Kurt Lewin was a German psychologist who developed his Change Theory based on his studies of group dynamics and field theory. Lewin's Change Theory involves three stages - Unfreezing, Changing, and Refreezing. In the Unfreezing stage, the need for change is identified and people are prepared mentally to accept it. In the Changing stage, the actual changes are implemented. In the Refreezing stage, the changes are stabilized and integrated into the regular work procedures. Lewin's Change Theory has been successfully applied to implement changes in nursing and other fields through the use of action research.
In this case study, the nurse manager needs to implement a new bowel monitoring system to reduce bowel obstructions in patients.
Clinical Journal of Oncology Nursing • Volume 18, Number 2 .docxbartholomeocoombs
Clinical Journal of Oncology Nursing • Volume 18, Number 2 • Evidence-Based Practice 157
The Iowa Model of Evidence-Based Practice to Promote
Quality Care: An Illustrated Example in Oncology Nursing
Carlton G. Brown, PhD, RN, AOCN®, FAAN
Evidence-based practice (EBP) improves the quality of patient care and helps control
healthcare costs. Numerous EBP models exist to assist nurses and other healthcare
providers to integrate best evidence into clinical practice. The Iowa Model of Evidence-
Based Practice to Promote Quality Care is one model that should be considered. Using
an actual clinical example, this article describes how the Iowa Model can be used
effectively to implement an actual practice change at the unit or organizational level.
Carlton G. Brown, PhD, RN, AOCN®, FAAN, is the director of Professional Services at the Oregon Nurses
Association in Tualatin. The author takes full responsibility for the content of the article. The author did not
receive honoraria for this work. No financial relationships relevant to the content of this article have been
disclosed by the author or editorial staff. Brown can be reached at [email protected], with copy to
editor at [email protected]
Key words: evidence-based practice; research; decision making
Digital Object Identifier: 10.1188/14.CJON.157-159
N
urses understand that evidence-
based practice (EBP) improves the
quality of patient outcomes while
controlling the cost of healthcare (Mel-
nyk, Fineout-Overholt, Gallagher-Ford, &
Kaplan, 2012). But even in the year 2014,
barriers and roadblocks exist to imple-
menting EBP at the bedside or chair side.
The Institute of Medicine estimated that
it takes more than 17 years to implement
a research finding into clinical practice
(Institute of Medicine, 2001). Although
research may exist that should be trans-
lated into practice, the time it takes to
deliver these research-based interventions
to patients takes too long. In their study
of 1,054 RNs, Melnyk et al. (2012) discov-
ered that although nurses value EBP, they
required education, access to information,
and time to implement EBP into daily prac-
tice. Nurses and other healthcare provid-
ers want their practice based in evidence,
but they also acknowledge the barriers
of lack of education and time to actually
implement and use EBP.
EBP is a problem-solving approach to
clinical decision making that integrates
the best evidence from well-designed
studies with a clinician’s expertise along
with patients’ preferences and values
(Melnyk et al., 2012). Numerous EBP
models are available to help nurses orga-
nize and systematically track progress in
implementing evidence into practice, in-
cluding the Stetler Model of Research Uti-
lization (Stetler, 2001), the Iowa Model of
Evidence-Based Practice to Promote Qual-
ity Care (hereafter referred to as the Iowa
Model) (Titler et al., 2001), and the Johns
Hopkins Nursing Model (Newhouse, Dear-
holt, Poe, Pugh, &.
Change ModelsDifferent models have been developed to help plan f.docxsleeperharwell
Change Models
Different models have been developed to help plan for and implement change. Change has been studied from the conceptual approach, such as "what," as well as from the process approach of "how."
The conceptual models of change usually concentrate on content and strategic initiatives. On the other hand, process models focus on the sequence of events necessary to effect organizational change by focusing on the stages and steps of implementation.
Develop Contextual Issues of the Change
Once the need for change and the cause for implementation have been established, the contextual issues of the change can be developed to help evaluate the extent of change that an organization can implement with the resources available. Factors to consider during this process include:
· Readiness of the organization
· Culture of the organization
· Systems issues
· Amount of resistance that might be involved
Communicate the Vision to Employees
Once the vision for the change has been developed, the leaders should communicate the vision to employees. The vision should be clearly articulated, including how the change will impact the employees. This can be difficult when the change will have a negative impact on employees, but it is better for employees to understand the change than to be in the dark.
When change is implemented and individuals' employment is affected, it may be best for leaders to hold off and not communicate any reductions in force until it is necessary for the employees to know. Any change in employee status can be hard for everyone, including the employees who are staying. Both groups of employees need careful communication and support while going through the transitions.
Plan Strategies and Develop Criteria
Once the reason for the change has been communicated, implementation strategies should be considered. This is an opportunity for the leadership to involve the workforce as the workforce can be instrumental in developing the implementation strategies. As the implementation strategies are being formed, how the outcomes would be measured should be considered. How will an organization know when the change is finished and successful? If the organization includes outcome measures (e.g., increase in market share and decrease in costs) in its planning, it will help those implanting the change to know what constitutes success.
Implement and Monitor
Change can then be implemented, monitored, and managed to ensure that sequential steps are taken and continuous feedback is available.
While there are several steps for managing and monitoring change, most change processes will follow this type of model. On the other hand, conceptual models of change emphasize the mental constructs and sense making of the change
Change Process Models
There are several change models that can be used to implement a change effort. The process models are often used because they provide leaders and organizations with a sequential approach to cha.
SYSTEMS THEORYAs noted in the Learning Resources, systems theory p.docxjonghollingberry
SYSTEMS THEORY
As noted in the Learning Resources, systems theory provides a meaningful and beneficial means of examining challenges in health care organizations. To do this effectively, however, it is essential to assess
all
system components, as some may be relatively healthy while others are problematic.
For this Assignment, you apply systems theory to the examination of a problem in a department or a unit within a health care organization. (
Note:
You may use the same problem you identified for the Discussion as long as it meets the criteria for this assignment.)
To prepare:
·
Review the Meyer article, “Nursing Services Delivery Theory: An Open System Approach,” in this week’s Learning Resources. Focus especially on the information presented in Table 1 (p. 2831) and Figure 2 (p. 2833).
·
Reflect on your organization or one with which you are familiar. Within a particular department or unit in this organization, identify a problem the staff is encountering.
·
Using Table 1 in the Meyer article as a guide, analyze the department or unit, identifying inputs, throughput, output, cycles of events, and negative feedback. Consider whether the problem you have selected relates to input, throughput, output, cycles of events, and/or negative feedback.
·
Think about how you could address the problem: Consider what a desired outcome would be, then formulate related goals and objectives, and translate those goals into policies and procedures.
·
Research professional standards that are pertinent to your identified problem.
·
Reflect on the organization’s mission statement and values. In addition, consider how addressing this problem would uphold the mission and values, while improving the organizational culture and climate. (Depending on the organization you have selected, you may have explored these in the Week 1 Discussion.)
To complete:
Write a 3- to 5-page paper (page count does not include title and reference page) that addresses the following:
·
Describe a department or unit within a health care organization using systems theory terminology. Include a description of inputs, throughput, output, cycles of events, and negative feedback.
·
Describe the problem you identified within the department or unit using an open- systems approach, and state where the problem exists using the systems theory model (input, throughput, output, cycles of events, or negative feedback).
·
Based on this information, explain how you would address the problem as follows:
o
Formulate a desired outcome.
o
Identify goals and objectives that would facilitate that outcome.
o
Translate those goals and objectives into policies and procedures for the department or unit.
o
Describe relevant professional standards.
·
Explain how your proposed resolution to the problem would uphold the organization’s mission and values and improve the culture and climate.
*This paper must include a title page, introduction, summary, and references.
* Follow APA 6
th
ed for the ci.
Clinical Journal of Oncology Nursing • Volume 18, Number 2 .docxbartholomeocoombs
Clinical Journal of Oncology Nursing • Volume 18, Number 2 • Evidence-Based Practice 157
The Iowa Model of Evidence-Based Practice to Promote
Quality Care: An Illustrated Example in Oncology Nursing
Carlton G. Brown, PhD, RN, AOCN®, FAAN
Evidence-based practice (EBP) improves the quality of patient care and helps control
healthcare costs. Numerous EBP models exist to assist nurses and other healthcare
providers to integrate best evidence into clinical practice. The Iowa Model of Evidence-
Based Practice to Promote Quality Care is one model that should be considered. Using
an actual clinical example, this article describes how the Iowa Model can be used
effectively to implement an actual practice change at the unit or organizational level.
