Sustaining change can be difficult, as there are many variables that can affect implementation. One critical component of EBP is to ensure that practice change is part of an organization’s culture so it will continue to impact outcomes over time. Name two potential barriers that may prevent your EBP change proposal from continuing to obtain the same desired results 6 months to a year from now, and your strategies for overcoming these barriers.

(Luz Rom 6/10)


Sustaining changes and education is a never-ending variable, especially when implementing EBP. This is crucial to every organization because this will help improve and keep us moving forward. I see a potential barrier in nursing shortage if this continues to be a problem nurses are short staffed and will take shortcuts meaning drawing from same site blood cultures will start to occur because of time management. Staff understand proper aseptic techniques, but time is of the essence in the emergency room, so spending too much time on a patient is frowned upon by management because nurses need to keep their patients moving. The evidence is weak but indicates that levels of nurse staffing in the ED are associated with patients leaving without being seen, ED care time and patient satisfaction. Lower staffing is associated with worse outcomes. There remain significant gaps and in particular a lack of evidence on the impact of staffing on direct patient outcomes and adequate economic analyses to inform decisions about nurse staffing. Given that an association between nurse staffing levels and patient outcomes on inpatient wards has been demonstrated, this gap in the evidence about nurse staffing in EDs needs to be addressed (Recio-Saucedo… 2015).  

Another barrier I see is trying to get a new nurse out onto the floor so that they may start working as soon as possible. This is an obstacle because inexperienced staff are not getting the proper training to draw aseptic blood cultures along with any other training, this keeps them from working to their full potential management just wants bodies on the floor. So, with a fully staff emergency room and proper training I believe blood culture contamination can keep decreasing.  



Recio-Saucedo, A., Pope, C., Dall’Ora, C., Griffiths, P., Jones, J., Crouch, R., & Drennan, J. (2015). Safe staffing for nursing in emergency departments: evidence review. Emergency medicine journal : EMJ32(11), 888–894. 



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