Patient safety interventions are practices aimed at reducing the probability of adverse patient outcomes caused by the health care system. It can be stated that patient safety is the key priority of the health care system (Fitzsimons & Vaughan, 2015). This is because successful interventions in that field can reduce or prevent known harm. Planned local Intervention chosen for weeks 1 and 2 is a thirty-minute pre-discharge medication counseling.
The intervention does not have any potential harms, and the expected benefits include improved medication accuracy, a decrease in the number of unplanned physician visits, and a lower rate of hospital admissions. Pre-discharge medication counseling will be especially helpful for older patients who are prescribed several medications at a time. It is crucial that the implementation of the chosen intervention must be guided by personal and professional values of the staff. This is because such values of healthcare professionals directly influence their clinical decisions and thus patient outcomes. If medical workers value precision and accuracy in caring, responsibility, trust, and human relationship, then it can be expected that intervention will be implemented positively.
The intervention does not violate moral principles, particularly avoiding harm or self-determination. Conversely, pre-discharge medication counseling is aimed at preventing patients from harming themselves by using the prescribed medication inappropriately. Speaking of objections that might be raised, one could mention that the intervention will require additional time from a nurse or a pharmacist and patients might be unwilling to spend their time on counseling. As a result, the number of hours per patient day (HPPD) may slightly increase. However, considering that the intervention has overall positive outcomes, such as better drug knowledge, reduced visits to the doctor and readmissions, it has to be implemented. Above-mentioned objectives can be addressed by making changes in the nursing schedule.
The intervention requires the creation of an action plan, which is a defined program with specific outcomes. The model selected for the implementation of the proposed intervention is Lewin’s Three Stage Change Process Model. The framework is based around a three-step process which allows for applying a high-level approach to the change implementation. The main stages of the given framework are unfreezing, change, and freezing.
The use of Lewin’s Change Model can support health care workers through the transitions and help determine barriers and facilitators to implementation. During the unfreezing stage, the change focus should be identified, specifically, implementing a thirty-minute pre-discharge patient counseling. At this step, the key component is open communication with all stakeholders of the intervention, such as nurses, managers, and administrative staff (Ip, Tenney, A. Chu, P. Chu, & Young, 2018). Possible barriers to implementation may include staff resistance to pre-discharge patient counseling and the lack of trust in the positive outcomes of the intervention. Facilitators to the implementation include support from the upper-level management and incorporation of leadership strategies
During the change stage, implementation of the planned intervention will occur. This will require a sustained effort from all the key stakeholders. Nurse managers will have to redesign nursing schedule with consideration of time spent on thirty-minute counseling. Nurses will have to counsel patients on the use of prescribed medications. Administrative staff will have to create tools to assess the benefits of the intervention. Challenges in this stage may include discovering a need in educational training for nurses and adverse effects on workflow. The process would be facilitated by a nursing leader who could monitor the intervention.
During the final stage of freezing, the change should be stabilized. At this step, barriers are the lack of support from the staff, and facilitators are nursing leaders who promote the change. Resources that are needed for successful implementation of thirty-minute pre-discharge patient counseling are only human ones. However, in order to evaluate the effect of the intervention, data collection and assessment tools should be considered.
Reference
Ip, R. N., Tenney, J. W., Chu, A. C., Chu, P. L., & Young, G. W. (2018). Pharmacist clinical interventions and discharge counseling in medical rehabilitation wards in a local hospital: A prospective trial. Geriatrics, 3(3). Web.
Fitzsimons, J., & Vaughan, D. (2015). Top 10 interventions in paediatric patient safety. Current Treatment Options in Pediatrics, 1(4), 275-285. Web.