Change Proposal Summary Report
Introduction
Proposing evidence-based change involves a structured approach to identifying the problem, gathering relevant information, and presenting compelling evidence to support a change.
Problem Identification
The first step is to identify the problem that needs to be addressed. This requires an in-depth understanding of the issue and its root cause.
NURS FPX 6218 Assessment 1 Proposing Evidence-Based Change
Gathering Relevant Information
Once the problem has been identified, the next step is gathering relevant information to inform the proposed change. This may involve conducting research, analyzing data, or seeking expert opinion (Halawa et al., 2020).
Executive Summary
NURS FPX 6218 Assessment 1 Proposing Evidence-Based Change
Proposed Change
Medication errors in the USA are a significant problem that can harm patients, cause prolonged hospital stays, and increase healthcare costs (Rodziewicz et al., 2022). The purpose of this report is to analyze the issue of medication errors in the M Health Fairview Ridges Hospital and propose a change to address this problem. The proposed change is the implementation of an Electronic Medication Administration Record (eMAR) system in the hospital.
Importance of Addressing Medication Errors
According to the World Health Organization (WHO), medication errors cause patient harm and can occur at any stage of the medication use process (World Health Organization, 2022). Various factors, including communication gaps, inadequate training, and lack of standardization, contribute to medication errors (Nguyen et al., 2022). In the United States, medication errors harm at least 1.3 million people annually, costing the healthcare system billions of dollars (Caboral-Stevens et al., 2020). M Health Fairview Ridges Hospital has experienced medication errors resulting in allergic reactions, side effects, and interactions with other medications (Leapfrog Survey, 2022).
Proposed Solution: Electronic Medication Administration Record (eMAR) System
An eMAR system is a digital record that tracks and documents the administration of medications in real time. By implementing an eMAR system in M Health Fairview Ridges Hospital, the risk of medication errors can be significantly reduced. The system ensures the proper medication is given to the right patient at the right time and dose, improving patient safety (Gregory et al., 2021).
Expectations for Improvement
NURS FPX 6218 Assessment 1 Proposing Evidence-Based Change
Research on eMAR System Effectiveness
Studies have shown that implementing an eMAR system can lead to significant reductions in medication errors. For example, a study published in the Journal of Medical Systems found that using an eMAR system reduced medication errors by 50% compared to traditional paper-based systems (Chan et al., 2019). Another study published in the American Journal of Health-System Pharmacy reported a 44% reduction in medication errors after implementing an eMAR system (Hanifin & Zielenski, 2020). Therefore, implementing an eMAR system in M Health Fairview Ridges Hospital is expected to reduce medication errors, ultimately improving patient safety and outcomes (Gregory et al., 2021).
Desired Outcomes
The desired outcomes of implementing an eMAR system in M Health Fairview Ridges Hospital include:
- Improved patient safety
- Increased efficiency
- Enhanced communication and coordination
- Improved compliance (Chan et al., 2019)
Rationale for the Desired Outcomes
Implementing eMAR systems has been shown to reduce medication errors and improve patient safety. A study published in the Journal of Quality and Patient Safety found that implementing eMAR systems reduced medication errors by up to 55% (Iqbal et al., 2021). Additionally, eMAR systems have been found to improve medication adherence rates by 22%, leading to better health outcomes and reduced healthcare costs (Moore et al., 2020).
NURS FPX 6218 Assessment 1 Proposing Evidence-Based Change
Funding Sources
Centers for Medicare & Medicaid Services (CMS)
CMS offers various funding opportunities for healthcare organizations to implement patient safety initiatives. The proposed implementation of an eMAR system in M Health Fairview Ridges Hospital aligns with CMS’s focus on improving medication safety and reducing medication errors. By securing funding from CMS, the hospital can cover the costs associated with the acquisition, implementation, and training related to the eMAR system.
Hospital Budget Allocation
M Health Fairview Ridges Hospital should consider allocating a portion of its budget to support the implementation of the eMAR system. The upfront costs may include purchasing the software, hardware, and any necessary infrastructure upgrades. Additionally, ongoing expenses such as maintenance, updates, and staff training should be factored into the budget allocation.
Grant Opportunities
Exploring grant opportunities from foundations, government agencies, and healthcare improvement organizations can provide additional funding for the eMAR system implementation. These grants often focus on patient safety, quality improvement, and innovation in healthcare delivery. M Health Fairview Ridges Hospital should research and apply for relevant grants to supplement its funding for the proposed change.
