Application of change theories in implementation of evidence based practice

This article discusses Application of change theories in implementation of evidence based practice in nursing.

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Sample Question

Compare and contrast two change theories, and determine which theory makes the most sense for implementing your specific EBP project. Why? Has your mentor used either theory, and to what result.

Sample Answer

Change is inevitable in all aspects of human endeavor. For this reason, various change theories have been developed   to explore the phenomena in diverse organizational settings.  Some of the common change theories include Lewin three step change theory, social cognitive theory and Lippitt Phases of Change theory. This paper compares and contrasts two change theories, namely Lewin three step change theory and social cognitive theory and explores their suitability in implementing evidence based practice project in nursing.       

Lewin three step change theory examines behavior as a product of driving and restraining forces, which work in opposing directions (Kritsonis, 2005).  Driving or motivating forces are positive and they encourage people to act or move in the required direction. Restraining forces on the other hand undermine change in teams by pushing individuals to move in opposite directions (Kritsonis, 2005).

In Lewin three step change theory, the first phase in transforming behavior of people begins by unfreezing or disrupting the current status.  This can be done by the use of various techniques, including increasing the motivating factors and reducing the restraining aspects. The second step of the theory in regard to modifying behavior involves movement. This entails relocation of the behavior system of an individual to another level, by use of various methods, such as persuasion. The third step of Lewin change theory involves refreezing, which entails conditioning the individuals to permanently embrace the desired change so that they do not revert to their original behaviors. In this regard, Lewin three step change theory focuses on the roles of driving and restraining forces in changing behavior of people.

The second change theory is the social cognitive theory that emphasizes on the importance of the environment, personality and attitudes in modifying behavior of individuals (Robbins, 2003). For behavior change to take place, the individual must be self-motivated and possess self-efficacy. This involves resolute self-belief in one’s abilities to adopt a particular change and self-motivation to undergo the transformation process (Robbins, 2003).  For this reason, social cognitive theory is founded on the assumption that behavior is motivated by the consequences. The anticipated outcomes therefore act as a motivation to embrace and sustain the behavior.  This is one of the main differences between social cognitive theory and Lewin three step change theory.  Lewin theory of change is pragmatic, balanced and goal oriented (Kritsonis, 2005).  This is due to the fact that it does not take into consideration the personality or attributes of an individual but rather the external factors to behavior change.  However, both theories consider the role of external factors in influencing behavior change of individuals.

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The theory that makes most sense in implementation of my EBP project is Lewin three step change theory. This is due to the fact that the change theory is more rational and pragmatic, since it takes into consideration the dynamic external factors evident in the nursing practice. The driving factor in my project is enhanced health outcomes brought about by prewarming the surgical patient, thereby minimizing incidents of hypothermia.  My mentor has used Lewin three step change theory and produced positive outcomes. The results were reinforced by retraining  and motivating the nurses to embrace the recommended evidence based practice.