Capella 4010 Assessment 4 : Stakeholder’s Presentation 

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Capella University

Capella 4010 Assessment 4

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Stakeholder’s Presentation 

As a nurse leader, it is crucial to possess effective communication skills and be able to articulate the importance and potential impact of projects to stakeholders and organizational leadership. Being able to create persuasive presentations and ensure consistency in messaging can help build trust and secure support for initiatives. In this way, nurse leaders can promote their personal and professional brand within their organization and contribute to the success of healthcare projects. Today, I will be highlighting an important issue, namely, the medication errors that many healthcare facilities face. For this issue, my presentation will cover the evidence-based plan involving the stakeholders, its implementation and outcomes for the organization, and lastly, its evaluation. 

Organizational Issue

Medication errors are a serious problem in healthcare and can cause harm to patients, increase healthcare costs, and result in legal and ethical consequences for healthcare providers. Medication errors can occur at any point in the medication use process, including during prescribing, dispensing, administering, and monitoring. They can be caused by a variety of factors, such as communication breakdowns, inadequate staffing, a lack of education and training, and inadequate medication reconciliation processes.

One area where medication errors are particularly problematic in this case is in the emergency room (ER), where patients are often in critical condition and multiple healthcare providers are involved in their care. These issues arose mainly due to staffing shortages and a lack of communication among healthcare practitioners. Staffing shortage in healthcare facilities has been identified as a major factor contributing to medication errors. Several studies have demonstrated a significant relationship between inadequate staffing levels and an increased risk of medication errors.

Capella 4010 Assessment 4

A systematic review by Twig et al (2019) concluded that staffing shortages, particularly of nurses, were associated with a higher incidence of medication errors. Staffing shortages can lead to increased workload and stress for healthcare workers, which can result in errors related to medication administration, transcription, and communication. Addressing staffing shortages in healthcare facilities is crucial to reducing the risk of medication errors and improving patient outcomes. An interdisciplinary team approach involving nurses, physicians, pharmacists, and other healthcare professionals can help to address this issue and improve patient safety in the ER.

The specific improvement goal for this collaborative approach could be to reduce the incidence of medication errors in the ER by a certain percentage, such as 50%. This could be achieved through a variety of strategies, such as implementing electronic health records (EHRs) and medication barcode scanning, improving communication between healthcare providers, standardizing medication orders and protocols, and providing education and training for healthcare providers.

There are three main classifications of medication errors that can occur in the ER of any healthcare facility. These include: 

1. Prescribing Errors: Prescribing errors are made by healthcare providers when prescribing medication. These errors may include selecting the wrong medication or dose, prescribing medication to a patient with a known allergy or contraindication, or failing to adjust the dosage for patients with renal or hepatic insufficiency (Sharma et al., 2022).
2. Administration Errors: Administration errors occur when medication is administered incorrectly, such as administering the wrong medication, administering the medication by the wrong route or at the wrong time, or failing to administer the medication at all. These errors can occur due to factors such as lack of knowledge, distraction, or miscommunication (Mekonen et al., 2020).
3. Dispensing Errors: Dispensing errors occur when the medication is not prepared or labeled correctly by the pharmacist. These errors may include selecting the wrong or incorrect dosing, or failure to include necessary information on the medication label (Dengela, 2023).

If this issue is not addressed, the consequences can be severe. Patients may experience harm, which can lead to prolonged hospital stays, readmissions, and even death. Healthcare providers may face legal and ethical consequences, which can damage their professional reputation and impact their ability to practice. The healthcare organization may also face financial consequences, such as malpractice lawsuits and decreased patient satisfaction and loyalty.

Evidence-based Interdisciplinary Plan 

To address the issue of medication errors in hospitals, an evidence-based interdisciplinary plan can be developed. First, an interdisciplinary team comprising physicians, nurses, pharmacists, and other healthcare professionals can be established to identify medication errors and implement a plan to reduce them. This team can develop a comprehensive medication management system that includes medication reconciliation, standardization of medication administration, and electronic prescribing systems to reduce errors related to incorrect dosages or drug interactions. Several studies have suggested the importance of establishing an interdisciplinary team approach to medication safety to reduce medication errors in healthcare settings.

