Posted: April 16th, 2022
The DNP student will be utilizing Kurt Lewin’s Unfreezing-Change-Refreezing Model for the DNP project. Kurt Lewin (1947) created the change model with its fundamental approach to managing changes within the organization. Lewin (1947) stated that a successful change involves three aspects: unfreezing, change, and refreezing. The change model implicates preparing employees for change, creating changes, and normalizing and incorporating those changes inside the organization. The change model was chosen due to its simplicity and applicability to the evidence-based change project impacting both individual and organizational changes. The application of the 4AT rapid delirium tool with appropriate reinforcement and education can address the current beliefs and practices related to delirium, which will require changes in processes, modifications of behaviors, and leadership involvement.
The three phases of the change model can be utilized in each period of the project. During the unfreezing stage, the Director of Quality and DNP student had identified the increased usage of restraint in the year 2020, which relates to the current everyday processes and practices of staff. In the unfreezing stage, it is essential to bring light to the increase use of restraints, especially in the 4West Neuro/Tele unit to aid in changing values, set of beliefs, and norms of the unit. The change phase will be the implementation of evidence-based intervention of the 4AT assessment tool to detect delirium, which will help hopefully decrease restraint usage, improve patient outcomes, and prompt the usage of the tool in all the units of the organization. The freezing stage involves prompting the involvement of leadership, continual training for delirium and processes involved, and incorporation of the assessment tool in Cerner. In each phase, employee’s involvement will be more effective if employees are enabled in responsibilities and authorities with the help of leadership as a change agent (Hussain et al., 2018).
The project will be implemented in the 4West Neuro/Telemetry Floor of an acute care hospital. Saint Joseph Medical Center is a 355-bed capacity hospital that offers various services, including cancer treatment, surgical services, and behavioral health center. The designated unit services patients with neurological diseases mainly stroke, COVID, gastrointestinal bleed, and overflow for telemetry. The unit can hold 32 patients and mainly involves adult patients. On average, patients can stay in the unit for 3 to 5 days but varying factors can impact length of stay.
The patient population will be all the admitted patients in 4West Neuro/Tele floor of Saint Joseph Medical Center. The anticipated number of admissions over eight weeks will be around 300 patients. Inclusion criteria are patients admitted in 4West and adult population. Exclusion criteria include patients not admitted in 4West, patients involved with another intervention project, and ages under 18 years and younger.ReferencesHussain, S., Lei, S., Akram, T., Haider, M., Hussain, S., & Ali, M. (2020). 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). https://doi.org/10.1016/j.jik.2016.07.002Lewin, K. (1947). Frontiers in group dynamics: Concept, method and reality in social science; social equilibria and social change.Human Relations,1, 5-41. http://lchc.ucsd.edu/MCA/Mail/xmcamail.2013_07.dir/pdfeF83xvxgaM.pdf
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