Technology For Patient Safety: Change Proposal Sample Paper

Introduction

Patient safety is the core concept of healthcare, and the rising use of technology can be explained by healthcare establishments’ need to provide patients with a more comfortable and safe environment (Carayon et al., 2014). Such innovations as the Electronic Health Record (EHR) already make some hospitals’ information systems more reliable than before, allowing them to access information and store it securely.

However, the presence of human errors can still lead to adverse effects on human health. For this reason, the incorporation of an electronic prescribing (e-prescribing) system may contribute to the hospital’s level of innovation, reduce human error, and increase the quality of care (Porterfield, Engelbert, & Coustasse, 2014). However, while the implementation of this technology may positively impact patient safety, one should account for such factors as resistance to change and find ways to communicate the need for it to avoid problems.

Technology

The proposed change lies in the implementation of e-prescribing. It is a system that can be used in collaboration with the EHR or separately (Motulsky et al., 2015). E-prescribing allows physicians and nurses to send patients’ prescriptions directly to pharmacies electronically (Porterfield et al., 2014). During this process, the need for paper-based approaches becomes non-existent, eliminating the use of handwritten notes and the reliance on patients’ understanding of the process. Moreover, as this technology can be used together with an EHR system, patients’ information becomes even more centralized, including all health records and prescriptions and the communication with the pharmacy.

Impact

Some positive outcomes can be expected as a result of introducing e-prescribing to a hospital. First of all, the possibility of human errors can be significantly reduced (Porterfield et al., 2014). While handwritten notes may be lost, changed, or difficult to read, electronic messages are easy to interpret and impossible to change without having permission from the system. Thus, human interaction with these notes is highly limited, which makes these prescriptions safer for patients. Moreover, the centralized system of storing people’s prescription history can help the hospital’s staff to be always informed about patients’ needs and conditions. E-prescribing can reduce the rate of miscommunication and disinformation among personnel and provide medical workers with a reliable system of data storage. Thus, patient safety is increased by eliminating human errors.

Issues

One of the main problems that can influence the process of implementation is the existence of such human factors as resistance to change, the lack of competency, and human error. For instance, physicians may adversely view the introduction of new technology due to the existence of habits and reliance on old experiences (Motulsky et al., 2015). Furthermore, a limited understanding of technology as a whole may also become a barrier to implementation. Such a cognitive burden may affect worker’s job satisfaction and also impact their relationship with the hospital, patients, and other employees (Rosenbaum, 2015). These challenges can be overcome with education for people who work with e-prescription. By helping employees understand why this technology is essential and how it works, the hospital can introduce the new system and have workers who are confident enough to use it without making mistakes.

Measuring the Impact and Implementation

The impact of this change can be measured using the Systems Engineering Initiative for Patient Safety (SEIPS) (Carayon et al., 2014). This system uses a human factors approach to assessing the use of new technology to increase patient safety. The SEIPS model applies a more complicated process of evaluating outcomes and advances in the process than other approaches (Carayon et al., 2014). For example, it can be used to estimate the change in the rate of incorrect or not used prescriptions and see whether patient satisfaction and safety are higher than before. If the proportion of errors is lower with the use of this new technology than it was with older methods, then the implementation may be considered successful.

The implementation of this system would require some preparations. First, employees who are going to work with e-prescribing should be trained to use this system. Next, the hospital should acquire hardware necessary for the technology and install software that is fit for the establishment according to its size and number of users and patients. Furthermore, a period of adjustment should be established to allow users to shift from a traditional paper-based prescription process to a new system.

Finally, the assessment of the new technology’s efficiency should be included to make some additional changes and see whether it is working as planned. Communication with workers and patients is a significant part of every mentioned step because it may help employees to overcome their resistance to change and patients to understand the necessity of the new technology. Moreover, the continuous interaction may help uncover some issues with the implementation in their early stages.

Conclusion

The need for new technology arises because of hospitals’ need to provide patients with a safe environment and high-quality care. As patient safety often depends on human factors, the use of such technology as e-prescribing can significantly benefit patients and employees as well. With successful implementation, e-prescribing can reduce human errors, store patients’ data in a secure place and create a more reliable way of communicating with pharmacies. Resistance to change and other human factors can be overcome with training and communication.

References

Carayon, P., Wetterneck, T. B., Rivera-Rodriguez, A. J., Hundt, A. S., Hoonakker, P., Holden, R., & Gurses, A. P. (2014). Human factors systems approach to healthcare quality and patient safety. Applied Ergonomics, 45(1), 14-25.

Motulsky, A., Sicotte, C., Gagnon, M. P., Payne-Gagnon, J., Langué-Dubé, J. A., Rochefort, C. M., & Tamblyn, R. (2015). Challenges to the implementation of a nationwide electronic prescribing network in primary care: A qualitative study of users’ perceptions. Journal of the American Medical Informatics Association, 22(4), 838-848.

