Assignment 4 training strategy

Diabetes Management Policy Proposal

Miatta Teasley

Capella University

NHS-FPX6004 Health Care Law and Policy

Professor Georgena Wiley

May 19, 2022

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Hello and welcome to today’s presentation on drug error regulatory policy proposals. This presentation is intended to provide you, your stakeholders, with all pertinent information regarding the need for an institutional policy to reduce medication errors in medical centers. We will also go over the scope of the recommendations, strategies for addressing medication errors, and stakeholder involvement in putting these strategies into action.

Policy Proposal

Diabetes Management

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This proposal revolves around creating and implementing strategies that will help Med’s caregivers be able to improve on patient care regarding diabetes.

Presentation Outline

Policy on Managing Medication Errors

Need for a Policy

Scope of Policy

Strategies to Resolve Mediation Errors

Role of the Hospital Staff

Positive impact on Working Conditions

Issues in the Application of Strategies

Alterative Perspectives on Mitigating Medication Errors

Stakeholder Participation

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The presentation highlights key functions in any policy implementation process. The steps this presentation takes appear in the order as indicated here. We will start y looking at

Policy on Managing Medication Errors then

Need for a Policy followed by

Strategies to Resolve Mediation Errors. Then the

Role of the Hospital Staff and the

Positive impact on Working Conditions. Also, we will look at

Issues in the Application of Strategies and the

Alterative Perspectives on Mitigating Medication Errors and finally,

Stakeholder Participation

Policy on Managing Medication Errors

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Health practitioners should create and advance engaging policies

Many Healthcare departments require modernization

Healthcare policies should be adjusted to meet defined benchmarks

Key stakeholders are vital for successful implementation of proposed policies

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When advocating for organizational regulation changes about federal, state, or local health care guidelines or rules and regulations, healthcare practitioners should be able to create and advance an engaging and logical policy and guideline parameters that will provide a segment, a group, or an entire institution to correct and shed light on issues of accomplishment and execute developments in the quality and safety of medical management.

Despite being recognized as one of the greatest health insurance carriers for people over 65, several departments need to be modernized. The most pressing of these has been controlling dialysis measures and therapy adherence. Dialysis measures, inpatient mortality, and intervention adherence are linked to higher healthcare costs, poor treatment outcomes, and decreased efficiency. This paper explains why policy and practice standards must be adjusted to meet the defined benchmarks in controlling dialysis measurements and therapy adherence.

The proposed policy and practice guidelines changes, the impact of factors on practice guidelines application, and the need to include key stakeholders to guarantee successful implementation.

Need for a Policy

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There exits unreliability in dialysis measures at Med.

Med is operating at 82% dialysis recommendations

There is need for more resources in patient care

A policy to reduce medication mistake is needed.

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There exists a number of unreliability in dialysis measures at Med. The two stand out on the dashboard for carrying out the planned actions and procedures, with a 77 percent compliance rate for obtaining blood cultures before delivering antibiotics and a 58 percent conformity value for dispensing vasopressors to patients who need them. According to Medicare.Gov (n.d.), the country-level for achieving dialysis recommendations is 72 percent, while the state of Minnesota is 60 percent, meaning that Med is operating at an inclusive rate of 82%. Bigger quota is needed to guarantee that inhabitants of healthcare institutions have a better quality of life.

Inpatient mortality, intervention adherence, and dialysis measurements need more resources and care interventions, lowering the efficiency of health care services provided. Given the costs that such incidents may impose on patients and health care providers, an organizational policy to address the gap in medication mistake reduction is required.

Scope of the policy

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The policy covers:

Nursing employees,

Medical staff,

Emergency and allied care practitioners,

Pharmacy professionals

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The policy covers nursing employees, medical staff, emergency and allied care practitioners, and pharmacy professionals. Everyone involved is responsible for managing dialysis measures and ensuring intervention compliance. This is because they are directly involved with the patents with regards to administration of medications and other procedures as recommended.

