1. Journal of Soc. & Psy. Sci. 2018 Volume 11 (1): 51-55
Available at: www.jspsciences.org
HISTORY OF PSYCHOLOGY AND THE ROLE OF ETHICS
IN THE DISCIPLINE
Ian Lawson
ABSTRACT
This paper discusses some of the moral and ethical issues
2. associated with psychological
research throughout history. This is a very broad area which
covers a vast array of topics.
However, it is not within the scope of this paper of focusing on
absolutely every single aspect
of this area. Thus, not sacrificing depth of analysis, the present
paper brings relevant issues
for discussion by examining some key areas including,
schizophrenia, and gender and IQ
research, as well as hypothesis and significance testing, which
normally constitutes the basis
for changes in ethics and research development. These areas
have become paradigmatic for
much criticism concerning its moral and ethical implications for
individuals who received
diagnostic labels as a consequence of such research. This paper
takes the position that the very
practice of uncritically presenting such research as being ‘value
free’ or as some form of
universal and absolute truth is in itself a cause for major ethical
concerns.
Keywords: Critical Psychology, history of psychology, IQ,
Schizophrenia
4. should also be noted that early research being carried out in
human participants
involved deliberate violation of ethics conduct (Mandal,
Acharya & Parija, 2011).
For instance, in 1946 the American tribunal brought leading
German physicians to
justice due gross negligence of ethics and crimes against
humanity. More
specifically, these physicians were being tried mainly due to
conducting medical
experiments on thousands of concentration camp prisoners
without their consent.
As a result of such experiments most prisoners would either be
permanently disabled
or would die (Mandal, Acharya & Parija, 2011). It should be
evident that much of
such atrocities were carried out in the name of scientific
progress, which seems to
be the usual argument for changes and negligence in ethics.
When it comes to examining epistemological and ontological
stand point of
scientific underpinnings of mainstream psychology it should be
5. evident that many
constructs emerging through psychological research have not
withstood the test of
time. For example psychological ‘problems’ such as Gender
Identity Disorder have
been treated as an objective fact, and treatment for such
condition had quite often
involve electroconvulsive therapy For instance when examining
abnormal behaviour
one must take into account what are the culturally and
historically dominant notions
of normality and ‘normal’ behaviour. In every time in history
socially acceptable
forms of behaviour are bound to change. In other words,
notions of ‘normality’ are
very subjective, culturally specific, and contingent upon socio-
economic and
historical factors. In this way, the objectification of normal
behaviour, and the
subsequent objectification of abnormality is by no means trivial.
It follows that one
of the problems with the scientific method is the fact that its
popular hypothesis
testing paradigm has some flaws. Quite often researchers
6. naively assume that a
significant relationship between two variables implies causality.
In most cases, even
if there is an association between two variables, the direction of
causality may not
always be evident (Shadish, Cook & Campbell, 2002).
Additionally, an association between two variables may not
even imply a causal
relationship. This is particularly due to the fact that there are a
myriad of variables
co-occurring when individuals are situated in their normal day-
to-day environmental
settings studies (Shadish, Cook & Campbell, 2002). Most of
these variables cannot
be completely controlled under experimental settings, and
laboratories do not reflect
real life situations. Thus, it should be noted that the
statistically significant p value
http://oxford-mosaic.co.uk/
Journal of Soc. & Psych. Sci. (2018) Vol.11 (1): 51-55
Ian Lawson 53
8. discourse or
particular version of the truth, and not necessarily the absolute
truth. It is the failure
of acknowledging this fact which has led to several ethical and
moral issues in
psychological research, theory and practice.
It has been argued that psychological research cannot be value
free given that
researchers impinge their own values upon the research process
(Norman, 2013). In
addition, the very fact that, for instance the UK Government
drafts the mental health
bill together with the British Psychological Society further
suggests that there are
real socio-political implications of psychological research.
More specifically, the
dynamics between research and politics can result in limiting
educational and career
opportunities for individuals who have been given a diagnostic
label. However, one
should not deny the physicality of symptoms attached to such
labels, as there are
9. very tangible. It only becomes problematic when psychologist
disregard wider
social factors which are also implicated in the aetiology of such
diagnostic labels
There is dimension to reality which is not objectively
measurable, and this is true
even in ‘hard’ sciences such as physics (Bohm, 2002). For
instance, under
experimental conditions subatomic particles behave either as
particles or as waves.
