DNP 820 A Topic 8 DQ 1 Explain why the change model you selected for the DPI Project is best for implementing your proposed intervention.

DNP 820 A Topic 8 DQ 1 Explain why the change model you selected for the DPI Project is best for implementing your proposed intervention.

Change in the healthcare environment is a huge task as it’s an innate trait of people to be resistant to change. Change is unavoidable but time-consuming to achieve. Hence, for change to be effective, it must be planned in the right surroundings, at an appropriate time, and with the necessary support required to effect the change. Using best practices resulting from change theories can help adjust the chances of success and successive practice enhancement (Barrow, Annamaraju & Toney-Butler, 2022). Kurt Lewin’s change theory was chosen for assisting with the implementation of prophylactic multilayered foam dressing in the prevention of healthcare-associated pressure injuries. This change model approaches change in steps through different stages which are crucial for it to be effective. In addition, organizational change describes the undertaking of an organization from the accepted to the unfamiliar. This is because the future of this change is lacking stability and may cause unease in people’s values, coping abilities, and aptitudes, so the people of the organization do not support change unless they are persuaded against the current situation (Memon, Shah, & Khoso, 2021; Kwong, Hung & Woo, 2016). 

Kurt Lewin’s change model enabled the execution of interventions to encourage changes in nursing staff. This model views behavior as the harmonizing of forces working in contrasting directions; therefore, following the breakdown of forces, the application of the three-step model can balance the direction of the change plan. Lewin’s theory has three major concepts: driving forces, restraining forces, and equilibrium. Driving forces are those that push in a direction that causes change to occur, facilitating the patient and staff in the desired direction, and causing a shift in the equilibrium toward change. Restraining forces are those that counter the driving forces, causing a shift in the equilibrium that opposes change (White, Dudley-Brown & Terhaar, 2021). Lewin’s theory proposed that change occurs in three stages: unfreezing, change, and refreezing stage.

Kwong, Hung, and Woo (2016) mentioned that in the unfreezing stage, there are numerous levels of planning being done to help in implementing the intervention to effect change. There is data gathering and action planning and data is inputted, and feedback is gained from numerous committees that are set up to direct the plans. In the stage of change, the actions are initiated, and the intervention is implemented. This is a learning process and a period of transformation. There is continuous feedback and action steps are initiated to ensure that the change is executed successfully. In the stage of refreezing, the intervention is implemented and there is an actual change in the behavior of the staff, and it is evident that there is a change in how things are done. Data gathering continues and is measured to ensure that this established new approach is continued. Hence, the three cyclical stages in Kurt Lewin’s change model will be adopted to manage the changes in the practice of nursing staff on HAPI prevention to develop the prevention protocol of using foam dressing to reduce HAPI.

References

Barrow, J.M., Annamaraju, P., & Toney-Butler, T.J. (2022, September 18). Change Management. In: StatPearls [Internet]. StatPearls Publishing; https://www.ncbi.nlm.nih.gov/books/NBK459380/

Kwong, E. W., Hung, M. S., & Woo, K. (2016). Improvement of pressure ulcer prevention care in private for-profit residential care homes: an action research study. BMC Geriatrics, 16(1), 192. https://doi.org/10.1186/s12877-016-0361-8

Memon, F. A., Shah, S., & Khoso, I. U. (2021). Improving Employee’s Engagement in Change: Reassessing Kurt Lewin’s Model. City University Research Journal, 11(1), 144-164. https://lopes.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/improving-employees-engagement-change-reassessing/docview/2542758465/se-2

White, K. M., Dudley-Brown, S., & Terhaar, M. F (2021). Translation of evidence into nursing and healthcare. (3rdEd.). Springer Publishing

I agree with you that change is a serious task in the healthcare environment. Therefore, healthcare institutions are required to be flexible to embrace change. At the same time, healthcare professionals with negative attitude towards transformation may struggle to remain relevant in the ever-changing healthcare environment. Change is unavoidable but time-consuming to achieve (Vaishnavi & Suresh, 2020). Resources and time directed towards change may compromise organizational operations. Therefore, adequate time is allocated in planning and implementing change. Unfortunately, change may not always guarantee the expected outcome. Inadequate support from different stakeholders and resistance among some proposed agents of change may frustrate the process. Frequently, change is considered as problem-solving engagement (Chênevert et al., 2019). Therefore, healthcare providers invest significant part of their budget to fund changes. Kurt Lewin’s change theory was chosen for assisting with the implementation of prophylactic multilayered foam dressing in the prevention of healthcare-associated pressure injuries. The change theory assumes that change happen in three stages that are important and aligned.

