Discussion: diffusion of innovation theory

Discussion: diffusion of innovation theory ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Discussion: diffusion of innovation theory In 500-750 words (not including the title page and reference page), apply a change model to the implementation plan. Include the following: Discussion: diffusion of innovation theory Rogers’ diffusion of innovation theory is a particularly good theoretical framework to apply to an EBP project. However, students may also choose to use change models, such as Duck’s change curve model or the transtheoretical model of behavioral change. Other conceptual models presented such as a utilization model (Stetler’s model) and EBP models (the Iowa model and ARCC model) can also be used as a framework for applying your evidence-based intervention in clinical practice. Apply one of the above models and carry your implementation through each of the stages, phases, or steps identified in the chosen model. In addition, create a conceptual model of the project. Although you will not be submitting the conceptual model you design in Topic 5 with the narrative, the conceptual model should be placed in the appendices for the final paper. 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. Please refer to the directions in the Student Success Center. Upon receiving feedback from the instructor, refine “Section E: Change Model” for your final submission. This will be a continuous process throughout the course for each section. section_e_rubric.docx get_up_and_go_home_juliebraylock Evidence-Based Practice Proposal – Section E: Change Model 2 1 Less than Unsatisfactory Satisfactory 0.00% 80.00% 3 Satisfactory 88.00% 4 Good 92.00% 5 Excellent 100.00% 100.0 %Change Model 100.0 % Apply a Implementation Implementation Interpretation Analysis and Analysis and change model plan is loosely plan is loosely and evaluation evaluation evaluation draw to the connected to a connected to of the change draw warranted use implementation change model. the chosen model are not warranted use of the specified plan. Carry the Inaccurate change model. presented of the specified change model, implementation comprehension Identification, comprehensively change model, and rationale is plan through of material is interpretation, and may be and rationale is appropriately each of the revealed, as is and evaluation ambiguous at appropriately supported. A stages, phases, the lack of of the change times. A basic supported. A detailed and/or steps ability to apply model are not description of detailed outline descriptive identified in the information. presented the of the narrative of the chosen model. Subject matter comprehensively implementation implementation implementation is absent, and/or may be plan through the plan through plan through inappropriate, ambiguous at stages, phases, each of the each of the and/or times. A lack of and/or steps stages, phases, stages, phases, irrelevant. comprehension identified in the and/or steps and/or steps is Surface errors is displayed, but chosen model is identified in the provided, as is a are pervasive there is an provided. chosen model solid enough that attempt to apply Comprehension is provided. An interpretation they impede information. of the material is individual of the change communication There is weak, exhibited and interpretation model in of meaning. marginal there is clearly on the relation to the Inappropriate coverage of an attempt to effectiveness of implementation word choice subject matter integrate and the model in plan. and/or with large gaps apply relation to the Appropriate sentence in presentation. information. All implementation evaluation of construction Frequent and subject matter is plan is the are used. repetitive covered in presented, but effectiveness of mechanical minimal it lacks depth. the model is errors distract quantity and Integrative and provided, the reader. quality. Some accurate demonstrates Inconsistencies mechanical comprehension clarity and in language errors or typos is specificity of choice (register), are present, but demonstrated comprehension, sentence are not overly and and synthesizes structure, and/or word choice are present. 100 % Total Weightage distracting to the reader. Correct sentence structure and audienceappropriate language are used. information is all relevant applied as information. appropriate. Coverage There is extends beyond comprehensive what is needed coverage of to support subject matter. subject matter. Discussion: diffusion of innovation theory Prose is largely Writer is clearly free of in command of mechanical standard, errors, written, although a few academic may be English. present. A variety of sentence structures and effective figures of speech are used. GET UP AND GO HOME 1 Get up and go Home Julie Braylock Grand Canyon University: NUR:699 Cindy Boyer GET UP AND GO HOME 2 Abstract An abstract is a brief, comprehensive summary of the contents of a paper (American Psychological Association, 2010) that runs a maximum of 120 words. It should contain a synopsis of the points in the paper, but also be readable and well organized. To use this page of the template, simply delete this paragraph and start typing. The formatting should stay the same. GET UP AND GO HOME 3 Spring Valley Hospital was established in 2003 as the first acute care hospital in Southern Nevada in Las Vegas. The hospital has recorded