In this respect, it has been found that the shift from wave to
particle and vice-versa
is mediated by the observer. More specifically, when one is
observing it, matter
behaves as a particle, and when one is not looking at it behaves
as waves (Bohm,
2002). From this vantage point one must conclude that
subjective experience is just
a worthy of studying as it is objective experience. This is a
very important point
given that it challenges the very ontological and
epistemological foundations of the
scientific method as well as its justifications for changes in
ethics in the name of
11. and brain region has been implicated in its aetiology (Bentall,
2003). In this way,
it is important that one approaches changes in ethics in the
name of scientific
progress with much reticence and academic scrutiny.
CONCLUSION
In conclusion, it should be evident that one of the main reasons
why many ethics
fallacies and flaws of throughout history arose from the fact
that mainstream
psychological research maintained the ideological position that
it is a value-free and
objective endeavour. Contrary to what it advocates, one has
witnessed throughout
history sets of theories and research being replaced as such
knowledge is disproved
as conducting research on humans subjects is by no means
trivial given that humans
attach subjective meaning to things, other people and situations.
This makes the
12. outcome of the research process very unpredictable. In this
way, one should note
that much of changes and development of ethics in Psychology
where grounded in
the argument that such changes are inevitable in order to avoid
hindering scientific
progress. In this way, one must conclude that so long as
mainstream psychological
discourses concerning individuals’ mental health remain hidden
and inexplicit, its
scientific credibility and ethical and moral underpinnings will
remain questionable.
REFERENCES
Wlash, R.T.G, Teo, T. & Baydala, A. (2014). A Critical History
and Philosophy of
Psychology. Cambridge: Cambridge University Press
Bennett, C. M., Miller, M. B., & Wolford, G. L. (2009). Neural
correlates of
interspecies perspective taking in the post-mortem Atlantic
Salmon: An
14. DTI: Artifacts, Tips,
and Tricks. In Clinical Functional MRI (pp. 313-336). Springer
Berlin
Heidelberg.
Mandal, J., Acharya, S., & Parija, S. C. (2011). Ethics in human
research. Tropical
Parasitology, 1(1), pp.2–3.
Boyle, M. (2002) Schizophrenia: A Scientific Delusion?
London: Routledge
Boyle, M. (2004) ‘Schizophrenia’ and Genetics: Does critical
thought stop here? The
Journal of Critical Psychology, Counselling and Psychotherapy.
Vol. 4 (2)
78-85
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Our Caring Culture-Your Nursing Destiny
Illustration
This section will contain an ongoing case study illustrating
some of the critical thinking and reflection of a nurse related to
the weekly learning objectives. We will follow Nurse Daniel
through his planning process involving a possible nursing
practice change on his unit. The process he uses will parallel
the process you will use in selecting a clinical topic, locating
evidence through a systematic review, and applying the ACE
Star Model of Knowledge Transformation (Stevens, 2013) in
planning a change.
Daniel has been an RN for 12 years and works on a Medical-
Surgical unit at a community hospital. He is completing his
BSN program in a few weeks and is being mentored by his
supervisor, the current Unit Manager, who will soon be retiring.
Daniel will be promoted to that leadership position shortly after
graduating. Daniel is aware of challenges that are impacting
patient outcome measures. Daniel is also cognizant of his own
strengths and limitations and is currently developing a plan to
address the unit patient issues, communicate effectively, and
stay engaged with his peers, as well as maintaining his own
positive health status.
Week 2: Lesson - Illustration
Illustration
Daniel has identified a practice issue on his unit that he would
like to address for better patient outcomes. The number of
health-associated infections (HAI's) have been increasing for
patients with central lines on his unit. The current Unit Manager
has alerted Daniel to the fact that infection rates of patients on
16. the unit have increased by 35% in the past year. Daniel is
unsure of the exact nature and cause of this increase but
suspects there may be non-adherence to policies and/or
procedural errors. As he reflects on this, he also becomes aware
that when his role changes to the new Unit Manager, this issue
will take on renewed importance and accountability. Deciding
to be proactive, Daniel begins to search for a systematic review
that could be used as part of an evidence summary for quality
improvement with the HAI issue. He also plans to inquire about
the unit data and other in-house information that might be
pertinent. After discussing his plan with the Unit Manager,
Daniel decides to use the Cochrane Database of Systematic
Reviews to find an appropriate systematic review. His manager
suggests he also use the ACE Star Model as a strategy for
looking at the evidence and planning a possible change of
practice.