Carlton G. Brown, PhD, RN, AOCN®, FAAN, is the director of Professional Services at the Oregon Nurses
Association in Tualatin. The author takes full responsibility for the content of the article. The author did not
receive honoraria for this work. No financial relationships relevant to the content of this article have been
disclosed by the author or editorial staff. Brown can be reached at [email protected], with copy to
editor at [email protected]
Key words: evidence-based practice; research; decision making
Digital Object Identifier: 10.1188/14.CJON.157-159
N
urses understand that evidence-
based practice (EBP) improves the
quality of patient outcomes while
controlling the cost of healthcare (Mel-
nyk, Fineout-Overholt, Gallagher-Ford, &
Kaplan, 2012). But even in the year 2014,
barriers and roadblocks exist to imple-
menting EBP at the bedside or chair side.
The Institute of Medicine estimated that
it takes more than 17 years to implement
a research finding into clinical practice
(Institute of Medicine, 2001). Although
research may exist that should be trans-
lated into practice, the time it takes to
deliver these research-based interventions
to patients takes too long. In their study
of 1,054 RNs, Melnyk et al. (2012) discov-
ered that although nurses value EBP, they
required education, access to information,
and time to implement EBP into daily prac-
tice. Nurses and other healthcare provid-
ers want their practice based in evidence,
but they also acknowledge the barriers
of lack of education and time to actually
implement and use EBP.
EBP is a problem-solving approach to
clinical decision making that integrates
the best evidence from well-designed
studies with a clinician’s expertise along
with patients’ preferences and values
(Melnyk et al., 2012). Numerous EBP
models are available to help nurses orga-
nize and systematically track progress in
implementing evidence into practice, in-
cluding the Stetler Model of Research Uti-
lization (Stetler, 2001), the Iowa Model of
Evidence-Based Practice to Promote Qual-
ity Care (hereafter referred to as the Iowa
Model) (Titler et al., 2001), and the Johns
Hopkins Nursing Model (Newhouse, Dear-
holt, Poe, Pugh, &.
Change ModelsDifferent models have been developed to help plan f.docxsleeperharwell
Change Models
Different models have been developed to help plan for and implement change. Change has been studied from the conceptual approach, such as "what," as well as from the process approach of "how."
The conceptual models of change usually concentrate on content and strategic initiatives. On the other hand, process models focus on the sequence of events necessary to effect organizational change by focusing on the stages and steps of implementation.
Develop Contextual Issues of the Change
Once the need for change and the cause for implementation have been established, the contextual issues of the change can be developed to help evaluate the extent of change that an organization can implement with the resources available. Factors to consider during this process include:
· Readiness of the organization
· Culture of the organization
· Systems issues
· Amount of resistance that might be involved
Communicate the Vision to Employees
Once the vision for the change has been developed, the leaders should communicate the vision to employees. The vision should be clearly articulated, including how the change will impact the employees. This can be difficult when the change will have a negative impact on employees, but it is better for employees to understand the change than to be in the dark.
When change is implemented and individuals' employment is affected, it may be best for leaders to hold off and not communicate any reductions in force until it is necessary for the employees to know. Any change in employee status can be hard for everyone, including the employees who are staying. Both groups of employees need careful communication and support while going through the transitions.
Plan Strategies and Develop Criteria
Once the reason for the change has been communicated, implementation strategies should be considered. This is an opportunity for the leadership to involve the workforce as the workforce can be instrumental in developing the implementation strategies. As the implementation strategies are being formed, how the outcomes would be measured should be considered. How will an organization know when the change is finished and successful? If the organization includes outcome measures (e.g., increase in market share and decrease in costs) in its planning, it will help those implanting the change to know what constitutes success.
Implement and Monitor
Change can then be implemented, monitored, and managed to ensure that sequential steps are taken and continuous feedback is available.
While there are several steps for managing and monitoring change, most change processes will follow this type of model. On the other hand, conceptual models of change emphasize the mental constructs and sense making of the change
Change Process Models
There are several change models that can be used to implement a change effort. The process models are often used because they provide leaders and organizations with a sequential approach to cha.
SYSTEMS THEORYAs noted in the Learning Resources, systems theory p.docxjonghollingberry
SYSTEMS THEORY
As noted in the Learning Resources, systems theory provides a meaningful and beneficial means of examining challenges in health care organizations. To do this effectively, however, it is essential to assess
all
system components, as some may be relatively healthy while others are problematic.
For this Assignment, you apply systems theory to the examination of a problem in a department or a unit within a health care organization. (
Note:
You may use the same problem you identified for the Discussion as long as it meets the criteria for this assignment.)
To prepare:
·
Review the Meyer article, “Nursing Services Delivery Theory: An Open System Approach,” in this week’s Learning Resources. Focus especially on the information presented in Table 1 (p. 2831) and Figure 2 (p. 2833).
·
Reflect on your organization or one with which you are familiar. Within a particular department or unit in this organization, identify a problem the staff is encountering.
·
Using Table 1 in the Meyer article as a guide, analyze the department or unit, identifying inputs, throughput, output, cycles of events, and negative feedback. Consider whether the problem you have selected relates to input, throughput, output, cycles of events, and/or negative feedback.
·
Think about how you could address the problem: Consider what a desired outcome would be, then formulate related goals and objectives, and translate those goals into policies and procedures.
·
Research professional standards that are pertinent to your identified problem.
·
Reflect on the organization’s mission statement and values. In addition, consider how addressing this problem would uphold the mission and values, while improving the organizational culture and climate. (Depending on the organization you have selected, you may have explored these in the Week 1 Discussion.)
To complete:
Write a 3- to 5-page paper (page count does not include title and reference page) that addresses the following:
·
Describe a department or unit within a health care organization using systems theory terminology. Include a description of inputs, throughput, output, cycles of events, and negative feedback.
·
Describe the problem you identified within the department or unit using an open- systems approach, and state where the problem exists using the systems theory model (input, throughput, output, cycles of events, or negative feedback).
·
Based on this information, explain how you would address the problem as follows:
o
Formulate a desired outcome.
o
Identify goals and objectives that would facilitate that outcome.
o
Translate those goals and objectives into policies and procedures for the department or unit.
o
Describe relevant professional standards.
·
Explain how your proposed resolution to the problem would uphold the organization’s mission and values and improve the culture and climate.
*This paper must include a title page, introduction, summary, and references.
* Follow APA 6
th
ed for the ci.
6410 Application 3 Becoming a Leader in the Translation of Evide.docxtroutmanboris
6410 Application 3: Becoming a Leader in the Translation of Evidence to Practice
Note: Have an APA Level 1 header for each area noted below in blue (a level 1 header is centered, bolded, using upper and lower case letters—see APA manual area 3.03) Follow APA format and include a minimum of 5 scholarly references less than 5 years old.
Include a BRIEF Introduction and Summary in addition to the headers below. DO NOT EXCEED THREE PAGES AND MUST CITE OFTEN THROUGHOUT THE PAPER.
Grading Area
Points Possible
Points Earned
Potential areas for earning points:
Header: Efforts to Increase Finance and Economic Knowledge
How you would continue to increase your knowledge and awareness of financial, economic, and other concerns related to new practice approaches
2
Header: Use of Evidence to Improve Practice
How translating evidence would enable you to affect or strengthen health care delivery and nursing practice
2
Header: Advocating for EBP Policy Change
How you would advocate for the use of new evidence-based practice approaches through the policy arena
2
Potential areas for losing points:
Grammar, Spelling, and APA errors
Up to 2 pt. deduction
Went Over Page Limit (2-3 pages max)
Up to 2 pt. deduction
Improper credit & citation issue
(See Turnitin Report)
1-6 pt. deduction
Late Submission
20% deduction (1.2 pts) per day late (per syllabus)
6 Total Points Possible
Total Points Earned
P.S. Under the first header on “Effort to Increase Finance and Economic Knowledge, please refer to the attached week 6 discussion you did for me, except you did not include specific numbers and statistics. Below is the critique made by the professor on that area. Please read through the critique and try to incorporate it in this portion of this paper.
Dear student: Thank you for your contribution to this week’s discussion. You brought forward potential costs associated with increased mobilization of ICU patients….namely the need for more nurse time. Do you have some hard numbers you can provide on the potential cost of this? Do you have any local or national information on the cost of not mobilizing the patients (longer stays, increased infection, readmission)? Calculating approximate cost associated with the practice change versus the cost of not changing is important. This will help stakeholders see the value in the investment.
