Influencing Multiple Systems through Evidence-Based Change (1 page) Write a cohesive response that addresses the following: • Describe at least three evolving issues that are internal or external to your practicum setting that could affect the implementation and sustainability of your proposed change. From what systems level do those issues originate (e.g., organizational, local, state, national, global) and what other systems are then involved in response to that factor? • How might your proposed change, in turn, lead to shifts at other levels beyond your initial focus? Readings • Bevan, H. (2010). How can we build skills to transform the healthcare system? Journal of Research in Nursing, 15(2), 139–148. doi:10.1177/1744987109357612 Retrieved from the Walden Library databases. This article addresses the need to invest in leadership skill building and shifts in mindset to promote large-scale change. • Gifford, W., Davies, B., Tourangeau, A., & Lefebre, N. (2011). Developing team leadership to facilitate guideline utilization: Planning and evaluating a 3- month intervention strategy. Journal of Nursing Management, 19(1), 121–132. doi:10.1111/j.1365-2834.2010.01140.x Retrieved from the Walden Library databases. The authors discuss operationalizing leadership behaviors that can help to further evidence-based practice. • Goeschel, C. A. (2011). Nursing leadership at the crossroads: Evidence-based practice “Matching Michigan-minimizing catheter related blood stream infections.” BACCN Nursing in Critical Care, 16(1), 35–42. Nursing leadership at the crossroads: evidence-based practice ‘Matching Michigan-minimizing catheter related blood stream infections’ by Goeschel, C., in Nursing in Critical Care, Vol. 16/Issue 1. Copyright 2011 by Blackwell Publishing – Journal. Reprinted by permission of Blackwell Publishing – Journal via the Copyright Clearance Center. This article features lessons learned from the implementation of evidence-based practice in more than 100 ICUs across the United States. • Mathews, S. C., & Pronovost, P. J. (2011). The need for systems integration in health care. JAMA,305(9), 934–935. Retrieved from the Walden Library databases. In this article, the authors discuss the need for systems integration in order to promote quality and safety on a larger scale. • Pronovost, P. J., Marsteller, J. A., & Goeschel, C. A. (2011). Preventing bloodstream infections: A measurable national success story in quality improvement. Health Affairs, 30(4), 628–634. doi:10.1377/hlthaff.2011.0047 Retrieved from the Walden Library databases. The authors discuss the multi-step process taken by many stakeholders (e.g., states, federal agencies, hospitals, clinicians) to successfully reduce and eradicate

Using Evidence-Based Change to Influence Multiple Systems (1 page)


In your response, be sure to touch on the following points:
• Identify at least three developing problems, either inside or outside of your practicum environment, that might have an impact on the success and sustainability of your suggested adjustment. What other systems are then involved in response to that element, and from what level of systems (e.g., organisational, local, state, national, and global) do those issues originate?
• How would the proposed adjustment affect things at levels other than the one on which it was first focused?

Readings
Howard Bevan (2010) How can we develop the necessary skills to change the healthcare system? doi:10.1177/1744987109357612 Journal of Research in Nursing, 15(2), 139–148.
retrieved from the databases of the Walden Library.
This article discusses the necessity of making investments in attitude changes and the development of leadership skills to support systemic transformation.
• Lefebre, N.; Gifford, W.; Davies, B.; Tourangeau, A. (2011) Creating team leadership to promote the use of guidelines: developing a 3-month intervention plan doi:10.1111/j.1365-2834.2010.01140.x Journal of Nursing Management, 19(1), 121–132.
retrieved from the databases of the Walden Library.
The authors talk about how to operationalize leadership actions that can advance evidence-based practice.
(2011). Goeschel, C. A. Evidence-based practice is the fork in the road for nursing leadership. “Matching Michigan-reducing bloodstream infections associated with catheters”
Critical Care Nursing, 16(1), 35–42, BACCN.
Evidence-based nursing leadership is at a crossroads. In Nursing in Critical Care, Vol. 16/Issue 1, article by Goeschel, C., “Matching Michigan-minimising catheter-related blood stream infections,” Blackwell Publishing: Journal, 2011. Copyright. Reprinted with permission from the Copyright Clearance Centre and Blackwell Publishing—Journal
Lessons from the adoption of evidence-based practice in more than 100 ICUs across the United States are presented in this article.
• Pronovost, P. J., & Mathews, S. C. (2011) System integration is necessary in the healthcare industry. JAMA,305(9), 934-935.
retrieved from the databases of the Walden Library.
The authors of this paper talk about how systems integration is necessary to advance quality and safety on a larger scale.
Pronovost, P. J., Marsteller, J. A., and Goeschel (2011) A measurable national success story in quality improvement: preventing bloodstream infections
628–634 in Health Affairs, 30(4) doi:10.1377/hlthaff.2011.0047
retrieved from the databases of the Walden Library.
The authors go over the multi-stage procedure used by numerous parties (such as states, federal organisations, hospitals, and doctors) to successfully remove

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