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the procedure to begin and all staff is in place the team will perform a time out to make sure that the right procedure is being done on the right person, right site. There will be an audit tool that
8Organizational System and Quality Leadership, Task 2; SAT1-1217will go with the time out. The anesthesia provider will push the ordered medications and the respiratory therapist will monitor breathing. The nurse will be at the computer recording what is happening, assessing the vital signs and able to call on others for needed supplies that were not planned for. When the procedure is complete the RN will stay with the patient until patient’s level of consciousness is back to their baseline. The patient will be monitored up to 1 hour after return to baseline and able to eat and drink and go to the bathroom without problems. At this time the provider can choose to discharge the patient. B1. Change TheoryKurt Lewin’s change theory states that organizational change can occur in three stages: Unfreezing, change and freezing. During the unfreezing stage it says we need to look at our attachments to the current way we do things and unfreeze/unattached to those current attitudes orpractices. During the unfreezing stage the we convince the staff as to why change is necessary and how it can be accomplished. We can do this by communicating the positive reasoning with the staff and providing evidence base research and data as to how this change is good and will improve the process. We will need to talk about the training and how we are going to achieve this change with the staff before it happens, so they can prepare themselves for the change. The next stage is to make the change. This can happen in stages or all at once. Having it happen all at once prevents staff from going back to their previous way of doing things and forces them to just make the change. During this stage the staff will need support for questions and problems. The last phase is the freezing stage. During this stage Lewin identifies a need to actively “re-freeze” the process in its new state. This is when we follow new policies and procedures. This will help the staff move forward and not backward. There will need to be process checks to learnhow the new process is working and then reassessment of the policies and procedures. There
9Organizational System and Quality Leadership, Task 2; SAT1-1217needs to be a process for taking the data back to the staff so that they are continuing to learn the new processes.In my above improvement plan I am sure I will get push back from staff and administration. The biggest push back, I believe, would be the increased staffing need during a moderate sedation procedure from administration. To them it is not just increased staffing, it is decreased income for the hospital. I believe that though my RCA I would be able to prove to them the needs outweigh the decreased income and eventually will have an increase of income due to patient satisfaction.
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Nursing, Failure mode and effects analysis, Quality Leadership