DISCUSSION PAPER
Evidence-based practice models for organizational change: overview
and practical applications
Marjorie A. Schaffer, Kristin E. Sandau & Lee Diedrick
Accepted for publication 19 July 2012
Correspondence to M.A. Schaffer:
e-mail: [email protected]
Marjorie A. Schaffer PhD RN
Professor of Nursing
Bethel University, St. Paul, Minnesota, USA
Kristin E. Sandau PhD RN CNE
Professor of Nursing
Bethel University, St. Paul, Minnesota, USA
Lee Diedrick MAN RN C-NIC
Clinical Educator
Children’s Hospitals and Clinics of
Minnesota, St. Paul, Minnesota, USA
S C H A F F E R M . A . , S A N D A U K ..
Assignment Application Adoption of New Technology SystemsAs a nu.docxrosemariebrayshaw
Assignment: Application: Adoption of New Technology Systems
As a nurse, you can have a great impact on the success or failure of the adoption of EHRs. It is important for nurses to understand their role as change agents and the ways they can influence others when addressing the challenges of changing to a drastically different way of doing things.
Everett Rogers, a pioneer in the field of the diffusion of innovations, identified five qualities that determine individual attitudes towards adopting new technology (2003). He theorized that individuals are concerned with:
Relative advantage: The individual adopting the new innovation must see how it will be an improvement over the old way of doing things.
Compatibility with existing values and practices: The adopter must understand how the new innovation aligns with current practices.
Simplicity: The adopter must believe he or she can easily master the new technology; the more difficult learning the new system appears, the greater the resistance that will occur.
Trialability: The adopter should have the opportunity to “play around’ with the new technology and explore its capabilities.
Observable results: The adopter must have evidence that the proposed innovation has been successful in other situations.
Note:
You are not required to purchase Rogers’ book or pursue further information regarding his list of five qualities. The information provided here is sufficient to complete this Assignment. The full reference for Rogers’ work is provided below the due date on this page.
For this Assignment, you assume the role of a nurse facilitator in a small hospital in upstate New York. You have been part of a team preparing for the implementation of a new electronic health records system. Decisions as to the program that will be used have been finalized, and you are now tasked with preparing the nurses for the new system. There has been an undercurrent of resistance expressed by nurses, and you must respond to their concerns. You have a meeting scheduled with the nurses 1 week prior to the training on the new EHR system. Consider how you can use the five qualities outlined by Rogers (2003) to assist in preparing the nurses for the upcoming implementation.
To prepare
Review the Learning Resources this week about successful implementations of EHRs.
Consider how you would present the new EHR system to the nurses to win their approval.
Reflect on the five qualities outlined by Rogers. How would addressing each of those areas improve the likelihood of success
RESOURCES
McGonigle, D., & Mastrian, K. G. (2015).
Nursing informatics and the foundation of knowledge
(3rd ed.). Burlington, MA: Jones and Bartlett Learning.
Chapter 15, “The Electronic Health Record and Clinical Informatics”
This chapter describes the crucial parts of an electronic health record system and explores the benefits of implementing one.
Bates, D. W. (2010). Getting in step: Electronic health records and their role in care co.
Rules for my assignments1. Kindly follow APA format (American Psy.docxkathyledlow2rr
Rules for my assignments:
1. Kindly follow APA format (American Psychology Association 6
th
edition) for the citation and references! References should be between the period of 2011 and 2016…
2. Please utilize the references I posted below…
3. 2-3 pages
Transitioning From Closed to Open Systems
How do effective nurse leaders and others approach problem solving and decision making in organizations? As suggested in this week’s Learning Resources, systems theory provides a valuable way to assess situations and prepare to address problems.
For this week’s Discussion, you identify an issue or process that could be improved and apply knowledge and strategies related to systems theory.
Note:
You may find it helpful to view the Assignment instructions and use the same problem for this Discussion.
To prepare:
·
Review the information presented in this week’s Learning Resources on systems theory and the difference between open and closed systems.
·
Reflect on the practices and processes with which you are familiar in your organization. Identify one problematic issue or process that could be improved.
·
Consider the problem from a closed-system perspective. Then think about how the issue or process you selected could be addressed by viewing it from an open-system perspective. How would the transition from a closed- to an open-system view help you and others to address the problem and improve outcomes?
Please answer these questions for my assignment:
1.
Description of the problem that you identified in your selected organization.
2.
Explain the problem from a closed-system perspective.
3.
Then, describe how the problem could be addressed by viewing it from an open-system perspective, and explain how this modification would help you and others improve health care outcomes.
4.
Conclusion/Summary
Required Resources
Note:
To access this week's required library resources, please click on the link to the Course Readings List, found in the
Course Materials
section of your Syllabus.
Readings
·
Marquis, B. L., & Huston, C. J. (2015).
Leadership roles and management functions in nursing: Theory and application
(8th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.
o
Review Chapter 7, “Strategic and Operational Planning”
See especially Figure 7.1 on page 147.
o
Chapter 8, “Planned Change”
§
Organizational Change Associated With Nonlinear Dynamics (pp. 172–176)
Read this section of Chapter 8 on planned change. Consider the role of leaders in effectively managing planned change.
o
Chapter 12, “Organizational Structure”
§
“Organizational Culture” (pp. 274–276)
There are many structures organizations take, and these structures influence how the organization functions. This chapter discusses many different organizational structures and provides insights into how these structures influence the change process, as well as leadership and management.
·
Johnson, J. K., Miller, S. H., & Horowitz, S. D. (2008). Systems-based practice: Impr.
8410 Application 1 Identification of a Practice Issue for the Evide.docxsleeperharwell
8410 Application 1: Identification of a Practice Issue for the Evidence-Based Practice (EBP) Project
Note: Have an APA Level 1 header for Each Area Noted below in Blue (a level 1 header is centered, bolded, using upper and lower case letters—see APA manual area 3.03)
Grading Area
Points Possible
Points Earned
Potential areas for earning points:
Header: Summary of Practice Issue
Summary of practice issue. (Note: The issue you select must be suitable for completing the entire EBP Project in 8410.)
2
Header: Exploration of Research Literature
Exploration of the research literature on
this issue.
3
High level of scholarship commensurate with doctoral level evident
1
Potential areas for losing points:
Grammar, Spelling, and APA errors
Up to 2 pt. deduction
Went Over Page Limit (2 pages max)
Up to 2 pt. deduction
*Improper credit & citation issue
1-6 pt. deduction
Late Submission
(posted X.XX.20XX, due X.XX.20XX )
20% deduction (1.2 pts) per day late (per syllabus)
6 Total Points possible
? Total Points Earned
Running head: EBP Project 1
EBP Project 4
Evidence-based Practice Project: PIICOT Statement
Student’s Name
Institution
Date
Evidence-based Practice Project: PIICOT Statement
Delayed patient transfers from the intensive care unit (ICU) is a significant practice problem that affects the quality and safety of healthcare delivery as well as the costs and efficiency of service delivery in a healthcare institution. It is nurses’ role to identify issues and develop strategies for quality improvement (Stillwell, Fineout-Overholt, Melnyk & Williamson, 2012). The following PIICOT Statements seeks to develop an intervention to reduce the rates of delayed transfers to enhance patient experiences and outcomes.
PIICOT Statement
In patients in extended intensive care within an urban acute care facility in Eastern United States, how does early mobilization as recommended by National Institute of Health and Care Excellence clinical guidelines on rehabilitation of patients after critical illness impact early transfers from intensive care as measured 6 months post-implementation when compared to the current standard of care including minimal mobilization of patients?
P: Adult patients
I: in extended intensive care within an urban acute care facility
I: increased mobilization of the patients
C: minimal mobilization of the patients
O: early transfers of the patients from intensive care
T: 6 months
Salient Elements that Inform the Research Question
The research question above has been developed based on observations in clinical practice of patients in intensive care, who overstay their admission in the ICU. Past research shows that delayed transfers of patients from the ICU to non-intensive care wards or the community settings have a negative effect on patient experiences and the patient outcomes. Some of the common negative effects of delayed patient transfers that have been identified by past researchers include an increased risk .
REPLY1Widely used nursing theories include Lewin’s 3 stage model.docxchris293
REPLY1
Widely used nursing theories include Lewin’s 3 stage model and Lippits phase theory. The Lewin’s change theory consist of three stages including unfreezing, moving and refreezing stages. Unfreezing stage is when you recognize a change is needed, then you move to the phase when the change occurs and refreezing stage happens after equilibrium is established leading to satisfactory results and the cycles goes on and on. A distinct feature of Lewin theory is that it contains both driving forces and resisting forces and for the theory to be successful then the driving must overcome resistant forces. Lippits, Watson and Westley seven phase theory, first phase entails diagnosing the problem, assessing motivation, and capacity for change, evaluating change agent’s motivation and resource, choosing the appropriate role of the change agent, maintaining difference and last phase is termination of the help relationship (Tappen, 2016).
