Assess the culture of the organization for potential challenges in incorporating the nursing practice intervention. Use this assessment when creating the strategic plan.
Write a 150-250 word strategic plan defining how the nursing practice intervention will be implemented in the capstone project change proposal.
APA style is not required, but solid academic writing is expected.
Capstone Project Topic Selection and Approval; Improving Barcode Scanning Compliance in the Emergency Department
Identification of the problem which is the focus of the change proposal
Drug administration errors present a significant cause of prolonged admissions, deaths, and disabilities among emergency department patients (Freund et al., 2015; Misasi & Keebler, 2019). Delivery of medicine to the wrong patient, indication, timing, and dosage compromise the anticipated care and quality of life-quality experiences. Gaps in the workforce exemplified by understaffing, poor workflow systems, and negligence among providers are linked to the increasing incidence and severity of drug-administration errors and their adversities (Freund et al., 2015; Misasi & Keebler, 2019). The problem, which accounts for approximately 7,000 annual deaths globally, could be reduced by integrating electronic and automated care delivery systems (Freund et al., 2015; Misasi & Keebler, 2019). Barcode scanners exhibit a crucial technological aspect whose use in the emergency department that experiences many patient populations with different demands could reduce the probability of medication errors (Dunn & Anderson, 2019). However, there are challenges in using the technology since care providers do not embrace its use optimally, and the low compliance accounts for the persistent rise in drug administration errors. The development of an evidence-based protocol that would enhance the adherence to barcode scanners in the emergency department is likely to bring short and long-term benefits to patients’ safety and quality.
Setting or context in which the problem can be observed
Emergency departments receive high numbers of patients with different medical conditions, which could disrupt care providers’ attention and competency. Confusion due to patients’ diverse needs accounts for the high numbers of medication administration errors and their adversities. The emergency department faces 4-14% of medical errors since each critical patient receives an average of 2.5 drugs per episode of care (Di Simone et al., 2018). The increased prevalence of chronic conditions further increases the number of medications that the nurses and healthcare staff are expected to know (Di Simone et al., 2018). The emergency department’s unique nature linked to critical care defines the need for automated systems that enhance all patients’ safety regardless of their volumes or demands.
High-level description of the problem
A medication error is depicted as a preventable event that may cause harm to a patient during drug administration under a healthcare provider (Shitu et al., 2020). In the United States, a minimum of 1.5 million people are injured annually due to errors, and a cost of $3.5 billion is incurred yearly (Shitu et al., 2020). The global cost of the problem is $42 billion, with the emergency department contributing significantly to the problem (Shitu et al., 2020). The heavy workload, multiple specialties, diverse illnesses, and medications contribute to the emergency department’s high error vulnerability (Wisor, 2016). The department’s diverse providers require coordinated approaches facilitated by automated systems to reduce gaps in care delivery.
Effects of the problem
Drug medication errors compromise patients’ safety and quality through low life spans, morbidity, and high medical costs (Di Simone et al., 2019; Shitu et al., 2020). Care providers battle with legal and ethical implications related to the poor drug administrations in scenarios that negligence is confirmed. Healthcare organizations lose their reputation due to medication errors in value-based care; hence the problem causes multi-disciplinary problems whose effects are universal among providers, organizations, patients, and their families. The absence of evidence-based interventions aligns with the poor use of electronic systems like barcode scanners, which offer accurate information and drug administration guidelines. The emergency department’s errors alter the care delivery process due to delays in the care area that handle numerous critical care patients.
Significance of the topic and its implications in nursing practice
Nursing practice is a foundational element in care delivery since nurses act as forefront workers spending most of their time with patients. Medication administration errors compromise the ethical code for nurses, and their values of compassion, love, care, and empathy are crippled when patients face adversities under their care (Shitu et al., 2020). The topic creates a platform for exploring the best interventions focusing on individuals and systems that would be appropriate for holistic health promotion through error prevention. The nursing practice could enhance its practice and health outcomes by adhering optimally to the barcode scanner and automated systems that significantly reduce errors.
Proposed solution and how it will affect nursing practice
Increased adherence to barcode scanners through higher funding, training, and adequate technical support is a promising approach for reducing or eliminating medication errors in the emergency department. The barcode scanner automatically identifies drugs meant for specific patients and offers electronic charts for cross-checking and monitoring response to the medication (Berdot et al., 2019; Wisor, 2016). The scanners inform the nurses and diverse healthcare providers about the intended drug and dosage for specific patients suffering from target medical issues reducing the probability of confusion prone to the emergency department (Berdot et al., 2019; Wisor, 2016). Therefore, implementing evidence-based strategies that optimize these systems’ use will be beneficial to patients, providers, and faculties due to the elimination of deaths, hospitalizations, and legal and ethical penalties.
Berdot, S., Korb-Savoldelli, V., Jaccoulet, E., Zaugg, V., Prognon, P., Lê, L. M. M., & Sabatier, B. (2019). A centralized automated-dispensing system in a French teaching hospital: return on investment and quality improvement. International Journal for Quality in Health Care, 31(3), 219-224. , https://doi.org/10.1093/intqhc/mzy152
Di Simone, E., Giannetta, N., Auddino, F., Cicotto, A., Grilli, D., & Di Muzio, M. (2018). Medication errors in the emergency department: Knowledge, attitude, behavior, and training needs of nurses. Indian journal of critical care medicine: peer-reviewed, official publication of Indian Society of Critical Care Medicine, 22(5), 346. DOI:10.4103/ijccm.IJCCM_63_18
Dunn, L., & Anderson, J. (2019). Barcode medication administration implementation in the operating room. American Journal of Health-System Pharmacy, 76(10), 636-637. https://doi.org/10.1093/ajhp/zxz039
Freund, Y., Rousseau, A., Berard, L., Goulet, H., Ray, P., Bloom, B., … & Riou, B. (2015). Cross-checking reduces adverse events resulting from medical errors in the emergency department: study protocol of the CHARMED cluster-randomized study. BMC emergency medicine, 15(1), 21. https://doi.org/10.1186/s12873-015-0046-1
Misasi, P., & Keebler, J. R. (2019). Medication safety in emergency medical services: approaching an evidence-based method of verification to reduce errors. Therapeutic advances in drug safety, 10, 2042098618821916. https://doi.org/10.1177/2042098618821916
Shitu, Z., Aung, M. M. T., & Kamauzaman, T. H. T. (2020). Prevalence and characteristics of medication errors at an emergency department of a teaching hospital in Malaysia. BMC Health Services Research, 20(1), 1-7. https://doi.org/10.1186/s12913-020-4921-4
Spain, D., Crilly, J., Pierce, J., Steele, M., Scuffham, P., & Keijzers, G. (2015). Can a barcode scanner for blood collection improve patient identification integrity in the emergency
department? A prospective before‐and‐after study. Emergency Medicine Australasia, 27(1), 47-54. https://doi.org/10.1111/1742-6723.12334
Wisor, C. (2016). Increasing compliance of bar code medication administration in the emergency room. Increasing Compliance of Bar Code Medication Administration in the Emergency Room (shu.edu). For more information on A Strategic Plan Summary see this: https://en.wikipedia.org/wiki/Strategic_planning
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