NURS FPX 4010 Interview and Interdisciplinary Issue Identification Report

Assessment 2 Interview and Interdisciplinary Issue Identification

For this assessment, you will create a 2-4 page report on an interview you have conducted with a health care professional. You will identify an issue from the interview that could be improved with an interdisciplinary approach, and review best practices and evidence to address the issue.

As a baccalaureate-prepared nurse, your participation and leadership in interdisciplinary teams will be vital to the health outcomes for your patients and organization. One way to approach designing an improvement project is to use the Plan-Do-Study-Act (PDSA) cycle. The Institute for Healthcare Improvement describes it thus:

The Plan-Do-Study-Act (PDSA) cycle is shorthand for testing a change in the real work setting—by planning it, trying it, observing the results, and acting on what is learned. This is the scientific method adapted for action-oriented learning…Essentially, the PDSA cycle helps you test out change ideas on a smaller scale before evaluating the results and making adjustments before potentially launching into a somewhat larger scale project (n.d.).

You might also recognize that the PDSA cycle resembles the nursing process. The benefit of gaining experience with this model of project design is that it provides nurses with an opportunity to ideate and lead improvements. For this assessment, you will not be implementing all of the PDSA cycle. Instead, you are being asked to interview a health care professional of your choice to determine what kind of interdisciplinary problem he or she is experiencing or has experienced in the workplace. This interview, in Assessment 2, will inform the research that you will conduct to propose a plan for interdisciplinary collaboration in Assessment 3.

It would be an excellent choice to complete the PDSA Cycle activity prior to developing the report. The activity consists of four questions that create the opportunity to check your understanding of best practices related to each stage of the PDSA cycle. The information gained from completing this formative will promote your success with the Interview and Interdisciplinary Issue Identification report. This will take just a few minutes of your time and is not graded.

Reference

Institute for Healthcare Improvement. (n.d.). How to improve. http://www.ihi.org/resources/Pages/HowtoImprove/default.aspx

Demonstration of Proficiency

• Competency 2: Explain how interdisciplinary collaboration can be used to achieve desired patient and systems outcomes.
  • Summarize an interview focused on past or current issues at a health care organization.
  • Describe collaboration approaches from the literature that could be relevant in establishing or improving an interdisciplinary team to address an organizational issue.
• Competency 3: Describe ways to incorporate evidence-based practice within an interdisciplinary team.
  • Identify an issue from an interview for which an evidence-based interdisciplinary approach would be appropriate.
• Competency 4: Explain how change management theories and leadership strategies can enable interdisciplinary teams to achieve specific organizational goals.
  • Describe change theories and a leadership strategy that could help develop an interdisciplinary solution to an organizational issue.
• Competency 5: Apply professional, scholarly, evidence-based communication strategies to impact patient, interdisciplinary team, and systems outcomes.
  • Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.
  • Apply APA formatting to in-text citations and references, exhibiting nearly flawless adherence to APA format.

Professional Context

This assessment will introduce the Plan-Do-Study-Act (PDSA) Model to create change in an organization. By interviewing a colleague of your choice, you will begin gathering information about an interprofessional collaboration problem that your colleague is experiencing or has experienced. You will identify a change theory and leadership strategies to help solve this problem.

Scenario

This assessment is the first of three related assessments in which you will gather interview information (Assessment 2); design a proposal for interdisciplinary problem-solving, (Assessment 3); and report on how an interdisciplinary improvement plan could be implemented in a place of practice (Assessment 4). At the end of the course, your interviewee will have a proposal plan based on the PDSA cycle that he or she could present to stakeholders to address an interdisciplinary problem in the workplace.

For this assessment, you will need to interview a health care professional such as a fellow learner, nursing colleague, administrator, business partner, or another appropriate person who could provide you with sufficient information regarding an organizational problem that he or she is experiencing or has experienced, or an area where they are seeking improvements. Consult the Interview Guide [DOCX] for an outline of how to prepare and the types of information you will need to complete this project successfully.

Remember: this is just the first in a series of three assessments.

NURS FPX 4010 Interview and Interdisciplinary Issue Identification Report Instructions

For this assessment, you will report on the information that you collected in your interview, analyzing the interview data and identifying a past or current issue that would benefit from an interdisciplinary approach. This could be an issue that has not been addressed by an interdisciplinary approach or one that could benefit from improvements related to the interdisciplinary approach currently being used. You will discuss the interview strategy that you used to collect information.

