Advanced Evidence-Based Innovation in Nursing Practice

Healthcare delivery faces dynamic patient, professional, and environment changes. New policies and laws affecting healthcare are developed and implemented constantly at the local, state, and national levels. Patients are developing increasing needs and healthcare knowledge, and new diseases such as COVID-19 and Ebola are rising. In addition, new problems such as staff shortage, medical errors, and increased disease burdens (such as diabetes) lead to the dynamicity of healthcare. Healthcare professionals, such as nursing innovators, must constantly evaluate healthcare institutions to improve them and ensure better outcomes, meet all needs, and patient and staff satisfaction.

The Roles and Scope of the Nurse Innovator

Nursing is a profession with many roles that are vital to its survival. Nursing services extend to various areas, such as healthcare improvement, care delivery, and leadership. Nurses play essential roles as innovators in healthcare improvement. Nurse innovators are not confined to healthcare but also work in research and education to improve education, health outcomes, and the profession’s future. Cusson et al. (2021) note that every nurse is a nurse innovator owing to their roles in improving nursing education, care delivery, and the profession. They work with multidisciplinary teams to implement change in healthcare institutions. These professionals are not confined to the three institutions but can also occupy higher positions such as working in the county, state, or nation in health improvement positions in their areas of jurisdiction.

Nurse innovators rely on data, and one of their roles is to collect patient data and other relevant information to inform improvement. The professionals collaborate with other team members to develop standards at their levels through which they evaluate results. They then determine the level of performance based on these standards and produce reports for further assessment (Azar, 2021). The results help determine areas that require improvement. Nurse innovators participate in proposing and implementing improvement programs to ensure better outcomes (Azar, 2021). After implementing programs, they monitor, control, and evaluate programs to ensure they meet their overall goals and objectives. They participate in improving these programs and developing innovative disruptions for better outcomes.

Nurse innovators are essential professionals in policy development and leveraging healthcare technologies (Marshall, 2019). Healthcare improvement is integral, but its implementation and adherence can be problematic without legal backing. Nurse innovators participate in policy development and implementation through their roles in data collection, analysis, and reporting. They provide insights into developing policies that align with the patient, professional, and organizational needs. The data they provide is integral to decision-making and healthcare improvement. Marshall (2019) notes that nurse innovators are on the frontline in embracing incorporating healthcare technologies to improve healthcare outcomes. They assess available technologies and their compatibility with the organization and implement them. Thus, nurse innovators are essential professionals in improving healthcare institutions, the nursing profession, and care delivery. Technology has infiltrated healthcare and is widespread in communication, procedures, and care coordination. Technological advances such as healthcare dashboards have enabled healthcare institutions to track their performance against internally and externally set standards. Other technologies such as electronic health records and collaborative software have improved care delivery by increasing professionals’ access to information and thus allowing prompt action. Clinical decision support systems help healthcare professionals make informed decisions hence better precision in care delivery. These technologies are developed with the help of healthcare professionals to improve care delivery. Sophisticated machines have also been deployed in activities such as the surgery of vital organs. Nurse innovators develop ideas and suggest improvements for better outcomes (Cusson et al., 2019). These technologies reduce work overload and help perform complex tasks. Nurse innovators thus participate in their development and implementation to improve organizational performance.

Knowledge and Skills of a Nurse Innovator

The knowledge and skills of a nurse innovator are directly related to the roles. The nurse innovator must be a registered nurse or an advanced practice nurse with basic training in nursing roles and the nursing profession. Nurse innovators have advanced knowledge in leadership, communication, and quality improvement. The topics are broad, and a deep understanding of these areas is essential for one to be considered for the nurse innovator role. Cusson et al. (2019) state that nurse innovators also undergo training that increases their knowledge in interprofessional collaboration and data handling, including utilizing results and change management. These nurses have often amassed knowledge before serving as nurse innovators. The experience is essential and helps them make informed decisions that positively impact the professionals, patients, and healthcare institutions. Thus, nurse innovators are equipped with extensive knowledge in the nursing profession, leadership, quality improvement, and change management to succeed in their roles.

Coordination and communication skills are vital to any nurse innovator. Their roles require them to coordinate various professionals and executive teams to produce outcomes. Leary et al. (2022) note that communication skills are vital to a nurse innovator. They help them coordinate with professionals, pass appropriate information on time, and use the proper channels. Change management skills are essential for quality improvement. These include rhetoric skills that enable them to convince nurses and other healthcare professionals. These skills enable them to convince professionals of the need for change and the benefits of the changes over current practices.

