Overcoming Barriers and Enhancing Patient Care

Summary of Project

Introduction: In healthcare, change management is necessary because it assists the service providers to achieve desired care outcomes for the patients and offer them satisfactory care by overcoming the barriers and resolving the gaps in care.

Aim: The plan aims to explore the strategies to be implemented for pressure ulcer risk management and control among the UK elderly in hospital settings.

Methods: In discussing the way of project implementation, the PDSA cycle is to be used. The change management model to be used is Lewin’s Change Management model because it helps in easier accomplishment of change . The autocratic leadership style is to be followed in making the change because it helps in making quick decision for change and promote greater productivity.

Evaluation: The project is to be evaluated by using process evaluation model. The interview, survey and feedback are to be used in collecting information from the patients regarding the successfulness of the project.

Introduction

The change management is referred to the systematic process of managing transition or transformation of the goal, technologies and working approach of the organisation. In healthcare, change management is necessary because it assists the service providers to achieve desired care outcomes for the patients and offer them satisfactory care by overcoming the barriers and resolving the gaps in care. It is also important because it assists in overcoming error in care and promotes high-quality care to be delivered to the patients (Milella et al., 2021). Thus, a plan for change management to overcome the gaps and barriers in risk management and care for pressure ulcers in the elderly by the nurses will be discussed. This is because it would help to inform the strategies and way they are to be implemented to provide high-quality care and achieve effective prevention or control of pressure ulcer occurrence in the UK elderly.

Aim

The plan aims to explore the strategies to be implemented for pressure ulcer risk management and control among the UK elderly in hospital settings.

SMART Objectives

To enhance wound management regarding risk of pressure ulcers in UK elderly

To provide training to the nurses to develop skills for risk management and prevention of pressure ulcers in UK elderly

Discussion of Project Implementation

In discussing the way of project implementation, the PDSA cycle is to be used. This is because it is a problem-solving model which is efficient to draw out ideas and strategies in improving a process or way to execute any change in real work settings. It also supports continuous improvement required for successfully establishing any change (Christoff, 2018). The PDSA Cycle stands for plan, do, study and act (Christoff, 2018).

Plan

The Plan stage assists in recognising the opportunity of change and develop systematic steps to achieve the change (Christoff, 2018). In the planning stage, the stakeholders to be involved in achieving the plan is to be identified. The stakeholders are the individuals and groups who are to be influenced in the successful accomplishment of the change plan. It is often the knowledge and skill that is communicated and consulted with the people who will be responsible for determining the success of the initiative for change (Augustsson, Churruca & Braithwaite, 2019). In this change plan, the stakeholders are the nurses who are involved in delivering care for managing risk of pressure ulcers in the UK elderly in the hospital settings. In the successful accomplishment of change, the need for the change is to be communicated to the stakeholders. As argued by Kho, Gillespie & Martin-Khan (2020), lack of understanding regarding the need for the change makes the stakeholders lack interest in support the change. This is because they do not understand the value and purpose of supporting the change which makes them show avoidance in working towards the change.

In communicating the need of the change, the SWOT analysis is to be performed. This is because it would inform the strength and weaknesses to be faced with or without the change along with the opportunity they have in accomplishing the change and threats to be managed for successful achievement of the change (Abedi et al., 2018). According to SWOT analysis of the current change plan, the strength to be access with the change implementation is enhanced pressure ulcer risk management among the UK elderly in hospital settings and reduction in the prevalence of the condition. This is because promotion of effective nursing intervention and risk management of pressure ulcers would help in quality care delivery for lowering the prevalence of the condition in elderly (Sumarno, 2019). The weakness to be faced for not accomplishing the change is the increased cost of care and long hospital stays are to be faced by elderly with deteriorated health conditions.

The opportunity for the change is positive realisation of gaps in care by the nurses regarding pressure ulcer management. The awareness regarding gaps in care makes nurses understand they are to execute more effective actions in resolving them to achieve better care delivery to patients (Philpot, Ebbert & Hurt, 2019). However, the threat in making the current change is the lack of adequate funding. The lack of enough money in making change creates barriers to arrange adequate resources and services needed for accomplishing the change (Li et al., 2018). The communication of the vision and purpose of the change is important to make the stakeholders realise the goals of care to be achieved through the change (Butler, 2018). In this change management, intranet facility and social media communication is to be used in communicating the change plan and goals to the stakeholders. The change management model to be used is Lewin’s Change Management model because it helps in easier accomplishment of change within limited time and creates systematic complications in making any change (Harrison et al., 2021). At the current stage, the unfreeze steps of Lewin’s model is followed as actions are taken to unfreeze the steady process followed in pressure ulcer management which involves gaps in care. The autocratic leadership style is to be followed in making the change because it helps in making quick decision for change and promote greater productivity (Blaževičienė et al., 2018).

Act

The Change and Refreeze stages of Lewin’s model is applied in performing the actions in this stage. This is because in the Change stage, the stakeholders are found to have accepted to improve and show a willingness to make the change by fostering realisation of the importance of the change (Teguh, Hariyati & Muhaeriwati, 2019). According to this stage in the plan, the stakeholders making the change are required to perform actions in accomplishing the change. For this purpose, the stakeholders are required to play the role of showing increased interest in participating in pressure ulcer management training. Moreover, they are required to show affinity to learn regarding the way digital wound management, as well as quality assessment of pressure ulcer care, is to be performed for the elderly at risk of the condition in the hospital settings.

