Enhancing the Sustainability of EBP Initiatives
Patients admitted in intensive care units (ICU) often face challenges obtaining adequate sleep. Sleep deprivation among critically ill individuals can affect patients’ recovery and increase risks of complications. The evidence based initiative implemented at JS hospital to resolve this problem was based on developing a scheduled quiet time for patients to ensure that patients rested well.
Adequate rest is essential in promoting patient recovery. Studies have shown a correlation between the external environment and the internal circadian clocks and their link to sleeping patterns among patients (Korompeli, et al., 2017). Research has also shown a high risk of sleep delirium among patients placed on mechanical ventilation who had not been given sedatives (Boesen, Andersen, Bendtsen, & Jennum, 2016). The implementation of the quiet time initiative was successful as it was supported by evidence from research articles that proved its efficiency in other clinical settings. The facility has managed to sustain the quiet time initiative by coordinative care provision activities among healthcare practitioners, limiting visitation time, and developing work plans daily.
I would use the transtheoretical model of health behavioral change (TMHBC) in an advanced nursing role to promote the sustainability of an EBP initiative. The model entails five stages, which includes precontemplation, contemplation, preparation, action, and maintenance, that individuals or organizations go through in promoting behavioral change (Hashemzadeh, Rahimi, Zare-Farashbandi, Alavi-Naeini, & Daei, 2019; Melnyk & Fineout-Overholt, 2019). The model would be useful as it focuses on ensuring that people understand the need for change, prepares them for change, implements the action, and uses approaches of maintaining the acquired behavior.
The sustainability of EBP initiatives relies of models of change used. The TMHBC would be an effective model for promoting behavior change in advanced nursing roles. Using the model could also promote among the individuals.
References
Boesen, C. H., Andersen, J. H., Bendtsen, A. O., & Jennum, P. J. (2016). Sleep and Delirium in Unsedated Patients in the Intensive Care Unit. Acta Anasthesiologica Scandinavica, 60(1), 59-68.
Hashemzadeh, M., Rahimi, A., Zare-Farashbandi, F., Alavi-Naeini, A. M., & Daei, A. (2019). Transtheoretical Model of Health Behavioral Change: A Systematic Review. Iranian Journal of Nursing and Midwifery Research, 24(2), 83-90. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6390443/.
Korompeli, A., Muurlink, O., Kavrochorianou, N., Katsoulas, T., Fildissis, G., & Baltopoulos, G. (2017). Circadian Disruption of ICU Patients: A Review of Pathways, Expression, and Interventions. Journal of Critical Care, 38, 269-277.
Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-Based Practice in Nursing and Healthcare. Wolters Kluwer.