NUR 550 Week 5 DQ 2 Consider A Recent Practice Change
NUR 550 Week 5 DQ 2 Consider A Recent Practice Change
NUR 550 Topic 5 DQ 2
Consider a recent practice change that resulted from research efforts. What were some barriers to
implementation? What are common barriers for translating research into practice?
Just this week, in our huddle notes, there is a quality initiative for the emergency room at my workplace. Management wants us to have shift report at the nurse’s station but wants both the night nurse and the day nurse to go around to each patient, to allow all information to be transferred according. What is said during the report needs to match the patient. It is funny because my whole PICOT statement is regarding shift reports moving bedside. The major barrier to this implementation changes. Nurses are stuck in their ways and habits. After I get the shift report, I usually take the next 15 minutes looking through the patient’s chart to get more of a picture of why they are here. Shift reports at the nurse’s station may be sporadic and it is hard to gauge what happened or what brought them in. Because of this, it may take close to 45 minutes before I set foot in the patient’s room and the status of their condition may have changed. Translation research into practice may have barriers due to a lack of evidence. It is well-known the benefits of doing bedside shift report but there is also a lot of complaints…takes longer and there are many factors that contribute to an effective bedside shift report exchange. The barriers would be to limit outside factors that would affect the quality of the report. For example, there should be a standardized report for each patient, allowing the ease of information to flow from one nurse to another nurse.
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Amber, that is interesting because I know my work is also working on an initiative for bedside report. My unit is an oncology unit and there is often very sensitive information that revolves around the patients prognosis. Because of this we do a modified bedside report and do report right outside of the room and then go into the room together and check lines, introduce oncoming nurse to patient. This way we avoid reminding the patient every 12 hours about their very sensitive condition and this had improved patient satisfaction. BUT as time has gone on sometimes report is not being done like this. things are being missed, patients aren’t being greeted at shift change, etc. So now they are going back to drawing board to change how we do report. I always wondered how report worked in the emergency department since it can be like a revolving door down there. Thanks for sharing.
A new quality initiative in my workplace in about scanning barcodes on medications, and lab specimens. Although scanning is not a new thing, I guess that the percentage of lab specimen collections and medications that are being scanned is very low. This brings safety concerns. Management noticed this trended and has now identified quality initiatives to improve this to reduce errors and improve patient safety. Scanning patients, medications, and specimens also protects the nurses license to practice. There is a bonus for the nurse with highest scanning percentage on the unit each month, also there is now a informatics nurse that comes around once every shift asking if we need scanning or EMR help. On top of this we are now required to call pharmacy if a barcode is not scanning. We have to then tube the medication down to the pharmacy and fill out paperwork. We are not allowed to give medication that cannot be scanned. Also, when it comes to lab specimens if the patient’s band or sample is not scanned it will be rejected by the laboratory and the specimen will need recollected.
Some barriers I believe to the implementation of medication barcode scanning is if the technology is not working or the barcode is not perfect and not scanning, I do not think it’s okay to delay patient care to fix it. If it is a reasonable timeframe like a quick fix such as pulling a new med from the pyxis or trying a different scanner but having to call to pharmacy and tube down the medication and wait for a response is an unnecessary wait to help a patient control their pain, give insulin, or any other very important time sensitive medication. Also, when it comes to having to recollect a lab specimen this is invasive to the patient, puts them more at risk for being exposed to an infection and should be avoided. Something such as scanning should not cause a patient to go through this again. Especially if the patient is a hard draw. There is obviously evidence that scanning these things helps prevent errors and improves patient safety but there is a line to where a nurse needs to be accountable and have the competence to safely pass a medication without the use of technology. Medication safety is the responsibility of all members of the healthcare team from the nurses to the prescribers, to the pharmacist and medication errors are one of the leading causes of death in hospitalized patients (Naidu & Alicia, 2019). Use of barcode systems effectively reduce the number of errors with efficient technology and with the appropriate training and support, the healthcare team would be able to adhere to a high standard through the use of technological advancement in healthcare and reduce the number of reported errors (Naidu & Alicia, 2019).
References
Naidu, M., & Alicia, Y. L. Y. (2019). Impact of Bar-Code Medication Administration and Electronic Medication Administration Record System in Clinical Practice for an Effective Medication Administration Process. Health, 11(05), 511–526. https://doi.org/10.4236/health.2019.115044