Your interview strategy should be supported by citations from the literature. Additionally, you will start laying the foundation for your Interdisciplinary Plan Proposal (Assessment 3) by researching potential change theories, leadership strategies, and collaboration approaches that could be relevant to issue you have identified. Please be certain to review the scoring guide to confirm specific required elements of this assessment. Note that there are differences between basic, proficient and distinguished scores.

When submitting your plan, use the Interview and Issue Identification Template [DOCX], which will help you to stay organized and concise. As you complete the template, make sure you use APA format for in-text citations for the evidence and best practices that are informing your plan, as well as for the reference list at the end.

Additionally, be sure to address the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so you understand what is needed for a distinguished score.

• Summarize an interview focused on past or current issues at a health care organization.
• Identify an issue from an interview for which an evidence-based interdisciplinary approach would be appropriate.
• Describe potential change theories and leadership strategies that could inform an interdisciplinary solution to an organizational issue.
• Describe collaboration approaches from the literature that could facilitate establishing or improving an interdisciplinary team to address an organizational issue.
• Communicate with writing that is clear, logically organized, and professional, with correct grammar and spelling, and using current APA style.

Additional Requirements

• Length of submission: Use the provided template. Most submissions will be 2 to 4 pages in length. Be sure to include a reference page at the end of the plan.
• Number of references: Cite a minimum of 3 sources of scholarly or professional evidence that support your central ideas. Resources should be no more than 5 years old.
• APA formatting: Make sure that in-text citations and reference list follow current APA style.

NURS FPX 4010 Interview and Interdisciplinary Issue Identification Report Assessment 2: Interview Summary Example

The interview was with Ms. Decker (not her actual name). Miss Decker is a unit manager in the medical unit of a teaching and regional hospital in my state. She agreed to have the interview with me via zoom meeting due to convenience and time constraints. The healthcare organization in which Decker works is a big facility that offers inpatient and outpatient care in pediatric, medical, surgical, obstetric, oncological, dental, and psychiatric care.

Her unit, the medical unit, has the largest bed capacity and the number of nurses and other healthcare workers in the hospital. As a unit manager, she has leadership and management roles in the unit that involves both direct clinical and administrative duties. She oversees the quality improvement projects and answers directly to the chief nursing executive, the overall coordinator of care quality and patient safety in the healthcare organization.

More than 18 months ago, her healthcare organization was recording increasing incidences of medication errors despite having implemented Epic^® electronic health records technology to improve patient safety and care quality more than six years ago. Therefore, the quality team convinced the hospital budgetary and administrative team to implement new technology, barcode medication administration (BCMA) systems.

Eighteen months after BCMA implementation, the healthcare organization still recorded a high number of medication errors. From the interview, she also said that the quality team of which she is a member plans to sit next month to discuss these quality outcomes and plan the next steps. Her organizational administrative culture encourages communication and collaboration between various healthcare professionals involved in direct care and those providing auxiliary services.

Whenever patient safety is at risk, healthcare professionals are allowed to report these incidences for immediate preventive action to their unit managers first before involving higher administrative personnel in the facility. Ms. Decker has had to communicate with other unit managers to compare implementation strategies and share ideas with other departments regarding patient safety and care quality. As a nurse leader, she is also a member of an interdisciplinary team that works with the office of the chief nursing executive to promote care quality.

Issue Identification

The use of technology has been associated with improvement in care quality. However, not all time does this quality results after the implementation of these technologies. Other factors, both human, system, and medication-related, impact the quality outcomes, especially in medication error prevention. From this interview, the clinical issue concerned the lack of achievement of goals of patient safety improvement using additional technology. According to Al-Ahmadi et al. (2020), medication errors are usually multifactorial and multidisciplinary in etiology and risk factors in the same setting or the same patient situation.

The problem, being a multidisciplinary clinical issue, an interdisciplinary approach could offer better outcomes. From my interviewee’s practice setting, the medication use and treatment process involve not only nurses and doctors but also pharmacists, informaticists, and technologists. The patient still remains the chief stakeholder in medication use. Issues such as policy deviations, distractions, usability, and consistency in technology greatly affect the outcomes of technology in medication error prevention (Mulac et al., 2021; Rasool et al., 2020). Therefore, an interdisciplinary approach would be appropriate for this issue.

Change Theories That Could Lead to an Interdisciplinary Solution

Kotter’s Change Management Model is a potential theoretical model that would be used to develop and facilitate an interdisciplinary team in finding a solution to this issue. This theory emphasizes creating a sense of urgency and forming a coalition that would lead to short-term wins. This theory would be appropriate for this clinical issue because it would bring together all stakeholders by creating the need and urgency for a team approach.

