Reasons of the medication Errors
The essay brings about the discussion on the health care settings and the impact of effective or ineffective medication system. The essay has represented through the scenario, which has been used and shown that the electronic medication in nursing system has led to safety of the medication administration. In every healthcare there are some issues related to the patient diagnosis, treatment and the recovery, which is often the result of the ineffective treatment therapy, or the human error. The major problems are sometimes identified as human errors, which are called as ‘medication error’ (Cloete, 2015).
The term medication errors refers to any preventable event which may lead to the harm to the patient by the wrong use of medications while the medication given to the patient is in control of the healthcare professional or the patient/consumer. With the case of the two-hundred bed hospital, there are some of the critical incidents identified. Incidents were reported from the last three years and have been shown on the quality improvement website by the state organisation. These incidents were reviewed by the nurse/midwifery in this case and concluded that it is caused by the medication errors. There are many reasons behind the occurrence of the medication errors in the healthcare (Scott, 2016).
Medication errors are identified as a common problem in nursing and healthcare leading to the major issues causing harm to the patient. The most common causes for the medication errors in the hospitals or the health institution is due to the poor communication between the doctors, or between the doctor and the patient. Wrong interpretation of the drugs as medicines also leads to the medication errors. It can also be caused due to the short forms or the abbreviations used in the medicines, which is found difficult by the nurses or the staff of the hospital (Jones, 2014).
In a healthcare settings prescribing, preparation and the administration of the medication is a complex procedure and performed in a complex system. Therefore, errors are a common issue, which might occur even after proper care and management. Organisations/healthcare needs to bring change regarding the development of effective medication system. This can be done by the use of the electronic medication system in the hospitals. For the purpose of defining and establishing the mainframes the ‘Lewin’s model of change’ has been used (Smith et al, 2016).
Lewin’s model of change relates to gaining an understanding of the human behaviour as it related to the change and the patterns of resistance to the change in patients. A ‘3-step’ process which includes unfreezing, freezing, and refreezing. The ‘unfreezing’ step refers to the identifications of the difficulties found in the healthcare and the developing the driving force or reducing the effect of resistance. Freezing means the equalization of the opposing force i.e. it is the step where the actual change takes place. The last step of refreezing refers to the implementation of the project thereby producing the required change in the healthcare (Manchester et al, 2014).
Lewin’s model of change – 3-step process
Unfreezing stage – During the first stage of change management in the hospital, first requires the implementation of the bar-code scanning system of medication delivery. Communicating the system upgradation with all the key stakeholders such as nurse, staff, frontline nurses, and the administration is essential step. It is a purposeful step to ensure the safety and trust between the nurses and the patient by keeping the communication lines open, and honest (Cummings, Bridgman & Brown, 2016).
Then it further requires a round-table discussion to clarify the driving and the restraining forces in the hospital. This involves identifying the restraining forces such as resistance shown by the patient to use the electronic system of medication, computerized devices due to lack of experience and trust in these devices. Equalising them with the driving forces such as financial investment in the support from the top-level managers, potential for the ease in the use of such devices, and effective time-management skills; resulting into the implementation of the BCMA in the healthcare. The implementation of devices, facilities and other programs are the milestones to be achieved in the period of 2 months (Laumer et al, 2016).
Moving stage- the stage defines about the process through which actual change is taking place in the healthcare. Efforts from the various different teams in the healthcare such as IT staff, clinical nurse and the information services, and the other administrators in the hospital. There are some of the areas that need to be considered while implementing such facilities in the organisation such as educational training needs, effect on workflow or leadership. It also includes an analysis over the reliability of the equipment’s used. The goals or the objectives stated here are the milestones to be achieved within the timeframe of 2months at least (Galani et al, 2014).
Refreezing stage – This final stage of the Lewin’s model of change in the healthcare organisation, lead to the evaluation of the stability and effectiveness of the proposed change in the hospitals. It mentions that a continuous support of the clinical nurses should be regularly implemented to all the key stakeholders in the hospital. This is essential until the change is deemed complete and the users are accustomed with the technology. The milestones stated by this step are to be achieved within the timeframe of 2 months. Thus, after the realisation of the operational system, an evaluation of the systems and problems must be encountered. It also records about the success or effectiveness achieved during process of change and challenges met for any future reference. Hence, the overall plan of the change is expected to be achieved within the period of next 6 months (Bolster & Rourke, 2015).
