Theoretical Framework and Models for Change-A Comprehensive Nursing Essay Example
Framework or Model for Change
In nursing practice, change constitutes an important component. Nurse leaders, therefore, have the enviable task of leading change amidst the challenges and complexities that characterize the ever-evolving healthcare environment and the provision of quality patient care. Moulin et al. (2020) aver that implementation science emerged from a desire to resolve the challenges encountered in the utilization of research to achieve more in healthcare and related professional fields using EBP. The researchers further note that there are many benefits to ineffective use of implementation frameworks, models, and theories to guide change management. Scholars in healthcare also warn that inadequate use of frameworks can affect both the viability and success of implementation initiatives leading to wastage of resources, erroneous conclusions, and errors in specifications about implementation methods and data analyses amongst other errors (Hashish et al., 2020). Therefore, this pape purposes to discuss a combination of Lewin’s change model and the IOWA EBP model as the most appropriate theoretical framework for change to guide my proposed EBP project.(Theoretical Framework and Models for Change-A Comprehensive Nursing Essay Example)
The Selected Model for Change and Its Relevance to the Proposed Project
The EBP model and theory are key determinants in either the success or failure of the proposed change in nursing practice. As such, the proposed project will utilize Lewin’s theory of change as its guiding model. Lewin’s change model entails three key steps namely unfreezing, changing, and refreezing. At the same time, the primary investigator integrates the IOWA Model of EBP model as its development endeavored to outline the steps to help nurse researchers to identify issues, research solutions, and implement changes. Its relevance to the proposed project is to help establish that the issue of bed assigning needs to be prioritized at LAMC, confirm the existence of sufficient evidence to support a change in the healthcare organization system, and decide whether the proposed change is feasible and sustainable as demonstrated by the findings of the OCRSIEP readiness for change and adoption in the facility’s medical-surgical unit.(Theoretical Framework and Models for Change-A Comprehensive Nursing Essay Example)
The Stages in the Change Model/Framework
The IOWA model for EBP was developed in the 1990s by the University of Iowa Hospitals and Clinics with subsequent revisions in 2015 to help guide nurses who desire to use research findings to help improve patient care (Hanrahan et al, 2019). It comprises of 8 steps. Step 1 has the researcher nurse identify either a knowledge focus trigger or problem focus trigger that requires an EBP change. Step 2 entails determining if the problem at hand is a priority for the organization, practice department, or unit while Step 3 follows with the formation of a team that will formulate, evaluate, and implements the EBP change. At Step 4 the lead investigator gathers and analyzes relevant research related to the desired change in practice followed by a critique and synthesis of the research retrieved from the literature search in Step 5. Step 6 is a critical decision point where one stops and decides if there is enough research to implement the proposed change; if the answer is No review and research more go back to step 5 before moving to Step 7. If the answer is Yes – move to Step 7 which entails the implementation of change into a pilot program. As a rule, do not conduct full practice change. Instead, change one or two smaller unit areas for evaluation. Having evaluated the pilot project, decide if the change is feasible, does it improve outcomes, and is appropriate for full adoption. If NO continue to evaluate the care and revisit the issue in the future. If YES introduce the change across the department, unit, practice, or organization.(Theoretical Framework and Models for Change-A Comprehensive Nursing Essay Example)
Lewin’s Change Model
. According to Hussain et al (2018), Kurt Lewin considers the process of change as involving the creation of awareness that a change is needed, then moving towards the new, desire practice behavior, and lastly solidifying that new behavior as the health care agency’s norm. Concisely speaking, the process involves unfreezing, changing, and refreezing.(Theoretical Framework and Models for Change-A Comprehensive Nursing Essay Example)
A Description of How One Would Apply Each Stage of The Model Or Theoretical Framework In The Proposed Implementation
The IOWA Model of EBP
There was a discussion with LAMC leadership that established a change was needed to improve patient throughput in the medical-surgical unit admissions. The change is in line with the LAMC goals. Following extensive and intensive literature search, review, appraisal, and subsequent synthesis of retrieved evidence, the outcome of the review reinforced the fact that enough evidence currently exists to support change. The outcomes of this project will be used to determine whether the adoption of the proposed change in practice is suitable for the permanent implementation of a bed ahead concept in assigning beds in the medical-surgical unit. (Theoretical Framework and Models for Change-A Comprehensive Nursing Essay Example)
The Lewin’s Change Model
It is necessary that the [proposed EBP change project have a sustained and clinically significant impact on patient outcomes in both the patient care process and organizational culture. Lewin contends that change happens in three steps unfreeze, change, and refreeze. The unfreezing process commences with the identification of current assigning as a problem within the medical-surgical unit letting the workers recognize the need for change and embrace a new process.(Theoretical Framework and Models for Change-A Comprehensive Nursing Essay Example) The bed ahead concept where the nurse in charge ensures there a one extra bed available will alter the process of nurse handoff for admissions in the medical-legal unit. The refreezing process will be evident upon successful implementation of the project and LAMC leadership accepting it. Improved outcomes in line with those of expected outcomes will encourage the hospital management to a bed ahead protocol of bed assignment one of the hospital’s policies.(Theoretical Framework and Models for Change-A Comprehensive Nursing Essay Example)
In conclusion, this section has determined there is a need for a researcher to utilize conceptual and theoretical framework as the basis from which a generalizable implementation knowledge of a proposed EBP project can be propagated. Failure to use a suitable framework or model to change obstructs implementation science. Nurses and other health care professionals must embrace change as part of nursing and healthcare practice and have a thorough understanding of frameworks and models to change management to be able to improve the quality of services they offer to patients(Theoretical Framework and Models for Change-A Comprehensive Nursing Essay Example)
References
Hanrahan, K., Fowler, C., & McCarthy, A. M. (2019). Iowa model revised: Research and evidence-based practice application. Journal of pediatric nursing, 48, 121-122.(Theoretical Framework and Models for Change-A Comprehensive Nursing Essay Example)
Hashish, A., Aly, E., & Alsayed, S. (2020). Evidence-Based Practice and its Relationship to Quality Improvement: A Cross-Sectional Study among Egyptian Nurses. The Open Nursing Journal, 14(1).(Theoretical Framework and Models for Change-A Comprehensive Nursing Essay Example)
Hussain, S. T., Lei, S., Akram, T., Haider, M. J., Hussain, S. H., & Ali, M. (2018). Kurt Lewin’s change model: A critical review of the role of leadership and employee involvement in organizational change. Journal of Innovation & Knowledge, 3(3), 123-127.(Theoretical Framework and Models for Change-A Comprehensive Nursing Essay Example)
Moullin, J. C., Dickson, K. S., Stadnick, N. A., Albers, B., Nilsen, P., Broder-Fingert, S., … & Aarons, G. A. (2020). Ten recommendations for using implementation frameworks in research and practice. Implementation science communications, 1(1), 1-12.(Theoretical Framework and Models for Change-A Comprehensive Nursing Essay Example)
Appendix A- The IOWA Model-Revised for EBP Practice
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