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Kurt Lewin's model of change management proposes that change occurs in three steps: unfreezing, changing, and refreezing. While some have criticized Lewin for oversimplifying change, his model remains foundational. Lippitt later expanded on Lewin's work by proposing a seven phase model of change that includes increasing awareness of the need for change, establishing change objectives, making adjustments, and accepting new stability. Nursing often involves complex changes on multiple levels to address critical patient issues. Referring to change management theories can help increase the success of changes in healthcare practice.
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REPLY1Widely used nursing theories include Lewin’s 3 stage model.docx
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.
BIOL 1115 Human BiologyLab –Integumentary SystemGo to SCI.docx
BIOL 1115 Human Biology
Lab –Integumentary System
Go to SCI: Skin Cancer Investigation and enter the site. Begin with the Healthy Skin section and read about the three layers of the skin by clicking on the image of the skin on the right. Next answer these questions:
1. What are the types of cells in the epidermis and how are they related to each other?
2. What is melanin and what is its role in the epidermis?
3. What is keratin and what does it do?
4. What are the two primary features of the dermis?
5. Describe the subcutaneous tissue.
To continue through the interactive, click on the right arrow at the bottom of the screen to go to the section Effects of the Sun on the Skin and watch the animation about the benefits of the sun and risks of sunlight. Then answer these questions:
1. Name the main benefits of sunlight.
2. What are some of the benefits of the sun's UV rays?
3. How are these rays harmful?
Now go to the section titled Causes and read about how over-exposure to the sun can cause skin cancer. Watch the animation on how normal cells multiply and divide to replace damaged or dead cells. Then answer these questions:
1. How do UV rays affect normal cell division?
2. Why do some people have a greater chance of developing skin cancer compared to others?
Continue on to Tumors and answer this question:
1. What are the main differences between benign and malignant tumors?
Now click on and read the Common Risk Factors. Click on each factor to learn more about the risks. Then answer these questions:
1. What are the five most common modifiable risk factors of skin cancer?
2. How can where you live increase your chances of developing skin cancer?
3. How does genetics play a role?
4. What is actinic keratosis?
Now go to the Glowell Clinic: Lab. Click on any patient file where an image of a growth will appear along with the patient's history.
Review the list of symptoms and check those that describe the growth. Decide whether the growth is cancerous or not. Select the next patient and complete the same steps.
Patient
Symptoms
Cancerous?
A
B
C
D
E
F
Evidenced-based communication skills, change processes, and interventions to guide work in field experience:
I am using Lewin’s theory of planned change to guide the change process in this field experience rotation. The first stage of Lewin’s theory is the unfreezing phase whereby a change agent recognizes a problem, identifies the need for change, and determines the differences between the current and desired state (Shirey, 2013). The second stage is the moving phase which involves viewing the change as a process rather than a single event (Shirey, 2013). The change agent creates a solid plan for change, ideally consisting of actionable items that engage people to attempt the proposed change (Shirey, 2013). Finally, the refreezing phase involves solidifying the process(es) and creating policies such that the change becomes the new normal (Shirey, 2013).
According t ...
Nursing working.pptx
1) The purpose of this project was to increase nursing satisfaction in a local critical care unit through evidence-based interventions.
2) A literature review identified three interventions for increasing satisfaction: decreasing burnout, improving teamwork, and enhancing the work environment and retention.
3) Surveys were administered to nursing staff and management to identify satisfaction levels and areas for improvement. Lewin's change theory was used to implement changes through education and new guidelines. Evaluation found improved morale and communication among nurses.
Clinical Journal of Oncology Nursing • Volume 18, Number 2 .docx
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, &.
Transforming Nursing and Healthcare through TechnologyDiscussion.docx
Transforming Nursing and Healthcare through Technology
Discussions
1. Electronic Health Records
Electronic health records (EHRs) are at the center stage of the effort to improve health care quality and control costs. In addition to allowing medical practitioners to access and record clinical documentation at much faster rates, EHRs are also positively influencing care delivery and nurse-patient interaction. Yet despite the potential benefits of EHRs, their implementation can be a formidable task that has broad-reaching implications for an entire health care organization.
In this Discussion, you appraise strategies for obtaining the benefits and overcoming the challenges of implementing and using electronic health records.
To prepare
Review the implementation of EHRs in an organization. Reflect on the various approaches used.
If applicable, consider your own experiences with implementing EHRs. What were some positive aspects of the implementation? What suggestions would you make to improve the process?
Reflect on the reactions of others during the implementation process. Were concerns handled effectively?
If you have not had any experiences with an EHR implementation, talk to someone who has and get his or her feedback on the experience.
Search and indicate examples of effective and poor implementation of EHRs.
RESOURCES
Required Readings
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 coordination. Journal of General Internal Medicine, 25(3), 174–176.
The author of this editorial critically analyzes current applications of electronic health records (EHRs) and their impact on cost, quality, and safety of health care delivery. The author describes a study on the use of vendor-developed EHRs in clinical practice settings, the results of which pinpointed the benefits and drawbacks of EHRs.
Cresswell, K., & Sheikh, A. (2009). The NHS Care Record Service: Recommendations from the literature on successful implementation and adoption. Informatics in Primary Care, 17(3), 153–160.
This article defines the United Kingdom’s National Health Service’s Care Record Service (NHS CRS) as a standard electronic health record system. The article describes the challenges associated with implementing this new information technology and provides recommendations for overcoming those challenges.
Fickenscher, K., & Bakerman, M. (2011). Change management in health care IT. Physician Executive, 37(2), 64–67.
This article offers strategies for health care leaders to successfully implement change programs in their organizations, especially with regard to the new standards for electronic health ...
Discussions1.Electronic Health RecordsElectronic healt.docx
Discussions
1.
Electronic Health Records
Electronic health records (EHRs) are at the center stage of the effort to improve health care quality and control costs. In addition to allowing medical practitioners to access and record clinical documentation at much faster rates, EHRs are also positively influencing care delivery and nurse-patient interaction. Yet despite the potential benefits of EHRs, their implementation can be a formidable task that has broad-reaching implications for an entire health care organization.
In this Discussion, you appraise strategies for obtaining the benefits and overcoming the challenges of implementing and using electronic health records.
To prepare
Review the implementation of EHRs in an organization. Reflect on the various approaches used.
If applicable, consider your own experiences with implementing EHRs. What were some positive aspects of the implementation? What suggestions would you make to improve the process?
Reflect on the reactions of others during the implementation process. Were concerns handled effectively?
If you have not had any experiences with an EHR implementation, talk to someone who has and get his or her feedback on the experience.
Search and indicate examples of effective and poor implementation of EHRs.
RESOURCES
Required Readings
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 coordination. Journal of General Internal Medicine, 25(3), 174–176.
The author of this editorial critically analyzes current applications of electronic health records (EHRs) and their impact on cost, quality, and safety of health care delivery. The author describes a study on the use of vendor-developed EHRs in clinical practice settings, the results of which pinpointed the benefits and drawbacks of EHRs.
Cresswell, K., & Sheikh, A. (2009). The NHS Care Record Service: Recommendations from the literature on successful implementation and adoption. Informatics in Primary Care, 17(3), 153–160.
This article defines the United Kingdom’s National Health Service’s Care Record Service (NHS CRS) as a standard electronic health record system. The article describes the challenges associated with implementing this new information technology and provides recommendations for overcoming those challenges.
Fickenscher, K., & Bakerman, M. (2011). Change management in health care IT. Physician Executive, 37(2), 64–67.
This article offers strategies for health care leaders to successfully implement change programs in their organizations, especially with regard to the new standards for electronic health records (EHRs). The article provide.
Grantham University Wk 11 Evidence Based Nursing Practice Discussion Question...
The document discusses evidence-based practice and the importance of integrating different types of evidence beyond just scientific research. It argues that evidence-based practice requires the expert judgment and knowledge of experienced clinicians, not just research evidence. True evidence-based practice considers both research findings as well as clinical expertise and patient preferences. The Iowa Model of evidence-based practice is presented as a framework to guide the implementation of evidence into clinical practice through identifying problems or knowledge triggers, forming teams, reviewing and critiquing research, and piloting changes.
