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Issue Identification and Background Explanation

The primary issue at hand, which I wish to address and rectify, revolves around the critical aspect of patient care within our surgical ward. Specifically, it concerns the lack of consistency in dressing change techniques and a concerning non-compliance with established ward policies (Dong & Guo, 2021). This issue possesses wide-ranging effects since it has led to a noticeably higher rate of patient readmissions, primarily as a result of the emergence of complications connected to wound breakdowns (Dong & Guo, 2021). The importance of this situation cannot be emphasized, as it has severe consequences for our patient's well-being and the overall quality of care. Dressing changes constitute a fundamental element of post-operative care (Seminara et al., 2023). They are a crucial component of the healing process, having an impact on our patients' psychological as well as physical rehabilitation (Reis et al., 2023). Patients deserve and expect a level of care that ensures their safety, comfort, and a smooth path to recovery (Reis et al., 2023). The existing state of affairs in our surgical ward not only falls short of this expectation, but also damages the trust that our community has in our healthcare services (Dong & Guo, 2021). The significance of adhering to standardized dressing change protocols is underscored by contemporary medical literature. From the research works of Perez, (2021) it is acknowledged that adherence to established protocols is paramount as it directly impacts patient outcomes and the overall quality of healthcare services. In accordance to the authors Nilsen et al., (2020) it is realized that consistency in dressing change techniques is vital for patient well-being. The observed discrepancy in techniques, potentially resulting from inadequate guidance and training, raises concerns about the possible safety of our patients (Nilsen et al., 2020). A coherent and standardized approach to dressing changes is essential to mitigate complications and reduce patient readmissions (Reis et al., 2023). By ensuring that all staff members follow established protocols, we can minimize the risk of wound breakdowns and other post-operative complications (Dong & Guo, 2021). As a result, our healthcare services will be more trusted and appreciated by patients.

Proposed Interventions

The first intervention I propose is the adoption of standardized wound care training and regular skill assessments for all surgical ward staff responsible for dressing changes (Redmond et al., 2020). The proposed approach is specific and highly achievable, and it directly addresses the inconsistency in dressing change techniques (Redmond et al., 2020). Several workshops and orientation sessions will be conducted so as to introduce the training program to all staff members (Farzi et al., 2018). These sessions will serve as a platform to explain the rationale behind the intervention, its objectives, as well as the expected outcomes. In order to engage stakeholders with this implementation, we can collaborate closely with the Nursing Education Department, which plays a pivotal role in staff training and development (PSA, 2022). Their expertise in educational strategies and training programs will be instrumental in designing and implementing wound care training. In addition, engaging our ward staff is essential as they are the direct implementers of dressing changes (PSA, 2022). We will involve them in the development of the training content, ensuring their experiences and challenges are considered. It can be said that regular skill assessments will be held to identify areas where improvement is needed and gather feedback from the staff members (Redmond et al., 2020).

Another intervention can be revising and reinforcing nursing policies related to providing safe patient care. This intervention is also specific and readily achievable, and it aims to ensure that nursing staff adhere to the protocols mentioned in the guidelines by NMBA for maintaining the safety of patients (NMBA, 2023). This intervention will improve our existing practices with the highest professional standards and enhance patient care by ensuring compliance with regulatory requirements. In order to make this implementation successful, we will collaborate with the hospital's quality improvement team, a vital stakeholder in policy development and adherence (Farzi et al., 2018). Their expertise in policy revision and implementation will be instrumental in this process. Regular meetings will be conducted where the NMBA policies regarding safe care (standard 6 th of NMBA) will be discussed between the staff members and the stakeholders (NMBA, 2023). In addition, clear and concise policy documents will be provided both in print and electronically to ensure easy reference (PSA, 2022). Moreover, regular audits will also be conducted to monitor compliance with the revised policies. The outcomes of the audit will be communicated transparently, highlighting areas of success and areas requiring improvement (Redmond et al., 2020). It can be said that with the help of regularly monitoring staff’s compliance to the nursing guidelines, this approach encourages accountability and identifies where additional support or training may be necessary.

