Implementing Change With an Interprofessional Approach Presentation NURS 514 Assignment

Implementing Change With an Interprofessional Approach Presentation NUR 514

Implementing Change With an Interprofessional Approach Presentation NURS 514 Assignment

Change is an important aspect for health organizations. Health organizations embrace change as a way of ensuring that they respond to the actual and potential needs in their environment. Change also ensures that the organization adopts interventions that will ensure sustainability and success in its markets. Organizations that embrace change on a regular basis are adaptive in nature. The organizations have mechanisms that ensure that they respond positively to both the anticipated and unforeseen events. Employees in organizations that are receptive of change are innovative in nature. They understand the need for the adoption of new practices that promote quality and efficiency in the provision of healthcare services. Therefore, the continuous adoption of change is critical, as it develops culture of excellence in health organizations.

The change that was being implemented in our organization is the implementation of barcode medication administration technology. The barcode medication administration technology is used in the medication administration to minimize errors. Nurses are required to counter-check the prescribed medications for the patients prior to administering them. The nurses achieve it by using the technology to confirm the patient’s identity, medical diagnosis, any significant histories, and prescribed medications. The technology also assists the nurses in determining the dose, route of administration, strengths and time prior to medication administration. The aim of the adoption of the technology was to prevent medication administration errors in practice.

The need for the adoption of the barcode technology for medication administration was attributed to a number of reasons. Firstly, the rate of medication administration errors in the hospital was rising significantly. An assessment of health organizations that had the lowest rates of medication administration errors showed them to use health technologies in addressing the issue. As a result, the use of barcode medication administration technology was considered for use in the institution. The other reason for the implementation of the barcode medication administration technology was to promote quality and safety in healthcare. The use of the technology was anticipated to minimize the risk of errors in the administration of medications. The minimization of errors was therefore considered a predictor of quality and safety of care in the institution. The technology was also adopted with the aim of enhancing efficiency in the institution. The technology was anticipated to ease the burden of medication administration and minimize wastages in the institution. Through it, the cost of care was anticipated to reduce significantly.

The internal inter-professional stakeholders that should have been involved in the implementation of the above change in the organization were varied. One of them should have been the nurses. Nurses were the primary implementers of the change. As a result, they should have been involved in all the processes of implementing the change for its success. Nurses should have been trained in the whole process of implementing the project. The successful use of the technology depends on the active collaboration between the physicians, nurses and pharmacists. There was therefore the need to incorporate the pharmacists and physicians into the implementation of the change. The pharmacists and physicians should have been trained on the use of the technology to strengthen safety and quality in the provision of care. The other stakeholder is quality assurance personnel. The quality assurance personnel would have been tasked with the role of determining the safety, credibility, efficiency, and need for the barcode medication administration technology. The IT technicians should have been involved in ensuring that they provide the technical support and maintenance of the system.

The successful implementation of the project requires the involvement of a number of external stakeholders. The first one is trainers of trainees. External trainers of trainers should have been involved in ensuring that the internal stakeholders have the required knowledge and skills for implementing the change. The trainers of trainees should have ensured that the users of the technology have the needed competencies for the successful implementation of change. The second external stakeholder is experts from institutions that have demonstrated excellent results following the use of the technology. The experts would have provided critical insights into the requirements of successful use of the technology in practice. The last external stakeholder is representatives from the company selling the technology. The representatives would have provided the technical support in the use of the barcode medication administration in the institution.

The theory of innovation diffusion by Rogers asserts that change occurs in steps. The steps include knowledge, persuasion, decision, implementation and confirmation. The steps occur in a sequential manner. In this case, the successful implementation of change is only achieved once the requirements of a previous step have been met. For example, the implementation of change depends on the knowledge about change and persuasion level of the adopters. The incorporation of change into the organizational culture also depends on whether its use has been confirmed by the adopters or not. The use of theory of innovation by Rogers points towards the need for the adoption of interventions that develop the stakeholders and address the identified and potential issues that might affect the change. As noted initially, the theory can be used for evaluation purposes. The implementation of change can be evaluated at each step of the model to determine whether the adopters are ready for the change or not.

Initiating change will occur in a number of steps. The first step will be needs assessment. Needs assessment will be performed in the organization to determine why the organization requires change. Needs assessment will provide information on the areas that will benefit significantly from the implementation of change. The assessment will also inform the understanding of the needs of the critical stakeholders that must be involved in the change. The second step is communicating change. The change should be communicated to the adopters for them to make informed decision on the use of the change. Communicating change will also create awareness among them on the critical determinants for the change in the institution. The third step will be training the adopters. Training will be needed to ensure that the adopters of the change have the required knowledge and skills for the change. Training will promote the successful implementation of the change since the risk of resistance to change from the stakeholders will be minimized. The change should then be implemented following training. The implementation should aim at determining whether the goals of the project are being achieved or not in the organization.

