1. My EB project Picot is: In elderly patients at risk of falls, does the implementation of fall prevention interventions combined with medication adherence strategies (I) compared to fall prevention interventions without medication adherence strategies or standard care (C) lead to a reduction in fall rates and improved medication adherence (O) over a 6-month period (T)?
2. My organization is The Sylvester Comprehensive Cancer Center in Miami, FL and my role is Nurse manager for chemo infusion
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Developing a Comprehensive Plan to Overcome Barriers to Implementing Fall Prevention
Interventions and Medication Adherence Strategies at The Sylvester Comprehensive
Cancer Center
Students Name
Institution Affiliation
Course Title
Instructors Name
Date of Submission
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Introduction
At The Sylvester Comprehensive Cancer Center in Miami, Florida, where I work as the Nurse
Manager for Chemo Infusion, it is my job to manage the nursing staff and ensure that
chemotherapy is administered securely and efficiently. This plan aims to create a clear and
detailed approach to overcome barriers in the way of the suggested evidence-based practice
change in fall prevention treatments and medication adherence techniques for senior patients at
risk of falling. The senior patients in our cancer center receiving chemotherapy may be at higher
risk for falling and experiencing medication-related problems, so this move is especially crucial.
We aim to increase patient outcomes, decrease fall rates, and improve patient safety by adopting
comprehensive fall prevention programs and encouraging medication adherence.
Proposed EB Practice Change
Implementing medication adherence techniques and fall prevention measures for older patients at
risk of falls is the specific evidence-based practice change we advocate at The Sylvester
Comprehensive Cancer Center. This modification recognizes older cancer patients’ special
difficulties and tries to prevent falls and medication-related problems, given their greater risk of
falling. The realization that older people have unique needs and run a higher risk of falling
motivated this treatment adjustment. Elements like aging-related changes in balance, mobility
restrictions, and probable chemotherapy side effects influence this elevated risk. We can
proactively detect and eliminate potential fall risks by implementing fall prevention treatments,
such as routine assessments of patients’ fall risk, altering the environment to remove hazards, and
educating patients on fall prevention techniques. Incorporating medication adherence techniques
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like patient education, streamlined medication schedules, and routine medication reviews can
also improve drug use and lower the risk of falls linked to medication.
The Sylvester Comprehensive Cancer Center’s elderly patients stand to gain a lot from this
practice adjustment. First, it can significantly lower the likelihood of falls, which helps decrease
physical injuries and prevents consequences like fractures or head traumas. The efficacy and
safety of treatment regimens can be improved by increasing medication adherence, which would
benefit these susceptible individuals’ overall health. The likelihood of medication mistakes and
unfavorable drug events is decreased by improved medication adherence. Additionally, putting
fall prevention interventions and medication adherence techniques into practice shows our
dedication to patient safety and high-quality care, which can benefit patient satisfaction and
boost our cancer center’s reputation.
Anticipated Barriers
The Sylvester Comprehensive Cancer Center may run into several barriers when implementing
the suggested adjustment in medication adherence tactics and fall prevention programs. The
organization’s culture values established routines and dislikes upheaval and is a major barrier to
change. This opposition might make it difficult to implement new procedures, such as evidencebased interventions for medication adherence and fall prevention.
The staff’s ignorance of the significance of these therapies for elderly patients is another barrier.
Staff members may not fully understand the hazards of falls or the advantages of medication
adherence measures. This lack of knowledge may hamper their dedication and active
participation in implementing the desired change (Koinings et al., 2021).
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Resource limitations present further difficulties or barriers. This is because the implementation
process may be hampered by the organization’s limited resources, including staff. To fund
infrastructure, training programs, and equipment purchases, adequate resources are required. The
allocation of resources to the execution of fall prevention and medication adherence measures,
however, can be constrained by conflicting priorities and a shortage of healthcare workers.
For a practice change to be successful, the staff must buy in. This makes it a fourth barrier since
Some medical personnel could show opposition or not fully comprehend the suggested
interventions. Skepticism about their necessity or effectiveness may impact staff involvement
and motivation (Stevens et al., 2019). My leadership is crucial in addressing these issues and
encouraging employee acceptance as the Nurse Manager for Chemo Infusion.
Collaboration across disciplines is yet another obstacle. Coordinating and working with different
healthcare professions on fall prevention and medication adherence initiatives might be
challenging (Ain et al., 2019). Disparities may hamper effective collaboration between
disciplines in expertise, communication issues, and conflicting agendas. Promoting
interdisciplinary y teamwork and open communication is necessary to overcome this obstacle.
You can raise the possibility that the suggested practice change will be implemented successfully
by acknowledging these impending challenges and coming up with solutions.
Plans to Overcome Barriers
As the Nurse Manager for Chemo Infusion at The Sylvester Comprehensive Cancer Center, I
will implement various measures to overcome the potential obstacles for the suggested practice
shift. First, I’ll concentrate on overcoming opposition to change by explaining to staff members
the advantages of the suggested change. I’ll use my position to speak with staff members one-on-
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one and in groups about their concerns, focus on patient safety, and encourage acceptance of the
practice shift. I will also hold training and education sessions to boost staff awareness and
comprehension of fall prevention measures and medication adherence strategies. These meetings
will allow staff members to clarify their understanding, ask questions, and engage in discussions.
I will plan educational seminars and presentations to help people overcome the potential barrier
of ignorance. These initiatives will emphasize the significance of medication adherence measures
for seniors at risk of falls and fall prevention programs. I want to increase employee
understanding of and appreciation for the suggested change by disseminating pertinent research,
data, and success stories. These educational initiatives will aid in closing the knowledge gap and
guarantee that all staff members know the need to use these evidence-based approaches to
improve patient outcomes.
