In the context of implementing the HEART pathway tool, the choice of nursing theory and evidence-based practice (EBP) model is crucial for the success of the project

QUESTION

Would you recommend that others implementing that HEART pathway tool use the same nursing theory and EBP model? Would you suggest a different theory? Why or Why not? Was there a step in the EBP that was particularly criteria to the success of the project? Your results weren’t statistically significant, so would you use a different EBP model based on those results?

Dorothea Orem’s self-care deficit theory and John Kotter’s eight-step change model provided the scientific underpinnings of the project. Orem’s self-care deficit nursing theory was applied to support the need to evaluate ED patients with chest pain to determine whether they have major adverse cardiac events, resulting in an accurate assessment providing an opportunity for timely management associated with a decrease in LOS (Orem, 1971).

According to Orem (1971), self-care deficit nursing theory mainly deals with significant factors such as nursing, humans, the environment, health, and self-care. It is essential to consider patients and their conditions before and after treatment. It was, however, of great importance that all these factors were considered while conducting the QI project and during tests. As stated earlier, many patients suffered after treatment, hence the need for a permanent solution that could help. While considering this theory, many healthcare facilities should ensure that self-care is also considered, which is very helpful for patients after treatment.

ANSWER

In the context of implementing the HEART pathway tool, the choice of nursing theory and evidence-based practice (EBP) model is crucial for the success of the project. In this case, Dorothea Orem’s self-care deficit theory and John Kotter’s eight-step change model were utilized. The question of whether others should use the same nursing theory and EBP model or consider different ones depends on several factors.

Firstly, the choice of nursing theory should align with the specific goals and objectives of the project. Dorothea Orem’s self-care deficit theory is particularly relevant when the project aims to improve patient outcomes by focusing on self-care behaviors. This theory emphasizes the importance of assessing patients’ ability to engage in self-care and providing support when deficits exist. For the HEART pathway tool, which involves assessing and managing chest pain in the emergency department, understanding patients’ self-care capabilities is vital, especially after they leave the hospital.

Secondly, the EBP model, in this case, John Kotter’s eight-step change model, addresses the process of implementing change within an organization. This model provides a structured approach to managing change, which can be highly effective when introducing new tools or protocols like the HEART pathway. Each step in the model, from creating a sense of urgency to anchoring changes in the corporate culture, contributes to the successful adoption of the pathway.

Regarding the results not being statistically significant, this should not necessarily lead to a change in the EBP model. The lack of statistical significance could be due to various factors, such as a small sample size or variations in practice that were not adequately addressed. It’s essential to thoroughly analyze the reasons behind the non-significant results and make appropriate adjustments to the project, rather than immediately switching to a different EBP model.

In summary, the choice of nursing theory and EBP model should be based on the specific objectives and context of the project. Dorothea Orem’s self-care deficit theory and John Kotter’s eight-step change model were suitable for the HEART pathway tool implementation, as they align with the project’s goals of improving patient care and facilitating change management. Rather than changing the EBP model based solely on non-significant results, a more comprehensive analysis of the project’s challenges and potential improvements should be conducted.