Strategies to Resolve Mediation Errors

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Med is perennially understaffed

Med lacks defined policy for care

Dialysis interventions are given incorrectly

Qualified and skilled staff should be employed

Develop a plan for recommended dialysis interventions

Learning from the mistakes will improve are actions

Failure mode and effects analysis will help analyze pharmaceutical errors

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The institution is dealing with two major concerns. The Department’s principal problem is that it is perennially understaffed. On a monthly average patient number, the Department was understaffed by 1.34 nurse workload departments. According to the compliance team, the institution has not followed the Department’s mandatory standard. There are various factors to consider when it comes to employing qualified and skilled staff, such as financial burden and logistics (Rizzolo, Novick & Cervantes, 2020).

Another issue is that Med does not have a defined policy or practice norms for any of the care at any institution level, which could lead to dialysis interventions not being given correctly. The institution for critical care medicine, according to a memorandum, has created the final standards for practice in treating adult diabetes. There are no policies to govern how medical personnel employ these resources in their approach. Procedures should be defined and reinforced to protect the ordering required for tests (Rizzolo, Novick & Cervantes, 2020).

On the other hand, learning from these blunders will help to limit their recurrence and improve care actions. Every reported error is an opportunity to create a countermeasure that will aid in avoiding or mitigating the repercussions of the same mistake in the future (Weant et al., 2014).

A healthcare system that exposes patients to medical blunders must be scrutinized. Failure mode and effects analysis is a technique for analyzing instances involving pharmaceutical errors. The medical facility can use this type of analysis to commission the development of a multidisciplinary committee to assess processes prone to errors.

To improve health care outcomes, the institution must develop a plan within the presently tracked recommended dialysis interventions that will deliver the greatest results for administering vasopressors and performing blood cultures. This recommendation is made with the patients and ethical care in mind.

Role of the hospital staff

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Managing dialysis measures

Ensuring intervention compliance

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The nurses and pharmacists have a critical role in ensuring that correct dialysis is done. They need to make suggestions for patient care.

Positive impact on Working Conditions

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Development of new suggestions for patient care

Creating and conducting training

Compliance with all critical interventions

Development of automated protocols

Precise workflow

Dialysis testing is ordered and completed on time

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Creating a training program is crucial for introducing nurses and doctors to the best practices for dealing with the problem. From the aspect of the patient’s safety, the plan will also emphasize on the significance of compliance with all critical interventions (Erickson & Winkelmayer, 2018).

The development of automated protocols may aid in ensuring rapid responses to the tests required when performing dialysis on patients. Ordering doctors, nurses, laboratory personnel, and the Department of Technology and Information should be included. Each unit is responsible for ensuring that dialysis testing is ordered and completed on time.

Issues in the Application of Strategies

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Environmental elements

Incidents of compliance and intervention concerns

Inaccuracies in verbal communication

Several proximate causes and risk factors

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Environmental elements play part in the etiopathogenesis of diabetes. Stress, dirt, absence of physical exercise, polluted water, an unhealthy diet, insufficiency of vitamin D, subjection to enteroviruses, and immune cell destruction are all environmental contributors (Raman, 2016).

These environmental factors can impact how practice recommendations are implemented, hypertension intervention, and inpatient mortality. Incidents of compliance and intervention concerns are routinely reported verbally, regardless of how frequently they occur. As a result, faults may go unnoticed. Inaccuracies in verbal communication may result in data documentation problems. According to Claudia et al., the prospect of improving patient safety is limited when mistakes are discussed verbally (Elden & Ismail, 2016).

Diabetes and obesity are frequently associated with hypertension. These disorders are grouped as metabolic syndrome. Persons having metabolic syndrome are at a higher risk of going down with cardiovascular infection.

Diabetes and hypertension share several proximate causes and risk factors. A person who has one ailment is more likely to develop the other. Similarly, a person who has both illnesses may find that one worsens the other (Medical News Today, 2022).

Alterative Perspectives on Mitigating Medication Errors

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Regular training of healthcare practitioners

Creating simulated environments

Develop a safety culture within the organization

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Healthcare practitioners must be regularly trained on new medications, procedures, and policies for the recommended practice guidelines to be effectively implemented. Aside from that, creating simulated environments will provide caregivers confidence in their abilities to deliver drugs. It is critical to develop a safety culture within the organization, allowing caregivers to disclose errors without fear of repercussions or compulsion.