The practice change must be implemented successfully to address constraints on resources. I will
seek grants as the nurse manager to support the implementation process and locate potential
funding sources. The Sylvester Comprehensive Cancer Center’s current resources will be
maximized through my collaboration with the administration. To ensure that the practice change
has the support it needs, streamlining processes, eliminating inefficiencies, and wisely allocating
resources will be prioritized. I want to get around the problems presented by limited resources
and make it easier to conduct fall prevention programs and medication adherence techniques by
advocating for resource optimization and using funding opportunities.
Colleagues to Facilitate Change
I will coordinate and work in collaboration with the following colleagues to ensure the
recommended practice change is implemented successfully:
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A. Nurse practitioners: This are clinical specialists who have extensive training. Their
participation will aid in creating and using standardized protocols and recommendations
for fall prevention interventions and medication adherence techniques. Our ability to
guarantee that nursing practices follow evidence-based recommendations will improve
patient care and outcomes if we work closely with nurse practitioners.
B. Pharmacists: Pharmacists are essential for drug adherence and management (Kretchy et
al. 2021). Their knowledge of pharmacology and drug interactions will help to make
successful medication adherence tactics more widely used. They can offer insightful
information on medication optimization, counseling, and education, which will help to
lessen drug-related falls and increase patient safety. The suggested practice change would
include a thorough approach to drug management thanks to collaboration with
pharmacists.
C. Physical therapists: These professionals focus on movement and recovery. In order to
design specialized fall prevention interventions, such as balancing training and exercises,
to meet the particular needs of senior patients, their participation and cooperation will be
essential. Together, we can create comprehensive care plans that support patient mobility
and independence while incorporating physical therapy techniques.
D. Quality improvement specialists: Quality improvement specialists are skilled in data
analysis and process improvement. Their participation will aid in the evaluation and
monitoring of the adopted procedures. The effectiveness and efficiency of the fall
prevention programs and medication adherence techniques can be continuously improved
by reviewing data and finding areas for improvement. Working together with experts in
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quality improvement will yield useful information for continuing assessment and
improvement of the practice change.
Stakeholders for the Change in Practice
The Sylvester Comprehensive Cancer Center’s numerous stakeholders’ cooperation and
assistance are necessary for the suggested practice change to be implemented successfully.
A. Doctors: Doctors are essential to the care and treatment of patients (West & Coia, 2019).
They must support and participate in the planned change to ensure that fall prevention
interventions and medication adherence techniques are incorporated into the overall care
plan. We can align practices, correct issues, and build a common commitment to patient
safety and well-being through collaboration with doctors.
B. Nursing Staff: The nursing staff, which consists of licensed practical nurses and
registered nurses, is directly involved in patient care and will be in charge of carrying out
the suggested modification. For the practice shift to succeed, they must actively
participate, provide feedback, and commit to evidence-based procedures. They will be
understood and supported throughout the process with the help of clear communication
and training initiatives.
C. Patients and their families: They are significant stakeholders in healthcare decisions.
Thus, they should be considered. To get the intended results, it is imperative that they
actively participate in, comprehend, and adhere to the medication and fall prevention
intervention techniques. Patients and their families will feel empowered to take an active
role in their care and contribute to their safety through education, communication, and
shared decision-making (Jolles, 2019).
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D. Administrators and Managers: Administrators and managers offer the organizational
structure, resources, and support required to implement change successfully(Doz, 2020).
Their job responsibilities include funding allocation, staff training opportunities, and
creating policies and procedures that support patient safety and adherence to evidencebased treatments. Administration and management cooperation will guarantee the
essential organizational support and maintenance of the accomplished modifications.
Conclusion
Implementing a practice shift at The Sylvester Comprehensive Cancer Center for fall prevention
interventions paired with medication adherence techniques for older patients at risk of falls
necessitates carefully analyzing anticipated challenges and proactive planning to overcome them.
As the Chemo Infusion Nurse Manager, I will take the lead in overcoming opposition to change,
raising awareness, optimizing resources, building staff buy-in, and facilitating interdisciplinary
collaboration. To ensure successful implementation, I will work with essential colleagues like
nurse practitioners, pharmacists, physical therapists, and quality improvement specialists.
Involving stakeholders such as physicians, nursing staff, patients and their families,
administrators and managers, will help support and promote the practice change. We can remove
hurdles, improve patient safety, and improve results for older patients at The Sylvester complete
Cancer Center by adopting this complete plan.
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Reference
Ain, N., Vaia, G., DeLone, W. H., & Waheed, M. (2019). Two decades of research on business
intelligence system adoption, utilization and success–A systematic literatue
review. Decision Support Systems, 125, 113113.
Doz, Y. (2020). Fostering strategic agility: How individual executives and human resource
practices contribute. Human Resource Management Review, 30(1), 100693.
Jolles, M. P., Richmond, J., & Thomas, K. C. (2019). Minority patient preferences, barriers, and
facilitators for shared decision-making with health care providers in the USA: a
systematic review. Patient education and counseling, 102(7), 1251-1262.
Könings, K. D., Mordang, S., Smeenk, F., Stassen, L., & Ramani, S. (2021). Learner
involvement in the co-creation of teaching and learning: AMEE Guide No. 138. Medical
Teacher, 43(8), 924-936.
Kretchy, I. A., Asiedu-Danso, M., & Kretchy, J. P. (2021). Medication management and
adherence during the COVID-19 pandemic: perspectives and experiences from low-and
middle-income countries. Research in social and administrative pharmacy, 17(1), 20232026.
Stevens, E., Moroney, R., & Webster, J. (2019). Professional skepticism: The combined effect of
partner style and team identity salience. International Journal of Auditing, 23(2), 279291.
West, M., & Coia, D. (2019). Caring for doctors, caring for patients. General Medical Council.
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