Essential II requires the DNP prepared nurse to have the knowledge and understanding of evidence-based practice guidelines and quality improvement. This assignment aligns with Essential II because it requires the DNP student to investigate different models for organizational change and select the most appropriate model which would create the most success when implementing the DNP project.

The model I think would provide the most success in implementation of my project would be the ARCC Model. This model combines both control theory and cognitive behavioral theory (Melnyk, 2019). I chose this model for my project because it addresses the use of an EBP mentor to help with implementation. This mentor has the knowledge and skill set of EBP, can provide leadership, problem shoot issues that may arise, and provide education on EBP. The ARCC Model’s conceptual framework is based on the control theory which states that there are discrepancies between a standard or goal and the current state of the facility which should motivate the behaviors of others to achieve the standard or goal (Melnyk, 2019). The ARCC Model identifies 6 barriers to clinicians implementing EBP: 1) inadequate knowledge or skills of EBP, 2) lack of support from administration, 3) no EBP mentor 4) belief that EBP does not improve patient care and outcomes, 5) perceived lack of authority to change current patient care procedures, and 6) leadership resistance (Melnyk, 2019). The ARCC Model incorporates EBP mentors into the healthcare system to help diminish barriers (Melnyk, 2019). The ARCC Model contends that when clinicians’ beliefs about EBP and their ability to implement it into everyday practice is changed by education, support, and skill building, the facility will be able to implement EBP (Melnyk, 2019).

The ARCC Model as it applies to my project:

Assessment of Organizational Culture and readiness for EBP: The Greenville Free Clinic is constantly implementing new or different procedures due to potential funding opportunities. Based on their constant change of procedures, I feel they are likely ready as they have experienced changes before.

Identification of strengths and major barriers to EBP implementation:

Strengths would include strong support from the clinical coordinator, flexibility of most staff members, and the increased number of med students and NP students rotating through the clinic (necessitates providers keep up with changes in EBP).

Potential Barriers include the large number of volunteer staff (nurses and providers), adding more work to staff, and overall disinterest in change with some of the older clinicians.

Use of EBP mentors: Implementation of EBP could offer educational and skill building workshops, provide knowledge to what the overall goal of implementation would mean to the clinic and community. Patients could also be given more education on preventive screenings (cervical and breast cancer) allowing them to make more informed decisions on participation in screening and ease fears of these tests.

Increased EBP implementation: Implementation of this project would hopefully provide increased cervical and breast cancer screenings leading to earlier cancer detection rates, thus providing a cost savings for stakeholders.

References

Melnyk, B. F.-O. (2019). Evidence-Based Practice in Nursing and Healthcare: A Guide to Best Practice (4 ed.). Philadelphia: Wolters Kluwer.