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Scholarship essay


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Scholarship essay example

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Scholarship essay

  1. 1. Running head: ASPIRATION PNEUMONIA 1 Aspiration Pneumonia Name Institutional Affiliation Course Instructor’s Name Submission Date
  2. 2. ASPIRATION PNEUMONIA 2 Organizational Change on How to Tackle Aspiration Pneumonia Description of the Problem Aspiration pneumonia refers to the infection of the lower respiratory tract that is caused by the entry of secretions from the oropharynx or stomach contents into the lungs. In many cases among the healthy adults, the normal defense mechanisms such as lung cilia and cough facilitate the removal of the aspirated materials and, as a result, there are no ill effects. According to Johnson & Hirsch (2003), patients or the elderly are often at a high risk of developing pneumonia as a result of aspiration. Aspiration pneumonia complicates the process of treatment for elderly patients. For instance, cancer patients often face the risk of aspiration pneumonia due to the various cancer treatments and the disease’s progress (Guy & Smith, 2009). The condition raises a lot of concern because it is a significant cause of mortality among patients from the infections got from a hospital setting. The ailment has a 21-44 percent per 1000 incidence rate for older adults (Janssens & Krause, 2004). Moreover, Janssens & Krause (2004) states that this rate is four times that of younger people. Thus, it calls for more focus on the issue so as to curb the deaths and complications that result from it such as bronchiectasis or lung abscess, and acute respiratory distress. Therefore, it is vital and significant for the hospital to ensure patient safety through the adoption of modern safety measures and relevant evidence based treatments for aspiration pneumonia (DiBardino & Wunderink, 2015). The hospital’s purpose is to ensure that the elderly and ill patients do not have complications as a result of aspiration pneumonia. This will be achieved via the adoption of preventive strategies, and specific treatment routines. Further, the hospital’s culture is based on the tenet of good health care delivery to its patients or community. Thus, changing the clinical
  3. 3. ASPIRATION PNEUMONIA 3 care processes by the use of modern and relevant strategies to manage aspiration pneumonia is in line with the organization’s culture. To change these clinical care processes, the various participants who make up the organizational structure have to be on board (hospital management, health care professionals such as nurses, patients and their families). It is vital for the hospital’s chief executive officer to agree to the change since he exerts control over the hospital staff. Also, an informal leader such as a nurse who is knowledgeable about aspiration pneumonia will be identified. A more knowledgeable health care provider will be viewed as being credible by other health care providers. This will motivate the nurses in the hospital to easily agree to the clinical process changes. The Risk Factors of Aspiration Pneumonia Aspiration usually occurs as a result of impaired consciousness, reflux esophagitis, in bulbar palsy if trachea-esophageal fistula (TOF) is absent. The risk factors include alteration of the level of consciousness due to general anesthesia, seizures, sedation, drug or alcohol abuse, head injury and acute stroke. They also include reduced mobility, increasing age, nil per oral measures, male gender, Chronic Obstructive Pulmonary disease, and the increase in the number of medications. Swallowing disorders such as dysphagia, esophageal stricture, neuromuscular disorders, and pharyngeal disease also pose a risk. The others are nasogastric feeding tube, ventilator-associated pneumonia, tracheostomy, post-gastrectomy, and gastro-esophageal-reflux (Johnson & Hirsch, 2003). Driving and restraining forces The adoption of the clinical process change will encounter driving and restraining forces. However, the manager and the informal nurse leader will provide information that will try to
