Planned Change in the ICU Department

Introduction

The healthcare industry experiences increased acuity among patients thereby highlighting the need to revise the traditional nursing practices with the goal of improving the quality of care. The issue is complicated by the fact that health systems are multidimensional. This is particularly true for the intensive care unit (ICU) where different medical personnel are engaged to deliver patient-centered care. In addition, changes in the economic and social environments have prioritized healthcare reforms with the focus on workflow. This is based on the awareness that offering the high quality care is a responsibility shared by all medical personnel thus necessitating change (Walsh, 2010). The present paper explores the concept of change within a medical environment Planned Change in the ICU Department.

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Identify a problem, inefficiency, or issue within a specific department/unit.

End of shift handoff in the ICU has typically been conducted in the nurses’ station. Although the purpose of the handoff is to offer an opportunity for nurses to practice, organize, and plan teamwork while socializing, debriefing and educating each other, that is only partially achieved when the handoff is conducted in the nurses’ station. In fact, the handoff fails to realize the objective of care continuity and even misses some of the required information. To be more concise, even as nurses present handoff reports that they consider comprehensive, their efforts are limited by omission of important information when they fail to engage the patients. The result is that the therapy progress reduces, patients are likely to be harmed, essential information is not relayed, and care quality is lowered (Sherman, Sand-Jecklin & Johnson, 2013).

Describe a specific, realistic change that could be made to address the issue.

Based on the arguments presented by Ford, Heyman, and Chapman (2014), it is reasonable to accept that conducting the shift handoff at the bedside could address the issue by allowing the patients to offer input. That is to say that conducting handoff at the bedside collects complete information since patients can also act as a direct source of information when asked questions to clarify issues Planned Change in the ICU Department.

Summarize how the change would align with the organization’s mission, vision, and values as well as relevant professional standards.

As a medical facility, the organization mission is to address the patients’ needs. This includes conducting accurate review of their condition to include conducting the right diagnostic tests, presenting the right diagnosis, and prescribing the right treatment. Presenting the right information within the handoff helps in achieving this objective by facilitating the patient’s evaluation and determining their needs. In addition, it improves the patients’ satisfaction since their opinions are taken into account when planning for care. Besides that, this helps nurses in achieving their duty of offering the best possible medical care (Marquiz & Huston, 2017).

Identify a change model or strategy to guide your planning for implementing the change. Provide a rationale for your selection.

Lewin’s change model will be applied to plan and implement the change. The model has three stages of which the first stage has been completed. The first stage is unfreezing whereby the problem was identified and a viable solution presented. The problem was identified as collecting incomplete information by conducting handoff reporting in the nursing station. The solution is to conduct handoff at the bedside where patients can offer input to ensure that complete information is collected and presented. The second stage is the change whereby nursing personnel will be convinced about the need for the proposed change. This would entail changing their behavior, feelings and thought to ensure that they buy in into the idea of conducting end of shift handoff at the bedside rather than at the nurses’ station. The final stage is refreezing that will entail applying the change as routine and standard practice that becomes a new habit even as the old method of conducting handoff at the nurses’ station is discarded (Marquiz & Huston, 2017; Shirey, 2013).

Outline the steps that you and/or others would follow to facilitate the change. Align these steps to your selected change model or strategy.

The change steps will be conducted at the change stage of the model. That is because the freezing stage has already been carried out and the unfreezing stage will only be carried out if the change stage is successful. The first step in the change stage is to discuss with the nurses about the need for change and how the current situation is negatively influencing care outcomes. The second step is to present the proposed solution and convince them that it solves the problem. The final step is to have the nurses apply the change by having the nurses conduct end of shift reporting at the bedside while noting any incidental care improvements (Marquiz & Huston, 2017)Planned Change in the ICU Department.

Explain who would be involved in initiating and managing this change. Describe the skills and characteristics that would be necessary to facilitate the change effort.

The change will be initiated and managed by the ICU charge nurse who holds a supervisory position within the department. The charge nurse is a skilled, knowledgeable and experienced professional who is responsible for translating policy into practice. This means that the charge nurse is best placed to initiate and manage the change as an extension of the current professional responsibilities.

Conclusion

One must accept that the healthcare industry is suffused with change even as traditional nursing practices are revised to improve care quality and outcomes. This is reflected in the ICU where nurses’ end of shift reporting is conducted in the nurses’ stations thus denying patients the opportunity to offer their opinion. The result is that the reports are incomplete since they lack the information that could have been offered by the patients. To address this concern, it is proposed that end of shift reporting should be conducted at the bedside where patients are able to contribute. Lewin’s model is presented as the tool for driving the change since it presents a formalized plan that organizes the available resources to implement the change. Also, the ICU charge has been identified as the person who will initiate and manage the change since this is an extension of supervisory responsibilities.

References

Ford, Y., Heyman, A. & Chapman, Y. (2014). Patients’ Perceptions of Bedside Handoff: The need for a culture of always. J Nurs Care Qual, 29(1), 371-378.

Marquis, B. L. & Huston, C. J. (2017). Leadership roles and management functions in nursing: theory and application (9th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.

Sherman, J., Sand-Jecklin, K. & Johnson, J. (2013). Investigating Bedside Nursing Report: A synthesis of the literature. MedSurg Nursing, 22(5), 308-318.

Shirey, M. R. (2013). Lewin’s Theory of Planned Change as a strategic resource. The Journal of Nursing Administration, 43(2), 69-72.

Walsh, N. (2010). Dissemination of Evidence into Practice: Opportunities and threats. Journal of Primary Health Care, 20(3), 26-30 Planned Change in the ICU Department.

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