According to the Joint Commission, medical errors are linked to the death of at least 60,000 patients every year (2012). In addition, health care workers experience a high rate of non-fatal occupational illness and injury (The Joint Commission, 2012). The proponents of this study are in agreement with The Joint Commission’s report, especially after they have witnessed firsthand the safety and work-related issues in this hospital. Looking at the data gathered, they realized that this particular healthcare facility did not have enough manpower to ensure the safety of both workers and patients. The proponents of the study pointed out that burnout and nursing staff’s inadequate skills were the root causes of potential accidents (Barnsteiner, 2011).
They suggested implementing a training program that would create a culture of safety within this healthcare facility. They also suggested two solutions. First, the hospital must hire additional nurses. Second, the hospital must train the current crop of nurses in order to update them about recent trends, and recent techniques in health care (Barton, 2009).
Contribution to the Future of Healthcare
Insights gleaned from the study can be utilized to develop a better health care system. The end result is a healthcare system that is more reliable in improving safety for both patients and workers. The study can help identify management principles. It can also help identify strategies that can assist educate policy makers about patient and worker safety. Hospital managers will see the value of constantly updating the skills of nurses, and the need to maintain a certain number of health workers to prevent burnout. There are two major stakeholders that will benefit from the creation of solutions to health care safety issues. They are the nursing staff and the patients.
Change Model Overview
The problem came into focus and the strategies were identified, when data went through the Rosswurm and Larrabee’s problem solving framework. The change model was a useful tool because it gave researchers a logical and theory-driven structure to see the root cause of the problem. The said framework assisted researchers to develop the appropriate solution. In the past, health workers were aware of the symptoms of the problem.
But it was extremely difficult for them to get to the bottom line and perceive the root cause of the issue. But when the proponents of the study utilized the Rosswurm and Larrabee’s change model, they were able to develop strategies to improve nurse and patient safety. In addition, the solutions that they will try to analyze are not based on guesswork. It will be developed through an evidence-based approach.
Step 1: Asses the Need for Change
It is imperative to solve the problem of burnout. Nurses were struggling because of burnout. The conclusion was also based on feedback and documented errors committed during nursing rounds (Hirsch & Schumacher, 2012). Patients suffered from the indirect effect of burnout because nurses committed errors while doing the rounds in the hospital. It was also made clear that safety problems were linked to inappropriate use of modern equipment (Mcnamara, 2012). The high rate of infection was unacceptable. As a consequence, hospital management was forced to intervene (Potter, 2013).
According to external data gathered, the problems were similar to other cases, wherein nurses suffered because of the lack of training and support (Mcnamara, 2012). Research data revealed that work related accidents were common in hospitals wherein the nursing staff and hospital management did not establish a culture of safety (Barnsteiner, 2011).
Step 2: Link the problem, interventions, and outcomes
The primary problem was the lack of manpower to handle the heavy workload in the hospital. The secondary problem was the nursing staff’s inability to handle state-of-the-art equipment. There were many nurses who did not went through the proper training on how to use the said equipment. There is a need to invest in knowledge transfer schemes, such as seminars and training programs. In addition, there is a need to hire more nurses. It can be accomplished by developing more attractive compensation packages so that nurses will come and apply for work (Worthington, 2001). The hospital will be able to reduce or eliminate accidents and other patient safety problems if these two strategies are implemented. In addition, the hospital can reduce employment turnover of nurses.
Step 3: Synthesize the Best Evidence
There was a definite need to establish a culture of safety and this realization must form the basis for developing strategies to solve safety problems (2011). All health workers must prioritize safety within the hospital (Barnsteiner, 2011). All health workers must learn how to use tools and equipment in order to provide a better service (McNamara, 2012).
Research materials also revealed the need for the Human Resources Department to develop a remuneration package that could attract and retain new nurses (Hirsch & Schumacher, 2012). The need for two-way communication between workers and administrators was highlighted (Potter, 2013). The review of related literature also revealed that it was critical to hire the optimum number of nurses to work in the hospital (Worthington, 2001).
Step 4: Design Practice Change
Hospital management must try to be practical by using senior nurses to train junior nurses. However, the nursing staff is undermanned and, therefore, there is a need to hire third-party experts to conduct training programs. Third-party trainers and mentors must train nurses how to use modern hospital equipment. They must train nurses to understand the latest trends and techniques in health care. In this knowledge-sharing environment, they can help nurses appreciate the importance of establishing a culture of safety within the healthcare facility.