The inter-professional teams will embrace a number of decisions if the project is unsuccessful. The first decision will be the re-assessment of change. The stakeholders will examine the factors that might have contributed to the failure of the change. The re-assessment will provide information that will be used to improve the strategies that were used in the process. The information from re-assessment will also be used to introduce new processes that will strengthen the need and effectiveness of the change. The inter-professional teams may also consider extending the project timelines. Extension might be required due to the revision of strategies and introduction of new processes. The team may recommend termination of the project if they find it to have negative effects on the outcomes of the organization.

Implementing Change With an Interprofessional Approach Presentation NURS 514 Assignment REFERENCES

• Senior, B., Swailes, D. S., & Carnall, C. (2020). Organizational Change, 6th Edition. Pearson Education Limited.
• Singh, R., & Ramdeo, S. (2020). Leading Organizational Development and Change: Principles and Contextual Perspectives. Springer Nature.
• Sveningsson, S., & Sörgärde, N. (2019). Managing Change in Organizations: How, what and Why? SAGE.
• Xie, N., Kalia, K., Strudwick, G., & Lau, F. (2019). Understanding Mental Health Nurses’ Perceptions of Barcode Medication Administration: A Qualitative Descriptive Study. Issues in Mental Health Nursing, 40(4), 326–334. https://doi.org/10.1080/01612840.2018.1528321

Implementing change requires interprofessional involvement

They help in conducting a needs assessment and planning (Finkelman, 2018)

uAt the present work station- need to reduce patient fall was the safety implementation strategy

uA team was constituted to develop the plan; change never achieve effectiveness

uPresent study focus on development of steps for successful implementation of the change

The hospitals I work for and to which I am a nurse leader intended to implement a patient safety measure to reduce falls in the in-patient units. A team was constituted including physicians, nurses and physiotherapists to formulate a plan on the improvement strategy. The selected professionals were to assess the causes of patient falls, reported cases of falls in the facility and educate other care providers on preventive measures (Finkelman, 2018). A patient care protocol was formulated with greater emphasis placed on providing ambulatory services to frail patients. While this initiative was a positive move, it failed to be implemented effectively. This was due to inadequate education on modes of implementation especially to care providers with close proximity to patients. Besides, the ambulatory service equipment were not availed in each unit as previously planned due to inadequate budgetary allocation. This alternative the implementation of change process.

Background of the situation including rationale for change

uFacility records incidences of patient falls

qMost incidences occurs at the surgical and medical wards

uFactors potential in causing patient falls-

qwalking and transfers, confusion, medication side effects and frequent toilet needs (Ganz et al., 2013)

uPatient falls attributed to negligence of care providers especially;

qnurses, physician and physiotherapists

uIncidences also attributed to organizational framework

qlacks adequate wheelchairs and ambulatory services to support movement of frail patients

uHigh rates of patient falls calls for a need to formulate safety implementation strategies.

Every year, hospitals in the United States of America record between 700,000 and 1,000,000 falls. Often the falls are related to fractures, internal bleeding and overall weakness in patients. Patient falls are reported as the most safety issue in care facilities accounting for about 32% patient safety incidences (Ganz et al., 2013).  About 30% of falls in the inpatient units leads to physical injuries while about 7% accounts for serious injuries. Patient falls leads increased hospitalization as well as elevated cost on care. Falls also affects care providers directly involved with the patient as they may experience guilt together with apprehension especially if the incidence occurred due to their negligence. Studies indicate that about one-third of falls in hospitals can be prevented.

Key interprofessional stakeholders: Internal

Interprofessional approach in care is important to address the incidences of patient falls in the care facility. The implementation of the approach requires involvement of key stakeholders who services directly influence patient outcomes. In practice, doctors, nurses and physical therapist as well as pharmacists influence the disease management in patients (Ganz et al., 2013). During the formulation of implementation strategies, their services must be incorporated in decision making. However, physicians may have a perception that their professional practice does not directly affect patient falls. However, multidisciplinary falls assessment must be implemented to guide on decision making related for successful intervention. The team also formulate practice protocols which are to be followed by other allied care providers on reduction of patient falls in the institution.

Details:

In a fast-paced and complex healthcare setting, change is constant and inevitable. Thus, the advanced practice nurse needs to lead and also conform to the constant altering environment even as they work with a multidisciplinary team or teams. Imagine that your director has assigned you to work with a certain multidisciplinary team that is helping with transition from the present paper-based system to the more modern electronic health record.

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Formulate a PowerPoint presentation encompassing between 10-15 slides in which you are going to examine the situation and the steps that should be employed in order to successfully execute the change. Also, ensure that your PowerPoint slides have 1—250 word speaker notes per slide in order to give them weight. Your presentation should have the following points:

• Describe the driving forces that relate to the need for implementing electronic health records.
• Identify the key interprofessional stakeholders (both internal and external) that should beinvolved in change efforts.
• Outline how you would initiate the change and be a change advocate. Utilizing change theory and innovative models of care, explain how you would provide a structure for the planned change to achieve successful implementation of the EHR.