After searching the Cochrane Database, Daniel located a
systematic review that aligned with his topic issue. He has
decided to use a PICOT format to further clarify what he is
wanting to summarize and plan. As far as the scope of this
practice issue, Daniel also found slight increases in the numbers
of HAI on other units within the facility for patients with
central lines. His thinking is that the nurses may be missing the
signs of infection through irregular assessment and monitoring.
Therefore, his PICOT contains the following:
· P=Patients over the age of 25 years with central lines
· I=Develop and implement an early detection system on his
unit to compare with another unit
· C=The comparison of the 2 units related to the number of
infections (HAI) on each unit
· O=The targeted outcome would be a decrease in central line
infections
· T=The timeframe would be for a 6 month period of trial time
Daniel knows it will be important to justify his rationale for this
type of trial, so he is preparing to summarize the discovered
evidence. His Unit Manager has informed him that any trial
17. involving a possible change of practice requires submission of
evidence from the literature and presentation of the practice
issue and evidence summary to the Unit Council for
consideration. Daniel plans to recommend a Modified Early
Warning Scoring (MEWS) system and emphasize the dangers of
HAIs, patient safety concerns, unsatisfactory patient outcomes,
and the variances in nursing practice from unit to unit in caring
for patients with central lines.
For his evidence summary, Daniel hopes to convey:
· a statement of the problem and the possible related nursing
practices that may be contributing factors
· the PICOT outline
· the chosen systematic review (related to improving
professional adherence to guidelines for prevention of device-
related infections)
· a summary of the review as it relates to the identified practice
issue and suggested interventions to improve patient outcomes
As Daniel prepares his documentation, he is also aware that the
Unit Council will want to know more about his implementation
plan. He plans to address any limitations from the systematic
review and how this could impact a trial.
Week 3: Lesson - Illustration
Illustration
Daniel continues to think about a change intervention to support
patient outcome improvement with HAIs. He begins searching
practice guidelines and standards in order to further assess the
feasibility of his planned intervention. His Unit Manager has
suggested he do this in order to strengthen his rationale for this
change and add to the evidence from the unit/hospital data and
his chosen systematic review. Daniel has located and retrieved
information from several other sources to add to his data and
review. These include HAI-related articles and video
presentations from the Centers for Disease Control and
Prevention (CDC), The Joint Commission, and the Agency for
Healthcare Research and Quality (AHRQ). He also retrieved a
scholarly article about Modified Early Warning Scores (MEWS)
18. describing how this system might be implemented. He plans to
use all of this material in thinking about his recommendations
for change.
STAKEHOLDERS
Please watch the following video on Stakeholders:
<span itemprop='thumbnail'
content='http://cfvod.kaltura.com/p/2363221/sp/2363221/thumb
nail/entry_id/0_1yxlriq1/version/100002'></span>
Daniel begins critically thinking about the possible costs of a
change intervention and the stakeholders involved. He is aware
that his organization requires permission to be obtained prior to
trialing a change. Securing permission involves communication
with all of the stakeholders for the change to be successful. He
considers the culture of his organization, the informal and
formal power structures, and the types of interactions he
experiences with other nurses on his unit. Daniel is also aware
of how change can be perceived differently by individuals so
relating any potential changes to peers will require sensitivity
and support. He knows his presentation to the Unit Council is a
critical step in gaining further permission to proceed. In his
hospital, the chairperson of the Unit Council will then make a
presentation to the Quality Council for final approval.
Previous
Week 4: Lesson - Illustration
Illustration
Daniel continues to work through the steps of the ACE Star
Model (Stevens, 2013) as he further develops his intervention
plan. In reviewing his scope of evidence, Daniel concludes that
there are a number of variations in HAI prevention throughout
organizations. Based on this, he decides to proceed with a plan
to include the MEWS (AHRQ, Innovations, n.d.) system as well
as periodic education sessions for nurses regarding central line
best practices. Daniel works with his Unit Manager to create a
19. plan to include the resources needed to initiate a trial of this
system. Resource allocation is a critical factor for this
intervention, therefore Daniel wants to also present evidence of
the positive outcomes of using a MEWS (AHRQ, Innovations,
n.d.) system based on experiences from other facilities. His Unit
Manager has arranged a conference call to include Daniel and
an assistant nursing director friend who currently uses the
MEWS (AHRQ, Innovations, n.d.) system on her unit in a
similar-sized community hospital.