Grantham University Wk 11 Evidence Based Nursing Practice Discussion Question...
The document discusses evidence-based practice and the importance of integrating different types of evidence beyond just scientific research. It argues that evidence-based practice requires the expert judgment and knowledge of experienced clinicians, not just research evidence. True evidence-based practice involves synthesizing knowledge from various sources, including research findings as well as clinical expertise. The Iowa Model of evidence-based practice is presented as a framework to help implement changes based on the best available evidence.
Recommended
REPLY1Widely used nursing theories include Lewin’s 3 stage model.docx
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.
BIOL 1115 Human BiologyLab –Integumentary SystemGo to SCI.docx
BIOL 1115 Human Biology
Lab –Integumentary System
Go to SCI: Skin Cancer Investigation and enter the site. Begin with the Healthy Skin section and read about the three layers of the skin by clicking on the image of the skin on the right. Next answer these questions:
1. What are the types of cells in the epidermis and how are they related to each other?
2. What is melanin and what is its role in the epidermis?
3. What is keratin and what does it do?
4. What are the two primary features of the dermis?
5. Describe the subcutaneous tissue.
To continue through the interactive, click on the right arrow at the bottom of the screen to go to the section Effects of the Sun on the Skin and watch the animation about the benefits of the sun and risks of sunlight. Then answer these questions:
1. Name the main benefits of sunlight.
2. What are some of the benefits of the sun's UV rays?
3. How are these rays harmful?
Now go to the section titled Causes and read about how over-exposure to the sun can cause skin cancer. Watch the animation on how normal cells multiply and divide to replace damaged or dead cells. Then answer these questions:
1. How do UV rays affect normal cell division?
2. Why do some people have a greater chance of developing skin cancer compared to others?
Continue on to Tumors and answer this question:
1. What are the main differences between benign and malignant tumors?
Now click on and read the Common Risk Factors. Click on each factor to learn more about the risks. Then answer these questions:
1. What are the five most common modifiable risk factors of skin cancer?
2. How can where you live increase your chances of developing skin cancer?
3. How does genetics play a role?
4. What is actinic keratosis?
Now go to the Glowell Clinic: Lab. Click on any patient file where an image of a growth will appear along with the patient's history.
Review the list of symptoms and check those that describe the growth. Decide whether the growth is cancerous or not. Select the next patient and complete the same steps.
Patient
Symptoms
Cancerous?
A
B
C
D
E
F
Evidenced-based communication skills, change processes, and interventions to guide work in field experience:
I am using Lewin’s theory of planned change to guide the change process in this field experience rotation. The first stage of Lewin’s theory is the unfreezing phase whereby a change agent recognizes a problem, identifies the need for change, and determines the differences between the current and desired state (Shirey, 2013). The second stage is the moving phase which involves viewing the change as a process rather than a single event (Shirey, 2013). The change agent creates a solid plan for change, ideally consisting of actionable items that engage people to attempt the proposed change (Shirey, 2013). Finally, the refreezing phase involves solidifying the process(es) and creating policies such that the change becomes the new normal (Shirey, 2013).
According t ...
Nursing working.pptx
1) The purpose of this project was to increase nursing satisfaction in a local critical care unit through evidence-based interventions.
2) A literature review identified three interventions for increasing satisfaction: decreasing burnout, improving teamwork, and enhancing the work environment and retention.
3) Surveys were administered to nursing staff and management to identify satisfaction levels and areas for improvement. Lewin's change theory was used to implement changes through education and new guidelines. Evaluation found improved morale and communication among nurses.
Clinical Journal of Oncology Nursing • Volume 18, Number 2 .docx
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, &.
Transforming Nursing and Healthcare through TechnologyDiscussion.docx
Transforming Nursing and Healthcare through Technology
Discussions
1. Electronic Health Records
Electronic health records (EHRs) are at the center stage of the effort to improve health care quality and control costs. In addition to allowing medical practitioners to access and record clinical documentation at much faster rates, EHRs are also positively influencing care delivery and nurse-patient interaction. Yet despite the potential benefits of EHRs, their implementation can be a formidable task that has broad-reaching implications for an entire health care organization.
In this Discussion, you appraise strategies for obtaining the benefits and overcoming the challenges of implementing and using electronic health records.
To prepare
Review the implementation of EHRs in an organization. Reflect on the various approaches used.
If applicable, consider your own experiences with implementing EHRs. What were some positive aspects of the implementation? What suggestions would you make to improve the process?
Reflect on the reactions of others during the implementation process. Were concerns handled effectively?
If you have not had any experiences with an EHR implementation, talk to someone who has and get his or her feedback on the experience.
Search and indicate examples of effective and poor implementation of EHRs.
RESOURCES
Required Readings
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 coordination. Journal of General Internal Medicine, 25(3), 174–176.
The author of this editorial critically analyzes current applications of electronic health records (EHRs) and their impact on cost, quality, and safety of health care delivery. The author describes a study on the use of vendor-developed EHRs in clinical practice settings, the results of which pinpointed the benefits and drawbacks of EHRs.
Cresswell, K., & Sheikh, A. (2009). The NHS Care Record Service: Recommendations from the literature on successful implementation and adoption. Informatics in Primary Care, 17(3), 153–160.
This article defines the United Kingdom’s National Health Service’s Care Record Service (NHS CRS) as a standard electronic health record system. The article describes the challenges associated with implementing this new information technology and provides recommendations for overcoming those challenges.
Fickenscher, K., & Bakerman, M. (2011). Change management in health care IT. Physician Executive, 37(2), 64–67.
This article offers strategies for health care leaders to successfully implement change programs in their organizations, especially with regard to the new standards for electronic health ...
Discussions1.Electronic Health RecordsElectronic healt.docx
Discussions
1.
Electronic Health Records
Electronic health records (EHRs) are at the center stage of the effort to improve health care quality and control costs. In addition to allowing medical practitioners to access and record clinical documentation at much faster rates, EHRs are also positively influencing care delivery and nurse-patient interaction. Yet despite the potential benefits of EHRs, their implementation can be a formidable task that has broad-reaching implications for an entire health care organization.
In this Discussion, you appraise strategies for obtaining the benefits and overcoming the challenges of implementing and using electronic health records.
To prepare
Review the implementation of EHRs in an organization. Reflect on the various approaches used.
If applicable, consider your own experiences with implementing EHRs. What were some positive aspects of the implementation? What suggestions would you make to improve the process?
Reflect on the reactions of others during the implementation process. Were concerns handled effectively?
If you have not had any experiences with an EHR implementation, talk to someone who has and get his or her feedback on the experience.
Search and indicate examples of effective and poor implementation of EHRs.
RESOURCES
Required Readings
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 coordination. Journal of General Internal Medicine, 25(3), 174–176.
The author of this editorial critically analyzes current applications of electronic health records (EHRs) and their impact on cost, quality, and safety of health care delivery. The author describes a study on the use of vendor-developed EHRs in clinical practice settings, the results of which pinpointed the benefits and drawbacks of EHRs.
Cresswell, K., & Sheikh, A. (2009). The NHS Care Record Service: Recommendations from the literature on successful implementation and adoption. Informatics in Primary Care, 17(3), 153–160.
This article defines the United Kingdom’s National Health Service’s Care Record Service (NHS CRS) as a standard electronic health record system. The article describes the challenges associated with implementing this new information technology and provides recommendations for overcoming those challenges.
Fickenscher, K., & Bakerman, M. (2011). Change management in health care IT. Physician Executive, 37(2), 64–67.
This article offers strategies for health care leaders to successfully implement change programs in their organizations, especially with regard to the new standards for electronic health records (EHRs). The article provide.
Grantham University Wk 11 Evidence Based Nursing Practice Discussion Question...
The document discusses evidence-based practice and the importance of integrating different types of evidence beyond just scientific research. It argues that evidence-based practice requires the expert judgment and knowledge of experienced clinicians, not just research evidence. True evidence-based practice considers both research findings as well as clinical expertise and patient preferences. The Iowa Model of evidence-based practice is presented as a framework to guide the implementation of evidence into clinical practice through identifying problems or knowledge triggers, forming teams, reviewing and critiquing research, and piloting changes.
