DNP 835 Adopting Professional Practice Behaviors DQ

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DNP 835 Adopting Professional Practice Behaviors DQ

DNP 835 Adopting Professional Practice Behaviors DQ

 

DQ1 Identify a mentor that guided you through a key process
of adopting professional practice behaviors. Discuss how the mentor assisted
you with the process.

DQ2 Describe three methods you will use to recognize and
share quality professional behaviors.

A best practice may be a particular method, or it may be a whole program or intervention. “Best practice” status is sometimes conferred either officially – by a government body, professional association, or other authoritative entity – or by published research results. In general, a method or program gains such status by being:

  • Measurable. That means that its goals are clear and that progress toward them can be measured. A smoking cessation program, for instance, can find out exactly what percentage of the smokers it served quit, and remained smoke-free after a year. It can also compare that percentage to similar percentages for other smoking cessation programs and for the general population.
  • Notably successful. The method or program not only gains good results, but makes more progress toward achieving its goals than most others with similar aims.
  • Replicable. The method or program is structured and documented clearly enough so that it can be reproduced (“replicated” is the formal term that social scientists, health professionals, government agencies, and funders often use) elsewhere.

Replication is always an issue. Even when every detail of a program is recorded, and its philosophical base is carefully explained, it’s seldom possible to reproduce it exactly. Communities and populations are different in size, character, culture, and other ways, and all of that affects the operation of a program or the application of a technique. In addition, some programs work as well as they do because of the individual skills or character of those who run them, a factor that it’s often impossible to reproduce.

The real test of replication, as far as you’re concerned, should be whether you can reproduce it – exactly, or adapted to your needs – in your own situation. If you can, it’s replicable; if you can’t, it’s not, regardless of what the research says. In a sense, the more adaptable a program or practice is, the more replicable it is, and that may be the key to whether it will be adopted by others.

Best practices, in short, are those methods or programs that have been found to be successful in accomplishing their goals, and that can be used, or adapted for use, in your circumstances. The standards for choosing a best practice vary tremendously, depending upon who’s doing the choosing. In some cases, almost any program that can show some success is labeled a best practice. In others, the criteria are so strict that only a few are selected (more likely with professional associations that are trying to set or uphold research standards.)

Where the standards are relatively loose, programs designated as best practices may be only adequate, rather than truly the best the field has to offer. Where the standards are too strict, many superb programs may be passed over because they don’t collect enough data on themselves, or for other technical reasons. When looking at best practices with an eye toward using one for a local intervention, it’s important to keep in mind whose best practices they are, and how they were chosen.

Keep in mind that “promising practices” – those that may not have been tested or in existence for very long, but seem to work – are also worth investigating. You may find something that seems to have serious potential, and that fits perfectly with the folks you work with, the goals you want to accomplish, and your philosophy.

Some other things to keep in mind when considering best practices:

  • Fit with your community and population. Does the method or program make sense given the realities of your community? Can it be adapted to match those realities?

A community health education program may ignore the possibility that a large part of the population may speak very little or no English, for instance, or may be illiterate in any language. The program may be adaptable, but it also may make more sense to find a program that takes such circumstances into account.

  • Appropriateness to your goals. Does the best practice in question actually address your specific goals? The fact that it’s a best practice for the issue you’re concerned with doesn’t necessarily mean that it has the same aims you do. If it treats the symptoms of a problem, that may not be enough if you’re attempting to deal with the underlying causes, for instance.
  • Fit with the structure and philosophy of the organization or initiative that will use it. A program all of whose authority is in the hands of organization staff would not be a good fit with an organization whose main thrust is to help participants take control of their lives, for example.
  • Availability of resources. A sure way to make an effort fail is to approach it with inadequate resources, whether money, personnel, or skills. Make certain you understand exactly what a particular best practice will require in the way of resources – and that you can somehow provide them – before you commit to using it.
  • Cost-effectiveness. If a program works well, but costs huge amounts of money or time to reproduce, it may be all but useless to most organizations or communities that want to use it. A program that works slightly less well, but costs a third as much might, in fact, be a much better candidate for the “best practice” label.

We have previously set out some general criteria for identifying best and promising practices and programs, based largely on the work of Lisbeth Schorr. According to those criteria, best practices have all or many of these characteristics:

  • They are comprehensive, aiming at all aspects of an issue.
  • They are flexible and responsive, reacting to the needs of the population and changes in circumstances and conditions.
  • They persevere, keeping at it as long as is necessary – indefinitely, if that’s what it takes.
  • They look at issues and people in their context – family, history, community, etc.
  • They target the underlying causes in addition to the symptoms of an issue or problem.
  • They have – and stick to – a clear mission.
  • They evolve over time, as need dictates.
  • They are managed by competent people with appropriate skills.
  • Their staff members are trained and supported to provide high-quality, responsive service.
  • They foster strong staff/participant relationships based on mutual respect.
  • They collaborate, both internally and externally.
  • Both the organization and individual staff members have a set of core values that strengthen their dedication, morale, and resolve, and that give them a shared sense of purpose for the work.

WHY PROMOTE THE ADOPTION AND USE OF BEST PRACTICES?

One answer to this question is obvious: employing a method or program that’s been tested and found successful increases the chances that you’ll accomplish your goals, and that life will therefore be better for the folks who participate. There are, however, further reasons why the use of a best practice can be advantageous.

