Predicting Successful Implementation of Practice Initiatives in a Magnet Organization using the Organizational Readiness to Change Assessment

2.50
Hdl Handle:
http://hdl.handle.net/10755/308088
Category:
Abstract
Type:
Presentation
Title:
Predicting Successful Implementation of Practice Initiatives in a Magnet Organization using the Organizational Readiness to Change Assessment
Author(s):
Lancaster, Kelly E.; Kent, Gertrude; Hyrkas, Kristiina; Michaud, Debbie
Lead Author STTI Affiliation:
Kappa Zeta-at-Large
Author Details:
Kelly E. Lancaster, RN, MSN, CAPA, lancak@mmc.org; Gertrude Kent, RN, BSN; Kristiina Hyrkas, PhD, LicNSc, MNSc, RN; Debbie Michaud, RN
Abstract:

Session presented on: Sunday, November 17, 2013

Background:  The Organizational Readiness to Change Assessment (ORCA) measures readiness for successful implementation of evidence-based practice changes. Organizations may support innovation, but the context and cultures of clinical units may not reflect that support, affecting the success of practice implementation. The purpose of this study was to examine the predictive validity of the ORCA by comparing the scores of two groups of nurses demonstrating high sustainability in the use of buffered lidocaine as local anesthesia for IV catheter insertion with the scores of nurses demonstrating low sustainability. 

Methods:  RNs (n=109) from eight clinical units within a 605 bed tertiary medical center participated in this exploratory study.  Units were chosen based on previous quality improvement data regarding the sustainability of the evidence-based practice initiative. The intervention group (1), consisting of 4 nursing units,  received high facilitation (education) to encourage the use of intra-dermal lidocaine, but showed low rates of sustainability. The control group (2), also consisting of 4 nursing units, did not receive high facilitation, but demonstrated high sustainability. 

Results: Both Linear and Logistic Regression analyses identified the ORCA model variables of evidence assessment (t=-6.30, P<.001), context assessment (t=2.41, p=.0192), and implementation plan (t=2.06, p=.0435) to be significant predictors of successful practice implementation. These three variables accounted for 46.28% of the fitted model (R-Square = 0.4628). The t-test was used to compare the intervention group (1) with the control group (2). Results showed that group 2 (low facilitation/high sustainability) had significant differences with clinical experience (t=-3.92, p=.000), perceptions of patient preference (t=-2.51, p=.014), and staff member culture (t=-2.02, p=.046) compared to group 1. 

Conclusions & Implications: Good predictive validity was shown with the three model variables. The results of the study suggest that ORCA was able to identify differences in groups relative to the facilitation of an evidence based practice initiative.

Keywords:
Organizational Readiness to Change; Evidence-based Practice; Sustainability
Repository Posting Date:
19-Dec-2013
Date of Publication:
19-Dec-2013
Conference Date:
2013
Conference Name:
42nd Biennial Convention
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Indianapolis, Indiana, USA
Description:
42nd Biennial Convention 2013 Theme: Give Back to Move Forward. Held at the JW Marriott
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titlePredicting Successful Implementation of Practice Initiatives in a Magnet Organization using the Organizational Readiness to Change Assessmenten_GB
dc.contributor.authorLancaster, Kelly E.en_GB
dc.contributor.authorKent, Gertrudeen_GB
dc.contributor.authorHyrkas, Kristiinaen_GB
dc.contributor.authorMichaud, Debbieen_GB
dc.contributor.departmentKappa Zeta-at-Largeen_GB
dc.author.detailsKelly E. Lancaster, RN, MSN, CAPA, lancak@mmc.org; Gertrude Kent, RN, BSN; Kristiina Hyrkas, PhD, LicNSc, MNSc, RN; Debbie Michaud, RNen_GB
dc.identifier.urihttp://hdl.handle.net/10755/308088-
dc.description.abstract<p>Session presented on: Sunday, November 17, 2013</p><b>Background:</b>  The Organizational Readiness to Change Assessment (ORCA) measures readiness for successful implementation of evidence-based practice changes. Organizations may support innovation, but the context and cultures of clinical units may not reflect that support, affecting the success of practice implementation. The purpose of this study was to examine the predictive validity of the ORCA by comparing the scores of two groups of nurses demonstrating high sustainability in the use of buffered lidocaine as local anesthesia for IV catheter insertion with the scores of nurses demonstrating low sustainability.  <p><b>Methods</b>:  RNs (n=109) from eight clinical units within a 605 bed tertiary medical center participated in this exploratory study.  Units were chosen based on previous quality improvement data regarding the sustainability of the evidence-based practice initiative. The intervention group (1), consisting of 4 nursing units,  received high facilitation (education) to encourage the use of intra-dermal lidocaine, but showed low rates of sustainability. The control group (2), also consisting of 4 nursing units, did not receive high facilitation, but demonstrated high sustainability.  <p><b>Results:</b> Both Linear and Logistic Regression analyses identified the ORCA model variables of evidence assessment (t=-6.30, P<.001), context assessment (t=2.41, p=.0192), and implementation plan (t=2.06, p=.0435) to be significant predictors of successful practice implementation. These three variables accounted for 46.28% of the fitted model (R-Square = 0.4628). The t-test was used to compare the intervention group (1) with the control group (2). Results showed that group 2 (low facilitation/high sustainability) had significant differences with clinical experience (t=-3.92, p=.000), perceptions of patient preference (t=-2.51, p=.014), and staff member culture (t=-2.02, p=.046) compared to group 1.  <p><b>Conclusions & Implications:</b> Good predictive validity was shown with the three model variables. The results of the study suggest that ORCA was able to identify differences in groups relative to the facilitation of an evidence based practice initiative.en_GB
dc.subjectOrganizational Readiness to Changeen_GB
dc.subjectEvidence-based Practiceen_GB
dc.subjectSustainabilityen_GB
dc.date.available2013-12-19T17:26:44Z-
dc.date.issued2013-12-19-
dc.date.accessioned2013-12-19T17:26:44Z-
dc.conference.date2013en_GB
dc.conference.name42nd Biennial Conventionen_GB
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen_GB
dc.conference.locationIndianapolis, Indiana, USAen_GB
dc.description42nd Biennial Convention 2013 Theme: Give Back to Move Forward. Held at the JW Marriotten_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission.en_GB
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