Evidence-Based Practice II

Clinical Requirement:

Speed Bumps and Pitfalls EB.RESPOND.wk.6.EvidenceBasedPracticeII.docx Evidence Based Practice II Speed Bumps and Pitfalls Read a selection of your colleagues’ posts.  Respond to  at least two of your colleagues by supporting or expanding on their responses or sharing additional or alternative perspectives. PEER #1 Tokunbo Ndidi Allen Tokunbo Ndidi Allen Tokunbo Ndidi Allen Speed Bumps and Pitfalls Implementing a practice change initiative entails several challenges and impediments that must be addressed to ensure the effectiveness of the planned intervention. An issue faced in this period is the reluctance to change among organizational members. This arises from the hesitance of organizational members to embrace the proposed intervention. The principal element contributing to resistance to change is the lack of information and abilities among organizational members about implementing the planned initiative (Sharplin et al., 2019). To address the difficulty, it is essential to implement educational or training sessions to inform organizational members about the necessity of the proposed practice change in improving fluency and effectiveness in service delivery. Understanding that resistance is inherent to human nature, implementing optimal initiatives can mitigate this resistance and enhance the commitment of all organizational members to the practice change project. The insufficiency of appropriate resources to execute the practice change project is a significant setback, potentially resulting in delays in implementing the planned change. This arises from inadequate budgeting strategies and insufficient preparation, complicating the aggregation of all necessary resources to implement the practice change project (Risk et al., 2019). The DNP-prepared nurse assured the availability of sufficient resources before the project's commencement to facilitate the seamless implementation of the suggested practice change. The initiative advocates for efficient coordination between the DNP-prepared nurse and organizational executives to provide a consistent supply of all essential resources necessary to implement the specified procedures to ensure the project's success. The DNP-prepared nurse will meticulously monitor project resources to prevent the misappropriation of materials, which could delay the completion of all scheduled project operations. Conflicts of interest among project members significantly hinder the implementation of a practice change endeavor. Conflicts arise from disputes regarding roles and responsibilities or issues of supremacy among project members (Sharplin et al., 2019). The initiative will be addressed by assigning duties and responsibilities to each project participant. Implementing the strategy will ensure that each member complies with their assigned tasks, reducing interpersonal problems that could compromise service delivery during the project. The initiative would also entail enforcing stringent disciplinary actions among the project members. Implementing this measure will guarantee that all project members maintain elevated standards of professionalism and decorum throughout the project. Inadequate communication channels represent a significant obstacle faced during the implementation phase. The inadequate communication channels hinder the monitoring of project activities, potentially resulting in delays in project completion (Risk et al., 2019). The DNP-prepared nurse addressed this difficulty by establishing good communication channels within the project team, facilitating the monitoring of project activities, and identifying any challenges encountered while implementing the planned solution. A further expected obstacle in executing the planned intervention is time constraints. The project is expected to be completed within an 8-week, which may be insufficient to implement all specified steps to ensure success in the practice change initiative. To address this difficulty, the DNP-prepared nurse will utilize a project management program to guarantee that all project actions are executed within the designated timeframe. Despite these problems, the DNP-prepared nurse recognized the obstacles by collaborating closely with the organization's administration to implement effective solutions to address the prevailing issues (Sipes, 2024). The project mentor and academic adviser's contributions significantly facilitated the novel intervention's successful implementation. References Risk, J., Mohammadi, L., Rhee, J., Walters, L., & Ward, P. R. (2019). Barriers, enablers, and initiatives for uptake of advance care planning in general practice: a systematic review and critical interpretive synthesis. BMJ open, 9(9), e030275.  http://dx.doi.org/10.1136/bmjopen-2019-030275Links to an external site. Sharplin, G., Adelson, P., Kennedy, K., Williams, N., Hewlett, R., Wood, J., ... & Eckert, M. (2019, November). Establishing and sustaining a culture of evidence-based practice: an evaluation of barriers and facilitators to implementing the best practice spotlight organization program in the australian healthcare context. In Healthcare (Vol. 7, No. 4, p. 142). MDPI.  https://doi.org/10.3390/healthcare7040142Links to an external site. Sipes, C. (2024).  Project management for the advanced practice nurse (3rd ed.). Springer Publishing. PEER #2 Oluwakemi Aregbesola Oluwakemi Aregbesola Oluwakemi Aregbesola Week 6 Discussion: Main Post The focus of my practice improvement project is educating the staff on effective discharge planning to reduce no-shows among individuals with alcohol use disorder (AUD). Some of the speed bumps and pitfalls I have encountered include staff attendance in sessions, resistance to change, and communication challenges. Participation in the educational sessions was concerning, as most of the facility's staff had tight schedules, which impacted session attendance. Also, due to the high patient load, most staff had little time to spare to attend sessions. I made efforts to speak with the director at the practicum site to allow scheduling flexibility for staff at a time to promote the attendance of educational sessions. Enabling flexibility in participation has been found to promote the implementation of quality improvement projects (Aredo et al., 2023). Some staff were unwilling to adopt a new intervention on effective discharge planning after highlighting challenges with increased discharge procedures and time constraints, as the intervention would require more time. The staff cited that collaborations with others may take time, potentially impacting the workflow. I addressed the above pitfall by seeking the assistance of a change champion and opinion leader involving a nurse practitioner and psychiatrist working at the facility to influence the implementation of the intervention. Seeking the assistance of opinion leaders and change champions can result in improved implementation of practice change interventions (Santos et al., 2022). The participants in the educational sessions needed more clarity on implementing effective discharge planning, especially in addressing concerns about the duplication of roles. I explained that collaboration with others to develop comprehensive discharge instructions would promote effective patient education on the need to follow up on treatment. I also explained that maintaining open communication with the multidisciplinary team and the patients would promote collaboration and effective discharge planning. Maintaining transparent and open communication channels was impactful in addressing the key concerns of the participants (Albright et al., 2022). Implementing the above approaches effectively addressed the bumps and pitfalls in the practice change implementation. References Albright, K., Navarro, E. I., Jarad, I., Boyd, M. R., Powell, B. J., & Lewis, C. C. (2022). Communication strategies to facilitate the implementation of new clinical practices: A qualitative study of community mental health therapists.  Translational Behavioral Medicine,  12(2), 324–334. https://doi.org/10.1093/tbm/ibab139 Aredo, J. V., Ding, J. B., Lai, C. H., Trimble, R., Bromley-Dulfano, R. A., Popat, R. A., & Shieh, L. (2023). Implementation and evaluation of an elective quality improvement curriculum for preclinical students: A prospective controlled study.  BMC Medical Education,  23. https://doi.org/10.1186/s12909-023-04047-0 Santos, W. J., Graham, I. D., Lalonde, M., Demery Varin, M., & Squires, J. E. (2022). The effectiveness of champions in implementing innovations in health care: A systematic review.  Implementation Science Communications,  3(1), 80. https://doi.org/10.1186/s43058-022-00315-0