The Refreeze stage indicates the state when the stakeholders have moved towards transition in making a stable change which can be regarded as change equilibrium. In this stage, the stakeholders making the change internalise the new ways of working mentioned through the change in delivering care and performing their responsibilities for patients (Harrison et al., 2021). Thus, by this stage, the stakeholders involved in making the current change regarding pressure ulcer risk management are to internalise the skills and knowledge of pressure ulcer management mentioned in the training. Moreover, they are to apply them along with digital wound management and quality assessment of pressure ulcer care in delivering improved quality care to the elderly.

The nurse manager or supervisor is to be delegated in undertaking the aspect of the current project. This is because the nursing manager act as a supervisor to all nurses in the care environment to make them follow effective care standards so that the quality of care is maintained (Saleh et al., 2018). Thus, the delegation of responsibilities to the nurse manager from higher authorities in the current project would help them to create a closer environment where nurses can personally contact the supervisor in resolving their queries for making the change required for pressure ulcer management. The nurse manager also has the responsibility in ensuring patient as well as staff satisfaction in delivering care (Birken et al., 2018). Thus, the delegation of change management responsibility on nurse managers is appropriate as they can guide the change in care required without creating dissatisfaction of either the patient or nurses.

The nurse manager also has the responsibility in managing human and financial resources in care environment (Saleh et al., 2018). Thus, the delegation of the change management role on nurse managers is appropriate because they can develop effective plan in identifying ways to spend the existing finances and arrange other resources for the successful accomplishment of the change. One of the threats identified in accomplishing the change for pressure ulcer management is lack of effective finances. This is to be mitigated by arranging to crowdfund for the cause and asking nursing staffs along with patients to make donations informing way the finances will be used in the betterment of the nursing skills for the patients to access enhanced care regarding pressure ulcer management. The autocratic management approach is also to be used now because it would help the leader to create a clarified chain of commands to be followed by the nurses in making the change in faster way (McIntosh & Layland, 2019).

Do

In this phase, the prospective achievement from the implementation of the action are evaluated to determine the success of any project. In this process, the Process Evaluation Model will be used in evaluating the effectiveness of the project. This is because process evaluation helps in examining if the project is being executed as per the terms mentioned in the plan and if it has reached the target audience (May et al., 2018). As argued by Liu et al., (2019), the determination of the effectiveness of the program is considered to be futile if there is no certainty that the structure, objective, programming and audience determined in the project are met. This is because it indicates that the activities mentioned in the change management is not been performed accordingly to meet the requirement of change.

The process evaluation helps in measuring the activities and quality of the program and the audience for whom the change is made in the environment or organisation. The model mentions to determine if the project has reached the target group (May et al., 2018). In order to determine if the current project has reached the target group that is elderly at risk of pressure ulcer, feedback from the patients are to be taken regarding the care provided to them. This is because feedback from patients helps in determining the extent to which their needs and demands of care are gradually fulfilled in the care environment by the nurses (McAleavey, Nordberg & Moltu, 2021). The process evaluation model informs that for evaluating success of change management plan, the determination of all activities of the project reaching all parts of the target group is to be ensured (Liu et al., 2019). For this purpose, an observational analysis is to be made. This is because observation analysis helps to determine through observation to what extent project activities have reached to target patients in the real care environment by the nurses and analyse the information to relate with the project objectives. It is to determine to what extent the activities are executed as per the mentioned objectives.

The process evaluation mentions to determine if the participants and key stakeholders involved in participating in the change are satisfied with all the aspect of the project (May et al., 2018). For this purpose, the interview of the nurses and elderly patients at risk of pressure ulcer who are receiving care for the condition is to be performed. This is because it would help in determining the detailed attitude and feelings of the stakeholders and participants in the change leading to examine their level of satisfaction with the change. The process evaluation mentioned to determine if any changes in activities are made and if all the materials, presentation and information are suitable for target audience (May et al., 2018). In order to determine these aspects, the interview of the nurses and patients at risk of pressure ulcer is to be made to determine if they understood all aspects and process of the change.

Study

In order to determine if the intended aim in the study is achieved, the survey is to be performed. The survey helps in gathering quicker objective information from participants regarding the success of the study. It helps in examining the representativeness of individual experiences and views regarding the accomplishment of aim of the study (Moreno et al., 2020). Thus, survey questionnaire will be used in gathering the opinion of the nurses involved in taking care of elderly patients suffering from or at risk of pressure ulcers to inform to the extent they feel the aim is fulfilled through the current plan. In relation to the current project, the action to be taken differently in future is that stakeholders involved in accomplishing the change are to be involved at the beginning of the project to make them provide ideas regarding the way change is to be planned. This is because accessing ideas from increased stakeholders helps in the inclusion of diverse ways of making better change management in resolving issues in care. In addition, training is to be provided to nurses regarding the way quality assessment of care for pressure ulcer management in elderly in hospital settings is to be performed. This is because many nurses may lack effective idea regarding all the parameters to be examined for quality assessment regarding pressure ulcer care management in elderly in hospital settings. The current project is not related to any guidance or policy or quality improvement directives. The findings of the study will be reported to the senior nursing manager to make the individual understand the way the project has been accomplished. The information is to be shared at the end of the project by presenting a detailed project report regarding the impact of the determined actions taken in the project to care for patients.

Conclusion

The above discussion concludes that pressure ulcer is a prominent risk among the elderly in UK and strategies are to be taken to resolve it. Thus, the study has aimed to explore the strategies to be implemented for pressure ulcer risk management and control among the UK elderly in hospital settings. For this purpose, the PDSA cycle is followed in implementing the plan. The Lewin’s Change Management model is followed in making the change according to which information from the SWOT analysis is informed to the stakeholders responsible in establishing the change to motivate them in participating in the change. The intranet and social media will be used for communicating regarding the importance of the change. The process evaluation model is to be used for examining the success of the change and a survey will be performed for determining if the aim of the project plan is effectively fulfilled.

References

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Appendix

Grant Chart