Critical and creative thinking are essential skills for nurse innovators. Critical thinking skills help them analyze situations and programs to determine their relevance and significance. The analysis helps them unearth areas for improvement and supplement areas already doing well. Creative skills help them develop unique ideas and solutions to current problems (Leary et al., 2022). These skills ensure continuous improvement and evolvement to meet the ever-changing patient, environment, and professional needs. Decision-making is integral because nurse innovators are bombarded with choices from ideas generated by other professionals. Decision-making skills help ensure inclusivity and high-quality decisions that meet the needs and are acceptable to all professionals (Leary et al., 2022). They thus help avoid conflicts, improve outcomes, and prevent delays and loss of finances that occur with poor decision-making in the institutions. These skills are integral for nursing innovators to implement their roles efficiently.

Stakeholder Table and Rationale

Stakeholder

Rationale

Hospital Nursing Informaticist

Mrs. Thompson

Nursing informaticists handle healthcare, particularly nursing data. They collect and analyze data as routine and for special evaluation purposes. As identified earlier, data is the backbone of healthcare improvement. These professionals will provide data and reports that identify gaps in current practices that necessitate improvement. They will also validate claims through data, thus promoting better results for the proposed innovations.
Nursing Services Manager

Mr. Allen

The nursing services manager is the topmost nursing position in the hospital. They command the highest authority for the nursing professionals in the healthcare organization. The professionals s important because they authorize innovations and their support is integral. The nursing services managers also handle nursing data; thus, their involvement is key to the success of healthcare improvement.
Research Department Manager, Mr. Anderson The research department handles data and is also responsible for performing research into innovations. They are vital in pre and post-implementation surveys for nursing innovations. They provide vital insights using their surveys that help shape innovations to produce the best outcomes. The head of the department is well versed with research and healthcare knowledge and understands issues such as implementation, monitoring, and evaluation techniques that produce the highest results. Their involvement as stakeholders in innovations is thus integral to the teams’ success.
The Hospital Public Health Nurse,

Ms. Alice

The public health office handles the hospital and understands the disease burden within the hospital and in the community. Public health officers are important professionals in enhancing hospital preventive, promotive, curative, and rehabilitative services. They provide knowledge and data that help improve healthcare service delivery. They are also important professionals in implementing and evaluating current health programs and data integral to developing innovations.
Head of Quality Improvement Department

Mr. Jordan

The quality improvement department is important in the healthcare department. The nurse innovator is one of the professionals in this department. The head of the department will entail vital information on quality improvement. They provide information on current and past innovations, achieved milestones, and the steps required to enhance the success of innovations. This department head’s experience and knowledge will positively influence outcomes.

Phase 2
The goal of the Brainstorming Session and Processes for Generating Ideas

The meeting aims to analyze current healthcare data, innovations, and effectiveness to determine areas that require improvement and develop innovations to improve these areas. The best intervention for the meeting is to hold an online convenience meeting. These stakeholders are within the hospital, and the meeting will be part of their specific roles. Informing the team members early in the meeting will ensure they prepare their schedules early. Online meetings are convenient, but more dialogue and attention are present during a physical meeting (Sandeep, 2020). Thus, a 2-hour video conferencing with Google meet will help discuss innovations for the healthcare institution.

Brainstorming is one of the main methods of generating innovative ideas and the selected one. Brainstorming entails asking professionals to think and develop ideas. The technique utilizes logic and knowledge. Reverse brainstorming will be integral in selecting these ideas to select the best idea based on the merits, demerits, and care costs (Bobkowska, 2019). The SCAMPER technique will help collect and select the best innovation idea. The first step, substitute, entails determining what needs to change, such as the areas of improvement. “Combine” is the next step and entails determining areas that can be combined, such as dashboards and electronic health records. The next step, adapt, entails determining what can be added. The step evaluates current policies and their performance to determine what can be added to improve efficiency or achieve the desired effect (Ahmed, 2021). The next step is modifying also entails maximizing and minimizing. The step modifies current policies and alters their functions. These innovations do not change the entire policies but some aspects. The next step, put to other use, entails determining how these innovations can be overflowed to other areas. Professionals then determine areas that can be removed, and lastly, professionals determine the effects of the reversal of policies (Ahmed, 2021). They evaluate the effects of changing policies, programs, and innovations to prove their relevance and significance. The methods and process outlined will be integral to developing the innovation.

