Change occurs continuously around people, and one of the major concerns in healthcare is managing change. Healthcare professionals like nurses are required to have the necessary expertise and maintain vital skills to undertake professional roles. The biggest task in change management is handling complexities around its process. Theories and research show that effective change in an organization is characterized by the practice of unfreezing old behaviors and introducing new norms to freeze. Even though change is endorsed, stakeholders must be aware of why it is happening, who, and how people are affected. The purpose of this paper is to assess the role of a registered nurse leader as a change agent.
Background of a Situation
When recalling a situation that did not go well in a healthcare organization, the Integration of foley catheters comes in mind. Typically, Foley catheters are widely applicable for indwelling urinary drainage. The application of this system is, however, not obvious or easy at its sounds since there are complications associated with them, and this happens especially where there is less knowledge to both patient and professional about the drainage system. The most common pitfalls or complications of Foley catheters that were witnessed include mechanical trauma, infections, and bleeding. When such problems arise, catheter systems can become complex, requiring surgical intervention. The result is not welcoming to both patients and the organization.
The rationale for choosing this change is that health complications associated with foley catheter insertions are common as well as critical and can compromise the overall patient well-being. Patients seek health interventions trusting that medical professional will provide their best support. The primary goal of nurses is ensuring quality care is provided to patients. However, these objectives cannot be reached when the wrong change approach is applied. The goal of seeing a better change implementation is to make sure patients are free from urinary catheter risks. One in five patients in healthcare will use foley catheters, and the aim should be to keep patients as safe as possible from contracting related illnesses.
Key Interprofessional Stakeholders
For a successful change implementation on better use of Foley catheters, the effort will require collaboration with key stakeholders- both internal and external. Internal stakeholders include employees, managers, educators, doctors or physicians, a team of risk management, healthcare insurance companies, and the government. External stakeholder includes patients and family members. Developing a catheter-related urinary tract infection prevention approach requires inputs from a diverse team force. For change to be achieved, stakeholders will have to be identified, and leaders ensure their direct involvement is supportive. Nurse leaders, too, are part of the key stakeholders and will work along with professionals to see change come through.
Physicians, as among stakeholders, maybe professionals from specialties like hospitalists, infectious disease specialists, urologists, intensivists, geriatricians, and emergency physicians. Each team plays an essential role in customizing an evidence-based CAUTI prevention approach to attain healthcare goals and better outcomes for patients. Professional team members have a stake in developing, implementing as well as evaluate practices change that is designed to lower CAUTI in patients that an organization serves. Patients and family’s stakeholders are engaged in the change because they are beneficiaries of outcomes and help facilitate better healthcare services. Should a patient suspect discomfort form indwelling catheter, they are required to notify a care team of professional like nurses for medical intervention.
Appropriate Change Theory or Model
The right models to apply in this catheter-related change include reducing unnecessary urinary catheter use and educating patients as well as professionals on the importance of foley care. The primary goal is to keep patients free from catheter-related risks, and as such, the right approach in layman way would be to do something in the right direction or avoid doing it at all. Typically, urinary tract infections (UTIs) or catheter-associated urinary tract infections (CAUTIs) are considered the most common infections that patients might contract in healthcare. Most of the infections occur after the placement of an uncomfortable, often unnecessary, and easily forgotten urinary catheter.
CAUTIs prevention strategy of educational intervention would help improve the right clinical skills in catheter placement, educate on behavioral interventions like removal protocols and catheter restriction. Through training programs, especially to medical students, nurses will learn how to use specific technology such as bladder ultrasound. Improving the practice concerning placement of urinary catheter need an intervention to change habits of nurses, patients, and doctors concerning the need for Foley catheters. With that, the system will not be in use when unnecessary hence reducing the chances to get infections. Both patients and nurses need consistent adequate education on the need for Foley care.
Initiating the Change
The first step to initiate the change would be conducting a review of CAUTI events in the organization better to understand the root cause of mistakes or errors. Analyzing previous instances where Foley Catheter application had gone wrong will raise insight on common mistakes that professionals like nurses do, leading to infections in patients. One likely example of common mistakes includes forgetting to remove the urinary catheter and using the wrong procedure when doing it. Like the saying, people learn from mistakes, and by analysis, a better approach will be communicated via training. To support better removal of the Foley catheter, the leader will issue urinary catheter removal protocols to all nurses.
Communication is crucial during change management, and in this, nurse leaders will interact with nurses as well as patients to monitor performance, provide feedback and guidance on catheter insertion or removal where necessary. The organization leader will hold daily huddles with stakeholders to review patients with Foley catheters and note the progress. CAUTI prevention education will be facilitated through proper teachings to enlighten both patients and nurses on catheter hygiene practices like hand washing and sterilizing techniques. The change process will require close monitoring, and this will be done through ongoing review by attending to nurses during bedside rounds as well as on surgical tables.
Impact on the Organization
Impacts on the organization if change implementation of proper Foley catheter program goes wrong are tremendous, including costs, loss of clients, damages in reputations, and cancelation of an operating license. Treating catheter-related infections is costly due to the prevalence rate of spread to a larger patient population. If the change is not successful, more patients will get infected, and this will cost hospital and insurance companies expense to treat occurring illnesses. Should the change be unsuccessful, an interprofessional team needs to be better engaged by the leaders. Nursing and physician leaders must partner together to determine existing gaps in performance and come up with the best evidence to lower the utilization of Foley catheters. With the physician championship, the change will be possible. Persistent contraction of urinary infection through catheters means proper hygiene has not been enhanced well yet. Thus, the interprofessional team would devise a minimum number of catheter days and consider alternative ways to drain the bladder.