Possible Barriers

Staff opposition to adopting new practices and procedures constitutes a substantial individual barrier to change in our surgical ward. As per the research works of authors Welsh, (2018) it is understood that the nursing staff who have been practicing in a certain style for a long time may be resistant to change due to being comfortable and familiar with their present routines. They may view new protocols and training as additional burdens or stressors in their already demanding roles (Welsh, 2018). Addressing this specific barrier will necessitate a cautious approach. Engaging with resistant employees to understand their issues and giving them a forum for them to express their concerns is critical (PSA, 2022). It is important to communicate clearly about the reasons for the change and benefits it provides to both patients as well as staff. Involving workers in decision-making and training program development can also help lessen opposition because it empowers them and provides them with a sense of ownership in the changes (NMBA, 2023).

An organizational barrier to change is the continued reliance on paper-based medical records in our health service district, while other health services are shifting to Electronic Medical Records (EMR) (Jedwab et al., 2019). This dependence on paper records may hinder the adoption of modern, technology-driven healthcare procedures, as well as present barriers to providing efficient and high-quality patient care (Negro-Calduch et al., 2021). The continual usage of paper-based medical records can lead to inefficiencies in obtaining and modifying patient information, causing errors and delays in care delivery (Jedwab et al., 2019). So, it can be said that reliance on paper-based medical records could end up in higher operational expenses, lower productivity, and lower patient satisfaction in the long run (Negro-Calduch et al., 2021). However, transitioning from paper records to EMR is a complex and resource-intensive process, so resistance to change might arise from the presumed uncertainties associated with this transition (Jedwab et al., 2019). Addressing this organizational barrier necessitates careful planning, resource allocation, and a phased implementation approach. It's crucial to provide the staffs with effective training and assistance as they adjust to EMR technologies. Clear communication about the benefits of EMR, such as improved data accessibility, reduced errors, and streamlined processes, is essential to gain support from stakeholders and staff (Jedwab et al., 2019).

Leadership Style: Transformational Leadership

The leadership style I will adopt for this innovation in change management is transformational leadership. Transformational leadership is characterized by its ability to inspire and motivate individuals to achieve higher levels of performance (Jankelová & Joniaková, 2021). A compelling vision is a central attribute of transformational leadership. It identifies leaders who can establish and articulate a clear and inspirational vision of the future (Labrague et al., 2020). In the context of our proposed changes, having a strong vision is critical for uniting staff members and stakeholders behind a common purpose and direction (Jankelová & Joniaková, 2021). A clear and concise vision serves as a beacon, providing a sense of purpose and direction to both staff members and stakeholders. This shared vision goes beyond the specifics of training programs and regulatory changes to express the wider picture- the pursuit of excellence in patient care (Collins et al., 2020). People are more inclined to actively participate in the change process when they can relate their efforts to a meaningful vision and comprehend the purpose behind it (Jankelová & Joniaková, 2021). This attribute not only inspires commitment but also serves as a framework for decision-making, facilitating in prioritizing actions that contribute to the achievement of standardized, patient-centered care practices (Collins et al., 2020).

On the other hand, individualized consideration is another fundamental attribute of transformational leadership. It entails identifying the particular requirements, assets, and issues of each team member and offering them specialized help and direction (Labrague et al., 2020). Individualized consideration will be essential in addressing the varied requirements and challenges faced by staff members in the context of our change management approach. By demonstrating individualized consideration, we will be able to respect the specific concerns as well as apprehensions of staff members who may be resistant to change (Labrague et al., 2020). This attribute will enable us to assist those who may need specific assistance, direction, and encouragement. Additionally, it encourages open communication, which makes it easier for the patients and staffs to voice their issues and ask for help (Ferreira et al., 2020). In navigating the complexities of change, the ability to address the unique needs of staff members is vital. As per the research works of Ferreira et al., (2020) it can be said that individualized consideration ensures that no individual remains behind and all staff members receive the support and resources they require to adjust to the new procedures. Ultimately, this attribute of transformational leadership fosters trust and support within the team by making members feel valued and heard, thus contributing to the effectiveness of this leadership style (Jankelová & Joniaková, 2021).

Therefore, I kindly request your consideration and assistance in implementing these changes for the betterment of our surgical ward and, most importantly, the well-being of our patients. Thank you for your time and consideration. I eagerly anticipate the opportunity to work together in realizing these crucial improvements.

