Question 1. Stakeholder support is necessary for a successful change proposal project implementation. Consider your internal stakeholders, such as the facility, unit or health care setting where the change process is situated, and your external stakeholders, like an individual or group outside the health care setting. Why is their support necessary to the success of your project, and how you will go about securing that support?
Stakeholders are very important in moving your project proposal forward, but how to approach them may vary depending upon whether they are internal or external. In either case, knowing the subject matter and being able to demonstrate how the project will benefit them and /or the patients is vital. In this case, the proposal is developing and putting into place as assessment tool that will help identify patients that are abusing opiates or are at risk of becoming addicted. Internal stakeholders would include the staff, including nurses and physicians, management, and the hospital administration. Pandi-Perrumal, et al (2015), states that stakeholder engagement “provides opportunities to further align clinical research practices with societal needs, values, and expectations, helping to drive long-term sustainability…intended to help administrators fully realize the benefits of applying community and patient interest in hospital programs, and to ensure that research and program changes benefit those who are most directly affected”. It is clear that the research and the project clearly demonstrate a benefit to society, reflect values important to those we serve, as well as be in line consistent with the values of the institution. The project must demonstrate that it will have a lasting influence and benefit to the community and the organization. In this situation, convincing external stakeholders that this project is worthy may be easier. External stakeholders could include patients, families, law enforcement, EMS agencies, local and state government entities, the media, insurance companies and nursing organizations to name a few. It is hard to imagine that it would be hard to find someone against such a program as helping identify those at risk of drug abuse, especially with the publicity the problem has earned in the news. For these stakeholders to be more than a group agreeable that a need exists, we need to recruit them to the cause. The Agency for Healthcare Research and Quality (n.d.) states that a key strategy is identifying “Champions” that will assist with program rollout and will help build a sustainable program. Champions can also be sources of feedback, provide evaluation and help in interpreting results. Still, it will be important to understand that stakeholders, whether internal or external, will want to see the research and data to support the project.
Agency for Healthcare Research and Quality (n.d). Designing and implementing Medicaid disease and care management programs. U.S. Department of Health and Human Service.Retrieved from https://www.ahrq.gov/professionals/systems/long-te…
Pandi-Perumal, s., Akhter, S., Zizi, F., Jean-Louis, G., Ramasubramanian, C., Freeman, R. and Narasimhan, M. (2015). Project stakeholder management in the clinical research environment: how to do it right. Frontiers in Psychiatry. 2015, 6:71. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC44348…
With the knowledge of stakeholders and their role in education implementation will be essential in my change plan. The internal stakeholders for my proposal would be the home health organization, the nurses involved in the education and implementation, and the management team. The external stakeholders would be the families receiving the education, and the patients whose family is educated through the new programs.
Using our knowledge on these stakeholders helps us to create a plan that will gain more support and be more successful as well as identify risks and potential issues with the new implementation. In addition, communication with stakeholders throughout the process is necessary to make sure the goals are being met (Agency for Healthcare Research & Quality, 2014). Both internal and external stakeholders have personal goals and priorities so understanding them helps improve the success.
Having stakeholder support is important to my change proposal for many reasons. First, working for a private organizations means that a large portion of funding is from private donors, so the education plan would most likely need to be approved by those funding it and the organizations management team. Gaining their support would help to initiate the change and provide necessary starter funds for the locations and staffing costs of the education program. Second, the organization itself would have to arrange the education sessions with nurses, respiratory therapists and patient families. They would ideally want a strategic plan in place prior to implementing these measures to ensure there is a need for the program. In addition, to engage the internal stakeholders, current research and data on the issue would be necessary to include. We would need to convey an urgency for the need of this additional education program to improve patient safety or reduce negative outcomes. External stakeholders would have different needs to be addressed, but are equally important in the success. Patients and their families have safety and health as their biggest priorities, so providing them with research would also be beneficial. Structuring the program based on their financial needs and other demographic factors and location would be relevant to creating a program they would be interested and capable of attending.
In engaging stakeholders, the goal would be to educate them on the background of need, the process, and the anticipated results. Doing so would involve research in similar education programs, current health statistics relevant to the cause, and proof of education deficits (AHRQ, 2014). Engaging stakeholders is also something that is done throughout the process, not just before its implementation. Using professional communication and updating the stakeholders on the progress helps to keep them supportive and engaged through the entire process, and helps increase the chance of success.
