DNP-840A- Leadership for Advanced Nursing Practice
Choose a nursing theory. Using the nursing theory and the change management theory you selected, describe how you will formulate a strategy for leading, managing, stewarding, and collaborating within the context of your DPI Project. How will your strategy support coalition building and health advocacy?
Professor’s Response & Follow-Up Question
Dr. Guelsy Diaz
Hello, thank you for sharing an insightful post. Benner’s Novice to Expert Theory is very well known and designed to make the transitioning of a new nurse to a proficient one. However, change is ever occurring and continuous, therefore, there will always be room to learn and for improvement. Patricia Benner’s model stands on how a nurse develop nursing knowledge, skill, clinical competence and comprehension of patient care through complete theoretical training and experiential learning from novice stage to expert stage (Ozdemir, 2019).
QUESTION: What do you foresee learning more about, while utilizing this theory, once you complete your DPI?
Ozdemir, N. G. (2019). The development of nurse’s individualized care perceptions and practices: Benner’s Novie to Expert perspective. International Journal of Caring Sciences, 12(2), 1279-1285.
The goal attainment theory by King Imogen is one of the most commonly used theories in nursing. King Imogen developed the theory in the 1970s based on the idea that nurses can set realistic goals with their patients and help them meet them using collaboration and good communication (Gonzalo,2021). The three main concepts on which the theory is based are communication, interaction, and perception. Perception refers to the individual’s beliefs about health and how they perceive their ability to meet the goals related to health. Communication is the exchange of thoughts, ideas, and information between the nurse and the patient. Interaction s the way in which the nurse and patient work together towards achieving the goals. Understanding patients’ perceptions of health is essential; all three concepts are vital (Karota et al., 2020). King Imogene’s theory of goal attainment uses a patient-centered approach to meeting the desired health goals. The theory also explains the barriers in nurse-patient relationships, such as stress, a difference of opinion, lack of communication, and religious/cultural beliefs. King described the concept of environment, nursing, patient s individual health, human behavior affecting health, and interpersonal relationships. The three interacting systems defined by the theory of goal attainment are personal, interpersonal, and social. The personal system is about the patient and includes his thoughts, beliefs, behavior, choices, and preferences. The interpersonal method involves interaction between the nurse and the patient and the patient and his environment. The social system includes society, caregivers, family members, and other associations/organizations. King Imogen’s theory explains the nursing steps: assessment, nursing diagnosis, planning, implementation, and evaluation.
The ACE star model is a framework used to guide and evaluate the implementation of evidence-based practice in healthcare. The model explains five critical stages for knowledge transformation knowledge discovery, evidence synthesis, translation into practice recommendations, implementation into practice, and evaluation(Zarchi, 2020). The ACE Star Model is designed to provide a systematic and comprehensive approach to implementing evidence-based practices in healthcare settings, focusing on ensuring that the most appropriate and effective solutions are selected and implemented in a way tailored to the specific context and needs of the target population. It is widely used in healthcare settings to guide quality improvement initiatives and promote evidence-based practices to improve patient outcomes.
The learner will integrate the nursing theory and ACE star model to lead, manage, steward, and collaborate within the context of the tai chi fall prevention project by:
· Assessing the situation: this will be done by evaluating the situation at the practice site, including the target population, incidents of falls, and current fall prevention strategies. Gathering data on the incidents of falls and ee=ffectivenes of previous fall prevention measures. For example, the recent site for the learner’s DPI project is a home-care setting with a Licensed home care agency, and the fall data for the previous eight weeks(people aged 65 years and above) is 147/1000 patients, which is alarming. The data in the month of December was 158/1000 patients. After gathering the realistic data, the learner has assessed the situation, which provides a comprehensive background for leading the fall prevention project.
· Clarifying the roles and responsibilities, and goals for the project. The learner will establish goals for the project and formulate a clinical project team defining roles and responsibilities. The learner looks forward to formulating a team of RNs and a compliance manager at the new practice site. The goal of the project will be to reduce the incidence of falls.
· The project will be enveloped using the ACE Star Model, including the goals, objectives, timeline, resources needed, and evaluation method. The learner will ensure the plan aligns with the organization’s mission and vision and the goals are realistic.
· Implementation of the project will be done as identified in the project plan. The project team will be provided with comprehensive training to deliver the interventions.
· The project evaluation will be done using the ACE star model. Data will be collected pre and post-implementation, and this data will be used to measure the effectiveness of the interventions and overall impact on patient outcomes.
· The learner will facilitate sound communication among the involved stakeholder.s Regular in-person and virtual meetings will be conducted, and the project team will be engaged and informed.
· The learner will ensure the project is sustained over time by establishing a system for ongoing monitoring, evaluation, and quality improvement. The learner will develop a plan to disseminate the project’s findings to the stakeholders and share best practices.
Expanding public health advocacy education across all disciplines and within the nursing profession is essential (Morris et al., 2019). The strategy discussed above supports coalition building and health advocacy by emphasizing collaboration among the team members, good communication networks among the stakeholders, data collection and evaluation, stewardship by the learner which is critical for sustaining the health advocacy efforts over time, and dissemination of findings by sharing information and expertise which builds a broader coalition of support for fall prevention techniques and promotes health advocacy.
