As An Advanced Registered Nurse, You Will Serve As A Leader

As An Advanced Registered Nurse You Will Serve As A Leader Within You

As an advanced registered nurse, you will serve as a leader within your organization. Part of this role will entail being a change agent, and spurring positive change on behalf of patients, colleagues, and the industry. Consider a situation you experienced previously where change did not go as planned in your health care organization (e.g., fall prevention plan). Create a 10-15 slide PowerPoint presentation in which you will assess the situation and the steps that should have been taken to successfully implement change.

Sample Paper For Above instruction

Introduction

As advanced practice registered nurses (APRNs), we hold not only clinical expertise but also leadership roles that involve guiding change within healthcare organizations. Effective leadership in change management is essential to improve patient outcomes, enhance workflows, and foster a culture of continuous improvement. This paper reflects on a past situation where a fall prevention initiative did not proceed as planned, analyzing the factors involved and proposing a comprehensive approach to successful change implementation.

Background of the Situation

The fall prevention plan was introduced in a busy adult medical-surgical unit aiming to reduce patient fall rates and associated injuries. The rationale was rooted in recent hospital data indicating an increase in falls, which compromised patient safety and hospital accreditation standards. The goal was to implement a multifaceted approach including bed alarms, patient education, staff training, and environmental modifications to lower fall incidents by 25% within six months.

However, despite initial enthusiasm, the initiative faced resistance from staff, logistical challenges, and inconsistent adherence to protocols. Fall rates remained unchanged over the subsequent quarter, demonstrating that the change process was not effectively executed.

Key Stakeholders in Change Efforts

• Internal Stakeholders: Nursing staff, physicians, interprofessional team members (e.g., physical therapists, occupational therapists), unit managers, quality improvement team, hospital administration.
• External Stakeholders: Patients, patient family members, regulatory bodies, healthcare vendors providing safety equipment, and community health agencies.

Involving these stakeholders ensures diverse perspectives, promotes collaboration, and fosters shared ownership of the change process, which are critical for successful implementation.

Change Theory or Model for Achieving Results

The Lewin’s Change Management Model is appropriate for this situation; it comprises three stages: unfreeze, change, and refreeze. In the unfreezing stage, resistance is addressed through communication, education, and motivation, preparing staff for change. The change stage involves implementing new protocols and practices, with ongoing support and feedback. Finally, the refreezing solidifies the change, integrating it into routine practice through policies, ongoing education, and reinforcement.

Alternatively, Kotter’s 8-Step Change Model could be employed, emphasizing creating urgency, forming guiding coalitions, developing and communicating vision, empowering action, and anchoring change in culture (Kotter, 2015).

Initiating the Change

The change initiation begins with leadership engaging staff early in the process via meetings, education sessions, and demonstrating the benefits of the fall prevention strategies. Establishing a multidisciplinary team to oversee implementation builds commitment. Clear goals and timelines are set, and feedback mechanisms are created to address concerns promptly. Pilot testing the intervention on a small scale facilitates manageable adjustments before broader rollout.

Potential Impact of Unsuccessful Change and Next Steps

If the change effort fails again, the organization risks increased fall rates, patient harm, potential legal liabilities, and loss of credibility. To address persistent barriers, the interprofessional team could revisit stakeholder engagement, provide additional education, modify strategies to better fit the workflow, or incorporate technology improvements. Conducting root cause analyses of previous failures helps identify overlooked factors, leading to more tailored interventions and sustained success.

Conclusion

Effective leadership, strategic planning, and evidence-based frameworks are vital to implementing successful change initiatives in healthcare. As APRNs, embracing these principles ensures positive outcomes for patients and organizations alike.

References

• Kotter, J. P. (2015). Leading change: Why transformation efforts fail. Harvard Business Review, 93(1), 96-103.
• McAlearney, A. S., Hefner, J. L., Sieck, C. J., & Kelleher, S. (2019). Cultivating leadership for health system transformation. Leadership in Health Services, 32(2), 184-197.
• Rousseau, D. M. (2018). Organizational change: Creating change through employee involvement. Journal of Change Management, 18(1), 1-4.
• Schein, E. H. (2017). Organizational Culture and Leadership. Jossey-Bass.
• Waddell, J., & Costa, L. (2020). Implementing evidence-based fall prevention strategies in hospital units. Journal of Nursing Care Quality, 35(4), 317-322.