outrageous growth regarding community that they provide their services. Currently, the hospital has a bed capacity of 292. The services that are offered are inclusive of emergency services offered in 24 hours, maternity services, inpatient and outpatient rehabilitation, wound care and cardiovascular services. I conducted an evidencebased practice readiness survey at my hospital. The mission of the hospital is to “provide a culture of excellence with committed employees, physicians, and volunteer deliver safe quality patient care for their community” (Spring Valley Hospital 2018). I have worked at Spring Valley for several years, and it is evident to me that the hospital is striving to provide optimal care to the patients which includes best practice guidelines to insure the best possible patient outcomes. Knowing this, I scored the facility a 5 for this category. The organization’s level of readiness lies in interprofessional collaboration. The hospital is part of six acute care hospitals that are responsible for providing patient care within Southern Nevada and Las Vegas at large. The other hospitals that take part include Desert Springs Hospital Medical Center, Summerlin Hospital Medical Center, Valley Hospital Medical Center, Henderson Hospital and Centennial Hills Hospital Medical Center (Spring Valley Hospital Medical Center, 2018). Interprofessional collaboration is essential since it improves the outcome of patients. Additionally, teamwork is vital in reducing workload and thus improves job satisfaction for both the healthcare workers and the patients (Bosch & Mansell, 2015). As a worker at the facility, I noticed how the workers were relieved of workload and this increased work efficiency. The program also helped in interprofessional-based education among the workers in the hospital. GET UP AND GO HOME 4 The hospital is not a Magnet Hospital but does have some evidence-based practice (EBP) guidelines in effect. Nurses are educated and responsible to adhere to the guidelines daily. I did score give a score of 5 because the most recent EBP guidelines are put into practice. I scored a 3 for the degree in which nursing staff is dedicated to EBP. I scored this this area low because working in the ICU I do see where staff does fall short in committing to guidelines. Some of the barriers does tie in with lack of education. Discussion: diffusion of innovation theory The hospital also offers minimal training opportunities to nurses. I would have to score the hospital at a 3 in this area. Training is crucial since it improves skills and knowledge. Through training, nurses can improve their basic understanding and thus become more robust when faced with challenges in their daily activities. The hospital use of electronic health records requires people who are trained. The electronic records make the work easy as the files are easy to find and thus time conscious. The hospital has fewer staff members than the required number. However, to curb this issue, the hospital allows volunteers who fill the gap to ensure that workload is minimized, and the patients stay in the hospital is reduced. This is mainly because of the training that is offered to ensure that the serviced offered are of good quality and up-to-date. Evidence-based practiced (EBP) in nursing at Spring Valley Hospital is apparent. EBP aims to make available valuable and practical care to the patients with the intent to improve the outcome. The hospital fulfills this by ensuring that the EBP in nursing is practiced (Spring Valley Hospital Medical Center, 2018). The patients who were admitted to the hospital give feedback stating that they received the most effective care based on available facts. Possible project barriers for EBP in the hospital include misunderstanding of the statistics, scarce time to carry out the EBP and to read the literature and lack of power to change the care given to the patients. Barrier facilitators include support from peers and colleagues as GET UP AND GO HOME 5 well as managerial support. Insufficient authority to prompt a change in the practice setting has been a major barrier in the hospital. The organization should be willing to support the implementation of research in the six facilities that are within the Valley system. Lack of time to implement and review the findings was also another barrier in the hospital. I scored the facility at a 4 in this area. There are less training opportunities and support policies that are in the hospital, and this makes it hard for the hospital to promote EBP at regular intervals. Promoting clinical inquiry and generating an interest in EBP is significant in a hospital setup. This is because they facilitate positive outcomes such as build of interdisciplinary relationships, creating rapport and generating a continuing trustworthy structure. One of the methods to improve clinical inquiry is through coaching and mentorship of the steps involved in EBP. Another method is to change the authority among the nurses to provide a platform to ask what is not understood. Moreover, encourage the nurses to identify patients who are interested in taking part in the EBP. Problem Statement According to (Truong et al, 2009) “In the Intensive Care Unit, critically ill mechanically ventilated patients have been considered too ill to move leaving them to traditional bed rest to which can lead to detrimental effects on the patients