NURS FPX 4005 Assessment 2 Interview and Interdisciplinary Issue Identification
Student Name
Capella University
NURS-FPX4005
Professor Name
Submission Date
Interview and Interdisciplinary Issue Identification
It is important to work closely with other Health Care Organisations and employees within interdisciplinary teams to promote the provision of high-quality, co-ordinated care. Improved interprofessional communication can directly translate to more patient safety, higher productivity and continuity of care in health care facilities. This assessment is intended to be directed towards the barriers to communication that will be identified during an interview with a working nurse, as well as identifying an organisational issue that could be resolved using a coordinated interdisciplinary approach.
Interview Summary
The interview was carried out with a registered nurse who works in a busy medical-surgical unit. A big challenge is effective communication among different health care providers during discharging the patient, said the nurse. The prescription is not recorded in time, and sometimes the pharmacist isn’t informed before the patient leaves the pharmacy, meaning that the pharmacist does not have enough time to check the prescription. Nurses, then, may not be able to provide complete patient and family education and important orders may be sped up or forgotten.
The other nurses’ observation was that the members of the teams did not necessarily have clear goals in the discharge process. Sometimes, nurses, pharmacists and physicians think that something has been performed by another profession, leading to further confusion and delay as well. The nurse believed a need for improvement in communication and an organised interdisciplinary approach to problem solving was the answer to the problems encountered. However, the nurse suggested that, if effective tools and processes are used, they will then be able to cooperate.
Strategies Employed in the Interview
The type of design of interviews that were used was the Semi-structured interview. In Semi-structured interviews, there is room for exploring the answers that help identify the situation, perception and barriers to a series of pre-programmed open questions. With regard to sampling, participants would be purposely selected from two key areas of discharge planning (practising nurse leader) and medication reconciliation (ward pharmacist). The ethical issues to be addressed were: informed consent and confidentiality. The focus for data collection was the recent discharges that occurred and what each role meant. Within the last few years, the use of semi-structured interviewing and thematic analysis was validated as a pragmatic and efficient method to address the questions of improvement in healthcare quality.
Issue Identification
Patient discharge is the obvious major challenge that could be discovered during the interview, due to lack of uniformity and coordination in communication within the disciplines. These gaps can mean there is a possibility for medication errors and readmissions, impacting the quality and safety of care. The nurse emphasised that this is not because the staff members do not want to communicate with one another, but because they don’t have a uniform system that will allow them to communicate with each other in a timely fashion.
The interprofessional approach to address this issue can be seen as being structured, and the use of standardised communication tools in a discharge huddle. The research shows that there are benefits to holding regular interdisciplinary huddles, which lead to improved communication, role clarity and decreased errors. Standardised checklists and short daily huddles are consistent with the Team Strategies and Tools to Enhance Performance and Patient Safety (STEPPS), which has proven to be effective in improving interdisciplinary communication and enhancing interdisciplinary collaboration in the clinical context. This would assist the nurses, pharmacists and physicians to achieve safer and more effective discharge procedures and serve as a continuity of care as well.
Change Management Theories
The programme can be described using two different change theories that are complementary: The eight steps put forward by Kotter are a viable plan for establishing urgency, building guiding coalitions and integrating new processes into the corporate culture. Lewin’s three-stage approach of unfreeze, change, refreeze is an easy way to get staff ready for a change in routine, working processes and embedding them in the work routine (Stanz et al., 2021). Kotter would take the following steps: Sequence, create a sense of urgency using baseline data, create a guiding coalition, create and communicate short-term wins from the pilot, and institutionalise the new process. Lewin’s model would be the model that would help the staff support the behavioural transitions. Both peer-reviewed sources—Prosci and Stanz—can lend credibility and support for evidence to validate Kotter and Lewin’s model as effective for changing behaviour and cultural change in a clinical setting.
Leadership Strategies That Could Lead to an Interdisciplinary Solution
This is the first style of leadership: the advisable leadership, and that is transformational leadership. The different systematic nursing reviews in the past few years have linked “transformational leadership” to improved nursing work environments, job satisfaction and patient satisfaction. In the case of transformational leaders, they will inspire the employees to adopt new operations by building a unifying vision. A transformational leader who wants to change the right way as outlined by the suggested discharge improvement needs to demonstrate transformational behaviours and seek ongoing feedback. The model of transformational leadership can be added to Lewin’s model to motivate and empower employees to accept change.
