Interview and Interdisciplinary Issue Identification

Interview and Interdisciplinary Issue Identification

I interviewed a registered nurse working in the general ward unit of a health care facility. The nurse provides care to inpatients. The care entails closely monitoring and assessing their condition to determine their prognosis and administration of medications and other healthcare interventions. The nurse reported that she enjoys working at the facility because the nurse staffing ratios are optimized. However, she noted that there had been an increase in ventilator-associated pneumonia in patients who require mechanical ventilation at the hospital. She indicated that interprofessional collaboration had not been embraced in its entirety. She acknowledged that an interprofessional effort would improve the quality of services she offers at the hospital. She pointed out organizational and team-level factors that impede interprofessional collaboration.

The team of healthcare providers at the facility lacks clear and concise goals and objectives that should be achieved. Furthermore, they rarely have interprofessional collaboration training. Consequently, this has created role ambiguity for the interprofessional team members. The nurse reported that the administration is not research-oriented and doesn’t provide regular feedback on the performance of employees. She said the organization used to award best-performing departments regarding quality-of-service provision and patient satisfaction. However, this tradition was eroded. Accordingly, this has created a culture that fails to embrace interprofessional collaboration in healthcare service delivery.

The nurse reported that she concentrates on her unit and rarely collaborates with other healthcare providers. Before the interview, I developed my structured questions to ensure sufficient information was collected. During the interview, I embraced active listening, avoided disrupting the interviewee, and recorded the feedback in my notebook to demonstrate interest.

Issue Identification

The nurse reported that the incidences of ventilator-associated pneumonia have been on the rise. Essentially, ventilator-associated pneumonia is common in patients receiving mechanical ventilation. This nosocomial disease is prevalent in patients undergoing endotracheal intubation. It occurs within or more than forty-eight hours after patient admission (Martin-Loeches et al., 2018). Ventilator-associated pneumonia has increased patient morbidity and mortality rates. Patients are forced to stay longer and pay extra treatment costs (Sousa et al., 2019). An interdisciplinary collaborative approach can help to minimize the prevalence of ventilator-associated pneumonia. Collaboration among physicians, nurses, pharmacists, and other healthcare team members will ensure appropriate strategies are implemented. They include proper patient oral hygiene, the presence of the CASS tube, minimizing proton pump inhibitors, and subglottic suctioning (Álvarez-Lerma et al., 2018). According to Sousa et al. (2019), other methods that can be adopted after research and collaboration include placing patients in a semi-recumbent posture and minimizing the duration of mechanical ventilation.

Change Theories That Could Lead to an Interdisciplinary Solution

Havelock’s change model will be used to create an interdisciplinary solution. This change model has six stages (Udod & Wagner, 2018). The first phase is pre-contemplation and relationship building, where the necessity for change is determined. The second phase is problem diagnosis and exclusive contemplation, where the relevance and urgency of change are selected (Udod & Wagner, 2018). The next phase is acquiring resources for change and involves active research for creating change. The next step is pathway selection, during which a specific facilitator of change is selected and implemented. The fifth phase is establishing and accepting the change (Udod & Wagner, 2018). The last phase is maintenance and separation, during which follow-up ensures the organizational culture embraces the transition.

This change theory will promote self-awareness and self-direction among interprofessional team members. It will enable them to recognize ventilator-associated pneumonia’s clinical and economic impacts, plan and research evidence-based preventive strategies, implement them, and monitor their effectiveness. This change benefits ventilator-associated pneumonia (VAP) because it will ensure that the best preventive evidence-based practices are adopted. Furthermore, the change theory will ensure that VAP incidences are significantly lowered due to the follow-up provided in the maintenance and separation phase.

Leadership Strategies That Could Lead to an Interdisciplinary Solution

According to Folkman et al. (2019), leaders can use strategies to promote interdisciplinary collaboration, including shared leadership, appreciative inquiry, and emotional intelligence. Shared leadership entails recognizing each member of the multidisciplinary team as necessary. Each member has a specific specialty knowledge base that can generate solutions to the existing problem. Emotional intelligence requires the leader to focus on the strengths and achievements of team members rather than being judgmental (Folkman et al., 2019). This is an enabler of trust and teamwork among members. Like emotional intelligence, appreciative inquiry focuses on and reinforces employees’ strengths. This encourages collaboration and participation in finding a solution. These three strategies will enable the interprofessional team to develop evidence-based practices that reduce the incidences of ventilator-associated pneumonia.

