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Case Report: Application of Theory to Organizational Mission, Vision, and the Christian Worldviews

Submitted by

Insert Your Full Legal Name (No Titles, Degrees, or Academic Credentials) Comment by Author: For example: Jane Elizabeth Smith

Equal Spacing Comment by Author: Delete yellow highlighted “Helps” as project develops.

~2.0” ~

Grand Canyon University

Phoenix, Arizona

2

[Insert Current Date

Provide a brief overview of what this paper will outline. Tell the reader about the project’s purpose using the templated purpose statement, and what they will be reading about. Have a transition statement that introduces the next section of the paper. Please keep the heading the same as outlined in this template.

Purpose of the Project

The firsts sentence or two outlines the problem; why is this being addressed and includes the gap at the site? (Example: Smoking is an independent risk factor for patients with type two diabetes (DMT2), making it essential for providers to address smoking cessation consistently. At the project site, there is no tobacco cessation protocol in use). The next sentence outlines the purpose of the project. Use this full template for best success: The purpose of this quantitative quasi-experimental project was to determine if or to what degree the implementation of _________________ (intervention) would impact ______________(what) when compared to _______________________ among ___________(population) in a ________ (setting ie: primary care clinic, ER, OR) in ________ (state) over four-weeks . The purpose of this quantitative, quasi-experimental quality improvement (QI) project was to evaluate if or to what degree the implementation of a tobacco cessation protocol using the Five A's model would impact the patient's motivation, nicotine dependence, and healthcare provider compliance with assessing tobacco use in adult diabetic smokers in a podiatry clinic for four weeks in the northeastern United States).

Christian Worldviews

Reflect on Grand Canyon University’s (GCU) Doctrinal Statements. Please synthesize the nine statements and introduce the document as Appendix A in the paper using APA formatting.

Organization’s Mission and Vision to Theory and Model

Introduce this section of the paper to the reader

Mission and Vision

In this section you will need to cite the organizations mission and vision using proper APA citations. Supply a clear screen shot of the organization’s mission as Appendix B and the vision as Appendix C.

Connection of Mission and Vision to Nursing Theory. In this section you will need to discuss how the organization’s mission and vision align to your chosen nursing theory. Please provide at least two examples.

Connection of Mission and Vision to Evidence-based Change Model. In this section you will need to discuss how the organization’s mission and vision align to your chosen evidence-based change model. If the model has many steps summarize them and how the mission and vision are aligned with them. Please provide examples.

Pulling it Together

In this section connect the purpose of your projects to the Christian Worldviews (CWV), the Organization’s mission and vision, and the chosen nursing theory and evidence-based change model.

How are they aligned? Support with examples.

Do they support one another? Support with examples.

How are you incorporating what you have learned about GCU’s CWV’s to the DPI project being developed? Are you aligned to them? Support with examples

Conclusion

Please provide a conclusion. This should be a summary of the main points of the paper. There should be no less than 5-6 statements

References

Appendix A

Title

Appendix B

Title

Appendix C

Title

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Professor’s Feedback

DQ 2

Health behavior change theories suggest behavior change as a "process," not an "event." Propose a health behavior change theory that corresponds to your DNP Project.

SOLUTION

In principle, theories are helpful and required in explaining and predicting health behavior, in addition to the designing and evaluating interventions. Its component which, for example, predicts change should be better elaborated in order for us to easily understand what is actually driving behavior change. Furthermore, theories must be empirically testable in two ways. First, they must specify a set of changeable predictors that describes, explains, and predicts behavior change, also, they must enable us to design effective interventions that produces exactly those changes in behavior that are predicted by the relevant theory (Prestwich, Kenworthy, & Conner, 2018).

Health behavior is regarded as being a type of concept which is involved in the definition of the human character in the general along with the personal spectrums. A variety of theories usually try to illustrate the health behavior change in distinct ways. The basic is regarded as being the social cognitive theory which is involved in scanning of the environment which directly impacts human behavior (Durham et al., 2021). Therefore, it is vital to understand that behavior change is a kind of process whereby these kind of influences gradually become a part of an individual’s life and eventually wholly transforming their beliefs.

