DNP-Evidence Based Practice II

Wk.2.Evidence Based Practice II

Discussion responses

Read a selection of your colleagues’ posts. 
Respond to
two of your colleagues by supporting or expanding on their identified barriers and solutions. Work to share additional perspectives on the issue described by your colleague. 

PEER #1

Wanda Booker

                                                                             
Week 2: Discussion 1

       Challenges and barriers to implementing changes are anticipated outcomes within any healthcare system. These challenges will occur, particularly as a system or practice is established (Phillips & Klein, 2023). For changes to be effective in healthcare settings, they would require the assistance and active involvement of stakeholders, clinicians, and administrative personnel within the organization. It remains imperative that, as nurse leaders, we must be knowledgeable about monitoring, anticipating, and implementing effective strategic methods to safely and effectively address any gaps in implementing necessary changes.

        Hence, for my practicum project, I expect the challenges and barriers to implementing the changes in how the inpatient and homecare discharge processes are currently managed among the homecare patient population. Another critical gap is the noted need for more appropriate knowledge and skills of clinicians providing care for this identified patient population. Upon evaluation and dissemination of the plans to create and implement a best practice method, such as a Clinical practice guideline (CPG)  to address the noted gap, there were noted stakeholder biases as concerns were verbalized among the clinicians regarding additional tasks being added to their numerous daily patient care tasks responsibilities (Maurer et al., 2022).

       Nevertheless, to address this barrier and ensure compliance and buy-in from all stakeholders, I plan to modify the CPC to ensure the most pertinent information is outlined with checkboxes/checklist format (Maurer et al., 2022). Secondly, there would be ongoing education regarding the purpose of the CPG and its intended impact on safe and high-quality patient care. Finally, as the change agent and leader, I will include the internal nursing team and field supervisors to assist with the implementation phase. The identified strategies will be evaluated for effectiveness, and modifications will be made until at least 90% participate in the changes.                                                  

                                                                              
 References

Maurer, M., Mangrum, R., Hilliard-Boone, T., Amolegbe, A., Carman, K. L., Forsythe, L.,

      Mosbacher, R., Lesch, J. K., & Woodward, K. (2022). Understanding the Influence and

      Impact of Stakeholder Engagement in Patient-centered Outcomes Research: Qualitative

      Study. 
Journal of general internal medicine, 
37(Suppl 1), 6–13.

        to an external site..

Phillips, J., & Klein, J. D. (2023). Change Management: From Theory to Practice. 
TechTrends :

     for leaders in education & training, 
67(1), 189–197. 
to an external site.

     00775-0

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PEER #2

Sharon Cunningham

Barriers to Project Implementation

Barriers to any project can occur. This can especially happen when implementing a research project. Alqahtani, et. al. (2022) notes that when implementing evidence-based projects barriers can include lack of time to find research outputs, insufficient availability of resources, and difficulty in understanding research findings. In a different take of project implementation from the student perspective, Keadle (2023) found 5 barriers to implementation. These include ignoring the implementers-including students, skipping the “why”, avoiding the nay-sayers, forgetting to communicate and thinking short-term.  

When beginning this project last session, barriers have always been a four-thought. The barriers that I have identified for this project include unwillingness to implement the project, lack of staff participation, poor follow-through, and long-term usage of the implemented changes. Keadle (2023) states that evaluation, continuous improvement, and sustainability are benchmarks for project success. If a project is only utilized for a short time frame, then its success is never really determined. 

Prior to the implementation in week 3, the staff of the clinical site has been educated on the purpose of the project and that the concept was requested by the FNP at the clinical site. The clinical site is very small; however, the staff are eager to help the FNP to improve patient outcomes for their diabetic patients. The staff have all agreed to be proactive with the change and to provide feedback on how the project is impacting workloads. I will be reviewing the algorithm and monitoring tool weekly with the staff for ongoing critiques of the system and any input for changes. Finally, the FNP is committed to continuing with the project after the session has ended. Together, my preceptor (the FNP) and myself have been developing the monitoring form as well as I have been working with the clinics EMR system to be able to empower the FNP to utilize the EMR’s ability to quality manage diabetic indicators that she wants to monitor going forward. Overall, I think with the ongoing education and empowerment that has carried over from last session to this one will ensure that project implementation will be successful and sustainable.

Alqahtani, J.M., Carsula, R.P., Alharbi, H.A., Alyousef, S.M., Baker, O.G., & Tumala, R.B. (2022). Barriers to Implementing Evidenced-Based Practice among Primary Healthcare Nurses in Saudi Arabia: A Cross-Sectional Study.
 Nursing Reports. 12, 313-323. 
to an external site.

Keadle, V. (2023). 5 Barriers to Effective Implementation and How to Combat Them. Student Ready Strategies. 
to an external site.