Introduction Of Electronic Prescribing And Medicines Administration In Adult Mental Health

 1. Introduction Of Electronic Prescribing And Medicines Administration In Adult Mental Health

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“Electronic Prescribing” and “Medicines Administration” an applications of electronic systems to encourage and increase the communication of a medicine order or prescription, assist the choice, administration and contribution of a drug through comprehension and resolution support along with delivering a strong survey for the whole medication use steps  “Adult Mental Health Rehabilitation Centre Barnet”.This facility has been providing the clinician with a 24/7 approach to the medication of the patient and can be recorded from any place. “Electronic Prescribing” and “Medicines Administration” also provide time efficacy, safety management and integrated decision support. This process aims to generate a clinical structure which was composed of a total record of all the medicines prescribed along with administration so that the pieces of medicine information can be accessed from any location at any time and 24/7. This assignment aims to explore the electronic prescription as well as medical administration of medicines by nurses in the improvement of mental patient safety.

The particular service is to make improvements to “Electronic Prescribing” and “Medicines Administration”by overcoming the barriers. There are many variations in the prospective pathways by which patients' medicine uses could be targeted to upgrade the outcomes so that simple innovations may be efficacious. The service needs to renovate some points to meet effective results. Antibiotic prescribing is detained often, which creates a problem in the electronic prescribing systems and this is need to be solved. All the nurses along with the physicians have to deliver self-management skills through counselling, training and follow-ups, by this, the patients can get a positive impact towards the treatments. However, many segments of the “Electronic Prescribing” system can authorize drugs to be used more aptly but it has to be kept in mind that the drugs should be less expensive so that any type of patient’ can afford them. In this assignment at the beginning challenges with electronic prescription will be defined based on the improvement in implementation strategy from a nursing perspective will be incorporated. Additionally, an action plan for the implementation of electronic prescriptions successfully will be provided.  

2. Context and Background

2.1 Current challenges of healthcare in the UK or England

The healthcare system of the UK is facing various challenges to meet the efficient treatment requirements of the patients. The major challenge experienced by the health service providers of the UK is efficiently providing medications to all the patients in the community (Commonwealthfund.org, 2020). The United Kingdom has thus, established the "National Health Services (NHS)" to improve health services. They aimed to outreach medical services to the people free of cost. One of the challenges for doctors and nurses is to provide effective medications to adults suffering from mental disorders. Though the NHS has played an integral role in the mental health department to treat "anxiety disorder” and “mild depression", serious mental patients lack proper treatment (Gov.uk, 2020). The other challenge that the United Kingdom is facing in their healthcare system is the efficient tracking of health and its facilities available to the people of the UK. 

The health system of the United Kingdom for the treatment of mental patients has introduced the innovative “electronic prescription" to prescribe medicines to patients. The main issue of an "E-prescription" is that it cannot be assessed physically causing difficulty for the patients to handle such prescriptions (Janett and Yeracaris, 2020). The patients and their families find it difficult to understand the medicines prescribed electronically. Sometimes they also find it difficult to buy a licensed drug from an authorised pharmacist. Thus, it is challenging for patients to handle electronically generated prescriptions and the availability of drugs in licensed pharmacies. 

2.2. Change Drivers of “Electronic Prescribing” “Medicines Administration”

“Electronic Prescribing” and “Medicines Administration” need to change the identified challenges to increase safety management within the “Adult Mental Health Rehabilitation Centre”. The drugs which are prescribed through electronic mediums should aware of “drug age”, “drug disease”, “drug-allergy discrepancies”, “drug reciprocity”, “progressive toxicity”, and “duplicate therapies” (Warner et al., 2022). These filters of a particular drug while prescribing will help to maintain the safety of a patient. Physicians need to be trained with self-management skills to use the system of “Electronic Prescribing” also some physicians need to be available at the time when a patient wants to connect to solve any confusion regarding any drug intake. 

