Describe at least three evolving issues that are internal or external to your practicum setting

• 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

central-line infections.


 

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