Grantham University Wk 11 Evidence Based Nursing Practice Discussion Question...
The document discusses evidence-based practice and the importance of integrating different types of evidence beyond just scientific research. It argues that evidence-based practice requires the expert judgment and knowledge of experienced clinicians, not just research evidence. True evidence-based practice involves synthesizing knowledge from various sources, including research findings as well as clinical expertise. The Iowa Model of evidence-based practice is presented as a framework to help implement changes based on the best available evidence.
Running head CAPSTONE PROJECT 1CAPSTONE PROJECT 3.docx
Running head: CAPSTONE PROJECT 1
CAPSTONE PROJECT 3
Capstone Project Topic Selection: Improving Workflow for Nurses Working in Primary
Care Settings
Capstone Project Topic Selection and Approval
Problem or Issue
One of the major problems that affect nurses is improving workflow in a busy environment. When nurses are few and, healthcare professionals often face work overload. This has the potential to affect the quality of care given to patients in busy environments. When workload is high, efficiency reduces, thus making nurses vulnerable to errors (Cain & Haque, 2009). The healthcare sector has often faced a lot of demands to develop or reestablish its workflow. In many situations, the desire for evaluating workflow is the need to respond to new ways in which tasks are completed. There are various workflow issues that continue to face nurses in their working environments. They include challenges related to providing services to critically ill patients, and emergence of multidisciplinary teams in care. In such environments, all healthcare professionals struggle with the need to implement change that makes the care team more patient-centered.
Setting/ Context
The context under which this problem is common is primary care setting. Primary care settings are those that provide medical and psychological diagnosis and treatment. Primary healthcare settings are also involved in the provision of personal support for patients of all backgrounds, and in all stages of illness (Goroll & Mulley, 2012). In primary healthcare settings, nurses and other professionals are involved in the communication of information about prevention, diagnosis, treatment, and prognosis, as well as the prevention and care of chronic disease and disabilities through risk evaluation, health education, and early disease detection.
High-Level Detail of the Problem
Nurses operating in primary healthcare settings are often overburdened with many tasks that interfere with the workflow. This is particularly true when they are working in multidisciplinary teams that require coordination and cohesion. In such cases, it might be difficult to clearly determine each professional’s roles and responsibilities (Hickey & Kritek, 2011). At the same time, when the number of nurses is few, the available one’s face stress and physical strain that might interfere with the quality of care given to patients and increase likelihood of errors. In an environment where technological interventions do not sufficiently meet the objectives of healthcare groups, it might also cause workflow issues. Such alternative flows arouse worries since the non-formal mechanisms depend upon the health professionals’ memory and may overlook the safety systems that might be offered.
Impact of the Problem
Workflow issues often generate vinous negative impacts on both the nurses and the patients. For instance, poor coordination among healthcare professionals can result in errors that pose many harms to the pa ...
1.10 Contact Info for Site Approver & Expected Approval Date1.Je.docx
1.10 Contact Info for Site Approver & Expected Approval Date
1.Jennifer Lopez (713)770-7107-pending & pending
2.Robert Garza (713)791-1414
3. Karl Covington (713)695-8686
Section #2
To be completed by Learner
2.1 Project
Write approximately one paragraph that describes the action research project and the basis for it being addressed.
The action research project deals with a pertinent leadership effectiveness issue created by the healthcare reform process in healthcare institutions across the United States. The reform process has created a dynamic environment that is in constant flux. Essentially, healthcare reform institutionalization has proved to be very beneficial. For instance, strives to reduce high costs of healthcare. Additionally, it ensures that effective delivery of primary care is achieved so as to reduce the prevalence of chronic illnesses such as diabetes and cardiac-related health problems. The shift towards preventive care for the reduction of chronic illnesses requires more engagement between the patients and the doctors and closer follow-ups of patient outcomes. This requires a leadership that is effective in engendering a workforce that is responsive to long-term patient needs. This means the healthcare professionals such as the physicians and nurses need effective leadership in hospital management so as to ensure they are motivated and engaged in the change process through teamwork and partnerships within hierarchical structures. Therefore, the purpose of this action research is to provide a leadership model and qualities of leadership most relevant for the dynamic healthcare environment. The action research project evaluates the case about the Hospital Corporation of America (HCA), Houston, Texas, to understand the leadership mechanisms within the institution and how they influence employee and patient outcomes. Based on the findings of the studies conducted, the possibility of using the leadership model proposed to improve outcomes will be elaborated upon. Comment by Heather: Please consider revising this sentence. The project cannot deal. Comment by Zerwekh, Tyler: How so? Reference? Comment by Heather: Incomplete sentence. Please revise. Comment by Zerwekh, Tyler: Strides? Comment by Heather: I understand why you would select this word- but at quick glance it can be confusing and even mistook for engineering. You may want to reconsider a synonym like generate or produce. Comment by Heather: Will your research be providing the model or will it be looking at existing models? Will you be doing a pilot study will you introduce a model and then examining the model through prospective follow-up? Of are you just looking at the current leadership style then gaging outcomes? It is a bit ambiguous in nature how you will be conducting your study. Comment by Zerwekh, Tyler: This still reads confusing. Consider revising Comment by Heather: I think really you are looking at how the leadership mechanisms impact or influ ...
Strategic Analysis and Leadership Interventions 1Strategic A.docx
This document summarizes a case study about Southwest Airlines facing increased competition from major carriers like United and Continental. Ann Rhoades, VP of People at Southwest, is preparing for a meeting to discuss how Southwest can maintain its competitive advantage in light of these new threats. Southwest has traditionally relied on strong company culture and human resource practices to drive lower costs and better service. However, Rhoades is concerned the competition may be able to imitate these practices. She will review Southwest's strengths and weaknesses and make recommendations. The case provides background on Southwest's history and culture since its founding in 1971.
A Nurse Residency Program For New Nursing
This document summarizes a study that examined nurses' use, knowledge, and attitudes toward evidence-based practice (EBP) at a large Magnet hospital. The study used a questionnaire divided into three subscales to assess EBP use, knowledge, and attitudes. The results found that higher levels of education and years of experience were associated with more positive EBP attitudes and knowledge. Additionally, specialty certification was linked to greater EBP use and knowledge. The study provides insights into factors that can increase nurses' adoption of EBP.
Reply 1 and 2 words each one by at pm.docx
Lewin's theory of change was used to improve hourly rounding in an emergency department which led to improved patient experience scores. The theory involves three steps - unfreezing current practices, moving to implement new practices, and refreezing the changes. Similarly, nursing students used Lewin's theory to develop and pilot a peer mentorship program. Middle-range theories in nursing identify measurable concepts between practice and grand theories. Two articles operationalized middle-range theory concepts related to self-care for chronic diseases and hypertension management. These concepts included habits, beliefs, motivation, and locus of control.
Leading change in healthcare- thesis_Mulondo_160601
This document summarizes Jerry Mulondo's master's thesis which explored leadership approaches associated with positive change in healthcare. The thesis used narrative analysis of interviews with 19 physician leaders in Sweden. Five major themes were identified: an evidence-informed and problem-focused approach; driving goals from the front; leaders as facilitators; vision guiding leadership; and principles guiding leadership. These themes were linked to leadership theories. The study found that leadership development programs should draw from various leadership theories and develop capabilities for data-informed change processes. Further research is needed on physician leadership and the factors affecting leadership style choices in different healthcare settings.
Lewin’s Force Field Analysis.Components and steps of Lewin’s For.docx
Lewin’s Force Field Analysis.
Components and steps of Lewin’s Force Field Analysis:
Kurt Lewin was social psychologist that practiced in the 1930’s and 1940’s. When we hear about three changes: unfreezing- change – refreezing. Kurt Lewin suggests that there are influences that affect change. Lewin’s change in general means that an individual or organizations to see that they need a change and want to make a change that will work and stay implemented.
Lewin’s three-step model of change theory:
#1 Unfreezing this where we acknowledge there is a challenging issue. We know that we want to make a change.
