By Mark Connelly Last modified:
Implementing a change in practice within these environments can produce anxiety or fear of failure in nurses, leading to a resistance to change practice. Medication errors in hospital settings lead to devastating consequences for both nurse and patient that can be reduced significantly through the use of technology that improves patient care and saves time for busy nurses.
Bar-coded medication administration is one type of technology that uses a scanning device to compare bar codes on patient identification bands with bar codes on prescribed medications, electronically verifying the medications against the medication records, thereby reducing medication errors significantly.
Keywords Change management, Lewin change theory, Medication errors, Bar-coded Medication Administration Introduction Medication safety has been identified by the Institute for Safe Medication Practices Canada ISMPC as a priority among hospitals and long term care facilities since medication errors in hospitals are a serious threat to patient safety.
The ramifications of medication errors affect all healthcare organizations, resulting in consumer mistrust, increased healthcare costs, and patient injury or death Carroll, Bar coded medication administration is one such tool that has the potential to reduce medication errors significantly, when used correctly Carroll, ; Dennison, The current system of medication delivery and administration at our facility involves old medication carts in poor repair and relies on manual checks to ensure the right drug is given to the right patient at the right time, route, site and dosage by the nurse.
The psychiatric facility in question is now planning a complete overhaul of the pharmacy system and is incorporating automated dispensing machines, along with electronic medication records and bar coding of medications to modernize their care and improve patient safety.
This large project will have the greatest impact on front line nurses, many of whom are skeptical of change or lack confidence in their ability to adapt to new technologies, therefore careful implementation of this project is imperative. Without a framework for guidance, new technologies can result in workarounds that threaten patient safety.
Medication errors are a common occurrence in healthcare facilities around the globe, with serious consequences resulting in death or harm, increased inpatient days in hospital, erosion of trust between consumer and healthcare organizations, and a great deal of economic expense Carroll, ; Dennison, The economical impact of medication errors is estimated to be around five thousand dollars per error unless there is legal litigation, when the costs can skyrocket into the millions Dennison, No less important, but certainly less discussed, is the harm to nurse morale after being involved in a medication error, potentially leading to lost time from work Dennison, While medication errors can occur at any stage in the process, the nurse is often the last line of defense for catching mistakes due to the nature of the administration of meds at the bedside.
The ISMPC has worked closely with hospitals, pharmacies and drug companies to address many preventable occurrences ranging from medication reconciliation programs to the standardization of drug names and labeling.
The introduction of automated pharmacy dispensing machines, bar-coding and scanning of medications is a national project throughout Canada, aimed at reducing medication errors and ultimately improving patient safety.
The technology involved in bar-code scanning also integrates electronic medication records EMR and computerized physician order entry CPOE into practice, thereby reducing paper documents and the possibility of transcription errors, ineligible handwriting or missed signatures.
BCMA technology consists of bar coded medication packets and bar codes on patient identification bands as well as a scanner attached to a medication cart.
With added distractions, complexities of care, and faced paced environments, nurses may inadvertently overlook inconspicuous errors or fail to catch packaging errors, leading to medication mishaps that could have serious consequences.
The introduction of BCMA technology at our psychiatric facility can improve patient safety and also decrease time spent on medication administration, thereby allowing more time for patient contact.
Currently nurses use old medication carts that have worn wheels, broken drawers and some are health and safety hazards. The nurses use paper medication records and must double check medications against the MAR sheets before administering.Kurt Lewin developed a change model involving three steps: unfreezing, changing and refreezing.
The model represents a very simple and practical model for understanding the change process. Lewin's Change Management Model is a simple and easy-to-understand framework for managing change. By recognizing these three distinct stages of change, you can plan to implement the change required.
You start by creating the motivation to change (unfreeze). The Kurt Lewin Change Management Model By Mark Connelly Last modified: Nov Kurt Lewin emigrated from Germany to America during the 's and is recognised as the "founder of social psychology" which highlights his interest in the human aspect of change.
Kurt Lewin is widely considered the founding father of change management, with his unfreeze–change–refreeze or ‘changing as three steps’ (CATS) (see Figure 1 above) regarded as the ‘fundamental’ or ‘classic’ approach to, or classic ‘paradigm’ for, managing.
Applying Lewin’s Change Management Theory to the Implementation of Bar-Coded Medication Administration.
Feb 10, · This article explains the theory of Lewin’s change model, developed by Kurt Lewin in a practical way.
After reading you will understand the basics of this powerful change management tool.. What is the Lewin’s Change Model?
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