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In this case study, nurses are resisting a recent health policy that introduces a practice guideline with new suction techniques. The approaches are based on evidence and have been accepted by a variety of committees. They are highly likely to result in better health outcomes for patients if used in treatments. Nevertheless, the adoption of the new methods is happening at a rate that is considered to be too slow. The purposes of this paper are to identify the potential reasons why nurses may reject the new techniques and provide recommendations for encouraging acceptance.
Reasons for Opposition
Unwillingness to implement evidence-based practice would most likely be the primary reason for the refusal to use the new technique. According to Tacia, Biskupski, Pheley, and Lehto (2015), the main barriers include “time, access to quality information, knowledge to translate evidence to practice, and interdisciplinary collaboration” (p. 95). While evidence-based practice may show excellent results in controlled clinical environments, nurses in other settings may not feel confident using an unfamiliar approach. This attitude could have been predicted, as it applies to evidence-based practice in general and is most likely not significantly modified by being limited to the specific area of suctioning techniques.
The methods utilized by the people who try to promote the change may also not always be practical. Advanced practice nurses are usually at the forefront of progress and therefore serve as excellent teachers for their less experienced colleagues.
However, according to Tacia et al. (2015), such highly experienced practitioners often hold a low opinion of the potential of their staff counterparts. The attitude may foster conflict, which would lead to a low adoption rate of the new ideas. The participation of experienced teachers is vital to the successful introduction of a new method, but they should take care to address the concerns associated with evidence-based practice.
Recommendations for Encouragement
As was mentioned above, leadership is critical to the effectiveness of an introduction effort. Bjuresäter and Athlin (2016) consider the existence of exact and sufficient instructions as well as the direct involvement of a central figure that coordinates the activities of other facilitators significant promoting factors. A leader would be able to provide a direction to the adoption project and to motivate the participants to make efforts towards evidence-based practice. In addition, he or she would be able to evaluate the progress and address arising issues quickly. This aspect is particularly important considering the structure proposed by the next recommendation.
Promoters of new approaches should include both teachers and nurses who have been convinced to use the method. However, the latter require support, which can be provided through organizing the facilitators in a group and providing mutual aid. The presence and continuous support by the teacher, or leader, are especially influential, as both parties can learn from each other and offer encouragement (Bjuresäter & Athlin, 2016). Like many other projects, innovations in nursing require management and commitment from all participants, and the recommendations outlined above may help to encourage these traits for staff nurses and improve adoption speeds.
The nurses are likely introducing the new suctioning method slowly due to the general challenges of implementing evidence-based practice. A more direct leadership model is necessary to encourage adoption, with precise instructions and participation by experienced practitioners, preferably advanced practice nurses. These workers should attempt to avoid dismissive views and form mutual support groups with nurses who have accepted the new method to encourage facilitation.
Bjuresäter, K., & Athlin, E. (2016). Improvement of nursing care by means of the evidence based practice process: The facilitator role. Journal of Nursing Education and Practice, 6(11), 61-72.
Tacia, L., Biskupski, K., Pheley, A., & Lehto, R. H. (2015). Identifying barriers to evidence-based practice adoption: A focus group study. Clinical Nursing Studies, 3(2), 90-96.