#2 Changing: This is the stage that we plan for the change. This is where we bring the stakeholders for training and education of how the change with affect and benefit the organization. This phase is also where we do education to the frontline staff and implement the new plan.
#3 Refreezing: In this phase we have already implemented the change. The entire organization or group is onboard. This phase is especially important because this is where we monitor how we are doing with change. We have created performance indicators and they are continuously monitored.
Does the model or theory contain a component for appraising the evidence?
After review of the theory, I do not feel that there is any evidence of a component for appraising the evidence. There is no evidence of what needs to be done to in between the phases.
Does the model or theory contain a component for networking with the stakeholders during all phases of practice change?
For Lewin’s theory the stakeholders fall into each phase. When there is an issue that this identified for change, the stakeholders are aware and need to be onboard and support the need for change. When we move onto the next phase of change the stakeholders are involved the most in this phase. The stakeholders informed of the benefits of the change and give input of the changes. In the final stage the stakeholders can review the performance indicators and are able to help reinforce education and compliance in the refreezing change.
Does the model contain components for identifying barriers and addressing barriers to implementation?
I do not feel that there are specific components that identify barriers and barriers to implementation. If you look at the whole theory, you can see #1 We identify the problem. #2 Create the plan and implement it. #3 Monitor the plan and keep it going. We can see the “general” plan. I do not feel that this gives us the specifics of how to dissolve the process and create a new process. We need to have the specifics of how to get the buy in from the stakeholders and the frontline staff. How do we gather the information for the buy in of everyone involved? I also feel that there is a time frame issue with this process. We are not educated on how long or in general should each phase take. How ling does it take to get all people “onboard”?
As .
Presentation for nursing 3
1) The purpose of the project was to increase nursing satisfaction in a local critical care unit using evidence-based research.
2) Three interventions were identified to increase satisfaction: decreasing burnout, improving teamwork, and enhancing the work environment and job retention.
3) Surveys were conducted anonymously over three weeks to collect data on satisfaction levels. Analysis found improved morale and communication between nurses as well as increased responsiveness from management to staff needs.
Presentation for nursing 3
1) The purpose of the project was to increase nursing satisfaction in a local critical care unit using evidence-based research.
2) Three interventions were identified to increase satisfaction: decreasing burnout, improving teamwork, and enhancing the work environment and job retention.
3) Surveys were distributed to nursing staff and management to collect data on satisfaction over three weeks. Analysis found improved morale and communication among nurses as well as increased responsiveness from management to staff needs.
Presentation for nursing 3
1) The purpose of the project was to increase nursing satisfaction in a local critical care unit using evidence-based research.
2) Three interventions were identified to increase satisfaction: decreasing burnout, improving teamwork, and enhancing the work environment and job retention.
3) Surveys were conducted anonymously over three weeks to collect data on satisfaction levels. Analysis found improved morale and communication between nurses as well as increased responsiveness from management to staff needs.
Presentation for nursing 3
1) The purpose of the project was to increase nursing satisfaction in a local critical care unit using evidence-based research.
2) Three interventions were identified to increase satisfaction: decreasing burnout, improving teamwork, and enhancing the work environment and job retention.
3) Surveys were conducted anonymously over three weeks to collect data on satisfaction levels. Analysis found improved morale and communication between nurses as well as increased responsiveness from management to staff needs.
Theories in health promotion and health behavior
This document discusses several theories related to health promotion and health behavior. It describes the stages of change model, which outlines stages individuals move through when adopting a new healthy behavior, from precontemplation to maintenance. It proposes this model can help understand the process of overcoming heroin and opioid addiction. The document also discusses using the health belief model to convince states to provide Medicaid coverage for addiction treatment, arguing it will reduce healthcare costs by preventing illnesses.
Social Cognitive TheoryThis theory was introduced by Albert Band.docx
Social Cognitive Theory
This theory was introduced by Albert Bandura, which stated that individuals could learn positively by using interactive behavior, human dialogue, direct experiences, and common observations. The sole purpose of the theory is to comprehend and predict the individual or group behavior and to identify methods by which change or modification can be achieved. The major changes include the promotion of health activities, change in behavior, and improved personality. It is also indicated in the theory that environmental variations, behavior changes, and individual personal factors are the real causes to affect one’s behavior (White et al., 2019). Social cognitive theory is predominantly helpful when collaborated with educational institutions to improve behavior changes like introducing advanced knowledge into practice. Prochaska and DiClementi’s Model of Behavior Change is one of the most beneficial and productive models for health behavior changes.
Stages of Change Theory
Prochaska and DiClementi’s Model of Behavior Change was initially established to target the customers that need a change in health behavior, especially smokers under therapy treatment. There were four stages of this theory at the start, but now it has five different stages along with additional consideration of multiple audiences rather than individual cases. These stages of change theory are as follows:
Precontemplation
refers to the condition in which an individual does not understand and unaware consciously or unconsciously of the fact that change is a necessity for him/her.
Contemplation
indicates the situation of the person who is well aware of the problem and started to think about changing his or her attitude.
Preparation for action
indicates whenever the individual is ready to accept the challenge to change the attitude and start preparing to change is considered as “the act of preparation.” This stage may be clear within 02 weeks after making the decision to change. The
action
starts with the engagement of an individual into the change activities and understands how to cope with the behavioral change.
Maintenance
is considered as the final stage, which varies with individuals, but normally it may take up to six months. Any change in behavior must be strengthened in order to sustain the change.
Appraisal of evidence
There is a lot of evidence that proved that this model or theory could create a difference in the health behavior of an individual. Prochaska, DiClemente, and Norcross defined ten procedures that can evaluate and inspire the movement across the stages, which include Re-evaluation of environmental activities, Individual self-freedom, Social freedom, Sense of dramatic relief, Awareness levitation, Re-evaluation of self-esteem, Improvement in the relationships, Strengthening of management, Incitement control and Counter conditioning. These are some of the processes that can be achieved through this model or theory. The evide.
Processof changeresearchinsft chapter
The document summarizes research on the processes of change in systemic family therapy (SFT). It begins by defining SFT process research and distinguishing between mechanisms of change (mediators) and contexts of change (moderators). It then reviews process research on the major schools of family therapy, finding limited research on modern schools like Bowen and psychoanalytic therapy. More research exists for cognitive-behavioral, strategic, experiential, and structural models, especially as used in empirically supported treatments. Postmodern schools like solution-focused and narrative therapies have more process research due to their popularity in individual therapy. Overall, the review finds research support for strengthening family functioning, reframing problems systemically, externalizing issues, focusing on
Change Evaluation And Sustainability Essay Paper.docx
The document discusses implementing a change initiative to address compassion fatigue among nursing staff in a hospital's surgical units. It proposes educating nurses on compassion fatigue, identifying signs, and developing constructive coping strategies. An interprofessional team will introduce the change using the John Hopkins Nursing Evidence-Based Practice Model. Nurses will be surveyed before and after using a standardized questionnaire to evaluate the intervention's effectiveness in reducing fatigue and improving coping mechanisms. If shown to be effective, the change could be expanded to other units and facilities to help sustain improved nurse well-being and patient care over the long term.
Nursing Essay Writing
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D I S C U S S I O N P A P E RNursing Services Delivery The.docx
D I S C U S S I O N P A P E R
Nursing Services Delivery Theory: an open system approach
Raquel M. Meyer & Linda L. O’Brien-Pallas
Accepted for publication 30 July 2010
Re-use of this article is permitted in
accordance with the Terms and Conditions
set out at http://wileyonlinelibrary.com/
onlineopen#OnlineOpen_Terms
Correspondence to R.M. Meyer:
e-mail: [email protected]
Raquel M. Meyer PhD RN
Nursing Early Career Researcher
Ontario Ministry of Health & Long-Term
Care, and
Assistant Professor (CLTA)
Lawrence Bloomberg Faculty of Nursing,
University of Toronto, Ontario, Canada
Linda L. O’Brien-Pallas PhD RN FCAHS
Professor & CHSRF/CIHR Chair in
Nursing Human Resources
Lawrence Bloomberg Faculty of Nursing,
University of Toronto, Ontario, Canada
M E Y E R R . M . & O ’ B R I E N - P A L L A S L . L . ( 2 0 1 0 )M E Y E R R . M . & O ’ B R I E N - P A L L A S L . L . ( 2 0 1 0 ) Nursing services delivery theory:
an open system approach. Journal of Advanced Nursing 66(12), 2828–2838.
doi: 10.1111/j.1365-2648.2010.05449.x
Abstract
Aim. This paper is a discussion of the derivation of the Nursing Services Delivery
Theory from the application of open system theory to large-scale organizations.
