In the presently swiftly changing medical environment, advancements in technology as well as the computer assisted appliances have been challenging the nurses in numerous ways. Implementation of a new project within the health sector can result in nervousness or fright of disappointment in medical practitioners, which can lead to the inability to accept change practice. Health care faults in hospitals can result in devastating outcomes for both the medical practitioner and the patient that can be minimized significantly through the utilization of technology that enhances patient care and saves time for the nurses that are very busy (Bozak, 2003). Bar-coded medicine administration is a kind of technology that utilizes a scanning appliance for comparing bar codes of patient credentials bands with the bar codes on the given medicines by electronic means verifying the medicines against the documentations of the medication, thus, minimizing medication faults significantly. In health care, safety has been recognized as a priority among medical institution and long-standing care facilities since medication faults in medical institutions are severe threats to patient wellbeing (Carroll, 2003). This paper therefore discusses how Lewin’s theory of change can guide the procedure of the implementation of bar code medicine administration. A number of researches have expounded the necessity for a proper plan and effective communication between the medical practitioners and the management when trying to implement a change of this kind.
The significance of Bar-Coding
Medication faults have been described as any event that can be avoided that can result in an inappropriate use of medicines or harm the patient while the medication is being managed by a medical practitioner, the patient or any consumer. These kinds of occurrences are linked to practitioner practice, medical items, processes and equipments. Medication faults are very common in medical facilities globally with severe outcomes leading to loss of life, enhanced in patient days in sanatoriums and increased economic expenditure (Carroll, 2003). The monetary implication of medication faults is approximated to be around 5000 dollars per fault. Little research has been done concerning the self-esteem of the nurses after committing a medication fault, probably resulting in time wastage when off work (Dennison, 2007). Whilst medication faults can result at any level in the process, the nurses are normally the final line of defence for catching blunders because of the kind of medical administration at the bedside (Wilkins & Shields, 2008).
With numerous disruptions, intricacy of care and fast-paced settings, medical practitioners may unavoidably ignore not easily seen faults, or fail to recognize packaging faults resulting in medicine mishaps that may have severe outcomes. When utilized effectively, the bar code medicine administration system can minimize the chances of medication faults (Carroll, 2003). The introduction of the Bar code systems at the maternity facility can enhance patient safety and also minimize the time spent administering medicines, resulting in increased patient contact time. Presently, the nurses utilize hard copy medication documentation and must be certain before administering. Whilst a number of nurses will happily receive this technology, others may feel engulfed by the effect of change, thus careful planning is necessary to minimize the stress as a result of the implementation.
In the present day medical environment, medical practitioners are expected to keep up with the new technology, usually with very little to comment on how they are affected by them. As with any newly introduced technology, it is important for the nurses to be fully informed to facilitate smooth transition of the informatics projects (Bozak, 2003). Change management is normally very challenging in medical facilities and newly introduced technologies usually incite resistance from medical practitioners who already are not able to find sufficient time in their working hours to complete their tasks. Numerous common obstacles have been identified during implementation of a change, which includes lack of teamwork among the staff members, fear of utilizing novel techniques, and opposition of change with the hope that the newly introduced technology is likely to disappear (Spetz, Burgess & Phibbs, 2012).
One obstacle that may impact the change in the maternity department is the probability of the patients declining to put on the identification bands, which are important for the bar code medicine administration to function. Other obstacles are short cuts that some medical practitioners prefer for the reason of saving time, which contradicts the nursing criterions of practice. In order to implement the bar code project successfully, watchful planning is essential. It is also important to identify all the potential obstacles (Bozak, 2003).
Lewin’s theory has been utilized by numerous health care institutions for the purpose of understanding human behaviours in relation to change and resistance to change. Lewin’s model consists of 3 different segments: unfreezing, moving and freezing/refreezing. The intent of the model is to recognize the features that can delay change. When the medical institution comprehensively understands the kind of behaviours that are likely to oppose or promote change then work at strengthening the elements that promote change, change can be easy to implement (Bozak, 2003).
In the first stage, known as unfreezing, an understanding of the complexities associated with the recognized problems are solved and strategies are established to make stronger the positive elements and weaken the negative elements (Bozak, 2003). This stage involves the identification of the major players that are likely to be affected by change and gathering them to share thoughts and establish lists of all the positive and negative elements that are likely to affect the project. The moving phase includes the actual implementation of change. The refreezing stage is used for evaluating the stability of change and the general effectiveness of the change.
Applying Lewin’s theory
This stage involves the identification of the change focus; particularly, the implementation of the bar code system at a large maternity department. The major elements of this stage include communication with the potential stakeholders, which includes the nurses, directors and the administration. At this stage, it is significant that all the lines of communication remain open and trustworthy. This is to ensure security and confidence amongst the stakeholders. The involvement of the front line employees in the planning phase and the decision making process empowers them and helps to minimize resistance and also enables them to better understand the significance of the change and how it can benefit their patients (Bozak, 2003).
This phase signifies the time taken during the implementation process. The implementation of the bar code system within the department will necessitate prolonged effort from numerous teams including the information technology team, the pharmacy, the clinical information services, nursing, managing directors and administrators among others. This phase involves active involvement of all the stakeholders in creating a feeling of ownership of the successfulness of the change procedure. What to put into consideration here includes the period of implementing the change, dependability of the system, need for preparation, impact on practice and institutional traditions (Spetz, Burgess & Phibbs, 2012).
Here, the procedure of refreezing the implemented project transpires and results to constancy and appraisal. The support of the medical practitioners and other stakeholders continues until the change is considered complete and all the potential users are contented with the newly introduced technology. Once it has been completed and is fully functional, an evaluation and summary of the problematic issues encountered, the successes and the challenges faced all through are noted down for future reference (Bozak, 2003).
For successful implementation of change, it is important to have an absolute plan. Applying Lewin’s theory to help in the implementation of the bar code system in the maternity department can help in promoting acceptance by the frontline medical practitioners by ensuring they are involved in all the aspects of planning and implementing change. The aspect of sharing facts for identifying the positive and negative elements is a significant step in this process. Addressing the negative elements assists in promoting adoption, ensuring easy implementation of the bar code system. In most cases, nurses are normally pressured into change practice without being granted the chance to contribute, which has interfered with their trust of the institutions they work for over time. By utilizing Lewin’s theory, stakeholder resistance can be minimized through the establishment of an effective plan and ensure active participation of all the stakeholders.
Bozak, M., (2003). Using Lewin’s force field analysis in implementing a nursing information system. Computers, Informatics, Nursing, 21(2), pp.80-85.
Carroll P. (2003). Medication errors: The bigger picture. R N, 66(1), 52-58.
Dennison, R. (2007). A medication safety education program to reduce the risk of harm caused by medication errors. Journal Of Continuing Education In Nursing, 38(4), 176-184.
Spetz, J., Burgess, J. F., & Phibbs, C. S. (2012). What determines successful implementation of inpatient information technology systems? The American Journal of Managed Care, 18(3), 157-162.
Wilkins, K. & Shields, M., (2008). Correlates of medication error in hospitals. Statistics Canada.