NUR 550 Topic 5 DQ 2: WHAT ARE COMMON BARRIERS FOR TRANSLATING RESEARCH INTO PRACTICE?
NUR 550 Topic 5 DQ 2: WHAT ARE COMMON BARRIERS FOR TRANSLATING RESEARCH INTO PRACTICE?
Identify a quality initiative from your workplace. What were some barriers to implementation? What are common barriers for translating research into practice?
Re: Topic 5 DQ 2
Sepsis remains a significant cause of mortality in the United States because identifying sepsis in its early stages is challenging. Sepsis Alliance (2021) defines sepsis as a life-threatening response to infection that can lead to organ failure, damage, and even death. Therefore, patients with sepsis require close monitoring and assessment. At my workplace, although we had previously adopted a program with the slogan “Recognize, Resuscitate, refer” to reduce the intensive care unit rates and deaths associated with sepsis. NUR 550 Topic 5 DQ 2: WHAT ARE COMMON BARRIERS FOR TRANSLATING RESEARCH INTO PRACTICE?
The program was proven effective and working at the health facility. However, the implementation of the program was faced with some barriers that hindered complete transition. Among the obstacles that I identified include the technology gap, lack of clarity, and instability leadership. In modern health care practice, technology has influenced the dissemination of information and application of skills.
NUR 550 Topic 5 DQ 2: WHAT ARE COMMON BARRIERS FOR TRANSLATING RESEARCH INTO PRACTICE?
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Now that this program was more aligned with technology, some of the older health care providers were not conversant and lacked the know-how to use identified technology to recognize, resuscitate, and refer sepsis patients. Also, lack of clarity contributed to the partial failure of the 3R program. Some people did not clarify specific issues, such as recognizing patients suffering from sepsis and referring such patients.
In addition, in less than two months after the 3R program was enrolled, the managing director who was coordinating the program resigned from work. This disrupted the implementation process.
NUR 550 Topic 5 DQ 2: WHAT ARE COMMON BARRIERS FOR TRANSLATING RESEARCH INTO PRACTICE?
Available evidence shows that translating research into clinical practice is becoming a challenge despite its importance (Curtis et al., 2017). Nevertheless, translating research to clinical practice has led to efficient and effective healthcare responses meeting patient’s expectations. Some of the common barriers include but are not limited to inadequate resources, personal experience, unsupportive leadership, negative organizational culture, and lack of continuing nursing education (Curtis et al., 2017).
For instance, disseminating research knowledge requires adequate resources such as training health care providers on best approaches to translate research to clinical practice.
Resources NUR 550 Topic 5 DQ 2: WHAT ARE COMMON BARRIERS FOR TRANSLATING RESEARCH INTO PRACTICE?
Curtis, K., Fry, M., Shaban, R. Z., & Considine, J. (2017). Translating research findings to
clinical nursing practice. Journal of clinical nursing, 26(5-6), 862–872. https://doi.org/10.1111/jocn.13586
Sepsis Alliance. (2021). What is Sepsis? https://www.sepsis.org/sepsis-basics/what-is-sepsis/
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RESPOND HERE (150 WORDS, 3 REFERENCES)NUR 550 Topic 5 DQ 2: WHAT ARE COMMON BARRIERS FOR TRANSLATING RESEARCH INTO PRACTICE?
I do agree with you that sepsis is a life-threatening condition in US which requires immediate medical intervention measure. The condition affects approximately 1.7 million adults annually in the US, with an annual death toll of about 250, 000 people (Rhee et al., 2019). Healthcare organizations need to advance the clinical procedures to have the sepsis recognized early and treated before progressing to a more fatal condition. This calls on quality improvement and effectiveness in the nursing process.
Implementation of the measures faces challenges ranging from financial, human resource and leadership that does not recognize the need for promoting quality care. Transformational leadership is crucial in driving change processes in healthcare organization hence improved quality of care, patient satisfaction and general well-being of the public (Asif et al., 2019). Another barrier to implementing the change process on the sepsis treatment and control measure is limited resources which hinder the acquisition of appropriate technological tools and expertise required to speed up the diagnosis and treatment of the condition.