2.3. Innovation to assist the challenges

The rehabilitation centre of mental health has made innovations in “E-prescribing” and “Medicines Administration” by introducing “e-Prescribing software” for electronic prescriptions which have been purchased from specialist retailers (Alshehriet al., 2021). The software has been developed to indicate the problems which are reducing the chances of implementation for electronic prescription. This electronic prescription is essential for recording proper information related to patients (Schiff et al., 2018). Nurses can access this electronic prescription before and after mental health care, and a drug administration which is helpful to avoid medication errors. However, software which has been used to implement the electronic prescription for the mental health patient should be secured as the patient personal information is written and recorded within the electronic prescription (Warner et al., 2022). Therefore, the software can address the problems related to electronic prescriptions such as toxicity related to drugs that can occur in patients using different medicines as well as cyber security for patients' data would be altered by this software. 

2.4 Change management plan and implementation

Electronic prescription is a system that is related to the development of electronic health records that consist of information related to the patients such as administered medicines and others. However, it has been identified that medication errors are still there in the presence of electronic prescriptions (Ho et al. 2021). Hence, nurses and other health professionals are required to be trained regarding the accurate and proper use of electronic prescriptions. Clinic workflow can be improved using eth electronic prescription 

Plan to study and act on a few things which should be implemented:

• Need well-trained nurses and also need more involvement in the process of electronic prescription.
• Need to implement tools for the technical department and also need a medical coding specialist team (Kooij et al. 2019).
• Need to generate a training section for the nurses to understand and learn the work by using the specific technology for the electric-generated prescription.  
• Need an experienced practitioner to lead a team guide who also holds the knowledge of the technology and tools in the electrical prescription. 
• Also need to create a feedback portal for the customer from there the center can get all the suggestions to improve and also implement new things in the center. 

3. Discussion

3.1 Strategy for Implementing Electronic Prescription

“Adult Mental Health Rehabilitation Centre Barnet" has aimed to implement the technology of electronic prescription for the patients of the rehabilitation centre. It is a professional tool for the medical staff of the centre to provide medical information to the patients. The prescription has increased the professional level of the physicians and other staff of the hospital (Aldughayfiq and Sampalli, 2021). The E-prescription can be automatically generated from the information of the patients uploaded in the database of the rehabilitation centre. The strategy of implementing innovative technology in the medical section for the prescribing of medicines has been enhanced in the United Kingdom. The patients suffering from mental health are tracked and data is recorded in the database along with prescribing suitable medicines (Aldughayfiq and Sampalli, 2021). However, one of the challenges faced by the "adult mental health rehabilitation centre barnet” is the safety of the records of patients.

There is always a risk to the data privacy of the patient records and information, and there are high chances of breaching the data privacy policy. The breaching of data from the database of the rehabilitation centre can lead to the loss of personal information of the patients (Zheng et al. 2021). Thus, the implementation of electronic prescriptions in the healthcare system requires a high-security policy. This can help them avoid the personal data loss of not only patients but also the health workers of the rehabilitation centre. The managers of the rehabilitation centre are required to necessarily analyse and wisely make decisions on the benefits and drawbacks of electronic prescription (Zheng et al. 2021). The advantageous aspects of the implementation of electronic prescriptions for treating adult patients who are mentally ill must be considered. The “adult mental health rehabilitation centre barnet” has found it highly beneficial and works efficiently for the staff while providing medication to the mental patients.

3.1.1 Implementation plan and timeline

The large program of the health centre which is continuously growing and also progressing and computerizing the health centre, needed a professional and also a brilliant practitioner to implement the context and also the system of the whole general guides which was generated by the various suppliers (Mwebe et al. 2021). The selection of the guide or the practitioner is also crucial and has to work widely and have the knowledge of the technology which is used in electronic prescribing.

