Healthcare is Changing, Why are Nurses Being Left Behind? Alicia Henderson
In Partial Fulfillment of the Requirements for the Degree of Bachelors of Science in Nursing
Healthcare is Changing, Why are Nurses Being Left Behind?
Nurses must deliver care based on the best available practice, which suggests there is a continual need to update, or make changes to practice (Mitchell, 2013). Change is defined by Grohar-Murray and Langan (2011) as a dynamic process by which an alteration is brought about that makes a distinct difference. Changing established behavior of any kind can be difficult. There are many models and theories that can be used to for implementing, managing, and evaluating change. However Kurt Lewin’s Change Theory is most widely used, it identifies three stages in which change agents must proceed before change becomes part of a system: unfreezing, moving, and refreezing (Mitchell, 2013). Change agents are people who initiate an idea for a goal-directed change, direct stages of the change process or do both (Grohar-Murray & Langan, 2011, p. 250). The survival of change does not depend on the model or theory, but rather on how a leader manages change. Leaders will be faced with barriers to overcome change. An organization where there is strong leadership and everyone is focused on improving patient care will develop a motivated staff with a desire for continuous improvement (National Institute for Health and Clinical Excellence, 2007). Why Change?
Nurses base their clinical expertise on evidence-based practice. Evidence-based practice (EBP) is best described as the integration of best research evidence with the clinical expertise and patient values (Brady & Lewin, 2007). Nursing is continually struggling to successfully implement research into practice (Brady & Lewin, 2007). In order to achieve better patient outcomes, new knowledge must be transformed into clinically useful forms, effectively implemented across the entire care team within a systems context, and measured in terms of meaningful impact on performance and health outcomes (Stevens, 2013). Major changes in the United States (U.S) health care system and practice environment will require profound changes in the nursing field (Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine, 2011). Various forces drive change in health care including rising cost of treatments, workforce shortages, professional obligations, advances in science, aging population, the potential to increase patient satisfaction, and promotion of patient and staff safety (Mitchell, 2013).
Planned change is the ideal form of change necessary to bridge the gap between research and practice. This change is purposeful, collaborative, and calculated to bring about improvement with the assistance of a change agent. (Mitchell, 2013). Planned change is based on empirical evidence of a need, aims at improving a system of operation, involves others in decisions, and provides time for the reeducation of those affected by change (Grohar-Murray & Langan, 2011, p. 257). Before change can be initiated, leaders and/or managers should self-reflect and consider their strengths and weakness, because this can determine how well a change project will be represented. The first step in Kurt Lewin’s stages of change theory is unfreezing. During unfreezing, there is a gradual introduction of new ideas with information about how the change will benefit individuals (Grohar-Murray & Langan, 2011, p. 261). The second stage of the change theory is moving. Within the moving stage, the primary objective is reeducation of the new change. There should be detailed information that implies that there is supporting evidence that this change is purposeful, specific, integrated, time sequenced, adaptable, cost-effective, and has been proven by research studies (Grohar-Murray & Langan, 2011, p. 262). The...
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