Lippits theory expands on Lewin’s model of change into the seven steps mentioned above as well it is more comparable to nursing process hence there is no significance difference between the two (Alageel, Gulliford, McDermott & Wright, 2018). However, Lewin’s is built on three fundamental steps thereby facing a lot of criticism since nursing is more complicated than the three levels. Similarly, both theories are widely used in nursing and both requires nurses who are willing and want to make change. The mentor has applied Lewin’s change theory because she has successfully introduced a new paper work despite the hospital having several rounds every hour. In the unfreezing period she has describe to nurses of the importance of the sheet and how to sign, in the moving stage she let the nurses give their opinions on the system and lastly in the refreezing stage she went round and made sure nurses make this a daily habit. In my own opinion, I believe that Lewin’s theory is more appropriate for my project since most nurses’ push for change receiving less resist from people.
Reference
Tappen, R. M. (2016). Advanced nursing research: From theory to practice. Jones & Bartlett
Publishers.
Alageel, S., Gulliford, M. C., McDermott, L., & Wright, A. J. (2018). Implementing multiple health behaviour change interventions for cardiovascular risk reduction in primary care: a qualitative study.
BMC family practice
,
19
(1), 171.
REPLY2
There are several change theories that would be good to use for the implementation of my capstone change project. After discussing these theories with my preceptor and listening to her stories of success as well as failures, we decided Lewin’s change theory will work best in implementing my change project at the acute care hospital, because there will need to be a strong push for this to be accepted into practice. She had successfully used this theory in the hospital when implementing changes in the past, but she supports the idea that depending on the theory or approach, the outcome can be ve.
his is the first in a series of interactive webinars designed to build capacity in the basic principles of knowledge translation and implementation science.
WATCH-ON DEMAND: https://goo.gl/hnp8gi
On completing this chapter, you will be able to:
Describe why research is important in the nursing profession and discuss the need for evidence-based practice
Describe historic trends and future directions in nursing research
Describe alternative sources of evidence for nursing practice
Describe major characteristics of the positivist and naturalistic paradigm, and discuss
similarities and differences between the traditional scientific method (quantitative research) and naturalistic methods (qualitative research)
Identify several purposes of qualitative and quantitative research
Planned Change in a Department or UnitHealth care organizations ar.docxrosacrosdale
Planned Change in a Department or Unit
Health care organizations are continuously immersed in change from the emergence of new policies, to promote quality care and improve patient safety to keeping pace with the rapid growth in knowledge and best practices. Establishing a solid framework for planning and implementing change is a wise move, as it provides a foundation for the extensive coordination that will be needed to successfully facilitate the change.
For this Assignment, you propose a change at the department or unit level and develop a plan for guiding the change effort.
To prepare:
·
Review Chapter 8 in the course text. Focus on Kurt Lewin’s change theory, and contrast it with other classic change models and strategies.
·
Reflect on problems, inefficiencies, and critical issues within a specific department, unit, or area in your organization or one with which you are familiar. Select one issue as a focal point for this assignment, and consider a change that could be made to address the issue.
·
Think about how the change would align with the organization’s mission, vision, and values as well as relevant professional standards.
·
Using one of the change models or strategies discussed in Chapter 8, begin formulating a plan for implementing the change within the department/unit. Outline the steps that you and/or others should follow to facilitate the change effort. Align these steps to the change model or strategy you selected.
·
Determine who should be involved in initiating and managing the change. Consider the skills and characteristics that are necessary to facilitate this change effort.
To complete:
Write a 3- to 5-page paper (page count does not include title and reference page) that addresses the following:
1.
Identify a problem, inefficiency, or issue within a specific department/unit.
2.
Describe a specific, realistic change that could be made to address the issue.
3.
Summarize how the change would align with the organization’s mission, vision, and values as well as relevant professional standards.
4.
Identify a change model or strategy to guide your planning for implementing the change. Provide a rationale for your selection.
5.
Outline the steps that you and/or others would follow to facilitate the change. Align these steps to your selected change model or strategy.
6.
Explain who would be involved in initiating and managing this change. Describe the skills and characteristics that would be necessary to facilitate the change effort.
REMINDERS:
·
Kindly put introduction, purpose of the paper, body of the paper (6 headings addressed the 6 questions), summary/conclusion, and references (Put headings on it).
·
Kindly follow APA format for the citation and references! References should be between the period of 2011 and 2016.
·
Please utilize my resources below at least three references on the list and you can add more in your own resources…
RESOURCES
Readings
·
Marquis, B. L., & Huston, C. J. (2015).
Leadership rol.
The Duty of Loyalty and Whistleblowing Please respond to the fol.docxcherry686017
"The Duty of Loyalty and Whistleblowing" Please respond to the following:
· Analyze the duty of loyalty in whistleblower cases to determine to whom loyalty is owed and who shows the greater duty of loyalty. Support your analysis with specific examples. Then, suggest at least one (1) change to an existing law.
· Reexamine the Citizens United decision in Chapter 1, and determine which of the following groups has the greatest free speech rights: corporations, public employees, or private employees. Provide a rationale for your determination.
11 Combining Research Methods: Case Studies and Action Research
Rebecca Jester
Introduction
In Chapters 7 and 8, we focused on the unique features of quantitative and qualitative research. In this chapter, we aim to demonstrate how research methods can be integrated and combined to address specific research questions. The chapter will provide an overview of two specific research designs: action research and case studies, together with examples from research projects conducted by the author. This chapter does not aim to provide an in-depth philosophical debate related to case study and action research approaches, but rather a practical discussion of the merits, limitations and application of these two approaches. We begin by discussing the concepts of ‘mixed methods’ and ‘triangulation', first introduced in Chapter 2.
Mixed methods approaches
Traditionally, within health and social research, individuals have aligned themselves with either the quantitative or qualitative paradigm. However, in reality, many real world research projects benefit from mixing or combining methods. Mixed methods research can be accomplished either by using specific approaches to research, such as action research or case study, as discussed within this chapter, or by adopting a phased approach within a study. This might involve the first stage being exploratory within the qualitative paradigm, and the results from this being used to form specific hypotheses for testing within an experimental design, such as a randomized controlled trial. Equally, a quantitative approach (say, a questionnaire) might be used to gather data from a wide range of people, with the results being used to develop a qualitative interview schedule for use with a small sample of respondents.
Triangulation
Very often a research study is undertaken with multiple datasets, mixed methodology or with different researchers, such as at different sites. Triangulation is a very useful technique that enables you to enhance and verify concepts. As Ramprogus (2005, p. 4) suggests, ‘triangulation … tries to reconcile the differences of two or more data sources, methodological approaches, designs, theoretical perspectives, investigators and data analysis to compensate for the weaknesses of any single strategy towards achieving completeness or confirmation of findings’. However, triangulation must be exercised with caution; it is no substitute for robust and well-established ...
Running head RESEARCH CRITIQUE & PICOT - FINAL 16RE.docxtodd521
Running head: RESEARCH CRITIQUE & PICOT - FINAL 1
6
RESEARCH CRITIQUE & PICOT
Research Critique & PICOT Statement – Final Draft
Student’s Name
NRS-433V Introduction to Nursing Research
Grand Canyon University
Due Date
Research Critique & PICOT Statement - Final Draft
Give a brief introduction of this paper as it is the final draft. In this section include the names of the studies that were critiqued in the qualitative and quantitative sections below with the cited reference after the name of each study. The graded assignments from weeks one, two and three should be the basis for this assignment. The corrections made for all sections of those assignments according to the instructor’s comments should be clearly present. Do not include the instructor’s comments. Just make the corrections and put them in the proper places noted by the headings below. Throughout this paper, you should use spell check and grammar check always. Speak in the active voice and not a passive voice. Support statements with references. Use citations in all sections when references are made to the study or studies used in this paper. (Keep the word count between 1500 and 1750 words. Going outside of the word count will cause a 10% deduction of total points.)
Nursing Practice Problem and PICOT Statement
Nursing Practice Problem
State the practice problem that is relevant to nursing. This should be an extension of the PICOT question that was in the introduction of the literature Search on Week 1 of this class. The PICOT question should support the nursing practice problem with current research. Be clear, concise and relate the problem to nursing practice. State how current research supports this problem. Describe the relevant details and explain how the PICOT statement is linked or related to nursing practice. Current research must be used to show how the PICOT supports the nursing practice problem.
