Nursing Change Proposal Assignment
Benchmark – Capstone Project Change Proposal
Question: In this assignment, students will pull together the change proposal project components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. At the conclusion of this project, the student will be able to apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice.
Nursing Change Proposal Assignment
Students will develop a 1,250 – 1,500 word paper that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal:
- Problem statement
- Purpose of the change proposal
- Literature search strategy employed
- Evaluation of the literature
- Applicable change or nursing theory utilized
- Proposed implementation plan with outcome measures
- Identification of potential barriers to plan implementation, and a discussion of how these could be overcome
- Appendix section, if tables, graphs, surveys, educational materials, etc. are created
Review the feedback from your instructor on the Topic 3 assignment, PICOT Statement Paper, and Topic 6 assignment, Literature Review. Use the feedback to make appropriate revisions to the portfolio components before submitting.
Prepare this assignment according to the guidelines found in the APA Style Guide. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. You are required to submit this assignment to Turnitin.
Nursing Change Proposal Assignment Sample Paper
Interdisciplinary interactions in nursing involve two or more areas of practice or disciplines in providing care to the patient. Therefore, proper interdisciplinary collaboration relationships are essential for healthy interactions. Poor interactions leading to violence or malpractice jeopardize patient safety and quality of care. This paper reports an interview with a colleague about an interdisciplinary issue that requires an interdisciplinary approach in finding solutions.
Summary Interview Report
My practicum is a nursing home facility. The colleague, AM, reported that the relationship among nurses and physicians, professional caregivers, and dieticians has been dwindling because of ‘behaviors’ that she described as misappropriate. She reports that junior staff members have been facing ‘tough’ times communicating with their seniors on matters of care progression and shift reporting.
The nutritionist, dieticians, and visiting physicians do not document their care but some of them expect the report on the progress of the care they provided earlier in the absence of the nurses and caregivers. This has caused turbulence in care provision progress where nurses and junior workers have been blamed for any medical errors or negligence that may arise in the care.
Caregivers of junior cadres have resigned from the facility while others have chosen to persevere the ‘pressure’, as she referred to it. The interviewee is also a victim of this interdisciplinary issue. She reports that at some point she wanted to quit and advance her profession to become a senior but due to factors known to herself, she stayed. She narrated an encounter with a physician who was discussing end-of-life care with a client in the nursing home.
The client was terminally ill and had provided a Do-Not-resuscitate order to be obeyed in a critical situation. However, this discussion was verbal and was not recorded in the patient’s health records. The client was resuscitated by the interviewee and other colleagues when she had a cardiac arrest later and threatened to sue the interviewee because she already provided her wish in critical situations.
Potential Change Theories and Leadership Strategies
Workplace incivility presents in various forms. Incivility is evident in the above interview as a blame from senior staff, lack of proper documentation, and pressure from seniors. Workplace incivility in healthcare tends to have extensive impacts on the emotional and physical health of nurses and other caregivers. The incivilities undermine the respect of the other workers and reduce their morale, a situation that, according to Keller et al. (2020), later impact their productivity. Therefore, timely mitigation to prevent further negative consequences on healthcare quality delivery is necessary.
The ‘freeze-change-unfreeze’ theory is a potential change theory that would be employed in coming up with and implementing intervention strategies. In this theory, potential stressors leading to the problem are identified and the status quo is interrupted. The involvement of the general organization leadership is required to ensure the involvement of affected disciplines. Therefore, good leadership that is transformative is a key requisite for this change initiative.
The respective heads of the departments and disciplines such as nursing, nutrition, medicine, and caregivers should be involved in patient care. The best communication strategies are necessary for successful interprofessional collaboration to ensure safe and effective patient care (Squires et al., 2019). As Handzel (2020) espouses, input from the different departments within the healthcare organization would be integral in coming up with concrete solutions to manage emergent behavioral issues. The incivility has potentially identifiable and unidentifiable stressors leading to the negative behaviors, hence the need for effective and timely intervention.
The nursing workplace has various care specialists whose cooperation is necessary for a successful collaboration in patient care delivery. However, workplace incivility is an evident obstacle to enhanced collaboration as seen in the interview with my colleague, AM. Workplace incivility has affected her morale and of her colleagues, resulting in others quitting their jobs due to inhospitable work environment. To curb this interdisciplinary issue, the organization can adopt the free-change-unfreeze model of change implementation while involving all departmental heads in coming up with collaborative solutions.
