NRS 493 Name two potential barriers that may prevent your EBP change proposal from continuing to obtain the same desired results 6 months to a year from now, and your strategies for overcoming these barriers

Regardless of the information and efforts taken place to promote evidence-based practices (EBP), there may be potential barriers in any organization/hospital/clinic sustaining the practices. One barrier may be uncertainty or a lack of understanding or knowledge due to a pre-formed bias or current understanding may be or become a barrier which ties in with another potential barrier of resistance per Ginex writing, “because we’ve always done it this way” (2018). To this, Ginex informs us that one voice alone is not sufficient to change, create and sustain a change of practice (2018) and continues of the importance therefore for support (internal and external stakeholders) to see it through and continue it. The capstone project this student chose includes interventions which, although utilized in several countries including a retrospective study done in three US hospitals and two hospitals in Honduras which assessed the outcome of patients receiving a multi-medication approach (MMA) including ivermectin and resulted in positive outcomes for patients who received ivermectin/MMA with the standard of care compared to patients only receiving the standard of care (Pascua et al., 2021).

Strategies to overcome barriers is to remain kind and courteous, no jugular veins quivering nor eyes bulging as the information is provided as has been seen on both “sides” of the information. The information speaks for itself. It simply needs a voice. There are already to amazing MDs in our Valley which have utilized early interventions and have saved countless lives in our community and shared some of their information at a County Board of Supervisors meeting with the public (Tyson & Fareed, 2021). They are the key persons who have made a difference since the beginning of Covid-19. Provision of the many resources and studies proclaiming the prophylactic or illness benefits of off-brand medications including Boldescu et al who provided vital antiviral information pre-Covid, regarding ivermectin which was/is proven to be safe, broad spectrum, effective and cost efficient against such viruses as Dengue, Zika Virus, Yellow fever, River Blindness, and elephantiasis (2017). An example via Kerr et al. is the Brazilian city-wide prophylactic provision {if the person and/or their MD approved/desired it} which resulted in city-wide death rates falling (2020). A supplementation that is not often told of is vitamin D which in the study by Abrishami et al. resulted in “significant” differences for Covid-19 positive persons with to have much higher lung-involvement issues if they were vitamin D deficient and subsequently “significantly” less lung involvement when patients had sufficient vitamin D levels (2021). These are brief glimpses of the information that is readily available. It simply needs to be further told, informed and educated about.

Resource

Abrishami. A., Dalili, N., Torbati, P. M., Asgari, R., Arab‑Ahmadi, M., Behnam, B., & Sanei‑Taheri, M. (2021). Possible association of vitamin D status with lung involvement and outcome in patients with COVID‑19: A retrospective study. European Journal of Nutrition. 60, 2249–2257. https://doi.org/10.1007/s00394-020-02411-0

Boldescu, V., Behnam, M., A. M., Vasilakis, N., & Klein, C. D. (2017). Broad-spectrum agents for flaviviral infections: Dengue, Zika and beyond. National Review of Drug Discovery, 16(8), 565-576

Ginex, P. (2018). Overcome barriers to applying an evidence-based process for practice change. Oncology Nursing Society (ONS). ONS Voice. https://voice.ons.org/news-and-views/overcome-barriers-to-applying-an-evidence-based-process-for-practice-change

Kerr, L, Cadegiani, F. A., Baldi, F., Lobo, R. B., Assagra, W. L. O., Proenca, F. C., Kory, P., Hibberd, J. A., & Chamie-Quintero, J. J. (2020). Ivermectin prophylaxis used for COVID-19: A citywide, Prospective, observational study of 223,128 subjects using propensity score matching. Cureus, 14(1). doi:10.7759/cureus.21272

Pascua, V. F., Diaz, O., Medina, R., Contreras, B., Mistroff, J., Espinosa, D., Sekhon, A., Paz Handal, D., Pineda, E., Vargas Pineda, M. and Pineda, H. (2021). A multi-mechanism approach reduces length of stay in the ICU for severe COVID-19 patients. PloS one, 16(1). https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0245025

Tyson, B. & Fareed, G. (2021). Presentation regarding the importance of early intervention for Covid-19 to the Imperial County Board of Supervisors and community. https://imperial.granicus.com/player/clip/2078?view_id=2&meta_id=346679&redirect=true

Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS NRS 493 Name two potential barriers that may prevent your EBP change proposal from continuing to obtain the same desired results 6 months to a year from now, and your strategies for overcoming these barriers:

Sustaining change can be difficult, as there are many variables that can affect implementation. One critical component of EBP is to ensure that practice change is part of an organization’s culture so it will continue to impact outcomes over time (Wayne, 2021). One potential barrier that may prevent my EBP change proposal from continuing to obtain the same desired results 6 months to a year from now would be the state of the economy at this moment in the United States and inflation that makes money tight for the average citizen therefore the struggle to stay afloat would be twice as hard for those who have low-incomes that causes individuals to focus more on making money so taking on more shifts which decreases their availability to caring for their own health. Another barrier that can be categorized as the main potential barrier is the hospital and governments wariness of allocating money, personnel and resources to this change proposal but to overcome this there must be emphasis on convincing these institutions on the popularity that the hospital or organization would acquire once patients realize the goal of the group is the focus of providing equitable care to all types of people regardless of their financial background is significant (Silva-Perez et al, 2019). Positive international attention and press to the organization would will allow it to flourish. While financially it is a more expensive route, it would be covered if all other hospitals and the government aided in collaboratively contributing to allocating funds for the poor which allows clinics and other healthcare organizations to use money in a more efficient manner by reducing cases of disease. Another barrier is lack of personnel which could be overcome by providing volunteer hours for those who need it which would attract a large amount of students, nurses, and other personnel similar to BSN students who need clinical and volunteer hours.

