Question

"Darn! I have to call Pharmacy again," Lisa, staff nurse on 6 East, muttered under her breath. "This is the third time today and it's not even noon!" She left the Omni-Cell Cart in the medication room and proceeded to the phone at the nurses station. She dialed the familiar number - she had it memorized of course - and thought, "There has to be a better way." For the past few days, she had noticed an increase in the number of medications missing from the medication carts. Two days in a row, she was able to get a vitamin from another patient's medication drawer and administer it to her patient, but she knew this did not solve the problem. She was try to make it through her shift and get the patient what they needed. In the meantime, on 6 West across the hall, Deirdre had a similar issue. The morning dose of her patient's oral antibiotic was not in the drawer, so she gave the dose that was labeled "evening dose." The evening shift nurse then had no evening antibiotic dose in the drawer and had to call the pharmacy to get a replacement. Numerous calls were being placed to the pharmacy. The pharmacy technicians were so busy fielding phone calls that non of them were available to deliver medications, so the staff nurses had to leave their units and patients and go to the pharmacy in the basement to retrieve their missing doses. The pharmacy technicians began complaining to their supervisors that those 6th floor nurses call so frequently that they do not have time to do their work. Nurses complained to each other that pharmacy was not stocking the medication carts correctly. Lisa notified her nurse manager, Katie, that their was an increase in the number of medication doses that were unavailable at the time of their scheduled administration. Likewise, Marcus, the nurse manager on 6 West, heard from his night shift nurses that they had to "run to the pharmacy" many times during the night to get medications that were not in the medication cart. That same morning, Katie was on the way to a Nurse Manager Meeting when she ran into her colleague on 6 West, Marcus. After exchanging greetings, Katie asked Marcus how it was going. Marcus explained that several of his nurses complained about pharmacy not stocking that medication carts appropriately, but he had no time yet to verify this or talk to the pharmacist. It was on his "to do" list though. Katie explained that one of her staff nurses made this same complaint earlier that day. They both decided to raise this as an issue to be discussed at the Nurse Manager Meeting. "Is anyone else having trouble with Pharmacy?" Marcus asked at the end of the meeting. "My staff nurses are complaining that the med carts are not stocked correctly." Many hands went up, and others chimed in that they thought it was an issue only for their specific units, but now they realize how widespread this problem was. Because the Nurse Managers practice shared governance, they appointed Katie and Marcus to lead a Performance Improvement (PI) Team to figure out what the problem was and to take action. Three other Nurse Managers volunteered and joined the team; after a short meeting, the team agreed upon a plan.

As a PI team member—do you anticipate any resistance to problem solving at this point? Why or why not?

Answer 1

Resistance to problem solving at this time to arise is minimal ,like the pharmacy technicians denying their faults by saying that the nurses are too disturbing by making calls in the most busy hours which can make them to miss the stocks in the medication carts when supplying.

Otherwise simply denying the complsintscraised by the nurse.

The pharmacy manager can be a resistance ,if unaware of the situation faced by the nurses due to short supply

Lack of training, new pharmacy technician, increased workload can easily hinder the problem solving approach.