DQ: Examine change theories in scholarly literature
DNP 815 Topic 7 DQ 2
Examine change theories in scholarly literature. Describe the application of a change theory from the perspective of a DNP-prepared nurse in relation to the proposed changes in your DNP Project.
REPLY TO DISCUSSION
Change is inevitable in health care. A significant problem specific to health care is that almost two-thirds of all change projects fail for many reasons, such as poor planning, unmotivated staff, deficient communication, or excessively frequent changes. (Barrow, et al 2021). All healthcare providers, at the bedside to the boardroom, have a role in ensuring effective change. Using best practices derived from change theories can help improve the odds of success and subsequent practice improvement
Lewin.s change theory singled out unfreezing, moving, and refreezing as significant phases of change. The existing hospital fall prevention program with limited exercise/physical therapy is not efficient. Awareness of the problem leads to the demand for change. Thus, it is supposed that interventions of patient education and regular exercises can be effective for senior hospitalized patients. The second stage of the theory will con
tribute to the development of a detailed plan of patient education interventions. Moreover, this stage defines the responsible parties and outlines the expected outcomes. Also, it is important to assess the possible risks of the planned interventions. Finally, the third stage of the theory is used to manage the assessment of the planned interventions. In case they are efficient, it is possible to use them on a regular basis. On the whole, Lewin’s Three-Step Change Theory is useful for managing the process of change in nursing because it helps to follow all-important stages and make the change project more efficient.
Barrow, J. M., Annamaraju, P., & Toney-Butler, T. J. (2021). Change Management. In StatPearls. StatPearls Publishing
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I must commend you for this poignant post. Let me respond to your post by noting that leadership, effective communication, and teamwork are the essential ingredients needed to effect a planned change. Leadership skills and style, more that any character, are needed to accomplish the successful implementation of a planned chain. Mitchell (2013) identified three leadership style, autocratic, democratic, and carefree, that can influence a planned change and went further to highlight the features of each one. Understanding the weaknesses and strengths of these leadership styles is essential before embarking on change. Mitchell (2013) noted that a thorough grasp of these characteristics is the first and meaningful step that greatly impact the outcome of a change. It is worthy to note that attempt to implement change can be daunting. It is, therefore, imperative to use tested model, like that of Lewin’s, to guide the process of planned change to desired outcomes.
You are appreciated for sharing this educative post.
Reference
Mitchell, G (2013). Selecting the best theory to implement planned change. Nursing Management, 20 (1), 33-37.
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Interesting discussion! Planned change in nursing practice is necessary for a wide range of reasons, but it can be challenging to implement. Understanding and using a change theory framework can help managers or other change agents to increase the likelihood of success. Can you please comment on how you select which theory for change success?
Replies
The planned behavior theory predicts an individual’s intention to engage in a behavior at a specific time and place. The theory was intended to explain all behaviors over which people have the ability to exert self-control. The key component to this model is behavioral intent which are influenced by the attitude about the likelihood that the behavior will have the expected outcome and the subjective evaluation of the risks and benefits of that outcome.
Hence for this to be applied to my proposed DPI project on patient centered fall prevention the patient needs motivation and ability to perform. the patient is expected to have actual control over the behavior, this theory has been applied in a wide range of health behaviors and intentions including smoking, drinking, health services utilization, breastfeeding, and substance use, among others with great success and I believe it can be achievable through education and communication if applied to patients at fall risks who has certain behaviors that needs a change in attitudes (such as use of call lights,). and ability to exert self-control.
The proposed change model is Lewin’s change model, which offers a simplified approach to change implementation. This model proposes three fundamental strategies, i.e. unfreezing, movement and refreezing. This is considered valuable for successful implementation. This change model contemplates three distinct stages. The first is refreezing, which supposes disruption. It supposes creating awareness about the need for change, thereby promoting support for said change. The second stage is movement, which means deciding on how to proceed with actual implementation of the change intervention. The third and final stage, i.e., refreezing, implies assimilating and normalizing the change intervention as standard practice (Teguh et al., 2019).
For this change model to be achievable and successful been open to feedbacks , regular communication , education and getting everyone involved is the key .
Teguh, A., Hariyati, R. T. S., & Muhaeriwati, T. (2019). Applicability of Lewin’s change management model for optimization management function in nursing delegation between head nurse and team leader: A mini project in Jakarta military hospital. International Journal of Nursing and Health Services (IJNHS), 2(2), 66-74.
