Facilitating EBP
There several strategies for facilitating EBP change related to orthopedic pain management. The report “Future of Nursing: Leading Change, Advancing Health” addresses the process of change in a bid to facilitate the development of patient-centred care (Institute of Medicine, 2011). A practice change involves a change theory, communicating to staff about the change, phases of transition, need for revaluations, supporting staff through the change, monitoring progress, and preventing backwards slip (Barrow & Toney-Butler, 2019).
Key Stakeholders
Orthopedic nurses are the key stakeholders for the proposed EBP change. Taking care of surgical patients is one of their main responsibilities. The nurses monitor and record the patient’s vital signs, monitor the surgical site and track any changes in the patient’s condition, and administer pain medication when necessary (Denness et al., 2017).
The Change Model
A change theory that is most applicable in health care settings was developed by Kurt Lewin. The theory offers a platform for change implementation, management, and evaluation (Wojciechowski et al., 2016). It has three stages: unfreeze, change, and unfreeze. The theory applies in EBP change as it explores forces that influence its implementation both positively and negatively. According to the theory, the forces that promote EBP must be greater than the forces opposing it for change to occur. The first stage (unfreeze) involves identifying the need for change and making necessary arrangements. The second stage (change) is where change is implemented by the introduction of new policies, processes or procedures (Wojciechowski et al., 2016). The final stage (freeze) involves stabilizing the change to prevent a relapse into old ways. Supporting staff through the change is an important aspect of the change process as nurses in clinical settings often cite lack of time and knowledge as the major barriers to EBP implementation (Melnyk, 2016).
An issue that needs to be clear is what non-opioid pain management strategies will be included in multimodal pain management. SORT 1 evidence considered in the evidence table and synthesis produces conflicting results making it difficult to make a firm conclusion on the effects of non-opioid pharmacological strategies.