NR 451 WEEK 3 DISCUSSION, FEASIBILITY OF YOUR DESIGN PROPOSAL AND IMPORTANCE OF COMMUNICATION

Week 3: Feasibility of Your Design Proposal and Importance of Communication . Now that you have identified your capstone change project, it is time to look at its feasibility. • What tangible and intangible resources will be needed to implement your project? • What improved outcomes do you anticipate will occur that could indicate the project produced a successful return on investment (ROI) of these resources? • How will you communicate your plan for change with key decision makers so that they will support the allocation of the resources you are seeking? The Standards of Professional Nursing Practice are outline competencies for the professional nurse. In the reading for this week, practice # 13 indicates that the registered nurse integrates evidence and research findings into practice (ANA, 2015). The nurse is to be competent in identifying problems or gaps in practice, conduct proper research, and to implement changes of practice with valid research findings, to achieve better outcomes. In addition, we must maintain quality of practice (standard # 14) and be able to properly utilize resources (standard # 16) in decision making that are safe, effective, and at lowest cost (ANA, 2015). To implement my project, medical supplies are the tangible resources. Having the appropriate dressings and topical antibiotics for surgical incisions available on the unit. Dressing supplies should be kept bedside to change the primary dressing 24hrs post op or if the dressing becomes soiled. Topical antibiotics available in the Pixis or locked patient bin. The intangible resources are the skills and knowledge of the nurses, the preference of the patient, and the contracts the hospital has with suppliers. The improved outcomes I predict will be decrease in surgical site infections. Decreased length of hospitalization and decreased readmission for infection. The first step in initiating my plan for change would be to communicate with my unit manager. I am a member of the Clinical Application of Practice of Excellence (CAPE). The function of this counsel is to foster the development of nursing practice to improve quality and efficiency of care rooted in evidence based practice and nursing innovations to result in exceptional outcomes. The next step would be presenting my clinical question and/or problem identification the CAPE counsel. The CAPE may also assist in the research aspect after a problem has been identified. The CAPE then makes recommendation for improvement and refers to the Advocate Practice Nursing Counsel for a final change decision. Roll out and support would be done with the assistance of the Nursing Education and Leadership Councils. My facility boasts shared governance by allowing nurses control and autonomy over practice rather than having the practice controlled by executives (French-Bravo & Crow, 2015). I have noticed that many of the nurses that have been on the unit do not believe in shared governance and demonstrate a passive role to change. It is important to be able to gather enough nurses in support of the change. In the lesson this week, I learned the meaning of relative advantage which is the degree to which an innovation is perceived as being better than what already exists (Sanson-Fisher, 2004). Does the new proposal or solution provide an advantage over the current situation or over alternative solutions (Chamberlain, 2017)? I am interested in knowing if you find that in your facility that change is sometime difficult because it has been something that works in the past for “seasoned” nurses? I have also heard statement “we have tried this before and it did not work or improve anything.” References American Nurses Association. (2015). Nursing: Scope and standards of practice (3rd ed.). Silver Spring, MD. Page 77. Chamberlain University (2018). NR 451 Capstone: Week 3: The Ace Star Model of Knowledge Transformation. Downers Grove, IL: Devry Education Group. French-Bravo, M., Crow, G. (2015). Shared Governance: The Role of Buy-in in Bringing About Change. The Online Journal of Issues in Nursing. Vol 20: NO 2. Retrieved from: Sanson-Fisher, R. W. (2004). Diffusion of innovation theory for clinical change. Medical Journal of Australia, 180, 55-56.