Assignment task: Enablers and Barriers to Translation
There are many hurdles to overcome when it comes to the translation of evidence into practice. As noted in White et al. (2024), of all the identified evidence, only about half of it is ever actually put into practice. Thus, being able to detect the potential enablers and barriers that you may encounter when implementing an EBP initiative is critical to your success. For this Discussion, you will draw on your professional experience in healthcare settings to consider specific enablers and barriers to evidence-based practice (EBP) quality improvement (QI) initiatives.
Resources:
- White, K. M., Dudley-Brown, S., & Terhaar, M. F. (Eds.). (2024). Translation of evidence into nursing and healthcare (4th ed.). Springer.
- Chapter 13, "Teamwork for Translation" (pp. 257-270)
- Chapter 14, "Barriers and Facilitators to Translation" (pp. 270-280)
Note: Read one or more of the following exemplars based on the focus of your Discussion post:
- Chapter 18, "Acute Care Exemplars" (pp. 315-355)
- Chapter 19, "Primary Care Exemplars" (pp. 356-379)
- Chapter 20, "Certified Registered Nurse Anesthetists Exemplars" (pp. 391-417)
- Chapter 21, "Health Systems Exemplars" (pp.417-458)
- Chapter 22, "Team Projects Exemplars" (pp. 461-500)
- Cane, J., O'Connor, D., & Michie, S. (2012). Validation of the theoretical domains framework for use in behaviour change and implementation science. Implementation Science.
To Prepare
- Review the Week 7 Learning Resources. Pay particular attention to the theories and best practice recommendations related to enablers and barriers to translating and applying evidence in support of practice or organization change initiatives.
- Select an organization and a practice or organization issue within that organization. Consider evidence-based practice (EBP) quality improvement (QI) initiatives to address the issue.
- Select one evidence-based practice (EBP) quality improvement (QI) initiative on which to focus for this Discussion. Note: You may reuse an initiative you selected earlier in this course or select a new one.
- Think about the kinds of enablers you might encounter when translating and applying evidence for the evidence-based practice (EBP) quality improvement (QI) initiative you selected.
- Think about the kinds of barriers you might encounter when translating and applying evidence for the evidence-based practice (EBP) quality improvement (QI) initiative you selected.
- Consider the ways in which you might address the barriers you identified.
Post the following:
1. Identify the organization you selected.
2. Describe the practice or organization issue you selected.
3. Describe the evidence-based practice (EBP) quality improvement (QI) initiative you selected to address the issue.
4. Describe the types of enablers that you might encounter when translating and applying evidence for the evidence-based practice (EBP) quality improvement (QI) initiative. Be specific and explain how enablers can benefit the project.
5. Describe the types of barriers that you might encounter when translating and applying evidence for the evidence-based practice (EBP) quality improvement (QI) initiative. Be specific and explain how barriers may challenge the project.
6. Explain how, as a DNP-prepared nurse, you would address the barriers you identified. Be specific and describe specific approaches to address each barrier. Need Online Tutoring?
Note: Your posts should be substantial, supported with scholarly evidence from your research and/or the Learning Resources, and properly cited using APA Style. Personal anecdotes are acceptable as part of a meaningful post but cannot stand alone as the entire post.
Respond to at least two of your colleagues, on different days, by suggesting additional approaches to address the barriers they identified. Be specific and cite sources to support your recommendations.
Note: Your responses to colleagues should be substantial (250 words minimum), supported with scholarly evidence from your research and/or the Learning Resources, and properly cited using APA Style. Personal anecdotes are acceptable as part of a meaningful response but cannot stand alone as a response. Your responses should enrich the initial post by supporting and/or adding a fresh viewpoint and be constructive, enhancing the learning experience for all students.
Return to this Discussion in a few days to read the responses to your initial posting. Note what you have learned and/or any insights that you have gained because of your colleagues' comments.
Respond To This Discussion Post
Lod Rog
Chosen Organization and Concern
The selected institution is a 35-bed private long-term care facility in a sizable community. A significant number of patients receive extensive intravenous (IV) drugs necessitating a central line. The hospital has been contending with central line-associated bloodstream infections (CLABSI) for more than a year. Central line-associated bloodstream infections (CLABSIs) remain a significant concern in healthcare, leading to increased mortality, morbidity, prolonged hospital stays, and elevated expenses for medical facilities (Pate et al., 2022).
Evidence-Based Practice (EBP) Quality Enhancement Initiative
The matter necessitates a multidisciplinary team comprising leadership, infection control specialists, physicians, nurses, a quality assurance team, and staff members. The Quality Improvement program will focus on the CLABSI preventive bundle, which includes hand hygiene, appropriate dressing changes, chlorhexidine (CHG) baths, and aseptic technique during insertion. The multidisciplinary team will get education and training on the CLABSI bundle to ensure its effectiveness in preventing CLABSI.
Enablers for the Initiative
Various enablers can guide and facilitate the execution of the CLABSI prevention bundle. Collaboration encourages team members to exchange ideas and expertise, enabling them to pursue objectives and enhancing problem-solving and results. Engaging stakeholders throughout the planning phase helps foster support. Effective communication may improve and involve personnel.
Barriers to Initiative
Employees may exhibit resistance to change and lack enthusiasm for acquiring new habits. Resistance may arise from participating in prolonged meetings and training, resulting in extended work hours. A deficiency in staffing may lead to psychological and physical exhaustion. Insufficient resources, ambiguous goals and objectives, and an impractical timescale impede transformation (Mahr & Lombardo, 2023).
Addressing Barriers as a DNP Prepared Nurse
Stakeholders will participate in the planning phase and be informed about the implementation process. When involved, stakeholders cultivate a sense of commitment, shared values, trust, and happiness regarding the change (Kang, 2012). I will show data on reducing CLABSIs, which can foster trust and confidence within the interdisciplinary team. Advocating ongoing education and annual skills assessments would evaluate the staff's understanding and proficiency regarding the QI project.
I would collaborate extensively with nurses to guarantee that new nurses will receive adequate training on all aspects of central line access. Weekly audits will evaluate the dressings and documentation of central line management and treatment. I would conduct daily rounds with the healthcare team to assess the necessity of continuous access for patients with central lines; if access is no longer required, the central lines should be removed. I would instruct patients and their families on maintaining and managing central lines, ensuring they comprehend the significance of IV access.
Summary
Given the prevalence of CLABSIs, it is imperative to execute a quality improvement project. Establishing a multidisciplinary team while implementing an organizational change is essential. Stakeholders ought to participate in the planning phase to foster trust and confidence. Facilitators can advocate for transformation and execute the program. Obstacles may impede progress, yet through education and resources, we may surmount them. As a DNP-prepared nurse, I will persist in educating and supplying resources to the staff to promote evidence-based practice initiatives.
References:
- Kang, M. (2012). Toward a model of engaged publics: Trust, satisfaction, and the mediating role of public engagement in supportive behaviors [abridged version of Doctoral thesis]. Syracuse, NY: Syracuse University.
- Mahr, N., & Lombardo, J. (2023, November 21). Overcoming barriers to organizational change examples
- Pate, K., Brelewski, K., Rutledge, S. R., Rankin, V., & Layell, J. (2022). CLABSI Rounding Team: A Collaborative Approach to Prevention. Journal of nursing care quality, 37(3), 275-281.