During his conference call, Daniel learned that the patient
outcome data indicated a positive impact due to an increase in
nursing awareness and knowledge of HAIs as well as
documenting of symptoms. However, there were still issues with
nurse response times to patients whose symptoms changed. This
information was helpful for Daniel and confirmed his
intervention ideas of including an ongoing nursing education
component as part of the introduction of an early warning
system. With this added information, Daniel suggests to the
Unit Manager that prior to his initial presentation to the Unit
Council, education department personnel may need to be
consulted regarding the feasibility of a related ongoing
education initiative.
Daniel continues to identify team members in his plan and
define their roles and responsibilities in this process. His
thinking also includes attention to patient safety and
satisfaction as well as the costs involved. Team members will
include professionals from other disciplines. These members
will also need educated regarding the MEWS (AHRQ,
Innovations, n.d.) scoring system.
Daniel develops a timeline for the six month trial, including a
pre-trial education period for the team members on the unit.
Infection rates will be monitored as part of the data collection
after the MEWS (AHRQ, Innovations, n.d.) system is in place
for the trial. He and his Unit Manager complete a cost analysis
of the trial resources to be used, including the costs incurred
when patients develop central line infections, as a way to
20. demonstrate how infection prevention will actually result in a
cost savings.
Previous
Week 5: Lesson - Illustration
Illustration
Daniel decides to prepare his presentation for the Unit Council
in hopes of gaining support for his change process plan. His
presentation will include the following:
· An overview of the ACE Star Model (Stevens, 2013) as a
method to incorporate a change process with supportive
evidence. This lets the Unit Council know he is using an
evidence-based process in his assessment and planning efforts.
· An explanation of the problem identified, the scope of the
problem, and an evidence summary will be detailed. He will
include his PICOT question here.
· The evidence summary will include:
· potential interventions identified in a systematic review and
other scholarly sources;
· specific data from his unit and other units in the hospital;
· information from professional practice guidelines and sources
such as the CDC and Joint Commission; and,
· the information from his conference call regarding the use of
early warning systems.
· Recommendations for change are described and based on the
evidence summary.
· The identification of the stakeholders, the practice area, team
member roles and responsibilities, and the required resources
needed are included.
· The Action Plan including:
· the activities of the team involved through the process,
· ways to inform the staff of the plan,
· inclusion of data worksheets, tip sheets, and protocols;
· the coordination of ongoing weekly updates and education of
staff, and
· the timeline to be used.
21. For the evaluation process, Daniel plans to include: a strategy
for evaluating the results, who is to be involved in this
collaboration, and next steps before disseminating information
about the findings. Comparative measurable data outcomes will
be recorded over the 6 month period with the hope that the
MEWS intervention and education sessions will result in a
decrease in central line infections on the unit. Daniel plans to
use a bar chart throughout the timeline to illustrate the results
on a poster within the unit.
If results are positive in decreasing the unit HAI rates, the
decision for key hospital leaders will be to consider using a
permanent warning system throughout the facility and then
allocating the resources needed to accomplish this.
Daniel and his Unit Manager meet to go through the
presentation content. Daniel is planning to use a PowerPoint
presentation at the Unit Council meeting and also provide
handouts to include his timeline, data worksheets to be used in
the process, and the references and permalink to the systematic
review article from the hospital library. His Unit Manager
reminds him there are a few nurses she identifies as informal
leaders on the unit that might be somewhat resistant to this type
of change. These nurses are experienced and outspoken and
have influence with their peers. Daniel considers ways to
address this issue in hopes of gaining informal leader support.
