As with any project implementation its best to envision any potential issues before they arise. Therefore, I anticipate a few potential issues with the proposed implementation of my project. The first foreseen issue identified for the proposed implementation of my evidence-based project are financial concerns and will continue to be an ongoing concern. I was able to identify a couple of strategies to help with the financial concerns including executive leadership engagement in the process. Being fully transparent with the executive leadership team regarding the implementation plan including cost and methods of saving will aid in gaining their support. Another financial strategy would be to develop a team of subject matter experts/educators on the Physician Orders for Life-Sustaining Treatment (POLST) program utilizing the system Respecting Choices Model within the system. With the development of the program within the system there will be a reduction in further cost to outside resources.
This article reviews patients’ actions reflected by carrying out medication lists to diminish information loss from health care settings and identifying support for patient safety. The study reveals priorities for improving medication safety in primary care by addressing incomplete medication reconciliation. The strength of the study is reflected by the empowerment and confidentiality inspired to patients by involvement in medication management, increasing their dignity and self-esteem level, evidencing a form of resilience in nursing practice. Patient-held medication lists may be helpful for information transfer in emergency situations when communication is altered. Patient-held medication lists assist with taking medications, reordering, monitoring health care conditions, or tracking the efficiency of medications. The weakness of the study is reflected by possible disconnections between the information needs by health care professionals and the information being kept by patients who carried medication lists. Another limitation of the study is interviewing more females than males who carried a medication list, and the procedure suggests that more females carry a medication list than males and may reflect an inaccurate practice (Garfield et al., 2020).
The second foreseen issue is a lack of clinician buy in to the program and change management. In order to address this area education, engagement, and communication are necessary strategies. The education will include up-to-date best practices, refresher courses, audit, and review. The engagement strategies include ensuring confidence in their work, standardized workflow, ensuring collaboration and stakeholder involvement. The communication strategies include ongoing updates on education and engagement opportunities, events, current POLST literature, and development of newsletter.
The third foreseen issue is lack of quality of the POLST process and order sets. Quality of the work is a multifactorial problem; in that it relies heavily on the first two foreseen issues. “The quality of POLST documentation is only as good as the conversations that precede it” (Abbott, 2019, p. 297). Therefore, if there is a lack of financial support or clinician buy in, ultimately leading to a reduction in POLST quality.
Research on POLST implementation is actively being reviewed and updated therefore in order to ensure that my proposed evidence-based practice proposal is based on current evidence it’s necessary to regularly search for the most up-to-date literature.
Reference
Abbott, J. (2019). The POLST paradox: Opportunities and challenges in honoring patient end-of-life wishes in the emergency department. Annals of Emergency Medicine, 73(3), 294–301. https://doi.org/10.1016/j.annemergmed.2018.10.021
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