In the identified spectrum of the identified behavior change, it is essential to first comprehend the intrinsic as well as the extrinsic motivation that is behind the whole idea. The key aim regarding my DNP is to enhance the reporting of the aggression level in the workplace. The workplace aggression as well as violence is a personal thought. After identification of the motivation as well as the will to alter a behavior, the initial step will be making plans on where an individual will illustrate their preferred regular behavior. In the whole practice, the individual ought to anticipate negative energy from the peers but they need to maintain positivity at all times.

A DNP kind of project is one which needs high level research as well as extremism in the topic which needs some kind of practice as well as behavior. Often, there is a variety of distractions during the identified research, yet the identified project needs close to maximum attention. In that form of regard, a behavior form of change is vital to attain focus as well as getting rid of most of the distractions. For example, an individual can he involved in practice which assist them in the gathering of data for their project (Dorsett, 2021).

References

Dorsett, J. K. (2021). DNP Project Proposal: Nurse Practitioners’ Knowledge and Behaviors in Recommending Colorectal Cancer Screening.

Durham, C. O., Lauerer, J., & Smith, W. (2022). An innovative approach to a multitrack advance practice registered nurse program: The integration of psychiatric mental health and primary care cohorts. Nursing Education Perspectives,  https://doi.org/ 10.1097/01.NEP.0000000000000968

Lippke, S., & Ziegelmann, J. P. (2008). Theory-based health behavior change: Developing, testing, and applying theories for evidence-based interventions. Applied Psychology, 57(4), 698-716.  https://doi.org/ 10.1111/j.1464-0597.2008.00339.x

Prestwich, A., Kenworthy, J. B., & Conner, M. T. (2018). Health behavior change. Routledge.

Professor’s Feedback

Marian,

In your post, you discussed behavioral changes and how theory and change work together. You know that for your DPI Project you must have both a change model and a nursing theory to support your project. The issues you discuss in your discussion here are the reasons for that. Theory and the Change Model are the scientific underpinnings of the DPI Project. They support both aspects of the project. If you used just nursing theory, the theory would be the theoretical underpinnings of the study, but both equal the scientific underpinnings of the study. Having to find both for your DPI Project ensures the project initiates change while following evidence-based practice.

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DNP Learner Name: Marian Alli________ Current Course: DNP-815A Scientific Underpinnings

PICOT-D Question Template
P	Population	Adolescent population with mental health issues
I	Intervention	Ask Suicide-Screening Questions (ASQ)
C	Comparison	The existing tools
O	Outcome	The possibility of patient referrals
T	Timeline	8 weeks
D	Data	Electronic Health Record
What is your licensure?	APRN RN Is this practice change within the scope of your nursing practice? YES No By submitting this form, I am attesting I have read my state's Nurse Practice Act, and the project is within the scope of my practice.
PICOT	In the adolescent population with mental health issues, how does Ask Suicide-Screening Questions (ASQ) impact patient referrals to the psychiatric department over 8 weeks?
Problem Statement	It was not known if the implementation of __ Ask Suicide-Screening Questions (ASQ) ___would impact ___ patient referrals to the psychiatric department among ___ adolescent population
Purpose Statement	The purpose of this quality improvement project was to determine if the implementation of _ Ask Suicide-Screening Questions (ASQ)___ (intervention, make sure you have the evidence-base here) would impact ___ patient referrals to the psychiatric department among _______ adolescent population. The project was piloted over an eight-week period in an urban eastern, primary care clinic
Original Research articles: List all original research articles that support the intervention. Ensure there are hyperlinks to the articles and or embed the document. (Required)	1. Aguinaldo, L. D., Sullivant, S., Lanzillo, E. C., Ross, A., He, J., Bradley-Ewing, A., Bridge, J. A., Horowitz, L. M., & Wharff, E. A. (2021). Validation of the ask suicide-screening questions (ASQ) with youth in outpatient specialty and primary care clinics. General Hospital Psychiatry, 68, 52-58.  https://doi.org/ 10.1016/j.genhosppsych.2020.11.006 2. Horowitz, Lisa M., PhD, MPH, Bridge, J. A., PhD, Pao, M., MD, & Boudreaux, E. D., PhD. (2014). Screening youth for suicide risk in medical settings. American Journal of Preventive Medicine, 47(3), S170-S175.  https://doi.org/ 10.1016/j.amepre.2014.06.002 3. Horowitz, L. M., Bridge, J. A., Pao, M., & Boudreaux, E. D. (2014). Screening youth for suicide risk in medical settings: Time to ask questions. American Journal of Preventive Medicine, 47(3 Suppl 2), S170-S175.  https://doi.org/ 10.1016/j.amepre.2014.06.002 4. Inman, D. D., Matthews, J., Butcher, L., Swartz, C., & Meadows, A. L. (2019). Identifying the risk of suicide among adolescents admitted to a children's hospital using the ask Suicide‐Screening questions. Journal of Child and Adolescent Psychiatric Nursing, 32(2), 68-72.  https://doi.org/ 10.1111/jcap.12235 5. Milliman, C. C., Dwyer, P. A., & Vessey, J. A. (2021). Pediatric suicide screening: A review of the evidence. Journal of Pediatric Nursing, 59, 1-9.  https://doi.org/ 10.1016/j.pedn.2020.12.011

