Healthcare and Nursing
The purpose of this project was to develop a new evidence-based practice protocol for a healthcare organization that I work for known as Spring Gardens. Spring Gardens focuses on drug and alcohol abuse rehabilitation. The mission of the organization involves providing comprehensive and innovative services to a wide range of people in the community who abuse drugs, alcohol, or those who have a mental illness. Spring Gardens endeavors to achieve its mission through the provision of high-quality and holistic treatment that focuses on major areas of life such as social, family, educational, psychological, and spiritual spheres. The core principles of Spring Garden’s programs entail integrity, commitment to self-help, and respect for the client. In terms of organizational culture, the healthcare practice of Spring Gardens is underpinned by evidence-based practice. Spring Gardens recognizes that drug and substance abuse occur due to a range of triggers. Therefore, the organization aims at assisting clients in learning how to redirect or control urges to use drugs through evidence-based practices.
Although the workforce at Spring Gardens is keen on embracing evidence-based practices, several barriers such as inadequate financial support to support new practices and reluctance from some members impact the readiness of the organization. However, with sufficient managerial support and motivation, Spring Gardens can embrace new EBP practiceas new opportunities arise that create a compelling need for change. For instance, currently, the highest proportion of clients at Spring Gardens involves adolescents who suffer from substance abuse disorders. In the past, Spring Gardens has strived at using various interventions, such as family therapy, to treat adolescents with substance abuse disorders; however, the number of adolescent clients has continued to rise. National statistics also corroborate on the rising burden of drug and substance abuse and the need for better treatment methods. For instance, a recent national survey indicated that 78 percent of adolescents use alcohol in the US, and 47 percent of them take alcohol regularly (Somani& Meghani,2016).The management of substance use disorder among adolescent clients is further complicated by broader challenges such as recidivism, criminality, influences from peers and combined drug abuse practices (Belenko et al., 2017).Therefore, effective methods need to be implemented to assist adolescents to break free from drug and substance abuse.
At Spring Gardens, problems such as perceived lack of effectiveness of current treatment interventions produce a compelling opportunity for implementing new EBP practice.For instance, family therapy is the current strategy used in Spring Gardens for the management of substance abuse disorder among adolescent clients. The intervention seems ineffective, a finding that is supported in literature by Humayun et al. (2017). Therefore, the clinical inquiry guiding this project was, among adolescents attending therapy sessions at Spring Gardens, what are the best practice recommendations for treating substance use disorder to promote sobriety? Thefindings of this projectsupport the incorporation of motivational interviewing (MI) interventions. MI entails a directive and patient-centered counselling approach that helps patients to explore their natural ambivalence about change by eliciting motivation to change from within the patient (Magill et al., 2017).
The proposition to incorporate MI interventions in practice is firmly established on appraising several high-level evidence research studies which enabled retrieval of best practice recommendations (Mick, 2017). For instance, literature by Magill et al. (2017) supports that MI has high efficacy in managing heavy drinking among adolescents. Another study by Searight (2018) argues that MI is a successful evidence-based primary care intervention which promotes significant advancements in patient outcomes. The application of MI interventions has been studied among adolescents, whereby brief counselling interventions through MI strategies are effective for addressing and resolving substance abuse compared to other interventions (Kulak & Griswold, 2019). Another recent report by the National Institute on Alcohol Abuse and Alcoholism (2015) further supports the application of MI interventions stating that the intervention has high efficacy in the adolescent population. Therefore, there is a large body of evidence that currently supports the use of motivational interviewing interventions in treating adolescents with substance abuse disorder.
I would disseminate thefindings of this projectthrough inhouse continuous professional development (CPD) sessions organized at Spring Gardens. During the CPD sessions, I will describe the meaning, scope, feasibility, training and timeline of implementing MI intervention in the context of Spring Gardens. I will prepare excellent PowerPoint presentations to accompany my lectures in order to provide visual representation of the findingsthereby boosting the uptake of information (Schmaltz& Enström,2014). For instance, I will incorporate pie-charts and a Gantt chart in the slides to summarize the statistical findings and the timelines of future practice change. Additionally, I will distribute pamphlets to aid in sharing information, thereby assisting the therapists at Spring Gardens to grasp the information effectively. I chose to use CPD sessions for a few reasons. According to a study by Manley et al. (2018), CPD offers frontline healthcare staff an excellent chance to update their knowledge and skills by learning novel clinical approaches and exchanging ideas in a professional environment.
