NURS-FPX4010 Assessment 2 Interview and Interdisciplinary Issue Identification

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NURS-FPX4010 Assessment 2 Interview and Interdisciplinary Issue Identification

Interview Summary

In this interview, I talked with Mrs. Andy, an advanced practice registered nurse in one of the largest hospitals in my state. Mrs. Andy agreed to have the interview through videoconferencing through Google Meet. She works as a nurse manager in the surgical inpatient unit, which has a capacity of forty inpatient beds. Mrs. Andy has been working for the past six years as a certified nurse practitioner in the same organization and was promoted two years ago to work as a nurse manager in charge of seven other nurses in the same unit. She has administrative as well as clinical roles and usually balances these roles daily.

The purpose of this interview was to explore how she works collaboratively to reduce readmission rates in the surgical unit. Obamacare introduced the Hospital Readmissions Reduction Program (HRRP) to incentivize reimbursements to prevent readmissions and improve quality (U.S. Centers for Medicare & Medicaid Services, 2021). As an administrative nurse, Mrs. Andy has encountered various issues surrounding patient care quality and readmission reduction.

During interdisciplinary intra-organizational meetings, she has discussed readmission prevention and regular reports about the same. Her strategies to reduce readmission include incorporating technology, preventing medical and medication errors, patient education, and interdisciplinary collaboration. Her organization has been rigorous on matters of unplanned readmission and thus, the need for multimodal approaches to prevent unplanned readmission.

Issue Identification

Improving patient care quality through readmission reduction was an outstanding issue in the interview. The interviewee identified surgical site infection as the major cause of readmission in her unit. Infections are a major patient safety concern in nursing and healthcare quality. In Mrs. Andy’s case, surgical site infections need to be prevented from reducing the cost of care, mortality, and morbidity (Borchardt & Tzizik, 2018). It requires an interdisciplinary approach that would improve teamwork to prevent these infections and reduce new incidences of infection in the surgical unit.

Change Theories That Could Lead to an Interdisciplinary Solution

ADKAR change model by Jeff Hiatt is an appropriate model that would lead to interdisciplinary action for this issue. This model is an acronym that stands for five basic steps: awareness, desire, knowledge, ability, and reinforcement (Kachian et al., 2018). This theory would help create an interdisciplinary solution by involving teamwork and awareness. According to Balluck et al. (2020), this model for change management requires constant ongoing collaboration and communication that would improve the interdisciplinary approach.

This theory is relevant to the issue at Mrs. Andy’s unit because various stakeholders are involved. My sources by Balluck et al. (2020) and Kachian et al. (2018) are peer-reviewed scholarly journal articles published within the last five years. Therefore, it is a credible source. The application of the ADKAR model in Balluck et al. (2020)’s study relates to the need for change in infection control as both involve change management for infection prevention.

Leadership Strategies That Could Lead to an Interdisciplinary Solution

Enhancing an interdisciplinary solution to this issue will require a transformational leadership strategy. From the transformational leadership style in nursing, transformational strategy deviation from normal protocols to effect change require the leader to act as a role model and inspire other team members for the impending change. As a leader, I would empower my change team through awareness and expressing the need for change to ensure participation according to the ADKAR model for change.

This strategy would lead to an interdisciplinary approach because, as a leader, I will be required to collaborate with all stakeholders during the planning and intervention phases of change. Therefore, understanding their roles and their capabilities and readiness to effect change will be evaluated in the interdisciplinary team. My source by Hart et al. (2020) is from a scholarly peer-reviewed journal (SAGE journals). The information is relevant o my field of practice, and the authors are a practitioner in healthcare.

Collaboration Approaches for Interdisciplinary Teams

NURS-FPX4010 Assessment 2 Interview and Interdisciplinary Issue Identification

Incorporating collaborative approaches in this change management for infection prevention will require the application of the ADKAR theory and transformational strategy of leadership. Key collaborative strategies will include improving team access to information and evidence-based practice, open communication with the team, and taking a personal interest in staff. According to Bergstedt & Wei (2020), these fundamental strategies promote proline staff engagement and collaboration.