PICOT Statement
State the PICOT statement in a question. State the PICOT question using the format noted in the article on “EBP- Step-by-Step- Asking the Clinical Question: A Key Step in Evidence-Based Practice” by Stillwell, Fineout-Overhold & Melnyk (2010) found with the template for this assignment. Discuss the link betweenthe PICOT question, the nursing practice problem & evidence-based practice change how they are connected to relevant details supporting explanation.
Qualitative Study
Background of Study
Keep this section to just the criteria of the qualitative study. The clinical and research problem of the study, significance of the study, purpose of the study and main research question or hypothesis should be described briefly in this section.
Methods of Study
What qualitative methods were used to answer the research question stated above? Were there quantitative and qualitative studies of the literature review relevant to the focus of the study that were cited by the author? Were the references current? Were there weaknesses of the available studies us.
TTHIS IS LECTURER COMMENT FOR MODULE 5 ASSIGNMENT.Slide 2 The.docxjuliennehar
TTHIS IS LECTURER COMMENT FOR MODULE 5 ASSIGNMENT.
Slide 2: There is a typo in the notes page. The info on the slide is repeated in the notes page.
Slide 3: There are grammatical errors.
Slide 8: The article title in the reference list should be formatted like a sentence, only the first word should start with a capital letter. See Section 6.29 on page 185 of the APA manual.
Describe the current problem or opportunity for change. The problem is not identified. What is the current problem? Include in this description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general. Who are the stakeholders and what are the risks?
Identify an evidence-based idea for a change in practice.
What is your plan for knowledge transfer of this change, dissemination, and organizational adoption and implementation? This is not included in the slides.
· Describe the measurable outcomes you hope to achieve with the implementation of this evidence-based change. I do not see outcomes identified.
The tables are not mentioned. Each study is summarized in one or two slides. There is no synthesis of the knowledge to determine interventions to implement.
Some of the information from the tables is copied onto the slides, but there is no clearly identified knowledge gained from each table. Talk about the studies as a whole. Look at all the outcomes across the table-what do you know about all the studies? Look at all of the results across the table-what do you know? What level of evidence were the studies? All level1?
Based on the tables what can be implemented?
There is a title slide and two slides with introduction. After that there are about 1-2 slides per study, making a summary. No conclusions are drawn. No discussion of dissemination. There is no reference list.
It's harder to put bubbles on the slides so most comments are here. Let me know if there are questions.
Describe the current problem or opportunity for change. The problem is not identified. What is the current problem? Include in this description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general. Who are the stakeholders and what are the risks? Identify an evidence-based idea for a change in practice. What is your plan for knowledge transfer of this change, dissemination, and organizational adoption and implementation? This is not included in the slides. · Describe the measurable outcomes you hope to achieve with the implementation of this evidence-based change. I do not see outcomes identified. The tables are not mentioned. Each study is summarized in one or two slides. There is no synthesis of the knowledge to determine interventions to implement. Some of the information from the tables is copied onto the slides, but there is no clearly id ...
6410 Application 3 Becoming a Leader in the Translation of Evide.docxtroutmanboris
6410 Application 3: Becoming a Leader in the Translation of Evidence to Practice
Note: Have an APA Level 1 header for each area noted below in blue (a level 1 header is centered, bolded, using upper and lower case letters—see APA manual area 3.03) Follow APA format and include a minimum of 5 scholarly references less than 5 years old.
Include a BRIEF Introduction and Summary in addition to the headers below. DO NOT EXCEED THREE PAGES AND MUST CITE OFTEN THROUGHOUT THE PAPER.
Grading Area
Points Possible
Points Earned
Potential areas for earning points:
Header: Efforts to Increase Finance and Economic Knowledge
How you would continue to increase your knowledge and awareness of financial, economic, and other concerns related to new practice approaches
2
Header: Use of Evidence to Improve Practice
How translating evidence would enable you to affect or strengthen health care delivery and nursing practice
2
Header: Advocating for EBP Policy Change
How you would advocate for the use of new evidence-based practice approaches through the policy arena
2
Potential areas for losing points:
Grammar, Spelling, and APA errors
Up to 2 pt. deduction
Went Over Page Limit (2-3 pages max)
Up to 2 pt. deduction
Improper credit & citation issue
(See Turnitin Report)
1-6 pt. deduction
Late Submission
20% deduction (1.2 pts) per day late (per syllabus)
6 Total Points Possible
Total Points Earned
P.S. Under the first header on “Effort to Increase Finance and Economic Knowledge, please refer to the attached week 6 discussion you did for me, except you did not include specific numbers and statistics. Below is the critique made by the professor on that area. Please read through the critique and try to incorporate it in this portion of this paper.
Dear student: Thank you for your contribution to this week’s discussion. You brought forward potential costs associated with increased mobilization of ICU patients….namely the need for more nurse time. Do you have some hard numbers you can provide on the potential cost of this? Do you have any local or national information on the cost of not mobilizing the patients (longer stays, increased infection, readmission)? Calculating approximate cost associated with the practice change versus the cost of not changing is important. This will help stakeholders see the value in the investment.
DISCUSSION PAPER
Evidence-based practice models for organizational change: overview
and practical applications
Marjorie A. Schaffer, Kristin E. Sandau & Lee Diedrick
Accepted for publication 19 July 2012
Correspondence to M.A. Schaffer:
e-mail: [email protected]
Marjorie A. Schaffer PhD RN
Professor of Nursing
Bethel University, St. Paul, Minnesota, USA
Kristin E. Sandau PhD RN CNE
Professor of Nursing
Bethel University, St. Paul, Minnesota, USA
Lee Diedrick MAN RN C-NIC
Clinical Educator
Children’s Hospitals and Clinics of
Minnesota, St. Paul, Minnesota, USA
S C H A F F E R M . A . , S A N D A U K ..
Assignment Application Adoption of New Technology SystemsAs a nu.docxrosemariebrayshaw
Assignment: Application: Adoption of New Technology Systems
As a nurse, you can have a great impact on the success or failure of the adoption of EHRs. It is important for nurses to understand their role as change agents and the ways they can influence others when addressing the challenges of changing to a drastically different way of doing things.
Everett Rogers, a pioneer in the field of the diffusion of innovations, identified five qualities that determine individual attitudes towards adopting new technology (2003). He theorized that individuals are concerned with:
Relative advantage: The individual adopting the new innovation must see how it will be an improvement over the old way of doing things.
Compatibility with existing values and practices: The adopter must understand how the new innovation aligns with current practices.
Simplicity: The adopter must believe he or she can easily master the new technology; the more difficult learning the new system appears, the greater the resistance that will occur.
Trialability: The adopter should have the opportunity to “play around’ with the new technology and explore its capabilities.
Observable results: The adopter must have evidence that the proposed innovation has been successful in other situations.
Note:
You are not required to purchase Rogers’ book or pursue further information regarding his list of five qualities. The information provided here is sufficient to complete this Assignment. The full reference for Rogers’ work is provided below the due date on this page.
For this Assignment, you assume the role of a nurse facilitator in a small hospital in upstate New York. You have been part of a team preparing for the implementation of a new electronic health records system. Decisions as to the program that will be used have been finalized, and you are now tasked with preparing the nurses for the new system. There has been an undercurrent of resistance expressed by nurses, and you must respond to their concerns. You have a meeting scheduled with the nurses 1 week prior to the training on the new EHR system. Consider how you can use the five qualities outlined by Rogers (2003) to assist in preparing the nurses for the upcoming implementation.
To prepare
Review the Learning Resources this week about successful implementations of EHRs.
Consider how you would present the new EHR system to the nurses to win their approval.
Reflect on the five qualities outlined by Rogers. How would addressing each of those areas improve the likelihood of success
RESOURCES
McGonigle, D., & Mastrian, K. G. (2015).
Nursing informatics and the foundation of knowledge
(3rd ed.). Burlington, MA: Jones and Bartlett Learning.
Chapter 15, “The Electronic Health Record and Clinical Informatics”
This chapter describes the crucial parts of an electronic health record system and explores the benefits of implementing one.
Bates, D. W. (2010). Getting in step: Electronic health records and their role in care co.
Rules for my assignments1. Kindly follow APA format (American Psy.docxkathyledlow2rr
Rules for my assignments:
1. Kindly follow APA format (American Psychology Association 6
th
edition) for the citation and references! References should be between the period of 2011 and 2016…
2. Please utilize the references I posted below…
3. 2-3 pages
Transitioning From Closed to Open Systems
How do effective nurse leaders and others approach problem solving and decision making in organizations? As suggested in this week’s Learning Resources, systems theory provides a valuable way to assess situations and prepare to address problems.