Stakeholder Participation

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Key administrative staff can assist

Senior administrative individuals can foster a safety culture

Participation of Med’s administration and care providers improves transparency

Med’s administration and care providers will implement planned ideas.

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Key administrative staff like the director of nursing, the chief executive officer, or chief operating officer can assist. These experts can create a quality committee to share their expertise and oversee the successful implementation of the proposed measures. By establishing role accountability and regularly expressing the organization’s quality improvement norms, senior administrative individuals can foster a safety culture among the healthcare staff (Parand et al., 2014).

The participation of Med’s administration and care providers will lead to more transparency in strategy implementation. It will bring in varied knowledge, provide a forum for debate and discussion, and ensure that all parties concerned have a say in the decisions made by these strategies. As a result, teamwork between Med’s administration and care providers will ensure that the planned ideas are implemented successfully.

References

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Elden, N. M. K., & Ismail, A. (2016). The importance of medication errors reporting in improving the quality of clinical care services. Global Journal of Health Science, 8(8), 243–251. Retrieved from https://ncbi.nlm.nih.gov/pmc/articles/PMC5016354/

Erickson, K. F., & Winkelmayer, W. C. (2018). Evaluating the evidence behind policy mandates in US dialysis care. Journal of the American Society of Nephrology, 29(12), 2777-2779.

Kate Jones (2021). The 4 M’s of Diabetes Management. Retrieved from https://carilionclinicliving.com/article/conditions/4-ms-diabetes-management

Medical News Today (2022). The link between diabetes and hypertension. Retrieved from https://
www.medicalnewstoday.com/articles/317220#outlook

Parand, A., Dopson, S., Renz, A., & Vincent, C. (2014). The role of hospital managers in quality and patient safety: A systematic review. BMJ Open, 4(9). Retrieved from

https://ncbi.nlm.nih.gov/pmc/articles/PMC4158193
/

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References

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Raman, P. G. (2016). Environmental factors in causation of diabetes mellitus. In Environmental Health Risk-Hazardous Factors to Living Species. IntechOpen.

Rizzolo, K., Novick, T. K., & Cervantes, L. (2020). Dialysis care for undocumented immigrants with kidney failure in the COVID-19 era: public health implications and policy recommendations. American Journal of Kidney Diseases, 76(2), 255-257.

Tan, E., Polello, J., & Woodard, L. J. (2014). An evaluation of the current type 2 diabetes guidelines: where they converge and diverge. Clinical Diabetes, 32(3), 133-139.

Weant, K. A., Bailey, A. M., & Baker, S. N. (2014). Strategies for reducing medication errors in the emergency department. Open access emergency medicine: OAEM, 6, 45.

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Training Session for Policy Implementation

Learner’s Name

Capella University

NHS6004: Health Care Law and Policy

Instructor Name

January 1, 2021

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Training Session for Policy Implementation

Sound policy and practice guidelines for the management of medication errors are critical

for a premier medical center such as Mercy Medical Center. For the successful implementation

of the policy on managing medication errors, members of the nursing staff at the medical center

who will be responsible for enacting the policy must thoroughly understand the strategies

prescribed by the policy. A training program designed for staff members will ensure effective

dissemination of the knowledge and skills required to implement the policy guidelines. The

training program outlined in this paper will be conducted for a pilot group of 20 members of the

nursing staff from the pediatric division of the medical center.

Promoting Nurses’ Buy-In

According to Ruddy et al. (2016), for authentic transformation of medical practice

technical changes are necessary but not sufficient. Systemic practice changes happen when those

who practice are transformed. In a study by French-Bravo et al. (2020), nurses perceived that

strong communicative relationships with nurse managers encouraged their buy-in to

organizational initiatives. Nurse managers developed such strong relationships with nurses

through multimodal approaches to communicating with nurses and influencing them. In addition

to communicating information through email, huddles, and staff meetings, nurse managers

communicated the rationale for change using data in the form of statistics, facts, and patient

feedback comments. Nurse managers also served as role models to influence change, influenced

the culture of units, and demonstrated characters such as approachableness and attentiveness to

influence nurses. Nurse managers also facilitated change through management support and staff

engagement through strategies such as making time to listen to nurses’ concerns and supporting

them as individuals and collectively as a team. A staff-led decision-making approach facilitated

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by nurse managers involved helping staff understand unit goals, supporting them to drive the

work of the unit, and increasing manager-facilitated peer communication (French-Bravo et al.,

2020). Nurse managers, head nurses, and other members of nursing leadership will therefore play

a crucial role in promoting buy-in of nurses to implement the policy and practice guidelines.