In their systematic literature review, ensuring shared values, practicing transformational leadership, and providing access to knowledge and resources enhance change and staff participation for quality improvement. Specific collaborative strategies take a personal interest in individual team members to discover and understand them and ensure open and effective communication to build trusting relationships and keep the team on the same page. The source by Bergstedt & Wei (2020) is an incredible and high-level evidence source. It is recent and was published by two nurses with Ph.D. The information is relevant to application in my practice and providing an interdisciplinary solution.

Conclusion

The interview with Mrs. Andy provided insight into the need for infection prevention to improve care quality and patient safety to reduce readmission. The ADKAR change model and transformational leadership would be used to guide change management and interdisciplinary approach. Quality and credible sources have been used to back these strategies.

NURS-FPX4010 Assessment 2 Interview and Interdisciplinary Issue Identification References

Balluck, J., Asturi, E., & Brockman, V. (2020). Use of the ADKAR® and CLARC ® change models to navigate staffing model changes during the COVID-19 pandemic. Nurse Leader, 18(6), 539–546. https://doi.org/10.1016/j.mnl.2020.08.006

Bergstedt, K., & Wei, H. (2020). Leadership strategies to promote frontline nursing staff engagement. Nursing Management, 51(2), 48–53. https://doi.org/10.1097/01.NUMA.0000651204.39553.79

Borchardt, R. A., & Tzizik, D. (2018). Update on surgical site infections: The new CDC guidelines. JAAPA : Official Journal of the American Academy of Physician Assistants, 31(4), 52–54. https://doi.org/10.1097/01.JAA.0000531052.82007.42

Hart, A., Biggs, S., Scott-Bottoms, S., Buttery, L., Dennis, S., Duncan, S., Ebersöhn, L., Flegg, M., Kelso, C., Khaile, N. M., Mampane, M. R., Mampane, N. S., Nash, D. J., Ngoma, R., & Theron, L. C. (2020). Negotiating leadership in interdisciplinary co-productive research: A case study of an international community-based project between collaborators from South Africa and the United Kingdom. SAGE Open, 10(4), 215824402097159. https://doi.org/10.1177/2158244020971598

Kachian, A., Elyasi, S., & Haghani, H. (2018). ADKAR Model and Nurses’ Readiness for Change. Journal of Client-Centered Nursing Care, 4(4), 203–212. https://doi.org/10.32598/jccnc.4.4.203

U.S. Centers for Medicare & Medicaid Services. (2021, December 1). Hospital Readmissions Reduction Program (HRRP). Cms.gov. https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/Readmissions-Reduction-Program

NURS-FPX4010 Assessment 2 Interview and Interdisciplinary Issue Identification Instructions

For this assessment, you will create a 2-4 page report on an interview you have conducted with a health care professional. You will identify an issue from the interview that could be improved with an interdisciplinary approach, and review best practices and evidence to address the issue.

As a baccalaureate-prepared nurse, your participation and leadership in interdisciplinary teams will be vital to the health outcomes for your patients and organization. One way to approach designing an improvement project is to use the Plan-Do-Study-Act (PDSA) cycle. The Institute for Healthcare Improvement describes it thus:

The Plan-Do-Study-Act (PDSA) cycle is shorthand for testing a change in the real work setting—by planning it, trying it, observing the results, and acting on what is learned. This is the scientific method adapted for action-oriented learning…Essentially, the PDSA cycle helps you test out change ideas on a smaller scale before evaluating the results and making adjustments before potentially launching into a somewhat larger scale project (n.d.).

You might also recognize that the PDSA cycle resembles the nursing process. The benefit of gaining experience with this model of project design is that it provides nurses with an opportunity to ideate and lead improvements. For this assessment, you will not be implementing all of the PDSA cycle. Instead, you are being asked to interview a health care professional of your choice to determine what kind of interdisciplinary problem he or she is experiencing or has experienced in the workplace. This interview, in Assessment 2, will inform the research that you will conduct to propose a plan for interdisciplinary collaboration in Assessment 3.