Previous
Week 6: Lesson - Illustration
Transformational Leadership
Illustration
Daniel has successfully presented his change process proposal
to the Unit Council and has received support for this practice
change for the 6 month time period. He decided to invite two of
the informal nurse leaders from his unit to the Unit Council
meeting. They have been asked to serve as unit champions
throughout the change process. This helped Daniel ensure these
nurses were supportive of the plan and were willing to be
involved. He understands the great influence informal leaders
22. have and how valuable they are to the process. The Unit Council
members accepted the idea of nurse champions to assist. This
meeting helped reinforce the goals and the roles and
responsibilities of those involved in this interprofessional team.
Daniel and the designated unit champions meet to discuss the
tracking process involved in implementing this change. They
will be using a form for tracking outcomes during this trial. The
unit champions will be assisting in tracking data as well as the
nurse response times to fluctuations in patient vital signs or lab
findings. At the end of this implementation in 6 months, the
results will be compared to the stated measurable outcome goals
in order to determine success of the change.
Daniel and his Unit Manager discuss the specific elements they
want to include in ongoing education sessions with the staff.
They will need to collaborate with the Nursing Education
Director to plan this weekly series. Daniel is also interested in
receiving staff feedback throughout the process and thinks the
education sessions might serve as a time to survey staff or have
a discussion.
Moving forward in the process, Daniel schedules his meeting
with the Nursing Education Director to outline content. In these
sessions, he is wanting to review policies and protocols already
in place and emphasize best practices for central line infection
prevention. Meanwhile, his Unit Manager agrees to work with
the Chief Nursing Officer and other leaders to coordinate
scheduling for unit staff to attend the educational sessions.
Previous
Our Caring Culture-Your Nursing Destiny
Illustration
This section will contain an ongoing case study illustrating
some of the critical thinking and reflection of a nurse related to
the weekly learning objectives. We will follow Nurse Daniel
through his planning process involving a possible nursing
practice change on his unit. The process he uses will parallel
23. the process you will use in selecting a clinical topic, locating
evidence through a systematic review, and applying the ACE
Star Model of Knowledge Transformation (Stevens, 2013) in
planning a change.
Daniel has been an RN for 12 years and works on a Medical-
Surgical unit at a community hospital. He is completing his
BSN program in a few weeks and is being mentored by his
supervisor, the current Unit Manager, who will soon be retiring.
Daniel will be promoted to that leadership position shortly after
graduating. Daniel is aware of challenges that are impacting
patient outcome measures. Daniel is also cognizant of his own
strengths and limitations and is currently developing a plan to
address the unit patient issues, communicate effectively, and
stay engaged with his peers, as well as maintaining his own
positive health status.
Week 2: Lesson - Illustration
Illustration
Daniel has identified a practice issue on his unit that he would
like to address for better patient outcomes. The number of
health-associated infections (HAI's) have been increasing for
patients with central lines on his unit. The current Unit Manager
has alerted Daniel to the fact that infection rates of patients on
the unit have increased by 35% in the past year. Daniel is
unsure of the exact nature and cause of this increase but
suspects there may be non-adherence to policies and/or
procedural errors. As he reflects on this, he also becomes aware
that when his role changes to the new Unit Manager, this issue
will take on renewed importance and accountability. Deciding
to be proactive, Daniel begins to search for a systematic review
that could be used as part of an evidence summary for quality
improvement with the HAI issue. He also plans to inquire about
the unit data and other in-house information that might be
pertinent. After discussing his plan with the Unit Manager,
24. Daniel decides to use the Cochrane Database of Systematic
Reviews to find an appropriate systematic review. His manager
suggests he also use the ACE Star Model as a strategy for
looking at the evidence and planning a possible change of
practice.
After searching the Cochrane Database, Daniel located a
systematic review that aligned with his topic issue. He has
decided to use a PICOT format to further clarify what he is
wanting to summarize and plan. As far as the scope of this
practice issue, Daniel also found slight increases in the numbers
of HAI on other units within the facility for patients with
central lines. His thinking is that the nurses may be missing the
signs of infection through irregular assessment and monitoring.