Collaboration Approaches
The competencies and training in interprofessional competencies and teamwork provide a solid foundation for work in an interdisciplinary team. Awaisi et al. (2024) pointed out some examples of implementation elements that were identified in SRs as facilitators of collaboration: role definition, common goals, facilitator-led collaboration meetings and communication tools. The evidence-based teamwork program focused on communication, leadership and situation monitoring, and mutual support is called ‘TeamSTEPPS’. Recent analyses of results that have been achieved with the implementation of team-level team modifications, including adaptations, are showing that the combination of the two — team-level with local process and leadership modifications — can improve team performance and patient safety outcomes. Interdisciplinary discharge huddles are another possible way to do this. Short and scheduled daily huddles at a designated time allow each discipline to see who will be impacted by impending discharges. This will also improve teamwork and patient safety, and maintain interdisciplinary communication in different departments. Furthermore, Shi also presents compelling arguments that show how effective TeamSTEPPS is in improving the performance of the healthcare team and patient safety.
Conclusion
The interview was conducted, and it was revealed that there was no communication and role assignment during the discharge of patients. Structured discharge huddles with the help of the TeamSTEPPS tools and standardised checklists can help improve collaboration, roles and reduce mistakes through an interdisciplinary approach that is based on evidence. This is improved interdisciplinary teamwork, which improves safer, more effective and patient-oriented care.
References
American Nurses Association. (2023). What is transformational leadership in nursing? American Nurses Association.https://www.nursingworld.org/content-hub/resources/nursing-leadership/transformational-leadership-in-nursing/
Awaisi, A., Yakti, O. H., Elboshra, A. M., Jasim, K. H., AboAlward, A. F., Shalfawi, R. W., Awaisi, A., Rainkie, D., Mutawa, N. A., & Major, S. (2024). Facilitators and barriers to interprofessional collaboration among health professionals in primary healthcare centers in Qatar: A qualitative exploration using the “gears” model. Journal of Biomedical Science Primary Care, 25(1). https://doi.org/10.1186/s12875-024-02537-8
Chance, E. A., Florence, D., & Abdoul, I. S. (2024). The effectiveness of checklists and error reporting systems in enhancing patient safety and reducing medical errors in hospital settings narrative review. International Journal of Nursing Sciences, 11(3), 387–398. https://doi.org/10.1016/j.ijnss.2024.06.003
Pimentel, C. B., Snow, A. L., Carnes, S. L., Shah, N. R., Loup, J. R., Vallejo-Luces, T. M., Madrigal, C., & Hartmann, C. W. (2021). Huddles and their effectiveness at the frontlines of clinical care: A scoping review. Journal of General Internal Medicine, 36(9), 2772–2783. https://doi.org/10.1007/s11606-021-06632-9
Prosci. (2024). Kotter’s change management theory: Explanation and applications. Prosci. https://www.prosci.com/es/blog/recursos-humanos-clave-implementar-gestion-cambio-empresa
Schmiedhofer, M., Derksen, C., Keller, F. M., Dietl, J. E., Häussler, F., Strametz, R., Koester-Steinebach, I., & Lippke, S. (2021). Barriers and facilitators of safe communication in obstetrics: Results from qualitative interviews with physicians, midwives, and nurses. International Journal of Environmental Research and Public Health, 18(3), 915. https://doi.org/10.3390/ijerph18030915
Shi, Y., Miao, S., Fu, Y., Sun, C., Wang, H., & Zhai, X. (2024). TeamSTEPPS improves patient safety. British Medical JournalOpen Quality, 13(2). https://doi.org/10.1136/bmjoq-2023-002669
Stanz, L., Silverstein, S., Vo, D., & Thompson, J. (2021). Leading through rapid change management. Hospital Pharmacy, 57(4), 422–424. https://doi.org/10.1177/00185787211046855
Vaseghi, F., Yarmohammadian, M. H., & Raeisi, A. (2022). Interprofessional collaboration competencies in the health system: A systematic review. Iranian Journal of Nursing and Midwifery Research, 27(6), 496–504. https://doi.org/10.4103/ijnmr.ijnmr_476_21