Evidence Based Interventions

The Ontario government is focused on providing effective early interventions for young children with autism (Perry, n.d.). Throughout the years, a substantial amount of research has been done regarding the neuroplasticity and the effectiveness of early intervention in young children (Perry, n.d.). The results of this research have given professionals a greater understanding for a new program directed to young children- which is designed and implemented for children with a diagnosis of Autism Spectrum Disorder and some diagnosed with Pervasive Developmental Disorder- Not Otherwise Specified (PDD-NOS) are also eligible (Perry, n.d.). In 1999, $19 million was funded by the Ontario government to be invested in the services of Intensive Behaviour Intervention (IBI). This specific program is developed for children up to and including the age of 5 years old (Perry, n.d.).

Explain two models of behaviour change that have been used in recent national health education campaigns.

Evidence-based practice is extremely important in health care. It is not only important to know how to perform a certain skill, but why it should be done. There needs to be a standard of care and providers need to know the best way of doing things based on evidence. The article mentions that in the 20th century, many medial decisions were made on doctor assessment and preference (Brower, 2017). Many physicians were practicing dramatically different when compared with one another, which led to the realization that changes needed to be made and Evidence-based practice began to develop. Even though Evidence-based practices have been in play for a while, there is a gap between understanding and applying evidence-based

Gerrish, K. Lathlean, J. (2015). The research process in nursing. West Sussex: John Wiley & Sons. p263.

In this essay, I am going to consider how evidence-based practice can be used to support, justify, legitimate and/or improve clinical practice. I am also going to explore and discuss primary and secondary research evidences about how nursing interventions can potentially improve the quality of life of patients in the community suffering from heart failure. I will gather these evidences using a literature search which I will include an account of. Using a critiquing framework for support, I will appraise both primary and secondary evidences that I have chosen. I will also look at potential non-evidential factors that can influence evidence utilisation in practice. Finally, a conclusion will be drawn.

The Transtheoretical Model of Behavior Change (TTM) was created by Prochaska and DiClemente. It is based on “(1) the stages of change, (2) the decisional balance scale, (3) the strong and weak principle, (4) self-efficacy, and (5) the processes of change” (Kelly, 2008, p. 149). A person’s progression through the stages depends on their perception of the advantages of adopting a healthy lifestyle (Kelly, 2008).

Evidence-Based Practice Proposal Final Paper Usha Kizhakkedan Grand Canyon Final Paper of Evidence Based Proposal NUR-699 Dr. Debbie Long June 1, 2016 Table of Contents Part 1: Organizational Culture and Readiness Assessment 4 • Introduction to Evidence-Based Practice 4 • Barriers to Evidence-Based Practice 4 • Facilitators of Evidence-Based Practice 5 • Integration of Clinical Enquiry 5 • The Survey 6 Part 2: Problem Description 7 • Description 7 • Identification of change agents in the Health care system 8 • PICOT question 8 • Purpose and Objectives 9 • Rationale 10 • Literature support 10 • Research Method 10 Part 3: Literature Support 11 • Research Questions 11 • Search Method 12 • Organization of Literature 12 • Framework 12 • Nursing Rounds- Patient and Family Satisfaction: 13 • Communication: 15 • Management of Pain, Use of Call Lights and Cases of Patient falls 15 • Data Collection 16 Part 4: Solution Description 16 • Objectives 17 • Change Methodology 17 • Implementation Plan 18 • Evaluation 19 Part 5: Change Model 19 • Change Model 20 • Implementing Change 21 • Rationale 22 Part 6: Implementation Plan 22 • Staff Education 23 • Client feedback 23 • Timeframe 23 • Hiring Process 24 • Implementation 24 • Data collection and Evaluation 24 • Progression 24 • Resource Management 24 • Budget Plan 25 • Outcomes and its impact 25 • Summary 26 Part 7: Evaluation of Process 26 • Objectives 26 • Methodology 27 • Procedure 27 • Collection and Analysis of data

In order to develop nursing knowledge and establish evidence-based practice (EBP) in nursing, there needs to be a "concept model, one or more theories and one or more empirical indicators" (Fawcett & DeSanto-Madeya, 2013, p. 26). The theoretical framework can be advantageous in guiding and supporting the design and execution of an EBP change. Using a conceptual model (C) theory (T) and empirical research (E) provides the foundation for an intervention to an identified clinical problem. Known as C-T-E structure, the application of this system in nursing practice involves an elevated level of critical reasoning, which assists in knowing what data is important and how it relates to practice change (Chinn & Kramer, 2011; Fawcett & DeSanto-Madeya, 2013; Mazurek Melnyk & Fineout-Overholt, 2015). The doctoral level of nursing necessitates the need to combine the understanding and knowledge gained from using the C-T-E structure, and then integrate the concepts and theories into daily practice.