It would be an excellent choice to complete the PDSA Cycle activity prior to developing the report. The activity consists of four questions that create the opportunity to check your understanding of best practices related to each stage of the PDSA cycle. The information gained from completing this formative will promote your success with the Interview and Interdisciplinary Issue Identification report. This will take just a few minutes of your time and is not graded.

Reference

Institute for Healthcare Improvement. (n.d.). How to improve. http://www.ihi.org/resources/Pages/HowtoImprove/default.aspx

Demonstration of Proficiency

  • Competency 2: Explain how interdisciplinary collaboration can be used to achieve desired patient and systems outcomes.
    • Summarize an interview focused on past or current issues at a health care organization.
    • Describe collaboration approaches from the literature that could be relevant in establishing or improving an interdisciplinary team to address an organizational issue.
  • Competency 3: Describe ways to incorporate evidence-based practice within an interdisciplinary team.
    • Identify an issue from an interview for which an evidence-based interdisciplinary approach would be appropriate.
  • Competency 4: Explain how change management theories and leadership strategies can enable interdisciplinary teams to achieve specific organizational goals.
    • Describe change theories and a leadership strategy that could help develop an interdisciplinary solution to an organizational issue.
  • Competency 5: Apply professional, scholarly, evidence-based communication strategies to impact patient, interdisciplinary team, and systems outcomes.
    • Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.
    • Apply APA formatting to in-text citations and references, exhibiting nearly flawless adherence to APA format.

See Also:

Interdisciplinary Plan Proposal NURS-FPX4010

Professional Context

This assessment will introduce the Plan-Do-Study-Act (PDSA) Model to create change in an organization. By interviewing a colleague of your choice, you will begin gathering information about an interprofessional collaboration problem that your colleague is experiencing or has experienced. You will identify a change theory and leadership strategies to help solve this problem.

Scenario

This assessment is the first of three related assessments in which you will gather interview information (Assessment 2); design a proposal for interdisciplinary problem-solving, (Assessment 3); and report on how an interdisciplinary improvement plan could be implemented in a place of practice (Assessment 4). At the end of the course, your interviewee will have a proposal plan based on the PDSA cycle that he or she could present to stakeholders to address an interdisciplinary problem in the workplace.

For this assessment, you will need to interview a health care professional such as a fellow learner, nursing colleague, administrator, business partner, or another appropriate person who could provide you with sufficient information regarding an organizational problem that he or she is experiencing or has experienced, or an area where they are seeking improvements. Consult the Interview Guide [DOCX] for an outline of how to prepare and the types of information you will need to complete this project successfully.

Remember: this is just the first in a series of three assessments.

NURS-FPX4010 Assessment 2 Interview and Interdisciplinary Issue Identification Instructions

For this assessment, you will report on the information that you collected in your interview, analyzing the interview data and identifying a past or current issue that would benefit from an interdisciplinary approach. This could be an issue that has not been addressed by an interdisciplinary approach or one that could benefit from improvements related to the interdisciplinary approach currently being used. You will discuss the interview strategy that you used to collect information. Your interview strategy should be supported by citations from the literature.

Additionally, you will start laying the foundation for your Interdisciplinary Plan Proposal (Assessment 3) by researching potential change theories, leadership strategies, and collaboration approaches that could be relevant to issue you have identified. Please be certain to review the scoring guide to confirm specific required elements of this assessment. Note that there are differences between basic, proficient and distinguished scores.

When submitting your plan, use the Interview and Issue Identification Template [DOCX], which will help you to stay organized and concise. As you complete the template, make sure you use APA format for in-text citations for the evidence and best practices that are informing your plan, as well as for the reference list at the end.

Additionally, be sure to address the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so you understand what is needed for a distinguished score.

  • Summarize an interview focused on past or current issues at a health care organization.
  • Identify an issue from an interview for which an evidence-based interdisciplinary approach would be appropriate.
  • Describe potential change theories and leadership strategies that could inform an interdisciplinary solution to an organizational issue.
  • Describe collaboration approaches from the literature that could facilitate establishing or improving an interdisciplinary team to address an organizational issue.
  • Communicate with writing that is clear, logically organized, and professional, with correct grammar and spelling, and using current APA style.

