NURS-FPX4010 Interview and Interdisciplinary Issue Identification Essay

 

Interview Summary

The interview was with Ms. Decker (not her actual name). Miss Decker is a unit manager in the medical unit of a teaching and regional hospital in my state. She agreed to have the interview with me via zoom meeting due to convenience and time constraints. The healthcare organization in which Decker works is a big facility that offers inpatient and outpatient care in pediatric, medical, surgical, obstetric, oncological, dental, and psychiatric care. Her unit, the medical unit, has the largest bed capacity and the number of nurses and other healthcare workers in the hospital. As a unit manager, she has leadership and management roles in the unit that involves both direct clinical and administrative duties. She oversees the quality improvement projects and answers directly to the chief nursing executive, the overall coordinator of care quality and patient safety in the healthcare organization.

More than 18 months ago, her healthcare organization was recording increasing incidences of medication errors despite having implemented Epic^® electronic health records technology to improve patient safety and care quality more than six years ago. Therefore, the quality team convinced the hospital budgetary and administrative team to implement new technology, barcode medication administration (BCMA) systems. Eighteen months after BCMA implementation, the healthcare organization still recorded a high number of medication errors. From the interview, she also said that the quality team of which she is a member plans to sit next month to discuss these quality outcomes and plan the next steps. Her organizational administrative culture encourages communication and collaboration between various healthcare professionals involved in direct care and those providing auxiliary services. Whenever patient safety is at risk, healthcare professionals are allowed to report these incidences for immediate preventive action to their unit managers first before involving higher administrative personnel in the facility. Ms. Decker has had to communicate with other unit managers to compare implementation strategies and share ideas with other departments regarding patient safety and care quality. As a nurse leader, she is also a member of an interdisciplinary team that works with the office of the chief nursing executive to promote care quality.

Issue Identification

The use of technology has been associated with improvement in care quality. However, not all time does this quality results after the implementation of these technologies. Other factors, both human, system, and medication-related, impact the quality outcomes, especially in medication error prevention. From this interview, the clinical issue concerned the lack of achievement of goals of patient safety improvement using additional technology. According to Al-Ahmadi et al. (2020), medication errors are usually multifactorial and multidisciplinary in etiology and risk factors in the same setting or the same patient situation. The problem, being a multidisciplinary clinical issue, an interdisciplinary approach could offer better outcomes. From my interviewee’s practice setting, the medication use and treatment process involve not only nurses and doctors but also pharmacists, informaticists, and technologists. The patient still remains the chief stakeholder in medication use. Issues such as policy deviations, distractions, usability, and consistency in technology greatly affect the outcomes of technology in medication error prevention (Mulac et al., 2021; Rasool et al., 2020). Therefore, an interdisciplinary approach would be appropriate for this issue.

Change Theories That Could Lead to an Interdisciplinary Solution

Kotter’s Change Management Model is a potential theoretical model that would be used to develop and facilitate an interdisciplinary team in finding a solution to this issue. This theory emphasizes creating a sense of urgency and forming a coalition that would lead to short-term wins. This theory would be appropriate for this clinical issue because it would bring together all stakeholders by creating the need and urgency for a team approach. Such intervention would incorporate the aforementioned human and system factors that lead to medication errors. A systematic review study by Harrison et al. (2021) assessed various change models and nursing and healthcare practice and found that Kotter’s model applied to both direct care and management situations in facilitating change. This source is peer-reviewed, current, and authoritative and provides relevant and reliable findings. Therefore, it is a credible source.

Leadership Strategies That Could Lead to an Interdisciplinary Solution

Leadership strategies that would help in developing an interdisciplinary solution are open communication and collaboration, provision of education and training, encouraging team diversity and inclusivity, and shared decision-making. These strategies promote a team approach by bringing together all stakeholders with a common goal. Utilizing Kotter’s change model would be possible when these strategies are employed by the nurse leader. Creating a sense of urgency in the coalition would be facilitated by communicating, sharing, and setting goals among a diverse group from relevant disciplines. According to Caulfield and Brenner (2020), engaging patients and their families require that health professional deliver education with objectives targeting medication error prevention. Involving a group of different professionals provides multidisciplinary prevention. This source was from a retrospective clinical research published in a peer-reviewed journal called BioMed Central. This source is also credible because it is current and relevant.