Therefore, his PICOT contains the following:
· P=Patients over the age of 25 years with central lines
· I=Develop and implement an early detection system on his
unit to compare with another unit
· C=The comparison of the 2 units related to the number of
infections (HAI) on each unit
· O=The targeted outcome would be a decrease in central line
infections
· T=The timeframe would be for a 6 month period of trial time
Daniel knows it will be important to justify his rationale for this
type of trial, so he is preparing to summarize the discovered
evidence. His Unit Manager has informed him that any trial
involving a possible change of practice requires submission of
evidence from the literature and presentation of the practice
issue and evidence summary to the Unit Council for
consideration. Daniel plans to recommend a Modified Early
Warning Scoring (MEWS) system and emphasize the dangers of
HAIs, patient safety concerns, unsatisfactory patient outcomes,
and the variances in nursing practice from unit to unit in caring
for patients with central lines.
For his evidence summary, Daniel hopes to convey:
· a statement of the problem and the possible related nursing
practices that may be contributing factors
25. · the PICOT outline
· the chosen systematic review (related to improving
professional adherence to guidelines for prevention of device-
related infections)
· a summary of the review as it relates to the identified practice
issue and suggested interventions to improve patient outcomes
As Daniel prepares his documentation, he is also aware that the
Unit Council will want to know more about his implementation
plan. He plans to address any limitations from the systematic
review and how this could impact a trial.
Week 3: Lesson - Illustration
Illustration
Daniel continues to think about a change intervention to support
patient outcome improvement with HAIs. He begins searching
practice guidelines and standards in order to further assess the
feasibility of his planned intervention. His Unit Manager has
suggested he do this in order to strengthen his rationale for this
change and add to the evidence from the unit/hospital data and
his chosen systematic review. Daniel has located and retrieved
information from several other sources to add to his data and
review. These include HAI-related articles and video
presentations from the Centers for Disease Control and
Prevention (CDC), The Joint Commission, and the Agency for
Healthcare Research and Quality (AHRQ). He also retrieved a
scholarly article about Modified Early Warning Scores (MEWS)
describing how this system might be implemented. He plans to
use all of this material in thinking about his recommendations
for change.
STAKEHOLDERS
Please watch the following video on Stakeholders:
<span itemprop='thumbnail'
content='http://cfvod.kaltura.com/p/2363221/sp/2363221/thumb
nail/entry_id/0_1yxlriq1/version/100002'></span>
Daniel begins critically thinking about the possible costs of a
26. change intervention and the stakeholders involved. He is aware
that his organization requires permission to be obtained prior to
trialing a change. Securing permission involves communication
with all of the stakeholders for the change to be successful. He
considers the culture of his organization, the informal and
formal power structures, and the types of interactions he
experiences with other nurses on his unit. Daniel is also aware
of how change can be perceived differently by individuals so
relating any potential changes to peers will require sensitivity
and support. He knows his presentation to the Unit Council is a
critical step in gaining further permission to proceed. In his
hospital, the chairperson of the Unit Council will then make a
presentation to the Quality Council for final approval.
Previous
Week 4: Lesson - Illustration
Illustration
Daniel continues to work through the steps of the ACE Star
Model (Stevens, 2013) as he further develops his intervention
plan. In reviewing his scope of evidence, Daniel concludes that
there are a number of variations in HAI prevention throughout
organizations. Based on this, he decides to proceed with a plan
to include the MEWS (AHRQ, Innovations, n.d.) system as well
as periodic education sessions for nurses regarding central line
best practices. Daniel works with his Unit Manager to create a
plan to include the resources needed to initiate a trial of this
system. Resource allocation is a critical factor for this
intervention, therefore Daniel wants to also present evidence of
the positive outcomes of using a MEWS (AHRQ, Innovations,
n.d.) system based on experiences from other facilities. His Unit
Manager has arranged a conference call to include Daniel and
an assistant nursing director friend who currently uses the
MEWS (AHRQ, Innovations, n.d.) system on her unit in a
similar-sized community hospital.
During his conference call, Daniel learned that the patient
outcome data indicated a positive impact due to an increase in
27. nursing awareness and knowledge of HAIs as well as
documenting of symptoms. However, there were still issues with
nurse response times to patients whose symptoms changed. This
information was helpful for Daniel and confirmed his
intervention ideas of including an ongoing nursing education
component as part of the introduction of an early warning
system. With this added information, Daniel suggests to the
Unit Manager that prior to his initial presentation to the Unit
Council, education department personnel may need to be
consulted regarding the feasibility of a related ongoing
education initiative.
