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Frameworks for Becoming a Transformational Leader

Introduction to Electronic Medication System in Nursing

Many hospitals face serious issues like unsatisfactory delivery of quality care, ineffective communication between the patients and health care providers, and others due to insufficient facilities or technologies available in health care departments and centres. However, the use of electronic medication systems not only ensures effective communication, but also provides improve patient safety, access to medical records across a wide area, and active or passive decision support (Westbrook et al., 2016). These advanced technologies generate a change in healthcare centers and provide effective delivery of care services to the patients. These modern technologies reduce many errors and provide many benefits as well. This essay will discuss the reasons for adopting an electronic medication system. The latter sections will also discuss the leadership style to the plan of change and the resistance faced as well.

The Reasons to Adopt Electronic Medication System

The electronic medication system should be adopted as it is not less than a silver bullet that offers various advantages in healthcare. According to Pearce & Whyte (2018), the electronic medication system is a closed-loop system that encompasses barcode medication administration, automated dispensing cabinets, smart infusion pumps, pharmacy review, administration, prescribing, and anything that has electronic medicines datasets. This approach has several benefits like it ensures intensive care of the patients, improves overall legibility, easy access to the medical records, improves access to medication histories, and also decreases interpretive errors. Moreover, the systems can be standardized in response to many factors like acute coronary syndromes, vaccinations, pain management, standardized prescribing protocols for specific conditions, and many others (Hunt et al., 2018).

All these ensure the patient’s safety and quality care of the patient. According to Raban et al. (2019), such systems have alert systems help in on time medication administrations and no skipping/missing of doses. It also reduces the risk of dosing errors, provides clinical alerts, and allows the standardization of orders. The electronic medication systems reduce medication safety risks to the organization and the patient and provide the advantages of a single medication chart. Other reasons for adoption are like this system provides patient’s satisfaction with a personalized medication support system and provide less stay of the patients in the hospitals. All these factors enable effective care of the patient so electronic medication systems should be adopted in the hospitals and healthcare centers.

The Lewin’s Model for Plan of Change

According to Teguh et al. (2019), Lewin’s model has 3 stages – unfreezing, change process, and refreezing. This model is used to outline a plan for a change with timeframe and milestones. As per the step one of Lewin’s model, first, a 3-month survey will be conducted in the hospital to know about the regions where the change is required and why it is required. Like in hospitals the ineffective communication and difficulty in access to medical records create problems that need to be changed. Then, the patients and the health care professionals should be asked to contribute their efforts and support for the same. As per the second stage of the model, 2 months will be time framed for the change. In this, the information flow will be according to the hierarchy like from patient to nurse and then to the higher health professional authorities and vice-versa. So that everyone is involved in the plan of change. During this phase, the involved members in the plan of change should be made aware of the features of electronic medication systems that ensure effective communication. As per the third stage of the model, 3 months should be time-framed. In this, training will be conducted about how to use the systems, feedbacks from the patients will be noted for further new points or ideas.

A Leadership Style to Plan of Change

The transformational leadership style can be used to apply the plan of change. According to Broome & Marshall (2017), the leaders should be honest, open-minded and develop a strong relationship with all with whom he/she works with like the patients, higher health authorities and other health professionals. The leader/nurse unit manager should have qualities like critical thinking, problem-solving, and knowledge about the healthcare sectors resulting in a better and effective plan of change. The leader can be a nurse or a senior health care professional who can have his/her team with whom the plan will be executed. The leader/nurse unit manager should recruit those nurses who have high order thinking abilities and effectively communicate with co-workers and patients. This will ensure complete feedback from the patients and other health professionals regarding the plan of change and will also provide us with new ideas presented by the participants (Namnabati & Taleghani, 2017).

The leader should ensure that the nurses and other health professionals are trained well during the training so that the systems are easy to use at their ends and they in turn can help the patients to access the systems (Broome & Marshall, 2017). An effective leader who can organize the plan and execute it effectively will help in the removal of various barriers and roadblocks. This style will gain staff satisfaction and in turn, reflect with a major positive impact on reducing the rate of patient care errors. Moreover, the leader with a transformational style will encourage patients and staff in the plan of change towards a new direction (Fischer, 2016).

The Application of Transformation Leadership Style and Comparison to The Democratic Leadership Style

The transformation leadership style adopted for a plan of change can also face many barriers if the leader itself had less strategic planning skills and less knowledge about the facts and issues in the nursing/healthcare field. It can ineffective in ad-hoc or initial stages of initiatives. According to Vaismoradi et al. (2016), this type of style requires a pre-existing structure or model so that plan of change or development can be started. Therefore, growth can be planned as it is not an ideal style for those organizations that are brand new. According to Masood & Afsar (2017), transformational style can lead to the outcomes of negative impacts and it requires constant feedback, which if not taken then the plan of change might fail because in healthcare or nursing every patient has different needs and medical requirement and if they left unattended then quality care will not be delivered.

