Evidence-Based Practice Capstone Change Project Topic (Term Paper Sample)

Evidence-Based Practice Capstone Change Project Topic
Abstract
The health care field has continued to evolve throughout the years and history. Many new developments in technology help promote effective health care promotion and documentation. With the ongoing COVID-19 pandemic, we are short-staffed with nurses, translating to documentations burnout. Nurses are obligated to chart three times per shift for each patient. With the short staffing because of the pandemic, nurses are doubled with patients, resulting in the implementation of pandemic charting. The nurses are only obligated to chart once per shift, and if something out of the ordinary happens, they will complete a focused assessment charting. When speaking with my preceptor about a change project, she stated that implementing pandemic charting as the normal charting method would be ideal. Focused assessments are done regardless of a pandemic or not. When charting three times per shift for each patient, the assessment is usually the same, and if it is different, that is documented in the focused assessment. The change I want to implement is to have pandemic charting as the new normal charting method. This will prevent documentation burnout and allow the nurses more time for patient care, and ensure less room for error.
Pandemic Charting Method
Patient's medical records are critical to the healthcare delivery system because they help nurses and other healthcare providers make decisions concerning patient care. Patient data can be obtained from the records department charged with entering patients' data during admissions in a care facility. Additionally, nurses also maintain patients' records through charting, which entails documenting all the medical services that a single patient has received during their stay or visit to the hospital. Patients' charts' data include diagnostic test results, medications issued, and medical procedures. In most hospitals, nurses must perform charting more than once per shift. The records of different periods are then compared and any issue arising addressed.
Despite the positive contributions of charting in care outcomes, the concept is also associated with nurse burnout, especially during the pandemic. First, the pandemic has increased the demand for healthcare services among various populations. As a result, nurses are expected to provide services to an increased number of patients. The situation is further worsened by the growing nurse shortage across many regions. The increase in the demand for healthcare services and nurses increases workload per nurse, leading to burnout. Furthermore, charting each patient more than once per shift increases nurse burnout.
Due to the changes in demand and supply in the healthcare sector due to the pandemic, there is a need to implement a new strategy or adjust the existing ones to address the needs of patients and care providers. One of the intervention measures is to adopt pandemic charting as the normal charting method in healthcare facilities. Pandemic charting will require nurses to perform the exercise only once per shift for each patient. However, in case of any issues with a patient, the nurses will conduct focused assessment charting to identify the main cause of the problem.
Adopting the pandemic charting approach is an effective strategy for several reasons. In most cases, the charting records always show similar results, which makes multiple charting in a single shift irrelevant. Secondly, minimizing the number of charting in a shift reduces nurse burnout. Nurse burnout leads to poor quality services and adverse care outcomes. Moreover, the nurses will focus more on addressing individual patients' needs with a reduced workload. Therefore, reducing the number of chartings per shift will enhance nurses’ performance and patient outcomes.
Lewin’s Change Theory
Implementing the proposed change in healthcare facilities requires an effective change management strategy. The primary objective of change management is to enhance the implementation process by controlling activities and helping the employees to adapt to the new system. Additionally, the management should also ensure that all employees are on board through active engagement and participation. Furthermore, various change management theories can be applied in implementing evidence-based intervention. Kurt Lewin’s change theory will be applied to manage the transition to the pandemic charting method for the proposed project. Lewin’s theory is divided into three main phases: unfreezing, moving, and refreezing (Hussain et al., 2018).
Unfreezing
Unfreezing is the first step in Lewin’s change model, and it involves creating awareness about the need for change (Hussain et al., 2018). The unfreezing phase is important because it prepares all the stakeholders to let go of the old processes and practices and adopt the new ones. Therefore, the stage involves soliciting stakeholders' buy-in. If this phase is not handled properly, the health facility administrators may face several challenges in implementing the new charting method. Some of the methods that can enhance the success of the unfreezing phase include stakeholder education, issue identification, and stakeholder engagement.
When applying the first step of Lewin’s theory in implementing the pandemic charting, the first task would be to make the management aware of the impact of the old charting method on nurses’ productivity. The step will require proof that the multiple charting within a single shift increases nurse burnout, which, in turn, reduces their productivity. Moreover, the hospital leaders also need to be educated or reminded of the impact of high levels of nurse burnout on patient and organizational outcomes. Furthermore, all the stakeholders, including nurses and the management, should be encouraged to participate actively and contribute to the change implementation. This objective can be achieved by assigning them tasks and explaining the goal (s) of the initiative.
Moving/Changing
The second phase of Lewin’s change model is moving, which entails implementing the intervention (Hussain et al., 2018). One of the activities in this step is identifying and evaluating alternative courses of action. Therefore, this step involves a lot of brainstorming, critical thinking, and decision-making. The moving stage also identifies factors that facilitate a smooth transition and the barriers to change (Hussain et al., 2018). As a result, the leaders should always look for strategies that enhance the positive factors and reduce the negative forces.
The alternative solution that can help minimize nurse burnout has been identified for the project. Therefore, the management team has the task of identifying the enhancers and barriers to the change. Examples of factors that can facilitate the smooth transition from the old charting to pandemic charting methods include support from the administration, positive attitude from employees, and having effective teams. On the other hand, the barriers to change may include resistance from stakeholders, low stakeholder participation, and unreliable leadership. These barriers can be eliminated through coaching, training, reassurance of the benefits of the new project, and stakeholder engagement and inclusion. Once the barriers have been eliminated, the healthcare facility can gradually introduce the pandemic charting method while doing away with the old one.
Refreezing
The final step in Lewin’s change model is refreezing, which refers to incorporating the new system into organizational policies and processes (Hussain et al., 2018). Apart from integrating the new method, refreezing also reduces further changes that may affect the status quo. Based on this description, the refreezing stage includes all the actions taken to ensure that the stakeholders use the new method. The stage also ensures that the stakeholders do not revert to the old methods (Hussain et al., 2018). Some of the activities that enhance the success of the refreezing stage include frequent monitoring of outcomes, setting up new organizational policies, and sharing success stories with the stakeholders.
When implementing pandemic charting as the new charting method, one of the activities in the final step of the model is to redraft the facility’s charting policies. The management should ensure that the new policy is written and shared with all the stakeholders to promote adherence. Additionally, the facility’s leadership should also conduct frequent interviews and evaluate the changes in nurse burnout rates to determine the strategy’s effectiveness. Finally, the management should also support the new policy by working on eliminating barriers and being in constant communication with the nurses to understand their progress.
Literature Review
Nurse Burnout
Nurse shortage is a healthcare problem that cuts across various regions. The shortage reduces the nurse-patient ratio, leading to a high burnout rate. Nurse burnout has significant adverse impacts on all the stakeholders in the healthcare sector. For example, the situation leads to demotivation and low productivity among nurses. Additionally, nurse burnout may also lead to low-quality care, which causes poor patient experience and outcomes. Finally, care organizations that perform poorly due to low-quality services are also at risk of losing their clients and government funding.
Apart from the shortage of nurses, the emergence of pandemics also increases burnout among care providers, including nurses. An excellent example is a Covid-19 pandemic that has increased the demand for healthcare services. ...