Nursing leadership and management for patient safety and quality care.

Week 5 Responses to Peer Discussion

In your participation responses to your peers, comments must demonstrate thorough analysis of postings and extends meaningful discussion by building on previous postings. Support your responses with scholarly academic references using APA style format

Question 1 April Combs

If there is one constant in life, it would be the certainty of change. “Change is a dynamic process that results in altering or making something different” (Murray, 2017, p. 294). I think all areas of practice can utilize change theory, but a rehab environment is a good one to look at. The outcomes of the patients are dependent on constant interdisciplinary communication and collaboration of multiple physicians depending on the patient’s status. In the article that I researched, a large rehab hospital implemented a bedside shift report project in conjunction with Lewin’s Three- Step system. In the emergency department where I work, the environment ever changing and it is imperative that all disciplines collaborate and determine when and if change is needed, and then communicate that need for change effectively. Lewin’s model has the three steps of unfreezing, moving, and refreezing (Butts and Rich, 2018). I feel that most departments are floating between the “unfreezing,’ and “moving” sections of the theory in the ever-changing environments. One of the weaknesses of the change theory in my opinion is that it doesn’t always account for todays dynamic nursing environment.

Butts, J. B., & Rich, K.L. (2018). Philosophies and theories for advanced nursing practice. [SouthUniversity]. Retrieved from https://digitalbookshelf.southuniversity.

edu/#/books/9781284143010

Murray, E. Nursing leadership and management for patient safety and quality care. [South University]. Retrieved from https://digitalbookshelf.southuniversity.edu/#/books/9780803694538/

Wojciechowski, E., Murphy, P., Pearsall, T., French, E., (May 31, 2016) A Case Review: Integrating Lewin’s Theory with Lean’s System Approach for Change. OJIN: The Online Journal of Issues in Nursing 21(2) Manuscript 4. DOI: 10.3912/OJIN.Vol21No02Man04

Question #2

Kerah Clark

It is no secret that healthcare is always changing and evolving. According to Syed Hussain and Shen Lei, professors at Shanghai University, “change is crucial for organizations in growing highly competitive business environments” (pg. 123, 2016).

One of the areas that undergoes the most changes are patient care policies and best practice initiatives (Batras, Duff, & Smith, 2016). The point of the Change Theory is to motivate the people involved by involving and teaching (Syed, & Lei, 2016). Empowerment is also a key component.

One of the major problems being faced today revolves around staffing problems. Most changes dealing with direct patient care and outcomes standards are focused on time and attention to details. The problem becomes how do you motivate staff to do more when burnout and turnover rates are high? This can be a weakness to the application of the Change Theory. Although the staff maybe willing, some changes may not be physically possible in the allotted time frame for it to be met. Although most nurses aim to provide the best possible quality care, there are many things that hinder bedside nursing. Unfortunately, in my experience, organizations focus more on telling employees on what is wrong rather than what they are excelling at which can decrease moral and hinder process.

When it comes to change on an organizational level, there has to be patience and empowerment with a clear focal goal. There should be a set outline to reach that goal. However, there must be some flexibility built into the system as well to allow for the unexpected.

References:

Batras, D., Duff, C., & Smith, B. J. (2016). Organizational change theory: Implications for health promotion practice. Health Promotion International, 31(1), 231-241. doi:10.1093/heapro/dau098

Hussain, S. T., & Lei, S. (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. doi:10.1016/j.jik.2016.07.002

Subject:  Masters Nursing

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