Using Diffusion of Innovations Theory to Implement the Confusion Assessment Method for the Intensive Care Unit

Robitaille

The Canadian Journal of Human Sexuality

et al. 2014

In 2007, a task-shifting strategy through which a nurse, in collaboration with a community pharmacist, could start a healthy woman on hormonal contraception without a medical consultation was implemented in the province of Quebec. The purpose of this study was to identify factors associated with the 1) implementation of this new practice by nurses, 2) delay of implementation and 3) intensity of the practice. A validated questionnaire based on Rogers' theory of the diffusion of innovation was sent by postal mail or internet to all nurses that had successfully completed training in hormonal contraception since 2007, were registered at the College of nurses of Quebec and currently worked as nurses. The questionnaire was completed by 745 nurses between November 2011 and March 2012 for a response rate of 26.6%. Results show that implementation of this new nursing practice was more successful when nurses had a high degree of cosmopoliteness, they perceived the new practice as simple, they worked in youth clinics and if health organizations where they worked were open to innovation, had low centralized decision-making and organizational slack. Various attributes of innovation, diffusion networks and characteristics of the organizations also explained intensity of the new practice. The findings suggest new avenues to simplify and scale up this strategy for use in other health organizations.

Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Determinants of the implementation of a new practice in hormonal contraception by Quebec nurses

Robitaille

The Canadian Journal of Human Sexuality

et al. 2014

“…The endorsement of change from a practicing staff nurse can be very effective in changing behaviors of those reticent or skeptical of change. 1,63 Staff nurses are the direct advocates for patients, as they have the more face-to-face time with patients and patients' families. Coaching and performance feedback is best achieved when provided in real time in responses to actual cases.…”

Section: Staff Nurse As Change Leadermentioning

confidence: 99%

“…61,62 Identifying potential barriers early and developing specific strategies to overcome those obstacles can assist in making a significant practice change. 63 Leaders need to plan for a long lead time and incremental changes before realizing a successful change. Most reports about starting a new mobilization program in the ICU have described phases of team engagement and implementation that occur over 2 to 3 years.…”

Section: Specific Leadership Activities: Mobility Examplesmentioning

confidence: 99%

“…Staff engagement in the process produces a greater likelihood of effective improvement in patients' outcomes. 1,63 The new guidelines contain 32 practice recommendations and suggestions and 22 statements in the areas of pain, agitation/sedation, and delirium. It is unlikely that all of these practices are currently in place in any given unit; therefore, change can be anticipated.…”

Section: Staff Nurse As Recipient Of Planned Changementioning

confidence: 99%

See 1 more Smart Citation

Pain, Agitation, and Delirium Guidelines: Nurses’ Involvement in Development and Implementation

Davidson

Winkelman

Gélinas

et al. 2015

Critical Care Nurse

The 2013 American College of Critical Care Medicine/Society of Critical Care Medicine clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit serves as a living example of nurses’ involvement in the development and implementation of professional guidelines. Nurses who served on this guideline-writing panel describe their experiences. Specific examples from the pain, agitation, and delirium guidelines for care are used to explore the roles of the nurse leader, nurse informaticist, staff nurse, and nurse researcher in relationship to guideline implementation.

American J Industrial Med

A model for occupational safety and health intervention diffusion to small businesses

Sinclair

Cunningham

Schulte

2013

Background Smaller businesses differ from their larger counterparts in having higher rates of occupational injuries and illnesses and fewer resources for preventing those losses. Intervention models developed outside the United States have addressed the resource deficiency issue by incorporating intermediary organizations such as trade associations. Methods This paper extends previous models by using exchange theory and by borrowing from the diffusion of innovations model. It emphasizes that occupational safety and health (OSH) organizations must understand as much about intermediary organizations as they do about small businesses. OSH organizations (“initiators”) must understand how to position interventions and information to intermediaries as added value to their relationships with small businesses. Examples from experiences in two midwestern states are used to illustrate relationships and types of analyses implied by the extended model. Results The study found that intermediary organizations were highly attuned to providing smaller businesses with what they want, including OSH services. The study also found that there are opinion leader organizations and individual champions within intermediaries who are key to decisions and actions about OSH programming. Conclusions The model places more responsibility on both initiators and intermediaries to develop and market interventions that will be valued in the competitive small business environment where the resources required to adopt each new business activity could always be used in other ways. The model is a candidate for empirical validation, and it offers some encouragement that the issue of sustainable OSH assistance to small businesses might be addressed.