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Discuss how an effective Nurse Unit Manager would lead this change to address this patient safety issue.

This essay will need to:

Provide reasons to adopt the fully electronic medication system?use Lewin’s model to outline a plan of change that includes milestones and timeframes?choose and apply a leadership style to the plan of change. Critically evaluate the choice and compare with at least one other leadership style?describe two aspects of potential resistance and discuss how the resistance might be addressed.

Adopting the eMeds System

Thesis statement- Effective nursing leadership and enhanced healthcare are indispensable to each other.

Electronic medication system- eMeds systems have the advantage of supporting improve quality, effectiveness and safety of management of medications among all hospitals. Medication errors have been identified as the second most prevalent medical incidents that are reported across different nursing homes and hospitals. These primarily comprise of overdose or omission of medications that threaten patient health and safety (Foo et al., 2017). The eMeds are defined as systems that are capable of prescribing, supplying and/or administering medicines in an electronic format. The fact that eMeds cover a range of hospital medication cycles is particularly important in this case scenario that involves a hospital with 200 beds. Medication errors that were reported in the hospital result in a failure to deliver appropriate treatment services, and has the potential of harming the patients or service users (Ohashi et al., 2014). The most common impact of such medication error are patient injury and their subsequent death. The major benefit of eMeds can be attributed to the fact that it reduces medication errors. A completely computerised system of healthcare delivery would also prove beneficial by increasing the productivity and efficiency during all medication rounds.

They will also reduce the work pressure on registered nurses, and result in an enhanced decision making process and governance. Other advantages can be attributed to the fact that these systems improve the daily experiences that are related to nursing care, thus promoting overall patient safety. Furthermore, research evidences have also established the fact that these electronic medication management systems are quite cost effective (Pearce & Whyte, 2018). The cost-effectiveness can be associated with the reduction in the rate of probable adverse drug events across hospitals. Owing to the fact that the hospital being discussed in the case scenario has had faced an increase in the medication error related incidents over the past years, there is a need to implement eMeds for enhancing patient health, lowering ADE and improving the overall reputation of the hospital.

Change model- The change model was developed by Kurt Lewin and involved three steps namely, unfreezing, changing, and refreezing. This model of change theory will be applied for implementing the electronic medication management system across the hospital. The first stage of unfreezing will be one of the most essential stages that will make the entire setup ready for the change in medication management. It will involve preparing all stakeholders, patients, and healthcare professionals ideally for the change. This preparation phase will be conducted over a period of three months (Hossan, 2015). Meetings will be organised with nurses and other healthcare professionals for explaining the benefits of the change. These will be facilitated by displaying the statistical data on past incidents of medication error, followed by assessing the capacity for bringing about the change. The second stage of changing is most vital and encompasses a transition. This phase will be conducted over a period of six months and will comprise of a journey that will help in accomplishing the change.

Using Lewin's Change Model

The traditional paper-based medication management ways will be replaced by the new electronic healthcare system. This stage will be difficult to accomplish since most of the healthcare staff and members of the administration will be fearful and unsure of the replacing their conventional methods of medication management by eMeds (Batras, Duff & Smith, 2016). The phase will comprise of convincing all stakeholders of the benefits that the eMeds will exert on patients, and the healthcare organisation. The nurse unit manager needs to acts as a role model for allowing all people to effectively participate in the change program. This will be followed by the third stage of refreezing that will occur over a period of three-four months. This time frame will allow all nursing professionals, patients, and other stakeholders accept the new norms of the eMeds. The third stage will allow all people to establish a comfort zone with the electronic medication management system (Manchester et al., 2014). Hence, an implementation of the three-stage process will ensure patient safety and wellbeing.

Leadership style- Leadership is an essential function of management and assists in the process of maximising efficiency for achieving a set of organisational goals (Marquis, Huston & Propst, 2018). Transformational leadership is a form of leadership approach that has the potential of bringing about changes in the social and individual systems. It is imperative in creating a positive and valuable change, with the ultimate goal of changing followers into leaders. In this healthcare context, transformational leadership would prove most effective since it would be able to strengthen the integration and quality of care (Fischer, 2016). This type of leadership will be most essential during the unfreezing stage of the change process since, a nurse unit manager having transformational leadership skills will be able to create a vision that will guide the change process through sufficient inspiration and will also facilitate the execution of the plan (eMeds adoption), in tandem with the members who are committed to the hospital (Kelly, 2015). A transformational leader will create an impact on the overall hospital change process by coordinating with the employees, sharing knowledge and providing them the opportunity to participate in the decision making process.

