Critical Reflection Assignment Sample

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Introduction

Care delivery requires alignments between clinical processes and patient care interventions to achieve better results in health care. Giving of medicines and supervision of the patient are some essential steps through which nursing intercessions largely shape recovery and personal satisfaction. However, issues like failed handover and patient’s ignorance on their care schedules can result into poor service delivery within this sector, failure in administration of medication and monitoring as planned. Discussion of the implications of this challenge for patients, increased safety, staff productivity and overall healthcare delivery will then be made.

In the opinion, the problem needs to be solved by adopting calling card incentives that are aimed at informing the patients of missed visits and ensuing timely follow-ups. This new efficient idea will help to address the issues of interaction between the nurses and the patient as well as eliminate potential negligence and bolster the efficiency of services. It also goes a step further in developing further aspects of how effective implementation practices work such as staff training, resources provision, and the users feedback. Thus, the concept of this service improvement proposal highlights that the changes to the current practice of nursing can produce the healthcare setting that is safer and more effective in which patient requirements are valued most of all.

Critical Reflection on an Episode of Care

This Critical Reflection on an Episode of Care explores how ineffective communication during clinical rounds led to delayed medication administration and compromised patient safety. It analyzes the impact on patient outcomes, staff efficiency, and healthcare quality while proposing a practical calling card system to enhance coordination. This reflective piece demonstrates the application of evidence-based practice and professional growth in nursing, supported by expert guidance such as help writing assignments for structured academic reflection.

What?

While working clinically, medical staff organized their working hours and made rounds at set times to give medications and monitor progress. Despite their diligence, a recurring issue arose that included the scheduled visits, which may occur at a time when the patients were out of their rooms for some time, and they did not know when this would be. For this reason, critical activities such as administering medication and even patient monitoring only occurred once the staff had found the patients. This situation led to suboptimal work processes, including the risk of a worsening of patients’ conditions due to 27% missed medications or delayed assessments.

One particular event that highlighted this need for a change was when a patient who was recovering from surgery needed administration of pain daily. When the turn came for the nurse to administer the dose the patient was elsewhere in the common area. The other set of responsibilities for the nurse had already caused the nurse to be late by the time the patient came back as they were forced to wait and complain of discomfort in the process.

So What?

Impact on Patient Outcomes

This is exactly why medication administration is a critical aspect of patient safety and the treatment process which should be done at the right time. The World Health Organization asserts that any delays to medication especially for conditions such as post-operative pain or chronic diseases will worsen complications, slow recovery, and reduce public confidence in health services (WHO, 2019). In this case, lack of staff-patient communication led to gaps in treatment that were preventable and thus had the potential of jeopardizing patients’ health.

To this effect, the National Institute for Health and Care Excellence (NICE) also points to timely assessment in its guidelines on managing persistent illnesses insisting that missing appointments interfere with Christian early screening for adverse reactions (NICE, 2020). Failure to perform progress checks constantly may lead to missed deterioration in the patient’s condition, longer hospitalization, and a greater strain on economies.

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Impact on Staff Efficiency

From a nursing perspective patient elusiveness and failure to find the needed patients at the time of planned rounds meant a lot of time was being wasted and workload created. Furthermore, instead of addressing the patient's needs, staff found themselves rewinding or scouring through a room or hall, or looking for a patient whenever their task was interrupted. These lead to ineffective work pattern flow and can cause nurse burnout as confirmed by the International Council of Nurses given that badly managed scrubs can lead to staff fatigue, dissatisfaction, and turnovers, among other consequences (ICN, 2021).

Figure 1: Driscoll's Model of Reflection

(Source: https://www.researchgate.net/figure/Driscolls-Model-of-Reflection-Driscoll-2007_fig3_338775073)

Broader Context: National and International Perspectives

Failure to administer medications and missed care episodes are acknowledged worldwide concerns. The Patient Safety Learning Organization (2020) in the UK and the Agency for Healthcare Research and Quality (AHRQ) in the US note that communication breakdowns remain among the most critical precursors to care delivery disruptions. Some of these calls include AHRQ which creates protocols for conveying calm information which helps minimize care gaps by keeping patients and providers on the same page. This issue is also familiar with the case of ‘missed nursing care,’ which is widely studies in literature. According to Aldughayfiq & Sampalli, 2021, missed care is defined as failure to meet a patient’s need and has often a structural root cause.