Porterfield, A., Engelbert, K., & Coustasse, A. (2014). Electronic prescribing: Improving the efficiency and accuracy of prescribing in the ambulatory care setting. Perspectives in Health Information Management, 11. Web.

Rosenbaum, L. (2015). Transitional chaos or enduring harm? The EHR and the disruption of medicine. New England Journal of Medicine, 373(17), 1585-1588.

Low Nurse Staffing In Hospital Settings

Introduction

The problem of low staffing levels in the nursing setting has existed for many years (McHugh & Ma, 2014). Causing a significant drop in the quality of provided services, the issue has led to a steep rise in the number of medical errors, negative patient outcomes (e.g., instances of recidivism, mortality rates, etc.) (Twigg et al., 2016). Therefore, tools increasing the staffing of nurses in the hospital setting must be viewed as a crucial task. A change in the workplace environment that will imply a closer focus on the needs of nurses, including the necessity to develop new skills, acquire new knowledge, and build trust-based, cooperation-based relationships with colleagues, is likely to cause a positive change.

Evidence-Based Solution

At present, the problem of low nurse staffing levels in the hospital setting can be explained mostly by the lack of a positive environment in which nurses can evolve and feel comfortable, as well as high standards, which most applicants fail to meet (Kim & Mehrotra, 2015). By shifting workplace values toward meeting the needs of all stakeholders, including not only patients but also nurses, one will be able to create a setting where nurses will feel comfortable, as well as receive a powerful impetus for learning new information. As a result, loyalty levels will grow along with the level of professionalism among the target population (Twigg et al., 2016).

Nursing Intervention

Apart from creating a very uncomfortable environment in which nurses are forced to work nowadays, the current approach to managing staffing levels implies putting the target demographic under a considerable strain. The pressure of numerous tasks which are assigned to nurses due to their low staffing level often leads to the development of mental health issues, from minor concerns such as anxiety to more troubling tendencies such as depression (Kim & Mehrotra, 2015).

Reconsidering the existing set of values and the corporate philosophy that guides decision-making processes in the hospital setting will allow to identify nurses’ needs and, thus, to alter the current approach toward assigning roles and responsibilities to them. Incentives must be used to encourage a positive attitude. In addition, a more flexible schedule must be regarded as a necessity. As a result, nurses will be partially relieved of the pressure until the staffing levels increase.

Patient Care

It should be borne in mind, however, that the needs of patients will also have to be met. For this reason, the use of innovative technologies that contribute to the development of a closer bond between nurses and patients should be deemed as a possibility. As a result, nurses will be informed about the challenges that patients within a particular hospital deal with. The use of social networks as the means of maintaining communication between nurses and a target community should be regarded as especially important (Twigg et al., 2016).

Health Care Agency

The proposed solution is going to have a positive effect on healthcare agencies. Due to a shift in the corporate philosophy, hospitals will be able to invest in the professional development of their staff. Consequently, employees will acquire new competencies and will even be able to develop talents in the specified setting. Furthermore, their loyalty toward their organization will grow consistently.

Nursing Practice

The quality of nursing services is also going to increase with the adoption of the proposed solution. With the focus on the professional growth of nurses, innovative solutions to health issues will be created. In addition, nurses will be able to establish a stronger connection with patients (McHugh & Ma, 2014). Thus, the number of positive patient outcomes will grow gradually.

PICOT

For nurses working in the hospital setting, will the adoption of an intervention based on the reconsideration of the hospital’s philosophy and values by introducing incentives, opportunities for professional growth, interdisciplinary communication, etc., contribute to a rise in staffing levels and a drop in the number of workplace burnouts as opposed to the current increase in the number of nurses’ roles and responsibilities, within two months?

References

Kim, K., & Mehrotra, S. (2015). A two-stage stochastic integer programming approach to integrated staffing and scheduling with application to nurse management. Operations Research, 63(6), 1431-1451. Web.

McHugh, M. D., & Ma, C. (2014). Wage, work environment, and staffing: Effects on nurse outcomes. Policy, Politics, & Nursing Practice, 15(3-4), 72-80. Web.

Twigg, D. E., Myers, H., Duffield, C., Pugh, J. D., Gelder, L., & Roche, M. (2016). The impact of adding assistants in nursing to acute care hospital ward nurse staffing on adverse patient outcomes: An analysis of administrative health data. International Journal of Nursing Studies, 63(1), 189-200. Web.

Community Health Promotion As A Nurse’s Role

Community health has become a critical part of overall public health policy and strategies. It is necessary to protect the safety of populations within communities through disease protection and health interventions. The impact that nurses carry on influencing both policy development and patient behavior provides a need for community health nurses in public and private health organizations.