Assessment 3: Interdisciplinary Plan Proposal
The nursing practice issue of workplace incivility that cut across various disciplines had been discussed in the previous assessment. The proposed change theory model, namely unfreeze-change-refreeze, can be adopted in providing concepts for designing the solutions to this issue. This part addresses the proposal plan for finding the solution to the interdisciplinary issue.
Objective and Predictions for an Evidence-Based Interdisciplinary Plan
The nursing profession is known to be the kindest to their clients, yet sometimes the nurses do not show kindness towards their own. Arguably, cases exist where nurses also face discrimination and workplace incivility from other care professionals. This plan, therefore, aims at providing the foundations to address incivility in the nursing home facility. An interdisciplinary team will utilize a set out theoretical model to come up with the best solutions for problems plaguing the facility. The specific goal of this plan is to provide a framework for addressing the workplace incivility issue to minimize the related workplace stress and conflicts.
The Change Theory and a Leadership Strategy
Lewin’s change management model is related to the process of reshaping the ice. Initially, one has to melt the ice (unfreeze), change the shape (melt), and refreeze the ice into the desired shape. This property of the ice is similar to human behavior which is always amenable to appropriate change. Before applying this concept, the facility administration/leader needs to appoint a leader who would select an interdisciplinary team and lead it towards addressing the issue in a specific and efficient manner.
The interdisciplinary team would consist of representatives, preferably the heads of department, from all disciplines. This team would identify the stressors that cause incivility within the facility. This would be the first step of the change strategy. Understanding the causes or risks is necessary for selecting the best strategies in preventing further occurrence (Hussain et al., 2018). In the same phase, the ‘unfreezing’ of the existing behaviors and styles of practice is carried out.
The second phase of ‘melting the ice’ would include the process of behavior change through modification strategies. The transitioning of behaviors using the behavior change models would be employed. The last task of the team would be to come up with the new foundations of behavior, rules, and standards of practice that would create a favorable environment for healthy interactions among professionals.
Collaboration Needed by the Interdisciplinary Team
The success of the collaboration by the interprofessional team would be determined greatly by the availability of resources. In both resource-limited and resource-endowed settings, the concepts of culture and communication are essential determinants of the collaboration process (Busari et al., 2017). The collaboration process should consider the patient culture and the care professionals’ perspectives of the situation. Form this collaboration, team members would get to learn each other’s cultures and ways of pursuing their respective activities (Reeves et al., 2017). Collaborative leadership would be necessary for effecting a successful focused discussion among team members.
Necessary Organizational resources
Effective collaboration would require financial and physical resources. Effective communication would require the best technology such as audio and video conferencing in case the discussion is to be carried out over long distances (Rosen et al., 2018). Non-technological resources such as visual aids models on paper for the demonstration would also be necessary. The financial budget would, therefore, be drawn by the team leader to cater for all expenses of the team.
In a bid to change the current workplace culture characterized by persistent incivility, a team leader appointed by the organization’s management will be responsible for forming an interdisciplinary team. Once constructed, the team will need to embrace effective conversation strategies in designing an effective intervention plan. As shown in the discussion, Kurt Lewin’s Unfreeze-Transition-Refreeze model would be effective in addressing the behavior change objectives outlined by the team. Noteworthy is that for an effective change implementation process, the team will require sufficient financial and technological resources.
- Busari, J. O., Moll, F. M., & Duits, A. J. (2017). Understanding the impact of interprofessional collaboration on the quality of care: a case report from a small-scale resource-limited health care environment. Journal of Multidisciplinary Healthcare, 10, 227–234. https://doi.org/10.2147/JMDH.S140042
- Handzel, S. (2020, October 19). Incivility in nursing: An approach for change. Wolterskluwer.Com. https://www.wolterskluwer.com/en/expert-insights/incivility-in-nursing
- 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
- Keller, S., Yule, S., Zagarese, V., & Henrickson Parker, S. (2020). Predictors and triggers of incivility within healthcare teams: a systematic review of the literature. BMJ Open, 10(6), e035471. https://doi.org/10.1136/bmjopen-2019-035471
- Reeves, S., Pelone, F., Harrison, R., Goldman, J., & Zwarenstein, M. (2017). Interprofessional collaboration to improve professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews, 6, CD000072. https://doi.org/10.1002/14651858.CD000072.pub3
- Rosen, M. A., DiazGranados, D., Dietz, A. S., Benishek, L. E., Thompson, D., Pronovost, P. J., & Weaver, S. J. (2018). Teamwork in healthcare: Key discoveries enabling safer, high-quality care. The American Psychologist, 73(4), 433–450. https://doi.org/10.1037/amp0000298