Solution to Evidence-Based Nursing Practice is The Leadership Peer Response

(1) The main issue for my organization in addressing a solution to evidence-based nursing practice is the leadership.

One of the most common infections which we find in almost all the hospital set ups is a catheter-associated urinary tract infection (CAUTI). According to the American Association of Critical-Care Nurses, indwelling catheters are the cause of this infection.

Implementing a program to successfully reduce this catheter-associated urinary tract infections requires a great truly fine approach, dedicated resources, and leadership support from the highest levels of an organization. Senior leaders of healthcare organizations are responsible for navigating the constantly changing status of healthcare quality, financial, and regulatory issues. The first step in preventing CAUTI starts with the hospital role of leadership, including senior leaders in CAUTI prevention is a critical aspect of the design and implementation of infection prevention programs. Senior leaders must be at the forefront of infection prevention initiatives. Having a senior leader on the CAUTI prevention team is advised, but they do not have to be a clinician to be an effective leader (Davila, 2018). Following strict infection control protocol is a must and the leaders should be fair enough to keep an eye on these bedside procedures during insertion of urethral catheter, to be followed up daily with the proper maintenance, and strict hand washing techniques.

The role of clinical leaders, executives, and administrators is defined as leading the patient safety effort within an institution to implement a safety culture that frontline staff and patients experience at the bedside. Implementing a safety culture is a complex process, and senior leaders need to be at forefront of this effort. The importance of including senior leaders in CAUTI prevention has been highlighted as a critical aspect of the design and implementation of infection prevention programs (Davila 2018). Good teams work must be there to work collaboratively with senior leadership to address this requirement as well as the many evidence-based clinical requirements for patient care. A strong safety culture is important to the success and sustainment of any healthcare quality improvement initiative. If healthcare staff do not feel supported by leadership or demonstrate a lack of trust in the safety systems, implementing improvement processes will be challenging (Davila 2018).

(2)–There are many components that factor in when discussing the success or failure of evidence-based nursing practice. The reason this becomes such a critical discussion in today’s environment is largely related to the improved quality and patient safety that evidence-based practice (EBP) affords (Titler, 2018) Topics such as individual beliefs, time management, education, and age of the workforce all influence the organizational readiness to actively pursue EBP. In reflecting on my own organization’s ability to address EBP, I can appreciate that our own fallibilities may be contributed to education and age of our nursing workforce; both of which I will discuss in more detail below.

Education: Warren et al. (2016) has identified that RNs prepared at the master’s level or higher show a more favorable attitude toward EBP compared to nurses with diplomas, associates, or bachelor’s degrees. Appreciating this fact, I recognize that the majority of our rural nursing workforce is prepared at the associates level thus contributing to more resistance and possibly lack of understanding when it comes to the importance of EBP.

Age and work experience: Younger nurses and nurses with less experience have shown to be more positive believers in integrating EBP into the culture of an organization (Warren et al., 2016). Alternatively to this, my workplace has a higher demographic of experienced nurses, which in this example can prove to be a challenge of integrating EBP.

In considering the steps that are needed to address this issue, I would factor in statistical findings related to the challenges of EBP implementation and the reflection of my own organizational atmosphere. In doing this and finding age and education to be a factor, I would work on making a more diverse workforce that attracted a variety of age ranges. This may be achieved by incorporating nurse intern programs, where nursing students can be employed by the organization prior to graduation and easily transition into a full-time nursing role once they pass the NCLEX. Furthermore, providing educational reimbursement to achieve higher levels of education would also help attract new nurses and work toward bettering the understandings of EBP. I believe these efforts would work toward a goal of resolving some of the issues surrounding EBP.

(3) The main issues that I see in my organization are lack of time and resistance to change. Making sure staff is informed and educated takes a huge chunk of time. Hospitals need to educate all of the rotating shifts, day, evening, and nights, in addition to part time and per-diem staff. That can take months before anything is implemented. Nurse educators need to be pulled in to make sure the staff is adequately prepared with the knowledge. Nurse supervisors need to know how to answer questions and trouble shoot problem areas. A policy needs to be made. Documentation needs to be modified for any new criteria. Many nurses who have worked at my hospital resist change because they are afraid of it. Several of them have trained on paper charts and hold onto a “because we’ve always done it this way” attitude. These are the people that struggle with the computer system. They are superb nurses to their patients but have a hard time dealing with complex situations. The addition of another task to their workflow would cause them anxiety and they would instinctively refuse the education. It’s funny too because our “more seasoned” nursing staff are typically the first ones to speak up against something that they do not like, but when they are called to be part of that change to make it better, they find reasons why they cannot participate.

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