For instance, a study by Manias et al. (2020) found that interdisciplinary medication safety teams have been shown to be effective in reducing medication errors and improving patient outcomes. In terms of specific interventions that an interdisciplinary team can implement, medication reconciliation has been shown to reduce medication errors by identifying and addressing medication discrepancies during transitions of care (Dionisi et al., 2020). The standardization of medication administration processes has also been found to reduce medication errors, as it reduces variability and confusion among healthcare providers (Wolf & Hughes, 2019). Electronic prescribing systems have been shown to reduce errors related to incorrect dosages or drug interactions by providing decision-support tools and alerts to healthcare providers (Shahmouradi et al., 2021). 

Capella 4010 Assessment 4

The second step would be to arrange regular education and training sessions that can be conducted for healthcare providers to increase their understanding and knowledge of safe medication administration. These sessions can play a vital role in reducing medication errors by improving healthcare providers’ knowledge and skills related to safe medication administration. A study by Jaam et al. (2021) found that providing regular education sessions to nurses significantly reduced the incidence of medication errors in a hospital setting. The study emphasized that education and training should focus on several areas, including pharmacology, medication safety, and communication skills among healthcare team members.

Lastly, the use of modern technology can help greatly in overcoming these barriers in order to provide quality care. technology such as barcode scanning and automated dispensing systems can be implemented to improve medication tracking and reduce errors related to incorrect medication administration. Electronic health records (EHRs) can be used to analyze medication error reports to identify patterns and trends and adjust the plan accordingly. Studies have shown that using barcode scanning technology can significantly decrease medication errors by ensuring the correct medication is given to the correct patient, at the correct time, and in the correct dose. For example, It is seen that barcode scanning technology reduced the likelihood of medication errors by 57.5% (Kung et al., 2021).

Automated dispensing systems have also been shown to reduce medication errors by reducing the risk of human error in dispensing and administering medications. In addition, electronic health records (EHRs) can be used to analyze medication error reports and identify patterns and trends. By identifying the root causes of medication errors, healthcare organizations can adjust their medication management plans and implement targeted interventions to prevent future errors. It was found that using EHRs for medication error reporting and analysis resulted in a 61% reduction in medication errors (Gonzales et al., 2021). Therefore, implementing technology such as barcode scanning, automated dispensing systems, and EHRs can significantly reduce the incidence of medication errors and improve patient safety.

Stakeholders Involved in the Implementation 

Various stakeholders are involved in the implementation of a proposed plan. For the above-mentioned evidence-based interdisciplinary plan, the following stakeholders will be playing an important role;

1. Physicians: They would be responsible for prescribing medications and ensuring that they are safe and appropriate for the patient’s condition.
2. Nurses: They would be responsible for administering medications to patients and monitoring for any adverse effects or interactions.
3. Pharmacists: They would be responsible for verifying medication orders and ensuring that medications are dispensed safely and accurately.
4. Other healthcare professionals: This could include respiratory therapists, radiology technologists, and other specialists who may be involved in patient care in the ER.
5. Patients and their families: They would be responsible for providing accurate information about their medical history, allergies, and medications to help prevent medication errors.
6. Hospital administrators: They are responsible for providing the necessary resources, including personnel, equipment, and technology, to support the plan’s implementation and sustainability. They can also provide leadership and guidance to ensure that the plan aligns with the hospital’s goals and priorities.
7. IT- team: The IT team plays a crucial role in the implementation and maintenance of the technology solutions mentioned in the evidence-based interdisciplinary plan to minimize medication errors in the ER. They will be responsible for the implementation, configuration, and maintenance of barcode scanning and automated dispensing systems, as well as the electronic prescribing system and electronic health record system. They will work closely with the interdisciplinary team to ensure that the systems are integrated and functioning properly.

The roles of these stakeholders would include collaborating on the development of a comprehensive medication management system, participating in education and training sessions to increase their understanding of safe medication administration, and implementing technology such as barcode scanning and automated dispensing systems to improve medication tracking and reduce errors. The goal would be to ensure that medications are prescribed, dispensed, and administered safely and accurately in all areas of the ER, including trauma, pediatrics, and non-traumatic areas.

