NUR 590 Benchmark – Evidence-Based Practice Proposal Project Framework or Model for Change Essay

NUR 590 Benchmark – Evidence-Based Practice Proposal Project Framework or Model for Change Essay

Assessment Description

Successful implementation of a quality improvement project or an evidence-based practice project depends on various aspects, for instance, a framework or model for change (Moullin et al., 2018). The framework or models for change are instrumental in ensuring that the project has a theoretical underpinning for its implementation hence a more effective process (Melnyk & Fineout-Overholt, 2019). Therefore, the purpose of this write-up is to identify a framework or a model for change to guide the implementation process. As such, various aspects of the model will be explored, including the relevance of the model to the project, the stages of the change model, and the application of every stage of the model to the proposed implementation.

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The Model and Relevance to the Project

The change model selected for the project’s implementation is Kurt Lewin’s change model. This model has been widely applied in implementing various projects due to its versatility (Rotondo, 2017). This model is relevant to the project since the project proposes a change in practice regarding the prevention and management of CAUTIs, which requires stages for a complete and successful implementation. The theory is a three-phase model for change, making it relevant.

Stages of the Change Model

As earlier indicated, Lewin’s theory has three main stages, which makes it a suitable theory for implementing change. The three stages are unfreezing stage, change stage, and refreezing stage. The theory asserts that restraining and driving forces work in the opposite direction while influencing behavior and the desired change eventually occurs when the driving forces become too strong for the restraining forces (Hussain et al., 2018). The first stage is characterized by increased driving forces during which a problem is recognized, and the need for change becomes apparent. Other stakeholders are then made to see the need to undertake the change process.

The second stage, which is the change stage, involves making the proposed change a reality. It is enabled by formulating an action plan and ensuring that the stakeholders see the benefits of the desired change. During this stage, it is important to acknowledge that the existence of the restraining forces could derail the stage. Hence a plan should be in place to minimize the impacts of the same (Hussain et al., 2018). Finally, the last stage, refreezing state, involves making the change to be part of the normal practice and, therefore, a standard reference point. When the staff becomes comfortable with the change, it becomes part of the organization’s culture.

Application of the Stages of the Model to the Project

In the unfreezing stage, the investigator identifies the increased incidences of CAUTI as compared to the standards and other centers as a major clinical issue, therefore an immediate need for change. During the unfreezing stage, this evidence is presented to the nursing staff and the potential benefits of the proposed solution (Tolentino, 2020). During the change of movement stage, detailed plans are formulated, and the organization’s leadership is convinced for their buy-in. Education to the staff could be key in this stage and the next phases. It is imperative to increasingly involve the staff and encourage effective communication during this stage. During the refreezing phase, the proposed change, the proposed intervention, limiting the use of indwelling catheters and antibiotic-impregnated catheters, will be made part of the standard procedure at the implementation site.

Conclusion

A change model is key in implementing a project as it lays the foundation for various stages to undertake for a successful implementation. Therefore, for this project, Kurt Lewin’s change model has been identified as the model to lead the implementation. As such, the three stages of unfreezing, movement, and refreezing will be key in the implementation process.

References

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. https://doi.org/10.1016/j.jik.2016.07.002.

Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based Practice in Nursing & Healthcare: A Guide to Best Practice. Wolters Kluwer.

Moullin, J. C., Dickson, K. S., Stadnick, N. A., Rabin, B., & Aarons, G. A. (2019). Systematic review of the exploration, preparation, implementation, sustainment (EPIS) framework. Implementation Science, 14(1), 1-16. https://doi.org/10.1186/s13012-018-0842-6.

Rotondo, L. D. (2017). Change theories: The key to knowledge translation. Evidence-Based Practice in Nursing: Foundations, Skills, and Roles.

Tolentino, M. C. (2020). An Innovative Nurse Leader Redesign to Improve Span of Support. University of California, Los Angeles.