NRS 493 Name two potential barriers that may prevent your EBP change proposal from continuing to obtain the same desired results 6 months to a year from now

Silva-Perez, L. J., Gonzalez-Cardenas, N., Surani, S., Etindele Sosso, F. A., & Surani, S. R. (2019). Socioeconomic Status in Pregnant Women and Sleep Quality During Pregnancy. Cureus, 11(11), e6183. https://doi.org/10.7759/cureus.6183

Wayne, G. (2021, July 8). Nursing theories and theorists: An ultimate guide for nurses. Nurseslabs. Retrieved June 7, 2022, from https://nurseslabs.com/nursing-theories/#florence_nightingale

Evidence-based practice in health care plays a significant role in promoting a positive impact on patients and their families. Evidence-based practice results in patient and healthcare provider’s satisfaction and development of the healthcare facilities. Through evidence-based practice, the rate of health care is decreased, and the value of healthcare facilities is heightened. The evidence-based practice supports qualified and unique development of nurses and other health care specialists. Moreover, nurses who have confidence in evidence-based practice make good quality choices. Safety of patient care is a problem in healthcare sectors. It is connected with nursing consistent ratios which is a crisis in many organizations. Normally, a nurse is supposed to care for certain number of patients at a given time but due to lack of resources this has not been possible to achieve.

In many instances, stress has been viewed as an occupational hazard and can affect the outcome of a job. A study comparing registered nurses working shifts of 12 and 8 hours showed that RNs working 12-hours shifts had a higher level of stress than those working 8-hours shift (Stimpfel et al., 2012). With that said, we argue that increasing the number of nurses reduces working hours and job stress, hence positive patient outcomes and job satisfaction. To address the interdisciplinary barrier and encourage the adoption of evidence-based research, it is essential to promote collaboration in healthcare. Healthcare organizations should establish nurse-led evidence-based research programs that are used to redesign care delivery (Wyant, 2017). This helps in enhancing the efficiency and effectiveness of interventions while reducing safety and cost risks. Health professionals should be trained to promote collaboration between different health care disciplines and foster a culture of evidence-based research readiness.

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-change

Wyant, T. (2017). Adopt an Evidence-Based Practice Model to Facilitate Practice Change. Retrieved from. https://voice.ons.org/news-and-views/adopt-an-evidence-based-practice-model-to-facilitate-practice-change

Evidence-based practice is defined as the integration of clinical expertise, patient values, and the best research evidence into the decision-making process for patient care. Each organization has outlined a mission, vision, and core values. This blueprint offers staff, stakeholders, and consumers the opportunity to seek options of evidence-based practices which align with this. “The Institute for Healthcare Improvement said we should target the triple aim in health care: improving the patient experience, improving population health outcomes and decreasing health care costs,” says Dr. Melnyk. “Some years after the triple aim goal came out, a fourth aim was added: improving the work life of clinicians and their well-being” (Why Choose, 2018, 3). To best implement evidence-based practice interventions the collaboration of diverse healthcare professionals can be utilized to provide insight into how each unique discipline is able to benefit or not benefit from the intervention (Why Choose, 2018).

References:

Why choose evidence-based practice? (2018). American Association of Nurse Practitioners. Retrieved June 19, 2022, from https://www.aanp.org/news-feed/why-choose-evidence-based-practice

Sustainable healthcare quality improvement is critical in enhancing positive patient outcomes as well as ensuring safety among healthcare providers. However, there exist various barriers that prevent sustainable adoption of evidence-based practices which makes some of the implemented projects not to achieve some of the long-term objectives. Some of the common barriers in the sustainable implementation of evidence-based practices include challenges associated with translating evidence-based practices into actual practice as well as poor organizational culture that may not advocate for quality healthcare services from its employees. For implementation of my evidence-based practice, the two barriers that may hinder sustainable change implementation include poor organizational culture and lack of motivation by the nursing staff.

Poor organizational culture may be a critical hindrance to the implementation of my evidence base practice because if the organization does not demand for quality healthcare, there will be no motivation to implement projects meant to improve quality healthcare outcomes. Also, failure to provide the necessary resources for the implementation of the evidence-based practice will lead to failure to implement the evidence-based practice (Shayan, Kiwanuka & Nakaye, 2019). One strategy to overcome the challenge is by involving the organizational management during project implementation because they are critical in the provision of appropriate resources for the project implementation.

Another barrier is poor motivation of the healthcare staff implementing the project due to lack of incentives. Healthcare quality improvement is significantly influenced by the ability to provide incentives to the stakeholders. To facilitate promote motivation among nurses, there is need to provide incentives to the healthcare providers to enhance motivation to facilitate the implementation of evidence-based practice (Bach-Mortensen, Lange & Montgomery, 2018). For this case, as part of the project implementation resources, I will ensure the organizational management sets part of the financial resources to motivate healthcare providers involved in the implementation of the change.

References

Bach-Mortensen, A. M., Lange, B. C., & Montgomery, P. (2018). Barriers and facilitators to implementing evidence-based interventions among third sector organisations: a systematic review. Implementation Science, 13(1), 1-19.

Shayan, S. J., Kiwanuka, F., & Nakaye, Z. (2019). Barriers associated with evidence‐based practice among nurses in low‐and middle‐income countries: A systematic review. Worldviews on Evidence‐Based Nursing, 16(1), 12-20.

NRS 493 Name two potential barriers that may prevent your EBP change proposal from continuing to obtain the same desired results 6 months to a year from now, and your strategies for overcoming these barriers