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Agenda of the In-Service Program
An in-service program is an executive training and a follow-up discussion of the outcomes with other staff members. It is a crucial instrument for the professionals and beginning staff members in the field of health care and nursing in particular. During the session, the staff members are going to learn the safety improvement plan and their roles in it, analyze the work processes, and get feedback. First, the overview of the implementation plan is presented in relation to the medication administration issue. Second, the staff audiences roles are defined to help implementation. Third, the new processes and skills are analyzed through a group activity. Lastly, the audience gives feedback on the plan and session.
Outcomes
The health care environment rapidly changes, influenced by various technological advances and arising issues, including medication administration. The mistakes need to be carefully analyzed through the case study and evidence-based practices. The problem-based learning (PBL) is considered one of the most innovative strategies for problem-solving and learning in health care (Rakhudu et al., 2016). Improving the current policies and working on developing professional skills through in-service programs application has a range of benefits. All the programs activities allow the staff to develop a working improvement plan, create a team, and integrate the feedback for future improvement. It sets the standard for nursing practice in patient safety and quality care and increases staff professionalism in providing care with confidence for the reviewed case.
The Problem in Medication Administration
Identifying the existing mistakes is essential in the medical field as the root cause is not always apparent. Various human, environmental, communication, and technical factors can lead to irreversible consequences, including the patients death. Examining these mistakes in the specific circumstances allows for creating guidelines for medical institutions and preventing them in the future. An in-depth analysis of the mistake and correlating factors is essential in creating a plan for further actions. The reviewed sentinel case occurred primarily because of human and technical errors combined with environmental and communication factors.
Human error is considered the primary factor contributing to critical incidents in anesthesia between 65-85% of incidents. The causes for it may include fatigue, cognitive limitations, the workload for many others. Thus, the technical training is not enough to prevent the sentinels, but increased understanding of human nature and communication with the team helps (Rakhudu et al., 2016).
The medical team also did not communicate clear instructions contributing to communication challenges. Communication failures or errors of emission between the medical workers are considered the most common cause of medical failures in about 30% of the cases (Rakhudu et al., 2016). The following failures are divided into information failures in about 60% of the cases and the lack of shared understanding in 40% (Rakhudu et al., 2016). Since communication problems are the most common cause of medical errors, it is imperative to improve the communication channels and means between staff members to minimize information failures and lack of understanding.
The nurses also lacked knowledge or expertise in the field, which led to technical errors. On average, a patient is subject to at least one medical error a day with varying statics among hospitals, considering at least a quarter of them are preventable. To prevent the possible implications from technical and medication errors, the best practice strategies suggest to avoid abbreviation lists, use a computerized entry system to avoid human factor in the possible mistake, and compare patients medication orders with other medications through medication reconciliation to avoid omissions, dosing or technical errors and duplications.
The urgency of the event that facilitated the error can be considered an environmental factor. These issues comprise and characterize the current situation as not professional due to the significant risk to the patients life. The following factors need to be taken into account and decreased through practice and education.
Safety Improvement Plan
Medical errors are essential to be considered primarily to create a working improvement plan and prevent recurrence in the future. The following safety improvement plan main focus points are improved education, staff guidelines, user instructions, and emergency scenario practice. First, the root cause of human knowledge-based problems requires a policy for mandatory education and established guidelines. The staff training can at least minimize possible errors if not eliminate altogether. The policy needs to be based on the cases precedent and contain specific guidelines (Joint Commission, 2020). Technical failures can be prevented using explicit written and oral instructions, especially for the rarely-used or new medical devices. The medication and device design should be improved and labeled for better usability and medication safety (Joint Commission, 2020). Better communication and cooperation between staff members can also be achieved through in-service programs and team-building sessions. Moreover, education and guidelines should be combined and applied in practical emergency scenarios. The following plan should be carefully reviewed and implemented step-by-step with the policy introduced within a week and scenarios within a month.
The Plans Goal
The introduction of new learning and practice policies is required upon the completed analysis to improve the provided patients service and communication. According to the Joint Commission (2020) Patient Safety Goals, several goals to assist healthcare institutions were developed to ensure safer health practice for both patients and providers. They provide evidence-based goals to create a safer environment for medical institutions. It is essential to follow them to increase the quality of patient care and impact the medical field. Training contributes to greater efficiency leading to staff development, internal promotion, and success of organizational plans (Chaghari et al., 2017).
Audiences Role
Nurses play an instrumental role in improving health standards in the field. It is vital to update and improve ones knowledge and practical skills through in-service training. The audience is responsible for the active participation and implementation of strategic planning. Audience participation can lead to effective learning and professional development. The nurses should be aware of the learning objective and facilitate their own learning and assessment. Self-centred learning is proven to be an efficient learning technique in the medical field (Chaghari et al., 2017).
The staff members comprehend the necessity of the event and distribute the roles among themselves. It facilitates leadership and better resource management. The audience actively suggests new ideas or doubts about already existing recommendations. They contribute by providing cases from professional practice and representing patient care issues. Through the collection of various methods and diverse information about the issue, the audience educates oneself by collaborating.
