Amy Making Changes Are Never Easy, Especially In Health

Amy Making Changes Are Never Easy And Especially In A Healthcare Sett

Amy: Making changes are never easy and especially in a healthcare setting where there are many people with many different views working. There is a typical standard way of doing things but everyone goes about them differently and getting used to a new way of doing things can be difficult. My current healthcare facility tends to have a hard time with change. I work at the VA and I feel that technology is behind here and the standard is not the most up-to-date practices. Executive leadership tend to go against any new ideas that are mentioned and it is very difficult to get them on board unless it feels like an idea that came from them.

This is unfortunate and difficult, as nothing ever seems to change. The success of an organization is really dependent upon a good leadership team that works well with others and has a good foundation of up-to-date practices. In the past, there have been many ideas suggested and shot down right away. I feel that the best way to approach this situation and how I have been handling it is when I present something new or a new process/idea I submit the research and evidence with it, as well as outcomes. This tends to get a little more attention.

Research shows that best practices are supported by high quality evidence and also improve health outcomes and quality of care, in turn making the organization stronger (Ham-Baloyi, et. al., 2020). This is enough of a reason that leaders need to consider how changes will help the organization. Although gathering the research is not the most difficult part, translating the evidence into practice is. When organizations fail to adopt new policies it is usually due to the culture (White, et al., 2019). The culture of an organization can really hold the organization back from doing the right things, as well as the best things for the patient.

The culture of my organization is really a hindrance and this is partly due to the attitude of executive leadership and their inability to be flexible with change. I view my role as a DNP prepared nurse as very important and I view myself as a change agent. DNP prepared nurses are trained to find research, understand it, and put it into practice. Therefore, I feel a due diligence to ensure I have the right information to present to others. The Mayo Clinic Nursing Research model is one that could be helpful to promote a change using evidence-based practice.

This model uses the sciences of caregiving, symptoms, and self-management with technology, teamwork, data, and innovation to improve patients' overall well-being (Chesek, et. al. 2022). Looking at the many different aspects seems like it would be more beneficial vs. just one category. I would use this model for a project to implement a change as I see the many levels to be beneficial. Hani: Quality improvement (QI) initiatives, particularly in healthcare settings, face various barriers.

These hurdles range from resistance to change, lack of resources, and limited staff education and training to the need for more institutional commitment to evidence-based practice (EBP) (Djulbegovic et al., 2019). However, these challenges provide an opportunity for Doctor of Nursing Practice (DNP) professionals like myself to advocate for EBP and QI projects. One challenging and damaging issue in critical care nursing practice involves Ventilator-Associated Pneumonia (VAP). VAP significantly impacts patient morbidity and mortality rates in ICUs (Shaka et al., 2022). However, various studies show a significant reduction in VAP rates with effective oral hygiene care (OHC) strategies, such as consistent application of antiseptics or novel interventions like the combined use of colostrum and sodium bicarbonate.

Translating these evidence-based practices into routine patient care faces several hurdles. The inconsistency seen across studies regarding the preferred antiseptic, frequency of application, and the effectiveness of alternative OHC strategies poses a challenge to protocol standardization. Additionally, resource allocation, staff education, and shifting pre-existing attitudes toward OHC practices in ICUs further complicate the translation of evidence into practice. DNP-prepared nurses play an essential role in affecting change by leveraging their expertise in blending clinical, organizational, economic, and leadership skills (Boswell et al., 2021). As a future DNP nurse, my role involves implementing EBP, disseminating research findings, reviewing institutional policies, engaging stakeholders, and leading QI projects.

The profession's mission aligns with creating a healthcare culture that promotes the translation of evidence for quality improvement, thereby improving patient outcomes and advancing the nursing discipline. To address VAP incidence in the target healthcare organization, I propose developing and implementing a QI project focusing on OHC protocol standardization. This project will involve identifying optimal OHC strategies based on current evidence and systematically teaching them in the ICU routine. Providing standardized training to multidisciplinary care staff will ensure consistency in OHC applications, strengthening the fight against VAP. Regular audits and research will measure the impact and facilitate appropriate revisions.

Additionally, research advocacy is crucial, as it encourages constant scrutiny and evolution of EBP, enhancing generalizability and application across different settings (Harper & Maloney, 2019). As a DNP nurse, I can contribute to EBP by conducting studies exploring optimal OHC administration frequency, the potential correlation between VAP incidence rate and OHC practices, and investigating alternative strategies for VAP reduction. Moreover, modeling the integration of EBP in daily practice is vital. Clinical rounding, presenting current research in departmental and unit-based meetings, involving staff in journal clubs and reviews, and creating safe spaces where queries, apprehensions, and suggestions can be freely discussed are just a few practical ways to achieve this.

By consistently promoting and highlighting the benefits of EBP, staff can be encouraged to embrace these methods, which pave the way for enhanced quality healthcare and favorable patient results. As a future DNP nurse, my role goes beyond addressing immediate patient needs. It extends to shaping a care culture rooted in EBP and leading initiatives driving quality improvement in healthcare (Harvey et al., 2019). Although challenges in translating and applying evidence are multi-faceted, the opportunities to improve patient care, nursing practices, and healthcare outcomes are immense. Every resistance encountered is an invitation to advocate for better practice, and every barrier propels nursing a step forward toward a safer, quality healthcare landscape.

Paper For Above instruction

Implementing change within healthcare environments is a complex process that involves navigating organizational culture, leadership perspectives, resource limitations, and staff engagement. As healthcare professionals, especially advanced practice nurses like Doctor of Nursing Practice (DNP) prepared nurses, they have a vital role in leading evidence-based practice (EBP) and quality improvement (QI) initiatives to enhance patient outcomes. This paper explores the challenges of change management in healthcare settings, examines strategies to overcome barriers, and highlights the critical role DNPs play in translating research into practice to foster improvements in patient care and organizational performance.

