Application of Rosswurm and Larrabee Model to Clinical Situation
Health practitioners usually face challenges of how to implement evidence-based practices (EBP) to guarantee patient safety and optimize outcomes. The need to merge internal practices with standardized procedures has driven health care professionals to implement a model that would identify a problem and use evidence to make changes. Rosswurm and Larrabee came up with a model that could align EBP with theory-driven clinical practices. The model asserts that the conversion of research into practice needs a strong foundation in change theory, standards of research utilization, as well as use of homogeneous nomenclature. This study will focus the application of Rosswurm and Larrabee model in the clinical environment.
Six Steps in the Application of Rosswurm and Larrabee Model
The core belief in nursing care is that caring for patients should be built on the best experimental evidence available while incorporating the patient beliefs and preferences. According to Cody (2012), strong theoretical foundations should drive the nursing discipline. To achieve this, Rosswurm and Larrabee recommended a model that could guide clinical activities in a systematic process to enhance EBP. The EBP model has been helpful in guiding health care providers to utilize change theory, in addition to combining quantitative and qualitative data together to undertake clinical practices (Facchiano, Snyder & Nunez, 2011). The EBP model is applicable in six steps, which are explained below.
Step 1: Assess the Need for Change in Practice
This stage involves collecting internal data concerning the current practice and comparing such data with external data to identify a problem. For instance, clinicians should assess how they handle cancer patients in their facility and compare their practice with what other health care facilities are handling the disease. Such comparison will assist in identifying the problem. Clinicians should assess whether self-management strategies require some changes to enhance treatment plans. Clinicians should detect the need to come up with a unifying model to accommodate the complexity, as well as diversity of patient populations in the current nursing care practice (Cody, 2012). A careful assessment will be capable of detecting the need to advance staff’s knowledge in handling cancer patients.
Step 2: Link Problem with Interventions and Outcomes
This is the stage where standardized nursing classification system is utilized to classify the problem while the desired outcomes are realized by detecting early signs so that clinicians can suggest prevention measures. Clinicians should define the problem in a standardized language for easy understanding. The most important concept in this stage is to link patient-centered caring behavior to communication and patient safety through identifying outcomes indicators. Classification systems are necessary to demonstrate scientific concept and organization of knowledge.
Step 3: Synthesize the Best Evidence
In this stage, the practicability of implementing the model is assessed. The facilitators include high standards of care among clinicians, observing creativity and innovation, and merging the theory of human caring with the mission and vision of the health care organization. Clinicians can evaluate the strengths, as well as weaknesses of the proposed strategy and categorize gaps and disagreements in the available knowledge. Clinicians should review the knowledge concerning change, and weigh the evidence provided to enhance acceptability of the practice and to reduce the possibility of creating risks in the practice.
Step 4: Design Practice Change
This step involves planning for a pilot testing for the proposed change for a specified clinical setting. Pilot study forms should be drafted to enable clinicians to evaluate practice change. A review in literature supports self-management strategy in handling cancer patients; hence, it should be incorporated in the new curriculum. Resources are required to implement change in caring, which include training clinicians on new knowledge, as well as developing a new curriculum in clinical operations. Encouraging patients to embrace self-management can help in improving their conditions and outcomes.
Step 5: Implement and Evaluate the Practice Change
After identifying practice change, clinicians should be trained on how to carry Although EBP does not recommend changing practice, it builds and fortifies systems of understanding patients, identifying their problems early, as well as communicating changes in patient status on time. Clinicians can decide to adopt the proposed changes, or reject them, after analyzing the data. The outcomes and benchmarks of change can be reviewed by comparing old practice and new practice (Haas, 2010). The staff’s level of knowledge can also be evaluated to determine whether more effort is required in handling patients.
Step 6: Integrate and Maintain the Practice Change
After a pilot study, clinicians should gather to review some revisions. At this stage, clinicians should communicate the proposed changes to all stakeholders in the health care. Educating the staff on recommended change will enable them to improve the health care outcome, as they will integrate change into a standard of practice. The management should monitor the process to ensure that the change is maintained in health care. Maintaining practice change involves having effective, timely, quality, and patient-centered care on patients. The head of clinical operations can monitor the outcomes in all units to confirm the standards.
The Rosswurm and Larrabee Model has assisted the clinical facilities in leadership management, as well as guiding nursing professionals to make changes that enhanced positive outcomes. Clinicians and nurse administrators should endeavor to select a specific EBP model, which is capable of guaranteeing quality improvement. Clinicians have the opportunity to utilize evidence-based care on patients through empowering their patients while patients are capable of leading a productive life through EBP. The six steps in the practice change are necessary in clinical operations, as they assist in creating standards in health care provision.
Cody, W. K. (2012). Philosophical and theoretical perspectives for advanced nursing practice. Burlington, MA: Jones & Bartlett Learning.
Facchiano, L., Snyder, C. H., & Núñez, D. E. (2011). A literature review on breathing retraining as a self-management strategy operationalized through Rosswurm and Larrabee’s evidence-based practice model. Journal Of The American Academy Of Nurse Practitioners, 23(8), 421-426. doi:10.1111/j.1745-7599.2011.00623.x
Haas, M. (2010). Contemporary issues in lung cancer: A nursing perspective. Boston: Jones and Bartlett Publishers.
Schaffer, M. A., Sandau, K. E., & Diedrick, L. (2013). Evidence-based practice models for organizational change: overview and practical applications. Journal of Advanced Nursing, 69(5), 1197-1209. doi: 10.1111/j.1365-2648.2012.06122.x
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