Collaboration Approaches for Interdisciplinary Teams

Different collaborative approaches can be used to improve the interdisciplinary team’s cooperation to address the problem of VAP. The first strategy is open communication (Folkman et al., 2019). Effective communication helps to create goals and objectives for the team. In this context, the goal is to minimize the incidence of VAP. It also helps to avoid role ambiguity by describing the tasks to be performed by each team member. Open communication helps team members create a good rapport and increases their willingness to share information (Folkman et al., 2019). Information sharing is essential in research and establishing evidence-based practices. The second strategy is training. Training equips the team members with the necessary skills and knowledge to accomplish their tasks (Folkman et al., 2019). In this context, training can focus on the best mechanical ventilation techniques and how to ensure good oral hygiene. Training will enable team members to identify their unique roles in realizing established goals.

The other strategy is rewarding. The best-performing team members should be rewarded. As a result, this motivates other members and increases the quality of service provision (Buljac-Samardzic et al., 2020). By so doing, the goal of the team is accomplished. Performance feedback should enable teammates to evaluate themselves and their efforts. It allows them to modify their activities appropriately to achieve group goals and objectives.

References

Álvarez-Lerma, F., Palomar-Martínez, M., Sánchez-García, M., Martínez-Alonso, M., Álvarez-Rodríguez, J., Lorente, L., Arias-Rivera, S., García, R., Gordo, F., Añón, J. M., Jam-Gatell, R., Vázquez-Calatayud, M., & Agra, Y. (2018). Preventing ventilator-associated pneumonia: The multimodal approach of the Spanish ICU “pneumonia zero” program. Critical Care Medicine, 46(2), 181–188. https://doi.org/10.1097/CCM.0000000000002736

Buljac-Samardzic, M., Doekhie, K. D., & Van Wijngaarden, J. D. H. (2020). Interventions to Improve Team Effectiveness within Health Care: A Systematic Review of the Past Decade. Human Resources for Health, 18(1), 1–42. https://doi.org/10.1186/s12960-019-0411-3

Folkman, A. K., Tveit, B., & Sverdrup, S. (2019). Leadership in Interprofessional Collaboration in Health Care. Journal of Multidisciplinary Healthcare, 12, 97–107. https://doi.org/10.2147/JMDH.S189199

Martin-Loeches, I., Rodriguez, A. H., & Torres, A. (2018). New Guidelines for Hospital-Acquired Pneumonia/ Ventilator-Associated Pneumonia: USA vs. Europe. Current Opinion in Critical Care, 24(5), 347–352. https://doi.org/10.1097/MCC.0000000000000535

Sousa, A. S., Ferrito, C., & Paiva, J. A. (2019). Application of a Ventilator-Associated Pneumonia Prevention Guideline and Outcomes: A Quasi-Experimental Study. Intensive and Critical Care Nursing, 51, 50–56. https://doi.org/10.1016/j.iccn.2018.10.001

Udod, S., & Wagner, J. (2018). Common Change Theories and Application to Different Nursing Situations. https://opentextbooks.uregina.ca/leadershipandinfluencingchangeinnursing/chapter/chapter-9-common-change-theories-and-application-to-different-nursing-situations/

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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 discussion 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 of your patients and organization. One way to design an improvement project is by using 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 actual 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 project design model is that it allows nurses 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 healthcare professional of your choice to determine what kind of interdisciplinary problem they are experiencing or have experienced in the workplace. In Assessment 2, this interview will inform the research 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 before developing the report. The training 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 system outcomes.
Summarize an interview focused on past or current issues at a healthcare 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; contain 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.
Professional Context

This assessment will introduce the Plan-Do-Study-Act (PDSA) Model to create organizational change. 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 evaluations in which you will gather interview information (Assessment 2), design a proposal for interdisciplinary problem-solving (Assessment 3), and report on how a multidisciplinary 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 they could present to stakeholders to address an interdisciplinary problem in the workplace.

For this assessment, you will need to interview a healthcare 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 they are experiencing or have 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.

Instructions

For this assessment, you will report on the information you collected in your interview, analyze the interview data, and identify a past or current issue that would benefit from an interdisciplinary approach. This could be an issue that has not been addressed by a multidisciplinary 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. Citations from the literature should support your interview strategy. 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 the issue you have identified. Please review the scoring guide to confirm the specific required elements of this assessment. Note that there are differences between primary, 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 informing your plan, as well as for the reference list at the end.

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

Summarize an interview focused on past or current issues at a healthcare 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 clear, logically organized, professional writing, using correct grammar and spelling and current APA style.
Additional Requirements

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 at least three sources of scholarly or professional evidence that support your central ideas. Resources should be no more than five years old.
APA formatting: Ensure in-text citations and reference lists follow the current APA style.
Portfolio Prompt: Remember to save the final assessment to your ePortfolio so that you may refer to it as you complete the final Capstone course.