient follow-up or management review, but has developed into more extensive process of monitoring therapy and adjusting interventions over time (Barrett et al., 2014). Specific consideration needs to be made regarding the achievement of care goals and the suitability of these goals in future care episodes, based on patient factors and nurse factors.Planning For Implementing and Evaluation of Practice Change Essay

However, the evaluation process is not simply a process of clinical review, but can be considered a core aspect of the overall professional development of the nurse and a key learning process (Barrett et al., 2014). Indeed, reflective practice is increasingly recognised as fundamental to the nursing profession, allowing practitioners to develop strengths and target weaknesses in patient care (Redmond, 2017). The evaluation process therefore allows practitioners to engage in personalized care planning for the patient as well as professional development based on reflection on the care delivered to date.Planning For Implementing and Evaluation of Practice Change Essay

Extending and enhancing the APIE approach in practice
Although the APIE approach is a fundamental aspect of problem-solving in contemporary nursing practice, it is clear that the use of additional models and processes is essential to optimising care delivery for the individual patient. Furthermore, some authors have suggested that the APIE approach benefits from expansion of the terms and inclusion of additional areas (Hill, 2015). For instance, an extension of the APIE approach includes the use of further refinement stages and on-going follow-up of care planning, which are important additions to the problem-solving approach that recognise the importance of chronic disease management in contemporary practice.Planning For Implementing and Evaluation of Practice Change Essay

In addition, some authors advocate the inclusion of a decision-making phase following assessing, which formalises the need to develop a plan based on all available evidence, both quantitative and qualitative (Lumbers, 2018). Achieving a suitable diagnosis also has the benefit of allowing clear communication of the nature of the planning phase across multiple professional groups and may provide the patient with guidance on their future care needs.

Indeed, the ASPIRE approach has largely replaced APIE and comprises assessing, systematic nursing diagnosis, planning, implementing, re-check and evaluation (Lumbers, 2018). This approach will be widely known to nurses and emphasizes the importance of a systematic approach to diagnosing and re-checking the implementation process prior to evaluation. Extensions of the APIE can be considered refinements that only serve to augment the basic structure of problem-solving inherent in the approach. Therefore, the APIE or ASPIRE approach remains a core element of clinical decision-making in contemporary nursing practice.Planning For Implementing and Evaluation of Practice Change Essay

Conclusion
In summary, the APIE approach remains a commonly used and rationale approach to care planning in nursing practice. Each stage of the APIE is a justifiable component of the nursing process and can contribute to effective decision-making. However, the use of nursing models is often required to complement the APIE problem-solving approach, to ensure holistic wellbeing and a patient-centred approach to care. Therefore, the APIE can be considered a valuable tool in the context of wider nursing models to facilitate care planning and decision-making. Planning For Implementing and Evaluation of Practice Change Essay