Implementation of Evidence-based Interdisciplinary Plan – PDSA Change Model 

The plan can be implemented using the PDSA change model. This model has been widely used to implement various initiatives by various healthcare facilities. To implement the interdisciplinary plan for reducing medication errors in hospitals using the PDSA model, the team can follow these steps:

Plan

• Identify the problem: The interdisciplinary team can identify the problem of medication errors in hospitals and gather data to understand the causes and consequences of these errors.
• Develop a plan: The interdisciplinary team can develop a comprehensive medication management system that includes medication reconciliation, standardization of medication administration, and electronic prescribing systems to reduce errors related to incorrect dosages or drug interactions. They can also plan regular education and training sessions for healthcare providers to increase their knowledge and understanding of safe medication administration.
• Assign roles and responsibilities: The interdisciplinary team can identify stakeholders and assign roles and responsibilities to ensure that the plan is implemented effectively. For example, physicians can be responsible for prescribing medications, nurses can be responsible for administering medications, and pharmacists can be responsible for verifying medication orders.

Do

• Pilot the interventions: The interdisciplinary team can pilot the interventions on a small scale to test their effectiveness and feasibility. For example, they can implement the electronic prescribing system in one unit and monitor its impact on medication errors.
• Monitor the results: The interdisciplinary team can monitor the results of the pilot interventions to identify areas for improvement and modify the plan accordingly.

Study

• Analyze the data: The interdisciplinary team can analyze the data to evaluate the success of the interventions. They can use tools like process maps, flowcharts, and statistical process control charts to identify patterns and trends in medication errors.
• Identify areas for improvement: The interdisciplinary team can identify areas for improvement and modify the plan accordingly. For example, they can modify the education and training sessions to focus on areas where healthcare providers need more support.

Act

• Implement the modified plan: The interdisciplinary team can implement the modified plan and continue to monitor the results. They can also identify strategies for sustaining the improvements, such as creating a culture of safety and providing ongoing education and training for healthcare providers.
• Celebrate success: The interdisciplinary team can celebrate their success and recognize the contributions of all stakeholders. This can help to build momentum and support for future improvement initiatives.
  

Financial Resource and Budgeting 

Managing human and financial resources for the proposed interdisciplinary plan involves several strategies to ensure its success. Here are some ways to manage both resources:

1. Inspiring healthcare workers: One way to encourage healthcare professionals to increase their performance is by providing them with recognition and rewards for their hard work. This can include bonuses, promotions, or public recognition for a job well done. Additionally, providing opportunities for professional development and training can increase job satisfaction and motivation.
2. The increase in the nurse-to-patient ratio: Increasing the nurse-to-patient ratio can help manage the workload and reduce stress among nurses. This can be achieved by hiring additional nurses or reassigning staff to areas where there is a greater need (Kokoroko & Sandra, 2019).
3. Scheduling and handling workload: Managing the workload and schedule can be achieved by utilizing shift rotations and flexible scheduling. This can help ensure that staff members are not overworked and that there is always adequate coverage.
4. Resolution of disputes: To manage conflicts, a conflict resolution process should be established. This may entail figuring out the conflict’s underlying causes and coming up with a strategy for resolving them. 
5. Offering assistance, rewards, and assets: Providing support, incentives, and resources can help promote employee engagement and job satisfaction (Oubibi et al., 2019). This can include providing access to counseling services and providing financial incentives for meeting performance goals.
6. Purchasing a system for error reporting: It can help reduce medication errors and improve patient safety. It is important to ensure that staff members are trained on how to use these systems effectively (Shahmouradi et al., 2021).
7. Budgeting while maintaining a high standard of care: Managing finances without compromising on the quality of care involves developing a budget that takes into account the needs of the interdisciplinary plan. It is important to ensure that funds are allocated to areas that will have the greatest impact on patient care and safety. 
   

Evaluation 

It is essential to formulate criteria that can be used to evaluate the success of the plan once it is implemented. The main criteria that will be used to evaluate the success of the project are to conduct regular audits of medication administration, monitor medication error rates, and compare them to baseline data to determine the effectiveness of the interdisciplinary plan in reducing errors every 3 months. It will help in keeping track of medication error rates, and adherence to the medication management process, and it will also help in evaluating patient outcomes. 

Medication error rates: The plan’s success can be measured by comparing medication error rates before and after its implementation. Data can be collected from incident reports, medication administration records, and audits.