Now What?

Proposed Improvement: The Calling Card System

To this end, it is my suggestion that the administration adopt a calling card system, whereby anyone with legitimate business would have to formally identify himself before being granted access or after accessing any restricted private area. In case a patient failed to attend that particular visit, the card left in the patient's room would indicate that particular visit, the time of the visit, and that the patient should contact the next available nurse. Reason for the Suggested Change

Improved Communication: The card call system serves as a communication bridge between the patient and staff. This forms explanations since the patients receive schedule information about their care arrangement to follow through their planned care.

Time Management of Nurses: In this manner, the system saves time compared to the multiple visits or searches that enable nurses to stay put with the schedule, time-efficient (Alam, 2022).

Patient-Centered Care: The health care, in this case, becomes patient-centered through the process of aiding the patient to keep a reminder to follow up for his or her treatment.

Evidence-Based Justification

Alarm systems in the context of health care thus have received a lot of research input. Cheap and easy methods such as the use of displays produced a marked difference in the rate of compliance among patients (Svoboda et al. 2021). Though they were concerned with outpatient services their concepts of communication and adherence still apply to inpatient services.

Similarly, some researchers argue a similar factor in which cheap communication solutions help improve care coordination within the wards. The calling card system corresponds with such findings by introducing a practically efficient tool that helps to construct patient experience while optimizing the work of caregivers.

Implementation Considerations

Training and Awareness: The calling cards are going to be useful provided that the personnel underwent training in order to use them in the correct manner. Nurses need always to clarify the objectives of the system, how the cards are completed properly, and how their use can be explained to patients.

Patient Education: This implies that, wherever the calling card system is to be used, patients must be educated on this program on admission (Abdulmalek et al. 2022). Directions can be found in introductory packages, or discussed by workers with new patients and clients.

Monitoring and Feedback: Thus, it would be appropriate to download its effectiveness through staff and patient feedback and regular auditing. It is also pointed out that possible changes can be made according to the data gathered, so the job may be improved constantly.

Cost-Effectiveness of the Proposal

As it has been discussed, the calling card system is perfect from the point of view of economics since its very nature is cost-oriented (Maddox et al. 2021). These are relatively inexpensive to print at large numbers, and the value of the time that will be saved, and the quality of the patient care that will then follow, far outweighs the outlay.

Improvement proposal

1. Start out

SIP (Service Improvement Proposal):

“Enhancing Medication and Progress Record through the Calling card system”.

Meaning in general

Nursing staff and patient communication is the area of need that drives this particular project. It explains the problem of overlooked medication and progress check-up appointments. One great concern is that 25-31% of patients miss their scheduled visits and as a result of that they delay seeking treatment. This affects the organization and delivery of medicines and the tracking of patient improvement, features critical for wellness management and remediation (Chu et al. 2022). The idea is to have a system where nursing staff can leave a message dropped when they do not attend their shift as scheduled. The card will let the patient know about the missed visit, and whether to reschedule or to check on the next available time.

Meaning of the project

In as much as this project is concerned, a calling card system shall be in direct relation as a solution towards the solution of the visits that are tend to be missed. This means patients will be able to know whether or not they have a scheduled appointment with a healthcare provider, and follow them up if they missed the appointment (Al-Arkee et al. 2021). It is hoped that the system will reduce waiting times for both the medications and the assessments conducted on patients. That way, patient outcome will be better due to increased consistency of care.

Figure 2: Essentials of Pharmaceutical Marketing

(Source: https://www.nature.com/articles/s41569-023-00972-1)

2. Define and scope

Snapshot of the problem along with rationale

A common problem in the current model of care delivery is that some patients are not present in their rooms during the times when the nurse arrives to deliver medication and to assess progress. This can occur if the patient is going for a therapy session, to visit his or her relatives or for any other reason whatsoever, out of the unit. Consequently, the treatment is provided later, and the health condition of the patient together with the healing process may worsen (Al-Worafi, 2023). Secondly, nursing staff are overwhelmed since they look for patients to give medication or those they need to perform a future assessment on. This system will likely improve follow-up procedures because some medications are only effective when administered at a certain times, progress will also be monitored without lots of break in between.

