Interview and Interdisciplinary issues

Interview Summary Absemi's Structured Interview Strategy has been used in the interview process to understand an interviewee’s Organization. As an interviewer, my responsibility is to understand the issues of the interviewee. The interviewee is a nurse, and the purpose of the interview is to understand her duties and roles, current and past problems, issues of diverse populations, the effectiveness of interventions, interdisciplinary collaboration, leadership strategies, and the role of nurses in the organization. 2 The nurse works in a private acute healthcare facility (non-profit) with different units and 75 beds. The Organization is acquiring advanced technologies such as patient monitoring systems, EHRs, error reporting software, data analytics, telemedicine, and other technologies to enhance the quality of care (Afsar, 2019).

3 The nurse is working in an intensive care unit (ICU).  Her essential duties are to record, monitor, and report patient symptoms, data, and complications and coordinate, interpret and consult with healthcare professionals. In addition to this, she is also responsible for intravenous fluids, administering medication, maintaining equipment, creating sounds, and educating families and patients. 3 After understanding the role and organization, the interview schedule was discussed in a few sentences.  4 The entire interview style was flexible as it was consistent throughout, and the interviewee was given a full opportunity to discuss their perspective. However, the interview was based on open-ended questions to better understand past and current healthcare issues. More stress was exerted on benchmarks and statistics to understand the seriousness of the issue (Manias, 2018). 4 The nurse informed how past issues such as implementing telemedicine and EHRs affected both nurses and patients.  It was solved by implementing transformational leadership, training the nurses, and hiring specialized nurses to induce change.

Issue Identification The interviewee was also asked to prioritize the various issues based on severity, experience, and impact on the nurse and patients.  Past issues include workplace violence, nurse burnout, safety handling issues, and hazards such as hospital-acquired infections (HAIs) and patient falls.  3 However, HAIs and safety handling issues were below the average benchmark of "3,44 falls per 1000 patients" and 2.4 per patient. 4 Nurse burnout is a serious issue with other prevailing problems such as adverse events, medication errors, and increasing healthcare costs. Nurses faced various medication errors such as "discrepancies" 2 between medicine and prescription, interferences in drug administration, dispensing errors, adverse medication errors, and delays in care.  4 The nurse explained that medication errors are the most critical priority as these errors may lead to increased cost, blame culture, increased hospital stay, improved nurse burnout, and poor interprofessional collaboration (Hegge, 2020).

Identification of issues from the interview It is essential to mention that all issues need an evidence-based "interdisciplinary collaboration" to mitigate problems. When an issue includes multiple healthcare professionals, then collaboration is critical. 2 However, medication errors require a collaborative approach consisting of physicians, informatics nurses, lab technicians, pharmacists, and pain management nurses. The second reason is that errors can happen from anyone, so it can become challenging to find the root cause and detect errors when there is no interdisciplinary collaboration approach. For instance, if a patient is allergic to a particular medication and suffers from any complications, it will be challenging to know the root cause of the issue.

Interdisciplinary and interview issues Another essential issue is a delay in medical care that threatens quality care and patient safety. Any delay in medication administration can lead to several complications in patients. For instance, if the pharmacy gives the wrong medication and nurses have identified it, they are responsible for waiting for a response and reporting these errors. Another issue is blame culture in healthcare issues because various stakeholders are involved (Reed, 2020). For instance, a healthcare professional can prescribe medicine that may have an allergic reaction, improper disagreement, or a dosage sent without verifying the patient's medical history.

5 Change Theories That Could Lead to an Interdisciplinary Solution Lewin's change theory is based on unfreezing, moving, and unfreezing stages. The model can be used to deal with the issues of patient safety and quality of care. However, healthcare professionals can deal with Issues such as a blame culture where no one takes responsibility for medication errors. 4 The leadership theory facilitates unfreezing the present process to implement a change intervention and refreeze the process.  This helps in shared decision-making and collaboration.  2 Everette Rogers has updated Lewin's theory with additional stages, including interest, learning, implementation, evaluation, and adoption.

The theories help in motivating healthcare professionals towards change. However, it is crucial to evaluate the change process to monitor whether the interventions are beneficial or not. This objective can be achieved through Spradley's change theories with eight steps in which change stabilizes up, and evaluation plays an important role (Borel, 2021). These theories can be beneficial in understanding the perspective of different healthcare professionals, interventions, and processes.

6 Leadership Strategies That Could Lead to an Interdisciplinary Solution It is a known fact that the change can come with resistance, servant and Transformational leadership styles can help increase collaboration among the interdisciplinary team.  4 The leaders must use Strategies such as understanding the perspective of leaders, group discussion, creating an action plan, motivating professionals, creating an inclusive culture, shareholder's perspective, using root cause analysis, and offering direct communication channels along with a proper error reporting system so that patients get timely medication with no delay in communication. Also, it is important to share work burdens and reduce interference through effective scheduling and staffing.

Collaboration Approaches for Interdisciplinary Teams The literature has highlighted the positive influence of the medication error system on reducing medication errors. 2 The scholars have proposed a multimodal collaboration model consisting of communication tools such as communication logs, direct pharmacist involvement, collaborative medical review, and collaboration workshops and conferences. The model is essential because it addresses and influences all disciplines related to issues with medication errors. 3 Similarly, root cause analysis can also be used with a safety checklist to detect discrepancies. This is one of the most effective sources to deal with issues of wrong information. The system is also crucial because it integrates various approaches to enhance interdisciplinary collaboration regarding medication errors.

References

Afsar, B. (2019). 7 Does thriving and trust in the leader explain the link between transformational leadership and innovative work behavior?  A cross-sectional survey.  8 Journal of Research in Nursing.

Borel, M. C. (2021). Guideline for incorporating the Delphi method in the evaluation of nursing theories. Rev. Latino-Am. Enfermagem.

Hegge, M. J. (2020). 9 A Book Review of Nursing Theories and Nursing Practice (5th ed.), edited by Marlaine C. Smith. (2020). F.A. Davis Company. Nursing Science Quarterly.

Manias, E. (2018). 2 Effects of interdisciplinary collaboration in hospitals on medication errors:  an integrative review.  Expert Opinion on Drug Safety, 259-275.

Reed, P. G. (2020). 10 The Epistemic Dignity of Knowledge Developed Through Nursing Practice. Nursing Science Quarterly.