Method for Consensus Building, Description, and Rationale

Every executive team member needs to feel appreciated and important to the team. Innes (2018) notes that one way is to ensure their ideas are respected and considered during the meeting. There are various methods of consensus building, such as voting and merging alternatives (Li et al., 2018). These methods all ensure the professionals make a final decision for implementation. The selected method for consensus building is merging alternatives. Collaboration is a complex term; professionals can collaborate through unorthodox means such as coercion against their will. Collecting the perspectives of all stakeholders and merging their ideas to develop a working solution is thus integral. Another rationale for selecting the strategy is that all stakeholders are involved in the delegation efforts, hence higher acceptance and compliance (Li et al., 2018). The method employs collaboration and incorporates the best ideas from professionals to produce a hybrid solution that most or all professionals accept and uphold. Some methods, such as voting, use the perspectives of the majority over the minority and is not inclusive of all the professionals’ perspectives. Li et al. (2018) note that merging alternatives through collaboration allows professionals to analyze ideas critically to unearth their weaknesses, strengths, relevance, and significance. The method helps ensure that all executive team members feel appreciated and valued. They are then able to work in collaboration to achieve the desired outcomes.

Meeting Agenda, Idea Capturing, and Seeding Consensus

The meeting’s agenda revolves around improving the healthcare organization’s care delivery and selecting an innovation to improve healthcare delivery. The meeting will then develop the innovation and help develop the initial interventions towards the implementation of the innovation. The head of the quality assurance department will oversee the process of idea generation. The presence of this personnel is integral to coordinating and stimulating executives to participate in the process.

The first step, as identified earlier, will be brainstorming ideas. Each executive will get a chance to suggest innovations based on their assessment and knowledge that the healthcare institutions can implement to improve healthcare delivery. Each team member will have time to explain their ideas to enhance the idea-capturing process. They will also have an equal chance in processes such as voting. After collecting ideas, the team will explore them critically to identify the most applicable innovation based on available resources and anticipated results. All the team members will develop the selected idea.

Seeding consensus is a complex process whose beginning will be marked by discussing the issues for discussion. The next step will entail selecting an issue to focus on and generating ideas to help address the issue. It will also enhance understanding of the perspectives of all healthcare members regarding the issue. Members may have differing opinions, and dialogue is important to help understand their viewpoints and make decisions that favor both teams and align with the organizational goals and objectives (Woodock et al., 2020). The executive team members will then improve the selected ideas and amend them to ensure they meet the team members’ logical proposals. However, it is important to note that not all proposals by the members may be logical and coherent hence the need for their critical analysis before their incorporation. The last step, which entails agreement testing, helps determine the agreement of the executive team members. It is vital to ensure unanimous agreement because resistance to change at the executive level, even from one member, could lead to marked innovation failure (Woodcock et al., 2020). The innovation’s implementation can proceed if all members agree, and any disagreement should be promptly addressed.

Meeting Minutes, Ideas List, and the selected Innovative Idea

1.0 Preliminaries (meeting opening and introduction. No reading of previous minutes because this is the first meeting of its kind for this innovation)

1.1 Common problems affecting the healthcare institution

1.2 The list of ideas- The topics of interest/ or areas requiring change generated for this meeting are:

1.2.1 Cross-training to address the nursing shortage

1.2.2 Diabetes screening, prevention, and management

1.2.3 Promoting Mental health among adolescents

1.2.4 The selected innovation- Bedside patient handover reports- this is the selected topic. Patient handing over is a viral nursing role and ensures care continuity and maintains care quality between shifts. Most medical errors occur during patient handover when wrong information is passed. A systematic process utilizing tools at the bedside of the patient is important. The strategy will also increase patient involvement in their care. The innovation calls for restricting how reports are done and presented and using convenient tools to enhance the understanding of the patient.

1.3 Implementation process of the selected healthcare innovation

1.3 The requirements of the innovation, including regulatory and organizational requirements and resources

1.4 Organizational readiness for the innovation assessment

1.5 AOB

1.6. Adjournment of the meeting using the selected channel

Phase 3

Communication Plan Outline

Coordination is an important aspect of any project, and developing an elaborate communication plan is vital. A clear flow of information will ensure a lower risk of errors or role confusion. The communication plan will stem from the meeting when the executive members choose the right communication channel for all stakeholders to receive vital information about the innovation (Thapa & Shrestha, 2019). The channel will be used unanimously during the implementation of the project to ensure coherence and better outcomes. Email is an official channel and the best option for this innovation. All stakeholders will receive a process map, a tool that will give a clear idea of the information. The stakeholders and staff will also receive updates regarding the innovation through the selected media. In addition, posters, notice boards, and visual aids will be used to describe the innovation and staff training to improve awareness and garner support. Monthly meeting briefs and advanced reporting will help monitor and evaluate the innovation implementation (Thapa & Shrestha, 2019). Any information generated from these reports and monthly briefs will be communicated to the involved professionals through the official communication channel.

