Peripheral insertion of central nervous catheters in neonates is used in order to boost health of the neonates especially those suffering from chronic and acute illnesses. (Pedivan, 2010;Pettit & Wyckoff, 2007). However, wrongful insertion of catheters may bring catastrophic outcomes to the patients, healthcare professionals and healthcare facilities at large. Wrongful catheterization is in most casescaused by lack of professionalism of nurses or healthcare givers. After implementing the appropriate strategies in order to improve the results of PICC (Peripherally Inserted Central Catheters) in neonates, it is relevant to evaluate whether the objectives have been achieved.
This proposed professionalism matrix is intended to reduce malpractices in insertion of central catheters in new born patients. It is also meant to reduce litigations bombarding healthcare professionals and medical facilities in matters relating to the issue in question. The matrix comprises of various methods and variables, which will be relevant in evaluating effectiveness of the solution proposed.
- Survey the patients, staff and contributors’ attitude to job satisfaction before initiating change and after the same
- Obtain patient discharge surveys before initiating change and after the same
- Obtain related litigations before initiating change and after the same
One of the ways of assessing that the patients have a problem is by evaluating the cases arising from the issue. In order to understand the cause of a problem, it is relevant to assess all aspects relating to the issue. This includes assessing the patients and nurses and general medical facility. Comparing the level of satisfaction of contributors, patients and staff after the change was introduced with the outcomes before the change was initiated. It allows one to assess whether the intended change goals/objectives have been realized.
For instance, little or no significant changes in the number of malpractice cases in catheter insertion before and after change initiation prove inefficiency of the approach. Additionally, it could be noted that the issue (lack of professionalism/education) causing malpractice was not the main cause of the same. If either of the scenarios is the cause, then the initiators of the change should carry out relevant steps in order to ensure that the situation is corrected and the change is impactful.
Similarly, obtaining patient discharge surveys before and after change initiation also allows the change implementers to know whether the targeted goals/objectives are being achieved (Potter & Perry, 2009). If the change is effective, the patient discharged after the change with improved quality of life should be more than those discharged before the change was implemented. Moreover, the litigations identified after the change should be less than the ones recorded before the change.
- Staff perception, attitude and professional actions
- Patient perception, attitude and health status
- Rate of health issue related litigations
Measuring the variables allows evaluating the impact of the change implemented. The change indicated (whether positive or negative) will allow the initiators to identify their success or failure in implementing the change. For example, the change in attitude and actions of the health care givers before and after the change should be positive. Health care givers should be more careful, involved and reveal a positive attitude towards their patients and work after the change. In case of a negative change, the implementers should re-evaluate the change process. For example, if the number of patients with complications related to catheter insertion increases or remains the same after the change, this calls for a re-evaluation.
Educating project participants requires numerous tools. Firstly, refresher courses will play a significant role in achieving the goals set. Some health professionals may haveforgotten the proper manner of inserting the central catheter. In this case, a refresher cause will instill the professionalism needed. Training workshops present another useful tool (Littleton-Gibbs & Engebretson, 2002). The professionals should be taught by other expertsin various fields. However, the trainers may not necessary come from the facility in question. They could be from the healthcare department or other authorized bodies that have the expertise both from a practical and theoretical perspective. Professionals in the legal field including a professional who observes the policy implementation aspect of the facility in question should also be present.
Upon taking a course or participating in a workshop healthcare givers should pass exams in order to prove thatthe desired level of professionalism was attained. Booklets, charts, PowerPoint presentations and video clips, amongst others strategically placed in the medical facility may serve as constant reminders of how to avoid malpractices (Potter & Perry, 2009). Change initiators, as part of project contributors, should share common objectives and goals of initiating the change.
Assessment tools include questionnaires, interviews and surveys. Observation of a professional can also be used as a tool of assessment. Questionnaires will be used to assess health status, perception and attitude of the staff and patients. The questionnaires will be issued to and retrieved from the patients and staff through emails, mailing, health facility website and cell phone messages amongst others avenues.
Interviews will also be conducted on the staff and patients. Since the patients are children, the interviews will be mainly conducted on the children’s parents or guardians. The interviews can be conducted through telephones/cell phones, Skype and video conferences, amongst other avenues. Observations will be made by health professionals on the patients’ health status. Assessing and analyzing legal records of the health facility, as far as litigations are concerned, is another way of assessing the project outcomes. The number of litigations after the change should be fewer than prior to it.
Project results can be disseminated to key stakeholders through various avenues. The outcomes may be presented in the manner of a report. In order to go through the project outcomes, the report can be discussed at the stakeholders meeting. If there is no such meeting, the report can be delivered to the relevant parties via the provided mail addresses. The report could also be hand-delivered to them. Additionally, the report can be uploaded on the facility website for accessibility purposes. The results could also be made into a PowerPoint presentation, which should be available via the facility website. A short audio and video presentation could be made for purposes of the physically disabled persons.
The results could also be placed in the library where they would be available in numerous formats including Braille. Another advantage of placing the results in the library is that this will allow all interested parties to have a reference point even after the critical stages of the change implementation process are over. The initiators could also share the results through small booklets whichwould provide a summary of the main points. The booklets may act as reference points for the issues that need constant access by the stakeholders, especially the change implementers and the staff.
The relevant parties can share significance of the project resultswith the nursing community members through various avenues. As mentioned above, the information could be presented in a manner of a reportdistributed through various avenues. They could also spread awareness of the project outcomes through campaigns that run for a given period. The campaigns may be combined with workshops and training sessions in order to ensure awareness on the project outcomes is achieved.
If the project presents a major significance in the targeted area the project stakeholders could unite their efforts with the nursing education board. For example, in cases when the project realizes reduction in catheter-related complications and problems by eighty percent. By aliasing with the targeted board, the initiators could incorporate a topic or program in nursing schools that relates to the issue in question.
Spreading such information requires funds. The stakeholders need to find as many sponsors as possible in order to realize the intended outcomes. This can include sourcing for funds from corporations who have interest in the medical field,for example, sourcing funds from a company that manufactures or distributed catheters. Such companies can be asked to participate in the same in order to show that they are not only interested in making sales, but also in the general health of a patient.