The key stakeholders here are the members of the hospital management team, the nursing staff and the patients. Hospital management must also learn from the patients. Using questionnaires, the nursing staff can gather pertinent information on how to improve the healthcare service of the hospital. The information gathered can be incorporated into the training program. The third major stakeholders are the third-party experts; they will help the nursing staff establish a culture of safety within the hospital.
Step 5: Implement and Evaluate the Change in Practice
In order to deal with schedule difficulties, it is imperative to utilize the power of Information Technology. Due to the need for an effective information dissemination process, management should invest in creating web videos. Thus, nurses can view these web videos during their free time. The web videos are made available through popular video-sharing websites like YouTube. At the end of the implementation stage, hospital management must develop a monitoring scheme. The monitoring scheme can provide reliable feedback regarding the success or inadequacies of the training program.
Step 6: Integrate and Maintain the Change in Practice
The integration process begins after the nurses start attending training seminars. In a four-week period, nurses are exposed to the idea of establishing a culture of safety within the hospital. At the same time, they learn the various skills required to handle modern equipment. In the same time frame, the Human Resources Department of the hospital begins to hire new nurses. They must also develop a transparent performance evaluation scheme.
The new recruits are also exposed to the seminars and other training strategies. Nurses are encouraged to look at the web videos. They must be encouraged to learn from the web videos during their free time. Finally, evaluation protocols must be in place to ensure that hospital management and the nursing staff will faithfully implement the strategies a few months after conducting the first seminar.
Implement and Evaluation Plan
Hospital management must choose the date for the implementation of the change strategies. On the first day, they must conduct a training seminar. On the same day, the Human Resources Department must begin accepting new applicants, while at the same time, enhancing its drive to attract new nurses. In a four-week period, there will be a training seminar every Saturday morning. Hospital management must clear all the obstacles in order to accomplish this particular objective. Those who are unable to attend the seminars must access web videos that were created to capture the training sessions.
In the same four-week period, third-party experts will visit the hospital and provide hands-on training on how to use modern equipment. After the four-week process, hospital management must begin collecting information from the patients and the nurses. Hospital management must continually monitor the implementation of the said strategies by creating sensible metrics to measure the performance of the nurses. It must be made clear that the hospital should develop a feedback mechanism. Patients must have the ability to communicate their experiences during the implementation stage. Their feedback is instrumental in measuring the real advantages and disadvantages of introducing a new safety protocol.
Steps to Maintain Change
Hospital management must develop a recurring training program. For example, the graduates of the first batch are assigned to train the incoming batch of new nurses. However, senior nurses must be sent to conferences and seminars in order to be updated with current developments in the health care industry.
The hospital’s HR Department must also attend conferences in order to be updated on the current strategies when it comes to motivating employees or how to create the perfect remuneration package for nurses. They have to constantly study how to improve their performance evaluation tools to reward deserving nurses. This information must be made transparent to all the policy makers, they must not ignore the problem, in order to determine how to retain the services of qualified nurses. The HR Department must make the reduction of the turnover rate be its number one priority.
Conclusion
The Rosswurm and Larrabee’s change model is the appropriate tool when it comes to developing appropriate strategies for the health care industry. In this particular case, Rosswurm and Larrabee’s framework was particularly helpful in assessing the need for change and developing effective and sustainable solutions. After careful implementation of the strategies, the nurses will be able to handle the demanding jobs in front of them. They will be able to accomplish their goals because they receive the necessary training to do their jobs. In addition, they will have the support of other nurses, who are recruited by the hospital to distribute the workload. However, it is also imperative to consider the constraints of time. The proposed change must be completed within two months.
References
Barnsteiner, J. (2011). Teaching the culture of safety. The Online Journal on Issues in Nursing, 16(3), 5-12.
Barton, A. (2009). Patient safety and quality: An evidence-based handbook for nurses. AORN Journal, 90(4), 601-602.
Hirsch, B. T., & Schumacher, E. J. (2012). Underpaid or overpaid: Wage analysis for nurses using job and worker attributes. Southern Economic Journal, 78(4), 1096-1119.
Mcnamara, S. A. (2012). Incivility in nursing: unsafe nurse, unsafe patients. AORN Journal, 95(4), 535-540.
Potter, R. (2013). How do nurses go about blowing the whistle on unsafe staffing? Nursing Standard, 28(11), 32-32.
Rosswurm, M.A. & Larrabee, J.H. (2010). Nursing: scope and standards of practice (2nd ed.). MD: American Nurses Association.
The Joint Commission. (2012). Improving patient and worker safety. Web.
Worthington, K. (2001). Stress and overwork top nurses concerns: An ANA poll reveals that back injuries and needle sticks are also viewed as prime threats. American Journal of Nursing, 101(12), 96-105.