Rationale for Change

• Promote patient safety
• Promote quality in care
• Reduce cost of care
• Promote patient satisfaction with care

The rationale for change was attributed to a number of reasons. The first one was the need for the promotion of patient safety. The reduction in the risk and rate of patient fall was anticipated to translate into the improvement in the safety of patient care. The other need for change was the promotion of quality in care. The adoption of the change aimed at ensuring that the quality of care given to geriatric patients was improved through the minimization of harm. The change also aimed at reducing the cost of care. Patient falls increase the cost of care that patients and their significant others incur in seeking additional care. It also reduces the cost of care incurred by health organizations. The provision of safe, quality and cost-efficient care was therefore anticipated to lead to an improvement in patient satisfaction with care (Tappen et al., 2017).

Goals of the Change

• Reduce the rate of patient falls from 4% to 1.8% in five months
• Reduce the cost of care for geriatric patients by at least 25% by the end of five months
• To reduce the length of hospital stay by geriatric patients by at least three bed days by the end of five months

Why it Failed

• Lack of education/training for nurses
• Lack of stakeholder involvement
• Lack of open channels of communication
• Staff shortage
• Inadequate organizational support

The above change project failed due to a number of reasons. One of them was the fact that the nurses who were involved in the implementation of the project were not trained. The lack of training implied that they did not have the necessary knowledge and skills that were needed to undertake the assignment. There was also the lack of stakeholder involvement. Nurses in the geriatric unit were not actively involved in the project initiatives. The minimal involvement implied that they did not have the knowledge and skills that were needed for the successful implementation of the project.

There was also fragmentation in the communication in the department. For example, there was not two-way communication between the nurses and their managers. As a result, the needs and views of the staff nurses were not taken into consideration in the implementation of the change. The other challenge was shortage of nurses in the department. The shortage translated into high workload that rendered the use of bedside alarms ineffective. The last factor that led to the failure of the change was the lack of adequate organizational support. The organization did not provide adequate human resource support such as hiring additional staffs to facilitate the successful implementation of the change (Claretha, 2020).

• Demonstrate how the change will affect current workflows. What revised workflow would you implement?
• Identify resources (human, time, material, etc.) required for implementation.
• Identify risks within the implementation plan. What are the impacts of the poor planning on cost, quality, and safety?
• Identify potential barriers when implementing the change and discuss how you will handle resistance.

Integrate 3-5 scholarly sources into your presentation.

Background

• Implementation of fall prevention approach
• Hourly nursing rounds and call lights were to be used
• Implementation in all inpatient units
• Did not succeed due to lack of training, involvement, and high nurse-patient ratios

The change that was introduced in our hospital was a fall prevention strategy. The strategy entailed the introduction of the use of hourly nursing rounds as well as call lights in the prevention of patient falls. The main aim of introducing hourly nursing rounds was to identify earlier patients that were at a risk of falls and averting falls. The use of call lights was also introduced. The patients who suspected to be at a risk of falls were required to notify the nurses by pressing on a button that could rely the signal to the nursing station. The intervention was to be implemented in all the inpatient settings in the hospital. Despite robustness in the interventions, the implementation process failed.

The failure was attributed to a number of factors. The first one was the high number of patient to nurse ratio. The implementation of the project came at a time when the hospital had experienced a high rate of staff turnover. The available staffs were not adequate to meet the healthcare needs of the patients. There was also lack of involvement of the nurses in the assessment and implementation of the project. They felt that the decision was forced on them. Lastly, the nurses were not provided with training on successful implementation of the project. Cumulatively, these factors contributed to the failure of the project.

Prepare this assignment On according to the guidelines found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

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Assignment:

For the week assignment:

Develop a  powerpoint presentation of which your topic is “Implementing Change with an Interprofessional Approach”.  You presenting yourself as APRN leader within your organization, with intent to create positive change on behalf of patients, colleagues and the industry. You might think in the past where change did not go as planned in your Health Care Organization, and with assessment of the situation, you will take steps that will successfully implement a change.  Use the 5 bullet points in the directions and what is in the rubric, be sure to include slide notes (100-250 words per slide), APA format is required with 3-5 recent(within 5 years) resources.

Hi there Class! THis week we are looking at Organizational Change theories and stratgies, which you will discuss the NP role in the interprofessional health care environment and what aspects of stakeholders can affect that role. There will be change theories and collaborative models to review from the resources that will help you see how to promote successful changes, especially in terms of ethical, social, legal, economic and political implications.

Please Note: Assignment will not be submitted to the faculty member until the “Submit” button under “Final Submission” is clicked.

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