Discuss an EBP initiative that was implemented in a health care setting (use fictitious names for people and places) and whether it was successful or not sustainable, with rationale. Choose one of four models of organizational change (Melnyk [2019],  Chap. 15, pp. 432-437) that you would use in an advanced nursing role to enhance sustainability of EBP initiatives. Initial Post:

An evidence-based practice (EBP) initiative is a crucial component of healthcare organizations, aiming to improve patient outcomes through the integration of the best available evidence, clinical expertise, and patient preferences. However, the success and sustainability of such initiatives depend on several factors, including the chosen model of organizational change. In this discussion, I will describe a fictitious EBP initiative implemented in a healthcare setting and evaluate its success and sustainability. Additionally, I will select one of the four models of organizational change proposed by Melnyk (2019) to enhance the sustainability of EBP initiatives in an advanced nursing role.

The EBP initiative, named Project CARE (Creating Awareness and Reducing Errors), was implemented in a large urban hospital named Greenfield Medical Center. The primary goal of Project CARE was to decrease medication errors and improve patient safety. To achieve this goal, the initiative introduced barcode scanning technology and medication reconciliation processes within the hospital’s electronic health record system.

The implementation of Project CARE involved several key stakeholders, including nurses, physicians, pharmacists, and information technology specialists. A multidisciplinary team was formed to oversee the initiative, including a project manager and representatives from each stakeholder group. The team conducted a thorough needs assessment, identified gaps in the existing medication administration process, and developed a detailed implementation plan.

During the implementation phase, the team conducted training sessions for healthcare providers to ensure their competency in using the barcode scanning technology and medication reconciliation processes. Additionally, the team provided ongoing support and addressed any concerns or challenges faced by the healthcare providers during the transition period.

The success of Project CARE was measured through various metrics, including the reduction in medication errors, increase in medication reconciliation rates, and healthcare providers’ satisfaction with the new processes. Data collection and analysis were conducted before and after the implementation to assess the initiative’s impact on patient safety and workflow efficiency.

Based on the evaluation, Project CARE was largely successful in achieving its intended outcomes. Medication errors decreased by 40%, and medication reconciliation rates increased by 25% within the first six months of implementation. Healthcare providers reported a higher level of satisfaction with the barcode scanning technology and medication reconciliation processes, highlighting their ease of use and positive impact on patient safety.

However, despite its initial success, sustaining Project CARE proved challenging. One of the main reasons for this challenge was the failure to address the organizational culture and resistance to change. Although the multidisciplinary team engaged stakeholders during the implementation phase, the organizational culture within Greenfield Medical Center did not fully embrace the EBP initiative. Some healthcare providers were resistant to change, expressing concerns about the perceived increase in workload and disruption to their established workflows.

To enhance the sustainability of EBP initiatives, I would utilize the Transformational Leadership model proposed by Melnyk (2019). This model focuses on creating a culture of innovation, trust, and collaboration within the organization. Through transformational leadership, nurse leaders can inspire and motivate healthcare providers to embrace EBP and participate actively in its implementation and evaluation.

Transformational leadership encourages open communication channels, fosters a shared vision, and provides support and resources to healthcare providers. By addressing the cultural and organizational barriers to change, nurse leaders can help sustain EBP initiatives in the long term. Additionally, the Transformational Leadership model emphasizes the importance of continuous learning and professional development, which are essential for maintaining the momentum of EBP initiatives.

In conclusion, the Project CARE EBP initiative implemented in Greenfield Medical Center was successful in reducing medication errors and improving patient safety. However, its sustainability was compromised due to challenges related to organizational culture and resistance to change. To enhance the sustainability of EBP initiatives in an advanced nursing role, I would employ the Transformational Leadership model, focusing on creating a culture of innovation, trust, and collaboration. This model can provide nurse leaders with strategies and tools to overcome organizational barriers and foster a supportive and conducive environment for implementing and sustaining EBP initiatives.

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