Nursing Leadership: Implementing eMeds for Patient Safety in Hospitals

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This reflective essay examines the critical role of nursing leadership in implementing an electronic medication system (eMeds) within a 200-bed hospital to address increasing medication errors and enhance patient safety. The essay explores the benefits of eMeds, including improved medication management, reduced errors, and enhanced efficiency, while also discussing the application of Kurt Lewin's change model (unfreezing, changing, refreezing) to guide the implementation process. Furthermore, it highlights the importance of transformational leadership in fostering a positive change environment, contrasting it with transactional leadership and addressing potential resistance. The essay concludes by emphasizing the nurse unit manager's role in driving the change, promoting healthcare excellence, and ensuring the successful adoption of eMeds to improve patient outcomes.
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Running head: REFLECTIVE ESSAY
Nursing Leadership
Name of the Student
Name of the University
Author Note
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1REFLECTIVE ESSAY
Introduction- 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.
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
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2REFLECTIVE ESSAY
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.
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3REFLECTIVE ESSAY
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
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4REFLECTIVE ESSAY
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.
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
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5REFLECTIVE ESSAY
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.
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6REFLECTIVE ESSAY
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.
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7REFLECTIVE ESSAY
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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