Kendall Regional Medical Center: Clinical Obstacles

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Introduction

The proposed practice change concerns the prevention of complications arising from foley catheter use in surgical patients at the Kendall Regional Medical Center. Available nursing scholarship demonstrates that evidence-based practice changes are often faced by a multiplicity of barriers that reduce the desire of nursing professionals to implement the changes in treating patients (Wallis, 2012). The present paper reflects on the proposed practice change to not only analyze the nonhuman obstacles that may present during change implementation but also create a viable action plan that will be used to address the barriers.

Analysis of Nonhuman Obstacles

Upon reflection of the proposed practice change, it is evident that the existing organizational policies at the health organization may occasion some resistance due to perceived standards of practice, financial disincentives, and other organizational constraints. This is viewed as a nonhuman obstacle since it relates to the resistance that may be fueled by organizational policies and standards of practice, as opposed to opinions from senior leaders or attitudinal barriers.

These policies will influence the capacity of the organizations culture to support the proposed evidence-based project (Pagoto et al., 2007), thus the need to ensure that it is sufficiently addressed. Additionally, it may be difficult to locate adequate research-based information dealing specifically with the proposed practice change, leading to a situation where the researcher will be forced to categorize or conceptualize the main problem area into deficient characterizations that may be unable to provide fulfilling solutions.

The third non-human obstacle relates to the lack of adequate tools and resources needed to successfully implement the evidence-based practice change. To prevent complications arising from foley catheter use, the health care organization must invest in tools (e.g., up-to-date user-friendly technology and computer systems) and resources that may require additional training and education.

Here, the lack of appropriate tools and the inability of the organization to support the proposed interventions or provide the needed resources in terms of training and additional education may negatively impact the practice change (Pagoto et al., 2007). Lastly, the ever-busy workplace environment in the hospitals surgical department, as well as logistical difficulties, may hinder the successful implementation of the practice change effort (Johnston et al., 2016).

Action Plan

Since most of the obstacles identified are organizational, structural, or policy-oriented in nature, it is important to use a participatory approach that aims to involve nursing leaders and other stakeholders in the surgical unit in discussing the benefits of the proposed practice change and how it will be implemented.

A participatory approach is effective in not only providing the basis for a fruitful dialogue in attempting to address the barriers related to organizational policies and culture, but also in ensuring that important information is shared between relevant stakeholders with the view to ensuring that those who control resources can increase the local capacity that will deal with barriers of inadequate tools, logistical concerns, and untrustworthy research sources (Tacia, Biskopski, Pheley, & Lehto, 2015).

It is also important to increase departmental communication and use evidence-based practice mentors to champion advanced education and training for surgical nurses, enhance their participation in the proposed practice change, and liaise with the senior management to ensure the working environment is improved to allow the professionals adequate time to participate in the change effort. This action plan, in my view, will successfully address the obstacles and support project sustainability by stimulating shared ownership in the promotion of the best scientific evidence.

Conclusion

Drawing from the discussion and analysis, it is evident that the strategies identified in the action plan will be effective in addressing the nonhuman obstacles that relate to resistance due to organizational policies and culture, inadequate research-based information, lack of adequate tools and resources, busy workplace environment, as well as logistical difficulties.

References

Johnston, B., Coole, C., Narayansamy, M., Feakes, R., Whitworth, G., Tyrrell, T., & Hardy, B. (2016). Exploring the barriers to and facilitators of implementing research into practice. British Journal of Community Nursing, 21, 392-398.

Pagoto, S.L., Spring, B., Coups, E.J., Mulvaney, S., Coutu, M.F., & Ozakinci, G. (2007). Barriers and facilitators of evidence-based practice perceived by behavioral science health professionals. Journal of Clinical Psychology, 63, 695-705. doi: 10.1002/jclp.20376

Tacia, L., Biskopski, K., Pheley, A., & Lehto, R.H. (2015). Identifying barriers to evidence-based practice adoption: A focus group study. Clinical Nursing Studies, 3, 90-96.

Wallis, L. (2012). Barriers to implementing evidence-based practice remain high for U.S. nurses. American Journal of Nursing, 112, 15-21. doi: 10.1097/01.NAJ.0000423491.98489.70

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