References

Agency for Healthcare Research and Quality, Rockville, MD. (2017) Introduction and evidence

for early mobility: A protocol to get patients out of bed faster: Facilitator guide. Agency for Healthcare Research and Quality. https://www.ahrq.gov/hai/tools/mvp/modules/technical/intro-early-mobility-fac-guide.html

Creswell, J. W. & Creswell, J.D. (2018). Research design: Qualitative, quantitative, and mixed

methods approaches. (5th ed.) Thousand Oaks: Sage Publications.

Engel, H. J., Tatebe, S., Alonzo, P. B., Mustille, R. L., & Rivera, M. J. (2013). Physical Therapist-Established Intensive Care Unit Early Mobilization Program: Quality Improvement Project for Critical Care at the University of California San Francisco Medical Center. Physical Therapy, 93(7), 975–985. https://doi-org.lopes.idm.oclc.org/10.2522/ptj.20110420

Fisher, S. R., Kuo, Y. F., Graham, J. E., Ottenbacher, K. J., &Ostir, G. V. (2010). Early ambulation and length of stay in older adults hospitalized for acute illness. Archives of internal medicine, 170(21), 1942–1943. https://doi.org/10.1001/archinternmed.2010.422Organization for Economic Co-operation and Development. (2019). Length of hospital stay. Retrieved from https://data.oecd.org/healthcare/length-of-hospital-stay.htm

I, (Marian Alli), verify that I have completed and logged (5) clock hours in association with the goals and objectives for this assignment. I also have tracked said practice immersion hours in the Lopes Activity Tracker for verification purposes and will be sure that all approvals are in place from my faculty and practice immersion preceptor/mentor before the end of the course.

© 2022. Grand Canyon University. All Rights Reserved.

04.30.2021

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Connecting Nursing Theory and Evidence-based Change Models

Submitted by

Marian Omolola Alli

Grand Canyon University

Phoenix, Arizona

2

June 3, 2022.

The goal of this paper is to reduce the stigma associated with mental illness among healthcare providers in order to enhance patient satisfaction levels. Medical practitioners' negative attitudes and views about mental illness can have a negative impact on patient care and outcomes. According to current research, many healthcare professionals have a negative view on mental illness. Anyone with a mental disorder, such as anxiety, depression, or substance abuse, is impacted by mental health inequities. The best part is still to come, and that is the explanation of the theoretical foundation.