Consistency with national goals

This proposal can be aligned with the existing national healthcare goals and objectives. It promotes patient safety since it helps to reduce the possibility of leaving some treatments and assessments undone. It also joins current objectives for advancing timeliness of care delivery as a key and soluble health goal. It supports an important care objective of the NHS of achieving effective, safe and person-centered care (Pérez & Dzubay, 2021). The calling card system works in harmony with safe and effective care since patients get their medications for progress checks on time. This system is safe as it improves the experience of the patients through increasing the reliability of care to the patients hence improving their outcomes.

3. Measure and understand

Necessary informations

Key data points to be collected will include:

These surveys will help in ascertaining the appreciation of the patients with regard to the effectiveness of the calling card system in giving out information and enhancing the communication as well as the treatment experiences they perceived with the care they have received from healthcare service providers. To establish whether or not the call card results in less missed doses and increased medication compliance, the frequency of missing the medication will have to be observed to be compared with that before the implementation of the calling card system.

The priorities

To cover the patients’ need for medication, that is very important for their recovery and survival, it is important to deliver the medications as soon as possible. That the case of patients is checked frequently and changes made as and when needed in the care being provided to them (Palmer et al. 2021). Effective staff–patient communication is critical if the staff is to avoid giving the wrong impression or missing an appropriate opportunity. Through missed appointments, the nursing staff shall reduce time used following up patients to address missed appointments to perform other necessary tasks. The idea unveiled here is to facilitate the follow-up communication of a patient and make the process smoother thereby enfranchising the patient.

Stakeholders involved

Several stakeholders will be involved in the implementation and success of the calling card system:

Nursing Staff: Calling cards used in nursing homes are used mostly by the nurses themselves. They will be expected to drop the cards and ensure that among the patients who missed their appointments new dates are set.

Patients: Consumers will require sensitisation and encouragement to respond to the calling cards patients provide them with (Chandra et al. 2024). It is with this in mind that their engagement is very critical for the success of the system.

Ward Managers: The ward managers will be more directly involved in the Serve implementation and running, making sure the nursing staff sticks to new process, and assessing the change on the quality of care.

Healthcare Administrators: Health managers will assist in evaluating the possibility and needs for the project. They will be used in deciding on which financial resources to allocate and in offering support services.

IT/Printing Staff: These staff members will be involved in the preparation, the printing and the distribution of these calling cards (Fedorenko et al. 2020). They will also see to it that the system can easily fit the activities of the hospitals.

Figure 3: Healthcare Management System

(Source: https://otakoyi.software/blog/healthcare-management-system-features-and-benefits)

Information to implement the idea of plan improvement

The implementation of the calling card system is based on various sources of information. According to the survey, 21-24% of nurses complained that the time spent in searching for patients that failed to show up for an appointment delays care delivery. There arises the complaint of patients when medication is not on time or when checks done on the patients are not according to a given laid down timetable (Pulimamidi, 2024). A huge amount of literature review work was offered to give rather indicative evidence of the fact that the missed medications and assessments impair the state of the affected patients and create obstacles to effective and coherent provision of healthcare services. The use of Kotter’s model can help in improvement of the healthcare process.

Data Collection

The data will be collected through a combination of methods:

Surveys and Feedback: Questionnaires will be self-administered to both patients and nursing staff in the form of questionnaires to know their experience with the missed appointments and calling cards, and questionnaires offering views of the staff on the efficacy of the system.

Direct Observation: Care supervising ward managers and healthcare administrators will observe the way it is functioning and the difficulties encountered in the implementation process.

Review of Medication and Progress Check Records: The number of times the patient fails to take the medication and the frequency of progress checks will be observed in the patient records to check on improvements once the calling card system has been implemented.

