Organizational_Change_Plan__Knowledge_Based_Medication_Administration

Organizational Change Plan: Knowledge Based Medication Administration and Barcode Scanning HCS/587 September 25, 2011 Janet Treadwell Organizational Change Plan: Knowledge Based Medication Administration and Barcode Scanning In the United States, thousands of people go to respective hospitals in search of high quality care. Unfortunately, a great number of these patients do not make it out of the hospital doors alive, due to medication error. In this paper, I will discuss the growing problem of medication error, which happens in hospitals everywhere, the plan to help resolve this issue, and the need for the implementation of knowledge based medication administration and electronic barcode scanning. Every year, billions of dollars are spent, and innocent lives are lost, due to preventable medication error. Medication errors cost an estimated seven thousand deaths each year and cost the nation $2 billion annually. The majority of medication errors that actually reach a hospitalized patient occur when a dose of medication is incorrectly administered at the patient’s bedside (Paoletti, 2007). A particular instance that happened within my facility, when a patient was admitted from a nursing home and the wrong paperwork was sent with the patient to the hospital. The normal emergency room admissions process took place, medications were entered based on the list sent with the patient, and the patient was admitted to the floor for further care. As the nurse entered the room to check in on the patient and give them their medications, she realized that the patient on the paper was not the patient lying in the bed. Just happened so, the patient had been to the hospital before, and that nurse remembered taking care of them and identified them as someone else. This could have led to a deadly error. Lack of verification is one of the many reasons that medication errors occur. One of the first things that we learned in nursing school and what should be the goal of every hospital is to adhere to the four R’s of medication safety: 1. Right dose of 2. Right medication given to the 3. Right patient at the 4. Right time With every medication administration you must have a systematic way of verifying that you have drawn up the correct dosage of the correct medication for the correct patient and that you are giving it the time that it was ordered. For years, industry literature has stated that these objectives are often hindered by incompetencies in hospitals, such as order misinterpretations, incomplete or improper transcriptions, communication breakdowns, drug misidentification, faulty dose checking, drug-stocking problems, and lack of standardization (Dubin, 2010). Based on the statistics of death related to medication error and the amount of money that it costs the nation annually when these errors occur, the implementation of knowledge-based medication administration through a barcode scanning system is greatly needed in the hospital setting. When implementing new plans and ideas into an organization, there will always be barriers to that change. First, there is always the risk of resistance from the staff within the organization, specifically those who will be responsible for carrying out the change. One of the best ways to help ward off resistance is to include everyone that will be affected by the change in the change process. Being that electronic documentation and medication scanning is a change that cannot be avoided; the idea should be presented to all parties involved as a change that is coming to stay. Information should be provided, ensuring all staff that they will be properly educated as the new changes come into play. Staff should also be included by soliciting their thoughts, ideas, and opinions, such as what they would like to see incorporated with this new system. Another barrier would be the process of implementing the barcode system. There will have to be time and resources available to provide training for administration, pharmacy, and nursing staff. One must also consider the flow of the implementation process and be prepared for unforeseen problems or glitches along the way. Technology can also pose as a major barrier in this process, as it is the main ingredient of this process. It would also be good to evaluate what materials and resources the organization already has and what they will need to purchase in order for this change to be a success. In implementing this barcode scanning, there various factors that can influence how well this process goes. The culture of the organization can be a major influence, positive or negative, on this change process. A strong, internally consistent culture may resist change; adaptive cultures will embrace, encourage, and enable change implementation (Spector, 2010). Another influence will be the stakeholders in the whole process, which include administrators, physicians, pharmacists, pharmacy technicians, informatics technologists, and nurses. the attitude and behavior of these stakeholders will influence the this process as well as help determine the readiness of the organization for the proposed change. Other factors that may influence the organizations readiness would their technological level at the point of planning and implementation. In order or the scanning system to work there would need to be some form of wireless network available with the hospital support the scanning system. Another factor would be the medication barcodes. They have to have clearly printed barcodes that are matched with a major database that will recognize the barcode as it scanned. In incorporating this change, Lewin’s change model comes to mind. In this model, Lewin provides a three-step process for implementing change, which includes unfreezing, change, and refreezing. This model identifies variances between current practices and behaviors, and desired activities and behaviors, incorporates change based on new objectives revisions, and then implements and monitors the change, making adjustments where necessary (Borkowski, 2005). The implementation process will require the assistance of various resources. Internally, the pharmacists and information technology staff will play the biggest role in the implementing barcode scanning. It would be the responsibility of the pharmacists to make sure that dispensed medication has a barcode that can be easily scanned, and the I.T. staff will be responsible for installing the computer program to facilitate the scanning of medications and making sure that the scanners work and can read the barcodes. External resources include the pharmaceutical companies that dispense medication to the hospital, and the companies where scanners will have to be purchased. The implementation of knowledge-based medication administration through barcode scanning is very much on the rise in hospitals across the nation. It would benefit my organization greatly in order to aid in providing the best patient care by having a safe, systematic process in place in order to safely administer medication, decreasing the risk for possible medication error. It will not only provide a higher level of safety for the patients, but it will save lives and save money for the organization. References Borkowski, Nancy (2005). Organizational Behavior in Health Care- Chapter17: Resistance to Change and Change Management. Jones & Bartlett Publishers. Dubin, Cindy H. (2010). Bar-Code Scanning At four Health Care Facilities in the U.S. P&T Vol.35 No. 4 Guchelaar, Henk-Jan, Colen, H.B., Kalmeijer, M.D. (2005). Medication Errors: Hospital Pharmacist Perspective. Paoletti, R., Suess, T.M., Lesko, M. (2007). “Using bar-code technology and medication Observation methodology for safer medication administration”. American Journal of Health-System Pharmacies – Vol. 64