During the progress of the research specific challenges have been experienced so far. The experienced challenges are attributed to the given time frame, patient overload, leaves, time off and absence, availability of bedside computers, lack of awareness on in-service training and resistance from some CNAs
Given time frame
There was a short time for training the CNAs. The small window that was allotted for training nurses on handoffs communication proved insufficient resulting in disorganization in the process. The short time was also not sufficient to initiate the interaction with the nurses so that the challenges they experience can be diligently addressed. The project is trying to find a possibility of fixing this; either by modifying the training process. The project is striving to make the process of training faster than before, and this is only achievable through application of technology and more resources.
Patient overload
The facility is currently experiencing patients overload, and CNAs and RNAs are required to attend to them; thus, slowing down the progress of the project. Most of the time that should be dedicated to the success of the project is hindered due to the increased commitment by the CNAs and the RNs on the patients. Since the process is slowed down, obtaining the set objectives within the indicated time is likely not to be a success. However, some positive progress has been noted with some CNAs availing themselves and taking part in the survey. The health physicians have agreed to allocate time for a few nurses during a medical process to attend to the project, and this will be achieved through working in shifts.
Leaves, time off and absence
Some CNAs and nurses have taken leaves and time off as well as absence and this to some extent is a challenge since it would be impossible to train all of them. Sometimes certain CNAs begin training, but after a short time, they are absent. These time-offs affects the efficiency of the entire training process. Another factor is the refusal by some CNAs and nurses to take part in the survey is affecting the progress. However, a good number have taken part in the survey. The rate of time-offs and absenteeism will be reduced through a policy that is created by the director so that enough time is allocated for the project. The project is working to improve on training absence to ensure higher participation.
Availability of bedside computers
The project would likely face a challenge if the RNs concurrently use computers in making their bedside reports as this would deny them access to perform CNA handoff. If the computerized report is used daily by the health physicians and nurses to provide care, accessing the information on the patient portals will be a severe challenge. The RNs will be asked to make the patient information available for analysis when they are required by providing passwords to the CNAs.
Lack of awareness on the in-service training
Some charge nurses are not aware of the on-the-job training due to lack of adequate information. The project noted this challenge when these nurses could not inform the CNAs that were in training on what they needed to do. Improper communication results in reduced understanding and hence the project is working to support collaborative learning where all the CNAs will also be involved.
Resistance from some CNAs
The project realized that some CNAs expressed concerns that the training process would not be sufficient, which makes it somewhat difficult to proceed. While other CNAs regarded the project to place their job at risk since it infringes on their privacy and this will interfere with the relationship they have with their RNs. It is also identified that most of the CNAs believe that the project will not be able to address their challenges to the director since several projects have been done in the hospital, but the outcome have not resolved their problems. However, the project is improving on this by explaining more to the CNAs on what it hopes to achieve in the end. Clarity will be important in the initial stages of the project so that the CNAs and the RNs understand the benefit of the project to their profession.

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