NUR 590 Benchmark – Evidence-Based Practice Proposal Project Framework

NUR 590 Benchmark – Evidence-Based Practice Proposal Project Framework or Model for Change

The Trans-theoretical Model of behavioral change which was established in 1970s by Prochaska and DiClemente will be used in this project. This model details how people make decisions for behavior change. The presumption in this model is that behavioral change is a slow and continuous process through improvement in behaviors (Haghi et al, 2018). Essentially, the clinical issue in this project relates to heart failure among African American adults and how community health workers (CHWs) can control and manage the condition. In turn, this model is relevant to the topic because it acknowledges that change occurs in an orderly manner and not radically. For change to be effective, the staffs, especially CHWs must first be made aware of the need for change, applicable behaviors they need to acquire, and how to maintain the needed change. As such, this model is effective because it exhausts all possible stages of change, which ultimately ensures behavioral change.

Stages of Change in the Model

According Abdi, Eftekhar, Mahmoodi, Shojaeizade & Sadeghi (2015), this model has several steps including precontemplation, contemplation, preparation, action, maintenance, and termination, which are detailed below

Precontemplation

This is the first stage. It assumes that affected people are yet to establish intentions to embrace change in the near future. They do not consider their behaviors as problematic and so, they underrate the need for behavioral change.

Contemplation

At this second stage, people begin to portray the intention for behavior change in the near future. They are already aware that their behavior is problematic and marred by adverse outcomes on others. However, they are still reluctant in changing their behavior.

Preparation

This is the third stage in the model where people are ready to embrace behavioral change and begin to seek steps to realize the desired change.

Action

This is the fourth stage which is characterized by sustenance of behavior change by the people who recently embraced the change. They adjust their behavior to ensure they embrace change and enhance their new behaviors.

Maintenance

This is the fifth stage which is characterized by effort by those who have adopted change to continue with new behaviors. They strive to implement relevant intervention to prevent relapse.

Termination

This the last stage in the model. It is characterized by unwillingness of people to embrace their old behaviors. The relapse is entirely ruled out at this stage and the people are willing to seek more ways to achieve the benefits of the new behavior change.

 

Application of these Stages on Project Implementation

Precontemplation Stage

Here, CHWs have no intention to take action to control and manage heart failure among African American adults. They do not acknowledge that heart failure may cause adverse outcomes on the survival of African Americans.

Contemplation Stage

Here, CHWs starts to acknowledge the essence of examining survival rate African American adults with heart disease and taking initiative to manage and control the condition. They contemplate engaging in research on this area in the near future (Hayden, 2019). However, they are still hesitating for change.

Preparation Stage

The CHWs are ready to engage in research to find out how to control and manage heart failure. They initiate actions including critical evaluation of studies on the heart failure among African American adults.

Action Stage

At this stage, CHWs keep exploring the issue through further research.

Maintenance Stage

CHWs are willing to focus on future researches on the issue to enhance its applicability in the clinical practice. CHWs execute their research findings in the clinical practice and delve on their effectiveness routinely (Hayden, 2019).

Termination Stage

This stage is implementation of research findings in clinical practice by the CHWs and also maintaining the culture of EBP in caring from African American adults with heart failure.

References

Abdi, J., Eftekhar, H., Mahmoodi, M., Shojaeizade, D., & Sadeghi, R. (2015). Lifestyle of the employees working in Hamadan public sectors: application of the trans-theoretical model. Iranian Red Crescent Medical Journal, 17(2).

Haghi, M., Mazloomy Mahmoodabad, S. S., Mozaffari-Khosravi, H., Eslami Shahrbabaki, H., & Fallahzadeh, H. (2018). Analysis of Weight Control among Overweight and Obese Iranian Adolescents: Application of the Trans-theoretical Model. International journal of pediatrics, 6(2), 7013-7022.

Hayden, J. (2019). Introduction to health behavior theory. Burlington, MA: Jones & Bartlett Learning.

Assessment Description

Applying a model or framework for change ensures that a process is in place to guide the efforts for change. In 500-750 words, discuss the model or framework you will use to implement your evidence-based practice proposal project. You will use the model or framework you select in the Topic 8 assignment, during which you will synthesize the various aspects of your project into a final paper detailing your evidence-based practice project proposal.

Include the following:

1. Identify the selected model or framework for change and discuss its relevance to your project.
2. Discuss each of the stages in the change model/framework.
3. Describe how you would apply each stage of the model or theoretical framework in your proposed implementation.
4. Create a concept map for the conceptual model or framework you selected to illustrate how it will be applied to your project. Attach this as an appendix at the end of your paper.

Refer to the “Evidence-Based Practice Project Proposal – Assignment Overview” document for an overview of the evidence-based practice project proposal assignments.

You are required to cite minimum of four peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Complete the “APA Writing Checklist” to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as an appendix at the end of your paper.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

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 LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

NUR 590 Topic 4 DQ 2

Identify which statistical test you would use in conjunction with your selected research design from DQ 1 to evaluate the outcomes for your evidence-based project proposal and explain why you selected this test. What kind of information will this test provide about your outcomes?