Action	Resources	Goal	Time frame
Involvement of nursing members	Recruit professional members of nursing practitioner	Know about technology and also can work widely in a team and also for the centre	6 months
Medical coding	Recruit some technician who knows to code and also medical terminology.	Generate tools where all the data of the medicine and purpose would be restored and can be easily accessible.	12 months
Training to nurses related to use of the electronic prescription in the care of adults having mental health issues	Technicians need to be hired to train the nurses to use the technology.	All the employees, especially the nurses and the guilds can deal with the electrical prescription.	8 months
Monitoring the proper use of electronic prescription to the administration of the electronic prescription	Recruit experienced practitioners who know and also know the technical way of working.	a practitioner can give guidance and advice and also can lead the team and monitor the usage of the electronic prescription.	6 months
Feedback collection related to software	Survey or generate a portal on the website as nursing feedback related to the use of e-prescription	To improve and implement new things based on customer opinion.	5 months

3.1.2   Pilot the innovation

The innovation has been implemented within the hospital and health sectors. Therefore, this software has been tested by considering a small number of participants. Software tested on nurses and nurses has provided feedback based on that which has been intended to utilize in the future to improve the software related to electronic health prescription in order to ensure the ease of work. It has been found that the Thai project has several problems such as data security-related problems and others. However, the pilot project has highlighted the decreasing time of nurses required to deliver high-quality health care using electronic prescriptions (Müller-Sedgwick et al. 2020). Additionally, it has helped nurses to reduce medication errors as electronic prescriptions not only act as medical prescriptions but also act as record storage software. Hence, innovative software is beneficial to consider further. 

3.1.3Implementation of Software Innovation and leadership

An agile nursing leadership style can be considered to use electronic prescription. It has been found that agile nursing leadership is beneficial to disseminate innovation-related data among other nurses. The center of adult health care needed some innovative implements and also needed to improve the leadership and had to make strategies for the management. The list of management strategies are - 

• Make portfolios 
• Name of the project list
• Excellent leadership
• Maintain the external relationship
• Maintain the progress of the process
• Measure the performance
• Monitor the resources
• Maintain the technology department

Medical workers like nurses and the practitioner team need a professional team leader who can guide them and also train them for the implementation of the new technology. The management needs to do the portfolios for all the health workers in the centre and also have to do the portfolios for the patients. For the new innovative implementation, a well-experienced team leader and well strategic management team are needed. 

3.1.4Change management model

Change models in the management department are nothing but the theories, and the concept of the topic, methodologies that help to improve the health centre by implementing new proposals so that the centre can grow exponentially. Two important change models are ADKAR and the other one is Kotler. 

ADKAR- 

• Awareness
• Desire
• Knowledge
• Ability
• Reinforcement

The main motto of the change model is to make awareness in the management and also make the aim which is desired for the health centre (Kardaset al. 2020). This can make many moves and can change many areas of the management department. In the transition of the management department, the most important thing to occur is knowledge and the ability to gain knowledge. Understand the technology and learn from experienced people. 

Kotler's change model can be considered in order to change the management of health organizations in order to implement electronic prescriptions. There are five steps to implement change within an organization. These are -

• Core benefits
• Product of generic
• Product of expect
• Product of augment
• Product of potential

Moreover, the ADKAR model is an excellent choice to change a management department. This change model is oriented to the outcomes. This model can be used to change fasciitis and also can facilitate many kinds of changes. Each person in the process of changing needed to complete their goals and the magnetic targets.  

First, the healthcare management department needs to generate awareness that they are going to change and implement. Like in this case they have to inform everyone in the centre that electric prescriptions are going to be generated. In the health centre, every nurse practitioner and also the patients, and the connected supplier of the medicine, pharmacy all need to know about the new implications which are taken by the health care management department. 

Then the second part is to make the changes and all have to desire the outcomes. Some employees also do not want to have any changes in the department or working process. For that, all health workers need to understand the technology of the electrical prescription process and they also need to adapt to this need changing procedure. Otherwise, it will not be a successful procedure for the implementation (Kardaset al. 2020). It is required to provide technical knowledge to everyone in the healthcare centre to understand the process. Also, have to check the health care centre’s workers that they have at least the proper knowledge to make the changes in the work process. 