Another style is a democratic leadership style. According to Cope & Murray (2017), this always encourages the communication and inputs from the team that ultimately help a lot in decision making. It ensures that the team or members feel comfortable in speaking up and feel valued as well. The higher organizations always value expertise, not the ranks of seniority, making this style beneficial in creating a safe and culturally effective environment that ensures a good plan of change in healthcare. In transformation style, the decision making is left on workers whereas in decision making the team works together for decision making. The transformational style seeks to reward and punishment but the democratic style develops morals and satisfaction with patient care.

The Potential Resistances and Their Resolution

Some resistances might be faced – the issue with electricity and the other resistance can of the untrained next generation. As the implementation of an electric medication system depends upon the availability of electricity only. So, the hospital or nurse unit manager needs to ensure that the systems are all well set in all departments with sufficient space, well equipped, and made available with electricity 24/7 so that there is no lag in health professional’s end. According to Hodgkinson et al. (2017), the equipments in healthcare should be updated and well equipped. They should be timely checked and monitoring should be done. If the next generation is not trained about the use and importance of electronic medication systems then they will not be able to ensure effective communication and patient safety with the updated and modern technologies. The patient satisfaction can be unfulfilled and resulting in delivery of poor quality care of the patient. However, if the nurses or next generation health professionals are trained in their institutes and in their training hospital sessions then the issue can be resolved.

Conclusion on Electronic Medication System in Nursing

The electronic medication systems offer many benefits like it ensures intensive care of the patients, improves overall legibility, easy access to the medical records, improves access to medication histories, and also decreases interpretive errors. It also reduces the risk of dosing errors, provides clinical alerts, and allows the standardization of orders. The transformational leadership style can be used to plan the change in organizations. The democratic style can also be used to ensure the plan of change to be properly implemented in health care. The higher organizations always value expertise, not the ranks of seniority, making this style beneficial in creating a safe and culturally effective environment. However, there are many barriers that resist the improvement but with proper solution the issues can be easily resolved.

References for Electronic Medication System in Nursing

Broome, M., & Marshall, E. (2017). Frameworks for becoming a transformational leader. Transformational Leadership in Nursing, 145-170.

Cope, V., & Murray, M. (2017). Leadership styles in nursing. Nursing Standard31(43).

Fischer, S. A. (2016). Transformational leadership in nursing: A concept analysis. Journal of Advanced Nursing72(11), 2644-2653. https://doi.org/10.1111/jonm.12387

Hodgkinson, M. R., Larmour, I., Lin, S., Stormont, A. J., & Paul, E. (2017). The impact of an integrated electronic medication prescribing and dispensing system on prescribing and dispensing errors: A before and after study. Journal of Pharmacy Practice and Research47(2), 110-120. https://doi.org/10.1002/jppr.1243

Hunt, K. V., Harding, A. M., Taylor, S. E., & Curtain, C. (2018). Evaluation of medication dose omissions amongst inpatients in a hospital using an electronic Medication Management System. Journal of Evaluation in Clinical Practice24(4), 688-694.

Masood, M., & Afsar, B. (2017). Transformational leadership and innovative work behavior among nursing staff. Nursing Inquiry24(4), e12188.

Namnabati, M., & Taleghani, F. (2017). Nursing satisfaction with medication care by using neonatal electronic medication management systems. Iranian Journal of Neonatology IJN8(4), 43-56.

Pearce, R., & Whyte, I. (2018). Electronic medication management: Is it a silver bullet?. Australian Prescriber41(2), 32–33. https://doi.org/10.18773/austprescr.2018.012

Raban, M. Z., Walter, S. R., Pont, L. G., Cheung, L., Strumpman, D., & Westbrook, J. I. (2019). The potential impact of an electronic medication management system on safety‐critical prescribing errors in an emergency department. Journal of Pharmacy Practice and Research49(2), 108-115. https://doi.org/10.1002/jppr.1455

Teguh, A., Hariyati, R. T. S., & Muhaeriwati, T. (2019). Applicability of lewin's change management model for optimization management function in nursing delegation between head nurse and team leader: A mini project in Jakarta military hospital. International Journal of Nursing and Health Services (IJNHS)2(2), 66-74. https://doi.org/10.35654/ijnhs.v2i2.136

Vaismoradi, M., Griffiths, P., Turunen, H., & Jordan, S. (2016). Transformational leadership in nursing and medication safety education: A discussion paper. Journal of Nursing Management24(7), 970-980. https://doi.org/10.1111/jan.13049

Westbrook, J. I., Li, L., Raban, M. Z., Baysari, M. T., Mumford, V., Prgomet, M., & Dalla-Pozza, L. (2016). Stepped-wedge cluster randomised controlled trial to assess the effectiveness of an electronic medication management system to reduce medication errors, adverse drug events and average length of stay at two paediatric hospitals: A study protocol. BMJ Open6(10), e011811. http://dx.doi.org/10.1136/bmjopen-2016-011811

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