References NUR 550 Topic 5 DQ 2: WHAT ARE COMMON BARRIERS FOR TRANSLATING RESEARCH INTO PRACTICE?
Rhee, C., Jones, T. M., Hamad, Y., Pande, A., Varon, J., O’Brien, C., Anderson, D. J., Warren, D. K., Dantes, R. B., Epstein, L., & Klompas, M. (2019). Prevalence, Underlying Causes, and Preventability of Sepsis-Associated Mortality in US Acute Care Hospitals. JAMA Network Open, 2(2), e187571. https://doi.org/10.1001/jamanetworkopen.2018.7571
Asif, M., Jameel, A., Hussain, A., Hwang, J., & Sahito, N. (2019). Linking Transformational Leadership with Nurse-Assessed Adverse Patient Outcomes and the Quality of Care: Assessing the Role of Job Satisfaction and Structural Empowerment. International Journal of Environmental Research and Public Health, 16(13), 2381. https://doi.org/10.3390/ijerph16132381
Re: Topic 5 DQ 2 NUR 550 Topic 5 DQ 2: WHAT ARE COMMON BARRIERS FOR TRANSLATING RESEARCH INTO PRACTICE?
Being in Oncology and having a program that is Quality Oncology Practice Initiative (QOPI) certified always gives initiatives for quality to work on. One of the most recent quality initiatives that my center is tackling is that of obtaining actual and not stated heights and weights to meet the QOPI standard 1.3.3 and 1.3.4. Standard 1.3.3 is that weights are measured at least weekly when present in the health care setting and standard 1.3.4 is that heights are measured at least weekly when present in a healthcare setting (ASCO.org., 2018).
We were obtaining weights, although not accurate weights as some staff were taking stated weights instead of actual which can really affect the safety of chemotherapy dosing. We were only taking heights on the initial consult and not again after that. When trying to implement a new process for obtaining and documenting heights and weights some barriers that came up was that the EHR does not have an option to document if the height or weight was stated or actual including the inability to document the source of the weight such as a wheelchair scale or a standing scale etc.
At my facility in order to get any changes in the EHR made, a business case has to be developed through a power point presentation and then submitted to the IT team. From there it then has to go through multiple committees in order to get approval to change. This has created a huge delay in meeting our QOPI standards. When translating research into practice, there are common barriers that can be encountered. NUR 550 Topic 5 DQ 2: WHAT ARE COMMON BARRIERS FOR TRANSLATING RESEARCH INTO PRACTICE?
These barriers can include clinician behavior, lack of time, lack of continuing education, unsupportive organization, difficulties in developing evidence-based guidelines, individual motivation, and dissemination of evidence (Curtis et al., 2017). These barriers must be addressed in order to promote translation of research into clinical practice (Curtis et al., 2017).
References: NUR 550 Topic 5 DQ 2: WHAT ARE COMMON BARRIERS FOR TRANSLATING RESEARCH INTO PRACTICE?
American Society Of Clinical Oncology (ASCO). (2018). QOPI certification program standards. https://practice.asco.org/sites/default/files/drupalfiles/2018-06/QOPI%20Certification%20Standards%20June%202018.pdf
Curtis, K., Fry. M., Shaban, R., Considine, J. (2017). Translating research findings to clinical nursing practice. Journal of Clinical Nursing, 26(5-6), 862-872. doi:10.1111/jocn.13586
While I do not have experience working with the Philips Guardian system described in the video, I think it is a great use of technology in hospitals. This system detects trends in patients and whether they are trending downwards/abnormally (Philips Healthcare, 2017). By detecting and alerting nurses to abnormal trends earlier, there is more time for interventions before a patient spirals or codes (Philips Healthcare, 2017). NUR 550 Topic 5 DQ 2: WHAT ARE COMMON BARRIERS FOR TRANSLATING RESEARCH INTO PRACTICE?