References

Chênevert, D., Kilroy, S., & Bosak, J. (2019). The role of change readiness and colleague support in the role stressors and withdrawal behaviors relationship among health care employees. Journal of Organizational Change Management. https://doi.org/10.1108/JOCM-06-2018-0148

Vaishnavi, V., & Suresh, M. (2020). Assessing the readiness level of healthcare for implementing agility using fuzzy logic approach. Global Journal of Flexible Systems Management, 21(2), 163-189.

Topic 8 DQ 1

Explain why the change model you selected for the DPI Project is best for implementing your proposed intervention.

The change management theory of nursing was developed as a constructive framework for managing organizational change throughout different stages of the process. Kurt Lewin is considered the father of social psychology and the unfreezing-change-refreeze theory model is his most influential theory. Kurt Lewin’s change model theory was selected for my DPI Project because it examined the three stages of change unfreezing, movement, and refreezing which can be used in a clinical research site (Hussain, et al., 2018).

Unfreezing: Unfreezing stage occurs when an organization thinks there is a need for change such as when there is management or employee dissatisfaction or a falling profit. Once the decision for change is made, it has to be communicated to the leadership to prepare the employees and the organization for the change. In response, the organization and employees have to prepare for the upcoming change by creating awareness while monitoring employees’ resistance to the change (Cummings, et al., 2016). During the unfreezing stage, the researcher has to examine the existing structure and determine what needs to be changed. Communicate the benefit of the upcoming change to employees, address employee concerns, and get clinical site support (Cummings, et al., 2016).

Movement or change itself: During this stage, the researcher implements the actual change to the organization as quickly and seamlessly as possible. Depending on the company’s need, changes may vary in the degree which should be carefully determined with inputs from employees and the organization. During the change process, the researcher must clarify any misunderstandings, and rumors, and involve clinical site managers to provide day-to-day direction (Cummings, et al., 2016).

Refreezing: During refreezing, the research strives to solidify the change made during the research study. Refreeze is the critical stage because the researcher wants to ensure that the employees accept the change and that the change last for a very long time. Important activities the learner can use include, setting up a feedback system to collect employees’ feedback, address any concerns, and provide employee training and support to make employees comfortable, and eliminate anxiety and doubts (Cummings, et al., 2016).

Reference

Hussain, S. T., Lei, S., Akram, T., Jamal, M., Syed, H., Hussain, H., & Ali, M. (2018). Kurt Lewin’s change model: A critical review of the role of leadership and employee involvement in organizational change. Journal of Innovation & Knowledge, 3 (3), 123-127. Retrieved from https://www.sciencedirect.com/science/article/pii/S2444569X16300087 Cummings, S., Bridgman, T., Brown, K. G. (2016). Unfreezing change as three steps: Rethinking Kurt Lewin’s legacy for change management. Human Relations, 69 (1), 33-60. Retrieved from https://doi.org/10.1177/0018726715577707

it is true that Kurt Lewin’s change model theory has the three stages of change unfreezing, movement, and refreezing. Every change of the cycle is important in understanding and managing change (Moreno et al., 2020). In healthcare environment, change is a common practice. Therefore, healthcare providers and workers are expected to be ready and competent in implementing change. However, change implementation and management is prone to various challenges. Unfortunately, if these barriers are not addressed healthcare organizations may lose time and resources funding on a failed process. Organizations after evaluating their performance levels can decide to initiate change (Prado-Prado et al., 2020). Unfreezing is a first and importance stage that unlocks the change process.  The stage allows leaders to engage other stakeholders as well as listening to their comments about the proposed change. Movement is the active stage where change is implemented before refreezing. During refreezing stage, there are new conditions. Players are expected to adopt to the new environment in the final stage. 