For this week’s Discussion, you identify an issue or process that could be improved and apply knowledge and strategies related to systems theory.
Note:
You may find it helpful to view the Assignment instructions and use the same problem for this Discussion.
To prepare:
·
Review the information presented in this week’s Learning Resources on systems theory and the difference between open and closed systems.
·
Reflect on the practices and processes with which you are familiar in your organization. Identify one problematic issue or process that could be improved.
·
Consider the problem from a closed-system perspective. Then think about how the issue or process you selected could be addressed by viewing it from an open-system perspective. How would the transition from a closed- to an open-system view help you and others to address the problem and improve outcomes?
Please answer these questions for my assignment:
1.
Description of the problem that you identified in your selected organization.
2.
Explain the problem from a closed-system perspective.
3.
Then, describe how the problem could be addressed by viewing it from an open-system perspective, and explain how this modification would help you and others improve health care outcomes.
4.
Conclusion/Summary
Required Resources
Note:
To access this week's required library resources, please click on the link to the Course Readings List, found in the
Course Materials
section of your Syllabus.
Readings
·
Marquis, B. L., & Huston, C. J. (2015).
Leadership roles and management functions in nursing: Theory and application
(8th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.
o
Review Chapter 7, “Strategic and Operational Planning”
See especially Figure 7.1 on page 147.
o
Chapter 8, “Planned Change”
§
Organizational Change Associated With Nonlinear Dynamics (pp. 172–176)
Read this section of Chapter 8 on planned change. Consider the role of leaders in effectively managing planned change.
o
Chapter 12, “Organizational Structure”
§
“Organizational Culture” (pp. 274–276)
There are many structures organizations take, and these structures influence how the organization functions. This chapter discusses many different organizational structures and provides insights into how these structures influence the change process, as well as leadership and management.
·
Johnson, J. K., Miller, S. H., & Horowitz, S. D. (2008). Systems-based practice: Impr.
8410 Application 1 Identification of a Practice Issue for the Evide.docxsleeperharwell
8410 Application 1: Identification of a Practice Issue for the Evidence-Based Practice (EBP) Project
Note: Have an APA Level 1 header for Each Area Noted below in Blue (a level 1 header is centered, bolded, using upper and lower case letters—see APA manual area 3.03)
Grading Area
Points Possible
Points Earned
Potential areas for earning points:
Header: Summary of Practice Issue
Summary of practice issue. (Note: The issue you select must be suitable for completing the entire EBP Project in 8410.)
2
Header: Exploration of Research Literature
Exploration of the research literature on
this issue.
3
High level of scholarship commensurate with doctoral level evident
1
Potential areas for losing points:
Grammar, Spelling, and APA errors
Up to 2 pt. deduction
Went Over Page Limit (2 pages max)
Up to 2 pt. deduction
*Improper credit & citation issue
1-6 pt. deduction
Late Submission
(posted X.XX.20XX, due X.XX.20XX )
20% deduction (1.2 pts) per day late (per syllabus)
6 Total Points possible
? Total Points Earned
Running head: EBP Project 1
EBP Project 4
Evidence-based Practice Project: PIICOT Statement
Student’s Name
Institution
Date
Evidence-based Practice Project: PIICOT Statement
Delayed patient transfers from the intensive care unit (ICU) is a significant practice problem that affects the quality and safety of healthcare delivery as well as the costs and efficiency of service delivery in a healthcare institution. It is nurses’ role to identify issues and develop strategies for quality improvement (Stillwell, Fineout-Overholt, Melnyk & Williamson, 2012). The following PIICOT Statements seeks to develop an intervention to reduce the rates of delayed transfers to enhance patient experiences and outcomes.
PIICOT Statement
In patients in extended intensive care within an urban acute care facility in Eastern United States, how does early mobilization as recommended by National Institute of Health and Care Excellence clinical guidelines on rehabilitation of patients after critical illness impact early transfers from intensive care as measured 6 months post-implementation when compared to the current standard of care including minimal mobilization of patients?
P: Adult patients
I: in extended intensive care within an urban acute care facility
I: increased mobilization of the patients
C: minimal mobilization of the patients
O: early transfers of the patients from intensive care
T: 6 months
Salient Elements that Inform the Research Question
The research question above has been developed based on observations in clinical practice of patients in intensive care, who overstay their admission in the ICU. Past research shows that delayed transfers of patients from the ICU to non-intensive care wards or the community settings have a negative effect on patient experiences and the patient outcomes. Some of the common negative effects of delayed patient transfers that have been identified by past researchers include an increased risk .
REPLY1Widely used nursing theories include Lewin’s 3 stage model.docxchris293
REPLY1
Widely used nursing theories include Lewin’s 3 stage model and Lippits phase theory. The Lewin’s change theory consist of three stages including unfreezing, moving and refreezing stages. Unfreezing stage is when you recognize a change is needed, then you move to the phase when the change occurs and refreezing stage happens after equilibrium is established leading to satisfactory results and the cycles goes on and on. A distinct feature of Lewin theory is that it contains both driving forces and resisting forces and for the theory to be successful then the driving must overcome resistant forces. Lippits, Watson and Westley seven phase theory, first phase entails diagnosing the problem, assessing motivation, and capacity for change, evaluating change agent’s motivation and resource, choosing the appropriate role of the change agent, maintaining difference and last phase is termination of the help relationship (Tappen, 2016).
Lippits theory expands on Lewin’s model of change into the seven steps mentioned above as well it is more comparable to nursing process hence there is no significance difference between the two (Alageel, Gulliford, McDermott & Wright, 2018). However, Lewin’s is built on three fundamental steps thereby facing a lot of criticism since nursing is more complicated than the three levels. Similarly, both theories are widely used in nursing and both requires nurses who are willing and want to make change. The mentor has applied Lewin’s change theory because she has successfully introduced a new paper work despite the hospital having several rounds every hour. In the unfreezing period she has describe to nurses of the importance of the sheet and how to sign, in the moving stage she let the nurses give their opinions on the system and lastly in the refreezing stage she went round and made sure nurses make this a daily habit. In my own opinion, I believe that Lewin’s theory is more appropriate for my project since most nurses’ push for change receiving less resist from people.
Reference
Tappen, R. M. (2016). Advanced nursing research: From theory to practice. Jones & Bartlett
Publishers.
Alageel, S., Gulliford, M. C., McDermott, L., & Wright, A. J. (2018). Implementing multiple health behaviour change interventions for cardiovascular risk reduction in primary care: a qualitative study.
BMC family practice
,
19
(1), 171.
REPLY2
There are several change theories that would be good to use for the implementation of my capstone change project. After discussing these theories with my preceptor and listening to her stories of success as well as failures, we decided Lewin’s change theory will work best in implementing my change project at the acute care hospital, because there will need to be a strong push for this to be accepted into practice. She had successfully used this theory in the hospital when implementing changes in the past, but she supports the idea that depending on the theory or approach, the outcome can be ve.
his is the first in a series of interactive webinars designed to build capacity in the basic principles of knowledge translation and implementation science.
WATCH-ON DEMAND: https://goo.gl/hnp8gi
On completing this chapter, you will be able to:
Describe why research is important in the nursing profession and discuss the need for evidence-based practice
Describe historic trends and future directions in nursing research
Describe alternative sources of evidence for nursing practice
Describe major characteristics of the positivist and naturalistic paradigm, and discuss
similarities and differences between the traditional scientific method (quantitative research) and naturalistic methods (qualitative research)
Identify several purposes of qualitative and quantitative research
Planned Change in a Department or UnitHealth care organizations ar.docxrosacrosdale
Planned Change in a Department or Unit
Health care organizations are continuously immersed in change from the emergence of new policies, to promote quality care and improve patient safety to keeping pace with the rapid growth in knowledge and best practices. Establishing a solid framework for planning and implementing change is a wise move, as it provides a foundation for the extensive coordination that will be needed to successfully facilitate the change.
For this Assignment, you propose a change at the department or unit level and develop a plan for guiding the change effort.
To prepare:
·
Review Chapter 8 in the course text. Focus on Kurt Lewin’s change theory, and contrast it with other classic change models and strategies.
·
Reflect on problems, inefficiencies, and critical issues within a specific department, unit, or area in your organization or one with which you are familiar. Select one issue as a focal point for this assignment, and consider a change that could be made to address the issue.
·
Think about how the change would align with the organization’s mission, vision, and values as well as relevant professional standards.
