DNP 820 A Topic 8 DQ 1 Explain why the change model you selected for the DPI Project is best for implementing your proposed intervention.
Change in the healthcare environment is a huge task as it’s an innate trait of people to be resistant to change. Change is unavoidable but time-consuming to achieve. Hence, for change to be effective, it must be planned in the right surroundings, at an appropriate time, and with the necessary support required to effect the change. Using best practices resulting from change theories can help adjust the chances of success and successive practice enhancement (Barrow, Annamaraju & Toney-Butler, 2022). Kurt Lewin’s change theory was chosen for assisting with the implementation of prophylactic multilayered foam dressing in the prevention of healthcare-associated pressure injuries. This change model approaches change in steps through different stages which are crucial for it to be effective. In addition, organizational change describes the undertaking of an organization from the accepted to the unfamiliar. This is because the future of this change is lacking stability and may cause unease in people’s values, coping abilities, and aptitudes, so the people of the organization do not support change unless they are persuaded against the current situation (Memon, Shah, & Khoso, 2021; Kwong, Hung & Woo, 2016).
Kurt Lewin’s change model enabled the execution of interventions to encourage changes in nursing staff. This model views behavior as the harmonizing of forces working in contrasting directions; therefore, following the breakdown of forces, the application of the three-step model can balance the direction of the change plan. Lewin’s theory has three major concepts: driving forces, restraining forces, and equilibrium. Driving forces are those that push in a direction that causes change to occur, facilitating the patient and staff in the desired direction, and causing a shift in the equilibrium toward change. Restraining forces are those that counter the driving forces, causing a shift in the equilibrium that opposes change (White, Dudley-Brown & Terhaar, 2021). Lewin’s theory proposed that change occurs in three stages: unfreezing, change, and refreezing stage.
Kwong, Hung, and Woo (2016) mentioned that in the unfreezing stage, there are numerous levels of planning being done to help in implementing the intervention to effect change. There is data gathering and action planning and data is inputted, and feedback is gained from numerous committees that are set up to direct the plans. In the stage of change, the actions are initiated, and the intervention is implemented. This is a learning process and a period of transformation. There is continuous feedback and action steps are initiated to ensure that the change is executed successfully. In the stage of refreezing, the intervention is implemented and there is an actual change in the behavior of the staff, and it is evident that there is a change in how things are done. Data gathering continues and is measured to ensure that this established new approach is continued. Hence, the three cyclical stages in Kurt Lewin’s change model will be adopted to manage the changes in the practice of nursing staff on HAPI prevention to develop the prevention protocol of using foam dressing to reduce HAPI.
- Barrow, J.M., Annamaraju, P., & Toney-Butler, T.J. (2022, September 18). Change Management. In: StatPearls [Internet]. StatPearls Publishing; https://www.ncbi.nlm.nih.gov/books/NBK459380/
- Kwong, E. W., Hung, M. S., & Woo, K. (2016). Improvement of pressure ulcer prevention care in private for-profit residential care homes: an action research study. BMC Geriatrics, 16(1), 192. https://doi.org/10.1186/s12877-016-0361-8
- Memon, F. A., Shah, S., & Khoso, I. U. (2021). Improving Employee’s Engagement in Change: Reassessing Kurt Lewin’s Model. City University Research Journal, 11(1), 144-164. https://lopes.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/improving-employees-engagement-change-reassessing/docview/2542758465/se-2
- White, K. M., Dudley-Brown, S., & Terhaar, M. F (2021). Translation of evidence into nursing and healthcare. (3rdEd.). Springer Publishing