Please respond to a minimum of two (2) peers. Please consider the following when replying: Give feedback regarding other factors in Lewin’s three steps that should be considered when contemplating thi
Cherida,
Describe a change, big or small that you feel should be implemented in your current or prior workplace.
The first step of the nursing process is assessment, then diagnosis, and so forth. Assessment allows for thorough data collection before nurses implement interventions. Have you ever wondered what was assessed and if a visit warranted emergent attention? For example, a patient calls, and their chief complaint is constipation. I would determine diet, fluid intake, last BM, mobility pattern, bowel sounds, the shape of the abdomen, and current bowel medication regimen before sending a nurse out for an emergent after-hours visit. Another example is a distant family member reporting that the patient is distressed, having loose stools and emesis. Yet, the patient's disease process, diagnosis, and care plan require the patient to take loperamide twice daily, ondansetron three times daily, and PRNs available throughout the day for the chronic symptoms.
Often, the field nurses arrive, and the patient is at baseline and resting comfortably without signs of distress. Triage pathways should be modified. There should be an area in the patients’ charts that contains baseline data that triage coordinators, and field nurses can quickly glance at if, for some reason, a comprehensive chart review isn’t feasible.
As the unit manager, describe the steps you would take to facilitate this change, according to Lewin.
Unfreezing is the first stage, where the problem is identified and exposed to the team (Herzing University, n.d.). As the unit manager, I would bring awareness of my assessments regarding the ineffective current triage pathways. This exposure and understanding will allow the team to generate potential solutions.
Herzing University (n.d.) defines Lewin’s second stage, “moving,” as the planning and implementation phase. This moving stage allows team members to share new perspectives on why there should or shouldn’t be changes to the current triage pathways. Additionally, we would sit down and clarify and identify particular areas of the paths that need improvements for excellent patient and nursing outcomes.
The last stage is termed refreezing (Herzing University, n.d.). This stage allows for evaluation of the solution(s). New onset or acute assessment is now in the pathway for triage coordinators to assess; additionally, reviewing the disease process is now a part of the pathway for triage coordinators. Upon evaluation of the triage pathways, fewer unnecessary visits were made. The after-hours nurses could now devote their time to emergent patients and their family's needs while also not being so burnt out.
Hypothesize the potential facilitators and barriers associated with a Force Field Analysis of this change and how you would utilize this information.
Identification and analysis of restraining and driving forces in change refers to force field analysis (Herzing University, n.d.). Some potential facilitators and barriers are very similar: Devero the EMAR— would they have to recode items in the chart, would triage coordinators feel better prepared, would case managers have to keep up to date with their patient's baseline? Would there be emotional responses to the change?
Change initiatives require successful management to correctly identify and understand Lewin’s Force Field Analysis Model (Heath et al., 2022). The home team would have to meet with Devero, which would take some time. For the greater good, I would have a separate meeting involving the triage coordinators and the after-hours/on-call nurses to discuss the impact of the changes more in-depth. It might be difficult for case managers to keep up with baseline data, especially because every patient is unique and can change drastically; how could anyone keep up; would more weekly visits from the case managers be appropriate and feasible?
Keeping staff informed, actively listening, promoting action steps, reframing complex messages, encouraging participation, and soliciting input can be positive, practical strategies for managers to provide emotional support during change and stress (Herzing University, n.d.).
Janice,
Change is an inevitable element in the healthcare industry. While applying Lewin’s change theory and the Force Field Analysis concept to recommend changes in my organization, I suggest implementing a more comprehensive education program for nurses in my healthcare facility. This change will improve the knowledge and skills of our nursing staff, leading to better patient outcomes (Nilsen et al., 2020). If entrusted with the unit manager role, I would begin with the unfreezing stage, where I would communicate transparently with the nursing team about the benefits of continued learning. This open dialogue would be supplemented by actively asking for feedback from the nursing staff, as their input is critical.
Moving into the change stage, I would lead in developing a robust educational program in collaboration with subject matter experts. A pilot phase would facilitate feedback collection and program refinement based on practical insights. The refreezing stage would follow upon completion of the pilot phase (Barrow et al., 2022). An evaluation mechanism would be deployed to measure the program's impact. Besides, recognition and incentives would be established to motivate exemplary performance in the continuing education program.
Hypothesizing potential facilitators and barriers through a Force Field Analysis, facilitators may include strong nursing staff support, the commitment of the healthcare facility's leadership, and effective communication channels. Conversely, barriers may include resistance to change, logistical challenges in program implementation, and potential resource constraints. To address these factors, I would strategically amplify facilitators by fostering an environment of open communication (Barrow et al., 2022). Barriers would be mitigated through targeted change management strategies. These ideas would be validated by drawing from relevant nursing literature, best practices in healthcare education, and change management guidelines within the healthcare sector.
