NURS FPX4010 Assessment 2: Interview and Interdisciplinary Issue Identification INTERVIEW & INTERDISCIPLINARY ISSUE IDENTIFICATION 3

 

Past issues such as nurse burnout, workplace violence, and hazards, safety handling issues such as patient fall, and hospital-acquired infections (HAIs) such as VAP were prevalent. However, safety handling issues and HAIs were reduced to below the national benchmark of 3.44 falls per 1000 patient days and 2.4 per 1000 patent days respectively (Ahrq.gov, 2020).

Nurse burnout is still an issue with other current issues such as medication errors, near misses and adverse events, and increasing health care costs. The interviewee was asked to prioritize the issues based on experience, severity, and impact on the patients and nurse. She explained that medication errors are at the highest priority as these errors lead to adverse events, increases cost, increases hospital stay, blame culture, demonstrates poor interprofessional collaboration, and increases nurse burnout (Manias, 2018). The nurses faced medication errors as discrepancies between prescription and medicine, dispensing errors, interferences in drug administration, delay in care due to delayed response from physician and pharmacists, and adverse effects of medication on the patient (Srinivasamurthy et al., 2021).

Identifies an issue from the interview

Almost all of the issues need an evidence-based interdisciplinary collaborative approach to mitigate issue. However, the issue of medication error is a major issue and require interdisciplinary collaboration approach as it includes nurses, physicians, lab technician, pharmacist, informatics nurse, and pain management nurses. As the issue includes more than two health care professionals, collaboration is critical (Srinivasamurthy et al., 2021). The second reason is the error can be generated at any end and it will be difficult to detect the error and find root causes if there is no interdisciplinary collaboration approach. For example, if a patient with allergies to a specific medication suffers complications due to the patient then it will be difficult to find the cause for adverse events (Tena et al., 2018).

INTERVIEW & INTERDISCIPLINARY ISSUE IDENTIFICATION 4

Another reason is a delay in patient care leading to threats to patient safety and quality care. For example, if the pharmacy dispatches a wrong medicine and the nurse identifies the medicine, he or she has to report the error and wait for the response. This delays medication administration and may lead to complications in patients (Jember et al., 2018). Another reason is blame culture in the medication errors as different stakeholders are involved. For example, a physician can prescribe medicine with improper dosage, which might have an allergic reaction and a nurse administers the dosage sent by a pharmacist without verifying the patient information (Tena et al., 2018).

Analysis of potential change theories

Lewin’s change theory with three stages of unfreezing, moving, and refreezing stages holds good for the issue as driving forces include quality of care and patient safety, but resistance forces include blame culture where no professional wants to take the responsibility. The theory helps in unfreezing the current process to implement a change intervention, move the change towards positive effects, and refreeze the process to establish the change. This helps in collaboration and shared decision-making (Smith & Gullett, 2019).

Everette Rogers update Lewin’s theory with five stages of awareness, interest, evaluation, implementation, and adoption. This theory helps in promoting change and motivating professionals to adopt the change. However, the process of evaluating the outcome of change is important to check whether the intervention is beneficial or not. This can be achieved by Spradley’s change theory of eight steps where change evaluation and stabilization play a critical role. These theories help in understanding the perspectives of other health care professionals, discuss processes and interventions, take a group decision, and implement change by supporting each other (Smith & Gullett, 2019).