Such intervention would incorporate the aforementioned human and system factors that lead to medication errors. A systematic review study by Harrison et al. (2021) assessed various change models and nursing and healthcare practice and found that Kotter’s model applied to both direct care and management situations in facilitating change. This source is peer-reviewed, current, and authoritative and provides relevant and reliable findings. Therefore, it is a credible source.

Leadership Strategies That Could Lead to an Interdisciplinary Solution

Leadership strategies that would help in developing an interdisciplinary solution are open communication and collaboration, provision of education and training, encouraging team diversity and inclusivity, and shared decision-making. These strategies promote a team approach by bringing together all stakeholders with a common goal. Utilizing Kotter’s change model would be possible when these strategies are employed by the nurse leader.

Creating a sense of urgency in the coalition would be facilitated by communicating, sharing, and setting goals among a diverse group from relevant disciplines. According to Caulfield and Brenner (2020), engaging patients and their families require that health professional deliver education with objectives targeting medication error prevention. Involving a group of different professionals provides multidisciplinary prevention. This source was from a retrospective clinical research published in a peer-reviewed journal called BioMed Central. This source is also credible because it is current and relevant.

Collaboration Approaches for Interdisciplinary Teams

Interdisciplinary rounding, case conferences, and shared decision-making are three approaches that would be useful in creating and improving interdisciplinary teams. Interdisciplinary rounding would promote face-to-face interaction between nurses, pharmacists, and prescribers to discuss specific patient cases and implement together strategies to prevent medication errors.

During these rounds, shared decision-making can be made possible. At higher leadership levels, it is advisable to use case conferences to promote patient-centered care by focusing on patient-specific strategies in interdisciplinary meetings. Implementing Shared decision-making for this during conferences and interdisciplinary rounding would ensure that the process for transition between the prescriber, the dispenser, and the medication administrator is name possible through direct physical communication.

Chances of medication errors are therefore reduced by timely and effective communication. According to a qualitative study by Salar et al. (2020), some of these strategies promote professional actions and presenting technical strategies among interdisciplinary teams. This source interviewed healthcare professionals and is peer-reviewed. The content and findings relate to what we see in practice today and are thus valid. Overall, it is a credible source.     

Conclusion

Medication error prevention using technology may not be foolproof. Consideration of different factors requires the incorporation of interdisciplinary actions. In this healthcare issue, the problem was the underachievement of medication prevention goals despite using technology. The interdisciplinary approach would promote the finding of a solution through Kotter’s change management model, communication and collaboration, provision of education and training, encouraging team diversity and inclusivity, and shared decision-making in nursing leadership. Interdisciplinary rounding, case conferences, and shared decision-making are approaches that would promote interdisciplinary collaboration. Credible sources have been used to back up the argument for these strategies because these sources are current, authoritative, relevant, accurate, and purposeful.

References

Al-Ahmadi, R. F., Al-Juffali, L., Al-Shanawani, S., & Ali, S. (2020). Categorizing and understanding medication errors in hospital pharmacies concerning human factors. Saudi Pharmaceutical Journal: SPJ: The Official Publication of the Saudi Pharmaceutical Society, 28(12), 1674–1685. https://doi.org/10.1016/j.jsps.2020.10.014

Caulfield, J. L., & Brenner, E. F. (2020). Resolving complex community problems: Applying collective leadership and Kotter’s change model to wicked problems within social system networks. Nonprofit Management & Leadership, 30(3), 509–524. https://doi.org/10.1002/nml.21399

Harrison, R., Fischer, S., Walpola, R. L., Chauhan, A., Babalola, T., Mears, S., & Le-Dao, H. (2021). Where do models for change management, improvement, and implementation meet? A systematic review of the applications of change management models in healthcare. Journal of Healthcare Leadership, 13, 85–108. https://doi.org/10.2147/JHL.S289176

Manias, E., Street, M., Lowe, G., Low, J. K., Gray, K., & Botti, M. (2021). Associations of person-related, environment-related and communication-related factors on medication errors in public and private hospitals: a retrospective clinical audit. BMC Health Services Research, 21(1), 1025. https://doi.org/10.1186/s12913-021-07033-8

Mulac, A., Mathiesen, L., Taxis, K., & Gerd Granås, A. (2021). Barcode medication administration technology use in hospital practice: a mixed-methods observational study of policy deviations. BMJ Quality & Safety, 30(12), 1021–1030. https://doi.org/10.1136/bmjqs-2021-013223

Rasool, M. F., Rehman, A. U., Imran, I., Abbas, S., Shah, S., Abbas, G., Khan, I., Shakeel, S., Ahmad Hassali, M. A., & Hayat, K. (2020). Risk factors associated with medication errors among patients suffering from chronic disorders. Frontiers in Public Health, 8, 531038. https://doi.org/10.3389/fpubh.2020.531038