·
Using one of the change models or strategies discussed in Chapter 8, begin formulating a plan for implementing the change within the department/unit. Outline the steps that you and/or others should follow to facilitate the change effort. Align these steps to the change model or strategy you selected.
·
Determine who should be involved in initiating and managing the change. Consider the skills and characteristics that are necessary to facilitate this change effort.
To complete:
Write a 3- to 5-page paper (page count does not include title and reference page) that addresses the following:
1.
Identify a problem, inefficiency, or issue within a specific department/unit.
2.
Describe a specific, realistic change that could be made to address the issue.
3.
Summarize how the change would align with the organization’s mission, vision, and values as well as relevant professional standards.
4.
Identify a change model or strategy to guide your planning for implementing the change. Provide a rationale for your selection.
5.
Outline the steps that you and/or others would follow to facilitate the change. Align these steps to your selected change model or strategy.
6.
Explain who would be involved in initiating and managing this change. Describe the skills and characteristics that would be necessary to facilitate the change effort.
REMINDERS:
·
Kindly put introduction, purpose of the paper, body of the paper (6 headings addressed the 6 questions), summary/conclusion, and references (Put headings on it).
·
Kindly follow APA format for the citation and references! References should be between the period of 2011 and 2016.
·
Please utilize my resources below at least three references on the list and you can add more in your own resources…
RESOURCES
Readings
·
Marquis, B. L., & Huston, C. J. (2015).
Leadership rol.
The Duty of Loyalty and Whistleblowing Please respond to the fol.docxcherry686017
"The Duty of Loyalty and Whistleblowing" Please respond to the following:
· Analyze the duty of loyalty in whistleblower cases to determine to whom loyalty is owed and who shows the greater duty of loyalty. Support your analysis with specific examples. Then, suggest at least one (1) change to an existing law.
· Reexamine the Citizens United decision in Chapter 1, and determine which of the following groups has the greatest free speech rights: corporations, public employees, or private employees. Provide a rationale for your determination.
11 Combining Research Methods: Case Studies and Action Research
Rebecca Jester
Introduction
In Chapters 7 and 8, we focused on the unique features of quantitative and qualitative research. In this chapter, we aim to demonstrate how research methods can be integrated and combined to address specific research questions. The chapter will provide an overview of two specific research designs: action research and case studies, together with examples from research projects conducted by the author. This chapter does not aim to provide an in-depth philosophical debate related to case study and action research approaches, but rather a practical discussion of the merits, limitations and application of these two approaches. We begin by discussing the concepts of ‘mixed methods’ and ‘triangulation', first introduced in Chapter 2.
Mixed methods approaches
Traditionally, within health and social research, individuals have aligned themselves with either the quantitative or qualitative paradigm. However, in reality, many real world research projects benefit from mixing or combining methods. Mixed methods research can be accomplished either by using specific approaches to research, such as action research or case study, as discussed within this chapter, or by adopting a phased approach within a study. This might involve the first stage being exploratory within the qualitative paradigm, and the results from this being used to form specific hypotheses for testing within an experimental design, such as a randomized controlled trial. Equally, a quantitative approach (say, a questionnaire) might be used to gather data from a wide range of people, with the results being used to develop a qualitative interview schedule for use with a small sample of respondents.
Triangulation
Very often a research study is undertaken with multiple datasets, mixed methodology or with different researchers, such as at different sites. Triangulation is a very useful technique that enables you to enhance and verify concepts. As Ramprogus (2005, p. 4) suggests, ‘triangulation … tries to reconcile the differences of two or more data sources, methodological approaches, designs, theoretical perspectives, investigators and data analysis to compensate for the weaknesses of any single strategy towards achieving completeness or confirmation of findings’. However, triangulation must be exercised with caution; it is no substitute for robust and well-established ...
Running head RESEARCH CRITIQUE & PICOT - FINAL 16RE.docxtodd521
Running head: RESEARCH CRITIQUE & PICOT - FINAL 1
6
RESEARCH CRITIQUE & PICOT
Research Critique & PICOT Statement – Final Draft
Student’s Name
NRS-433V Introduction to Nursing Research
Grand Canyon University
Due Date
Research Critique & PICOT Statement - Final Draft
Give a brief introduction of this paper as it is the final draft. In this section include the names of the studies that were critiqued in the qualitative and quantitative sections below with the cited reference after the name of each study. The graded assignments from weeks one, two and three should be the basis for this assignment. The corrections made for all sections of those assignments according to the instructor’s comments should be clearly present. Do not include the instructor’s comments. Just make the corrections and put them in the proper places noted by the headings below. Throughout this paper, you should use spell check and grammar check always. Speak in the active voice and not a passive voice. Support statements with references. Use citations in all sections when references are made to the study or studies used in this paper. (Keep the word count between 1500 and 1750 words. Going outside of the word count will cause a 10% deduction of total points.)
Nursing Practice Problem and PICOT Statement
Nursing Practice Problem
State the practice problem that is relevant to nursing. This should be an extension of the PICOT question that was in the introduction of the literature Search on Week 1 of this class. The PICOT question should support the nursing practice problem with current research. Be clear, concise and relate the problem to nursing practice. State how current research supports this problem. Describe the relevant details and explain how the PICOT statement is linked or related to nursing practice. Current research must be used to show how the PICOT supports the nursing practice problem.
PICOT Statement
State the PICOT statement in a question. State the PICOT question using the format noted in the article on “EBP- Step-by-Step- Asking the Clinical Question: A Key Step in Evidence-Based Practice” by Stillwell, Fineout-Overhold & Melnyk (2010) found with the template for this assignment. Discuss the link betweenthe PICOT question, the nursing practice problem & evidence-based practice change how they are connected to relevant details supporting explanation.
Qualitative Study
Background of Study
Keep this section to just the criteria of the qualitative study. The clinical and research problem of the study, significance of the study, purpose of the study and main research question or hypothesis should be described briefly in this section.
Methods of Study
What qualitative methods were used to answer the research question stated above? Were there quantitative and qualitative studies of the literature review relevant to the focus of the study that were cited by the author? Were the references current? Were there weaknesses of the available studies us.
TTHIS IS LECTURER COMMENT FOR MODULE 5 ASSIGNMENT.Slide 2 The.docxjuliennehar
TTHIS IS LECTURER COMMENT FOR MODULE 5 ASSIGNMENT.
Slide 2: There is a typo in the notes page. The info on the slide is repeated in the notes page.
Slide 3: There are grammatical errors.
Slide 8: The article title in the reference list should be formatted like a sentence, only the first word should start with a capital letter. See Section 6.29 on page 185 of the APA manual.
Describe the current problem or opportunity for change. The problem is not identified. What is the current problem? Include in this description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general. Who are the stakeholders and what are the risks?
Identify an evidence-based idea for a change in practice.
What is your plan for knowledge transfer of this change, dissemination, and organizational adoption and implementation? This is not included in the slides.
· Describe the measurable outcomes you hope to achieve with the implementation of this evidence-based change. I do not see outcomes identified.
The tables are not mentioned. Each study is summarized in one or two slides. There is no synthesis of the knowledge to determine interventions to implement.
Some of the information from the tables is copied onto the slides, but there is no clearly identified knowledge gained from each table. Talk about the studies as a whole. Look at all the outcomes across the table-what do you know about all the studies? Look at all of the results across the table-what do you know? What level of evidence were the studies? All level1?
Based on the tables what can be implemented?
There is a title slide and two slides with introduction. After that there are about 1-2 slides per study, making a summary. No conclusions are drawn. No discussion of dissemination. There is no reference list.
It's harder to put bubbles on the slides so most comments are here. Let me know if there are questions.
Describe the current problem or opportunity for change. The problem is not identified. What is the current problem? Include in this description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general. Who are the stakeholders and what are the risks? Identify an evidence-based idea for a change in practice. What is your plan for knowledge transfer of this change, dissemination, and organizational adoption and implementation? This is not included in the slides. · Describe the measurable outcomes you hope to achieve with the implementation of this evidence-based change. I do not see outcomes identified. The tables are not mentioned. Each study is summarized in one or two slides. There is no synthesis of the knowledge to determine interventions to implement. Some of the information from the tables is copied onto the slides, but there is no clearly id ...
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
2. Who is Kurt Lewin
• Jewish psychologist born in Germany (Miner,
2006).
• Earned Doctorates degree in Psychology from
The University of Berlin in 1914 (Miner, 2006).
• Moved to US in 1933 prior to Hitler movement
after impressive visit with Lewis Terman
(founder of Stanford-Binet tests) at Stanford
University (Miner, 2006).