Theoretical Foundations

A stigma- and bias-free approach to treating mental illness can be built on the theoretical framework given by Peplau, Watson, and Barker. Stigmatization of mental illness among medical professionals was studied quantitatively. Pre- and post-test designs employing an established data collection method showed correlations between patient satisfaction and mental health stigma levels. The findings showed that the healthcare providers who took part in the study did have negative attitudes toward mental health. The empirical literature has shown that stigmatizing people with mental illness has a negative impact on their treatment and recovery. Patients' care and outcomes are harmed as a result of the unfavorable connotations that persist among mental health practitioners (Senn, 2017). A staff intervention can also help to remove these stigmas. Mental health stigma is widespread around the world, posing a danger to the health of the public, the general welfare of society, and the well-being of individuals.

Nursing Theory

Hidegard Peplau's theory of interpersonal interactions emphasizes the importance of excellent nurse-patient relationships. It suggests that the four pillars of human interaction are: the individual, the physical environment, health, and nursing care. The main conclusion from this hypothesis is that a patient's well-being and overall healthcare experience can be influenced by the contacts and communication patterns of nurses.

Theory of Interpersonal Relation. Peplau describes nursing as “An interpersonal process of therapeutic interactions between an individual who is sick or in need of health services and a nurse especially educated to recognize, respond to the need for help.” It is a “maturing force and an educative instrument” that involves coming together between persons sharing similar objectives.

With this mutual purpose, the nurse and patient respect each other as persons and evolve as a result of the therapeutic process in which they work together. When an individual chose and responds to stimuli in the environment, she or he learns. Orientation, identification, exploitation, and resolution are all stages of a romantic relationship. The problem is defined during the orientation phase. It all begins when a nurse and a patient meet for the first time as complete strangers. Orientation is the first step in determining what kind of service is needed. He or she asks for help and discusses expectations and assumptions based on previous experiences with the nurse (Senn, 2017). The nurse's assessment of the patient's health and circumstances is the focus of the orientation phase. Choosing a qualified professional to provide aid is part of the identifying process. An important aspect of this phase is that the patient feels more confident in dealing with the issue at hand, which reduces their sense of helplessness and hopelessness. The identification step involves the creation of a nursing care plan based on the patient's current state and long-term objectives. During the exploitation phase, experts are brought in to help find solutions to problems. The advantages of professional services depend on the patient's demands and interests. Patients who are being exploited may make small requests or employ attention-getting strategies because they feel like they are a part of the helping environment. Using interview approaches, the nurse should be able to discover, comprehend and effectively address the underlying problem. Additionally, the nurse must keep in mind that the patient's level of independence is likely to change with time (Hagerty et al., 2017). Toward the end of a patient's treatment, the nurse should help the patient to take advantage of all available resources. During this stage, the nursing plan is put into action, and steps are taken to achieve the objectives that were set during the identification phase.

The resolution phase comes at the end of the process. A mutual agreement between the patient and the nurse has led to the end of the professional relationship. To end their connection, they must cut all ties with one other. If there is still a psychological dependence, this might be tough for both parties. The nurse's relationship with the patient begins to deteriorate as the patient begins to wander away. In the end, the two of them have matured as individuals. This is how the nursing procedure is evaluated. It is up to the nurse and the patient to determine whether the established goals were achieved. Improving patient satisfaction by eradicating the stigma associated with mental illness is in line with the mentioned notion since it allows health care providers to better connect with patients and provide for their individual needs. A nurse theorist named Hidegard Peplau developed the theory of interpersonal relationships. At that time, mental health nurses were trained to give custodial care rather than therapeutic-treatment, and Peplau strongly lobbied for nurses to be educated, so they could provide this care.

Clinical Question.

To what degree does the implementation of reducing stigmas impacts patients’ satisfaction scores when compared to increase or maintenance of mental health stigmas among health professionals’ patients in a primary care clinic in Arizona?

Synthesis of Theory.

Client self-management, informed decision-making, and client participation are all aspects of Peplau's Theory that are relevant today (Hagerty et al., 2017). As part of the theory, healthcare professionals must seek to comprehend their own and their clients' behavior (Senn, 2017).