Agency for Healthcare Research & Quality [AHRQ]. 2014. Engaging Stakeholders in a Care Management Program. U.S. Department of Health and human Services [USDHHS]. Retrieved from https://www.ahrq.gov/professionals/systems/long-te…
Developing and implementing projects can be a complex and difficult process. Stakeholders are the important part of any project. Stakeholders are the customer, suppliers, general public, and any other groups which are likely to be affected by the organization/facilities ultimate decisions. Internal stakeholders include management, professional, and non-professional staff. Stakeholders are the groups and individuals who be in influential in the success of the change plans for my capstone project. When stakeholders are not fully engaged, the problem of getting them to support the process and use its outputs is even more difficult. Securing support and commitment with stakeholder is crucial. Support from stakeholder is necessary because these individuals can be useful supporters of a project or alternatively may block project. Building strong, trusting relationships from the start can make the difference between project success and failure. Securing support entails focusing additional energy on activities that both educate and expand understanding. This includes holding education workshops, presentations, meetings, and introducing them to the proposed benefits of the project and the direct effect it will have on them. Stakeholders input and feedback is a critical part of any organizations planning process (Leviton & Melichar, 2016).
Leviton, L. C., & Melichar, L. (2016). Balancing stakeholder needs in the evaluation of healthcare quality improvement. BMJ Quality & Safety, 25(10), 803–807. http://doi.org/10.1136/bmjqs-2015-004814
Technology is integral to successful implementation in many projects, through either support or integration or both. Name at least one technology that could improve the implementation process and the outcomes of your EBP project. Do you plan to use this technology? If not, what are the barriers that prevent its use?
There is so much technology available to help educate patients. Through research, interactive programs, videos, and tablets that patients can use during dialysis, the options are endless. I was in one dialysis clinic that gave each patient iPad to play on or watch TV on during their treatments. The iPad had a thick plastic over them that we were able to sanitize after each use. This could also be a great tool to help with patient education. There are so many more interesting and interactive ways to educate patients with technologic tools such as this. I think a really well-made YouTube video such as the Food Selection for Dialysis Patients Video (2014) can be much more interesting than someone talking at you. One of the barriers to letting patients use a tablet is obviously the cost. Most clinics can not afford tablets for each patient during their treatment. One option would be to have one or two tablets that the nurse or dietitian use just for education purposes. If the tablets are used while the patients are being treated they would need to be sanitized between treatments. The cover that can have bleach on it would add a small extra cost for the tablets. Patients who have their own can be given the resources to explore also.
Food Selection for Dialysis Patients Video (2014). YouTube. Retrieved from,
Nursing technology has played an important role in today’s healthcare arena. It has transformed the way nurses provide patient care and will continue to evolve to meet the needs of our patients. One technology that I believe would be needed to implement the needed change in my EBP would be the use of video conferencing (Rush University medical Center, 2012). The ability to interact with valuable stakeholders with the touch of a button will allow me to stay in contact with them and share important information as needed without the need of traveling. This form of technology offers advantages and opportunities like never seen before the era of technology. It makes it easier to stay in contact with important stakeholders and offer that face to face interaction needed to keep your supporters in the loop and on your side. Sometimes the lack of time can affect professional relationships, but the use of video conferencing can play an important role, and I believe it would help in my change proposal.
Rush University Medical center. (2012). 19 technologies that changed nursing forever. Retrieved from http://www.jobsatrush.com/19-technologies-that-changed-nursing-forever.html.
Technology is considered to be the driving force behind improvements in healthcare. Continuous technological developments in healthcare has saved countless lives and improved the quality of life for even more. A growing number of new technologies are becoming available within nursing care that can significantly improve the quality of care, reduce cost, or enhance working conditions (Fairley, 2011).
One technology that could improve the implementation and outcomes of my evidence based project is the utilization of immunochromatographic tests (ICT). This technology is a rapid test that uses finger prick blood specimens to detect HIV, syphilis, and hepatitis B or C. Early and accurate diagnosis of infections is essential in providing students with timely, appropriate, and effective treatment, in order to limit the spread of the infection. Counselling and partner notification can also be initiated without delay. Without accurate testing, asymptomatic cases could result in long-term reproductive complications and further spread of the infection to others (Peeling, 2011). Outside organizations that we refer our students to for free testing are currently utilizing this rapid test. Our facility is also in the process of using this test as well for the upcoming fall semester.
Fairley, C. K. (2011). Using information technology to control STIs. Sexually Transmitted Infections, 87(Suppl 2), ii25–ii27. http://doi.org/10.1136/sti.2010.048330
Peeling, R. W. (2011). Applying new technologies for diagnosing sexually transmitted infections in resource-poor settings. Sexually Transmitted Infections, 87(Suppl 2), ii28–ii30. http://doi.org/10.1136/sti.2010.047647