Early Indicators of Success

Three types of indicators can project the success of the policy at an early stage: structural

indicators, process indicators, and outcome indicators. Structural indicators emphasize the

quality of organizational aspects, for example, the availability and effective functioning of

equipment such as automated dispensing cabinets. Process indicators focus on the process of care

delivery. Efficiency in prescription management and in diagnosis management are two process

indicators that measure the effectiveness of the policy. Outcome indicators are result oriented.

Reduction in readmission rates, reduction in postsurgical wound infection rates, and patient

experience are a few outcome indicators that can measure the success of the policy (Grol et al.,

2013).

Nurses’ perceptions about automated dispensing cabinets are important indicators of their

readiness to implement the practice guidelines (Metsämuuronen et al., 2020). Understanding

their perceptions will help the center’s management gauge the success of initiatives aimed at

promoting buy-in. Survey questionnaires that include questions related to the change in policy

and practice guidelines can be developed to measure nurses’ perceptions about changes in their

work environment (Norman & Sjetne, 2017).

Impact of Policy and Practice Guidelines

The policy on the management of medication errors states the procedure that must be

followed in case of a medication error. The scope of the policy extends to the nursing,

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emergency care, and medical staff employed at Mercy Medical Center (Black County

Partnership, 2015). The policy requires that the medical center form a multidisciplinary

committee. This committee will assess potential discrepancies and address shortfalls in

medication processes (Weant et al., 2014).

Approaches to reduce medication errors include setting up a standardized medication

error analysis system and implementation of automated dispensing cabinets. To set up a

standardized medication error analysis system, the multidisciplinary committee should classify,

prioritize, and regularize the process of reporting medication errors. Understanding the causes of

medication errors through medication error analysis becomes simpler with the availability of

accurate data. Automated dispensing cabinets are computerized systems for medicine

management and are installed in health care units. These cabinets are used to manage errors that

occur when dispensing medication. The cabinets store and dispense medication and

electronically track drug inventory (Weant et al., 2014).

Impact of Policy Implementation on Nurses’ Work

Medication errors are indicative of poor-quality health care services in a medical center.

The proposed policy can prevent medication errors, ensure patient safety, help the medical center

avoid litigation for medical negligence, prevent harm to the medical center’s reputation, and

reduce unnecessary expenses (Black County Partnership, 2015). A study by Bourcier et al.

(2016), indicated that implementation of automated dispensing cabinets dramatically reduced the

time that head nurses spent on weekly inventories and orders. This allowed nurses and head

nurses to focus on their core responsibilities. The policy and guidelines change will increase the

efficiency of the nursing staff by decreasing the effort and time spent on medication procedures,

which will increase the job satisfaction of the members of the nursing staff.

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Concerns Over the Policy

The pilot group selected will be trained on the two strategies: installation and use of

automated dispensing cabinets and standardized medication error analysis. Staff members could

be apprehensive about reporting errors considering the degree of fatality of the error and the

disciplinary action as a consequence of underreporting (Chu, 2016). Such apprehension may

cause the nursing staff to object to the establishment of a standardized system for medication

error analysis. Implementation of the second strategy, installation of automated dispensing

cabinets, would be beneficial for medication management and prevention of errors; however,

automated dispensing cabinets can potentially cause errors in the retrieval of medication in case

of mismanagement of medical inventory (Weant et al., 2014). This could be a potential concern

for the nursing staff.

Interpreting the Policy for Nursing Staff

One of the complexities of implementing the strategies of the policy is deciding to report

an event as a medication error. The lack of standard definitions for medication errors leads to

unidentified errors because there is uncertainty around whether an error needs to be reported.