Summary

More advanced therapeutic nursing treatments, such as the seven nursing roles that depict the dynamic character roles typical of clinical nursing, were in development using Peplau's theory by subsequent nurse theory and clinical practitioners. When it comes to the profession of nursing, it means that a nurse's responsibilities go well beyond simply taking care of patients. As a result, an evidence-based change model is discussed below to help translate the research into practice

Evidence-based Change Model

As a heuristic tool and as a framework for expressing nursing administration research, practice, and teaching, the Iowa Model serves these purposes well. “The paradigm divides knowledge into two domains (systems and outcomes), each with three levels of abstraction (patient aggregates, the organization, and the health care system)” (Fating et al., 2021). Concepts that can be used to further an individual's understanding are outlined for every level. It is used in practice, research, and educational contexts.

Iowa Change Model

The following questions should be addressed prior to changing practice:

1. Is there enough supporting evidence to support change action?

2. Are the results similar across various research?

3. Are the nature and quality of findings enough?

4. Is there clinical relevance?

5. Are these findings good for the target patient population?

6. Is the clinical change feasible?

7. Is there an appropriate risk-benefit ratio to make the practice change?

The findings in this direct practice improvement has implanted this change as seen in the findings and evidence from the tests conducted.

Clinical Question.

This change model aligns with the chosen nursing theory as both of them focuses on patient care. This models takes steps to which the project is put into practice while the nursing theory provides theoretical foundation to the project.

Synthesis of Evidence-based Change Model.

According to Fating et al., (2021), the Lowa model has been employed in healthcare by the nurses handling trauma that was caused by the head injury. The model effectively worked meeting the expectation of the implementation team and considered it effective. This model is used in oncology nursing where Nurses understand that evidence-based practice (EBP) improves the quality of patient outcomes while controlling the cost of healing (Nelson et al., 2020).

Summary

There have been major model shifts in piloting, implementation, patient participation and maintaining transformation. The Iowa Model-Revised is still an EBP process application guide. Patients who raise questions and desire a systematic, EBP-based strategy to improve health care are the intended users of this tool.

Linking Nursing Theory, Change, Model, to the Direct Practice Improvement Project

The problem statement is that there has been rapid fall in customer satisfaction score due to health professionals mental health stigma. This issue need to be addressed to improve patient satisfaction score in the medical field. The gap now is the failure of common interaction between patient and nurse or health professionals who are strangers at first due to the stigma of the health professionals as a result of mental health. This is evident from the findings in the direct practice improvement. Therefore, the purpose of this quantitative quasi-experimental project was to determine if or to what degree the implementation of reducing mental health stigma would impact patient outcome when compared to current practice among health professionals in a primary care unit in Arizona over four-weeks.

Conclusion

Theory of interpersonal relations is important I'm the achievement of this direct practice improvement project as it provides a theoretical foundation. It gives how the patient should relate with the health professionals theoretically. The Iowa model used is implemented in the project as it provides guidelines on how to put the theory into practice. This is seen in the findings and results plus the conclusion of the DPI project. Bother the nursing theory and the change model has contributed effectively into making this project a success

References

Fating, L., Singh, S., & Ankar, R. (2021). Application of modified lowa model evidence-based practice on trauma care nurses regarding head injury. Journal of Pharmaceutical Research International, , 253-258.  https://doi.org/ 10.9734/jpri/2021/v33i52A33581

Hagerty, T. A., Samuels, W., Norcini-Pala, A., & Gigliotti, E. (2017). Peplau’s theory of interpersonal relations. Nursing Science Quarterly, 30(2), 160-167.  https://doi.org/ 10.1177/0894318417693286

Nelson, W., Dubinsky, I., & Poland, B. (2020). An innovative model for healthcare leadership education. Healthcare Quarterly (Toronto, Ont.), 22(4), 55-58.  https://doi.org/ 10.12927/hcq.2020.26083

Senn, J. F. (2017). Peplau’s theory of interpersonal relations. Nursing Science Quarterly, 26(1), 31-35.  https://doi.org/ 10.1177/0894318412466744

I, Marian Alli, verify that I have completed and logged 10 clock hours in association with the goals and objectives for this assignment. I also have tracked said practice immersion hours in the Lopes Activity Tracker for verification purposes and will be sure that all approvals are in place from my faculty and practice immersion preceptor/mentor before the end of the course.

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