Introduction
Nurses, physicians, administrators, and other healthcare professionals primarily work together in any organization. While they pursue the same goal of providing care, they have different duties and levels of autonomy. This variety in the professions can lead to conflicts or create an uncollaborative environment (Manias, 2018). As a result, many issues can occur, influencing patients and health care providers. The following interview with a registered nurse considers the problem of medication errors and possible theories that can aid an interprofessional collaboration intervention.
Interview Summary
The interviewee, a registered nurse, works at a medical intensive care unit of a small hospital. She does not have much prior experience, and she started this job less than a year ago. While the interviewee states that she still feels as though she is learning, she admits that her current coworkers do not communicate and prefer to use documents that are available through the hospital’s system. As a result, she has noticed that it is very easy for nurses and other health care professionals to make medication errors. Sometimes, a patient is prescribed conflicting medications, or a dose needs several corrections.
The interviewee considers these problems preventable and comments on how nurses and physicians do not communicate these problems openly. Instead, they usually talk in small groups and do not share the information systematically. The nurse comments that she often feels left out of these conversations as a relatively new employee, and physicians or other nurses do not take any steps to help integrate her into the processes.
Identified Issue
From the interview, it becomes apparent that medication errors are the top concern for this particular unit. This is a common problem that arises from nurses’ and physicians’ lack of communication and collaboration (Manias, 2018). As the professionals do not exchange information or offer advice to each other, they rely on limited data and their own understanding of each patient’s health. The outcome to this problem can include missed or incorrect doses administered to patients, incompatible or conflicting medications being prescribed, wrong drugs being used, and much more. Medication errors are considered preventable because they depend on healthcare professionals’ expertise and their use of available information (Manias, 2018). Therefore, interdisciplinary collaboration is vital in solving this problem, as it fosters communication and encourages knowledge sharing.
Change Theory
A change theory in the discussed case is needed to prepare health care professionals for a change and give them the tools to implement it. One of the most recognized theories is Lewin’s change model, and it includes three major steps – unfreezing, changing, and refreezing (Udod & Wagner, 2018). The first part, unfreezing, refers to the process of showing professionals why the change is necessary. Nurses and physicians do not engage in open conversations in the present unit. They are locked in a pattern of relying on themselves rather than on a team of professionals with shared knowledge and understating. Lewin proposes that one should “unfreeze” this old way of behavior and identify why professionals behave in this way (Udod & Wagner, 2018). Next, change is the intervention implementation process, where the proposed program is introduced and completed. Finally, the freezing stage is necessary to ensure that the intervention becomes the new habit in the unit.
Leadership Strategy
As the presented issue requires collaborative action, collective and transformational leadership styles can be proposed. Collective leadership relies on information sharing, group action, dispersed authority and duties (Nieuwboer et al., 2019). It depends on social interactions, which could help bring health care professionals in the unit together to create a stronger team. On the other hand, transformational leadership requires one or a small group of leaders that motivate others to achieve better results (Nieuwboer et al., 2019). Here, a charismatic person with a positive and active attitude is necessary to foster communication between other team members. Although both leadership strategies can lead to positive results, the appeal of collective leadership is its focus on relationships and shared responsibility. In the case of medication errors, this style may be more appropriate for encouraging all professionals to participate in the intervention.
Collaboration Approach
Many collaboration approaches have been reviewed in health care research to combat the high rate of medication errors. Manias et al. (2020) present an interprofessional team that includes a nurse, a physician, and a pharmacist as one of the effective collaborative efforts to reduce this problem. According to the available studies, such partnerships significantly decrease the rate of prescription errors and the use of inappropriate medications (Manias et al., 2020). Therefore, if a pharmacist monitors the team containing a nurse and a physician, all participants can improve their understanding of each patient’s needs as well as their professional expertise. Moreover, this strategy can also improve communication between professionals in the unit and inspire them to share their knowledge.
Conclusion
Medication errors are a common preventable problem in healthcare organizations. Poor communication and the lack of collaboration are at the root of this issue. Thus, a change is necessary to improve nurse-nurse and nurse-physician interactions and positively influence patient outcomes. Lewin’s change model can assist in designing the intervention because it is based on three simple steps. The collective leadership style is beneficial in the discussed case as it introduces the idea of shared decision-making and responsibility. One of the approaches proposed by research is pharmacist integration, where nurses, physicians, and pharmacists work together to reduce the rate of medication errors.
References
Manias, E. (2018). Effects of interdisciplinary collaboration in hospitals on medication errors: An integrative review. Expert Opinion on Drug Safety, 17(3), 259-275. Web.
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, 1-29. Web.
Nieuwboer, M. S., van der Sande, R., van der Marck, M. A., Olde Rikkert, M. G., & Perry, M. (2019). Clinical leadership and integrated primary care: A systematic literature review. European Journal of General Practice, 25(1), 7-18. Web.
Udod, S., & Wagner, J. (2018). Common change theories and application to different nursing situations. In J. Wagner (Ed.), Leadership and influencing change in nursing (pp. 228-253). University of Regina.