Nurse Leadership Styles in Promoting Electronic Medication System

Introduction

Nurses are the key contributors in meeting a country's challenges in the healthcare sector. The nurses and midwifery account for a significant section of healthcare services expenditure working from the community-based healthcare to inpatient care with the roles of delivering quality healthcare services, coordinating on the patient care, increasing safety and quality care improvement and the health service and system development. Strengthening quality and integration of care in promoting electronic medication requires proper management and leadership of healthcare professionals.

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Leadership is the relationship between those who lead and the individuals who accept to follow (Sawai, 2013). There are six leadership styles which include task-oriented leadership which involves a leader planning for the activities (Frandsen, 2014), transactional leadership, autocratic, transformational leadership, relationship-oriented leadership and the laissez-faire leadership. For high productivity levels within the healthcare, quality care is a vital factor to be considered. Quality care should have characteristics like being safe, effective, reliable, patient-centered, efficient and equitable to the services.

Reasons to adopt the electronic medication system

Electronic medication enables patients and healthcare professionals to access data more efficiently and improve which improves the quality of health and the social care. Improvement in technology is capable of providing cost-effective solutions to the growing aging population (Minshall, 2013). The deployment of the use of technology experiences some barriers in their full implementation as illustrated by the European Commission in 2014. EU commission 2014 suggested the solutions to technology implementation barriers to including adopting critical principles of data minimisation, giving patients control over their data and building trust by implementing the use of robust privacy and security arrangements.

The reasons to adopt a complete electronic medication system are in the information sharing discharge, electronic patient's portal, patient reminders using mobile technology, computerised provider order entry and clinical decision-support system. In considering the information sharing discharge, the clinicians need support and training to understand the use of electronic release (EDS) fully; they may promote faster transmission of patient information to the clinicians (Cresswell, Mozaffar, Shah & Sheikh, 2017). The use of patient electronic portals is essential since they include functions like securing the message. Patient reminders using mobile technologies are useful in passing information about the reminders in a large population, and also it is a two way messaging.

LEWIN'S PLAN MODEL

It entails the planned change and a new change in the management. Planned change approach recognises that the old characters should be abandoned for the new behaviours to come up in the organisation. Lewin's 3-step model shows how organisations change is actualised, the steps are unfreezing, moving and refreezing (Burnes, 2013). The first step, which is unfreezing, entails creating buy-in for change so that organisational members appreciate the need for change. The stage involves understanding the status quo inducing guilt and establishing the safety of psychology in the organisation (Burnes, 2013). The only mitigation anxiety towards change and the unknown fear after creating psychological safety can lead to the unfreezing of the old behaviours and new behaviours to be successfully adopted.

Lewin's second stage that is moving draws from the theories and group dynamics to identify the sector, which needs to change and develop an implementation strategy. All factors that may lead to hindrance are defined here, and then the next step which is refreezing have to occur to stabilise the groups of new Quasi-stationary equilibrium as illustrated by Burnes, (2013). Lewin's model of change is summarised into unfreezing which is examining the status quo increasing driving forces of change, moving which is taking actions to make changes involving people and refreezing to make changes permanent.

Leadership StylesManagers should consider their leadership skills regarding their strengths and weaknesses in the organisations since these skills could affect the change process. Howison and Stanton, (2003) state that proper leadership, effective communication and team working are the critical elements of the planned change. Jooste, (2014) declares the attributes of effective leadership to include, influencing the organisation members, ensuring workers are clear about their tasks, commitments, and self-image. The leadership styles are autocratic, democratic and Laissez-faire. This paper focuses on autocratic leadership to be employed by the nurse management and midwifery.

Autocratic leadership

It has a high level of productivity and can be predicted with low motivation, creativity, and morale (Marquis and Houston, 2013). When change is demanded in an organisation, autocracy is the best leadership style to be used because communication flows from the top downwards that shows clarity in the information passed. When it is compared to a Laissez-faire leadership style, it is highly preferred. Laissez-faire leadership style is non-directional and stressful to the nurse managers and midwifery; it cannot work for planned change, but only where organisational members are self-motivated and highly directed. There is always much resistance from the group members (Delmas & Toffel, 2013). Democracy is highly considered in this leadership style as it does not require multiple change agents leading to much resistance from members.

Aspects of Resistance to Organizational Change and How to Implement the Resistance

Resistance to change by the employees in an organisation can result in damages to the organisations. Some nurses are against the adoption of the use of electronic medication since the leadership styles employed by the nurse managers are not favourable to them. This leads to nurses spending high costs in the implementation of this programme in the healthcare sector (Neves, 2009). Resistance to change is related negatively to job satisfaction. To investigate on the aspects of strength a questionnaire was spread through the employees emails working in an organization in the healthcare sector. There was an instance of resistance in three organizations out of the five where the study was conducted. One of the respondents said, "There might be a lot of trouble with the implementation of an electronic medical system because many patients are not literate in the current technology."

Managing resistance in the organisation can be dealt with by changing managing actions by using the aristocratic leadership where all the staff is encouraged to participate in decision making, broadening staff interest by speeding up the process using such suggestions like helping staff with wise timing and coaching the teams. The other solution to resistance can also be using understandable terms (Lester & John, 2018).

Conclusion

Leadership styles improve quality measures in the healthcare and nursing sector, health-related outcomes are different because of the leadership styles applied, healthcare organisations should ensure technical expertise, build capacity and organisational culture in understanding the implementation of electronic medication in the healthcare sector. The attempts for explaining the planned change process face some problems, but in using the Lewin's plan model, the challenges can be eliminated. The resistance case is identified with the possible solutions highlighted to help the healthcare sector to improve the use of electronic medication. Since the purpose of Lewin's model does not guarantee success, careful considerations of the change theory can simplify the process for nurses and midwifery and make the patients more receptive to the change.

References

Al-Sawai, A. (2013). The leadership of Healthcare Professionals: Where do we start? Pg. 28, 285-287

Burnes, B, (2013). Kurt Lewin and the Planned Approach to Change: A re-appraisal. Journal of Management Studies 41(6): 977-1002

Frandsen, B. (2014) Nursing Leadership Management and Leadership Styles. American Association of Nurse Assessment Coordination.

Cresswell, K., Mozaffar, H., Shah. S, & Sheikh, A, (2017). Approaches to promoting the appropriate use of Antibiotics through hospital electronic prescribing system. A scoping review. Journal 25(1): 5-17

Jooste, K, (2014). Leadership. A New Perspective. Journal of nursing management. 12(3) 217-218

Howieson, A, $ Stanton, A, (2003). From conflict to collaboration. Contrast and convergence in the Development of nursing and management theory. Journal of nursing management. 11(1), 15-24

Lester, C, & John, R.P, (2018). Overcoming Resistance to Change. Human Relations, volume 1(4), 512

Minshall, S, (2013). A review of healthcare information system usability and safety. Studies in Health Technology and informatics. Journal 183: 151-7

Marquis, B, & Huston. C, (2013). Leadership Roles and Management Functions in Nursing. Theory and Application.

Neves, P. (2009). Readiness to Change, Contributions for employee's level of individual change and turnover intentions. Journal of Change Management. 9(2) 215-231