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Advancing Research & Clinical Practice through Close Collaboration
Bethanie Muraski BSN, RN, ONC, CMS
Bernadette Melnyk created this model in 1999. She utilized the ARCC model as a strategic planning initiative.
Her ultimate goal was to advance EBP in a medical Center.
Key constructs of the model were based off Ellen Fineout-Overholts' research on the Control theory & surveys.
Purpose
~ To provide clinical settings or Health Care institutions with an organized framework that has the ability to be implemented system wide, while utilizing/sustained use of Evidence Based Practice (EBP) to achieve the best quality outcomes for patients and clinicians.
~The Control Theory was utilized as a guide for the ARCC model.
**this theory tries to resolve a discrepancy between a common theme & a current state. This theory utilizes behaviors to motivate an individual to reach a goal.
Barriers exist in the clinical settings that restrict individuals (nurses & physicians) from being able to utilize EBP
Therefore the Organizational model is needed:
Barriers in Clinical Settings/Health Care Organizations:
* Inadequate knowledge & skill in EBP
*EBP mentors do not exist/ minimal amount of mentors
*No belief in EBP or outcomes r/t EBP
* No authority to be able to change procedures r/t pt. care
* Manager & Leader resistance
CBT is utilized to guide behavioral changes
in individuals (Clinicians/ Physicians etc)
to begin to use EBP.
Example:
Clinicians belief's on EBP
can be strengthened through education,
practice and utilization of skills.
(Bernadette Melnyk, Ohio State University Dean of Nursing and Creator of COPE). Retrieved from https://nursing.osu.edu/news/college-of-nursing-news-headlines/after-newtown.html.
Melnyk & Fineout- Overholt. (2005) Melnyk & Fineout-Overholt's ARCC model. Retrieved from Models to guide implementation and sustainability of evidence-based practice. In B. Melnyk & Fineout-Overholt (Eds.) (2014). P. 291
A Multistep process to implement ARCC into practice
First: Need to assess organizational readiness (by 26 item Likert Scale) this determines the strengths & weaknesses of the organization.
References:
1.Clinicians who gather evidence
2.Innovative decisions start
3.12 month program (to prepare EBP mentors)
6 workshops, 8 days of educational skills, implement 7 step EBP
4.***Baseline assessment on facility needs to be conducted ***
Examples of recent implementation:
Pressure ulcer rate reduction/ Early ambulation
EBPI- measures what was implemented (Clinicians resp w/ 18 quest. likert scale)
SECOND: (KEY COMPONENT) Need for EBP mentors in the system.
(typically APN or Bachelor prepared Nurses)
Dang, D., Melnyk, B, Fineout-Overholt, E., Ciliska, D.,DiCenso, A., Cullen L., ....Stevens, K. (2014).
Models to guide implementation and sustainability of evidence-based practice. In B. Melnyk, & Fineout-Overholt (Eds.), Evidence-based practice in nursing & healthcare: A guide to best practice (3rd ed.) (pp. 274-315), Philadelphia: Lippincott, Williams & Wilkens.
Would you feel capable/ willing to be a Mentor in this program?
THIRD: Utilize EBP belief scale in facility =16 Item Likert scale
(determines value & ability to implement EBP)
WestVirginiaU. (2014, March 6). 2014 WVU Distinguished Alumni: Bernadette Mazurek Melnyk. (Video File). Retrieved from www.youtube.com/watch?v=JbCeGHaI7FU
Then ONTO FINAL step............................
How do you feel about this 12 month program? Too long? Too many steps involved?
Did you realize these recent examples that were implemented were based off EBP?
Kane, J. Miller,R. (2016). After Newtown: Reading, Writing, Therapy. The Ohio State University. Retrieved by
https://nursing.osu.edu/news/college-of-nursing-news-headlines/after-newtown.html . Retrieved on October 25, 2016.
Melnyk & Fineout- Overholt. (2005). Control theory as a conceptual guide for the ARCC model. Retrieved from Models to guide implementation and sustainability of evidence-based practice. In B. Melnyk & Fineout-Overholt (Eds.) (2014). P. 290