Secondly, CPD’s efficacy stems from its ability to boost the personal drive and enthusiasm of professionals towards making personal and professional development thereby enhancingoverall positive change (Lee et al., 2011). Additionally, CPD suitably conceptualizes a learning need such that positive peer attitudes towards change become enhanced among clinicians. The applicability of CPD sessions to disseminate new practice changes in healthcare has been proven in several settings. In literature by Ong et al. (2020), a CPD approach was used to disseminate a Motivation for Change (MFC) programme among staff members in a hospital that caters for children with developmental disabilities. After evaluation of the programme, the staff reported significant improvements in their routine of care and confidence in working with the children. Therefore, a CPD approach is an efficient method of disseminating the findings of this study.
In terms of implementation of the new EBP practice, I will ensure effective leadership, activity planning, resource allocation and significant involvement of therapists (Hussain et al., 2018). For instance,I will lead the change by interacting with therapists at Spring Gardens to overcome resistance, to promote onboarding of all staff and to boost the operation of the new practice. I will also focus on designating resources for training therapists on the new practice, seeking financial support from the management of Spring Gardens, leading training sessions and collaborating fully with all the therapists at Spring Gardens. After rolling out the new EBP practice, I will ensure sustained organizational adoption through providing sustained support to all therapists, evaluation and monitoring the continued implementation of the new change, motivating therapists and overcoming future challenges in the implementation of the change. The measurable outcomes of this project involve successful adoption and implementation of MI interventions after three months of institution of the programand improvement in service delivery in alignment with Spring Garden’s mission statement.
In conclusion, the incorporation of new EBP practice at Spring Garden necessitates a significant call to action which can be achieved through excellent dissemination of this project’s findings among clinicians. Therefore, I will inspire all therapists at Spring Garden to implement the new practice change to effectively assist clients to recover from substance abuse disorder.
Belenko, S., Knight, D., Wasserman, G., Dennis, M., Wiley, T., & Taxman, F. et al. (2017). The Juvenile Justice Behavioral Health Services Cascade: A new framework for measuring unmet substance use treatment services needs among adolescent offenders. Journal of Substance Abuse Treatment, 74, 80-91. https://doi.org/10.1016/j.jsat.2016.12.012
Hussain, S., Lei, S., Akram, T., Haider, M., Hussain, S., & Ali, M. (2018). Kurt Lewin’s change model: A critical review of the role of leadership and employee involvement in organizational change. Journal Of Innovation & Knowledge, 3(3), 123-127. doi: 10.1016/j.jik.2016.07.002
Kulak, J. A., & Griswold, K. S. (2019). Adolescent substance use and misuse: Recognition and management. American family physician, 99(11), 689-696.
Lee, N. (2011). An evaluation of CPD learning and impact upon positive practice change. Nurse Education Today, 31(4), 390-395. https://doi.org/10.1016/j.nedt.2010.07.012
Magill, M., Colby, S. M., Orchowski, L., Murphy, J. G., Hoadley, A., Brazil, L. A., & Barnett, N. P. (2017). How does brief motivational intervention change heavy drinking and harm among underage Young adult drinkers? Journal of Consulting and Clinical Psychology, 85(5), 447–458. https://doi.org/10.1037/ccp0000200
Manley, K., Martin, A., Jackson, C., & Wright, T. (2018). A realist synthesis of effective continuing professional development (CPD): A case study of healthcare practitioners’ CPD. Nurse Education Today, 69, 134-141. https://doi.org/10.1016/j.nedt.2018.07.010
Mick, J. (2017). Call to action: How to implement evidence-based nursing practice. Nursing2019, 47(4), 36-43. https://doi.org/10.1097/01.nurse.0000513603.03034.5c
National Institute on Alcohol Abuse and Alcoholism (2015). Alcohol screening and brief intervention for youth: a practitioner’s guide. Retrieved from: https://pubs.niaaa.nih.gov/publications/Practitioner/YouthGuide/YouthGuide.pdf
Ong, N., Goff, R., Eapen, V., Tomsic, G., Moore, L., & Garg, P. et al. (2020). Motivation for change in the health care of children with developmental disabilities: Pilot continuing professional development‐quality improvement project. Journal of Paediatrics and Child Health. https://doi.org/10.1111/jpc.15175
Schmaltz, R. M., & Enström, R. (2014). Death to weak PowerPoint: strategies to create effective visual presentations. Frontiers in psychology, 5, 1138.https://doi.org/10.3389/fpsyg.2014.01138
Searight, H. R. (2018). Counseling patients in primary care: evidence-based strategies. American Family Physician, 98(12), 719-728.
Somani, S., &Meghani, S. (2016). Substance abuse among youth: A harsh reality. Emerg Med (Los Angel), 6(330), 2. https://doi.org/10.4172/2165-7548.1000330