The paper identifies obstacles to change project aimed to minimize PICC-related complications and reduce catheter reinsertion rates in Kendall Regional Medical Center.
Obstacle Analysis
The implementation of change required by the practicum project will likely be complicated and slowed down by a range of obstacles. While the human factor is always prioritized in leadership practices aimed at streamlining the change process, several non-human obstacles also need to be recognized.
First, the lack of information about the current state of procedures can be a serious drawback. The change requires a starting point and addresses the issues by introducing alternatives (Voehl & Harrington, 2016). In the case when there is no available information regarding the established procedures it becomes extremely difficult to locate the root of the problem which needs to be changed. It is important to note that the official guidelines and instructions of nursing personnel are of limited use only as it only illustrates the recommended methods, which are not necessarily implemented.
The obstacles of financial nature may also come into play. Almost any activity aimed at improvement of the patient outcomes, such as staff training and education, the production of handouts, and posters, not to mention the possible need for the equipment upgrade, requires funds. The literature on change implementation suggests the stakeholder buy-in as a solution (Marcinko & Hertico, 2013), but there is a possibility the organization does not have the required funds at the moment.
The issue of obsolete equipment brings up another obstacle: resource allocation. The resources in our case are the catheters of various kinds and the diagnostic equipment. The former will introduce undesirable unpredictability or minimize the improvements resulting from the change (Bonne et al., 2015). The latter can be already scarce and poorly managed, which reduces the possibility of obtaining permission to utilize it for the project’s needs.
The measurement is another critical factor that may become an obstacle. The success of the project depends on the monitoring of the results and timely corrections and adjustments which will guarantee the best outcome. The incorrect processing of data is thus unacceptable. This obstacle is usually attributed to the human factor, but the appropriate means of data analysis also play a considerable role in it (Panayotou, 2013).
Finally, the procedural obstacles introduced by the hospital’s activities may prove difficult to manage. For instance, prolonged hospitalization is associated with a higher risk of complications resulting from catheter insertion (Chopra et al., 2014). At the same time, the duration is determined by the established instructions rather than the human factor and is not easily avoidable.
Plan to Overcome Obstacles
To minimize the slowdown associated with the located obstacles, extensive planning is required. The impact of financial issues can be minimized by devising several cost-cutting measures which can be implemented one by one starting from those which introduce the least alterations to the change process (Hellriegel & Slocum, 2010). All of the available equipment needs to be listed, and proper schedules developed to assure the maximum output without compromising the existing hospital practices. Separate attention must be paid to the assessment of the practices currently in place.
If no such data exists, at least one survey must be conducted to detect the possible deviations from the current standards. Besides, at least one monitoring is required to complete the picture. The availability and characteristics of the PICC lines currently in use must be accounted for and, if any possibility of undesirable variety is detected, the use of the resources for the project must be homogenized. Finally, the instrumentation used for the measurement of the outcomes needs to be chosen with both the requirements posed by the project and the experience of the staff responsible for operating it to provide the most accurate results possible.
References
Bonne, S., Mazuski, J. E., Sona, C., Schallom, M., Boyle, W., Buchman, T. G.,…Schuerer, D. J. (2015). Effectiveness of minocycline and rifampin vs chlorhexidine and silver sulfadiazine-impregnated central venous catheters in preventing central line-associated bloodstream infection in a high-volume academic intensive care unit: a before and after trial. Journal of the American College of Surgeons, 221(3), 739-747.
Chopra, V., Ratz, D., Kuhn, L., Lopus, T., Lee, A., & Krein, S. (2014). Peripherally inserted central catheter‐related deep vein thrombosis: contemporary patterns and predictors. Journal of Thrombosis and Haemostasis, 12(6), 847-854.
Hellriegel, D., & Slocum, J. (2010). Organizational behavior. Mason, OH: Cengage Learning.
Marcinko, D., & Hertico, H. (2013). Financial management strategies for hospitals and healthcare organizations: Tools, techniques, checklists and case studies. Boca Raton, FL: CRC Press.
Panayotou, T. (2013). Instruments of change: Motivating and financing sustainable development. New York, NY: Routledge.
Voehl, F., & Harrington, J. (2016). Change management: Manage the change or it will manage you. Boca Raton, FL: CRC Press.