Management of change Essay Example | Topics and Well Written Essays - 4250 words

Management of change - Essay Example The rationale for this study, as well as the summary of the literature findings shall also be set forth. The change proposal shall then be laid out and the steps in the implementation process shall also be explained based on the change management framework developed by Lewin. Based on the Nursing and Midwifery Council (NMC, 2008), a nurse is obligated to deliver the best and the highest standard of care at all times. More specifically, they are called on to deliver care, according to the best available evidence and best practice; and they must also ensure that the advice they are giving to their patient, in terms of healthcare products and services, is based on evidence (NMC, 2008). There are numerous evidences which are often made available to nurses for use in their practice. For which reason, it is important for nurses to be knowledgeable and skilled in the critical evaluation of evidence and ensure that the evidence they would choose to support and apply in their practice would b e the best (Spector, 2007, p. 1). For the purpose of this essay, the definition of evidence-based practice by Sackett, Straus, Richardson, Rosenberg, and Haynes shall be adapted. They define the practice as â€Å"the integration of best research evidence with clinical expertise and patient values† (Sackett, Straus, Richardson, Rosenberg, and Haynes, 2000, p. 71). ... based practice therefore considers the role of the patient in the planning and conceptualisation of their care (Pipe, Wellik, Buchda, Hansen, and Martin, 2005). The nurses have to include and consider patient preferences in relation to the best evidence available and apply such to the planning process. Critics like Mullen and Streiner, however, are not supportive of EBP, contending that it prevents the application of the most effective treatment for the patient. They point out that EBP does not â€Å"fit the realities of individualised, contextualized practice, especially nonmedical practice wherein problems are less well defined (Mullen and Streiner, 2004, p. 133). They also emphasised that there are often many limitations in the methods of research in the systematic reviews and meta-analysis. Moreover, concern has been expressed on how evidence-based research can be conceptualised when competing elements like public opinion and resource limitations affect policy-making (Mullen and Streiner, 2004, p. 133). On the other hand, health practitioners are quick to point out that EBP is about being guided by the best available evidence. This means that absent available randomised controlled trials without design flaws, trials which have limitations can be used instead (Mullen and Streiner, 2004, p. 133). In effect, health practitioners and users of health services must be cautious about the risks and benefits when the evidence for decisions are made apparent, even if this would mean that there is not much evidence supporting the different choices (Mullen and Streiner, 2004, p. 133). Proponents of EBP also point out that even as the realities of practice may be far removed from the behaviour and practical aspects of the clinical practice, there is merit in considering the