Evaluation
There will be several aspects of assessing the change plan. First of all, it is necessary to ensure that the planned activities comply with the theoretical framework of the addressed issue. For this, data from relevant academic literature needs to be collected; this data will help confirm that additional patient education, promotion of patient participation, and regular exercise/physical therapy can reduce fall-related risks and injuries.
It is important that this data is specific to the change project and the PICOT question as opposed to general data describing the incidence of the problem or exploring predictive tools (Aizen & Zlotver, 2013). Further, data from the intervention providers (researchers) needs to be collected for the purpose of assessing the mastery of knowledge and skills that are acquired during the training process and needed for the provision of the intervention (see Educational Requirements).
Second, it is necessary to develop methods of evaluating the process of implementing the change plan. A specific method that can be proposed in this regard is collecting patient feedback. Grol, Wensing, Eccles, and Davis (2013) suggest that patient feedback is an important part of evaluating the implementation of change in health care; however, there are the issues of collection and analysis.
The proposed research does not focus on the perception of change; therefore, qualitative data analysis will not be part of assessing patient feedback. At the same time, the intervention providers will be encouraged to ask patients about perceived effects of education and physical therapy. It can be expected that the participants will willingly share their experience of going through the intervention, and their feedback will be a valuable contribution to the change plan; it cannot be ruled out that the providers will consider modifying the implementation plan based on specific suggestions from the patients.
Finally, the key points at which the change plan will be assessed will be program development (step one), baseline measurement process (step two), the provision of the intervention (step three), and evaluation (step four).
During the program development process, the assessment will address the justification of the proposed change plan based on evidence and theory. During the baseline measurement process, the validity of measurements will be assessed based on the relevance of research methods, including sampling and identification of fall-related factors and indicators. During the implementation, assessment will be carried out in the form of collecting patient feedback and feedback from the providers. During the evaluation process, assessment will be based on the results of the intervention after three months of implementation.
Dissemination
In nursing practice (and nursing change processes especially), the dissemination of results and other types of information is a key component because research can bring positive change only if its results are properly disseminated and taken into consideration. The first step in planning the dissemination is identifying stakeholders. The stakeholders in the proposed implementation plan have been previously identified (see Communication Strategies); however, stakeholders should be particularly discussed in the context of dissemination.
They will include administrators, the intervention providers, patients, and the members of the community of nursing care practitioners and theorists. It is noteworthy that, in designing the dissemination strategy, not only the results of the change plan implementation should be considered but also other types of information that will be disseminated as part of the project.
Administrators can be regarded as key stakeholders. It will be their responsibility to make decisions and introduce changes in policies and practices based on the change plan, which is why it is crucial to deliver the research results to them properly. Carter et al. (2014) have studied the preferences of health care facilities’ administrators in terms of channels through which nursing information is supplied, and it has been confirmed that electronic channels are preferred.
Another group of stakeholders consists of the providers, i.e. fellow researchers (see Communication Strategies); dissemination in this context will include the distribution of guidelines. According to Dogherty, Harrison, Graham, and Keeping-Burke (2014), researcher-based facilitation plays a significant role in the dissemination of guidelines, and this should be taken into consideration in the presented project.
The third group—patients—will be provided information in the form of patient education; further, the results of the intervention will be provided to them, too, as the participants will be contacted by the researchers for the specific purpose of confirming or disconfirming that their intervention was effective. Finally, the external stakeholder in the presented change project is the community of nursing care practitioners and theorists. It is important to disseminate information among them so that the results can be used in other nursing studies and intervention, and a way to achieve it is to publish the research (Grove, Burns, & Gray, 2012).
The results will be properly presented and structured according to the requirements of the selected journal. Electronic methods of disseminating information will be primarily employed in the communication with administrators and external audiences; however, in communicating with patients, it is important to establish personal contacts.
References
Aizen, E., & Zlotver, E. (2013). Prediction of falls in rehabilitation and acute care geriatric setting. Journal of Clinical Gerontology and Geriatrics, 4(2), 457-461.
Carter, N., Dobbins, M., Peachey, G., Hoxby, H., Ireland, S., Akhtar-Danesh, N., & DiCenso, A. (2014). Knowledge transfer and dissemination of advanced practice nursing information and research to acute-care administrators. Canadian Journal of Nursing Research, 46(2), 10-27.
Dogherty, E. J., Harrison, M., Graham, I., & Keeping-Burke, L. (2014). Examining the use of facilitation within guideline dissemination and implementation studies in nursing. International Journal of Evidence-Based Healthcare, 12(2), 105-127.
Grol, R., Wensing, M., Eccles, M., & Davis, D. (Eds.). (2013). Improving patient care: The implementation of change in health care (2nd ed.). Hoboken, NJ: John Wiley & Sons.
Grove, S. K., Burns, N., & Gray, J. (2012). The practice of nursing research: Appraisal, synthesis, and generation of evidence (7th ed.). St. Louis, MO: Elsevier.