Collaboration Approaches for Interdisciplinary Teams

Interdisciplinary rounding, case conferences, and shared decision-making are three approaches that would be useful in creating and improving interdisciplinary teams. Interdisciplinary rounding would promote face-to-face interaction between nurses, pharmacists, and prescribers to discuss specific patient cases and implement together strategies to prevent medication errors. During these rounds, shared decision-making can be made possible. At higher leadership levels, it is advisable to use case conferences to promote patient-centered care by focusing on patient-specific strategies in interdisciplinary meetings. Implementing Shared decision-making for this during conferences and interdisciplinary rounding would ensure that the process for transition between the prescriber, the dispenser, and the medication administrator is name possible through direct physical communication. Chances of medication errors are therefore reduced by timely and effective communication. According to a qualitative study by Salar et al. (2020), some of these strategies promote professional actions and presenting technical strategies among interdisciplinary teams. This source interviewed healthcare professionals and is peer-reviewed. The content and findings relate to what we see in practice today and are thus valid. Overall, it is a credible source.

Conclusion

Medication error prevention using technology may not be foolproof. Consideration of different factors requires the incorporation of interdisciplinary actions. In this healthcare issue, the problem was the underachievement of medication prevention goals despite using technology. The interdisciplinary approach would promote the finding of a solution through Kotter’s change management model, communication and collaboration, provision of education and training, encouraging team diversity and inclusivity, and shared decision-making in nursing leadership. Interdisciplinary rounding, case conferences, and shared decision-making are approaches that would promote interdisciplinary collaboration. Credible sources have been used to back up the argument for these strategies because these sources are current, authoritative, relevant, accurate, and purposeful.

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References

Al-Ahmadi, R. F., Al-Juffali, L., Al-Shanawani, S., & Ali, S. (2020). Categorizing and understanding medication errors in hospital pharmacies concerning human factors. Saudi Pharmaceutical Journal: SPJ: The Official Publication of the Saudi Pharmaceutical Society, 28(12), 1674–1685. https://doi.org/10.1016/j.jsps.2020.10.014

Caulfield, J. L., & Brenner, E. F. (2020). Resolving complex community problems: Applying collective leadership and Kotter’s change model to wicked problems within social system networks. Nonprofit Management & Leadership, 30(3), 509–524. https://doi.org/10.1002/nml.21399

Harrison, R., Fischer, S., Walpola, R. L., Chauhan, A., Babalola, T., Mears, S., & Le-Dao, H. (2021). Where do models for change management, improvement, and implementation meet? A systematic review of the applications of change management models in healthcare. Journal of Healthcare Leadership, 13, 85–108. https://doi.org/10.2147/JHL.S289176

Manias, E., Street, M., Lowe, G., Low, J. K., Gray, K., & Botti, M. (2021). Associations of person-related, environment-related and communication-related factors on medication errors in public and private hospitals: a retrospective clinical audit. BMC Health Services Research, 21(1), 1025. https://doi.org/10.1186/s12913-021-07033-8

Mulac, A., Mathiesen, L., Taxis, K., & Gerd Granås, A. (2021). Barcode medication administration technology use in hospital practice: a mixed-methods observational study of policy deviations. BMJ Quality & Safety, 30(12), 1021–1030. https://doi.org/10.1136/bmjqs-2021-013223

Rasool, M. F., Rehman, A. U., Imran, I., Abbas, S., Shah, S., Abbas, G., Khan, I., Shakeel, S., Ahmad Hassali, M. A., & Hayat, K. (2020). Risk factors associated with medication errors among patients suffering from chronic disorders. Frontiers in Public Health, 8, 531038. https://doi.org/10.3389/fpubh.2020.531038

Salar, A., Kiani, F., & Rezaee, N. (2020). Preventing the medication errors in hospitals: A qualitative study. International Journal of Africa Nursing Sciences, 13(100235), 100235. https://doi.org/10.1016/j.ijans.2020.100235

This specific assignment will be the first of 3 parts. If I could get the same writer for all 3, that would probably make things easier.

I can’t request the other 2 assignments from you guys without this one being completed first.

 

1st part: Interview and Interdisciplinary Issue Identification

2nd part: Interdisciplinary Plan Proposal

3rd part: Stakeholder Presentation