Quality improvement changes
I’m working on a nursing Discussion and need a reference to help me understand better.
In your clinical environment, consider what quality improvement changes are planned and those that are anticipated.
In your discussion response, please address each of the following prompts:
1. Discuss a specific change theory model that could be used to facilitate change.
2. Using this theory, discuss how the nurse leader supports staff through a quality improvement change.
3. Support your response with at least one scholarly source.
NOTE: You will use this theory in Part II of the Quality Improvement Plan due this week.
Please be sure to adhere to APA guidelines when citing sources. Also, as part of the discussion participation requirements, please be sure to respond to at least two peers each week.
This activity aligns with:
Course Outcome 1. Integrate nursing leadership concepts and theories into the various roles of the professional registered nurse to promote safe and high-quality nursing care.
AACN BSN Essential II.9: Apply quality improvement processes to effectively implement patient safety initiatives and monitor performance measures, including nurse-sensitive indicators in the microsystem of care.
I work on Med/Surge Unit
Student A
There is significant research on the benefits of increasing daylight exposure for institutionalized residents of nursing facilities or assisted living facilities who suffer from dementia. The benefits include improved sleep patterns, decreased agitation, improved cognition, and overall improved quality of life (Konis & Schneider, 2018). The exact reason for the benefits is not certain. Additionally, it is not certain how much time a person needs to get the maximum benefit of daylight exposure. For this reason, the Plan-Do-Study-Act (PDSA) is an excellent choice to facilitate change in the nursing home setting when elements of change need to be attempted and evaluated (Institute for Healthcare Improvement, 2019).
Using the PDSA, the nurse leader facilitates educating the team and creating the plan with input from all stakeholders. The nurse leader would oversee the implementation of the plan which is the “do” part of the cycle. In the study portion, the nurse leader ensures that all involved with implementation get an opportunity to contribute – with positive or negative comments – on the initiative since both are opportunities to ensure improved outcomes. In the final stage of the cycle which is act, the nurse leader determines if changes in the practice can be gleaned from the exercise and how the plan can be improved. The greatest responsibility the nurse leader has in implementing change is ensuring stakeholder involvement by promoting engagement and motivation.
Reference:
Konis, K., & Schneider, E. L. (2018). The Importance of Daylight in Dementia Care Communities: A Call to Action. Seniors Housing & Care Journal, 26(1), 28–37.
Institute for Healthcare Improvement. (2019). Plan-Do-Study-Act (PDSA) Worksheet. Ihi.org. http://www.ihi.org/resources/Pages/Tools/PlanDoStu…
Student B
Lewin developed the 3 Stage Model of Change. Lewin proposed that any individual’s behavior in response to a proposed change is a function of group behavior. Any interaction or force affecting the group structure also affects the individual’s behavior and capacity to change. Therefore, the group environment, or ‘field,’ must be considered in the change process. There are three stages in this nursing theory: unfreezing, change, and freezing. Lewin’s Change Management theory can support nurses through the transitions and identify areas of strengths and resistances before implementing change. It is essential to adapt to a changing environment and continue with growth and prosperity. Lewin’s change theory offers a method that nurse leaders can use to implement change within health care systems.
Experts assert that Lewin’s theory provides the fundamental principles for change; it is a common change theory used by nurses across specialty areas for various quality improvement projects to transform care at the bedside (Wojciechowski et al., 2016). To implement change, the nurse leader must understand that change should only be implemented for a good reason, change should always be gradual, and all individuals who may be affected by the change should be involved in planning for the change. In the unfreezing stage, leaders must recognize problems in an organization’s systems and their staff to help drive positive change. Providing clear goals for the entire team will help the leader guide the staff into positive behavior. To allow employees to change their behavior for both the staff and the organization’s benefit, leaders can build essential skills or encourage direct reports to stop doing something or do it better or differently (Wojciechowski et al., 2016). The refreezing stage ensures that people do not revert to their old habits of thinking or doing before the implementation of the change. To break with old routines, companies should tie the new changes into the culture by identifying change supports and change barriers. Develop and promote ways to sustain the change long-term. Offer training, support, and communication for both the short- and long-term.
References:
Wojciechowski, E., Pearsall, T., Murphy, P., & French, E. (2016). A Case Review: Integrating Lewin’s Theory with Lean’s System Approach for Change. Online Journal of Issues in Nursing, 21(2).
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