Evidence-Based Project Implementation Issues

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Table of Contents

Introduction
Issues Linked with Project Implementation
Conclusion
References

Introduction

Constraint analysis is of crucial importance in evidence-based project implementation. The nurse behavioral competency improvement project to be implemented at the University of Maryland Urgent Care should be analyzed with regard to barriers, deviations from practice, and overall feasibility. With reference to the project, this paper addresses some hypothetical implementation issues, such as employee resistance and subjectivity in data measurement, variances between accepted urgent care practice and planned staff education that are notable but do not pose risks to patients, and the plan’s preliminary benefits and areas for improvement.

Issues Linked with Project Implementation

Nurses’ Resistance to the Project

The first issue that might arise pertains to socio-cultural factors giving rise to ICU nurses’ resistance to the education-based project, skepticism, or the limited unwillingness to cooperate. There are two hypothetical causes of unenthusiastic collaboration during the data collection and behavioral health competency training linked with the practicum site’s ubiquitous culture of excellence, which might leave little room for honest concern reporting, and the nurse-perceived impracticableness of training. During the pre-intervention data collection stage, the Behavioral Health Care Competency Survey will be applied, but the questions regarding incident frequency and the fear for personal safety might promote overly optimistic responses, stemming from the fear of retaliation for creating reputational risks for the facility (Avery et al., 2020; Morrison et al., 2020). With the second cause, problematic encounters’ relative infrequency might promote the change-resistant mindset at the practicum site and the perceptions of the intervention as a workload-exacerbating factor. Thus, for the upcoming project, this issue’s emergence would mean participants’ lower engagement levels when attending the teaching intervention, resulting in evaluation-related challenges and compromised practice change assessment activities.

The Existing Life Quality Measurement Tools’ Correct Application

The second issue is at the intersection of technological and socio-cultural factors affecting the practicum site. As part of preliminary data collection, the selected tools, especially the Pro-QoL-5, despite possessing construct validity, might lead to the capturing of situational data and details that would understate the urgent care nursing workforce’s actual exposure to complicated clinical encounters and mentally unstable patients. With the Pro-QoL-5 scale, the issue might be caused by the presence of statements regarding happiness or feeling trapped, the responses to which might depend on minor non-job-related incidents or mood at the time of completing the survey (Galiana et al., 2020). The issue’s meaning for the project involves question formulation peculiarities’ ability to compromise the accuracy of baseline job and compassion satisfaction data, but it is unlikely to compromise the project as a whole as its impacts would not undermine the program implementation part.

Variances between Activities, Standards, and Best Practice Guidelines: Takeaways

Regarding significant takeaways, two variances between the planned project activities and the factual practice can be identified, and both of them build on the existing practice rather than narrowing it, which will promote staff learning without risks for healthcare consumers. The difference is that standards and guidelines pertaining to nurse education and skill sets in non-psychiatric urgent care settings do not actually emphasize self-care promotion for compassion fatigue prevention as part of necessary care provider education, so incorporating this component into the two-part behavioral health education would be innovative (Hossain & Clatty, 2021). Another dissimilarity might refer to expanding the existing best practice in comprehensive patient evaluation in urgent and emergency care settings. Standard 1.5 for ENPs’ practice with patients emphasizes practitioners’ preparedness for evaluating the patient’s potential for mental health deterioration, including suicidal risks (American Academy of Emergency Nurse Practitioners & Emergency Nurses Association, 2021). Education delivered within the project’s frame will take this competency even further by bridging the gap between the external observation of behavioral sanity and communication practices, thus enabling nurses to proceed with patient education by applying the necessary information delivery accommodations.

Planning/Implementation Evaluation and Opportunities for Improvement

Overall, the original plan for project implementation at the University of Maryland Urgent Care demonstrates a realistic approach to time-effort decisions, but the exact timing of intervention development and all employees’ access to education should be recognized as opportunities for learning in future projects. The initial plan seeks to approach implementation in a gradual manner, proceeding from pre-implementation organizational climate assessment to teaching module development and delivery, with at least two weeks dedicated to each activity. The promotion of staff development programs focused on building non-psychiatric nurses’ basic competencies in dealing with non-violent but problematic patients that might need communication- or education-related accommodations is considered a positive practice in the literature, especially for inpatient facilities, but incorporating teaching activities into settings’ multi-shift schedules can be problematic (Winokur et al., 2022). The logistics of teaching program preparation also present opportunities for improvement as the planning and program approval stage is supposed to take three weeks. It could be altered to take less time, making sure that the post-intervention stage is long enough for participants to assess subjective changes to mindsets and skills accurately.

Conclusion

On a final note, no insurmountable barriers to implementation can be noted in the analyzed case. The hypothetical constraints’ influences could be reduced by emphasizing respondents’ anonymity and stating the rationale for the project’s benefits clearly during any collaboration at the site. Project-standard variances are not significant to the extent of interfering with patient safety promotion, but program development timing could be improved for results’ enhanced generalizability.

References

American Academy of Emergency Nurse Practitioners & Emergency Nurses Association. (2021). Emergency nurse practitioner competencies. ENA. Web.

Avery, J., Schreier, A., & Swanson, M. (2020). A complex population: Nurse’s professional preparedness to care for medical-surgical patients with mental illness.Applied Nursing Research, 52, 1-5. Web.

Galiana, L., Oliver, A., Arena, F., De Simone, G., Tomás, J. M., Vidal-Blanco, G., Munoz-Martinez, I., & Sansó, N. (2020). Development and validation of the Short Professional Quality of Life Scale based on versions IV and V of the Professional Quality of Life Scale.Health and Quality of Life Outcomes, 18(1), 1-12. Web.

Hossain, F., & Clatty, A. (2021). Self-care strategies in response to nurses’ moral injury during COVID-19 pandemic.Nursing Ethics, 28(1), 23-32. Web.

Morrison, J., Hasselblad, M., Kleinpell, R., Buie, R., Ariosto, D., Hardiman, E., Osborn, S. W., & Lindsell, C. J. (2020). The disruptive behavior management and prevention in hospitalized patients using a behavioral intervention team (DEMEANOR) study protocol: A pragmatic, cluster, crossover trial.Trials, 21(1), 1-8. Web.

Winokur, E., Zamil, T., Loucks, J., Munoz, K., & Rutledge, D. N. (2022). Hospital nurse competency to care for patients with behavioral health concerns: A follow-up study.Journal for Nurses in Professional Development, 38(2), 71-75. Web.

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