Appendices

Concept map

APA Checklist Summarized

Page numbering- flush right	Yes
Title of document appears at the top of the first page of text	Yes
The introductory paragraph or section should not be labeled	Yes
Double line spacing	Yes
Margins- 1 inch	Yes
Paragraph formatting- indented and left-aligned	Yes
Punctuations after quotations	None
Section headings- level 1 headings centered and in bold, and in title case	Yes
References- in a new page. The word references centered.	Yes

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Assessment Description
Successful implementation of a quality improvement project or an evidence-based practice project depends on various aspects, for instance, a framework or model for change (Moullin et al., 2018). The framework or models for change are instrumental in ensuring that the project has a theoretical underpinning for its implementation hence a more effective process (Melnyk & Fineout-Overholt, 2019). Therefore, the purpose of this write-up is to identify a framework or a model for change to guide the implementation process. As such, various aspects of the model will be explored, including the relevance of the model to the project, the stages of the change model, and the application of every stage of the model to the proposed implementation.
The Model and Relevance to the Project
The change model selected for the project’s implementation is Kurt Lewin’s change model. This model has been widely applied in implementing various projects due to its versatility (Rotondo, 2017). This model is relevant to the project since the project proposes a change in practice regarding the prevention and management of CAUTIs, which requires stages for a complete and successful implementation. The theory is a three-phase model for change, making it relevant.
Stages of the Change Model
As earlier indicated, Lewin’s theory has three main stages, which makes it a suitable theory for implementing change. The three stages are unfreezing stage, change stage, and refreezing stage. The theory asserts that restraining and driving forces work in the opposite direction while influencing behavior and the desired change eventually occurs when the driving forces become too strong for the restraining forces (Hussain et al., 2018). The first stage is characterized by increased driving forces during which a problem is recognized, and the need for change becomes apparent. Other stakeholders are then made to see the need to undertake the change process.
The second stage, which is the change stage, involves making the proposed change a reality. It is enabled by formulating an action plan and ensuring that the stakeholders see the benefits of the desired change. During this stage, it is important to acknowledge that the existence of the restraining forces could derail the stage. Hence a plan should be in place to minimize the impacts of the same (Hussain et al., 2018). Finally, the last stage, refreezing state, involves making the change to be part of the normal practice and, therefore, a standard reference point. When the staff becomes comfortable with the change, it becomes part of the organization’s culture.
Application of the Stages of the Model to the Project
In the unfreezing stage, the investigator identifies the increased incidences of CAUTI as compared to the standards and other centers as a major clinical issue, therefore an immediate need for change. During the unfreezing stage, this evidence is presented to the nursing staff and the potential benefits of the proposed solution (Tolentino, 2020). During the change of movement stage, detailed plans are formulated, and the organization’s leadership is convinced for their buy-in. Education to the staff could be key in this stage and the next phases. It is imperative to increasingly involve the staff and encourage effective communication during this stage. During the refreezing phase, the proposed change, the proposed intervention, limiting the use of indwelling catheters and antibiotic-impregnated catheters, will be made part of the standard procedure at the implementation site.
Conclusion
A change model is key in implementing a project as it lays the foundation for various stages to undertake for a successful implementation. Therefore, for this project, Kurt Lewin’s change model has been identified as the model to lead the implementation. As such, the three stages of unfreezing, movement, and refreezing will be key in the implementation process.
References
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. https://doi.org/10.1016/j.jik.2016.07.002.
Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based Practice in Nursing & Healthcare: A Guide to Best Practice. Wolters Kluwer.
Moullin, J. C., Dickson, K. S., Stadnick, N. A., Rabin, B., & Aarons, G. A. (2019). Systematic review of the exploration, preparation, implementation, sustainment (EPIS) framework. Implementation Science, 14(1), 1-16. https://doi.org/10.1186/s13012-018-0842-6.
Rotondo, L. D. (2017). Change theories: The key to knowledge translation. Evidence-Based Practice in Nursing: Foundations, Skills, and Roles.
Tolentino, M. C. (2020). An Innovative Nurse Leader Redesign to Improve Span of Support. University of California, Los Angeles.Appendices
Concept map

APA Checklist Summarized
Page numbering- flush right Yes
Title of document appears at the top of the first page of text Yes
The introductory paragraph or section should not be labeled Yes
Double line spacing Yes
Margins- 1 inch Yes
Paragraph formatting- indented and left-aligned Yes
Punctuations after quotations None
Section headings- level 1 headings centered and in bold, and in title case Yes
References- in a new page. The word references centered. Yes