Implementing Change In Clinical Practice

Running head: IMPLIMENTING CHANGE IN CLINICAL PRACTICE 1

Implementing Change in Clinical Practice

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IMPLIMENTING CHANGE IN CLINICAL PRACTICE 2

Barriers to Change in Clinical Practice

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. Physician’s attitude is also a major barrier towards implementation of change in

clinical practice. Research indicates that most physicians perceive changes in clinical guidelines

IMPLIMENTING CHANGE IN CLINICAL PRACTICE 3

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).

IMPLIMENTING CHANGE IN CLINICAL PRACTICE 4

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

IMPLIMENTING CHANGE IN CLINICAL PRACTICE 5

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).

IMPLIMENTING CHANGE IN CLINICAL PRACTICE 6

References

Al Ghabeesh, S.H. (2015). Barriers and Suggested Facilitators to the Implementation of Best

Practice: An Integrative Review. Open Journal of Nursing, 5, 77-87

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

Schaaf, E.B.V., Seashore, C.J. &Rndolh, G.D. (2015). Translating Clinical Guidelines Into

Practice: Challenges and Opportunities in a Dynamic Health Care Environment. North

Carolina Medical Journal, vol. 76no. 4 230-234

Shifaza, F., Evand, D. & Bradley, H. (2014). Nurses’ Perceptions of Barriers and Facilitators to

Implement EBP in the Maldives. Advances in Nursing

Volume 2014 (2014)

IMPLIMENTING CHANGE IN CLINICAL PRACTICE 7

Scott, I. & Spouse, J. (2013). Practice Based Learning in Nursing, Health and Social Care:

Mentorship, Facilitation and Supervision. New York: John Wiley & Sons

Spallek, H., Song, M., Polk, D.E., Bekhuis, T., Frantsve – Hawley, j. &Aravamudhan, K. (2014).

Barriers to implementing evidence-based clinical guidelines: A survey of early adopters.

US National Library of Medicine

Taba, P., Rosenthal, M., Habicht, J., Tarien, H., Mathiesen, m., Hill, S. &Bero, L. (2012).

Barriers and facilitators to the implementation of clinical practice guidelines: A cross-

sectional survey among physicians in Estonia. US National Library of Medicine

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

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