Gonzalo, A. B. (2021, March 5). Imogene King: Theory of goal attainment. Nurseslabs. https://nurseslabs.com/imogene-m-kings-theory-goal-attainment/
Karota, E., Purba, J. M., Simamora, R. H., L., & Siregar, C. T. (2020). Use of King’s theory to improve diabetics self-care behavior. Enfermería Clínica, 30, 95–99. https://doi.org/10.1016/j.enfcli.2019.12.035
Morris, H., Hagen, L., Hyshka, E., & Francescutti, L. H. (2019). Empowering Students and Influencing Policy Change Through Experiential Public Health Advocacy Education. Journal of Nursing Education, 58(12), 698–703. https://doi.org/10.3928/01484834-20191120-04
Zarchi, T. (2020). Intent of health care providers to adopt a clinical decision support tool in the management of minor pediatric head injuries. Journal of the American Association of Nurse Practitioners, 32(2), 168–175. https://doi.org/10.1097/jxx.0000000000000208
A nursing theory helps guide nurses in laying the foundation for care. Duffy’s Quality Caring Model will be used as the theoretical framework for this learner’s direct practice improvement (DPI) project as it focuses on the nurse-patient relationship. There are eight caring behaviors associated with this theory, and it is through these behaviors that nurses can build connections with the patient (Duffy, 2005). This model places the patient at the center of care, and it is the relationships between the healthcare team and family that act as support for the patient to improve (Duffy, 2005). The eight tenets of the model are appreciation of unique meanings, encouraging manner, human respect, attentive reassurance, mutual problem solving, affiliation needs, basic human needs, and a healing environment (Compton et al., 2018). This is a perfect model for this learner’s DPI as it will enable the nurse to collaborate with other disciplines when leading the care for mechanically ventilated patients. The nurse is the leader of care and creates a healing environment of support while using mutual problem-solving and encouragement to help the patient believe they have the strength to improve (Duffy, 2005).
Lewin’s Change Model will be used in conjunction with Duffy’s Quality Caring Model. Lewin’s Change Model was chosen as it has the potential to help the group work cohesively for the good of the patient. The three-step change process begins when the current practice is unfrozen, the change happens, and the new process is frozen into place (Lewin, 1947). During the first step, the doctoral leader will educate staff on the project and outline the new interventions, during the second step, change will begin, and the third and final step will be when the new process becomes the standard of practice in the unit (Burnes, 2020).
When both are used together, the group will work to improve the patient. Though there may be times that the group is challenged and resistant, it is the caring behaviors and looking to what benefits the patient that will be the overriding determinator. As a doctoral leader, this learner will lead by role modeling and through exemplary communication skills. Education will be provided to staff on their role as a leader in bringing the interdisciplinary team together to support the patient in the Intensive Care Unit (ICU) Liberation Bundle to help get patients off the ventilator sooner; thus, leading to improved patient outcomes (DeMellow et al., 2020). It will be through refocusing the team on the patient and reminding them to keep the patient at the center that will be the common purpose of the group. The leader helps build coalitions by bringing all the right people together who share the same goal and have the knowledge and skills to improve outcomes for groups of patients (DeNisco, 2021). The nurse leader can advocate for the health and well-being of the patient and build a coalition of people who share the same goals in pursuit of reduced ventilator days. The physicians, respiratory therapists, dieticians, nurses, and support staff rally around the patient and family as a support system to get them back to their optional functioning; patients can better adhere to the treatment plan when they feel supported (Duffy, 2005).
Burnes, B. (2020). The origins of Lewin’s three-step model of change. The Journal of Applied Behavioral Science, 56(1), 32-59.
Compton, E. K., Gildemeyer, K., Mason, T. M., Hartranft, S. R., & Sutton, S. K. (2018). Nurses’ caring behaviors: The perception of patients with cancer at the time of discharge after surgery. Clinical Journal of Oncology Nursing, 22(2), 169–174. https://doi.org/10.1188/18.CJON.169-174
DeMellow, J. M., Kim, T. Y., Romano, P. S., Drake, C. & Balas, M. C. (2020). Factors associated with ABCDE bundle adherence in critically ill adults requiring mechanical ventilation: An observational design. Intensive & Critical Care Nursing, 60. https://doi.org/10.1016/j.iccn.2020.102873
Duffy, J. R. (2005). Implementing the Quality-Caring Model in acute care. JONA, 35(1), 4-6. https://www.nursingcenter.com/pdfjournal?AID=539833&an=00005110-200501000-00002&Journal_ID=54024&Issue_ID=539826
DeNisco, S. M. (2021). Advanced Practice Nursing: Essential Knowledge for the Profession. (4th ed.). Jones & Bartlett.
Lewin, K. (1947). Frontiers in group dynamics: Concept, method and reality in social science; social equilibria and social change. Human Relations, 1, 5-41. https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=1997-97489-023&site=eds-live&scope=site&custid=s8333196&groupid=main&profile=eds1
"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"