Overcoming Resistance to a Needed Change

Overcoming Resistance to a Needed Change

Table of Contents

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Instructions

Overcoming Resistance to a Needed Change

You are the charge nurse of a medical/surgical unit. Recently, your hospital spent millions of dollars to implement a bedside medication verification (BMV) system to reduce medication errors and to promote a culture of patient safety.

In this system, the nurse, using a handheld device, scans the drug he or she is planning to give against the patient’s medication record to make sure that the right drug, at the right dose, is being given at the right time to the right patient.

Overcoming Resistance to a Needed Change

The nurse then scans the patient’s name band/arm band to assure the right patient is receiving the drug and finally scans his or her own name badge to document who is administering the drug to the patient. If any of the codes do not match, a signal goes off, alerting the nurse of the discrepancy.

It has come to your attention, however, that some nurses are overriding the safety features built into the bar coding system.

Overcoming Resistance to a Needed Change

For example, some nurses are reluctant to wake sleeping patients to scan his or her bar code before they administer an intravenous push medication and instead simply scan the chart label.

Some nurses have overridden the bar code warning, assuming it was some kind of technological glitch. Some nurses have administered drugs to patients despite having name bands that have become smudged or torn and no longer scan well. Still, other nurses are carrying multiple prescanned pills on one tray or charting that drugs have been given, even though they were left at the bedside.

Finally, you learned that one nurse even affixed extra copies of her patient’s bar codes to her clipboard, so that they could be scanned more quickly.

Assignment:

Overcoming Resistance to a Needed Change

Despite thorough orientation and training regarding BMV, some staff have developed “work-arounds” to the bar coding system, increasing the risk of medication errors and patient harm.

Your staff suggests that although they understand BMV reduces risks to patients, the equipment does not always work and performing the additional safety checks often takes them more time than how they did it in the past, ultimately delaying medications to patients who need them.

The staff states they will try to be more careful in implementing the BMV procedures, but you continue to sense resistance on their part. What strategies could you employ now to foster refreezing of the new system? Would rational–empirical, power–coercive, or normative–re-educative strategies be more effective? Provide a rationale for your choice.

Overcoming Resistance to a Needed Change

RUBRIC
Excellent Quality 95-100%	Introduction 45-41 points The background and significance of the problem and a clear statement of the research purpose is provided. The search history is mentioned.		Literature Support 91-84  points The background and significance of the problem and a clear statement of the research purpose is provided. The search history is mentioned.			Methodology 58-53 points Content is well-organized with headings for each slide and bulleted lists to group related material as needed. Use of font, color, graphics, effects, etc. to enhance readability and presentation content is excellent. Length requirements of 10 slides/pages or less is met.
Average Score 50-85%	40-38 points More depth/detail for the background and significance is needed, or the research detail is not clear. No search history information is provided.		83-76  points Review of relevant theoretical literature is evident, but there is little integration of studies into concepts related to problem. Review is partially focused and organized. Supporting and opposing research are included. Summary of information presented is included. Conclusion may not contain a biblical integration.			52-49  points Content is somewhat organized, but no structure is apparent. The use of font, color, graphics, effects, etc. is occasionally detracting to the presentation content. Length requirements may not be met.
Poor Quality 0-45%	37-1 points The background and/or significance are missing. No search history information is provided.		75-1 points Review of relevant theoretical literature is evident, but there is no integration of studies into concepts related to problem. Review is partially focused and organized. Supporting and opposing research are not included in the summary of information presented. Conclusion does not contain a biblical integration.			48-1 points There is no clear or logical organizational structure. No logical sequence is apparent. The use of font, color, graphics, effects etc. is often detracting to the presentation content. Length requirements may not be met
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