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Apply knowledge acquired to the practice of professional nursing to improve a patient outcome, clinical issue, or organizational process. At some point in time, every nurse realizes that there are better ways to provide patient care, better policies to drive patient care, and better ways to organize and lead a patient care area (O’Grady & Malloch, 2013, p. 40). A nurse’s hallmark of excellence is to be able to use the best evidence to support nursing practice and generate new knowledge to identify a patient care problem, improve patient outcomes, address clinical issues, or organizational processes (O’Grady & Malloch, 2013). Practice changes that increase quality of care and safety for patients are the priority for the healthcare professional today. The dynamics of change are best understood when the stakeholders (who), the rationale (why), the content to be changed (what), the timing (when), and the techniques to change (how) are known (O’Grady & Malloch, 2013, p. 43). Identifying a patient care problem, clinical issue, or organizational process can come easily; however clarifying the problem and ideas to a practice or organizational change can be a daunting task (Lusardi, 2012). Various change theories provide a problem-solving approach to implementing planned change. It is up to the nurse leader to select which model is most appropriate based on the specific circumstances of the healthcare environment (Mitchell, 2012). Understanding and using a change theory framework can help the leader and/or change agent(s) increase the change for success. Various forces drive change in healthcare; such as rising cost of treatment, shortage in the workforce, potential to increase patient satisfaction, and promotion of patient and/or staff safety (Mitchell, 2012). However these drivers are also met with restraining forces; such as poorly developed action plans, staff not motivated to change, ineffective communication, and poor leadership. To support change, the nurse needs to know his or her leadership style, strengths and vulnerability, and effective communication and team working skills. He or she must also be open to ideas, have the courage to challenge the status quo, and be comfortable with rational risk taking (Mitchell, p 34). Resources: Lusardi, P (2012). So you want to change practice: Recognizing practice issues and channeling those ideas. Critical Care Nurse, Vol 32, No. 2, pp 55-64. Mitchell, (2013). Selecting the best theory to implement planned change. Nursing Management Vol. 20, No.1: 32-37. http://www.ncbi.nlm.nih.gov/pubmed/23705547 Learning Activity #5: Integrating Nursing Concepts to Identify Change Resources:  Johns Hopkins nursing evidence-based practice: Model and guidelines  Leadership in nursing practice: Changing the landscape of health care.  Called to care: A Christian worldview for nursing. The purpose of this course is to integrate the concepts of nursing practice to develop a proposal that supports a need for change related to one of the following: a patient outcome, clinical issue, or an organizational process. This is not a “hands-on” clinical experience but is about a need for change that you have identified within the healthcare organization. The project must be related to a change that will impact nursing. Write a two page paper where you:  Identify a patient care problem, clinical issue, or organizational process that needs to be changed (resource: PICO Question Template). Describe the nature of the problem and the stakeholders involved.  Identify what needs to be changed and why  Provide the rational for the change supported with evidence from the literature.  Cite your sources in APA format. PICO question 1 : (P): On an inpatient psychiatry unit with patients 18 years and older how does (I): purposeful hourly rounding by nursing staff as compared to (C): not rounding (O):increase patient satisfaction or prevent incidence occurrences?

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