Change Project Proposal: Nursing Shortage In ICU And How It Causes Lack Of Patient Safety - Essay Example

? Change Project Proposal: Nursing Shortage in ICU and how it causes lack of patient safety Change Project Proposal: Nursing shortage in ICU and how it causes lack of patient safety Background of the study Patient safety in the ICU has become a growing concern for both the health care practitioners and the community as a whole. However, the research shows that despite public outcry, there are notable failures within the health care services that are likely to pose a threat to patient safety. The biggest challenge towards moving to a safer health system is changing the culture of blaming health professionals for errors to one in which these errors are treated, not as individual failures, but as opportunities to prevent harm and improve the system (Guldenmund, 2000). Harm occurs if a patient’s quality of life or health is negatively affected by any element of their interaction with health care (Institute of Medicine.1999). This would be as a result of patient safety incident, which is any healthcare related event that is unexpected, unintended, and undesired and which could have or did harm the patients. It is, therefore, upon the NHS to ensure high standards: safe clinical care should be maintained and made sure it is in line with the current technology. According to the department of health, patient safety needs to be prioritized, as far as health care system is concerned. The resulting patient safety management knowledge continually heightens improvement efforts to better patients’ welfare such as applying lessons learned from industry and business, educating consumers and providers, adopting innovative technologies, enhancing the error and the reporting systems, and finally developing new economic incentives (Fleming, 2000). Arguably, researchers ought to investigate and find out the effectiveness of patient’s safety in the health care system. This, in essence, can help ascertain the measures that can improve the conditions if need. In this paper, the major concern entails patient care as practiced in any health care services with major focus on medication safety based on analyzing the current issues of patient safety management and understanding the system and human factors in maintaining patient safety. It is evident from the research that as far as patient safety is concerned, medication safety is one of the major issues that is quite disturbing. In this regard, human factors, which correlate with medication safety, play the major role. As far as patient safety is concerned, it cannot be overlooked when dealing with such sensitive issue as patient safety. Negligence, as a human factor, has increasingly become the factor that affects medication safety basically because of the lack of concern among the health care practitioners. For instance, there is a critical instant when a health care practitioner acting out of negligence failed to rescue the life of Elain Bremonung, a young woman who was hospitalized for a routine sinus surgery. During the anaesthesia she experienced breathing problems and the attending anaesthetis was slow at responding to the situation being unable to insert a device to open her airway. The most distressing thing about it is that the affected patient was in a critical state. If was not the alarm activated by one of the friends of the affected patient, she would have passed away. Arguably, there were no grave consequences reaped on this incident; however, one thing that is clear is that medication safety is up stake in many of the health care systems. This incident clearly shows that human factors, as well as organization factors, play a role in medical safety. This therefore calls for the need to investigate the link between human factors in relation to patient safety. This thesis proposes a change in the number of nurses working in the ICU with focus on how it causes lack of patient safety. Statement of the problem Throughout the nursing profession, the shortage in the number of nurses in the ICU and its impact of patient’s safety have been the weighty issue. Treatment of patients has also been a central issue as far as the medics are concerned. This implies that since the issue influences greatly on the general population and the world at large, there is a need to consider some transformation in this case. This research proposes a study to be conducted to ascertain how nursing shortage in ICU causes the lack of patient safety with a focus on establishing a change in the enrolment of nurses, ensuring that the issue of patient safety is addressed once and for all. Plan of Change Change entails transforming something in a way different from what it was initially. It is worth noting that change is an inevitable powerful part of daily life. There are those people who fear change with others championing it as a way to achieving social and political success. People would always change, whether voluntarily or in response to internal and external circumstances. Sometimes when people change, it is expected that personal intrinsic improvement resulting from such change makes them more organized, disciplined and self-fulfilled. This is also the case in the professions that people undertake. As companies struggle to keep up with the changing technology and market fluctuations, they have to impress change in every aspect. In this respect, organizations in their totality deal with change while seeking to better themselves in areas of profitability, productivity, as well as efficiency. Given that at the individual level, people must always deal with change at almost every stratum of life - there is a need for them to learn how to manage it wholly. As part of this effort, this paper deals with theories of change that are helpful in understanding the effect, managing change in order to make it more constructive rather than being a destructive force in life. The theory of change that this study proposed is Eric Havelock’s theory of change. According to this theory, change can be dealt on six stages, acknowledging resistance to change and requirement to plan for change carefully. Ideally, there are six aspects (Gaba, 2000). First, there is the relationship stage. In this stage, Havelock suggests that relationship with the respective system that is in need of change should be established. As in the case of the proposed change, this stage will be a pre-contemplation where there is no shortage in nursing in ICU, and therefore, one cannot ascertain the causes of patient safety lack. Stage two entails diagnosis. In this stage, it shall be expected that the agent of change shall be comfortable with the system the way it shall be: patients as well as nurses shall be evaluated to ascertain if they are aware of the need for change. This is a contemplation stage in which both nurses and patients shall be expected to decide whether or not change shall be required. Then the subjects shall decide whether change end prematurely or it is worth any effort to correct. Stage three shall entail acquiring resources for change. At this phase, the need for change shall be understood alongside understanding the process of coming up with the solution through gathering much information that is quite relevant to the situation requiring change. Stage four of the proposed change shall entail selecting a pathway. Basing on Havelock’s change theory, the pathway of change shall be selected from the list of available options for implementation purposes. For the subjects, who are nurses and patients, stage five of the proposed plan of change shall be expected to have an established and accepted change. It is emphasized that once the change has been implemented, it needs to be accepted and established. More often organizations and individuals become resistant to change; in this case, careful attention shall be provided in order to make sure that the established change becomes part and parcel of a new routing behavior. The change shall be declared to be successful at this stage, provided it was proved beyond reasonable doubt that it has been fully accepted. The final stage, according to Havelock’s theory, shall entail maintenance and separation. Given that change has been confirmed to be successful, the agent of change shall monitor it making sure it is successfully maintained. At this moment, change would have become a normal practice, and the agent causing the change shall be separated from either the organization or the person that had undergone change. Nurses and patients must have learned enough concerning themselves and the process of change that can help them maintain their new behavior. Evaluating the effectiveness of the proposed change, markers of the effectiveness of change shall entail assessing the developmental needs based on strategic plan, which include the evaluation of the desired goals in case they were fulfilled. Building internal sponsorship geared towards the change efforts. In order to realize the expanded role, there will be the need in undertaking a system change including expansion of the system, in this case, impressing the use DAPIM framework, the markers of effectiveness with a view to develop a strategy for how, when, and where the change can be implemented. References Fleming, N. (2000). "Measuring Safety Climate: Identifying the Common Features." Safety Science 34: 177-92. Guldenmund, F.W. (2000). "The Nature of Safety Culture: A Review of Theory and Research." Safety Science 34: 215-57. Gaba, D. (2000). Anaesthesiology as a model for patient safety in health care. BMJ 2000. 320785–788.788. Institute of Medicine. (1999). To Err Is Human: Building a Safer Health System. Washington, DC: National Academy Press. Read More