Challenges in Healthcare Change Implementation

Healthcare organizations are inherently resistant to change due to entrenched practices, cultural norms, and leadership attitudes. Amy’s reflection on her experience at the VA emphasizes the difficulty in convincing leadership to adopt new practices, especially when the organization’s technology infrastructure lags behind current standards. Resistance from leadership often stems from risk aversion, fear of disrupting routines, or skepticism about the evidence supporting proposed changes (Burke et al., 2018). Additionally, organizational culture—comprising shared values, beliefs, and behaviors—can either facilitate or hinder change efforts (Schein, 2010). In Amy’s case, a rigid culture and leadership reluctance act as barriers to progress, underscoring the importance of cultural change as a prerequisite for successful implementation.

Furthermore, translating research evidence into clinical practice presents its own set of hurdles. Evidence does not automatically lead to practice change unless actively integrated within the organizational context. White et al. (2019) highlight that many healthcare organizations experience “cultural inertia,” where current practices are maintained despite evidence suggesting the need for change. Such inertia is often compounded by limited staff engagement, insufficient training, and resource constraints, impeding the adoption of best practices. Amy’s approach of submitting research evidence with proposed ideas is a strategic step; however, shifting organizational culture requires ongoing leadership support and a comprehensive change management strategy (Kotter, 1996).

The Role of the DNP in Promoting Change

DNP-prepared nurses possess advanced clinical, leadership, and analytical skills that enable them to be effective change agents. Their training emphasizes the application of evidence to clinical decision-making, strategic planning, and system improvement, positioning them as pivotal in translating research into practice (American Association of Colleges of Nursing, 2006). The Mayo Clinic Nursing Research Model exemplifies a framework that DNPs can employ to facilitate change by integrating caregiving sciences, symptom management, and self-management strategies with technology, teamwork, and innovation (Chesek et al., 2022).

In the context of Amy’s proposed initiatives, a DNP can lead efforts to implement evidence-based protocols, such as those aimed at reducing Ventilator-Associated Pneumonia (VAP) or urinary tract infections in nursing homes. For instance, establishing standardized oral hygiene protocols to prevent VAP involves conducting literature reviews, designing staff training programs, and establishing audit systems to monitor compliance and outcomes (Boswell et al., 2021). As a change agent, the DNP advocates for organizational buy-in by presenting data, addressing resistance, and fostering a culture receptive to evidence-based changes.

Moreover, DNPs are adept at fostering interprofessional collaboration, which is essential for sustainable change. Creating multidisciplinary teams that include nurses, physicians, pharmacists, and administrators facilitates shared ownership of initiatives (Kirkway et al., 2020). Through effective communication, role modeling, and ongoing education, DNPs can nurture a culture where evidence-based interventions are standard practice. Engaging staff in journal clubs, quality rounds, and continuous education ensures that evidence remains at the forefront of clinical care.

Evidence-Based Practice and Quality Improvement Strategies

Effective EBP implementation requires a systematic approach, including assessment, planning, intervention, and evaluation—components encapsulated within quality improvement (QI) frameworks (Langley et al., 2009). Applying these frameworks, DNPs can develop targeted projects that address specific patient safety concerns, such as CAUTI prevention or mental health issues in correctional settings.

For example, Winnie’s discussion of CAUTI prevention highlights barriers like resource limitations and staff resistance. A DNP-led project could involve staff education on aseptic technique, resource allocation for necessary supplies, and policy revision to incorporate evidence-based practices (Meddings et al., 2017). Regular audits and data collection allow for ongoing assessment and continuous refinement of interventions (Hess et al., 2016).

Similarly, mental health initiatives in correctional facilities, as discussed by Myriah, require tailored evidence-based interventions that balance security concerns with therapeutic efficacy. Collaborative efforts with external agencies and ongoing staff training are vital to overcoming resistance and fostering a culture of inquiry (Kouyoumdjian et al., 2017). Disseminating research findings through departmental meetings, journal clubs, and presentations can further reinforce evidence-based care principles.

Overcoming Barriers to Change

Barriers such as resistance to change, limited resources, and inadequate staff training are pervasive. Strategies to address these include leadership engagement, fostering a culture of continuous learning, and securing resource support. Kotter’s 8-step change model provides a roadmap: establishing a sense of urgency, building guiding coalitions, creating a vision, communicating the vision, empowering broad-based action, generating short-term wins, consolidating gains, and anchoring new approaches in the culture (Kotter, 1996).

Creating a safe environment for staff to express concerns, ask questions, and suggest improvements encourages buy-in. Providing ongoing education tailored to the staff’s learning needs ensures that evidence-based interventions are understood and correctly applied (Melnyk & Fineout-Overholt, 2015). Leaders must also advocate for adequate resource allocation to support new protocols, technology upgrades, and staff development programs.

Conclusion

Change management in healthcare is inherently complex, requiring strategic planning, strong leadership, and a culture receptive to innovation. DNP-prepared nurses play a crucial role as change agents by translating evidence into practice, leading interprofessional teams, and fostering organizational cultures that prioritize quality and safety. Overcoming barriers through targeted strategies, continuous education, and leadership engagement ensures sustainable improvements. As Amy and others exemplify, embracing evidence-based practice and cultivating a culture of inquiry are essential steps towards delivering high-quality, patient-centered care in dynamic healthcare environments. The integration of models such as the Mayo Clinic Nursing Research Model and frameworks like Kotter’s change theory can guide successful transformation initiatives, ultimately enhancing patient outcomes and healthcare system performance.

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