At the inpatient psychiatric facility I worked at we did not use an early detection system like this. Our electronic health system was very basic and also did not connect to the vital machines the facility used. Therefore, BHTs and RNs would have to manually check patient vitals everyday and RNs would have to manually input them into the electronic system. NUR 550 Topic 5 DQ 2: WHAT ARE COMMON BARRIERS FOR TRANSLATING RESEARCH INTO PRACTICE?
However, sometimes nurses forgot to input the vitals into the system or patients refused to get up for vitals, making it difficult to track trends overtime and determine if there was a need for medical intervention. I think that all hospitals should utilize an early detection system like the one in this video because it helps nurses prioritize the needs of their patients and also improves patient outcomes.
Reference NUR 550 Topic 5 DQ 2: WHAT ARE COMMON BARRIERS FOR TRANSLATING RESEARCH INTO PRACTICE?
Philips Healthcare (2017, September 19). Quality improvement in nursing at Saratoga Hospital: A Philips customer story [Video]. https://www.youtube.com/watch?v=7WnYpBMHtQk
This Guardian monitoring system is wonderful. My post for this DQ was posing the need for something exactly like this, frequent monitoring affords early intervention. Unfortunately, our facility does not have anything like this monitoring system. Our electronic health system is MatrixCare and we are able to see a facility report, progress notes, vital signs, etc. but they are not readily available like the Guardian.
NUR 550 Topic 5 DQ 2: WHAT ARE COMMON BARRIERS FOR TRANSLATING RESEARCH INTO PRACTICE? Having this technology in our facility would be extremely beneficial, until that time this has encouraged me to do vitals and other monitoring tasks earlier in my shift and keep the information on my clipboard. In the skilled care setting we see a huge number of infections, especially UTIs, and early intervention is key.
Philips Healthcare (2017, September 19). Quality improvement in nursing at Saratoga Hospital: A Philips customer story [Video]. https://www.youtube.com/watch?v=7WnYpBMHtQk NUR 550 Topic 5 DQ 2: WHAT ARE COMMON BARRIERS FOR TRANSLATING RESEARCH INTO PRACTICE?
I am really impressed with the Philips Guardian system. I do not have any experience with using the system or a system like it, but I can immediately think of multiple instances where the system would be useful in my current place of employment. For example, it would be extremely useful to help alert nursing and medical staff of head and neck cancer patients whose weight is trending negatively and allow early intervention.
I do, however, have some concerns about medical staff becoming too dependent on technology and allowing it to take the place of through physical examination (Dempsy Kingsland Osteen, 2018). Overdependence on technology is a real threat as technology becomes more intertwined in the assessment process.
Refrence:
Dempsy Kingsland Osteen. (2018). Doctors: Too dependent on medical technology? https://www.dko-law.com/blog/doctors-too-dependent-on-medical-technology/
I don’t have any experience with the Phillips Guardian System however, at my hospital we use a similar system to trend abnormalities. On the unit where I work, we trend Sepsis alert. According to Ferguson et al (2019), sepsis is one of the leading causes of mortality and readmission in the hospital. Therefore, early recognition and treatment produces better outcome for the patient.
The sepsis alert protocol is a nurse directed standing order that outlines the different treatment modalities to implement if the patient meets certain criteria. During this research it was noted that sepsis-related mortality rate dropped from 12.5% to 8.4% with a mortality reduction of 4.5 deaths per 100 sepsis- related discharges (Ferguson et al, 2019). This was a great improvement. Improved patient outcome produces improved patient satisfaction and improves the overall health of the community.
Reference
Ferguson, A., Coates, D. E., Osborn, S., Blackmore, C. C., & Williams, B. (2019). Early, Nurse-Directed Sepsis Care. The American journal of nursing, 119(1), 52–58. https://doi.org/10.1097/01.NAJ.0000552614.89028.d6
Philips Healthcare (2017, September 19). Quality improvement in nursing at Saratoga Hospital: A Philips customer story [Video]. https://www.youtube.com/watch?v=7WnYpBMHtQk
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