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Why is it important to incorporate a theory or model related to change when implementing practice changes?

NUR699 Why is it important to incorporate a theory or model related to change when implementing practice changes?

NUR699 Evidence Based Practice Project

Week 5 Discussion

DQ1 Why is it important to incorporate a theory or model related to change when implementing practice changes? Does the benefit of incorporating an EBP model outweigh the time and effort it took to include it? Discuss the model you have chosen and why you believe this is the most appropriate for your intervention.

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Implementation science was borne out of a desire to address challenges associated with the use of research to achieve more evidence-based practice (EBP) in health care and other areas of professional practice. Early implementation research was empirically driven and did not always pay attention to the theoretical underpinnings of implementation. Eccles et al. ([1]:108) remarked that this research seemed like “an expensive version of trial-and-error”. A review of guideline implementation strategies by Davies et al. [2] noted that only 10% of the studies identified provided an explicit rationale for their strategies. Mixed results of implementing EBP in various settings were often attributed to a limited theoretical basis. Poor theoretical underpinning makes it difficult to understand and explain how and why implementation succeeds or fails, thus restraining opportunities to identify factors that predict the likelihood of implementation success and develop better strategies to achieve more successful implementation.

NURS6501 Week 11 Advanced Pathophysiology Discussion
NUR699 Why is it important to incorporate a theory or model related to change when implementing

However, the last decade of implementation science has seen wider recognition of the need to establish the theoretical bases of implementation and strategies to facilitate implementation. There is mounting interest in the use of theories, models and frameworks to gain insights into the mechanisms by which implementation is more likely to succeed. Implementation studies now apply theories borrowed from disciplines such as psychology, sociology and organizational theory as well as theories, models and frameworks that have emerged from within implementation science. There are now so many theoretical approaches that some researchers have complained about the difficulties of choosing the most appropriate.

This article seeks to further implementation science by providing a narrative review of the theories, models and frameworks applied in this research field. The aim is to describe and analyze how theories, models and frameworks have been applied in implementation science and propose a taxonomy that distinguishes between different approaches to advance clarity and achieve a common terminology. The ambition is to facilitate appropriate selection and application of relevant approaches in implementation studies and foster cross-disciplinary dialogue among implementation researchers. The importance of a clarifying taxonomy has evolved during the many discussions on theoretical approaches used within implementation science that the author has had over the past few years with fellow implementation researchers, as well as reflection on the utility of different approaches in various situations.