Topics: 1. Accurate documentation by staff in the EHR is a common management frustration in nursing and health care. Taking into account risk factors such as staffing ratios, increasing patient acuity, and frequent changes in documentation requirements, devise a plan for improvement in your facility; ensure you include staff education and ongoing monitoring. 2. The prevention of healthcare-associated infections (HAI) is a key focus for health care organizations of late. HAIs that occur have the potential to not only affect patient care outcomes but can also have a high impact on the financial operations of the organization. Develop a plan to implement HAI prevention compliance in your organization. 3. You are the charge nurse of a medical/surgical unit. Recently, your organization has implemented a bar-coded medication administration system to reduce medication errors. You have been notified that some of the nurses are overriding the safety features of the system, leading to an increase in medication errors. You will need to identify resources available and design a specific plan of action for monitoring compliance in using the system. Your focus is to implement a plan to monitor and evaluate nurse compliance with the new bar-coded medication administration system.

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Reply to this discussion post by offering additional ideas to overcome the barriers to strategies suggested by your colleagues and/or by offering additional ideas to facilitate dissemination. Several models have been created to help with disseminating evidence-based practice. The first model I am most inclined to use is the Iowa Model. Melnyk, B. & Fineout-Overholt, E. (2018) state that the purpose of this model is to guide nurses in developing questions related to clinical practice and decision making to affect improvement in patient outcomes. I like the Iowa model because its design is for nurses and clinicians in inpatient care. The model contains specific steps to identify a problem in current practice, identify measures for improvement, and then implement those improvements into practice. (Melynk, B. & Fineout-Overholt, E. (2018). One barrier to the Iowa model is that it is designed to identify an inquiry to fit the organization’s needs. (Melynk, B. & Fineout-Overholt, E. (2018). This can be a problem if your identified problem or area of interest does not align with something the facility is willing to research and implement. A way to overcome this would be to do independent research and present it to stakeholders on why your identified topic is essential to the organization. Another barrier is that stakeholder involvement is a crucial component to help with the dissemination and implementation of evidence-based practice. A way to overcome this would be by having fellow nurses collaborate with you on the topic’s importance to help influence the manager’s willingness to approve and participate in the proposed practice change. The ARCC Model is another model I am inclined to use for disseminating evidence-based practice. The ARCC model compares a standard of practice utilized in the past or over the years to the current standard of practice in the everyday practice area and identifies improvement needs. (Melynk, B. & Fineout-Overholt, E. (2018). This model is useful because nurses are always looking to improve current practices by comparing the past with current care standards. A barrier to the ARCC model will occur if the organization has inadequate knowledge related to evidence-based practice. This can be overcome by having educated mentors present to educate staff on evidenced-based practice through various methods. Another barrier is staff expertise in carrying out the evidence-based practice. (Melynk, B. & Fineout-Overholt, E. (2018). If there are no knowledgeable mentors and clinicians available to help carry out and monitor the evidence-based practice changes, results may not occur. This barrier is overcome by making sure enough competent clinicians are involved in the process. The Stetler Model is a strategy I least likely will use. Melynk, B. & Fineout-Overholt, E. (2018) states that the Stetler model favors individual practitioners and advanced practitioners over staff nurses or combined teams of interdisciplinary professionals. For a practice related to a hospital unit change, most of the team members involved would not be advanced practitioners, so this is why I feel like this model would not work. In conclusion, I believe the learning resources models are beneficial when it comes to implementing evidence-based practice. Reference Melnyk, B. M. & Fineout-Overholt, E. (2018). Evidence-based practice in nursing and healthcare: A guide to best practice (4th ed.) Philadelphia, PA: Wolters Kluwer, pp 378-427.

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