Bradley, S., & Mott, S. (September 2012). Handover: Faster and safer? Australian Journal of Advanced Nursing, 30(1), 23-32.

According to Stevens (2013), the call to develop and implement evidence-based practice (EBP) within all healthcare disciplines is fueled by legislative demands for improvement in standard medical metrics such as mortality and morbidity. However, increasing demands by the public for evidence related to the metrics and outcomes of such concepts as quality of life illustrate what may be more important to the client (Stevens, 2013). This client-directed focus has resulted in patient-centered outcomes research (PCOR) (Stevens, 2013). "The Patient-Centered Outcomes Research Institute (PCORI) helps people make informed health care decisions, and improves health care delivery and outcomes, by producing and promoting high integrity, evidence-based information

Evidence-based practice is a decision making process in which you combine scientific data with clinical expertise, patient values and circumstances of the patient. (Hoffmann, Bennett 2017). The World Health Organisation (WHO) defines chronic diseases as those which are caused by non-reversible pathological changes in the body, are permanent and leave a lingering disability, those that require ongoing rehabilitation or care. Indigenous Australians experience very high prevalence, morbidity and mortality from chronic health conditions such as diabetes, cardiovascular, renal and chronic respiratory disease. Multi morbid and comorbid chronic diseases are increasingly placing a greater burden on individuals, communities and health care services

Applying evidenced-based practice has three steps. Step one is making sure the research is creditable. Going into detail about step one should model a social work practice. In a social work practice, you always want to make sure you are looking for clarity and in some cases it helps to paraphrase it or reword it differently. As a social worker you have to be non-judgmental and try to understand every perspective. You have to be unbiased when it comes to wording and how it affects the meaning of the conversation. Also, making sure the research on the surveys or interviews are fair and represent the entire population. The second step is when you match your outcome of the research in your own “practice wisdom." As a social worker you want to compare the research you made with prior experience. You want to have different perspective and information that help you understand the client better. Lastly, the last step is to ask questions to the clients about their significance of what they have accomplished by working with you. Just asking what the client has learned can help

EBIs to reduce disruptive behavior and increase academic achievement can include trainings and implementation support at the school, class-wide, and individual student-level, and are often either academic or behavioral in nature. Overall, implementation of both universal (i.e. class-wide) and targeted (i.e. student-level) interventions have demonstrated positive impacts on decreasing disruptive behaviors and increasing student academic achievement (Flower, McKenna, Bunuan, Muething, & Vega, 2014; Vannest, Davis, Davis, Mason, & Burke, 2010).Ross, Romer, and Horner (2012) also found that teachers in schools implementing Positive Behavioral Interventions and Supports with high fidelity

An individual's attitude towards his health influences his capacity to maintain an optimum level of health, prevent illness or recover from a disease. Understanding patient's attitude towards his condition is the key to establishing an effective health-related program for health promotion, disease prevention and disease management. Hence, different health behavior theories have emerged. All of these are designed to help the patient and his family to facilitate learning, adjustment and behavior change to improve his quality of life. ( Butts & Rich, 2011)

From Week 4 lecture, I have learnt about the Theory of Planned Behaviour. Initially, I thought that if a person intend to do something, they will put in their best effort to do it. However, I realized that I was wrong because ‘intention does not always accurately predict behaviour when there is a reflex or conditioned response involved.’(Long-Crowell, 2003) For example, ‘my friend with a phobia may intend to stay calm and collected when faced with their fear, but may end up having a panic attack instead.’(Long-Crowell, 2003) After this lecture, I have learnt that this theory explores the relationship between attitudes and behaviour. A person who have the intention to change is determined by attitude, subjective norms and perceived behavioural control. For example, a person who know about the negative effects are more willing to quit smoking.