Additional Requirements for NURS-FPX4010 Assessment 2 Interview and Interdisciplinary Issue Identification

  • Length of submission: Use the provided template. Most submissions will be 2 to 4 pages in length. Be sure to include a reference page at the end of the plan.
  • Number of references: Cite a minimum of 3 sources of scholarly or professional evidence that support your central ideas. Resources should be no more than 5 years old.
  • APA formatting: Make sure that in-text citations and reference list follow current APA style.

Interview and Interdisciplinary Issue Identification Example 2

Interviews are a great way of gathering healthcare data to stimulate change interventions. Nurses are healthcare professionals closest to the patient, thus containing vital information that informs care delivery and changes focus. Well-structured interviews can generate information whose use can change the healthcare facility’s safety and quality of care delivery. This assessment focuses on an interview with a care provider, identifies a care issue at the care provider’s workplace, and describes a change theory that can help address the issue. The assessment will also evaluate a leadership strategy and collaboration strategy to address the issue.

Interview Summary

The interview was conducted with Mrs. Judy, a nurse practitioner and the in-charge of the ICU at MedStar Union Hospital. The NP coordinates care delivery and oversees care delivery at the facility. She also does other managerial duties such as scheduling, new staff training, and implementing disciplinary actions in the ward. The NP states that hospital-acquired infections are relatively high, with a rising mortality rate associated with infections. The leading ones include central-line associated bloodstream infections, catheter-acquired urinary tract infections, and surgical site infections. The facility has implemented a risk assessment tool for all these categories that helps identify the patients at risk for infections and manage them accordingly. 

The rates have dropped for some time, but the NP is concerned about the high rates of catheter-acquired urinary tract infections despite the organizational efforts to manage them. Other problems include medication errors, and patient falls, which are relatively high in the facility. The NP participated in the interprofessional teams assigned the role of developing the risk assessment tools, which was a great success. She is a member of the professional team concerned with infections in the facility. The organization promotes collaboration and increases the utilization of interdisciplinary collaboration by creating and supporting interprofessional team approaches.

Issue Identification

The issue that requires an interdisciplinary approach is catheter-acquired urinary tract infections. CAUTIs are associated with multiple factors, and their prevention entails many interventions delivered in care bundles. An interprofessional team must review healthcare data and perform a gap analysis, determining and implementing corrective action. According to Letica-Kriegel (2019), the risk factors for CAUTI include prolonged catheter use, female gender, catheter care violations, severe disease, diabetes, and immunocompromised.

An interprofessional team is required to ensure correct indications of catheters and management of other risk factors. About 15-25% of the patients are catheterized, meaning that 15-25% are at risk for CAUTIs (Wernburg, 2022). Physicians and nurse practitioners do the prescriptions, while risk assessment requires collaboration from all these professionals. Evidence from studies shows that interdisciplinary collaborative interventions can lead to better patient outcomes and a significant decrease in CAUTIs (Karimi et al., 2019).

Change Theory That Could Lead to an Interdisciplinary Solution

The change theory of interest is Kurt Lewin’s change theory. It is simple and easy to implement. The theory focuses on an issue generally and allows the care providers to implement the best-fit intervention for their problem. The first stage, unfreezing, entails mobilizing support for the change by showing the concerned parties the need for change. The second stage entails facilitating the change (such as providing resources required to implement it) and supporting staff to implement it (Saleem et al., 2019).

The theory is generalizable and can be used for organization-wide change, hence its significance in the interdisciplinary approach to CAUTI management. The third stage, refreezing, entails embedding the change into the organizational culture by incorporating it into the organizational policies (Saleem et al., 2019). The theory is widely applied in healthcare, and studies have used it as a framework to guide the implementation of evidence-based interventions and manage change (Iwe, 2022). The sources are current and published by reputable journals, hence the information’s reliability.

