Order Description;

Length: 2,500 words
Mark loading: 60%
The student is to develop a change management plan.
Assessment 2 – Marking Guide
Introduction – astute overview of the paper /5
Analytical discussion of relevant literature /10
Clear rationale for plan /5
Clear detailed plan /15
Clear strategies for assessing the plan outcomes /10
Summary and conclusion – Insightfully highlighting main issues /5
Submission is written in a manner consistent with academic writing/10

Answer;

Introduction

Apparently, it is quite devastating reading on print media that nurses are leading medical staff contributing to cases of medication errors. The paper will focus on providing readers analytical discussion of the literature review to shed light on the matter concerning medication errors. The primary focus of the paper will entail an overview of Lippits outlining the specific procedures of the needed seven steps of change. Readers would benefit from familiarizing with the process of implementation of changes. The final part of the paper will examine the overall insight of medical subject matter.

Discussion

A study conducted in Imam Khoimeni Hospital based in Tehran, Iran focused on obtaining demographic characteristics influencing medication errors. The study indicated that nurses contributed highly to cases of medication errors with a margin of 64.55 percent. 31.37 percent of participants confirmed that cases of medication errors were on the verge of occurring. The report further indicated that infusion rate and wrong dosage were the leading the cases were attributed similar identify of drugs, and use of abbreviations rather than full names. In other word, the study confirmed that lack of adequate knowledge of pharmacological was the leading causes of medication errors in the medical facility the report further revealed that working shifts, working experience, and age did not indicate significant relationships with medication errors. However, the study confirmed that gender and intravenous errors posed significant relationship with medication errors. Generally, the study indicated that medication errors are among the major problem in nursing (Cheragi et al., 2013).

Rationale

Nurses are highly blamed taking contributing the largest share of medication errors in many facilities based in the United States. The problem appears to originate from medical schools. Nursing training failed to account comprehensively for nursing professionals to attain the needed knowledge on right medicine prescription.

Naylor, (2002) studied that drugs are chemicals used by patients all over the world to treat diseases and relive pain. However, much as they play valuable role in treating patients, their chemical nature can cause causal indifference when health practitioner fail to administer the right prescription. The harm elevates when either the healthcare profession or patients in case of errors related to medicines. Apparently, healthcare professionals display unwillingness or naivety in cases related to medicine prescription thereby contributing to high cases of medication errors. Therefore, in order to improve patient safety. The world should hold a debate to discuss way of reducing adverse events induced by medication errors. Secondly, colleagues, students, and healthcare should be obliged to educate careers, patients, and healthcare systems on serious implications caused by medication errors.

An independent study conducted by Kaushal et al, (2001) focussed on assessing the influence effects of medication errors in paediatric inpatient setting. The research established that medication errors were identified through a review on medication administration records, patient charts, medication error sheets, and by clinical staff reports.

Medication errors are becoming global health concern that contributes to serious health concerns and death. Many studies indicate that lack of adequate skills displayed by nurses and physicians. Other factors such as extremes of age, urgent care, and unfamiliar procedure significantly contribute to medication errors. The study concluded the  medication errors were imminent among paediatric inpatient settings. Thus there was urgent need to reduce the rate of medication error in the target health facility (Committee on Identifying and Preventing Medication Errors et al., 2006).

Change Management Plan

In essence, the professional goal of nursing professional is to improve and provide human health. Therefore, incidences of medication errors are proving those nursing professionals are deviating from their professional goals. The IOM (IOM, 2014) brought the public into awareness regarding medical safety. The report provided four points concerning the problem; systems cause errors, errors are costly and common, errors are preventable, adverse events related to medication are leading causes of patient injuries, and safety can be improved. The report further indicates that it is very possible to implement changes that can improve medical safety despite the fact that the plan would be challenging (Bates, 2007). The following are steps highlights on implementing ways to prevent medication errors.

1. Diagnosis of the problem

Hospitals have exclusive obligations of changing the organizational culture as one of the essential elements that would provide safety to patient. Low performing organizational culture indicated that the procedures and practices formulated by the human resource (Snell & Bohlander, 2013) of a health facility fail to focus on nursing staff discipline.  In other words, incompetent leadership is one of the major contributing factors to medication errors. Apparently, nurses fail to comply with physicians instructions regarding prescription of medicine. Thus, it appears that the leadership of the health facilities have failed to implement the needed supervision towards nurses. Such hospitals tend to encourage nurses to take part in cases related to medication errors because they fail to provide a clear procedure on reporting the cases. In other words, the problem emanates from lack of reliable reporting procedures where every staff would be accountable for operations error especially medication errors.

2. Assessing Employees Motivation and Capacity to Change

The first motivational factor that health facility would consider is to formulate communication system where leaders, physicians and nursing staff would get an opportunity of interacting. The plan would entail a program where nurses would feel free to inquire any unclear information regarding medicine that they fail to understand. As mentioned, medication errors are attributed by unclear information regarding names of some drugs. Therefore, a clear system of communication would enable nurses to establish properly commendable relationships with physicians.

A capacity to change would be assessed once the health facility implements a positive organizational culture (Schein, 2010). The change can be implemented through integrating both clinical and administrative leadership. The strategic meeting should focus on improving patient safety and benefits that staff would achieve on ensuring that patients are on safe hands. In this case, the key leaders could also consider implanting the Executive Safety Round. The strategy entails a routine visit to the entire clinical units by the senior members of management with a primary intention discussing safety issues (Bretl et al., 2008). The technique would be ideal in the sense that it will involve key leaders to the health facility in discovering medication hazards and risks to patients and thus promote safety within the health facility. This way, nursing staff will feel that their efforts in promoting patient health are appreciated from the top management.