physical, emotional, and social health. ICU acquired weakness (ICU-AW) is an accumulative effect of prolonged bed rest, malnutrition, and systemic inflammation”. The author goes on to explain that “Once a patient has been compromised by ICU-AW, the patient may experience prolonged mechanical ventilation, prolonged hospitalization due to secondary diagnoses from hospital acquired injuries (HAIs), muscle wasting requiring ECF placement, and decreased quality of life due to prolonged effects GET UP AND GO HOME 6 of immobility” (Truong et al 2009). The general weakness of the muscles develops in patients admitted in the ICU due to acute illness or treatment of the disease. The loss of muscle mass and muscle strength in patients in the ICU was first recorded in the nineteenth century (Hermans & Berghe, 2015). Discussion: diffusion of innovation theory The main complications related to ICU-AW are critical illness polyneuropathy and critical illness myopathy. The incidence rate of ICU-AW is reported to be 25% to 100% (Zororwitz, 2016). It is a frequent complication of a critical illness which is linked to high morbidity and mortality rates. Additionally, the condition has long-term consequences in patients who are discharged from the hospital for an instance post-intensive care syndrome which comprise of mental, physical and cognitive dysfunction. ICU-AW is associated with multiple dysfunctions of organs, and thus patients have activity limitations. These patients require physical assistance mostly from the nurses to perform even the most basic activities related to bed movement. The purpose of this paper is to provide a proposed evidence-based project whose aim is to reduce the effects of ICU-AW and decrease hospitalization duration for patients with mechanical intubation in Spring Valley Hospital. The proposed problem is an issue not only in the US but a globally. Patients in ICU are at a higher risk of losing muscle mass and mass strength due to reduced physical inactivity and increased metabolism. Additionally, decreased pathophysiological mechanisms which include metabolic, microvascular, electrical and bioenergetic adaptation give rise to muscle atrophy and reduced muscle mass and strength (Zhou et al, 2014). From the proposed problem, researching Spring Valley Hospital would be of great importance as there would be an evidence-based project that will be used in the field of nursing. Moreover, the hospital will receive a good reputation. Weaning off mechanical ventilation is related to problems of the diaphragm, intercostals muscles, phrenic nerves and other accessory respiratory muscles. In rare cases, facial GET UP AND GO HOME 7 muscles may be affected, and thus paralysis of the muscles surrounding the eye may occur. The research will benefit patients who are in the ICU all over the world as well as nurses. EBP in the hospital will only be possible if there is collaboration among hospital workers and support from peers and colleagues as well as managerial support. When conducting this research, it is essential to develop a PICOT statement to enable useful interview due to this epidemic. The question could be: In critically ill mechanically ventilated patients (P), does the implementation of early mobility to reduce the risk of ICU acquired weakness (ICU-AW) (I) compared to use of complete bed rest (C) decrease hospital stay (O) over time (T)? The purpose of conducting this research is to find out practical interventions that will facilitate reduction of the effects of ICU-AW and aid in the reduction of hospital stay for patients with mechanical intubation. This will, therefore, reduce morbidity and mortality rate in the US as well as reduce the long-term complications for patients who are discharged. The EBP is essential in the field of nursing as it provides practical care for patients with similar conditions with the intention of improving the outcome of the patients. Evaluation of the Evidence Immobility in the ICU is a contributing factor to an increased hospital stay, complications upon discharge, and physical deconditioning. Even though early mobility has shown great improvements in ICU patients, research shows that there is lack of necessary resources that would significantly lead to the implementation of early mobility.Discussion: diffusion of innovation theory It is a frequent complication of a critical illness which is linked to high morbidity and mortality rates. Additionally, the condition has long-term consequences in patients who are discharged from the hospital for an instance post-intensive care syndrome which comprise of mental, physical and cognitive dysfunction. GET UP AND GO HOME 8 ICU-AW is associated with multiple dysfunctions of organs and thus patients have activity limitations. Risks factors associated with bed rest include poor response to stress responses for patients with muscle wasting and immobility. Early mobilization seeks to decrease the effects of ICU-AW and decrease hospitalization duration for patients in ICU. There was an initiative carried out by 13 ICUs in eight hospitals in the US which aimed at integrating the most recent evidence on the practice of mobility into the modern ICU culture (Bassett, Vollman, Brandwene, & Murray, 2012). This was done through designing and implementing evidence-based mobility continuum that was physiologically grounded and friendly to its users. Targeted messages and appropriate