Implementation Plan
1. Needs Assessment
Conduct a comprehensive needs assessment to identify the specific requirements and challenges of implementing an eMAR system in M Health Fairview Ridges Hospital. This assessment should involve key stakeholders such as physicians, nurses, pharmacists, and IT staff to gather their input and address their concerns.
2. Vendor Selection
Research and evaluate different eMAR system vendors to identify the most suitable option for M Health Fairview Ridges Hospital. Consider factors such as system functionality, user-friendliness, integration capabilities with existing systems, vendor reputation, and cost. Engage with multiple vendors to request demonstrations and obtain proposals.
3. Implementation Team Formation
Form an interdisciplinary implementation team comprising representatives from nursing, pharmacy, IT, quality improvement, and administration. This team will be responsible for overseeing the implementation process, coordinating training, and addressing any challenges that arise during the transition.
4. Training and Education
Develop a comprehensive training plan to ensure that all relevant staff members are proficient in using the eMAR system. This should include initial training sessions, ongoing support, and refresher courses. Collaborate with the selected vendor to provide specialized training tailored to the hospital’s workflow and medication administration processes.
5. Piloting and Evaluation
Before full-scale implementation, conduct a pilot phase in a specific unit or department to assess the effectiveness of the eMAR system and identify any necessary modifications. Collect feedback from users and use their insights to refine the system and address any usability issues.
6. Rollout and Monitoring
Once the eMAR system is deemed ready for full implementation, launch it gradually across the hospital, starting with units that are most receptive to change or have the highest medication error rates. Continuously monitor the system’s performance, gather feedback from users, and make adjustments as needed to optimize its functionality and user experience.
Conclusion
NURS FPX 6218 Assessment 1 Proposing Evidence-Based Change
Implementing an Electronic Medication Administration Record (eMAR) system in M Health Fairview Ridges Hospital is a crucial step towards reducing medication errors and improving patient safety. By following the proposed implementation plan and securing funding from various sources, the hospital can embark on this transformative change. The expected outcomes include improved patient safety, increased efficiency, enhanced communication and coordination, and improved compliance. Through careful planning, collaboration, and ongoing evaluation, M Health Fairview Ridges Hospital can successfully implement the eMAR system and create a safer medication administration process for its patients.
References
Caboral-Stevens, M., Ignacio, R. V., & Newberry, G. (2020). Undergraduate nursing students’ pharmacology knowledge and risk of error estimate. Nurse Education Today, p. 93, 104540. https://doi.org/10.1016/j.nedt.2020.104540
Chan, R., Booth, R., Strudwick, G., & Sinclair, B. (2019). Nursing students’ perceived self-efficacy and the generation of medication errors using an electronic medication administration record (EMAR) in clinical simulation. International Journal of Nursing Education Scholarship, 16(1).
Gregory, L. R., Lim, R., MacCullagh, L., Riley, T., Tuqiri, K., Heiler, J., & Peters, K. (2021). Intensive care nurses’ experiences with the new electronic medication administration record. Nursing Open, 9(3).
Halawa, F., Madathil, S. C., Gittler, A., & Khasawneh, M. T. (2020). Advancing evidence-based healthcare facility design: A systematic literature review. Health Care Management Science.
Hanifin, R., & Zielenski, C. (2020). Reducing medication error through a collaborative committee structure: An effort to implement change in a community-based health system. Quality Management in Health Care, 29(1), 40–45. https://doi.org/10.1097/qmh.0000000000000240
Hydari, M. Z., Telang, R., & Marella, W. M. (2018). Saving patients—Can advanced electronic medical records make patient care safer? Management Science. https://doi.org/10.1287/mnsc.2018.3042
Iqbal, A. R., Parau, C. A., Kazi, S., Adams, K. T., La, L., Hettinger, A. Z., & Ratwani, R. M. (2021). Identifying Electronic Medication Administration Record (eMAR) usability issues from patient safety event reports. Joint Commission Journal on Quality and Patient Safety, 47(12), 793–801. https://doi.org/10.1016/j.jcjq.2021.09.004
Jue, J. J., Cunningham, S., Lohr, K., Shekelle, P., Shiffman, R., Robbins, C., Nix, M., Coates, V., & Schoelles, K. (2019). Developing and testing the Agency for healthcare research and Quality’s national guideline clearinghouse extent of adherence to trustworthy standards (neats) instrument. Annals of Internal Medicine, 170(7), 480. https://doi.org/10.7326/m18-2950
Kelley, H. J., Basilica, A., Ladden, M., Boschitsch, M., Giordano, N., Hassmiller, S., & Fairman, J. (2022). The Robert Wood Johnson Foundation future of nursing scholars program: An overview. Nursing Outlook, 101891. https://doi.org/10.1016/j.outlook.2022.10.004
Kruse, C. S., Mileski, M., Syal, R., MacNeil, L., Chabarria, E., & Basch, C. (2020). Evaluating the relationship between health information technology safer- prescribing in the long-term care setting: A systematic review. Technology and Health Care, Preprint(Preprint), 1–14.