Role of a Community Health Nurse

Community health nurse is a term that has been interchangeably used with public health nurse, both suggesting population-oriented practice within community settings with the purpose of disease prevention and health promotion. These nurses are specially trained to work in public health settings and have skills to identify health issues and practice in a population-focused manner. Community health nurses are highly adaptable and able to provide comprehensive nursing care within non-traditional hospital settings, but rather local community locations which may require a specialist.

This type of nurse is most effective in working for public and government organizations, focusing on delivering care, and providing resources to those in need. Community nurses may attend to patients at home, organize public health interventions, and advocate for access to care. These nurses maintain a focus on client-centered care within any setting with a broad philosophy to attend to public health (Stanhope & Lancaster, 2015). They may be responsible for outreach and prevention of deadly diseases such as tuberculosis or HIV/AIDS in at-risk populations. Furthermore, community health nurses are responsible for emergency preparedness for disasters, including bioterrorism, which may impact the community.

Family Assistance

Community health competence and practice involve developing relationships with community members and noticing patterns within the overall social aspects of the neighborhood. That often means assisting families within home settings or working with community resources to provide any necessary medical services. For example, if there is a noticeable pattern of children being left home alone or with elderly caretakers, a program may be established through local schools to aid in this aspect. Although not directly related to health, such interventions are critical for community health nurses to ensure public safety. Community-based nursing is centered on care. It requires knowledge about family dynamics as well as cultural diversity that impact community and familial structures.

A nurse-patient relationship is formed with the family as well to provide care for patients in a home setting. That may include a comprehensive plan that evaluates a patient’s lifestyle patterns. A plan attempts to create a routine for patients that can be supported with the help of family members in order to ensure improvement. Since public health nurses are aware of all available community health resources, including providers, pharmacies, and support groups, they can direct families to receive necessary support in order to provide for patient needs. Overall, community health nurses work with patients and families to “assume responsibility for health care decisions” through the process of “planning, implementation, and evaluation of health care approaches” (Potter, Perry, Stockert & Hall, 2016, p. 43).

Barriers

Initiating and providing at-home care for patients is wrought with technical, financial, and practical challenges. With the extended life-span, the rise of chronic and multi-morbidity illnesses, and increasing costs of hospitalization, at-home care may be an appealing resource in communities for non-critical patients. A common barrier is based on simple logistics since providers are unable to plan and coordinate at-home care efficiently (resulting in decreased quality of care) due to limited resources and lack of communication methods.

They are unable to access critical data on a patient’s status, care plans, and diagnostic test results since electronic health records are rarely available from non-hospital infrastructure (Sockolow, Zakeri, & Bowles, 2014). As a result, competent health care delivery and decision-making that leads to positive outcomes are not as efficient.

Initiating home care services is bound to constraints within the regulatory and financial mechanisms. Current systems of Medicare and insurance do not support at-home care, and any existing systems do not include reimbursements for the information technology, travel, care transition, and staffing for such purposes (Landers et al., 2016).

Stakeholders are also concerned about the regulation of home-provided care services as new policies would have to be developed to establish eligibility, quality of services, and provider coordination. Furthermore, it would be necessary to ensure integrity and provide incidences of fraud and abuse by new entrants to the market if community-based care was to expand. Regarding quality and patient experience, new contexts and indicators have to be developed to protect patients and ensure the best quality of care (Landers et al., 2016).

Location Impact

Home health care delivery for patients differs based on geographical location as urban and rural areas can result in differing patient needs and viability of providing such care. For example, rural patients are often more severely ill, with risk factors for hospitalization, most often due to lack of participation in health promotions. Characteristics of rural households result in challenges to home health care access, which is difficult to attain as it is.

Geographical location leads to isolation and results in increased transportation and payroll costs. Other factors include lower income and educational attainment in rural areas than urban populations. Rural elderly are less likely to have private health insurance which is more open to at-home care rather than standard Medicaid. Urban households have a wide availability of services which can support a homebound patient which leads to the inclusion of health care as part of the basic needs (University of Washington School of Medicine, 2016).

References

Landers, S., Madigan, E., Leff, B., Rosati, R. J., McCann, B. A., Hornbake, R., … Breese, E. (2016). The future of home health care. Home Health Care Management & Practice, 28(4), 262-278. Web.

Potter, P.A., Perry, A.G., Stockert, P., & Hall, A. (2016). Fundamentals of nursing (9th ed.). St. Louis, MO: Elsevier Health Sciences.

Sockolow, P., Zakeri, I., & Bowles, K. H. (2014). Barriers and facilitators to implementation and adoption of EHR in home care. Web.

Stanhope, M., & Lancaster, J. (2016). Public health nursing – e-book: Population-centered health care in the community (9th ed.). St. Louis, MO: Elsevier Health Sciences.

University of Washington School of Medicine. (2016). Access to rural home health services: Views from the field. Web.

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