education was given to the stakeholders and change interventions were given to the staffs to modify their behaviors in their field of practice for it to be long term. Another study was carried out that involved 106 patients. The inclusion criteria of the study were patients had to be in ICU, the APACHE II score should not be below 14.7. The duration of the research was four weeks. The outcome measures used were number of days that the patient was mobilized, reasons why the patients were not mobilized and adverse events that took place during the search (Leditschke, Green, Irvine, Bissett, & Mitchell, 2012). Early mobilization therapy has been closely linked to improved survival in critically ill and mechanically ventilated patients. Prolonged lack of mobility and total bed rest increases catabolism and muscle wasting. These are the major reasons why patients in ICU have neuropathy and ICU-AW (Lipshutz & Gropper, 2013). Various equipment and expertise exist to ensure that there is compliance with early mobilization programs. Research and EBP should be conducted to find out the drugs that will reduce muscle atrophy for patients in ICU. GET UP AND GO HOME 9 Collection of qualitative data was used to evaluate issues that surround mobility as well as providing feedback to the stakeholders who were expected to support the change. Early mobilization is associated with reduced skin injuries, reduced longevity of hospital stay, improved ventilation-free days, decreased hallucinations and reduced cases of complications after discharge. The validity of the research was not correct since this study had fewer participants and a short period of time (Bassett, Vollman, Brandwene, & Murray, 2012). Analysis of benefits, safety, and feasibility of early mobility on critically ill patients compared to traditional bed rest. It had 10 studies with 868 participants. The study involved two prospective studies and two observational studies. From the reviews, the study showed that mobilization can be directed to the patients as to the patients as per their level of tolerance to the activity (Schweickert, et al., 2009). It thus promoted safety and positive effects of the therapy. There was also reduced the number of free ventilation. Presence of family was shown to be a motivational factor and beneficial in early mobilization. Engaging of the family together with the patients serve as a standard of care but in ICU, this is not allowed. The research was done to identify the role that the family plays to help in the recovery of the patients. This is beneficial for both the patients and the staff since workload for the staff is significantly lessened (Rukstele & Gagnon, 2013). Active presence, protection, facilitation, history, coaching, and volunteering of caregivers is importantDiscussion: diffusion of innovation theory . From the randomized control trials, it is evident that early mobilization of ICU patients is important as it helps in reducing hospital stay, reduces complications after discharge, reduced muscle atrophy and ICU-AW (Vollman, 2013). These studies, however, did not address adverse effects of immobility such as increased hallucinations, atelectasis, and skin injuries. However, there was improved muscle tone. Implementations of measures that reduce sedation and improve GET UP AND GO HOME 10 mobility are therefore important. This will significantly reduce the mortality rate associated with ICU acquired weakness. These trials provide techniques that are used to evaluate and implement treatments using evidence-based practices for patients in the ICU to provide the progressive guidelines that should be used in search cases. Solution Description Different studies have been carried out to identify safe and effective ways that will minimize cases of ICU-AW for mechanically intubated patients. The most common method that has been tried through EBP is early mobilization. Nonetheless, few patients are able to reach recommendable levels of active mobility and the studies are inconsistent making it hard to understand the optimum outcome of the EBP (Taito, Shime, Ota, & Yasuda, 2016). The proposed solution for ICU-AW in Spring Valley Hospital is consistent early mobility for all patients in the ICU which aims at reducing hospital stay and avoiding or reducing cases of ICUAW. This will significantly reduce cases of muscle wasting, critical illness polyneuropathy, and critical illness myopathy. Also, it will provide a platform with reliable, valid and up-to-date evidence that will help the nursing profession worldwide. The research will serve as a convincing and evident proof that early mobilization which is consistent, for mechanically ventilated patients is safe and effective. The proposed intervention of consistent early mobility in Spring Valley Hospital is realistic. This is because there are interprofessional collaboration and the fact that the hospital is part of a system that constitutes six other hospitals (Spring Valley Hospital Medical Center, 2018). The cost of the intervention is high due to proper training prior, during and after the EBP has taken place. However, the organization should ensure that the requirements are provided as the study will provide more advantages to both the hospital and the patients. The collaboration of GET UP AND GO HOME 11 the six hospitals makes it easier for the st … Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10