Background. The underlying mechanisms by which staffing indicators influence
outcomes remain under-theorized and unmeasured, resulting in a ‘black box’ that
masks the nature and organization of nursing work. Theory linking nursing work,
staffing, work environments, and outcomes in different settings is urgently needed to
inform management decisions about the allocation of nurse staffing resources in
organizations.
Data sources. A search of CINAHL and Business Source Premier for the years
1980–2008 was conducted using the following terms: theory, models, organization,
organizational structure, management, administration, nursing units, and nursing.
Seminal works were included.
Discussion. The healthcare organization is conceptualized as an open system
characterized by energy transformation, a dynamic steady state, negative entropy,
event cycles, negative feedback, differentiation, integration and coordination, and
equifinality. The Nursing Services Delivery Theory proposes that input, throughput,
and output factors interact dynamically to influence the global work demands
placed on nursing work groups at the point of care in production subsystems.
Implications for nursing. The Nursing Services Delivery Theory can be applied to
varied settings, cultures, and countries and supports the study of multi-level phe-
nomena and cross-level effects.
Conclusion. The Nursing Services Delivery Theory gives a relational structure for
reconciling disparate streams of research related to nursing work, staffing, and work
environments. The theory can guide future research and the management of nursing
services in large-scale healthcare organizations.
Key words: nursing management, Nursing Services Delivery Theory, open system
app.
The incorporation of a model when making practice changes is.docx
The document discusses the importance of using a change model when making practice changes in healthcare. It states that using a model can help ensure projects align with the organization, identify current research from a patient perspective, and clarify and guide changes to ultimately lead to better patient care. While using a model requires time and effort, it is worth it to help ensure successful projects that improve health outcomes for patients. As nurses, there is a responsibility to improve patient outcomes and further nursing research, and change models can help accomplish these goals.
Chapter 7 The Role of the Patient in Continuous Quality Improve
Chapter 7: The Role of the Patient in Continuous Quality Improvement
Contents
Introduction and background
Patient involvement in healthcare improvement overview
Rationale for Patient Involvement in CQI
Methods for Involving Patients in CQI
Factors Affecting Patient Involvement
The MAPR Model of Patient Involvement
Partners to Owners
Conclusion
Introduction
The primary function of health systems is to care for the health and wellbeing of populations in an effective and efficient way.
A range of mechanisms exist for measuring the quality of care provided by health systems
The role of the patient, family, and caregivers is much less clear
History, policy, and causality are conflicted on the role of and outcomes from the patient in CQI
Background
Most CQI systems value the involvement of the client in systemic change and development
Patient safety inquiries show that patients and carers often flagged problems first but were ignored
These inquiries were not isolated to one part of the health system – problems are diverse in type and location of occurrence
How can CQI help avoid these problems, halt their recurrence and improve systemic approaches?
Patient Involvement in Healthcare Improvement Overview
Patients are expected to be involved in health care as health systems have developed – CQI is a part of this
Social and health sector changes have contributed to the call for patient involvement
The dominance of medicine has been questioned by patients, advocates and health practitioners
The HIV/AIDS epidemic has been a major force for change in traditional health system approaches
Technological shifts have/are having a huge impact e.g. knowledge base, global contacts, volunteers for trials etc.
Rationale for Patient Involvement in CQI
Greater knowledge of health has increased knowledge of errors in the media and public domains
High profile cases continue to get major news coverage e.g. The Shipman Inquiry in the U.K.
Health systems have been forced to acknowledge the patient/client/carer perspectives
CQI is part of the shift to patient-centered health care e.g. Insurance systems, co-payments etc. also make patients customers
Methods for Involving Patients in CQI
Three important levels of patient involvement in CQI:
Micro-level involvement – active patient involvement as acknowledged in the concept of the self-managing patient;
Meso-level involvement – patients involved in health service or even whole system planning, management and evaluation;
Macro-level involvement – here patients are involved in national/international safety activities e.g. The WHO London Declaration
Factors Affecting Patient Involvement
The evidence base for patient involvement is small but growing
Patient willingness to participate is affected by several factors e.g. self-efficacy in the role, health literacy, shift/changes required in role
Inhibitory factors include e.g. type/severity of condition, SES factors (minority social position), the health setting and ...
Reimplementation of a bedside shift report 7 Errors are .docx
Reimplementation of a bedside shift report 7
* Errors are in red that must be addressed or more points will continue to come off.
· Clarification about the change process is needed; telehealth in ICU is mentioned but not explained as being relevant to BSR. There are many sentence structural issues. See my feedback throughout.
Change Proposal: Reimplementation of a Bedside Shift Report
The identified clinical problem that is relevant to nurses in the workplace is the bedside shift report (BSR). The bedside shift report may be used to help the development of teamwork, ownership, and accountability thus increasing the satisfaction of the nurses. The reason for selecting the reimplementation of a bedside shift report is because; at a targeted facility the implementation of the bedside shift report is becoming poor. This has led to the poor compliance with the standards of practice, and increase costs in the facility. Also, to have a reduced cost by removing overtime pay and scrubbing off legal errors which result in legal fees (Clark et al., 2020). (*Re-phrase this sentence, avoid slang).
The reimplementation of a bedside shift report is important for the nurse practicing in the organization. Bedside shift report assists in improving the experience of the client and improving the handoff care between the nurses through including the family and client in the delivery of care. Bedside shift report is leading to the introduction of a change in the nursing culture i.e. introduction of various methods of communicating patient-specific care at a shift transformation. Shift reports given at the bedside is helping in changing the manner in which nurses are communicating and practicing (Clark et al., 2020).
At the targeted facility, the execution of the bedside shift report is poor and this is associated to the lack of knowledge concerning the role of bedside shift reporting on the patient outcome. The healthcare providers at the facility are not directly engaged in the provision of healthcare. There is poor communication of the goals of the bedside shift reporting and their importance about the positive outcomes and benefits that are involved in the change (Clark et al., 2020).
According to the study by Gregory et al., (2014), the process of assessing the transformation in practice that involves transitioning of the bedside nurse shift handoffs is important. The evaluation process is helpful in the re-implementation plan to help in improving the areas of weaknesses. The evaluation process of the success in the implementation in the practice is assessing the perception of the nurses about the proposed changes i.e. the re-implementation plans. There is evidence showing the positive impacts of the bedside shift report in the safety of the patient, the control of the pain, the satisfaction of the patients, and improvement in the nurse to patient or nurse to nurse communication (Gregory et al., 2014).
A study by Dempsey et al., (2014) reveals t.
This week we are going to participate in a.docx
This week students will participate in a debate on whether the French Revolution was worth its human cost. They will be split into two groups - one arguing yes and one arguing no. The group arguing yes will analyze an excerpt from Peter Kropotkin's book The Great French Revolution 1789-1793 to defend their position that the French Revolution was worth its significant human toll.
This week begins an overview of the Research In.docx
This document provides an overview of the research process for an academic paper. It discusses considering thesis, motive, structure, finding topics, audience, and structuring the argument with initial research. The document recommends reviewing a guide to the elements of academic writing and lists three online writing support resources as samples for additional academic support.
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Similar to Many consider Kurt in three.docx
Running head CAPSTONE PROJECT 1CAPSTONE PROJECT 3.docx
Running head: CAPSTONE PROJECT 1
CAPSTONE PROJECT 3
Capstone Project Topic Selection: Improving Workflow for Nurses Working in Primary
Care Settings
Capstone Project Topic Selection and Approval
Problem or Issue
One of the major problems that affect nurses is improving workflow in a busy environment. When nurses are few and, healthcare professionals often face work overload. This has the potential to affect the quality of care given to patients in busy environments. When workload is high, efficiency reduces, thus making nurses vulnerable to errors (Cain & Haque, 2009). The healthcare sector has often faced a lot of demands to develop or reestablish its workflow. In many situations, the desire for evaluating workflow is the need to respond to new ways in which tasks are completed. There are various workflow issues that continue to face nurses in their working environments. They include challenges related to providing services to critically ill patients, and emergence of multidisciplinary teams in care. In such environments, all healthcare professionals struggle with the need to implement change that makes the care team more patient-centered.