Leadership Strategies That Could Lead to an Interdisciplinary Solution

The leadership strategies selected are open and effective communication and creating shared goals, objectives, and a strategic vision. Open and effective communication is a motivating factor for professionals to collaborate. Developing goals, objectives, and a strategic vision creates unity of direction as all professionals understand the implications of the change and the desired outcome/end product. Open and effective communication allows professionals to relay information flawlessly, facilitating change activities (Fox et al., 2021). These two strategies can thus support CAUTIs as professionals share information clearly and work towards common goals and objectives of eradicating CAUTIs.

Collaboration Approaches for Interdisciplinary Teams

The collaboration approaches of interest are shared decision-making and timely role communication. Role communication eliminates role confusion and promotes role execution by the various members of the healthcare team (Fox et al., 2021). Shared decision-making is an approach that requires the input of professionals, patients, and families in solving healthcare problems. Shared decision-making considers the ideas and perspectives of others in solving problems and making high-quality and reliable decisions. The collaboration approach makes all team members feel significant, stimulating their participation and input.

One of the advantages of the approach is the quality outcomes it produces in care delivery. Michalsen et al. (2019) note that interprofessional teams that share decisions have better outcomes, especially in UCU units, which is the focus of the healthcare issue. The study shows that shared decision-making in interprofessional teams increases information exchange, commitment to change, deliberation, and joint results attainment (Michalsen et al., 2019). The study is a systematic review with a high level of evidence from reputable databases. It was conducted within the last five years, making the data generated reliable.

Conclusion

Catheter-acquired urinary tract infections are the issue of interest from the interview. The interview with the NP showed that interdisciplinary efforts are required to manage the problem. Kurt Lewin’s Change theory is the selected framework that will guide the management of the issue. Open communication, the development and communication of common goals and objectives, shared decision-making, and role communication are the leadership and collaboration strategies that will facilitate interdisciplinary interventions in CAUTI management. Interviews are a great way to identify opportunities for change and address them.

NURS-FPX4010 Assessment 2 Interview and Interdisciplinary Issue Identification References

Fox, S., Gaboury, I., Chiocchio, F., & Vachon, B. (2021). Communication and interprofessional collaboration in primary care: from ideal to reality in practice. Health Communication, 36(2), 125-135. https://doi.org/10.1080/10410236.2019.1666499

Iwe, A. I. (2022). Silver Alloy-Coated Urinary Catheters: Preventing Urinary Tract Infection.

Karimi, S., Karimi, S., Kaiser, R., Cobbs, E., Lepcha, N., & Whitehead, S. (2019). Teaming up to Reduce Catheter-Associated Urinary Tract Infections. Journal of the American Medical Directors Association, 20(3), B25. https://doi.org/10.1016/j.jamda.2019.01.094

Letica-Kriegel, A. S., Salmasian, H., Vawdrey, D. K., Youngerman, B. E., Green, R. A., Furuya, E. Y., Calfee, D., & Perotte, R. (2019). Identifying the risk factors for catheter-associated urinary tract infections: a large cross-sectional study of six hospitals. BMJ Open, 9(2), e022137. https://doi.org/10.1136/bmjopen-2018-022137

Michalsen, A., Long, A. C., Ganz, F. D., White, D. B., Jensen, H. I., Metaxa, V., Christiane, H., Jos, L., Ribert, T., Jozef, K., Anna, M., & Curtis, J. R. (2019). Interprofessional shared decision-making in the ICU: a systematic review and recommendations from an expert panel. Critical Care Medicine, 47(9), 1258-1266. https://doi.org/10.1097/CCM.0000000000003870

Saleem, S., Sehar, S., Afzal, M., Jamil, A., & Gilani, S. A. (2019). Accreditation: application of Kurt Lewin’s theory on private health care organizational change. Saudi Journal of Nursing and Health Care, 2, 12. https://doi.org/10.36348/sjnhc.2019.v02i12.003

Werneburg, G. T. (2022). Catheter-associated urinary tract infections: current challenges and future prospects. Research and Reports in Urology, 109-133. https://doi.org/10.2147/RRU.S273663