Barriers to Change in Clinical Practice - Paper Example

Clinical practice is a dynamic profession that is prone to changes. An adjustment in clinical practice guidelines is the primary cause of change in healthcare institutions. Research has unveiled various factors that act as barriers and facilitators of such change in clinical practice (Spallek et al. 2012). Availability of insufficient resources is a significant barrier to change. To implement new and existing clinical guidelines, both the patients and the physicians require enough resources. Medical supplies are part of the resources that are necessary for successful implementation of change. Clinical facilities are also essential in the implementation of change. There must be enough facilities to accommodate the provisions of new guidelines. Time is also another resource that is likely to affect the implementation of change. This factor mostly applies to outpatient clinicians. Lack of enough resources for the implementation of change creates a disparity between various clinical institutions, mainly private and public (Lemire et al. 2016). Physicians who work in private health care institutions find it easy to access such resources compared to the physicians who work in the public institutions.

Poor accessibility to information also hinders implementation of change. Change is a comprehensive process that requires one to understand what the change entails clearly. Without enough and clear information, the clinicians might be unable to identify what is required of them during the change process. However, research indicates that different groups of physicians disagree on this factor as a barrier to change (Tacia et al. 2015). Most young clinicians with less than ten years of experience argue that access to information is not such a significant challenge. However, clinicians with more than twenty-five years of experience find it difficult to access information. Physicians attitude is also a major barrier towards implementation of change in clinical practice. Research indicates that most physicians perceive changes in clinical guidelines as a violation of the physician autonomy, and the restrictions on ways in which patients are handled. Most doctors, especially ones who have gotten used to the initial guidelines, feel that it is not necessary to change the rules based on clinical practice. Perhaps, they feel that the initial practice guidelines are already effective in enhancing a comprehensive clinical experience for both the patients and the clinicians. These barriers have a major influence on the implementation of specific care practices (Shifaza et al. 2014). This paper will address how the barriers prevent the implementation of prevention of fall and the implementation of medication safety in healthcare institutions.

Facilitators of Change

Apparently, barriers to clinical practice are overwhelming the healthcare sector. It is clear that they make it difficult for clinicians to implement new guidelines, which are aimed at improving quality of service or introducing new clinical practices. However, other factors can be considered to facilitate change within healthcare institutions. Availability of online information databases is a major facilitator to change (Gbadamosi, 2015). Apparently, information is essential to enhancing change. It enlightens the clinicians on the new concepts and how they can implement these ideas. Online databases are freely accessible to everyone to carry out research and discover new guidelines. Training is also a crucial facilitator of change. For change to happen, it is clear that the clinicians must be introduced to new guidelines of practice. Change is not just effective if it is addressed. Change is effective if it becomes successful in attaining the expected objectives. Training helps to equip the physicians with additional knowledge and skills that would enable them to tackle change. The training must focus on the aspects of change and how to integrate the new guidelines with the previous care practices (Taba et al. 2012).

Apart from online databases, information can also be availed more readily to both patients and the clinicians using other methods. Availability of consultancies can be an effective facilitator of change. This includes the availability of specific individuals in the aspects of change who offer guidance (Mateo & Foreman, 2013). Although the patients and the clinicians can acquire information from the internet, they can also find it difficult to understand some of the guidelines. The availability of consultancies can offer direct advice and answer questions that appear complicated in the implementation of the changes. These specialists must understand the full provisions of the new guidelines. They can also include people who were involved in the formulation of the guidelines, or lobby for the adaptation of the guidelines in clinical practice (Scott & Spouse, 2013).

The availability of printed information can also act as an important method of facilitating change. Printed materials are easy to circulate. The clinicians can also carry the material for further reading. This can help them to clearly understand what is required of them during the change process. Professional societies can also be used to avail the information and encourage physicians to embrace change. Functions such as seminars bring different specialist from different areas of practice together (Al Ghabeesh, 2015). Such functions can be used to express how essential it is to adopt these changes and the role of each stakeholder.

Effects of Barriers and Facilitators on Medication Safety and Fall Prevention

Fall prevention and medication safety are crucial in healthcare practice. Most changes that are addressed in health care must be assessed based on their impact on ensuring medication safety and fall prevention. Barriers to change in clinical practice can affect these two in different ways (Schaaf et al. 2015). Availability of insufficient resources can make it difficult to enhance fall prevention. Apparently, fall prevention can be achieved through the installment of bed alarms, beds that are lowered to the ground, and decluttering furniture. All these are resources that might be expensive to acquire for most health care centers. Without the resources, it might be difficult or even impossible for the health care centers to deal with the problem of falls (Mohsen et al. 2016). Seemingly, barriers such as the attitude of the clinicians can also affect the achievement of medication safety. Medication safety is a sensitive issue that requires prompt adjustment of physicians to new guidelines. Neglect of such instructions might result in the attainment of poor medication safety. Apparently, poor access to information can also affect both fall prevention and medication prevention. Knowledge helps to enlighten care providers about new guidelines on medication safety. It also helps to inform them about new provisions for fall prevention strategies.

Facilitators of change can also affect fall prevention and medication safety in many positive ways. Readily accessible sources of information are essential for the enlightenment of the physicians about the provisions for fall prevention and medication safety. If the physicians and the patients can access the data regarding these two concepts, they can become aware of what to do and what to expect. Other facilitators such as training are also essential in attaining medication safety and fall prevention. Training teaches the care providers about how to use the resources available for fall prevention. It also enlightens them on the importance of medication safety (Mohsen et al. 2016).

References

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Gbadamosi, N. (2015). What are the barriers to implementing change in the NHS?The Nursing Times

Lemire, A.M., Miles, A. & McCann, C.M. (2016). Changing clinical practice: Facilitators and barriers to the implementation of a nationwide videofluoroscopy evidence-based guideline. Speech, Language and Hearing Vol. 19 ,Iss. 2

Mateo, M.A. & Foreman, M.D. (2013). Research for Advanced Practice Nurses, Second Edition: From Evidence to Practice. New York: Springer Publishing Company

Mohsen, M.S., Safaan, N.A. &Okby, O. (2016). Facilitating Factors for Overcoming Barriers Facing Nurses for Research Utilization in Clinical Settings. American Journal of Nursing Research, Vol. 4, No. 1, pp 13-24. doi: 10.12691/ajnr-4-1-3

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Shifaza, F., Evand, D. & Bradley, H. (2014). Nurses Perceptions of Barriers and Facilitators to Implement EBP in the Maldives. Advances in NursingVolume 2014 (2014)

Scott, I. & Spouse, J. (2013). Practice Based Learning in Nursing, Health and Social Care: Mentorship, Facilitation and Supervision. New York: John Wiley & Sons

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Tacia, L., Biskupski, K., Phaley, A. &Lehto, R.H. (2015). Identifying barriers to evidence-based practice adoption: A focus group study. Clinical Nursing Studies, Vol. 3, No. 2