Data collection method

Two phases of data collection will be performed:

Pilot Phase: Using the questionnaires at the onset of the calling card system, results will be obtained to assess whether it helps in reducing appointment no-show rate and staff loads. Data for the weekly basis will be analyzed on medication data during the pilot phase.

Post-Implementation Phase: After bulk, data will still be replaced monthly. System feedback from the staff and 16% patient satisfaction will reveal changes and potential modification.

The opinion for improvement

The first aim is definitely to inform nursing staff and patients about the new calling card system. People should be aware of what the system aims at completing, how the method it adopts functions and need to remind people about the missed visits. Use of calling cards for notifying patients of impending home visits and ensure they follow up if they fail to receive the visit as explained on the informational materials (Charles et al. 2020). When the implementation of the pass system is not supported by education and training for the staff as well as the patients they will not be receptive and thus it will not work.

Some of the major activities and stakeholders

Nurses: The patients are the secondary receivers of the calling cards while the main target group of the system is the nurses. They will also give feedback on the efficacy of the system and any challenges faced when using the system.

Patients: The patients will have direct interactions with the system and their information shall be used in evaluating the impact the system is likely to have on the patients. The patients will be allowed to cancel appointments that they cannot attend for others using the calling cards.

Ward Managers and Healthcare Administrators: The ward supervisors will oversee the implementation of the system in such a way that it shall be implemented uniformly. Healthcare administrators will help in procurement for the project and ensure that the project is successful in achieving the goal of the hospital.

IT Staff: The calling cards will be printed by the IT and the printing staff and IT support will be rendered on how to incorporate the calling cards with the rest of the systems in the hospital.

Cost estimation

The expenses were identified, which are connected with the printing of the calling cards and development of the educational materials. Furthermore, 2.1. Million Euro costs of software development and of integration into the existing systems may also be incurred. Nursing staff should be willing to spend time for such training and molding into executing effective plans (Kiguba et al. 2023). Moreover, managers and administrators should monitor the progress of the initiative. Resources for the printing of the cards and provision of patients with educational information, will be needed. Ward managers may need to set some time aside for continuous training and supervision. There will be also required time for collecting, monitoring, and feedback reviews, data collection, monitoring, and feedback reviews

Benefits to Service Users

Timely administration of medications and patients' progress monitoring will ensure overall improvement in the health of the patient and the patient's satisfaction level will increase. Patients themselves will be informed by a calling card system, this means they will be more responsible towards their treatment.

Benefits to the NHS

Increased efficiency will be achieved since the delay in treatment will be shorter, thus it will be a reduction to the burden on the nursing staff. Such a system can therefore lead to reduced stay time in hospitals lower rates of readmitting patients and effective use of available resources.

The assumptions/barriers/resistance to change need to apply

Implementing the new system or the change in routine or extra workload may bring some resistance from some of the nurses. Prevention of this kind of problem can be brought about by proper training and subsequent communication of the usage of the new system (Kamin et al. 2022). Patients may not be interested in tracking their missed visits, therefore, may not use the system as was expected to happen. Issues dealing with calling cards may be costs of printing and distribution which in turn may become a problem if handled in an indifferent way.

Figure 4: Enhancing healthcare process

(Source: https://www.infineon.com/cms/en/applications/security-solutions/government-identification/electronic-health-card/)

4. Design and plan

Goal:

The main goal of this intervention is to ensure that the patients receive their medicine as expected, and be followed up as scheduled. These are forces that precipitate the need to ensure timely medication, and frequent monitoring for better patient satisfaction.

Objectives:

First of All, a Calling Card System in One Ward

In order to train 100% of nursing staff following goals are following:

Developing an Intervention

An aspect of the intervention will be to leave calling cards in patient rooms for times when the visit was missed. Every card is going to contain date of the missed visit and a plain message to let the patient speak to the next available nurse (Amjad et al. 2023). This will make the patient aware and in case the rescheduling happens, the patient will not be an obstacle. Current assessment of the system is proposed to be piloted in one ward though future implementation is to be extended once effectiveness is ascertained.

