NUR 590 Topic 5 DQ 1 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
NUR 590 Topic 5 DQ 1 Identify two stakeholder barriers you might experience during the implementation phase of your evidence-based practice project
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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.
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Collaboration within a cohesive unit is critical to an organization’s continued existence and progress. A lack of awareness of the issues plaguing an organization may complicate the process of putting implementation plans into action. This lack of information is common in many businesses, particularly those where leaders and management are cut off from the day-to-day operations that contribute to the firm’s operation. When a person rises through the ranks of an organization to a position of leadership, they gain knowledge and expertise that other managers would not have if they were hired from outside. Individuals who advance through the ranks have a better understanding of the organization’s inner workings, including its strengths and weaknesses, as well as the processes required to ensure the company’s long-term viability. Nothing will be accomplished as long as there is a schism between stakeholders in higher positions and those in charge of day-to-day operations.
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.
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:
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.
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 essential to the implementation process because the assistance provided can impede the potential outcomes and results of the research or interventions. Staff engagement and organizational allowance for collaboration are two stakeholder barriers I anticipate encountering during the project implementation process.
Nutrition education (specifically diet types) can be unfamiliar and uncomfortable for nursing staff, making engagement difficult. Nutrition in an acute setting can be seen through meals and nutrition deficits from a nursing standpoint. Expecting nurses to use nutrition education in an acute setting may be inappropriate because their primary focus is patient care and safety; engaging them in nutrition education would require them to shift their focus and may reduce patient outcomes. If interventions do not have a direct impact on acute care outcomes in this setting, nurses may be unmotivated to participate. This is why, in preparation for post-acute health and wellness, education may be promoted as a nursing education intervention, and the intervention should be designed to address nursing from a community health or public health standpoint (Leung, Trevena, & Waters, 2016).
Organizational tolerance for conducting internal research can also be challenging because most organizations do not want to allocate resources to interventions that do not benefit both the patient and the organization. This means that resources within the organization are less likely to be provided, and the researcher must acquire and obtain information, as well as deploy internal interventions, on their own. There is also the possibility of intervention approval being denied because the organization does not want to waste the time of education or nutrition staff on an intervention that may not have significant long-term care outcomes (Williams. Candon, Stewart, Byeon, Bewtra, Buttenheim, Zentgraf, Comeau, Shoyinka & Beidas, 2021).
A good suggestion for a colleague who is having difficulty with stakeholders is to understand and present the potential outcomes, as well as provide sufficient evidence to demonstrate that supporting the intervention can be part of a larger investment in the care provided. This could increase stakeholder support for an intervention.
References:
Williams. N, Candon, M., Stewart, R., Byeon, V., Bewtra, M., Buttenheim, A., Zentgraf, K., Comeau, C., Shoyinka, S., & Beidas, R. (2021). Community stakeholder preferences for evidence-based practice implementation strategies in behavioral health: a best-worst scaling choice experiment. BMC Psychiatry, 21(1), 1–12. https://doi-org.lopes.idm.oclc.org/10.1186/s12888-021-03072-x
Leung, K., Trevena, L., & Waters, D. (2016). Development of a competency framework for evidence-based practice in nursing. Nurse Education Today, 39, 189–196. https://doi-org.lopes.idm.oclc.org/10.1016/j.nedt.2016.01.026
When in a leadership role, leaders need to develop relationships with stakeholders. Engaging with stakeholders will build trust and develop learning systems for evidence-based projects. Stakeholders can also help define outcome metrics. Having buy-in from the beginning will aid in the planning of a more substantial project and execution approach. The two stakeholder barriers that one may experience during the implementation phase of the evidence paste project are resources and participation. Limited financial and personnel resources and competing goals might provide significant difficulties (Murphy et al., 2021). Financial assistance, space, and training were all limited, as was access to mental health treatment. Investing in and exploiting established local experience and capabilities can assist in resolving. The difficulty in obtaining active involvement from stakeholders and differing expectations about the nature of participation was recognized as obstacles, whereas possibilities for meaningful participation and empowerment were identified as drives (Ginex, 2019). Participants address the implications of working with and educating providers in the context of failing healthcare delivery systems, complicated socioeconomic settings, and management and organizational hurdles in the medical sector.
Ginex, P. (2019). Overcome Barriers to Applying an Evidence-Based Process for Practice Change. ONS Voice. https://voice.ons.org/news-and-views/overcome-barriers-to-applying-an-evidence-based-process-for-practice-change
Murphy, J., Qureshi, O., Endale, T., Esponda, G. M., Pathare, S., Eaton, J., De Silva, M., & Ryan, G. (2021). Barriers and drivers to stakeholder engagement in global mental health projects. International Journal of Mental Health Systems, 15(1). https://doi.org/10.1186/s13033-021-00458-y
Two stakeholder barriers that I think I will encounter are staff engagement with the project and lack of staff time. For the staff engagement barrier, I would first need to start by making sure the staff understood the reason behind the project. I would need to create a vision and understanding of how the project can improve patient outcomes by using examples of real clinical scenarios (Melnyk & Fineout-Overholt, 2019).I would utilize the unit-based nursing council to help with the education of colleagues and identification of project champions (Melnyk & Fineout-Overholt, 2019). This is important because a top-down approach is not successful because it leads to a lack of ownership from front line staff (Mathieson et al., 2019). The project champions would also be utilized to conduct audits and provide feedback.
For the lack of time barrier, it is important to start with organizational support of the project (DeNisco, 2021). Being a Magnet organization and an HRO there is always support over EBP (Evidence Based Practice) projects and quality improvement projects. I would need to set aside uninterrupted time for the unit-based council/champions to learn about the project and educate colleagues. The education would be done during change of shift nursing huddles to save time verses doing it during the work shift. As a NM I may need to wait to implement the project when the unit is better staffed. I am actively hiring and training new nurses in the unit. Once the nurses are trained and on their own this will allow for sufficient staff to implement the project. The project involves patient and family engagement, and the RN (Registered Nurse) needs to be able to educate the importance of CAUTI (Catheter Associated Urinary Tract Infection) prevention. This is not something that should be rushed.
DeNisco, S.M. (Ed.). (2021). Advanced practice nursing: Essential knowledge for the profession (4th ed.). Jones & Bartlett Learning.
Matheson, A., Grande, G., & Luker, K. (2019). Strategies, facilitators, and barriers to implementation of evidence-based practice in community nursing: A systematic mixed-studies review and qualitative synthesis. Primary Health Care Research and Development, 20 doi:10.1017/S1463423618000488
Melnyk, B.M. & Fineout-Overholt, E. (2019). Evidence-Based practice in nursing & healthcare: A guide to best practice (4th ed.). Wolters Kluwer, Inc