References

Collins, E., Owen, P., Digan, J., & Dunn, F. (2020). Applying transformational leadership in nursing practice. Nursing Standard , 35(5), 59-66. 10.7748/ns.2019.e11408

Dong, R., & Guo, B. (2021). Smart wound dressings for wound healing. Nano Today , 41, 101290. https://doi.org/10.1016/j.nantod.2021.101290

Farzi, S., Shahriari, M., & Farzi, S. (2018). Exploring the challenges of clinical education in nursing and strategies to improve it: A qualitative study. Journal Of Education And Health Promotion, 7. 10.4103/jehp.jehp_169_17

Ferreira, V. B., Amestoy, S. C., Silva, G. T. R. D., Trindade, L. D. L., Santos, I. A. R. D., & Varanda, P. A. G. (2020). Transformational leadership in nursing practice: Challenges and strategies. Revista Brasileira de Enfermagem , 73. https://doi.org/10.1590/0034-7167-2019-0364

Jankelová, N., & Joniaková, Z. (2021, March). Communication skills and transformational leadership style of first-line nurse managers in relation to job satisfaction of nurses and moderators of this relationship. In Healthcare, MDPI 9, 3, 346. https://doi.org/10.3390/healthcare9030346

Jedwab, R. M., Chalmers, C., Dobroff, N., & Redley, B. (2019). Measuring nursing benefits of an electronic medical record system: A scoping review. Collegian , 26(5), 562-582. https://doi.org/10.1016/j.colegn.2019.01.003

Labrague, L. J., Nwafor, C. E., & Tsaras, K. (2020). Influence of toxic and transformational leadership practices on nurses' job satisfaction, job stress, absenteeism and turnover intention: A cross‐sectional study. Journal of Nursing Management , 28(5), 1104-1113. https://doi.org/10.1111/jonm.13053

Negro-Calduch, E., Azzopardi-Muscat, N., Krishnamurthy, R. S., & Novillo-Ortiz, D. (2021). Technological progress in electronic health record system optimization: Systematic review of systematic literature reviews. International Journal of Medical Informatics , 152, 104507. https://doi.org/10.1016/j.ijmedinf.2021.104507

Nilsen, P., Seing, I., Ericsson, C., Birken, S. A., & Schildmeijer, K. (2020). Characteristics of successful changes in health care organizations: an interview study with physicians, registered nurses and assistant nurses. BMC Health Services Research , 20, 1-8. https://doi.org/10.1186/s12913-020-4999-8

Nursing and Midwifery Board of Australia (NMBA) (2023). Registered nurse standards for practice https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards/registered-nurse-standards-for-practice.aspx

Perez, S. (2021). Nursing Interventions for the Prevention of Surgical Site Infections in Post-Operative Care. https://www.theseus.fi/bitstream/handle/10024/507536/Thesis_Perez_Sofia_SNS18.pdf?sequence=2

Pharmaceutical Society of Australia (PSA) (2022).Wound Care and Clinical Assessment Workshops. https://my.psa.org.au/s/training-plan/a110o00000Fr07dAAB/wound-care-and-clinical-assessment-workshops-11-march-newcastle

Redmond, C., Hardie, P., Davies, C., Cornally, D., Daly, O., & O'Sullivan, C. (2020). Increasing competence in wound care: A cross-sectional study to evaluate use of a virtual patient by undergraduate student nurses. Nurse Education In Practice , 44, 102774. https://doi.org/10.1016/j.nepr.2020.102774

Reis, J. D. D., Sa-Couto, P., Mateus, J., Simões, C. J., Rodrigues, A., Sardo, P., & Simões, J. L. (2023). Impact of Wound Dressing Changes on Nursing Workload in an Intensive Care Unit. International Journal of Environmental Research and Public Health , 20(7), 5284. 10.3390/ijerph20075284

Seminara, D., Maese, J., Senk, L., Szerszen, A., & Taylor, A. (2023). Post-Operative Care in Skilled Nursing and Long-Term Care. In Acute Care Surgery in Geriatric Patients (pp. 519-531). Cham: Springer International Publishing https://doi.org/10.1007/978-3-031-30651-8_55

Welsh, L. (2018). Wound care evidence, knowledge and education amongst nurses: a semi‐systematic literature review. International Wound Journal , 15(1), 53-61. https://doi.org/10.1111/iwj.12822

Further Info.:- Challenges of Patient Handover Process in Healthcare

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