The implementation of a standardized system for medication error analysis would require that

medication errors be clearly defined. This would help nurses identify medication errors

accurately and report them (Chu, 2016).

The number of medication errors in Mercy Medical Centre’s medical and surgical units

increased by 50% from 2015 to 2016. Most medication errors occur during medication

administration by nursing staff (Ofusu & Jarrett, 2015). The training program on policy

implementation, therefore, intends to familiarize the nursing staff with complex sections of the

policy such as the repercussions of negligence and the protocol to be followed while addressing

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medication errors. The nursing staff will also be clearly informed of the chain of command for

the purpose of reporting errors.

Importance of Policy and Practice Guidelines in Nurses’ Work

Improved management of medication errors could reduce stress and improve work

satisfaction for nurses. A study by Metsämuuronen et al. (2020) assessed perceptions of nurses in

an observational study and an online survey to find that nurses believed that automated

dispensing cabinets would make their work easier. The nurses were able to save time and focus

on direct patient care activities. Another such study by Zaidan et al. (2016) has also indicated

that nurses were satisfied with the implementation and believed that these systems were easy to

use and helped them carry out their job safely.

Role of Nursing Staff in Policy Implementation

Nursing staff plays an important role in the implementation of a medication error

management policy because of their proximity to patients and medication processes. A nurse is

the last person involved in the administering of drugs. A nurse is responsible for physically

administering the right drug to a patient and can therefore easily identify and correct any error in

the medication process (Ofusu & Jarrett, 2015). In order to ensure that the policy on managing

medication errors is implemented efficiently, the nursing staff must focus on maintaining

accuracy and regularity in reporting medication errors. The nursing staff can prevent errors in

drug administration by practicing the five rights: right dose, right patient, right time, right drug,

and right route. The nursing staff can ensure that there are no medication errors while

administering medication. Some ways the nursing staff can contribute positively toward policy

implementation include calculating the amount of drugs accurately, reducing distractions while

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administering medication, informing patients about the effects of a drug, and continuous revision

of pharmacological knowledge (Chu, 2016).

Training Nursing Staff on the Policy

Nursing staff is involved in medication processes such as prescription and administration

of medication. During drug administration, a nurse is the last person who may be able to rectify

errors. While patient safety is a priority for nursing staff, they cause most medication errors

because of constant distractions and interruptions in their work routine (Ofusu & Jarrett, 2015). It

is important to train the nursing staff on the guidelines of the policy as inexperienced and

untrained staff may not be able to anticipate or identify a medication error. The policy on

managing medication errors requires that automated dispensing cabinets be set up and

medication error analysis be performed. For the successful implementation of automated

dispensing cabinets, it is crucial that the nursing staff be trained on the safe use of these devices.

While automated dispensing cabinets are introduced to reduce errors, their incorrect usage can

create problems in dispensing medication (Hamilton-Griffin, 2016). To implement the second

strategy, namely medication error analysis, nursing staff must be trained on new procedures that

will enable them to accurately and regularly report medication errors. Reinforcing the

importance of reporting during training will encourage nurses to adopt the medication error

reporting procedures, ensuring the availability of adequate data to perform a medication error

analysis.

Training Process

A 2-hour workshop will be conducted to train the nursing staff on the use of automated

dispensing cabinets and medication error analysis. A day before the training, a questionnaire will

be circulated to the pilot group to assess their understanding of the two strategies. This workshop

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will be divided into two sessions of an hour each. The first session will be conducted by local

opinion leaders, who are individuals recognized as clinical experts in a specific field of

medication. The opinion leaders will discuss the technical know-how required to operate

automated dispensing cabinets and the steps that must be followed for medication error analysis.

This session by local opinion leaders would have an influential impact on the nursing staff

because of the presence of a familiar figure whose credentials are known.

The second session will involve simulation-based training. Here, the staff will participate

in situations in which they have to operate automated dispensing cabinets and perform a mock

medication error analysis. This session will give the staff real-world experience and provide

insights into potential complexities they may encounter while using the automated dispensing

cabinets or conducting a medication error analysis (Grol et al., 2013).

