Phase 3 Outcome Management Model

I selected to do Phase three of the Outcomes Management Model. Phase three is about “the implementation of new evidence-based initiatives. This step involves role modeling and teaching new practices, making clear interdisciplinary expectations for use of newly adopted practices, determining the stability and reliability of new practices to ensure uniform use, and measuring outcome targets” (Melnyk, 2015).
I would apply the issue I am researching, the role of dipstick urinalysis in diagnosing urinary tract infections in older adults residing in health care facilities to phase three by implementing my findings into practice. The first step in this process would be to “educate clinicians and other stakeholders about new practice to be adopted” (Melnyk, 2015). In this case evidence shows that dipstick urinalysis alone should not be used to diagnosis urinary tract infections in the elderly. However, with symptoms present can be used as a diagnostic tool (Deville, 2004). Forthmore, urine dipstick assay can be used as a first level screening and can improve diagnostic accuracy (Deville, 2004).
I think that some of the facilitators to successful completion of phase three would be the administration team, nursing and physicians.
The administration team would be a facilitator of using dipstick assays as screening/diagnostic procedure because it is cheap than a urinalysis and culture completed in a laboratory (Deville, 2004). In a similar manner, nurse would be a facilitator because dipstick assays are easily obtained in-patient with incontinent or foley catheters. They are also quicker that laboratory urinalysis, meaning nurse can request treatment for urinary tract infections sooner (Deville, 2004). While on the same hand, physician would be facilitator because a urine dipstick assay gives the physician more objective evidence to look at and see the whole picture (Deville,
2004).
Some of the barriers to successful completion of phase three would be old habits and workload. What I mean by old habits is that as healthcare workers we get accustomed to do things one way and change is hard. I foresee it being a struggle for an awhile for physicians and nurse to want to skip and do a urinalysis and culture right away. Just because that’s what we have done for years and it feels safe to have that laboratory paper would with specific lab values in our hands. However, evidence says with positive symptoms and urine dipstick analysis a lab done urinalysis isn’t necessary (Deville, 2004).
In a similar manner increased workload would be another barrier. This change of practice would mean more work on the healthcare works part. Nurses would need to do through assessments of their patients for urinary tract infection symptoms and also obtain a urine dipstick assay. In the begging it would seem like more work, but after awhile it would become the normal. Also, often when we suspect someone has a urinary tract infection we start treatment before the lab result are back and then end up having to stop treatment because they don't have a urinary tract infection. The old way we are creating work for ourselves.
I would overcome these barriers by addressing them head on in the beginning. Providing everyone good education about why this is such an important practice change will have the biggest impact in reducing barrier (Titler, 2008). Everyone can agree that in the healthcare world want to do what is best for our patients. Likewise is would be important to continue to stay motivate and be a cheerleader for the cause. Having a positive attitude about the change will help the rest of the staff also maintain that positive outlook on the practice change (Titler, 2008).