Setting/ Context
The context under which this problem is common is primary care setting. Primary care settings are those that provide medical and psychological diagnosis and treatment. Primary healthcare settings are also involved in the provision of personal support for patients of all backgrounds, and in all stages of illness (Goroll & Mulley, 2012). In primary healthcare settings, nurses and other professionals are involved in the communication of information about prevention, diagnosis, treatment, and prognosis, as well as the prevention and care of chronic disease and disabilities through risk evaluation, health education, and early disease detection.
High-Level Detail of the Problem
Nurses operating in primary healthcare settings are often overburdened with many tasks that interfere with the workflow. This is particularly true when they are working in multidisciplinary teams that require coordination and cohesion. In such cases, it might be difficult to clearly determine each professional’s roles and responsibilities (Hickey & Kritek, 2011). At the same time, when the number of nurses is few, the available one’s face stress and physical strain that might interfere with the quality of care given to patients and increase likelihood of errors. In an environment where technological interventions do not sufficiently meet the objectives of healthcare groups, it might also cause workflow issues. Such alternative flows arouse worries since the non-formal mechanisms depend upon the health professionals’ memory and may overlook the safety systems that might be offered.
Impact of the Problem
Workflow issues often generate vinous negative impacts on both the nurses and the patients. For instance, poor coordination among healthcare professionals can result in errors that pose many harms to the pa ...
1.10 Contact Info for Site Approver & Expected Approval Date1.Je.docx
1.10 Contact Info for Site Approver & Expected Approval Date
1.Jennifer Lopez (713)770-7107-pending & pending
2.Robert Garza (713)791-1414
3. Karl Covington (713)695-8686
Section #2
To be completed by Learner
2.1 Project
Write approximately one paragraph that describes the action research project and the basis for it being addressed.
The action research project deals with a pertinent leadership effectiveness issue created by the healthcare reform process in healthcare institutions across the United States. The reform process has created a dynamic environment that is in constant flux. Essentially, healthcare reform institutionalization has proved to be very beneficial. For instance, strives to reduce high costs of healthcare. Additionally, it ensures that effective delivery of primary care is achieved so as to reduce the prevalence of chronic illnesses such as diabetes and cardiac-related health problems. The shift towards preventive care for the reduction of chronic illnesses requires more engagement between the patients and the doctors and closer follow-ups of patient outcomes. This requires a leadership that is effective in engendering a workforce that is responsive to long-term patient needs. This means the healthcare professionals such as the physicians and nurses need effective leadership in hospital management so as to ensure they are motivated and engaged in the change process through teamwork and partnerships within hierarchical structures. Therefore, the purpose of this action research is to provide a leadership model and qualities of leadership most relevant for the dynamic healthcare environment. The action research project evaluates the case about the Hospital Corporation of America (HCA), Houston, Texas, to understand the leadership mechanisms within the institution and how they influence employee and patient outcomes. Based on the findings of the studies conducted, the possibility of using the leadership model proposed to improve outcomes will be elaborated upon. Comment by Heather: Please consider revising this sentence. The project cannot deal. Comment by Zerwekh, Tyler: How so? Reference? Comment by Heather: Incomplete sentence. Please revise. Comment by Zerwekh, Tyler: Strides? Comment by Heather: I understand why you would select this word- but at quick glance it can be confusing and even mistook for engineering. You may want to reconsider a synonym like generate or produce. Comment by Heather: Will your research be providing the model or will it be looking at existing models? Will you be doing a pilot study will you introduce a model and then examining the model through prospective follow-up? Of are you just looking at the current leadership style then gaging outcomes? It is a bit ambiguous in nature how you will be conducting your study. Comment by Zerwekh, Tyler: This still reads confusing. Consider revising Comment by Heather: I think really you are looking at how the leadership mechanisms impact or influ ...
Strategic Analysis and Leadership Interventions 1Strategic A.docx
This document summarizes a case study about Southwest Airlines facing increased competition from major carriers like United and Continental. Ann Rhoades, VP of People at Southwest, is preparing for a meeting to discuss how Southwest can maintain its competitive advantage in light of these new threats. Southwest has traditionally relied on strong company culture and human resource practices to drive lower costs and better service. However, Rhoades is concerned the competition may be able to imitate these practices. She will review Southwest's strengths and weaknesses and make recommendations. The case provides background on Southwest's history and culture since its founding in 1971.
A Nurse Residency Program For New Nursing
This document summarizes a study that examined nurses' use, knowledge, and attitudes toward evidence-based practice (EBP) at a large Magnet hospital. The study used a questionnaire divided into three subscales to assess EBP use, knowledge, and attitudes. The results found that higher levels of education and years of experience were associated with more positive EBP attitudes and knowledge. Additionally, specialty certification was linked to greater EBP use and knowledge. The study provides insights into factors that can increase nurses' adoption of EBP.
Reply 1 and 2 words each one by at pm.docx
Lewin's theory of change was used to improve hourly rounding in an emergency department which led to improved patient experience scores. The theory involves three steps - unfreezing current practices, moving to implement new practices, and refreezing the changes. Similarly, nursing students used Lewin's theory to develop and pilot a peer mentorship program. Middle-range theories in nursing identify measurable concepts between practice and grand theories. Two articles operationalized middle-range theory concepts related to self-care for chronic diseases and hypertension management. These concepts included habits, beliefs, motivation, and locus of control.
Leading change in healthcare- thesis_Mulondo_160601
This document summarizes Jerry Mulondo's master's thesis which explored leadership approaches associated with positive change in healthcare. The thesis used narrative analysis of interviews with 19 physician leaders in Sweden. Five major themes were identified: an evidence-informed and problem-focused approach; driving goals from the front; leaders as facilitators; vision guiding leadership; and principles guiding leadership. These themes were linked to leadership theories. The study found that leadership development programs should draw from various leadership theories and develop capabilities for data-informed change processes. Further research is needed on physician leadership and the factors affecting leadership style choices in different healthcare settings.
Lewin’s Force Field Analysis.Components and steps of Lewin’s For.docx
Lewin’s Force Field Analysis.
Components and steps of Lewin’s Force Field Analysis:
Kurt Lewin was social psychologist that practiced in the 1930’s and 1940’s. When we hear about three changes: unfreezing- change – refreezing. Kurt Lewin suggests that there are influences that affect change. Lewin’s change in general means that an individual or organizations to see that they need a change and want to make a change that will work and stay implemented.
Lewin’s three-step model of change theory:
#1 Unfreezing this where we acknowledge there is a challenging issue. We know that we want to make a change.
#2 Changing: This is the stage that we plan for the change. This is where we bring the stakeholders for training and education of how the change with affect and benefit the organization. This phase is also where we do education to the frontline staff and implement the new plan.
#3 Refreezing: In this phase we have already implemented the change. The entire organization or group is onboard. This phase is especially important because this is where we monitor how we are doing with change. We have created performance indicators and they are continuously monitored.
Does the model or theory contain a component for appraising the evidence?
After review of the theory, I do not feel that there is any evidence of a component for appraising the evidence. There is no evidence of what needs to be done to in between the phases.
Does the model or theory contain a component for networking with the stakeholders during all phases of practice change?
For Lewin’s theory the stakeholders fall into each phase. When there is an issue that this identified for change, the stakeholders are aware and need to be onboard and support the need for change. When we move onto the next phase of change the stakeholders are involved the most in this phase. The stakeholders informed of the benefits of the change and give input of the changes. In the final stage the stakeholders can review the performance indicators and are able to help reinforce education and compliance in the refreezing change.
Does the model contain components for identifying barriers and addressing barriers to implementation?