• Study of groups and action research after his
move to the United States led to his
development of Change Theory; his major
contribution to nursing (Miner, 2006).
3. Lewin theorized
that “behavior is a
functional
interaction of
person and
environment”
(Miner, 2006).
Studied leadership
and leadership
climates which led to
the development of
the field of
Organizational
Behavior and Change
Theory (Miner,
2006).
Research on group
decisions and
democratic processes
led to the
development of
theories focusing on
the motivation of
change (Miner,
2006).
Change
Theory
Lewin studied group
dynamics and field
theory which led to
the development of
Action Research and
eventually change
theory (Suc, Prokosch
& Ganslandt, 2009).
Path to Change Theory
5. UNFREEZING
• Finding a method of making it possible for
people to let go of an old pattern that was
counterproductive.
• The stage where the desire to change occurs.
• The more transparent and inclusive the
process is, the more readily people move
through this stage.
Kaminski,J. (2011)
7. REFREEZING
• Establishing the change as a new habit or
process.
• Rewards, support, and champion leadership is
important through this stage.
• The changes are “frozen” in place to ensure that
they become part of normal working procedures.
• Establish supportive mechanisms such as policies,
rewards, ongoing support, and a solid orientation
for new employees.
Kaminski, J. (2011)
8. HOW THE CHANGE
THEORY MOTIVATES
NURSING
KURT LEWIN THEORY
Kaminski, J. (2011)
• The theory involves an action
of planning and fact gathering
before proceeding on to the
next phase of action.
• It ensures that all participants
are comprehending what is
expected of them correctly.
• Keeps a strong focal point in
the area of communication.
• A great article that regarding
how the theory motivated
nursing is:
http://en.articlesgratuits.com/
article.php/id_article=374
Keith, M. (2006)
UNFREEZING
INITIATION
CHANGE
ADAPTATION
REFREEZING
ACCEPTANCE
USE
INCORPORATION
DRIVING
FORCES
RESTRAINING
FORCES
EQUILIBRIUM
9. This is very similar to the five step
nursing process:
• Assessment
• Analysis
• Planning
• Implementation
• Evaluation
(Chitty and Black, 2011)
Action Research and the Successful application of Change
Theory to Nursing
(Suc, Prokosch and Ganslandt, 2009)
Successful application of Change Theory
requires the use of Action Research after
a problem is identified(Suc, Prokosch
and Ganslandt, 2009) :
• Reflection about what you know
• Planning a strategy for change
• Acting based upon the planned strategy
• Observation of the group and the
environment after the action has taken
place
/http://effective.leadershipdevelopment.edu.au/lewins-4-stage-model/active-
learning
Analysis
planning
Implementation
Evaluation
Assessment
10. Is Change Theory unique to
Nursing ?
•Change Theory can be
applied to any field of
practice where
implementation of change
is needed.
11. Change theory and the Four Global
Concepts
• Human being- There is always a force of resistance to change. “The
human factor must be taken into account to achieve acceptance and
commitment of all participants” (Suc, Prokosch & Ganslandt, 2009).
• Environment- The environment can be manipulated to encourage human
beings to move towards a change goal. The environment must be
evaluated for appropriate change interventions (Suc, Prokosch &
Ganslandt, 2009).
• Health- Unhealthy behaviors and unhealthy environments can be
changed if this theory is applied correctly (Suc, Prokosch & Ganslandt,
2009).
• Nursing – When working with large groups to implement change, this
model is ideal when used in conjunction with action research. It has
proven useful to nurse managers in the implementation of change and
“applicable to conflict situations in the nursing environment” (Suc,
Prokosch & Ganslandt, 2009).
12. What Practice Settings Have Used
Change Theory
• Information Technology- changing to a new data
collection system
- Management- changing processes to
improve efficiency and patient care
- Conflict Resolution- changing attitudes and behaviors
- Group Processes – Replacing older, familiar
products with new products and technology
(Suc, Prokosch & Ganslandt, 2009).
13. Strategies for Unfreezing
• Workshops
• Informational bulletins
• Active participation in the formulation of plan.
• Continuous feedback from participants in all
phases of change.
• Accountability without fear of punishment for
results.
(Suc, Prokosch & Ganslandt, 2009).
14. Conclusion
• Kurt Lewin’s Change Theory has been an effective
tool in organizational behavior modification.
• Change Theory has been instrumental in
implementing change in many difficult groups.
• Reflect on the needed change and what you
already know about it. Collect data about the
population, their attitudes and concerns.
• Plan a course of implementation and Act upon it.
• Observe the results of implementation and
modify the plan based on your results as needed.
15. Case Study (part 1)
• The Story
You are a nurse manager of a 750 bed nursing facility with 200 nursing care staff. This facility has been in existence for more than
50 years and you have staff with years of service ranging from 1-25 years. Over the past six months there has been a significant
increase of patients who have been admitted to the hospital emergently for bowel obstruction. To reduce the incidence of bowel
obstruction and reduce the cost of hospitalization you have been assigned to implement the use of a new bowel care monitoring
system. The current system has been in place for the entire history of the facility.
• The survey
Interviews and surveys were conducted to recognize the key factors for resistance and key factors to motivate change.
1. All of the direct care nurses with years of service ranging from 10 to 25 years were resistant to the implementation of a
new system. Theses nurses accounted for 65 members of the total nursing care staff.
2. Nurses who served in administrative and leadership roles were motivated to implement the change. These nurses
accounted for 45 members of the total nursing care staff
3. Nurses who had less than 10 years of service accounted for 110 members of the total nursing care staff and most were
neutral about change.
4. There are 13 nursing units in the entire facility. Each one operates differently and fear of a lack of consistency with
implementation was expressed.
5. Nurses with 10-25 years of service noted their fear of a less effective system being implemented.
6. There was an expressed fear of disciplinary repercussions for the failure of the new system.
7. All nurses noted their desire to provide quality effective care to all patients.
8. 20 patients in 6 months were hospitalized related to bowel obstruction. 10 cases were fatal from complications of the
illness.
Write a brief one paragraph summary based on the following exercises and include the questions on slide 16 in your answer.
Use the chart on the next slide to identify the factors that need to be addressed for change.
What would be your strategy for implementation of change based on Kurt Lewin’s Change Theory?
Use part 2 and the questions on slide 16 to help you formulate an answer.
Access the following website to help you formulate your answers http://www.change-management-
coach.com/kurt_lewin.html
16. Case Study (part 2)
Pro change Rate
it
Proposed
change
Resist
change
Rate
it
• Help participants understand that change is
required.
• Identify the key motivations to change and
key factors contributing to resistance of
desired change enter your findings into the
grid and rate your answers 1-5. (1 being lowest
rating and 5 being highest)
• Measure the motivation for change (pro
change), and the factors of resistance.
• Use the top rated factor of each category as a
strategy for implementation of change.
• There will be one proposed change for the
entire assignment. It will not change with
each factor.
• Enter the number of the factor from the
survey findings into the grid and rate each
one.
• There may be more than one factor with the
same rating in its column.
• Write a brief paragraph explaining your
findings.
17. Answer these questions in your
summary paragraph
• Who are the key figures to motivate change
and why?
• What are the key factors to motivate change
in this scenario?
18. Chitty, K.K., & Black, B.P. (2011). Professional nursing: Concepts and challenges (6th ed.)
Nursing pathway to professionalism. Maryland Heights, MO: Saunders
Kaminski, J. (2011). Theory applied to informatics-Lewin’s change theory. CJNI: Canadian
Journal of Nursing Informatics, 6 (1). Retrieved from http://cjni.net/journal/?p=1210
Keith, M. (2006). Change theory: The motivation it gives to health care nursing. Retrieved
from http://en.articlesgratuits.com/article.php?id_article=374
Kelly, T. (2009, April). [Diagram of Lewin’s four stage model]. The Effective Leadership
Development Community. Retrieved from
http://effective.leadershipdevelopment.edu.au/lewins-4-stage-model/active-learning/
Miner, J. (2006). Organizational behavior 1 : Essential theories of motivation and leadership.
Armonk, NY: M.E. Sharp, Inc. Retrieved from http://0-
site.ebrary.com.libcat.ferris.edu/lib/ferris/docDetail.action?docID=10178132
Suc, J., Prokosch, H. and Ganslandt, T. (2009, May). Applicability of Lewin's change
management model in a hospital setting. Methods of Information In Medicine, 48(5), 419-428.
doi:http://dx.doi.org/10.3414/ME9235
REFERENCES
