Theory Development

Running head: THEORY DEVELOPMENT
Theory Development for the study: Infection control practices and Quality Healthcare Delivery
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THEORY DEVELOPMENT 2
Theory Development for the study: Infection control practices and Quality Healthcare Delivery
Introduction
The professionalization of nursing has been facilitated through the establishment and the
application of a diversity of nursing theories. These theories have provided the conceptual
framework for examining different contexts in a clinical setting. Furthermore, these frameworks
provide the approach for analysis, organization as well as decision making in core nursing
practices. Consequently, the theories offer the structure for co-operating with other health care
workers in the delivery of health services. Nursing theories provide fundamental approaches to
infection control practices and healthcare delivery. This essay discusses the application of theory
in infection control practices and quality healthcare delivery. Mainly, the paper analyzes on how
the diffusion of innovation theory can be applied to enhance infection control practices in
healthcare. The fundamentals of this theory will then be used in developing a novel theory that
would better meet the needs of this research.
A Discussion of the Diffusion of Innovation Theory
The theory of diffusion of innovation considers diffusion as the process as to which an
innovation is conveyed through particular channels over a given period among the members of a
social system. The framework for this diffusion of innovation has been adapted for utilization in
the infection control and prevention (Radford, 2011). This framework can be applied just like the
other models from implementation science in the infection control and prevention research.
Krein, Saint & Damschroder (2015) observe that diffusion of innovation theory is
significant for infection control in health care. This theory has been based on an extensive tradition
of research in various disciplines which in turn offers a considerable framework for understanding
and solving the discrepancy between the ideal and practical use of evidence-based practices in the
clinical settings Increased concerns about having efficient and safer health care imply that more
emphasis has been made on ensuring the infection prevention and control innovations are
appropriate for clinical use. Apparently, clinical epidemiologists play a vital role in the
implementation process. McCullen (2013) further observes that the concepts of diffusion of
innovation theory as well as the new field of implementation science would be effective in
continuing to ensure that there is the future success in the effort to minimize health-care related
infection.
According to Rodgers (1962), diffusion is simply a decision-making process that takes
place in five stages. These processes consist of a series of communication channels over a specific
period for members of a similar social system. The processes include interest, awareness,
assessment, test, and implementation. It is possible for any person to reject a given innovation at
any time in the course of the adoption process. Figure 1.1 below presents Rodgers five stages of
the decision innovation process.
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Figure 1: 1 Five stages of the adoption process
Source: Rodgers, (1962)
Rodger’s Diffusion of Innovation Theory is based on the idea that over time, a given
concept or idea acquires momentum and spreads (diffuses) through a specific social system or
population. Consequently, people end up embracing a novel idea, product or behavior. Adoption
implies that an individual can do something differently than he or she used to do previously. This
includes changing behavior, purchasing a product/service or acquiring new behavior. Before
adoption, an individual must, first of all, perceive the knowledge, idea, behavior or product as a
new innovative. Through this, diffusion is them made possible. After knowledge, then people
must be persuaded to see the need of embracing the innovation. The individual then decides on
whether and how to make use of the idea. The next stage is the implementation phase where
individuals are now expected to apply the idea to the actual work contexts (Peres, 2010). The
applicability of this idea and its effectiveness is then confirmed by the management.
In this perspective, nurses must, therefore, understand novel infection control practices
and know how they can be applied for an effective health outcome. After this knowledge is
imparted to them, they are then persuaded on the need to use the new practice or idea in the
implementing the stipulated infection control practices other than the existing ones. They will
then be required to decide on the implementation of this practice/idea. After making a decision,
they will then apply the idea in their work setting. An evaluation should then be done on whether
or not the idea is effective. From this assessment, modifications can then be done accordingly.
The Behavioral Theory and Its Mechanism
The Behavioral Theory is about behavioral control mechanisms that can be used to
change the attitudes and behavior of health care practitioners into embracing change and new
practices to enhance healthcare delivery. This theory intends to explain the people’s ability in
exerting self-control when working under specific principles. Similar to the goals of Rodger's
Diffusion of Innovation Theory, the goal of the theory of behavioral control is to make change
THEORY DEVELOPMENT 4
their attitude and behavior towards new practices/idea. In normal occasions, behavioral
intentions of individuals are largely influenced by attitudes concerning the probability that the
behavior will exert towards the anticipated outcome alongside the subjective assessment of the
benefits and risks associated with the expected outcome.
