Overcoming Roadblocks in Nursing
Nurses have always being involved in clinical decision making. They are, however, being cast into more active decision making by other members of the multidisciplinary healthcare team and policymakers (Thompson et al., 2004). This paper will describe the decision making process with regards to whether a medical-surgical unit should be expanded to enable the unit take on step down patients from the neuro intensive care unit (ICU). The paper will also explore the barriers to the proposed change and ways of overcoming these barriers.
The conventional decision-making process would be followed in deciding whether to expand the medical-surgical unit to take step down patients from the neuro ICU. The first step would be to define the problem by identifying the existing problem, reasons why the problem needs to be resolved, and what should ideally be happening. The second step is to establish criteria for instance what the decision aims to achieve or problems it is intended to avoid. The third step is to consider alternative solutions to the problem and the factors affecting them. For instance, in this case, the feasibility of admitting the patients in the existing unit versus expanding the medical-surgical unit would be weighed. The best solution is then selected based on experience, current evidence, and/or intuition. Once the decision to expand the medical-surgical unit is made, a plan of action is developed and implemented (Guo, 2008).
A number of roadblocks are expected to the planned change. These include practical barriers like inadequacy of resources and personnel, financial and political barriers, lack of awareness and knowledge on the need for the change, and lack of skills amongst health staffs. A multi-faceted intervention strategy is likely to be more effective in overcoming the barriers to the proposed change project. This strategy would involve raising awareness on the need for the proposed change through educational materials like leaflets and booklets and conducting educational meetings like conferences and workshops. The other facet of the strategy would be to influence opinion leaders and other relevant stakeholders groups like the hospital board (National Institute for Health and Clinical Excellence, 2007). The activities for overcoming the roadblocks would be guided by a change management model like Kotter’s change management model. These models provide a philosophy and organizing framework for change management activities (Campbell, 2008).
In summary, this paper has described the decision making process that would be followed in deciding whether to expand the medical-surgical unit. This expansion is intended to enable the unit take on step down patients from the neuro ICU. The paper has also identified the roadblocks expected to the planned change and ways of overcoming these hiccups.
References
Campbell, R. J. (2008). Change management in health care. The Health Care Manager, 27(1), 32-39.
Guo, K. L. (2008). DECIDE: A decision-making model for more effective decision making by health care managers. The Health Care Manager, 27(2), 118-127.
National Institute for Health and Clinical Excellence (2007). How to change practice. Retrieved from http://www.nice.org.uk/Media/Default/About/what-we-do/Into-practice/Support- for-service-improvement-and-audit/How-to-change-practice-barriers-to-change.pdf
Thompson, C., Cullum, N., McCaughan, D., Sheldon, T., & Raynor, P. (2004). Nurses, information use, and clinical decision making-the real world potential for evidence-based decisions in nursing. Evidence-Based Nursing, 7, 68-72.