I do not feel that there are specific components that identify barriers and barriers to implementation. If you look at the whole theory, you can see #1 We identify the problem. #2 Create the plan and implement it. #3 Monitor the plan and keep it going. We can see the “general” plan. I do not feel that this gives us the specifics of how to dissolve the process and create a new process. We need to have the specifics of how to get the buy in from the stakeholders and the frontline staff. How do we gather the information for the buy in of everyone involved? I also feel that there is a time frame issue with this process. We are not educated on how long or in general should each phase take. How ling does it take to get all people “onboard”?
As .
Presentation for nursing 3
1) The purpose of the project was to increase nursing satisfaction in a local critical care unit using evidence-based research.
2) Three interventions were identified to increase satisfaction: decreasing burnout, improving teamwork, and enhancing the work environment and job retention.
3) Surveys were conducted anonymously over three weeks to collect data on satisfaction levels. Analysis found improved morale and communication between nurses as well as increased responsiveness from management to staff needs.
Presentation for nursing 3
1) The purpose of the project was to increase nursing satisfaction in a local critical care unit using evidence-based research.
2) Three interventions were identified to increase satisfaction: decreasing burnout, improving teamwork, and enhancing the work environment and job retention.
3) Surveys were distributed to nursing staff and management to collect data on satisfaction over three weeks. Analysis found improved morale and communication among nurses as well as increased responsiveness from management to staff needs.
Presentation for nursing 3
1) The purpose of the project was to increase nursing satisfaction in a local critical care unit using evidence-based research.
2) Three interventions were identified to increase satisfaction: decreasing burnout, improving teamwork, and enhancing the work environment and job retention.
3) Surveys were conducted anonymously over three weeks to collect data on satisfaction levels. Analysis found improved morale and communication between nurses as well as increased responsiveness from management to staff needs.
Presentation for nursing 3
1) The purpose of the project was to increase nursing satisfaction in a local critical care unit using evidence-based research.
2) Three interventions were identified to increase satisfaction: decreasing burnout, improving teamwork, and enhancing the work environment and job retention.
3) Surveys were conducted anonymously over three weeks to collect data on satisfaction levels. Analysis found improved morale and communication between nurses as well as increased responsiveness from management to staff needs.
Theories in health promotion and health behavior
This document discusses several theories related to health promotion and health behavior. It describes the stages of change model, which outlines stages individuals move through when adopting a new healthy behavior, from precontemplation to maintenance. It proposes this model can help understand the process of overcoming heroin and opioid addiction. The document also discusses using the health belief model to convince states to provide Medicaid coverage for addiction treatment, arguing it will reduce healthcare costs by preventing illnesses.
Social Cognitive TheoryThis theory was introduced by Albert Band.docx
Social Cognitive Theory
This theory was introduced by Albert Bandura, which stated that individuals could learn positively by using interactive behavior, human dialogue, direct experiences, and common observations. The sole purpose of the theory is to comprehend and predict the individual or group behavior and to identify methods by which change or modification can be achieved. The major changes include the promotion of health activities, change in behavior, and improved personality. It is also indicated in the theory that environmental variations, behavior changes, and individual personal factors are the real causes to affect one’s behavior (White et al., 2019). Social cognitive theory is predominantly helpful when collaborated with educational institutions to improve behavior changes like introducing advanced knowledge into practice. Prochaska and DiClementi’s Model of Behavior Change is one of the most beneficial and productive models for health behavior changes.
Stages of Change Theory
Prochaska and DiClementi’s Model of Behavior Change was initially established to target the customers that need a change in health behavior, especially smokers under therapy treatment. There were four stages of this theory at the start, but now it has five different stages along with additional consideration of multiple audiences rather than individual cases. These stages of change theory are as follows:
Precontemplation
refers to the condition in which an individual does not understand and unaware consciously or unconsciously of the fact that change is a necessity for him/her.
Contemplation
indicates the situation of the person who is well aware of the problem and started to think about changing his or her attitude.
Preparation for action
indicates whenever the individual is ready to accept the challenge to change the attitude and start preparing to change is considered as “the act of preparation.” This stage may be clear within 02 weeks after making the decision to change. The
action
starts with the engagement of an individual into the change activities and understands how to cope with the behavioral change.
Maintenance
is considered as the final stage, which varies with individuals, but normally it may take up to six months. Any change in behavior must be strengthened in order to sustain the change.
Appraisal of evidence
There is a lot of evidence that proved that this model or theory could create a difference in the health behavior of an individual. Prochaska, DiClemente, and Norcross defined ten procedures that can evaluate and inspire the movement across the stages, which include Re-evaluation of environmental activities, Individual self-freedom, Social freedom, Sense of dramatic relief, Awareness levitation, Re-evaluation of self-esteem, Improvement in the relationships, Strengthening of management, Incitement control and Counter conditioning. These are some of the processes that can be achieved through this model or theory. The evide.
Processof changeresearchinsft chapter
The document summarizes research on the processes of change in systemic family therapy (SFT). It begins by defining SFT process research and distinguishing between mechanisms of change (mediators) and contexts of change (moderators). It then reviews process research on the major schools of family therapy, finding limited research on modern schools like Bowen and psychoanalytic therapy. More research exists for cognitive-behavioral, strategic, experiential, and structural models, especially as used in empirically supported treatments. Postmodern schools like solution-focused and narrative therapies have more process research due to their popularity in individual therapy. Overall, the review finds research support for strengthening family functioning, reframing problems systemically, externalizing issues, focusing on
Change Evaluation And Sustainability Essay Paper.docx
The document discusses implementing a change initiative to address compassion fatigue among nursing staff in a hospital's surgical units. It proposes educating nurses on compassion fatigue, identifying signs, and developing constructive coping strategies. An interprofessional team will introduce the change using the John Hopkins Nursing Evidence-Based Practice Model. Nurses will be surveyed before and after using a standardized questionnaire to evaluate the intervention's effectiveness in reducing fatigue and improving coping mechanisms. If shown to be effective, the change could be expanded to other units and facilities to help sustain improved nurse well-being and patient care over the long term.
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D I S C U S S I O N P A P E RNursing Services Delivery The.docx
D I S C U S S I O N P A P E R
Nursing Services Delivery Theory: an open system approach
Raquel M. Meyer & Linda L. O’Brien-Pallas
Accepted for publication 30 July 2010
Re-use of this article is permitted in
accordance with the Terms and Conditions
set out at http://wileyonlinelibrary.com/
onlineopen#OnlineOpen_Terms
Correspondence to R.M. Meyer:
e-mail: [email protected]
Raquel M. Meyer PhD RN
Nursing Early Career Researcher
Ontario Ministry of Health & Long-Term
Care, and
Assistant Professor (CLTA)
Lawrence Bloomberg Faculty of Nursing,
University of Toronto, Ontario, Canada
Linda L. O’Brien-Pallas PhD RN FCAHS
Professor & CHSRF/CIHR Chair in
Nursing Human Resources
Lawrence Bloomberg Faculty of Nursing,
University of Toronto, Ontario, Canada
M E Y E R R . M . & O ’ B R I E N - P A L L A S L . L . ( 2 0 1 0 )M E Y E R R . M . & O ’ B R I E N - P A L L A S L . L . ( 2 0 1 0 ) Nursing services delivery theory:
an open system approach. Journal of Advanced Nursing 66(12), 2828–2838.
doi: 10.1111/j.1365-2648.2010.05449.x
Abstract
Aim. This paper is a discussion of the derivation of the Nursing Services Delivery
Theory from the application of open system theory to large-scale organizations.
Background. The underlying mechanisms by which staffing indicators influence
outcomes remain under-theorized and unmeasured, resulting in a ‘black box’ that
masks the nature and organization of nursing work. Theory linking nursing work,
staffing, work environments, and outcomes in different settings is urgently needed to
inform management decisions about the allocation of nurse staffing resources in
organizations.
Data sources. A search of CINAHL and Business Source Premier for the years
1980–2008 was conducted using the following terms: theory, models, organization,
organizational structure, management, administration, nursing units, and nursing.
Seminal works were included.