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Replies
Chronic diseases such as hypertension, diabetes, and end-stage renal disease are a few of the complex chronic conditions with high costs of chronic care, and health care organizations continuously demonstrate implementation of program designs to manage chronic conditions (Gilman, 2021). Chronic care management is a highly complex phenomenon requiring innovative frameworks. Complex adaptive systems (CASs) as a means of interactions within chronic care environments and understanding relationships can help develop a more comprehensive chronic care model to improve service excellence, quality of care, and quality of life of individuals with chronic conditions (Gilman, 2021).
Complex adaptive systems (CAS), as a framework for an integrated patient-care model, incorporates a holistic approach to strategies to improve health outcomes, improve quality of life, and decreased health care costs. The healthcare burden of chronic disease remains high, wherein the healthcare system’s resources continue to be challenged. Patient engagement in health care results to lower healthcare costs and better clinical outcomes. The self-care theory of Virginia Henderson would definitely benefit the population of patients with chronic conditions such as adherence to nutrition, lifestyle, and compliance with medications, and patients would feel empowered by their self-managed care actions (Santana, 2020).
As DNP-prepared nurses, we need to identify any areas for improvement and develop care models and innovative programs to promote quality of life and improve health care quality for individuals with chronic conditions and continually assess best strategies or explore new horizons to decrease or reduce health care costs.
References
Gilman, P. (2021). Complex adaptive systems: a framework for an integrated chronic care model. Advances in Nursing, 44 (4), 330-339.
https://oce-ovid-com.lopes.idm.oclc.org.article/00012272-202110000-00006/HTML
Santana, M.B.A., Vieira da Silva, D.M.G., Echevarria-Guanilo, M.E., Lopes, S.G.R., Romanoski, P.J., & Boelli, J.E.W. (2020). Self-care in individuals with chronic kidney disease on hemodialysis. Revista Gaucha de Enfermagem, 41.
https://doi.org/10.1590/1983-1447.2020.20190220
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Replies
Ruby thank you for your informative post, health management plans for chronic illness need to be integrated, adaptive, contextual, technology aided, patient driven, and designed to address the multilevel social environment of patients’ lives. Such primary care-based health management plans are feasible today but will be even more effective and sustainable if supported by systems thinking, technological advances, and policies that create and reinforce home, work, and health care collaborations.
Effective and resource-efficient long-term management of multimorbidity is one of the greatest health-related challenges facing patients, health professionals, and society more broadly. The relative scarcity of robust economic evaluations quantifying the cost-effectiveness of interventions for multimorbidity creates challenges for resource allocation decision making. Nonetheless, this does not negate the need for judicious allocation of resources to attempt to stem the burden of multimorbidity internationally, albeit in the presence of imperfect information. Perhaps one of the clear messages arising from both health and economic data pertaining to multimorbidity is that the best course of action may be to prevent the development of multiple chronic diseases at the outset.
This ACTS system builds on and extends the current chronic illness management approaches. It is feasible today and can produce even more dramatic improvements in the future.
Chronic diseases such as hypertension, diabetes, and end-stage renal disease are a few of the complex chronic conditions with high costs of chronic care, and health care organizations continuously demonstrate implementation of program designs to manage chronic conditions (Gilman, 2021). Chronic care management is a highly complex phenomenon requiring innovative frameworks. Complex adaptive systems (CASs) as a means of interactions within chronic care environments and understanding relationships can help develop a more comprehensive chronic care model to improve service excellence, quality of care, and quality of life of individuals with chronic conditions (Gilman, 2021).
Complex adaptive systems (CAS), as a framework for an integrated patient-care model, incorporates a holistic approach to strategies to improve health outcomes, improve quality of life, and decreased health care costs. The healthcare burden of chronic disease remains high, wherein the healthcare system’s resources continue to be challenged. Patient engagement in health care results to lower healthcare costs and better clinical outcomes. The self-care theory of Virginia Henderson would definitely benefit the population of patients with chronic conditions such as adherence to nutrition, lifestyle, and compliance with medications, and patients would feel empowered by their self-managed care actions (Santana, 2020).
As DNP-prepared nurses, we need to identify any areas for improvement and develop care models and innovative programs to promote quality of life and improve health care quality for individuals with chronic conditions and continually assess best strategies or explore new horizons to decrease or reduce health care costs.
References
Gilman, P. (2021). Complex adaptive systems: a framework for an integrated chronic care model. Advances in Nursing, 44 (4), 330-339.
https://oce-ovid-com.lopes.idm.oclc.org.article/00012272-202110000-00006/HTML
Santana, M.B.A., Vieira da Silva, D.M.G., Echevarria-Guanilo, M.E., Lopes, S.G.R., Romanoski, P.J., & Boelli, J.E.W. (2020). Self-care in individuals with chronic kidney disease on hemodialysis. Revista Gaucha de Enfermagem, 41.