The plan for minimization of PICC-related complications and the reduction of catheter reinsertion rates at KRMC involves negotiations with several stakeholders.
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Patients or their families permit the PICC line insertion procedure. If they are not willing to provide their consent, it is important to overcome non-acceptance with the use of individualized techniques. If patients are afraid of such side effects as blood clots, bleeding or infection, it is important to explain to them that the chances of those complications are insignificantly low and that the beneficial aspects of the procedure overweight the negative ones (MedlinePlus, 2015). According to a recent study, acceptance of a treatment strategy is more likely to happen in an atmosphere of an alliance between a patient and treating professionals (Vuckovich, 2009).
The medical consultant is one of the main stakeholders in the practicum project. Considering that a consultant must make the correct analyses assessment and make a decision on the appropriateness of the PICC line insertion procedure, they should support the proposed change (MedlinePlus, 2015). Moreover, the medical consultant is responsible for obtaining a patient’s informed consent; therefore, they must be interested in the prevention of complications and PICC line reinsertions. No negotiation strategy would be needed to receive their full support for the project (MedlinePlus, 2015).
A clinical nurse is responsible for conducting the procedure of inserting a catheter into a patient’s peripheral vein. They must also instruct the patient on the proper maintenance of the catheter. Considering that the nurse is responsible for the safety measures and the outcome of the procedure, they should not resist the change. However, if the opposite occurs, it is advisable to focus on their interest during the negotiations about the practicum project (Berlin & Lexa, 2007). According to the study on the negotiation techniques for health care professionals, “interests are the ultimate goal of a negotiation” (Berlin & Lexa, 2007). Therefore, it is necessary to ensure that the negotiator’s position in the discussion of the project is completely aligned with that of the nurse.
The radiographer plays an important role in the prevention of complications and PICC line reinsertions. They must make an ultrasound image of the patient’s circulatory system that will help to choose a large enough peripheral vein (MedlinePlus, 2015). An experienced radiographer should not resist the proposed change in the practicum project. However, if problems with the acceptance of the new strategy occur, the negotiator has to use the anchoring technique in the attempt to change the mind of the specialist. It is necessary to apply the anchoring concept and to set the value first (Berlin & Lexa, 2007).
Registered nurses are responsible for taking care of the patient after the PICC line insertion procedure has been completed. They have to make sure that the patient is comfortable with handling the catheter (MedlinePlus, 2015). Considering that registered nurses are not responsible for the safety measures during the procedure they should not resist the change. However, because their role is also important for the outcome of the change project, it is necessary to focus on their interest during the negotiations.
Berlin, J. & Lexa, F. (2007). Negotiation Techniques for Health Care Professionals. Journal of The American College of Radiology, 4(7), 487-491.
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MedlinePlus. (2015). Peripherally Inserted Central Catheter: Insertion. Retrieved from https://medlineplus.gov/ency/patientinstructions/000461.htm
Vuckovich, P. (2009). Strategies Nurses Use to Overcome Medication Refusal by Involuntary Psychiatric Patients. Issues in Mental Health Nursing, 30(3), 181-187.