This theory, therefore, rests on the assumption that ineffectively embracing a new idea,
practice or concept in infection control endeavors, then those mandated with the responsibility of
implementing them must be made to belief that the idea/practice is better than what is currently
available. This conception is borrowed from the first and second stages in Rodgers decision
innovation process. It is also related to the third stage of Rodger's model of decision making
since the theory also requires individuals to assess the benefits or drawbacks of embracing the
new concept before accepting/adopting them. Figure 1.2 below presents the key tenets of the
proposed model
The main components of the Behavioral Theory: Source:
The behavioral theory articulates that behavioral achievement is largely depended on
ability (which is behavioral control and motivation (intention). As depicted in the figure above,
the theory consists of six major constructs which represent an individual's control over a given
behavior.
Behavioral beliefs: This is the level at which a person harbors either unfavorable or
favorable assessment of a particular behavior in question. It involves taking into concern the
general outcome in performing the given behavior. For example, in the context of embracing
new infection control practices, the healthcare practitioners are naturally used to conventional
THEORY DEVELOPMENT 5
practices and methodologies in infection medicine. Therefore, for them to accept the new
concepts/approaches in the same, they would require a change of their attitudes towards a
positive trajectory so that they can see the benefit of the new concept and the expected outcome
it is supposed to generate.
Behavioral intention/Attitude towards the behavior: These largely consist of the
motivational factors that influence a certain behavior. When the motivation factors are stronger,
then there is more likely to cause the intention of performing the behavior. In other words, there
is more likelihood that the behavior will be undertaken. In the nursing context, the motivational
factors may include such issues as easiness of the practice, a more effective outcome, lesser
workload, and lesser resources used among others. On the other hand, patients will see the need
of embracing the new practice because it is more effective, has a better outcome, it is easy to use,
it is less costly, or it is friendlier than others.
Supposed Behavioral Control:
This is a perception of an individual regarding the difficulty or easiness of undertaking a
given behavior; in this case, a new practice of infection control. Supposed behavioral control
differs across actions and contexts, leading to people having different attitudes of behavior
control as per the situation demands. Therefore, the proposed theory will be able to harmonize
the diverse perceptions held by different people to achieve a common goal.
Research Questions and Hypothesis
1. What is the attitude of nurses towards implementation of a new practice in infection
control and healthcare delivery?
2. How will the nurse’s perception be changed to accommodate the new ideas and
practices for effective infection control?
3. How viable are the new practices/ideas compared to the existing ones in infection
control?
Hypothesis:
#1: Nurses have a negative attitude in embracing new practices for healthcare delivery
#2: It is possible to change the nurse’s perception positively to make them accept the new
practices
#3: The new practices have a high probability of enhancing the effectiveness of infection control
practices as well as improving the quality of healthcare delivery
Conclusion
THEORY DEVELOPMENT 6
It is hoped that the “behavioral control” theory can be effectively used in changing the
attitude of healthcare practitioners towards embracing change and innovation. In addition, it can
also be used by nurses in predicting and explaining a broad range of health intentions and
behaviors including utilization of health services, embracing the use of vaccines and preventive
medicines, application of new health practices by the nurses and above all help in normative and
behavioral control for both healthcare workers and patients.
References
Peres, R. (2010). Innovation diffusion and new product growth models: A critical review and
research directions. International Journal of Research in Marketing. 27(2): 91106
Krein, S., Saint, S., & Damschroder, L. (2015). Diffusion of innovation theory in hospital
Epidemiology and infection control. Infectious Disease Advisor. Retrieved from
https://www.infectiousdiseaseadvisor.com/hospital-infection-control/diffusion-of-
innovation-theory-in-hospital-epidemiology-and-infection-control/article/598549/
McCullen, N. J. (2013). Multiparameter Models of Innovation Diffusion on Complex
Networks. SIAM Journal on Applied Dynamical Systems. 12 (1): 515532.
Rogers, E. (1962). Diffusion of innovations (1st ed.). New York: Free Press of Glencoe
Radford, S. (2011). Linking Innovation to Design: Consumer Responses to Visual Product
Newness. Journal of Product Innovation Management. 28 (1): 208220.

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