References

Moreno, C., Wykes, T., Galderisi, S., Nordentoft, M., Crossley, N., Jones, N., … & Arango, C. (2020). How mental health care should change as a consequence of the COVID-19 pandemic. The Lancet Psychiatry, 7(9), 813-824. https://doi.org/10.1016/S2215-0366(20)30307-2

Prado-Prado, J. C., García-Arca, J., Fernández-González, A. J., & Mosteiro-Añón, M. (2020). Increasing competitiveness through the implementation of lean management in healthcare. International Journal of Environmental Research and Public Health, 17(14), 4981. https://doi.org/10.3390/ijerph17144981

Explain why the change model you selected for the DPI Project is best for implementing your proposed intervention.

Implementing the proposed intervention involves implementing a change. Adopting a change model to guide the implementation ensures that the change is well planned with a sequence of events applied to achieve established goals and bring about predictable outcomes. The change model selected for the DPI project is Rogers’ Change Theory, also known as Innovation Diffusion Theory. This is a five-step theory: knowledge/awareness, persuasion/interest, decision/evaluation, implementation and confirmation/adoption. This theory offers a linear and sequential approach to change in which the implementation is undertaken in a step-by-step fashion. The sequential steps make it easier to apply the change as the project only needs to follow the outlined steps (Taylor, Lynn & Bartlett, 2022). In addition, the theory helps in systematically exploring the many underlying issues that could affect the change, and identify what should be addressed as a priority to maximize outcomes. Besides that, it presents a framework for learning within the project. It articulates issues that could affect the project, making assumptions explicit on how the project is expected to yield results, and how the assumptions will be tested against the results, to include what has worked and what has not worked. This ensures a sound logic for achieving change. Furthermore, the theory helps in making project approach corrections if the approach is not working or if anticipated issues materialize. The lessons learned from the monitoring and evaluation phases will help in refining the assumptions made in the project and inform decisions on how corrections can be made to deliver the planned results (Helming, Shields & Avino, 2020). Moreover, the theory helps in better managing the project stakeholders in terms of establishing and incorporating different views and assumptions among the stakeholders. This fosters consensus and motivates the stakeholders by involving them early on in the project thus leading to better complementarity and coordination (Finkelman, 2019). Overall, Roger’s change model is appropriate for implementing the proposed intervention.

References

Finkelman, A. (2019). Professional Nursing Concepts: Competencies for Quality Leadership (4th ed.). Jones & Bartlett Learning, LLC.

Helming, M., Shields, D., & Avino, K. (2020). Dossey & Keegan’s Holistic Nursing: A Handbook for Practice (8th ed.). Jones & Bartlett Learning, LLC. Taylor, C., Lynn, P., & Bartlett, J. (2022). Fundamentals of Nursing: The Art and Science of Person-Centered Care (10th ed.). Wolters Kluwer

Implementing a change may be a solution to different healthcare problems. Unfortunately, some healthcare workers and providers struggle to plan, implement and manage change. However, in healthcare environment, change is inevitable. Therefore, healthcare institutions bank on competent workforce to led successful change routines. Change is well planned with a sequence of events applied to achieve established goals and bring about predictable outcomes (Cleary et al., 2019). Therefore, change requires order and high levels of professionalism. Innovation Diffusion Theory is a five-step change theory; knowledge/awareness, persuasion/interest, decision/evaluation, implementation and confirmation/adoption. The five phases in the Rogers’ Change Theory are interlinked. Besides, this theory offers a linear and sequential approach to change in which the implementation is undertaken in a step-by-step fashion. Nurse leadership has the mandate of ensuring that every stakeholder in different phases are incorporated in decision-making process and other crucial engagements throughout the process (Gordon & Pollack, 2018). Proper communication in all the five stages makes the Rogers’ change theory suitable in implementing and managing change in healthcare environment.

References

Cleary, M., West, S., Arthur, D., & Kornhaber, R. (2019). Change management in health care and mental health nursing. Issues in mental health nursing, 40(11), 966-972. https://doi.org/10.1080/01612840.2019.1609633

Gordon, A., & Pollack, J. (2018). Managing healthcare integration: Adapting project management to the needs of organizational change. Project Management Journal, 49(5), 5-21. https://doi.org/10.1177/8756972818785321