Written Summary of the Training Plan

Training is among the widely applied healthcare interventions to improve outcomes. The innovation will require professional training to include a process map. The tool will provide details on the innovation, why it’s needed, and what it hopes to achieve. The information will be integral for the implementation, assessment, and evaluation of the program to determine if it achieved the objectives for which it was created.

The selected learning intervention, depending on the training’s needs and nature, is the teach-back method. The training will enhance the nurse leaders’ knowledge to teach other staff members. The training will thus touch on areas such as teaching techniques and monitoring, besides education on innovation. It will enhance their ability to teach for improved healthcare outcomes. Anderson et al. (2020) note that the teach-back method allows trainers to deliver content and assess its understanding and implementation. The training will take place for a week to ensure they develop refined skills to teach other nurses and implement the innovation together. Teach-back methods are complex and have been used to teach patients and their caregivers about effective care models for the best outcomes (Anderson et al., 2020). Thus, the training strategy will be integral to the success of the training plan for the patient.

The training will be implemented in groups. Different training for different stakeholders is required. Nurses are difficult to educate because of the nature of their roles. Patients in the hospital must be under the management of a nurse 24 hours a day, and the different shifts make it possible to have nurses attend the training and deliver care adequately while maintaining the integrity of the shifts without overloading the nurses. The involved stakeholders will be notified through their work emails. Few resources, if any, will be required by the nurse leaders while trading their staff at the nurse leader-staff level. Nurse leaders such as the in-charges and their deputies will be trained. These nurses will then organize training for their nurses in the specific wards because the innovation affects inpatients. The first training, train-the-trainers, will be intensive and shall cover all aspects from rationale to costs to post-implementation evaluation (Poitras et al., 20221).

Training the leaders in the involved departments will help cut costs and ensure exclusive training while preventing the disruption of care delivery in the healthcare facility (Anderson & Taira, 2018). Training will take place physically for a week. PowerPoints and other technologies will be used to deliver the training. The training budget will also include refreshments, lunch, and allowances for the attendees’ motivation. The training will be intensive hence the need to motivate these professionals to participate actively in the innovation’s success. Other required resources include electricity, water, and other utilities to facilitate the training. The training leaders will also be compensated for their work because preparing and implementing the training is an added and demanding task.

Training will be implemented by the nursing informaticist and the head of the quality improvement department. These professionals have the most advanced knowledge of innovations and current healthcare technologies. They also have knowledge and skills in change, management, and staff training, which are requirements for the training program. External trainers are often voted the best professionals, but their shortfalls are in their high costs, and these professionals may have limited information compared to workers in healthcare institutions.

Innovation Action Plan

The innovation plan is complex and entails a transition from old practices to new practices aimed at improving healthcare delivery: to primarily reduce medical errors associated with poor nursing handing over reports. The innovation action plan will require the completion of various tasks to set the ground from about a month to its implementation. They will pave the way for innovation and will also enhance its success.

Table 2. Innovation Action Plan Table

Responsible Person (Role) Responsibilities Timeline
The Head of the Quality Improvement Department, Ms. Alice Development of the innovation process map detailing the innovation, including its implementation, and evaluation Three days
The hospital executive management team, particularly the Hospital CEO, Mr. James Brown Internal approval of the proposed innovation and authorization of its implementation. Failure of the innovation to be approved at the organizational level will lead to the crippling of innovation. One week
The nurse manager Development of a summary of the innovation and a written proposal to regulatory agencies and stakeholders for approval Three weeks
The innovation implementation team Pre-implementation survey and pilot testing to help with disruptive innovation and refine the implementation One month
Mrs. Thompson, the nurse informaticist Communicating with all stakeholders and gathering their responses to the process map and One week
Mr. Anderson, the head of the Healthcare Research department Change management survey to determine the healthcare professionals (nurses) attitude towards the innovation to predict resistance and its sources to help manage it Three days
Mr. Thompson had the quality improvement department Budgeting resource allocation for the training program for effective and efficient implementation Two weeks
Mr. Thompson, head of the quality improvement department Resource mobilization which entails all resources required for the training program are acquired and ready for use; for example, utilities are sorted, and teaching materials are purchased and ready Two weeks
The Nurse Informaticist, Mrs. Alice Preparation of materials, such as posters, notices, and billboards, to increase staff awareness of innovation and its relevance s One week
The innovation implementation committee Holding a pre-implementation meeting with all stakeholders to cross-check details and ensure all activities required before the implementation of the innovation are complete One day

References

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