However, this is in complete contrast with a transactional leadership style that focuses on the organisation, supervision and performance (Frankel & PGCMS, 2018). A transactional leader will promote compliance to a set of rules by the followers/employees by both punishments and rewards (Stanley, 2016). Unlike a transformational leader, presence of a nurse unit manager who follows the transactional leadership style will not look forward to the future prospects of eMeds. Instead the leader will try to maintain adherence to the conventional things (paper-based medication management) (Marquis & Huston, 2015). This in turn will fail to reduce the rates of medication error, and violate patient safety.

Choosing a Leadership Style

Potential resistance- Two most common barriers or resistance that will be encountered in the transformational change process are major employee resistance and poor communication. While communication problems can be addressed by paying due attention to the important psychological cues that are being provided during delivery of essential information, a proper plan must be formulated and executed during the change process. Employee resistance can be reduced by showing the nursing and other healthcare staff data and figures on the success of electronic medication management systems in eliminating medication errors and enhancing patient wellbeing. These positive results will help the employees gain a deeper understanding of the reasons why the change process should be initiated across the hospital. Focusing on nonverbal communication, being respectful of the ideas of all employees and being direct in the speech are some strategies that can be adopted in the case.

Conclusion:

Thus, it can be concluded that the nurse unit manager involved in the process of implementing electronic medication managements system in the hospital that comprises of 200 beds should display transformational leadership skills and demonstrate a dedication to healthcare excellence and proper mentorship capabilities. Taking into account Lewin’s theory of change management will facilitate the process of shifting from paper-based medication administration to computerised forms, thereby reducing chances of medication errors and adverse drug events among the service users.

Nursing leadership is considered as an essential determinant of vivacious professional nursing practice across a range of healthcare systems that allows empowered nursing professionals to accurately implement evidence-based strategies in their practice. The nursing profession is challenging and dynamic and always requires the engagement of nurses who can act as role models (Cherry & Jacob, 2016). Nurse unit managers are entitled with the duty of overseeing different aspects of operation in a nursing unit that exists in a healthcare facility. Their role encompasses supervision of all nursing staff to patient care monitoring (Weiss & Tappen, 2014). The essay would discuss the value of effective leadership in a healthcare setting that aims to implement electronic health records for enhancing patient safety and improving patient health.

References:

Batras, D., Duff, C., & Smith, B. J. (2016). Organizational change theory: implications for health promotion practice. Health Promotion International, 31(1), 231-241.

Cherry, B., & Jacob, S. R. (2016). Contemporary nursing: Issues, trends, & management. Elsevier Health Sciences.

Fischer, S. A. (2016). Transformational leadership in nursing: a concept analysis. Journal of advanced nursing, 72(11), 2644-2653.

Foo, G. T., Tan, C. H., Hing, W. C., & Wu, T. S. (2017). Identifying and quantifying weaknesses in the Closed Loop Medication Management System in reducing medication errors using a direct observational approach at an academic medical centre. Journal of Pharmacy Practice and Research, 47(3), 212-220.

Frankel, A., & PGCMS, R. (2018). What leadership styles should senior nurses develop?. Practice, 10, 18.

Hossan, C. (2015). Applicability of Lewin’s change management theory in Australian local government. International Journal of business and Management, 10(6), 53.

Kelly, P. (2015). Essentials of nursing leadership and management (2nd edition, pp. 152-159). Clifton Park, NY: Delmar Cengage Learning.

Manchester, J., Gray-Miceli, D. L., Metcalf, J. A., Paolini, C. A., Napier, A. H., Coogle, C. L., & Owens, M. G. (2014). Facilitating Lewin's change model with collaborative evaluation in promoting evidence based practices of health professionals. Evaluation and program planning, 47, 82-90.

Marquis, B. L., & Huston, C.J. (2015). Leadership roles and management functions in nursing: Theory and Practice (8th ed.). Philadelphia, PA: Wolters Kluwer Health.

Marquis, B. L., Huston, C. J., & Propst, J. (2018). Leadership roles and management functions in nursing: Theory and application. Journal for Nurses in Professional Development, 8(6), 284-287.

Ohashi, K., Dalleur, O., Dykes, P. C., & Bates, D. W. (2014). Benefits and risks of using smart pumps to reduce medication error rates: a systematic review. Drug safety, 37(12), 1011-1020.

Pearce, R., & Whyte, I. (2018). Electronic medication management: is it a silver bullet?. Australian prescriber, 41(2), 32.

Stanley, D. (2016). Clinical leadership: Innovation into action. Yarra, Australia: Palgrave Macmillan.

Weiss, S. A., & Tappen, R. M. (2014). Essentials of nursing leadership and management. FA Davis.

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