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  • Using a recognized best practice makes it easier to justify the work. If an organization or initiative is starting from scratch, the community – and especially potential participants – may be justifiably skeptical about what it’s doing. Demonstrating that it’s using a practice that has been shown to be effective can relieve at least some of that skepticism and gain support.
  • Using recognized best practices can bolster the credibility of an organization. It shows not only that the organization is using a tested process, but that it has been thinking ahead and conducting research to make sure it’s doing the best job possible.
  • Using best practices can make it easier to get funding. Funders look more favorably on proposals that can demonstrate proven success.

There is a downside to this advantage as well. Sometimes funders insist on the use of best practices, or of a single best practice. They see this as minimizing the possibility of interventions not working, but it also minimizes the possibility of innovation and the development of new best practices. Moreover, it ignores the fact that best practices don’t always work in every situation, and that some organizations may get outstanding results using practices that don’t show up in the research.

  • Using a best practice removes a lot of the guesswork from planning. Employing a program or method whose structure and process are carefully documented makes it easier to set up and implement, and increases the chances that it will go smoothly.
  • The originators of the practice are known, and might be available to consult on how to best implement it. They can troubleshoot when there’s difficulty, or help to adjust it to fit the community or population. If the originators aren’t available, there may be others experienced with the practice who can help.
  • Most important – and most obvious – we know that best practices work. They’ve been shown to provide the changes in behavior or conditions and the outcomes we’re interested in.

WHEN SHOULD YOU PROMOTE THE ADOPTION AND USE OF BEST PRACTICES?

Promoting the adoption of best practices should probably be an ongoing activity, but some times are especially appropriate for it.

  • Before a new intervention or program begins. It’s easier to incorporate or adopt a practice for something new than to superimpose it on a program or intervention that’s already up and running. Those starting a new operation are usually more open to existing practices as well, especially if they hold out a reasonable promise of success. In addition, using a best practice starts a new operation out on the right foot politically.
  • When there’s a serious community problem that has to be tackled. Nothing may have started yet, but the incidence of domestic violence, child abuse, tuberculosis cases, or homelessness has reached crisis proportions. The community and/or relevant organizations might be willing to entertain the idea of adopting a best practice to deal with the situation.
  • When what’s being done isn’t working well. If a current intervention simply isn’t having the desired effect on an issue, it’s probably a good time to suggest a proven practice.
  • When the community requests it. In some cases, publicity about a particularly effective program or process can mobilize community opinion, especially if citizens perceive, as in the paragraph above, that the community has a serious problem to address.
  • When funders or officials request or demand it. As research results become more and more easily available through online sources, more funders insist that proven practices be followed by those they fund. A word of caution here: make sure that funders’ requirements don’t rule out adaptation to your specific circumstances. As mentioned above, strict use of best practices can sometimes get in the way of flexibility and new ideas.

WHO SHOULD BE INVOLVED IN PROMOTING THE ADOPTION AND USE OF BEST PRACTICES?

In trying to persuade a community or organization to adopt best practices, it’s best to involve as many stakeholders – those affected by the proposed program or intervention – as possible. If they have a hand in seeking out and researching best practices, they’re more likely to be excited about and willing to adopt them, rather than feeling that their work is being challenged. Those who might be involved include:

  • Practitioners – health and human service workers, community developers, etc.
  • Members of the population that will participate in or benefit from the best practices in question.
  • Those who’ll be indirectly affected by the program. These include people whose jobs might change – police, social workers, etc. who are not directly involved, but who might have to deal with the effects of the practice – as well as landlords, business people, town boards, and others who might experience changes as a result of an intervention.
  • Interested community members. It’s always wise to include the community at large. Inclusion leads to more community support, which in turn can translate into resources.
  • Local and, if appropriate, county or state officials. If you’re seeking public funding, or, again, if you simply want community support, it’s crucial that you invite these people to be part of the process.

In practice, it may be unusual, or even impossible, to involve all these groups. If it is possible, however, the results of a participatory process are apt to gain greater community support for the program or practice, and increase the chances of success.

WHERE DO YOU FIND BEST PRACTICES?

Be aware that much of what you find may fall into the category of “promising practices,” or may simply be interesting ideas or programs that others have tried. Don’t sell these short – they may be a tremendous source of inspiration for a solution that will work for your situation.

Be aware that much of what you find may fall into the category of “promising practices,” or may simply be interesting ideas or programs that others have tried. Don’t sell these short – they may be a tremendous source of inspiration for a solution that will work for your situation.

To find best practices, try:

  • The Internet. The Internet has over a billion sites, and grows by millions a year. Once you develop good search skills, you can find nearly anything.
  • Networking. Talk to everyone you know, and find out what they know. They may even be able to provide introductions, or at least information, so that you can contact programs or initiatives and learn about what they’re doing.
  • Libraries. Public libraries, as well as those at colleges and universities, are a great source, and librarians can be extremely helpful in finding what you’re looking for. Many journals or individual journal articles found in libraries can now be found on the Internet as well, but may also require subscription or a membership or user’s fee, whereas access to those items – whether in hard copy or online – is generally free in libraries.
  • State and national advocacy and professional organizations. These organizations often give awards for best practices, or document them in journal articles and at conferences. The journals are usually available in libraries, either public or academic, and often on the Internet as well; conference proceedings are often posted on the Internet. You can contact the organization or go to its website to find out what’s available.
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