  4. 4. ASPIRATION PNEUMONIA 4 unfreeze the system via a reduction in restraining forces rather than increasing the driving forces (Dawson, 2003). Some of the driving forces for the organizational change are; the new way is more efficient. The adoption of evidence based and modern procedures for managing aspiration pneumonia are more efficient than the traditional approaches used by the organization. This is vital since the new procedures will reduce complications arising from the ailment. Also, the hospital manager supports the new change. Support from management implies that the change is acceptable. It’s also a go ahead sign from management. Managers in any organization determine the changes that have to take place in the organization. Thus, support from management will ensure that the change is implemented. Further, the adoption of the new change is not costly to the organization. The organization will need little financial costs to implement the change. A knowledgeable nurse in aspiration pneumonia will help other nurses comprehend the new techniques and processes involved. An inexpensive undertaking is a driving force since it improves the acceptability of the change by management. A hospital might lack the resources or funds needed to support the change leading to its failure. On the other hand, there are restraining forces to the change. First, the new change requires nurse training. Nurses will have to be trained about the new processes and changes in how to manage aspiration pneumonia. Also, the new change is time consuming since nurses will have to attend numerous training forums. Due to the limited number of nurses in the hospital, the training will imply that some nurses who will not be required to attend the training will be overburdened with work during the training period. Goals and outcomes The change process has three objectives or goals; 1. Better management of aspiration pneumonia
  5. 5. ASPIRATION PNEUMONIA 5 2. All nurses to be educated about the new methods of managing aspiration pneumonia 3. The change process should be completed in a time frame of one month. Process of Implementation of the Change Change implementation in an organization often requires tools and interventions which are specific to the problem and the required outcome. The organizational development theory will guide the change process in the hospital. The theory states that for an organizational to change successfully, the staff must accept the organizational goals or the goals for the change (Rhydderch et al., 2004). Also, Lewin’s three step change model will be adopted. The model specifies three steps which have to be followed during the change process; unfreezing, moving, and refreezing (Kaminski, 2011). Unfreezing deals with discouraging and stopping old routines or behaviours and habits while moving depicts the transition time. New behaviours and procedures are adopted in this step (moving step). Refreezing on the other hand signifies the establishment of the new procedures and routines or behaviours. A democratic type of leadership will be adopted during the change process so as to inspire the hospital staff. Implementation Process 1. Communication from management about the proposed changes to the nurses. The hospital manager will communicate to the nurses the need for change during the project’s first week. 2. Selection of the informal nurse leader. The nurse who will lead the exercise will be selected in the second week of the project
  6. 6. ASPIRATION PNEUMONIA 6 3. Nurses undergo training (freezing, moving). Nurses will be educated about the efficiency of the new approaches compared to the old approaches. They will also be trained on how to perform the processes in a clinical setting. The training will take a week. 4. Nurses implement the new processes to practice (refreezing). After training, the nurses will be required to implement the changes to their areas of practice after training. Evaluation During the change, nurses will be evaluated by the informal nurse leader and an outside health professional if they have grasped the processes. After the change, the impact of the new clinical changes will be evaluated to determine if the change had any significant impact on managing aspiration pneumonia. Some of the elements that will be evaluated six months after the change include: Do the nurses use the new methods in managing pneumonia? And how have the new changes impacted patient outcomes?
  7. 7. ASPIRATION PNEUMONIA 7 References Dawson, P. (2003). Understanding organizational change: The contemporary experience of people at work. Sage. DiBardino, D. M., & Wunderink, R. G. (2015). Aspiration pneumonia: A review of modern trends. Journal of critical care, 30(1), 40-48. Guy, J. L., & Smith, L. H. (2009). Preventing aspiration: a common and dangerous problem for patients with cancer. Clinical journal of oncology nursing, 13(1), 105. Janssens, J. P., & Krause, K. H. (2004). Pneumonia in the very old. The Lancet infectious diseases, 4(2), 112-124. Johnson, J. L., & Hirsch, C. S. (2003). Aspiration Pneumonia: Recognizing and Managing a Potentially Growing Disorder. Postgrad Med., 92-112. Kaminski, J. (2011). Theory applied to informatics-Lewin’s change theory. Canadian Journal of Nursing Informatics. Rhydderch, M., Elwyn, G., Marshall, M., & Grol, R. P. T. M. (2004). Organisational change theory and the use of indicators in general practice. Quality and safety in health Care, 13(3), 213-217.