The communication with the audience needs to be transparent and persuasive to increase buy-in. Persuasive communication allows the speaker to establish the need for the activity and inspire the listeners to participate. Transparent communication allows the audience to better understand the processes, clear the perception, and make the audience feel more comfortable with the plan.
Audiences Importance
The responsibility for self-learning, program engagement, plan implementation, and the following positive outcomes lies primarily on the audience. The awareness of the results interconnectedness with audience participation allows creating a more collaborative interprofessional environment. The nurses can assert their views and facilitate consensus through integration. The outcomes and decisions depend on the degree of engagement. Active audience participation also allows to design new work models and develop new delivery models (American Organization of Nurse Executives, 2015).
Participation Benefit
The benefits of participation do not end on individual advantages and professional development. The community benefits from the increased efficiency of the staff and a medical organization. The nurse participating in the following program becomes influential for improving patient care and populations health and reducing the overall cost of health care (American Organization of Nurse Executives, 2015).
New Processes
The in-service program incorporates new methods and processes to achieve the set outcomes. Strategic planning develops management skills in finance, human resources, and information. Participating in a staff group session allows developing and implementing outcome-based management, learning new business models for health care organizations, and identifying technological trends as they apply to medication administration. The staff also learns the relationship building processes through conflict resolution. Sharing the patient care models allows the staff members to evaluate the overall effectiveness, assess the risks, and introduce the new delivery models.
New Skills
The in-service program Participation in the program contributes to team building, and leadership development increases the knowledge of the health care environment and the patient care and fosters professional and business development. Communication and relationship building skill allows the audience to make the communication more effective, manage relationships, and involve the community in solving health care issues. Developing leadership fosters foundational and systems thinking, encourages succession planning, and improving the management. In-depth knowledge of the health care environment improves clinical practice knowledge, outcome measurement, and research. Increased patient safety improves overall performance and decreases risks. Professional skills, such as ethics, accountability, and advocacy, get enhanced. The business itself benefits because of the better human resource, strategic, and information management. All these outcomes create fruitful cooperation that allows nurses to impact the field of medicine (American Organization of Nurse Executives, 2015).
Emergency Simulation Scenario Activity
Various activities can contribute to a better understanding of the safety improvement initiative. Emergency simulation proves to be the best activity to encourage skills implementation and medical knowledge integration in a real-life scenario. The simulation combines the teaching methods and set guidelines applied to emergency scenarios. The simulation should be engineered to provide the staff with the medical practice of using particular devices and medicine and enhancing their cognition and teamwork skills. Such an emergency simulation allows a reduction of the risk of device misuse or medication maladministration and battles the root-cause of communication problems (Joint Commission, 2020).
The simulation practice activity consists of the scenario background introduction, distribution of the roles, scenario setup, and debrief. Based on the case study, the scenario is designed by the team and gets adjusted to the individual facility. Then the group distributes the roles where they operate as a team using a particular device. The roles should include a patient and medical workers. The audience needs to plan all the necessary supplies and equipment for the simulation activity as well. The scenario commences while being monitored by the other members of the team. Then a debrief is provided with the questionnaire and a discussion.
Feedback
Through the in-service program, nurses implement a holistic approach to learning through enhancing practical skills and knowledge. The feedback is also an essential part of comprehensive learning according to the clinical monitoring performance model (Rakhudu et al., 2016). It implies that clinical supervision in the form of training, advocacy, facilitating, and feedback through a survey. The feedback is necessary as it overviews the activity and facilitates analysis and improvement. The analysis of the collected data and its integration is the basis for improved service and enhanced medical administration.
The feedback is collected during the debrief stage of the activity and requires answering a questionnaire. The answers should be more than yes or no to open questions and provide objective feedback. The examples of the questions about the activity can be the following: What did you do during the activity and why? Did you think the interventions were helpful? If not, explain why. How do you evaluate the team members communication? What aspects of the scenario did you find especially helpful?
Conclusion
Recognizing the existing mistakes is essential in all the study fields as the root causes are not always obvious. Various factors can lead to positive or negative consequences up to the death of the patient. Examining these mistakes according to the studys goals allows for creating guidelines for medical institutions and preventing recurrence in the future. However, the mistakes identification is not enough without the practical application of problem-based learning and in-service programs in the medical administration context. Collaboration between the staff members to impact organizational performance and patients safety is a fundamental activity. An in-depth analysis of the mistake and correlating factors is essential in creating a plan for further actions (Rakhudu et al., 2016).
References
American Organization of Nurse Executives. (2015). Nurse executive competencies [PDF]. Web.
Chaghari, M., Saffari, M., Ebadi, A., & Ameryoun, A. (2017). Empowering Education: A New Model for In-service Training of Nursing Staff. Journal of advances in medical education & professionalism, 5(1), 2632.
Joint Commission. 2020 National patient safety goals. Joint Commission. Web.
Rakhudu, M. A., Davhana-Maselesele, M., & Useh, U. (2016). Concept analysis of collaboration in implementing problem-based learning in nursing education. Curationis, 39(1), 113.
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