Salar, A., Kiani, F., & Rezaee, N. (2020). Preventing the medication errors in hospitals: A qualitative study. International Journal of Africa Nursing Sciences, 13(100235), 100235. https://doi.org/10.1016/j.ijans.2020.100235

Interview and Interdisciplinary Issue Identification Scoring Guide

CRITERIA	NON-PERFOR MANCE	BASIC	PROFICIENT	DISTINGUISHED
Summarize an	Does not	Discusses an	Summarizes an	Summarizes an
interview focused on	summarize an	interview, but the	interview focused on	interview focused on
past or current issues	interview focused	focus of the interview,	past or current issues	past or current issues at
at a health care	on past or current	the issues addressed,	at a health care	a health care
organization.	issues at a health	or the specifics of	organization.	organization. Notes
	care organization.	health care		strategies employed in
		organizational context		the interview to ensure
		are unclear or		that sufficient
		missing.		information was
				gathered.
Identify an issue from	Does not identify	Identifies an issue	Identifies an issue	Identifies an issue from
an interview for which	an issue from an	with an unclear	from an interview for	an interview for which an
an evidence-based	interview for which	connection to the	which an evidence-	evidence-based
interdisciplinary	an evidence-based	interview or for which	based	interdisciplinary
approach would be	interdisciplinary	an evidence-based	interdisciplinary	approach would be
appropriate.	approach would be	interdisciplinary	approach would be	appropriate, providing
	appropriate.	approach seems	appropriate.	one or more specific
		inappropriate.		reasons to justify this
				approach.
Describe potential	Does not describe	Identifies change	Describes potential	Describes potential
change theories and	potential change	theories and	change theories and	change theories and
leadership strategies	theories and	leadership strategies	leadership strategies	leadership strategies
that could help	leadership	that are unclear,	that could help	that could help develop
develop an	strategies that	incomplete, or	develop an	an interdisciplinary
interdisciplinary	could help develop	irrelevant to	interdisciplinary	solution to an
solution to an	an interdisciplinary	developing an	solution to an	organizational issue.
organizational issue.	solution to an	interdisciplinary	organizational issue.	Notes which sources
	organizational	solution to an		seem most credible or
	issue.	organizational issue.		relevant to the specific
				organizational issue.
Describe	Does not describe	Identifies	Describes	Describes collaborative
collaborative	collaborative	collaborative	collaborative	approaches from the
approaches from the	approaches from	approaches from the	approaches from the	literature that could be
literature that could	the literature that	literature but the	literature that could	relevant in establishing
be relevant in	could be relevant	relevance to	be relevant in	or improving an
establishing or	in establishing or	establishing or	establishing or	interdisciplinary team to
improving an	improving an	improving an	improving an	address an
interdisciplinary team	interdisciplinary	interdisciplinary team	interdisciplinary team	organizational issue.
to address an	team to address	to address an	to address an	Notes which sources
organizational issue.	an organizational	organizational issue	organizational issue.	seem most credible or
	issue.	is unclear or		relevant to the specific
		insufficiently		organizational issue.
		explained.
Organize content so	Does not organize	Organizes content	Organizes content so	Organizes content with a
ideas flow logically	content for ideas.	with some logical flow	ideas flow logically	clear purpose. Content
with smooth	Lacks logical flow	and smooth	with smooth	flows logically with
transitions; contains	and smooth	transitions. Contains	transitions; contains	smooth transitions using
few errors in	transitions.	errors in	few errors in	coherent paragraphs,
grammar/punctuation,		grammar/punctuation,	grammar/punctuation,	correct
word choice, and		word choice, and	word choice, and	grammar/punctuation,
spelling.		spelling.	spelling.	word choice, and free of
				spelling errors.

 

CRITERIA	NON-PERFORMANCE	BASIC	PROFICIENT	DISTINGUISHED
Apply APA formatting	Does not apply	Applies APA	Applies APA	Exhibits strict and
to in-text citations	APA formatting to	formatting to in-text	formatting to in-text	flawless adherence to
and references	headings, in-text	citations, headings	citations and	APA formatting of
exhibiting nearly	citations, and	and references	references, exhibiting	headings, in-text
flawless adherence to	references. Does	incorrectly and/or	nearly flawless	citations, and
APA format.	not use quotes or	inconsistently,	adherence to APA	references. Quotes and
	paraphrase	detracting noticeable	format.	paraphrases correctly.
	correctly.	from the content.
		Inconsistently uses
		headings, quotes
		and/or paraphrasing.