Dealing with resistance to change

Loss of resistance can be reduced by different approaches at the workplace, communication, training, and supervision. Since many workers are likely to resist this type of change, it is advisable to explain the advantages of the calling card system for staff and patients (Psotka et al. 2020). To enhance the training effectiveness in the implementation of the new system, the training sessions will only be open to the nursing staff.

5. Pilot and implement

Initially the intervention will be implemented in experimental manner in one ward choosing a number of nursing staff and patients. The idea is to collect the feedback of both the staff and the patients to know whether the system is performing or not. This pilot phase will summarize the feasibility of applying and implementing the system and its influence on medication administration and 70% patient satisfaction.

The use of intervention

The pilot phase will commence one month from now to give adequate time in staff training and preparations. To capture enough information and assess the performance of the system, a pilot will take three months. This period will be applied to respond to challenges and make changes if it is appropriate (Stolldorf et al. 2021). As stated during this period the performance of the system in terms of reduction of 30-33% missed medication and patient progress check will be evaluated. After the pilot phase is over, the study will compile relevant outcomes, at which point full-scale implementation will proceed if the pilot phase was effective.

Involvement way of stakeholders

Moreover, stakeholders’ engagement with the implementation of future technologies will play a significant role throughout the pilot phase. Weekly/ fortnightly meetings will be held with nursing staff, ward managers, healthcare administrators and all in charge affecting the project to ensure that all of them are informed and on the same page concerning the project. There will be forever feedback from the nursing staff through an anonymous survey or talking about the hardships in using the system.

Leadership Approach to Guarantee Success

The intervention will be implemented through the lens of the transformational leadership approach. This approach is based on the encouragement of the staff and encouraging participation in change. Managers will express their rationality behind using calling card system, the advantages for employees and patients (Yasmin et al. 2020). Through the process of organisational culture that places curiosity for the applicant, the leadership team will make it easy for the staff to bring out their feedback and any impediments to success these staff come across to them.

6. Handover and Sustain

Reviewing the Outcomes and Approaches to Sustainability

When calling card system has been organized completely, basic parameters must be established in order to determine efficiency of the system. Measures of med admin, patient satisfaction and nursing staff’s work will be obtained to measure the effects of the intervention (Simon et al. 2021). This information will assist in determining whether the system has made a positive impact on medication adherence, minimized delays and the time nurses spend searching for patients.

Monitoring Data after Intervention

To maintain the documentation of the effects of the project, patients’ and nurses’ feedback will be assessed systematically. To supplement this, providing calling card systems to patients will have positive impacts on how patients rate the way the calling card system serves them. They will mainly include questions on timeliness of the administration of the medication, how often the patient was spoken to by staff and level of satisfaction of the services that were offered.

Sustaining the Project

In order to maintain the calling card system, idea feedback and control will be necessary in the future. The nursing staff and patient end-users will be regularly consulted to guarantee that the system remains relevant for this profession (Alomar et al. 2020). Future audits will review the outcome and effectiveness of the system and the process will be kept responsive.

Ensuring Long-Term Benefits

The proposal for calling card system will be centralized for future gains by making it an integral part of development and making it part of organizational culture. Such an integration makes work in the mentioned system routine and gets rid of an opinion that it is an extra obligation. There is also a plan for staff training in the future, the continuation of the audits that will ensure the continuation of the features of the intervention.

Conclusion

The calling card system that is called the “Improving Medication and Progress Monitoring through the Calling Card System” proposal addresses the problem of missed medication and progress checks caused by the patient’s absence. This intervention will improve interactions with focus on medication administration and general patients’ observations by members of nursing staff. Through the calling card system, patients will be informed of missed visits and advised what steps to take next, following the next available nurse to ensure that they do not waste time. The first trial of the system will be for a year in one ward and after the implementation of the system, feedback from the staff and patients who are clients will be used to assess the performance of the system.

As the system becomes incorporated as the norm into the day to day conduct of health facility business as well as the normal business processes, the project will impact overall positive patient outcomes, reduction in the 20% workload burdens placed on the nursing personnel, and increased compliance to medication regimens by patients. This proposal will therefore help create a more efficient and effective health care setting for both the customers and human resource.

Reference List

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