Change Theory and Elements of Change

The nurse is a member of the nursing staff at the hospital that is undergoing significant organizational change. Which factor is the greatest contributor to the resistance encountered with organizational change? A. Ineffective organizational management B. Insufficient staff involvement in the process C. Employee mistrust of management D. Poor organizational leadership

C. Employee mistrust of management

A nurse manager notices that supply carts are unorganized and could use some attention. What strategy can the manager use to help implement change in this area?

Encourage input from subordinates for potential options

Who developed a theory that provides nurse leaders with tools to become effective change agents?

Lewin

The nurse manager for a medical surgical unit is implementing change in unit procedures as it relates to patient discharge. During the fourth phase of change known as action, the manager should incorporate the major component known as:

communication

Stages of Change Model

precontemplation, contemplation, preparation, action, maintenance

Classic social strategies for change

rational, normative, power

A nurse leader is thinking about approaching their manager with a new idea. To be properly prepared, the nurse leader should recognize this as a natural and unexpected response to change.

resistance

The nurse leader should identify the _______ forces prior to attempting to implement change.

restraining

A few months ago, a new nurse leader at a hospital discovered through evidence-based practice that tablet computers improved accuracy of documentation and decreased patient wait time. The leader noted that these outcomes are beneficial to the facility, staff, and patients, as tablets provide portable access to patient electronic medical records. The nurse leader is currently in the planning stage. Which activities are part of the planning stage? (Select all that apply) A. Determining the scope of the change project, a schedule for its implementation, and a budget to submit to administration for approval B. Anticipating resistance to the change by less tech-savvy staff C. Keeping track of the pace and stress of change D. Brainstorming the impact, pros and cons, and potential challenges to implementation with impacted teammates E. Evaluating how to plan unfolds in real time

A. Determining the scope of the change project, a schedule for its implementation, and a budget to submit to administration for approval B. Anticipating resistance to the change by less tech-savvy staff

The charge nurse of a step down unit is implementing a new procedure for charting, which will impact all of the nursing staff. According to Lewin's Model of Change, the Movement stage can be more successful if certain things are considered by the change agent

Include all stakeholders Set target dates Implement the change

A single parent raising two children and relying on public transportation, is determined to become a registered nurse. What are the restraining forces in this situation?

Relying on public transport Being a single mother Stress of being away from children

The nurse leader should not only understand the change process but also understand how to adapt to various methods in order to become an effective change agent int their organizations.

true

The unit manager of a medical surgical unit is transitioning the unit to electronic charting. According to Lewin's model, which of the following roles describes you as the change agent?

unfreezer

After attending a healthcare research seminar, a registered nurse who works in the transplant unit became very interested in the ability of 3-D printing to help save lives. The nurse would really like to raise awareness and see the hospital invest in a 3-D printer. What are the different technical reasons for resistance that the nurse may encounter? (Select all that apply) A. Unqualified personal B. Power C. Public education D. Budget issues E. Lack of resources

A. Unqualified personal D. Budget issues E. Lack of resources

As the nursing manager of the unit, which key step should be performed before implementing a change effort? (Select all that apply) A. Delay gathering input from team members B. Encourage input from team members who would be impacted by the change C. Use a roadmap as a guide to complete the change D. Keep track of the pace and stress of the change E. Investigate the magnitude and complexity of the intended change

B. Encourage input from team members who would be impacted by the change C. Use a roadmap as a guide to complete the change E. Investigate the magnitude and complexity of the intended change

A nursing staff member in the ED has noted where improvement of a procedure would bring about more efficiency. The staff members wants to share their idea with their supervisor. What would be the best option to facilitate the possibility of change? A. Communicate with in a vacuum B. Schedule a meeting with your supervisor and submit a concise plan related to your idea for consideration C. Take initiative and implement the change without approval D. Minimize the use of grassroots support from other staff

B. Schedule a meeting with your supervisor and submit a concise plan related to your idea for consideration

The charge nurse for a postop treatment center believes that change needs to take place to make the nursing process smoother and the treatment center safer. The nurse's rationale for making change would include which reasons? select all that apply A. To establish leadership power B. To solve an existing problem C. To improve staff productivity D. To reduce unnecessary workload E. To fill work quotas

B. To solve an existing problem C. To improve staff productivity D. To reduce unnecessary workload

A new nursing graduate has just started working in a hospital unit that has had difficulty and staff retention. Which type of assistance may be a result of changes that will occur despite the believes of the workforce? A. Political B. Technical C. Personal D. Cultural

D. Cultural

The oncology unit has recently experienced a higher than normal patient census, which is requiring that nurses pick up an additional patient. The hospital CFO has indicated that there are no additional funds available to hire additional full-time nurses. As such, the unit manager anticipates some behavioral responses by the stakeholders of change (nursing staff) within the unfreezing phase. What are some possible behavioral responses?

anger withdrawal discontentment

You are the nurse manager of a medical surgical unit that is in need of a change in staffing rotation patterns. which will lead to major changes in how the unit is staffed. According to Lewin's Change Theory, what forces are in play to enact these changes?

driving force

True or False: Change should be immediately implemented if the need for change has been identified.

false

Self-organizing theory

human nature and surprising effects

Chaos theory

patterns, moving target, unpredictable

A nurse manager is assigned to a new unit due to issues of administrative mismanagement, which had resulted in staff becoming disillusioned as to the mission of the unit. As the unit manager, you are expected to develop new policies for the staff to follow. What is one of the greatest factors that may contribute to resistance of change on this unit?

lack of trust

A nursing staff member who is on a unit committee to bring about a plan to change is currently in the integrating phase of change. What activities are associated with the integrating phase? (Select all that apply) A. Assessing how well the new process is accepted and becoming the norm B. Brainstorming solutions by using your own skills and the skills of those who will be affected by the change' C. Assessing how well the change is working against an established measurement for success D. Asking a lot of questions, such as "What can be done to overcome barriers?" E. Investigating the magnitude and complexity of the intended change as it is implemented

A. Assessing how well the new process is accepted and becoming the norm C. Assessing how well the change is working against an established measurement for success

Complex adaptive systems theory

nonlinear process

A nurse leader recently transferred to a different hospital that is much older than the hospital at which the nurse was previously employed. After working in the new hospital for a month, the nurse leader believes it would be a great idea to brighten the rooms with a lighter paint job, obtain newer hospital beds and curtains, and hang some fun artwork. However, the nurse leader doesn't want to be perceived as a threat to the team. How could these ideas be presented to minimize resistance?

- Engage other nurses in a discussion about the benefits of exam room aesthetics, then present the idea - Engage other nurses in a discussion about the benefits of exam room aesthetics, then solicit their ideas to improve aesthetics. - Make over one of the exam rooms and use it as a test case to collect data on patient satisfaction, then present the data with the idea to the team if the experiment was successful