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Technology meets challenges,but training ensures success

Allen, Abigail BSN

doi: 10.1097/01.NUMA.0000407581.53397.b2
Feature: 2012 Guide to Patient Safety Medication administration

Abigail Allen is a nurse educator at Riverside Health Care in Kankakee, Ill.

The author has disclosed that she has no financial relationships related to this article.

This world is a continual flurry of change. Nowhere is this truer than in the world of nursing. New clinical standards, changing government regulations, and increasing patient demands are affecting the day-to-day workload of today's nurse. As technology continues to revolutionize the way healthcare is delivered, nurses are at the forefront of adoption and implementation of these new technologies. Helping nurses adapt to change through training and support is now more important than ever to ensure that the focus on patient care is never lost.

One of the most common pieces of technology that a nurse uses daily is the automated medication dispensing cabinet (ADC). According to the American Society of Health-System Pharmacists, more than 80% of hospitals use ADCs to manage patient medication distribution.

ADCs provide nurses with fast and easy access to patient medications, while keeping the pharmacy firmly in charge of inventory and provisions, thus enhancing nurse care and pharmacy operations.

ADCs offer nurses:

  • reliable access to medications
  • enhanced workflow supporting patient safety
  • better coordination with pharmacies
  • more time for patient care.

Pharmacies benefit from:

  • more efficient inventory control
  • tracking and exchange of usage data
  • improved reporting and compliance
  • better service to staff.

ADCs incorporate sophisticated software to manage this vital, yet complex aspect of patient care. As such, ADCs are continually advancing, creating more efficient workflows and facilitating compliance with emerging regulatory requirements. With nurses accessing the medication cabinet an average of 12 times per shift, they can't afford to lose valuable time learning new processes and procedures. Hospitals must ensure that they offer comprehensive staff training programs that can be quickly implemented to help nurses understand and accept the change, ultimately allowing them to spend more time on direct patient care.

Riverside Medical Center implemented ADCs in 2009. When Riverside upgraded its existing cabinet system in early 2011, the hospital's Education Department was sensitive to the changes that would impact the nursing staff. They worked to incorporate a training program to facilitate the transition, with minimal impact on workflow, while optimizing the functionality of the new cabinet.

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Communication is key

Change is difficult, even for the most flexible person. The key to executing change is engaging staff throughout the process to ensure a smooth and successful transition. At Riverside, the Education team's focus was on constant communication–-before, during, and posttraining.

Riverside's approach to training follows a simple, five-part formula:

(1) “What are the goals?” The top concern for nurses is patient safety and care. Connecting the need for change to the impact it will have on patient care helps staff to understand and accept the new program.

Before the ADC upgrade at Riverside, the Education team used a variety of communication channels to prepare for the pending adjustment. Initial announcements were sent to each of the nursing units. The team then personally visited each unit to talk about the upcoming changes.

(2) “Do it together!” Taking a collaborative approach to training will help staff accept new processes. It's important for the training team to understand existing workflow and the impact that the ADC will have on daily routines. It's the team's job to then identify the positive effects the cabinets will create during a workday.

For example, the Education team at Riverside focused on new features of the cabinet upgrade—easier access to medication, more efficient stocking of inventory, and enhanced patient safety—to underscore the unique benefits for the nursing staff. Trainers worked side-by-side with staff to acclimate them to new processes, while maintaining an efficient workflow.

(3) “What do you think?” It's important for nurses to know that their opinions matter. Trainers need to have an open conversation with staff to understand and address any concerns regarding adjustments. This conversation can further engage staff members in the “why” behind the change, and help them focus on the positive aspects change can bring. This step of the process can be challenging, but maintaining a positive attitude goes a long way toward developing a good, working relationship with the staff.

The training team at Riverside focused on learning the staff's likes and dislikes about the ADC. They then worked with the ADC vendor to address concerns and make adjustments based on the needs of the staff.

(4) “We listened!” Allowing staff to voice concerns and have input into executing change is important, but it's imperative to demonstrate the value of that input by ensuring concerns are resolved postimplementation.

(5) “We haven't forgotten you!” Once the initial training is completed, it's important to continue to follow up with staff for ongoing support. Adapting to changes in workflow takes time and can be frustrating for employees. It's useful to develop tools to aid everyone as they adjust. These can include tutorials and reference sheets.

In addition to providing flash drives with reference materials and emergency contact information for training support, the Education team at Riverside also made follow-up rounds to each nursing unit to offer on-site troubleshooting. This personal follow-up helped reduce staff frustration and encouraged faster adoption of new processes.

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Focus on the positive

Changing workflows and perceptions is difficult and trainers need to accept and expect challenges from staff. Trainers need to continually be aware of the demands on nurses and recognize the impact that a training program may have on their daily routine. Maintaining a positive approach will help overcome these challenges and make for an easier transition during training and implementation.

During training sessions at Riverside, the staff heard a Code Blue called on a unit that had just implemented the new workflow. The training team rushed to the unit to provide back up for the nursing staff—ensuring that no problems were encountered during the crisis.

As healthcare advances, hospitals must continually focus on helping their staff adapt to necessary modifications. Keeping staff members focused on the benefits of change while ensuring that they fully comprehend new programs will result in a positive, successful experience for everyone.

Copyright © 2011 Wolters Kluwer Health, Inc. All rights reserved.