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DQ: Identify two stakeholder barriers you might experience during the implementation phase of your evidence-based practice project

DQ: Identify two stakeholder barriers you might experience during the implementation phase of your evidence-based practice project

NUR 590 Topic 5 DQ 1

Identify two stakeholder barriers you might experience during the implementation phase of your evidence-based practice project. What strategies can you implement to gain stakeholder support for the project implementation. Provide a suggestion you would give to a colleague who is struggling with obtaining stakeholder support.

Cohesive Collaboration is important to the survival of and success of an organization. Implementation plans can face numerous challenges as a result of lack of knowledge of the problems hurting an organization. This lack of knowledge is common in many organizations were leaders and management are disconnected from day to day operations that help to run the organization. When a person rises through the ranks of the organization into a leadership role they have knowledge of and experience that other managers lack if they hired from the outside. The person who rises through the ranks has more understanding of the how the organization works, the weakness that exist, the organizations strength and how the organization needs to function in order to survive. Where there is s disconnect between stakeholders in higher positions and those working the day to day operations, noting will get done.

Some of the things that one might experience during the implementation phase are resistance and timing. “Lack of time is often cited as a barrier to implementing EBP. In addition, uncertainty or lack of knowledge about the EBP process is also a barrier, which includes critiquing and appraising the literature related to the clinical problem being addressed” (Ginex, 2018). In busy hospitals lack of time to study and understand new changes and policies can be a barrier. On time of this, resistance to change can also be a barrier. In there is already a flow that nurses are accustomed to even if it is chaotic, having to change that flow requires learning something new or changing ones workflow habits and that can cause resistance to change.

DQ Identify two stakeholder barriers you might experience during the implementation phase of your evidence-based practice project

The one suggestion I would give to a fellow colleague would be for them to ask questions, slow down the pace in order for them to understand the new policy and give themselves time to become accustom to it and to always remember that it will take them time to learn something new before they can master it.

 

Reference:

 

Ginex, P. (2018). Overcome Barriers to Applying an Evidence-Based Process for Practice Change. Retrieved from https://voice.ons.org/news-and-views/overcome-barriers-to-applying-an-evidence-based-process-for-practice-chang

Stakeholders are the people involved in carrying out the process under review or individuals who become affected with the change in practice (“John Hopkins Nursing”, 2021). It is important to determine the potential stakeholder barriers that will be encountered in order to address them accordingly. The two stakeholder barriers that can be experienced are resistance to change and lack of authority. Physicians, who are one of the main stakeholders, are perceived to be the least supportive in EBP implementation (Jordan et al., 2021). Without their support, it can make the implementation process difficult. Resistance of practitioners to change from traditional practices to newer concepts introduced in EBP can be a barrier to the implementation process (Jordan et al., 2021). Moreover, some staff nurses feel that they lack authority to make changes in their unit or they do not have the “power” to implement the EBP project. One study suggested that majority of the nurses in a private ICU reported that they lacked the authority to change practice in order to facilitate the implementation of EBP (Jordan et al., 2021).

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There are several strategies to gain stakeholder support. First, the support of physicians for the implementation of EBP should be encouraged (Jordan et al., 2021). It is important to keep an open communication between the researcher and physicians. Explaining the goals and benefits of the EBP project in improving patient care can help gain their support. Second, it is recommended to carefully identify individual barriers versus organizational barriers at an early stage (Jordan et al., 2021). Lastly, identifying your stakeholders as well as engaging them early in the EBP process is important because stakeholder buy-in is important for its successful implementation (“John Hopkins Nursing”, 2021). The goal is to gain their trust and confidence and gain as much support as possible for the successful project implementation.

DQ: Identify two stakeholder barriers you might experience during the implementation phase of your evidence-based practice project

DQ Identify two stakeholder barriers you might experience during the implementation phase of your evidence-based practice project

References

 

Jordan, P., Bowers, C., Cur, M. & Morton, D. (2016). Barriers to implementing evidence-based practice in a

private intensive care unit in the eastern cape. SAJCC, 32(2). DOI:10.7196/SAJCC.2016.v32i2.253

 

“John Hopkins Nursing”. (2021). Upstate Medical University. https://guides.upstate.edu/c.php?g=1023176&p=7411256

Stakeholders are vital to the implementation process as support supplied can hinder the potential outcomes and results of the research or interventions. Two stakeholder barriers I believe I would encounter during the implementation process for my project would be staff engagement and organizational allowance for collaboration.

Staff engagement from a nursing perspective can be difficult as education about nutrition (specifically types of diets) may be unfamiliar and uncomfortable. Although nutrition within an acute setting from a nursing perspective can be seen from meals and nutrition deficits. Expecting nursing to utilize nutrition education within an acute setting may be inappropriate as the focus of patient care and safety would be the priority, engaging them on nutrition education would demand them to switch their focus and may decrease patient outcomes. Nurses may not be motivated to participate in interventions if it does not directly affect acute care outcomes within this setting. This is why education may be promoted as a nursing education intervention as a preparation for post-acute health and wellness and the intervention should be made to address nursing at a community health or public health perspective (Leung, Trevena, & Waters, 2016).

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While evidence-based practice (EBP) promotes better quality care and positive patient outcomes, there can often be many barriers in place within healthcare organizations preventing the continued, competent delivery of EBP to patient populations (Melnyk & Fineout-Overholt, 2019). Healthcare providers cite factors such as lack of EBP knowledge, tradition-based organizational cultures, high patient loads, change resistance, lack of leadership support, and lack of autonomy over change practices as barriers to EBP implementation within their organizations (Melnyk & Fineout-Overholt, 2019). While my evidence-based practice project is designed around a unit similar to the one I currently work on, at a facility that does a large amount of clinical research trials, I still anticipate there being some potential barriers to implementation in the design of the project.

Those not familiar in EBP would need to have adequate education, knowledge, and skills training in its use and importance in clinical practice, as well as the promotion of an attitude of change in the organization. Though innovation is encouraged by the organization I work for, there are still those who are uncomfortable with change and prefer tradition-based practices despite these being proven not to best support positive patient outcomes (Melnyk & Fineout-Overholt, 2019). This could result in a culture of negative attitudes towards change on the unit where the practice project would be done, which could negatively impact participation in the study and create resistance to the implementation phase of the project. Advanced practice nurses could work with leadership within the organization to set expectations for staff regarding EBP use, as well as creating mentorship programs for EBP skills education and competency strategies (DeNisco, 2021). In doing so, a culture of change could be better supported from all levels within the organization as a better understanding of facility goals and improvement on health delivery becomes more widespread.

References

DeNisco, S. M. (Ed.). (2021). Advanced practice nursing: Essential knowledge for the profession (4th ed.). Jones & Bartlett Learning. ISBN-13: 9781284176124

Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing and healthcare: A guide to best practice (4th ed.). Wolters Kluwer. ISBN-13: 9781496384539