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Evidence Based Practice

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Evidence Based Practice
Change Management

Contents
Introduction…………………………………………………………….3
Evidence Based Practice……………………………………………….4
Clinical Governance…………………………………………………...5-6
Findings from the literature……………………………………………6-7
Implementing the change………………………………………………7-9
Leadership…………………………………………………………….9-10
The Un-freezing Stage………………………………………………10-11
The Moving Stage…………………………………………………...11-13
The Re-freezing Stage……………………………………………….13-15
Resistance and barriers to change…………………………………...15-16
Conclusion…………………………………………………………..16-17
References…………………………………………………………..18-24
Appendices………………………………………………………….25-26

Introduction

This is essay is being written to identify and promote change in clinical practice in relation to nursing and evidence based practice. This will be done in relation to nursing and will include supporting references. The literature review investigated nurses’ knowledge of pain management, finding that nurses’ had different ideas of what pain management is. Therefore the aim of the essay is to change practice by increasing nurses’ awareness of what exactly pain management is and from this how it can improve postoperative pain management in the clinical area.

This essay commences with a description of both clinical governance and evidence based practice (EBP) and the association between them, describing how this will assist achievement of clinical effectiveness. From this there will be a synopsis of the findings from a recent literature review of “Nurse Assessment and Management of Postoperative Pain” including a recommendation that was found from the evidence of this review and how this will have an impact for a change in practice. An analysis of different theories of change will be made, looking at several models and theorists. The chosen model for change will be used to bring the findings from the review into practice and what resources will be needed for the implementation of change and any barriers that may occur during the change process.



References: Allen, D. (2000) ‘The NHS is in need of strong leadership.’ Nursing Standard. Volume: 14, (Issue: 25) p. 25 Aneurin Bevan Health Board (2010) Education and Development Available at : http://www.wales.nhs.uk/sitesplus/866/page/40 (accessed October 16th 2011) Baulcomb, J Bell L, Duffy A, (2009) Pain assessment and management in surgical nursing: a literature review. British Journal of Nursing 18 (3) 153-156 Carlson C (2009) Use of three evidence based post-operative pain assessment practices by registered nurses Cordts G, Grant M, Brandt L, Mears S (2011) A qualitative and quantitative needs assessment of pain management for hospitalised orthopaedic patients. Orthopaedics. 34 (8) 368-373. Craig, J. Symth, R. (2008). The Evidence Based Practice Manual for Nurses. Churchill Livingstone. Second Edition Chapman L, Howkins E (2001) Developing a Learning Culture Cherry, B. Jacob, S. (2005) Contemporary Nursing: Issues, Trends and Management. 3rd Edition. Elsevier Health Science: Edinburgh. Department of Health (1989) working for patients. London: The Stationery Office. Department of Health, (1998) A First Class Service: Quality in the New NHS Dawson (2001) Clinical effectiveness in nursing practice. London: John Wiley and Sons. Dowsett C,(2001) Clinical Governance and pressure ulcer management. Nursing Standard. 15 (22) pg. 48-52 Gerris K, Lacey A (2010).The Research Process in Nursing Gopee N and Galloway J (2009) Leadership and Management in Healthcare. London: SAGE. Grol R and Grimshaw J (2003) From Evidence to Best Practice: Effective Implementation of Change in Patients’ Care. The Lancet. 362 pg. 1225-1230. Kotlyar, I., & Karakowsky, L. (2007). Falling Over Ourselves to Follow the Leader. Journal of Leadership & Organizational Studies, Vol. 14, No. 1, 38-49 Kumar N (2007) Normative Guidelines on Pain management Lewin, K. (1951) Field Theory and Social Sciences. Harper and Row: New York Lippitt, R Long A, and Harrison S (1996) “The balance of evidence.” Health Service Journal McAuliffe E, Vaerenbergh C V (2006) Guiding change in the Irish Health System McSherry R, Simmons M, Abbott P. (2002) Evidence –Informed Nursing: A Guide for Clinical Nursing. London: Routledge Morton and Morton (2003) evidence based nursing practice Available at: http://www.ebnp.co.uk/ (accessed October 16th 2011) Mullins L J (2010) Management and Organisational Behaviour Muir Gray JA (1997) Evidence-based health care: how to make health policy and management decisions. London: Churchill Livingstone. Muir-Gray J, A(2001) Evidence Base Health Care. 2nd edition. London: Churchill Livingstone. National Institute for Health and Clinical Excellence NICE, (2007) How to Change Practice. London: National Institute for Health and Clinical Excellence NICE. Nursing and Midwifery Council, (2008) The NMC code of professional conduct: standards for conduct, performance and ethics. London: Nursing and Midwifery Council. Parkin P (2009) Managing change in Health Care: Using Action Research. London: SAGE Pearce, C Pollit D E, Beck C T, Hungler B P, (2001) Essentials of Nursing Research Methods, Appraisal and Utilization. 5th Edition. United States of America: Lippincott. Royal college of Nursing (1996) Clinical effectiveness. A Royal College of Nursing Guide. London: RCN Robbins, S Sale, D. (2005) Understanding Clinical Governance and Quality Assurance – Making It Happen. Palgrave Macmillan: Houndsmill Sacket DL, Rosenberg WMC, Gray JAM and Richardson WS (1996) Sullivan, E. Decker, P. (1992). Effective Management in Nursing. 2nd Edition. Addison-Wesley, San Francisco CA. Upton, D Thornhill A, Lewis P, Millmore M, Saunders M (2000) Managing Change. England Financial Times: Prentice Hall Wright J, and Hill P, (2003) Clinical Governance

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