A nurse manager is providing education to a new nurse on barriers to the implementation of quality improvement processes. The manager judges the teaching to be effective when the new nurse states:

Question

a. "Expense is a primary barrier.".
b. "Resistance to change is a primary bar-rier.".
c. "One of the primary barriers is compla-cency with the status quo.".
d. "Not identifying the correct problem is a primary barrier.".

Answer 1

A
A primary barrier to implementing effective quality improvement (QI) programs is the cost. The cost of providing health care has greatly increased over the past few decades. However, through quality improvement measures, overall health care costs can be reduced. Other barriers (but not the primary one) to QI are nurses' loyalty to old practices and failure to recognize that changes are needed. Hospital administrators often oppose change of any kind because they may value traditional practices, have an authoritative management style, or may not value innovators. Nurses are often unaware or unwilling to change their practice from the way they have always done things—complacency with the status quo. Many practicing nurses remain resistant to change because it seems threatening and because it requires effort, retraining, and restructuring of habits, but cost still remains the primary barrier to implementing QI.