Plan for the project of identifying and solving issues of medication errors
With context to the problems identified in the hospital, and the plan implemented as per the Lewin’s model of change, the change management process can be linked to the leadership style. The style, which is suitable for this case, is the ‘Transformational leadership’. Transformational leaders identify the problems, takes into consideration the major stakeholders and their interest. These leaders are charismatic, intellectual, inspirational, and considers the individual aspects. Transformational Leadership style includes the belief of the leaders that involves stakeholders in the change management process. As the stakeholders can support the change, maximize the success rate and reducing the possibility of resistance by the staff or the patient. Therefore, this style of leadership is considered effective in such healthcare practices (Shu, 2015).
The discussion here represents the comparison of the transformational leadership with the Authoritarian style of leadership. The authoritarian style of leadership demonstrates the scenario when the leader takes the decisions without considering input from their staff. Under this style negative reinforcement and punishment is used by the managers/leaders to incorporate change. Mistakes are not accepted and found to be appropriate in the case of emergency or chaotic conditions. Therefore, it can be analysed that the transformational leadership is more effective in the nursing/healthcare leading to positive outcomes (Fischer, 2016).
Managing change in context to the healthcare settings refers to the handling of the complexities of the process. Therefore, it has been observed that many people resist to the change to be introduced in the organisation. Prior to the changes in the healthcare, the plan for the change in the hospital, there are some of the aspects considered for potential resistance. The stakeholders in the hospital will mainly observe the two aspects of resistance from change. As the support the change, thus they will be majorly impacted. The reasons can be mistrust, loss of job-security, wrong timing, or individual’s predisposition towards change (Tyler et al, 2014).
To conclude the above discussion, it has been analysed that the impact of medication errors is a major concern in every healthcare. Therefore, the essay implied the application of the Lewin’s model of change in the hospital. For explaining this, the leadership style is exercised and applied which clearly defines the achievement of the proposed change in the organisation. The essay also focused on the transformational leaders and their effectiveness, which includes the description of the resistance to change and the aspects related. Management, it can be concluded that the use of electronic medication system improves the patient safety standards, thus improving overall performance in the healthcare.
References
Bolster, L. & Rourke, L. (2015). The effect of restricting residents’ duty hours on patient safety, resident well-being, and resident education: an updated systematic review. Journal of graduate medical education, 7(3), 349-363.
Cloete, L. (2015). Reducing medication errors in nursing practice. Nursing Standard 29(20), 50-59.
Cummings, S., Bridgman, T. & Brown, K. G. (2016). Unfreezing change as three steps: Rethinking Kurt Lewin’s legacy for change management. Human relations, 69(1), 33-60.
Fischer, S. A. (2016). Transformational leadership in nursing: a concept analysis. Journal of advanced nursing, 72(11), 2644-2653.
Galani, M., Yu, P., Paas, F. & Chandler, P. (2014, January). Battling the challenges of training nurses to use information systems through theory-based training material design. In HIC (pp. 32-37).
Jones, J. (2014). Misread Labels as a Cause of Medication Errors. AJN, American Journal of Nursing, 114(3), 11.
Laumer, S., Maier, C., Eckhardt, A. & Weitzel, T. (2016). User personality and resistance to mandatory information systems in organizations: a theoretical model and empirical test of dispositional resistance to change. Journal of Information Technology, 31(1), 67-82.
Manchester, J., Gray-Miceli, D. L., Metcalf, J. A., Paolini, C. A., Napier, A. H., Coogle, C. L. & Owens, M. G. (2014). Facilitating Lewin’s change model with collaborative evaluation in promoting evidence based practices of health professionals. Evaluation and program planning, 47, 82-90.
Scott, L. (2016). Medication errors. Nursing Standard, 30(35), 61-62.
Shu, C. Y. (2015). The impact of intrinsic motivation on the effectiveness of leadership style towards on work engagement. Contemporary Management Research, 11(4).
Smith, O., Santiago, C., Butorac, E., Bell, K., Diston, M. T., Lewis, E. & Wannamaker, K. (2016). Nurse Satisfaction with Medication Management Before, and After Introduction of an Electronic Medication System in the Intensive Care Unit. Canadian Journal of Critical Care Nursing, 27(2).
Tyler, D. A., Lepore, M., Shield, R. R., Looze, J. & Miller, S. C. (2014). Overcoming resistance to culture change: Nursing home administrators’ use of education, training, and communication. Gerontology & geriatrics education, 35(4), 321-336.
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