Adherence to medication management processes: Regular audits of medication administration and management processes can assess plan adherence and identify improvement areas. Data can be collected through direct observation, surveys, and interviews with healthcare providers (Ellis et al., 2021).

Patient outcomes: The plan’s effectiveness can be measured by tracking patient outcomes, such as medication-related adverse events, hospital readmissions, and length of stay. Data can be collected from electronic health records and patient surveys.

Healthcare provider satisfaction: Feedback from healthcare providers can provide insight into the plan’s effectiveness and identify areas for improvement. Data can be collected through surveys, focus groups, and interviews.

References 

Dengela, T. A. (2023). Evaluation of the frequency, type, and reasons of dispensing errors at Enchini Primary Hospital in the Oromia Regional State of Ethiopia’s West Showa Zone. Journal of Nurses Voice and Impact (e-ISSN: 2582-7812), 6-17.

Dionisi, S., Di Simone, E., Liquori, G., De Leo, A., Di Muzio, M., & Giannetta, N. (2022). Medication errors’ causes analysis in home care setting: A systematic review. Public Health Nursing, 39(4), 876-897.

Ellis, L. A., Blakely, B., Hazell, P., Woolfenden, S., Hiscock, H., Sarkozy, V., … & CareTrack Kids Investigative Team. (2021). Guideline adherence in the management of attention deficit hyperactivity disorder in children: an audit of selected medical records in three Australian states. Plos One, 16(2), e0245916.

Gonzales, H. M., Fleming, J. N., Gebregziabher, M., Posadas-Salas, M. A., Su, Z., McGillicuddy, J. W., & Taber, D. J. (2021). Pharmacist-led mobile health intervention and transplant medication safety: a randomized controlled clinical trial. Clinical Journal of the American Society of Nephrology, 16(5), 776-784.

Jaam, M., Naseralallah, L. M., Hussain, T. A., & Pawluk, S. A. (2021). Pharmacist-led educational interventions provided to healthcare providers to reduce medication errors: A systematic review and meta-analysis. PloS One, 16(6), e0253588.

Kokoroko, E., & Sanda, M. A. (2019). Effect of workload on job stress of Ghanaian OPD nurses: The role of coworker support. Safety and Health at Work, 10(3), 341-346.

Küng, K., Aeschbacher, K., Rütsche, A., Goette, J., Zürcher, S., Schmidli, J., & Schwendimann, R. (2021). Effect of barcode technology on medication preparation safety: a quasi-experimental study. International Journal for Quality in Health Care, 33(1), mzab043.

Manias, E., Kusljic, S., & Wu, A. (2020). Interventions to reduce medication errors in adult medical and surgical settings: a systematic review. Therapeutic Advances in Drug Safety, 11, 2042098620968309.

Mekonen, E. G., Gebrie, M. H., & Jemberie, S. M. (2020). Magnitude and associated factors of medication administration error among nurses working in Amhara Region Referral Hospitals, Northwest Ethiopia. Journal of Drug Assessment, 9(1), 151-158.

Oubibi, M., Fute, A., Xiao, W., Sun, B., & Zhou, Y. (2022). Perceived organizational support and career satisfaction among Chinese teachers: the mediation effects of job crafting and work engagement during COVID-19. Sustainability, 14(2), 623.

Shahmoradi, L., Safdari, R., Ahmadi, H., & Zahmatkeshan, M. (2021). Clinical decision support systems-based interventions to improve medication outcomes: a systematic literature review on features and effects. Medical Journal of the Islamic Republic of Iran, 35, 27.

Sharma, K. K., Jain, A., Tyagi, S. S., Goel, Y., & Mittal, P. (2022). Clinical pharmacist’s role in medication error detection and management. Asian Journal of Medical Principles and Clinical Practice, 5(4), 11-20.

Twigg, D. E., Kutzer, Y., Jacob, E., & Seaman, K. (2019). A quantitative systematic review of the association between nurse skill mix and nursing‐sensitive patient outcomes in the acute care setting. Journal of Advanced Nursing, 75(12), 3404-3423.

Wolf, Z. R., & Hughes, R. G. (2019). Best practices to decrease infusion-associated medication errors. Journal of Infusion Nursing, 42(4), 183-192.

Capella 4010 Assessment 4