According to Parab & Bhalerao, “statistical tests are mathematical tools for analyzing quantitative data generated in a research study” (2010). There are a number or test that researchers can use which can also become overwhelming and cause confusion for the research, and that can lead to sabotaging and tainting their study. Selecting the statistical test helps the researcher understand what to look for in the study as well as help organize their data. Parab & Bhalerao (2010) stated that “Before selecting a statistical test, a researcher has to simply answer the following six questions, which will lead to correct choice of test:”.

1. How many independent variables covary (vary in the same time period) with the dependent variable?
2. At what level of measurement is the independent variable?
3. What is the level of measurement of the dependent variable?
4. Are the observations independent or dependent?
5. Do the comparisons involve populations to populations, a sample to a population, or are two or more

samples compared?

6. Is the hypothesis being tested comparative or relationship?

 

Statistical testing is used explain the results of a study. The test that I would use would be the t-test. “A t-test is a type of inferential statistic used to determine if there is a significant difference between the means of two groups, which may be related in certain features” (Investopedia, n.d.). I would used this test because of show the averages of nurses to patient ratios to help determine the correlation between low staffing and high staffing and whether each has a positive or negative effect on patient health outcomes.

 

 

 

Reference:

 

Investopedia. (n.d.). T-Test. Retrieved from https://www.investopedia.com/terms/t/t-test.asp

 

Parab, S. & Bhalerao, S. (2010). Choosing Statistical Test. International Journal of Ayurveda Research. 1(3): 187-191. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2996580/

Statistical tests can be chosen based on independent factors and other project designs. My project seeks to identify if PPE education increases informal (family) caregiver compliance to PPE usage. I’ve identified at least one confounding variable, which is the effects of PPE usage modeling by staff. Siebert et al. (2018) found staff modeling and teaching was a big part of compliance of visitors. However, there is a test which accounts for differences in participants.

I am choosing a mixed design ANOVA test due to the used of different participants in each group. A mixed design measures “change over time, differences between the groups, interaction of time and group effects”  (Tappen, 2016). This will show the differences between groups (education versus no education) and within the groups themselves.  It can be used to measure the change between before and after the intervention of education. It will help control for the different participants in each intervention group. It could measure the change from several different time points, as desired.

 

Seibert, G., Ewers, T., Barker, A. K., Slavick, A., Wright, M. O., Stevens, L., & Safdar, N. (2018). What do visitors know and how do they feel about contact precautions? American Journal of Infection. 

 

Tappen, R. (2016). Advanced Nursing Research. Jones & Bartlett.

1. 1: Unsatisfactory

0 points

The ability to apply theoretical frameworks from nursing and other disciplines to make decisions regarding practice and health-related problems at the individual and population level is not demonstrated.

Required Sources

5 points

Criteria Description

Required Sources

5. 5: Excellent

5 points

Number of required sources is met, but sources are outdated or inappropriate.

4. 4: Good

4.6 points

Number of required resources is met. Sources are current, and appropriate for the assignment criteria and nursing content.

3. 3: Satisfactory

4.4 points

Number of required sources is met. Sources are current, but not all sources are appropriate for the assignment criteria and nursing content.

2. 2: Less Than Satisfactory

4 points

Sources are not included.

1. 1: Unsatisfactory

0 points

Number of required sources is only partially met.

Thesis Development and Purpose

7 points

Criteria Description

Thesis Development and Purpose

5. 5: Excellent

7 points

Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.

4. 4: Good

6.44 points

Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.

3. 3: Satisfactory

6.16 points

Thesis is apparent and appropriate to purpose.

2. 2: Less Than Satisfactory

5.6 points

Thesis is insufficiently developed or vague. Purpose is not clear.

1. 1: Unsatisfactory

0 points

Paper lacks any discernible overall purpose or organizing claim.

Argument Logic and Construction

8 points

Criteria Description

Argument Logic and Construction

5. 5: Excellent

8 points

Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

4. 4: Good

7.36 points

Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.

3. 3: Satisfactory

7.04 points

Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.

2. 2: Less Than Satisfactory

6.4 points

Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.

1. 1: Unsatisfactory

0 points

Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.

Mechanics of Writing (includes spelling, punctuation, grammar, language use)

5 points

Criteria Description

Mechanics of Writing (includes spelling, punctuation, grammar, language use)

5. 5: Excellent

5 points

Writer is clearly in command of standard, written, academic English.

4. 4: Good

4.6 points

Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.

3. 3: Satisfactory

4.4 points

Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.

2. 2: Less Than Satisfactory

4 points

Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.

1. 1: Unsatisfactory

0 points

Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.

Paper Format (Use of appropriate style for the major and assignment)

5 points

Criteria Description

Paper Format (Use of appropriate style for the major and assignment)

5. 5: Excellent

5 points

All format elements are correct.

4. 4: Good

4.6 points

Template is fully used; There are virtually no errors in formatting style.

3. 3: Satisfactory

4.4 points

Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.

2. 2: Less Than Satisfactory

4 points

Template is used, and formatting is correct, although some minor errors may be present.

1. 1: Unsatisfactory

0 points

Template is not used appropriately or documentation format is rarely followed correctly.

Documentation of Sources

5 points

Criteria Description

Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)

5. 5: Excellent

5 points

Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

4. 4: Good

4.6 points

Sources are documented, as appropriate to assignment and style, and format is mostly correct.

3. 3: Satisfactory

4.4 points

Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.

2. 2: Less Than Satisfactory

4 points

Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.

1. 1: Unsatisfactory

0 points

Sources are not documented.