https://doi.org/10.3233/THC-202196
Leapfrog Survey. (2020). Sub factsheet: Bar code medication administration measures background. https://www.leapfroggroup.org/sites/default/files/Files/2020%20BCMA%20Fact%20Sheet.pdf
M Health Fairview Ridges Hospital | Ratings | Leapfrog Group. (n.d.). Hospital and Surgery Center Ratings | Leapfrog Group. Retrieved February 28, 2023, from https://ratings.leapfroggroup.org/facility/details/24-0207/m-health-fairview-ridges-hospital-burnsville-mn
Moore, E. C., Tolley, C. L., Bates, D. W., & Slight, S. P. (2020). A systematic review of the impact of health information technology on nurses’ time. Journal of the American Medical Informatics Association, 27(5).
https://doi.org/10.1093/jamia/ocz231
Naegle, M. A., Kelly, L. A., Embree, J. L., Valentine, N., Sharp, D., Grinspun, D., Hines-Martin, V. P., Crawford, C. L., & Rosa, W. E. (2023). American Academy of nursing consensus recommendations to advance system-level change for nurse well-being. Nursing Outlook, 71(2), 101917.
https://doi.org/10.1016/j.outlook.2023.101917
Nance, M. A., Boettcher, L., Edinger, G., Gardner, J., Kitzmann, R., Erickson, L. O., Wichmann, R., & Wielinski, C. L. (2020). Quality improvementParkinson’son’s disease: A successful program to enhance timely administration of Levodopa in the hospital. Journal of Parkinson’s Disease, 10(4), 1551–1559.
https://doi.org/10.3233/jpd-202024
Nguyen, K.-H., Wright, C., Simpson, D., Woods, L., Comans, T., & Sullivan, C. (2022). Economic evaluation and analyses of hospital-based electronic medical records (EMRs): a scoping review of international literature. Npj Digital Medicine, 5(1). https://doi.org/10.1038/s41746-022-00565-1
Rodziewicz, T. L., Hipskind, J. E., & Houseman, B. (2022, May 1). Medical error reduction and prevention. National Library of Medicine; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK499956/
Sharma, G., Srivastava, G., & Mago, V. (2020). A framework for automatic categorization of social data into medical domains. IEEE Transactions on Computational Social Systems, 7(1), 129–140.
https://doi.org/10.1109/TCSS.2019.2950153
Stolic, S., Ng, L., & Sheridan, G. (2022). Electronic medication administration records and nursing administration of medications: An integrative review. Collegian. https://doi.org/10.1016/j.colegn.2022.06.005
Tolley, C. L., Watson, N. W., Heed, A., Einbeck, J., Medows, S., Wood, L., Campbell, L., & Slight, S. P. (2022). The impact of a novel medication scanner on administration errors in the hospital setting: A before and after a feasibility study. BMC Medical Informatics and Decision Making, 22(1).
https://doi.org/10.1186/s12911-022-01828-3
Wadhera, R. K., Figueroa, J. F., Joynt Maddox, K. E., Rosenbaum, L. S., Kazi, D. S., & Yeh, R. W. (2020). Quality measure development and associated spending by the centers for medicare & Medicaid Services. JAMA, 323(16), 1614. https://doi.org/10.1001/jama.2020.1816
World Health Organization. (2022). Medication Without Harm. World Health Organization. Retrieved March 6, 2023, from https://www.who.int/initiatives/medication-without-harm
