Managing and Identifying Barriers

¶ … Managing Barriers

Barriers encountered in the Capstone project revolved around the idea that the staff felt it was not there job to read rhythm strips, and did not make the time to get off the floor for any continuing education. Good leadership can help eliminate these kinds of problems, as the problems have to be addressed from the standpoint of people who will insist that everyone does his or her job and makes the time to get involved with things like continuing education. As can be seen, there are generally a number of barriers that are encountered when trying to implement a change in practice. Even if that change will resolve a problem or address a concern, many people are still going to be resistant to it. The main barriers can include resistance to change from staff, lack of leadership, lack of resources (both financial and fiscal), environment, communication, and stakeholders, along with others (Pexton, 2005). Recognizing a barrier means an opportunity to take action to get that barrier out of the way.

Funk, Tornquist, and Champagne (1991) developed a scale based on four categories of barriers to research by nurses in practice. These factors were: characteristics of the potential adopter, characteristics of the organization, characteristics of the research, and characteristics of the communication of the research. There are also a number of ethical and legal dilemmas that have to be addressed, and that can affect barriers in nursing. Nurses have to take appropriate action to address issues like professionalism, health policy, reimbursement, and organizations that provide care. Professional ethics are part of the nurse's routine and, as such, professional organizations and groups have developed codes to follow. The American Nurses Association (ANA) Code of Ethics for Nurses with Interpretive Statements (2001) is one of those sources nurses use for guidance when ethical issues are experienced. Nurses also have a responsibility to report any unethical, incompetent, or illegal practices they come across.

Other ethical issues facing nurses include who gets access to healthcare, resource allocation, staffing and delegation, fraud and abuse, end-of-life concerns, informed consent, and ethics in research (Finkelman & Kenner, 2010). Unfortunately, there has been a long history of ethical problems in research, which led to reform and legal guidelines in the 1970s. Since that time, more attention has been paid to ethics when research is conducted and reported. Informed consent and IRB approval are both requirements, as well. Nurses should be concerned about the IRB approval issue, because they must follow the same kinds of rules that any researcher would be asked to follow with both human and animal subjects. Nurses also need to remain patient advocates when they are collecting data for ongoing research, and doing that can become a delicate balance. The rights of the patient must be upheld, over and above any research concerns that are taking place, and nurses are charged with the duty of ensuring that is the case for every patient they care for.