Training Material for Skill Development

Each participant will be given a handout containing the policy guidelines, a document

listing the steps to follow while conducting a medication error analysis, and a user manual for the

use of automated dispensing cabinets. In addition, a printed version of the content covered by the

opinion leader will also be provided to the staff for future reference. In order to ensure

continuous learning, the nursing staff will be given access to a virtual classroom using a log-in

ID and password to access lectures and self-learning exercises (Grol et al., 2013). The handouts

and the virtual learning material will be designed to help the staff members develop skills such as

critical thinking and attention to detail and the confidence required to implement the strategies of

the policy.

Conclusion

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The policy on the management of medication errors was proposed by the leadership of

Mercy Medical Center to reduce and prevent the occurrence of medication errors. For the

successful implementation of the policy, it is essential to design a training program for the

hospital staff on the various strategies of the policy. The program will help staff members

understand the importance of managing medication errors, thereby improving patient safety, the

medical center’s reputation, and the staff’s job satisfaction.

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References

Black County Partnership, NHS Foundation Trust. (2015). Medication error policy.

https://www.bcpft.nhs.uk/documents/policies/m/973-medication-errors/file

Bourcier, E., Madelaine, S., Archer, V., Kramp, F., Paul, M., & Astier, A. (2016).

Implementation of automated dispensing cabinets for management of medical devices in

an intensive care unit: Organisational and financial impact. European Journal of Hospital

Pharmacy, 23(2), 86–90. https://europepmc.org/article/pmc/6451497

Chu, R. Z. (2016). Simple steps to reduce medication errors. Nursing 2016, 46(8), 63–65.

https://doi.org/10.1097/01.nurse.0000484977.05034.9c

Grol, R., Wensing, M., Eccles, M., & Davis, D. (2013). Improving patient care: The

implementation of change in health care. https://ebookcentral-proquest-

com.library.capella.edu/lib/capella/reader.action?docID=1153537

Hamilton-Griffin, K. (2016). Developing improvement strategies on the use of automated

dispensing cabinets to reduce medication errors in a hospital setting (Doctoral

dissertation). ProQuest. (Order No. 10127834)

French‐Bravo, M., Nelson‐Brantley, H. V., Williams, K., Ford, D. J., Manos, L., & Veazey

Brooks, J. (2020). Exploring nurses’ perceptions of nurse managers’ communicative

relationships that encourage nurses’ decisions to buy‐in to initiatives that enhance

patients’ experiences with care. Journal of Nursing Management, 28(3), 567– 576.

https://doi-org.library.capella.edu/10.1111/jonm.12958

Metsämuuronen, R., Kokki, H., Naaranlahti, T., Kurttila, M., & Heikkilä, R. (2020). Nurses´

perceptions of automated dispensing cabinets — an observational study and an online

survey. BMC Nursing, 19, 1-9. https://doi.org/10.1186/s12912-020-00420-2

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Norman, R. M., & Sjetne, I. S. (2017). Measuring nurses’ perception of work environment: A

scoping review of questionnaires. BMC Nursing, 16(1), 66.

https://doi.org/10.1186/s12912-017-0256-9

Ofusu, R., & Jarrett, P. (2015). Reducing nurse medicine administration errors. Nursing Times,

111(20), 12–14.

https://www.nursingtimes.net/Journals/2015/05/10/t/l/q/130515_Reducing-nurse-

medicine-administration-errors.pdf

Ruddy, M. P., Thomas-Hemak, L. & Meade, L. (2016). Practice Transformation. Academic

Medicine, 91(5), 624–627. https://doi.org/10.1097/ACM.0000000000001059

Weant, K. A., Bailey, A. M., & Baker, S. N. (2014). Strategies for reducing medication errors in

the emergency department. Open Access Emergency Medicine, 6, 45–55.

https://doi.org/10.2147/OAEM.S64174

Zaidan, M., Rustom, F., Kassem, N., Al Yafei, S., Peters, L., & Ibrahim, M. I. M. (2016).

Nurses’ perceptions of and satisfaction with the use of automated dispensing cabinets at

the Heart and Cancer Centers in Qatar: a cross-sectional study. BMC nursing, 15(1), 4.

https://doi.org/10.1186/s12912-015-0121-7