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Kendall Regional Medical Center: Prevention of Complications

Forces whether internal or external delay the application of changes in the health sector on ways of administering health services. Rycroft-Malone et al. (2013) state that one challenge facing the realization of quality care based on evidence in health care involves coming up with effective ways of care delivery in the nursing practice. Implementation of the proposed changes takes a broad process of nurses’ training and acceptance of the change. Experiments carried out on new infrastructure and technologies, aimed at improving the delivery of health care. However, finding ways of applying the technologies remains an ongoing challenge in the healthcare sector. This paper aims at highlighting forces that significantly impact the implementation of change in the prevention of complications, as well as Peripheral Inserted Central Catheter (PICC) line reinsertions.

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The context within which health care is practiced takes a variety of cultures and communities that are influenced significantly by political, economic and social factors (Boaz, Baeza & Fraser, 2011). These external forces substantially impede the implementation of proposed changes in healthcare technology. Marsden (2013) states that the application of technology is a major external force that is crucial to enhancing efficiency, as well as promoting the overall realization of quality care. The age of computer equipment being used in PICC line insertions has impacted the patients’ care in that, most of them are getting outdated and remain analog in a completely changed healthcare system. According to Pai and Huang (2011), the lack of refresher programs on computer technology among health practitioners acts as a major impediment towards the effective implementation of change in service delivery. The inefficiency of refresher programs is caused by a lack of enough funding for retraining and capacity building. Further, it is affected by the minimal understanding of healthcare environments by IT experts involved in the management of hospital technology (Koo et al., 2011). With the training of medical information technology specialists, improvement can be realized in the communication processes between IT specialists and health practitioners.

The education level of nurses has a great impact on the implementation of change in a health care setting. Pai and Huang (2011) state that increased technological trends in the health sector, training among nurses in handling computerized hospital tools and continuous capacity building will enhance the quality of care, as well as improve evidence-based practice. Constant reforms in ways of administering healthcare present an advantage to improved patient healthcare. According to Boaz et al. (2011), many health professionals are not able to keep pace with the fast technological advancement within their practice. However, to ensure adaptability to change, continuous education with an emphasis on the discussion of evidence-based practices is necessary among nurses.

Rycroft-Malone et al. (2013) indicate that organizational structure is a major internal force that greatly affects the structural changes in the health care settings. Efficiency within the operations of the health care facilities is enhanced by having clear outlined systems of operations. Organizations that facilitate research and learning bring about change in their structural systems and thus, the need for coping mechanisms to ensure positive outcomes. In this context, leadership plays a pivotal role in the acceptability of change where transformational leaders encourage teamwork, value the contribution of every person to the organizational growth, and build an innovative culture in the working environment (Marsden, 2013). For the successful implementation of new healthcare ideas, more improved situations with decentralized decision-making are necessary. Further, having a motivated workforce, precise roles and continuous access to update the information to the personnel enhances nurses’ knowledge and skills (Boaz, Baeza, & Fraser, 2011).

Nurses’ resistance to change also constitutes an internal force that impedes the implementation of new plans in the health care system. The reason for this resistance may come from extensive criticism of the new system and is characterized by the system design, as well as the working culture of the nurses (Pai & Huang, 2013). Understanding the cause of the resistance in the implementation of change may enable the project managers to address the issues, and solve the impact of the change in personnel, as well as the benefits to the nurses (Marsden, 2013). Patients can also affect change in the implementation of healthcare procedural changes. For example, in the case of obese patients, technology issues in the PICC line insertions may seem problematic and pose significant difficulties to the nurse’s practice (Marsden, 2013). In such cases, new devices ought to be utilized in finding out the point of insertion of the catheters.

In conclusion, various internal and external factors pose a threat to the implementation of changes in nursing practice. Technology issues may impede the actualization of change in the case where nurses are not aware of the technicalities involved. Structural organization of the health institution impacts the progress in change based on the leadership methods utilized. Thus, to overcome slow implementation of change, health systems should embrace collaborative research, and leaders should foster strong working relationships where communication is adequate vertically and horizontally within the leadership hierarchies.


Boaz, A., Baeza, J. & Fraser, A. (2011). Effective implementation of research into practice: An overview of systematic reviews of the health literature. BMC Research Notes, 4(212), 1-8. Web.

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Koo, B.K., Erglis, A., Doh, J.H., Daniels, D.V., Jeger, S., Kim, H.S., Dunning, A., Defrance, T., Lansky, A., Leipsic, J. & Min, J.K. (2011). Diagnosis of ischemia-causing coronary stenosis by noninvasive fractional flow reserve computed from coronary computed tomographic angiosperms, JACC, 58(19), 1989-1997.

Marsden, A.L. (2013). Simulation-based planning of surgical interventions in pediatric cardiology, Phys. Fluids, 25(101303), 1-20.

Pai, F.H. & Huang, K.I. (2011). Applying technology acceptance model to the introduction of healthcare information systems. Technological Forecasting and Social Change, 78(4), 650-660.

Rycroft-Malone, J., Seers, K., Chandler, J., Hawkers, C.A., Crichton, N., Allen, C., Bullock, I. & Strunin, L. (2013). The role of evidence, context, and facilitation in an implementation trial: Implications for the development of the PARIHS framework. Implementation Science, 8(28), 1-13. Web.

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