peer responses 28

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1——— In order to reduce barriers when performing SBIRT (screening, brief intervention, and referral to treatment) in the medical department, the medical director, head of behavioral health, nurses, medical assistants, and providers would need to be involved in the change project. External stakeholders would include the American Indian/Alaska Native families that the clinic serves. For the project to be successful, the change agent(s) would need to be aware of cultural practices and beliefs in the community in order for the project to be successful. Luckily, many staff are from the community, so they can provide valuable input about a change project to make sure that the project is appropriate for the patients in the community. The last thing the change agent wants to do is to offend patients in the community. The community is very close, so mistakes do not go unnoticed. At Indian Health Council, if patient surveys are needed, the IRB (Institutional Review Board) would need to approve the surveys. According to Fineout-Overholt, Williamson, Gallagher-Ford, Melnyk, & Stillwell (2011),

an IRB is charged with making sure that subjects involved in a research study are safe

and that the research is conducted in such a way that the findings are applicable to a

broader population than just those in the study, which is known as generalizability. (p.55)

The IRB is made of board members from different tribes, so they will have a big impact on whether new research ideas can be implemented. Our clinic has already implemented SBIRT, but there are barriers for completing SBIRT in the department. This project will be more like a quality improvement project for eliminating barriers for SBIRT. According to Franz (2006), providing “…a rationale for the change and the evidence behind it will help facilitate staff acceptance of the new procedure” (p. 998). Education on the importance of SBIRT, how to perform screening better, and to make sure patients get an intervention are key to eliminating barriers for SBIRT. Getting the staff involved during the planning phase of the project can help generate creative ideas on how to implement the change, or it can bring up information about possible barriers to the change. The change agent needs to evaluate the change to make sure it does not decrease morale or have bad outcomes for the patients and staff. If staff realize how important SBIRT is in the clinic’s patient population, they will be more likely to screen patients more effectively.

2——–In my facility the pertinent stakeholders would be staff and management of the ICU. My project is focused on improving family satisfaction of family members in the ICU by implementing an educational tool that is aimed at enhancing communication between family and staff. When implementing a EBP project it is important to engage the appropriate stakeholders. This helps to build trust and enables the stakeholders to provide input on the project. This can help to have buy in from the stakeholders from the start and enhance the probability of the project being successful. Because, staff is likely to be more engaged with the idea. Having buy in from management can also help me to gain support for implementing the project (Ginex, 2018).

I feel comfortable in my environment that I have chosen a project that staff and management feel that it is important. Because, we do not have a formal educational program for family at the moment. As staff, we get so caught up in the chaos of the care that we are providing that sometimes we lack in providing time to fully engage with family and provide them with information that could help enhance their experience during their loved ones stay in the ICU. My idea is to implement an educational tool that helps to inform the family members about the ins and outs of our ICU and what to expect with regards to care teams, equipments, and common procedures that we perform at the bedside such as central line placement, arterial line placement, and rapid sequence intubation. These procedures are invasive and I think that preparing them for what to expect can help increase communication with staff and enhance their satisfaction.

3—–A mission statement defines the fundamental purpose of your organization whereas the vision statement describes what the company wants to achieve in the future. How could these statements help attract stakeholders and how else might they be beneficial?

minimum of 60 words per each discussion with proper citation and reference

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