Daniel continues to identify team members in his plan and
define their roles and responsibilities in this process. His
thinking also includes attention to patient safety and
satisfaction as well as the costs involved. Team members will
include professionals from other disciplines. These members
will also need educated regarding the MEWS (AHRQ,
Innovations, n.d.) scoring system.
Daniel develops a timeline for the six month trial, including a
pre-trial education period for the team members on the unit.
Infection rates will be monitored as part of the data collection
after the MEWS (AHRQ, Innovations, n.d.) system is in place
for the trial. He and his Unit Manager complete a cost analysis
of the trial resources to be used, including the costs incurred
when patients develop central line infections, as a way to
demonstrate how infection prevention will actually result in a
cost savings.
Previous
Week 5: Lesson - Illustration
Illustration
Daniel decides to prepare his presentation for the Unit Council
in hopes of gaining support for his change process plan. His
presentation will include the following:
· An overview of the ACE Star Model (Stevens, 2013) as a
method to incorporate a change process with supportive
evidence. This lets the Unit Council know he is using an
28. evidence-based process in his assessment and planning efforts.
· An explanation of the problem identified, the scope of the
problem, and an evidence summary will be detailed. He will
include his PICOT question here.
· The evidence summary will include:
· potential interventions identified in a systematic review and
other scholarly sources;
· specific data from his unit and other units in the hospital;
· information from professional practice guidelines and sources
such as the CDC and Joint Commission; and,
· the information from his conference call regarding the use of
early warning systems.
· Recommendations for change are described and based on the
evidence summary.
· The identification of the stakeholders, the practice area, team
member roles and responsibilities, and the required resources
needed are included.
· The Action Plan including:
· the activities of the team involved through the process,
· ways to inform the staff of the plan,
· inclusion of data worksheets, tip sheets, and protocols;
· the coordination of ongoing weekly updates and education of
staff, and
· the timeline to be used.
For the evaluation process, Daniel plans to include: a strategy
for evaluating the results, who is to be involved in this
collaboration, and next steps before disseminating information
about the findings. Comparative measurable data outcomes will
be recorded over the 6 month period with the hope that the
MEWS intervention and education sessions will result in a
decrease in central line infections on the unit. Daniel plans to
use a bar chart throughout the timeline to illustrate the results
on a poster within the unit.
If results are positive in decreasing the unit HAI rates, the
decision for key hospital leaders will be to consider using a
29. permanent warning system throughout the facility and then
allocating the resources needed to accomplish this.
Daniel and his Unit Manager meet to go through the
presentation content. Daniel is planning to use a PowerPoint
presentation at the Unit Council meeting and also provide
handouts to include his timeline, data worksheets to be used in
the process, and the references and permalink to the systematic
review article from the hospital library. His Unit Manager
reminds him there are a few nurses she identifies as informal
leaders on the unit that might be somewhat resistant to this type
of change. These nurses are experienced and outspoken and
have influence with their peers. Daniel considers ways to
address this issue in hopes of gaining informal leader support.
Previous
Week 6: Lesson - Illustration
Transformational Leadership
Illustration
Daniel has successfully presented his change process proposal
to the Unit Council and has received support for this practice
change for the 6 month time period. He decided to invite two of
the informal nurse leaders from his unit to the Unit Council
meeting. They have been asked to serve as unit champions
throughout the change process. This helped Daniel ensure these
nurses were supportive of the plan and were willing to be
involved. He understands the great influence informal leaders
have and how valuable they are to the process. The Unit Council
members accepted the idea of nurse champions to assist. This
meeting helped reinforce the goals and the roles and
responsibilities of those involved in this interprofessional team.
Daniel and the designated unit champions meet to discuss the
tracking process involved in implementing this change. They
will be using a form for tracking outcomes during this trial. The
unit champions will be assisting in tracking data as well as the
nurse response times to fluctuations in patient vital signs or lab
findings. At the end of this implementation in 6 months, the
results will be compared to the stated measurable outcome goals
30. in order to determine success of the change.
Daniel and his Unit Manager discuss the specific elements they
want to include in ongoing education sessions with the staff.
They will need to collaborate with the Nursing Education
Director to plan this weekly series. Daniel is also interested in
receiving staff feedback throughout the process and thinks the
education sessions might serve as a time to survey staff or have
a discussion.