3.1.5 Role and involvement of stakeholders in implementing the innovations

The stakeholders who are involved in the implementation of the electronic prescription are “nurses, administrative department, technicians and patients". The nurses handle and keep records of the patients in the database of electronic prescriptions. The medicines of the patients are prescribed and auto-generated based on the information entered in the database (Cantone et al. 2019). The administration handles and manages the records of the patients and the working of the rehabilitation centre. The administration is responsible for tracking the functioning of e-prescriptions. The technician is responsible for the proper functioning of the electronic prescription technology. The technician keeps track of the software and cyber security of the electronic prescription. The patients avail the facility to get information from the E-prescription database easily (Cantone et al. 2019). The patients can find all the old and new records of their health progress and get treated accordingly.

3.1.6 Assessment of risks of implementation of the innovation.

Financial risk -This new implementation in the healthcare sector is costly because the management department can face some financial problems (Ikkos et al. 2021). So, that risk can arise if the management department does not plan for the proper approach to the new changes. 

Monitoring risk - If the management department did not monitor the health worker's work and the improvement of the patient and the feedback from all the customers and the nurses then the department cannot access the improvement or any reduction in the progress. 

Acceptance risk - All the health workers cannot always accept or be able to understand new things and technology which will affect the health care department. 

3.1.7 Evaluating and monitoring the innovative E-prescription

The evaluation of the E-prescription can be done by taking feedback from the patients and the families of the patients. It is important to evaluate the usage of the newly introduced electronic prescription for further modification and upgradation (Matthews et al. 2019). The feedback of the patients and their families thus plays a vital role in the implementation process of E-prescription. The modification of the electronic prescription based on the feedback received can help to generate a better E-prescription of the medication. The medicines that are to be administered to the patients will be easier for the better understanding of the patients (Matthews et al. 2019). The medicines prescribed on the prescription can be easily understood and handled by the families of the patients.

3.1.8 Roles played by the nurses in managing the changes and innovations

The nurses of the healthcare system play a key role in caring for the mental health of the patients. The nurses need to be gentle towards the mental patients and monitor the health progress of the patients residing in the rehabilitation centre (Janett and Yeracaris, 2020). The patients are tracked efficiently by the nursing staff of the rehabilitation centre and medicines are administered accordingly. The innovative technology of electronic prescription is easily handled by the nurses and the medicines are prescribed. The movements are tracked by the nurses and recorded in the database of the patient record (Janett and Yeracaris, 2020). The records are easily checked by the rehabilitation staff and medicines are administered. 

4. Reflection on Innovation Implementation and Learning

Medication safety should be implemented in “Adult Mental Health Rehabilitation Centre” in “E-prescribing” and “Medicines Administration”. Medication safety enhancement has improved in decreasing the errors in medications in mental health services provided by nurses. However, during the development and implementation, all staff including nurses and prescribers should be given proper training and education to treat the upcoming changes in “E-prescribing” and “Medicines Administration” systems (Schiff et al., 2018). Clinical druggists should be given training in two succeeding check-ins. Training should be kept on a just-in-time basis and as needed. The pharmacists have to give a response in time via calls and e-mails through the software about any clinical issues. Lessons should be given to the clinical members on the implementation of the testing of the product in an effective way. Educational attempts should be conducted by the clinic for supplier pharmacists and “state board members” to ease the “E-prescribing”process (Warner et al., 2022). Therefore, the adoption of “E-prescribing” and “Medicines Administration” in “The Adult Mental Health Rehabilitation Centre” is useful to light up the problems via innovations, so that the patients could get a smooth experience while treatment. 

Conclusion

This study presents how to implement electrical prescription in the mental health care organization. The health workers in all groups need to gather knowledge about it. The process of this whole implementation in the organization is crucial and a time consuming work. But all the implementation helped the healthcare department and also the patients.  

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