3. Action plan

The strategy would require financial, technological, and human resource to implement. The human resources will include educational providers that the hospital would acquire to conduct the training session. The providers would e professional expertise with adequate knowledge on identifying medication errors and ways of providing safety to patients. Technological resources will play an instrumental role in reducing the intensity of medication errors in the health care facilities. In this particular case, the health facility would consider adopting infusion pumps and computerized physician order. The technology would help the nursing staff detect medication errors and deal with the error on time. Financial resources will be greatly required in the sense that the facility would need to conduct an intensive research on sourcing educators and purchasing machine and equipment. The financial resources would be used to compensate nursing educators and purchase other resources that the facility would need to conduct the workshop.

  1. Define progressive stages of change

Errors in medication can be avoided by creating a detailed plan to guide the procedure. Responsibilities need to be assigned to the right individuals involved in bringing the change. The medication errors arise from different situations, some of which cannot be avoided. One of the stages involved in reducing medication errors is by use of computerized systems. The physician should use computers to get advice on drug doses and frequencies. Another important component that can be used to reduce medication errors is use of computer alert system. Through this, the nurses are able to know of a potential risk caused by an adverse drug occurrence related wound. According to a study conducted in a health care centre, 44% of the outcome showed that physicians were alerted (Jones, 2007). The system should be designed to cater for all adverse drug events.

Medical Administration Records that are originally created by order entry in a pharmacy. This shows that these records can help in reducing medication errors. Other methods that can be applied include automated dispensing, individual patient medication supply, bar coding and bedside terminal systems. Use of pharmacists and improvising nursing care models can also help in reducing medication problems. Therefore, to promote change in the performance of nurses in the medical field, strategies that focus on the environment in which workers practice must be considered (Cohen, 2007). Learning sessions should be introduced to fully equip those with fewer skills in medicine. The sessions should be two hours long with healthy breaks in between every two sessions.

  1. Ensure the roles and responsibilities of change agents are clear and understood

All the stakeholders involved in the nursing process should be provided with reading manuals to ensure they understand any errors arising in medication. To enhance this process, it is important to use efficient modes of communication like emails to pass the relevant information to avoid misunderstanding. The performance of the healthcare individuals is considerably improved by creating a cordial atmosphere for change and application of practice enabling strategies. For instance, provision of rehearsal opportunities for new skills brings about an improvement in healthcare and reduction of medication errors. Clinical guidelines should refer to well developed strategies to help medical practitioners to make better decisions regarding specific clinical issues. The guidelines are important as they help medical practitioners to evaluate their duty of care and implement what has been taught to avoid errors (Poon et al., 2006).

  1. Maintain the change through feedback and group coordination

In this stage, the change must be monitored for advancement. All the relevant medical practitioners who take part in the change project communicate amongst themselves to establish the change agent of individual tasks. The development of quality management teams is a part of the strategic planning aimed at improving the quality in the organization. General skills are exchanged through group coordination and through feedback whereby a serene atmosphere of trust is created. Associates of the quality improvement team are advised how to come up with and put into use the various tools to examine the standard of the services they deliver. The employees working in a health care facility should be asked to give suggestions on how to improve the quality of services provided. This is important because it will help in minimizing costs incurred in cases of medication errors.

Existence of hospital committees in health care facilities ensures that quality of care is provided to reduce medication errors (Koppel et al., 2005). Such committees help in monitoring the vital aspects of the organization’s functioning. Development of clinical information systems does not usually improve the practitioner’s performance. The information got from the systems, rather, is the one used to improve performance of the members. The systems should be well managed and data organized into useful feedback for health care personnel. The health care delivery should be done in a cost effective manner through the utilization of management. There should also be a range of approaches applied to aid health care workers gain more skills on their job. On-the -job training is effective as the members involved acquire first hand information on how to reduce errors in medication. For instance, rotation through the various departments of the hospitals, participation in special projects and mentoring help health care workers to gain more experience and hence improve their performance.

  1. Gradually remove the change agents from the relationship, as the change becomes part of the organizational culture

In this stage, the external change agents are let go by the hirer and supervisors. The change acquired is made part of the organization through creation of policies and rules to be adhered to. Therefore, a system is important to monitor the changes done and allow smooth implementation of the new approaches. The health care members should meet regularly to solve any arising problems regarding the change and its implementation into the system of the health care facility. The change must be evaluated and its effectiveness on the reduction of medication errors assessed. The indicators of performance relevant to the change are incorporated into the system and become part of the organization (Tang et al., 2007).

Strategies for measuring outcomes

Outcomes research is important in measuring the risks and benefits gained from change to make well-informed decisions. For health care practitioners, outcomes help in identifying effective strategies that could be implemented to improve the quality and value of care (Fero et al., 2011). The errors made in medication can be reduced greatly through the analyzing of change outcomes and applying the beneficial outcomes. Feedback from graduates, bedside nurses, and physicians would help in outlining positive experience and finally determine if the health care facility will use outsiders in teaching workshops for the future (Wolcott et al., 2007). Multiple channels of communication will be used to encourage the implementation of the innovation made, bearing in mind to never rely on a single report or a bunch of feedback forms to achieve everything.

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