I want to start by saying I love the word cadre in this week’s discussion post! If we consider its definition as a group of people specially trained for a particular purpose or profession it works, OR if we assume it to be a group of activists or other revolutionary organization it works! Both fit in the role of the DNP as we consider their role in health care.
Melnyk et. al (2012), states that EBP gives nurses a voice, supports nurses as individuals and as a collective, and encourages patient advocacy with the intent to assure quality care. The research, EBP, and QI processes that give nurses this voice is driven by terminal degree Registered nurses such as the DNP. The DNP can lead not only by example but by shared advocacy. Whether it be a grassroots campaign to speak with local and state representatives to advocate for nursing or patient initiatives, or by being involved in a task force, activity, or key committees in health systems, our collective accomplishments speak much louder than individual ones.
The DNP cohort can lead the charge to translate evidence into practice by applying quality improvement strategies, heading interprofessional teams, mastering health information technologies, and championing patient-centered care through existing EBP principles (Melnyk, et.al, 2012)
The DNP cohort can lead clinical innovation by using the theories we reviewed in Scientific Underpinnings to inform and change EBP assuring quality patient-centered care. The DNP cadre can also advocate for legislative changes, curriculum changes, and lead research teams looking to address a knowledge gap. It will be important for the DNP army to be mindful of the interworking of the microsystems, mesosystems, and macrosystems in the organization they are trying to innovate.
Successful change is difficult, and many change initiatives ultimately fail. Patient care is too important to not overcome those barriers to effective change. As a DNP, my first step prior to implementing the change would be to review my organization’s structure and culture to identify challenges I will be facing regarding staff motivation for change. It will important that I recognize my own hesitations or transferences, and deal with those prior to addressing the team. I believe educated employees are empowered employees, so assuring they understand the evidence behind the change movement, and how it will impact the team’s daily tasks will be crucial. Elisabeth Kubler-Ross taught us many years ago that change is not a linear process, but a curved one where the team goes through shock, fear, acceptance, and commitment. Throughout the informed process, I will need to be consistent and transparent as I lead and coach the change to completion. I will need to ensure adequate communication that is clear, concise, and not overwhelming to staff. Once the change is implemented, it will be important I give and take feedback on the process and debrief the team. If the team can witness my dedication and passion to EBP and patient-centered care, they will be more trusting with future initiatives I bring forth.
Melnyk, B. M., Fineout-Overholt, E., Gallagher-Ford, L., & Kaplan, L. (2012). The state of evidence-based practice in US nurses: Critical implications for nurse leaders and educators. Journal of Nursing Administration, 42(9), 410–417. https://doi.org/10.1097/NNA.0b013e3182664e0
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