Discussion. The healthcare organization is conceptualized as an open system
characterized by energy transformation, a dynamic steady state, negative entropy,
event cycles, negative feedback, differentiation, integration and coordination, and
equifinality. The Nursing Services Delivery Theory proposes that input, throughput,
and output factors interact dynamically to influence the global work demands
placed on nursing work groups at the point of care in production subsystems.
Implications for nursing. The Nursing Services Delivery Theory can be applied to
varied settings, cultures, and countries and supports the study of multi-level phe-
nomena and cross-level effects.
Conclusion. The Nursing Services Delivery Theory gives a relational structure for
reconciling disparate streams of research related to nursing work, staffing, and work
environments. The theory can guide future research and the management of nursing
services in large-scale healthcare organizations.
Key words: nursing management, Nursing Services Delivery Theory, open system
app.
The incorporation of a model when making practice changes is.docx
The document discusses the importance of using a change model when making practice changes in healthcare. It states that using a model can help ensure projects align with the organization, identify current research from a patient perspective, and clarify and guide changes to ultimately lead to better patient care. While using a model requires time and effort, it is worth it to help ensure successful projects that improve health outcomes for patients. As nurses, there is a responsibility to improve patient outcomes and further nursing research, and change models can help accomplish these goals.
Chapter 7 The Role of the Patient in Continuous Quality Improve
Chapter 7: The Role of the Patient in Continuous Quality Improvement
Contents
Introduction and background
Patient involvement in healthcare improvement overview
Rationale for Patient Involvement in CQI
Methods for Involving Patients in CQI
Factors Affecting Patient Involvement
The MAPR Model of Patient Involvement
Partners to Owners
Conclusion
Introduction
The primary function of health systems is to care for the health and wellbeing of populations in an effective and efficient way.
A range of mechanisms exist for measuring the quality of care provided by health systems
The role of the patient, family, and caregivers is much less clear
History, policy, and causality are conflicted on the role of and outcomes from the patient in CQI
Background
Most CQI systems value the involvement of the client in systemic change and development
Patient safety inquiries show that patients and carers often flagged problems first but were ignored
These inquiries were not isolated to one part of the health system – problems are diverse in type and location of occurrence
How can CQI help avoid these problems, halt their recurrence and improve systemic approaches?
Patient Involvement in Healthcare Improvement Overview
Patients are expected to be involved in health care as health systems have developed – CQI is a part of this
Social and health sector changes have contributed to the call for patient involvement
The dominance of medicine has been questioned by patients, advocates and health practitioners
The HIV/AIDS epidemic has been a major force for change in traditional health system approaches
Technological shifts have/are having a huge impact e.g. knowledge base, global contacts, volunteers for trials etc.
Rationale for Patient Involvement in CQI
Greater knowledge of health has increased knowledge of errors in the media and public domains
High profile cases continue to get major news coverage e.g. The Shipman Inquiry in the U.K.
Health systems have been forced to acknowledge the patient/client/carer perspectives
CQI is part of the shift to patient-centered health care e.g. Insurance systems, co-payments etc. also make patients customers
Methods for Involving Patients in CQI
Three important levels of patient involvement in CQI:
Micro-level involvement – active patient involvement as acknowledged in the concept of the self-managing patient;
Meso-level involvement – patients involved in health service or even whole system planning, management and evaluation;
Macro-level involvement – here patients are involved in national/international safety activities e.g. The WHO London Declaration
Factors Affecting Patient Involvement
The evidence base for patient involvement is small but growing
Patient willingness to participate is affected by several factors e.g. self-efficacy in the role, health literacy, shift/changes required in role
Inhibitory factors include e.g. type/severity of condition, SES factors (minority social position), the health setting and ...
Reimplementation of a bedside shift report 7 Errors are .docx
Reimplementation of a bedside shift report 7
* Errors are in red that must be addressed or more points will continue to come off.
· Clarification about the change process is needed; telehealth in ICU is mentioned but not explained as being relevant to BSR. There are many sentence structural issues. See my feedback throughout.
Change Proposal: Reimplementation of a Bedside Shift Report
The identified clinical problem that is relevant to nurses in the workplace is the bedside shift report (BSR). The bedside shift report may be used to help the development of teamwork, ownership, and accountability thus increasing the satisfaction of the nurses. The reason for selecting the reimplementation of a bedside shift report is because; at a targeted facility the implementation of the bedside shift report is becoming poor. This has led to the poor compliance with the standards of practice, and increase costs in the facility. Also, to have a reduced cost by removing overtime pay and scrubbing off legal errors which result in legal fees (Clark et al., 2020). (*Re-phrase this sentence, avoid slang).
The reimplementation of a bedside shift report is important for the nurse practicing in the organization. Bedside shift report assists in improving the experience of the client and improving the handoff care between the nurses through including the family and client in the delivery of care. Bedside shift report is leading to the introduction of a change in the nursing culture i.e. introduction of various methods of communicating patient-specific care at a shift transformation. Shift reports given at the bedside is helping in changing the manner in which nurses are communicating and practicing (Clark et al., 2020).
At the targeted facility, the execution of the bedside shift report is poor and this is associated to the lack of knowledge concerning the role of bedside shift reporting on the patient outcome. The healthcare providers at the facility are not directly engaged in the provision of healthcare. There is poor communication of the goals of the bedside shift reporting and their importance about the positive outcomes and benefits that are involved in the change (Clark et al., 2020).
According to the study by Gregory et al., (2014), the process of assessing the transformation in practice that involves transitioning of the bedside nurse shift handoffs is important. The evaluation process is helpful in the re-implementation plan to help in improving the areas of weaknesses. The evaluation process of the success in the implementation in the practice is assessing the perception of the nurses about the proposed changes i.e. the re-implementation plans. There is evidence showing the positive impacts of the bedside shift report in the safety of the patient, the control of the pain, the satisfaction of the patients, and improvement in the nurse to patient or nurse to nurse communication (Gregory et al., 2014).
A study by Dempsey et al., (2014) reveals t.
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Many consider Kurt in three.docx
- 1. Many consider Kurt Lewin’s ‘changing in three steps’ (unfreezing, changing, Many consider Kurt Lewin’s ‘changing in three steps’ (unfreezing, changing, and refreezing) to be the classic or fundamental method to change management. Scholars have criticized Lewin for oversimplifying the change process, while others have defended him against such accusations. The model’s foundational significance, on the other hand, has remained uncontested. Kurt Lewin is commonly regarded as the “founding father” of change management, with his unfreeze–change–refreeze (CATS) strategy seen as the “basic” or “classic” approach to, or classic “paradigm” for, change management (Cummings et al., 2015). In the healthcare industry, change is unavoidable. Almost two-thirds of all change programs fail in health care for a variety of reasons, including poor planning, unmotivated employees, inadequate communication, or excessively frequent changes. From the bedside to the boardroom, all healthcare professionals have a responsibility to play in achieving effective change. Using best practices developed from change theories can assist increase the likelihood of success and subsequent development in practice. Building on Lewin’s original theory, Lippitt developed the Phases of Change Theory, which includes the following stages of change: Increasing awareness of the need for change Create a connection between the system and the change agent. Define a difficulty with change. Establish change objectives and a strategy for achieving them. Make the necessary adjustments. Staff accepts the modification; the situation is now stable. Redefine the change agent’s relationship with the system (Barrow & Toney-Butler, 2020). Lippitt’s seven-phase theory may be more equivalent to the nursing process; there is a slight difference between the two, but Lewin’s contains three basic processes. Nursing is frequently far more complicated than the three levels. Looking back on my experiences as a critical care nurse, some circumstances were less complicated, but the majority were complex on numerous levels. Because these people are in critical condition, the issues that need to be addressed are as well. It appears that getting stuck in the Moving phase after three steps would be simple. My preceptor has not had the opportunity to use any of these theories. Reference Barrow, J. M., & Toney-Butler, T. J. (2020). Change Management. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK459380/ Cummings, S., Bridgman, T., & Brown, K. G. (2015). Unfreezing Change as Three steps: Rethinking Kurt Lewin’s Legacy for Change Management. Human Relations, 69(1), 33–60. Sagepub. https://doi.org/10.1177/0018726715577707 REPLYSG