Moving forward in the process, Daniel schedules his meeting
with the Nursing Education Director to outline content. In these
sessions, he is wanting to review policies and protocols already
in place and emphasize best practices for central line infection
prevention. Meanwhile, his Unit Manager agrees to work with
the Chief Nursing Officer and other leaders to coordinate
scheduling for unit staff to attend the educational sessions.
Previous
1
Week 6 Assignment: EBP Change Process form
ACE Star Model of Knowledge Transformation
Follow Nurse Daniel as your process mentor in the weekly
Illustration section of the lesson.
Name: _____________________
Star Point 1: Discovery (Identify topic and practice issue)
Identify the topic and the nursing practice issue related to this
topic. (This MUST involve a nursing practice issue.)
Briefly describe your rationale for your topic selection. Include
the scope of the issue/problem.
31. Star Point 2: Summary (Evidence to support need for a change)
Describe the practice problem in your own words and formulate
your PICOT question.
List the systematic review chosen from the Cochrane Database
of Systematic Reviews from the Chamberlain library. Type the
complete APA reference for the systematic review selected.
List and briefly describe other sources used for data and
information. List any other optional scholarly source used as a
supplement to the systematic review in APA format.
Briefly summarize the main findings (in your own words) from
the systematic review and the strength of the evidence.
Outline one or two evidence-based solutions you will consider
for the trial project.
32. Star Point 3: Translation (Action Plan)
Identify care standards, practice guidelines, or protocols that
may be in place to support your intervention planning (These
may come from your organization or from the other sources
listed in your Summary section in Star Point 2).
List your stakeholders (by title and not names; include yourself)
and describe their roles and responsibilities in the change
process (no more than 5).
What specifically is your nursing role in the change process?
Other nursing roles?
List your stakeholders by position titles (charge nurse,
pharmacist, etc.).-Why are the members chosen (stakeholders)
important to your project?
What type of cost analysis will be needed prior to a trial? Who
needs to be involved with this?
33. Star Point 4: (Implementation)
Describe the process for gaining permission to plan and begin a
trial. Is there a specific group, committee, or nurse leaders
involved?
Describe the plan for educating the staff about the change
process trial and how they will be impacted or asked to
participate.
Outline the implementation timeline for the change process
(start time/end time, what steps are to occur along the timeline).
List the measurable outcomes based on the PICOT. How will
these be measured?
What forms, if any, might be used for recording purposes during
the pilot change process. Describe.
What resources are available to staff (include yourself) during
the change pilot?
Will there be meetings of certain stakeholders throughout the
trial? If so, who and when will they meet?
34. Star Point 5: (Evaluation)
How will you report the outcomes of the trial?
What would be the next steps for the use of the change process
information?
2.2019 Update. DLP
1
2.2019 Update. DLP
Week 6 Assignment:
EBP
Change Process
form
ACE Star Model of Knowledge Transformation
Follow Nurse Daniel as your process mentor in the weekly
Illustration section of the lesson.
35. Name:
_____________________
Star Point 1: Discovery
(Identify topic and practice issue)
Identify the
topic
and the
nursing practice issue
related to this topic.
(This MUST involve a nursing
practice issue.)
Briefly describe you
r
rationale
for your topic selection.
Include the
scope
of
the issue/problem.
36. S
tar Point 2: Summary (Evidence to support need for a change)
Describe the
practice problem in your own words
and formulate your
PICOT
question.
List the systematic review chosen from the
Cochrane Database of Systematic Reviews
from the
Chamberlain
library
.
Type the complete
APA reference
37. for the
systematic
review
selected
.
1
2.2019 Update. DLP
Week 6 Assignment: EBP Change Process form
ACE Star Model of Knowledge Transformation
Follow Nurse Daniel as your process mentor in the weekly
Illustration section of the lesson.
Name: _____________________
Star Point 1: Discovery (Identify topic and practice issue)
Identify the topic and the nursing practice issue related to this
topic. (This MUST involve a nursing
practice issue.)
Briefly describe your rationale for your topic selection. Include
the scope of the issue/problem.
38. Star Point 2: Summary (Evidence to support need for a change)
Describe the practice problem in your own words and formulate
your PICOT question.
List the systematic review chosen from the Cochrane Database
of Systematic Reviews from the
Chamberlain library. Type the complete APA reference for the
systematic review selected.
