Lewin’s Change Theory has three concepts that includes “driving forces,” “restraining forces,” and “equilibrium.” As the driving force implies, there are forces that push or cause things to change, shifting the equilibrium. Restraining forces fight against the driving forces which also causes shifts in equilibrium. Equilibrium can be described when no changes occur due to equal amount of force applied. There are three stages in his theory and that is “unfreezing,” “change,” and “refreezing.” Unfreezing is getting out of the rut of behaviors that are not healthy or productive. This requires fortitude to break out of the individual mindset and group conformity. This can be accomplished by either increasing the driving forces that direct behaviors away from the current norm or by decreasing the restraining forces that negatively affect movement away from equilibrium. A third alternative would be a combination of both. The change stage is producing growth and moving to a new level. It is evidenced by new thought, feeling and/or behavior changes. The refreezing stage is making the new patterns set as the new normal. Once they are “frozen,” it helps to prevent falling back into old unhealthy patterns (Change Theory, 2011).
Imogene King: Goal Attainment Theory has an emphasis on interaction theory vs systems theory. The concepts are based on an open system framework that honors nursing as a major system within the health care system, and places high emphasis on interpersonal processes. In the conceptual framework are three systems; the Personal (individual), Interpersonal (individuals interacting with each other) and the Social where groups of people in a community or society share common goals, interests, and values and is studied as a whole vs isolated parts. The practice of nursing is differentiated from other healthcare professions in that interpersonal systems are in place and this is reflected in the nurse-client relationship. The individual is viewed as a spiritual being, rational thinker, and records own history through own language, and expresses individual needs, wants, and goals. Humans have three fundamental needs: access to health information, illness prevention, care in times of illness. Health is dependent on continuous adjustment to stressors in the internal and external environments with use of ones resources to achieve maximum potential (Gragera, 2013).
Theory for EBP Project
The Goal Attainment Theory seems to be the best fit for the Capstone project. Results of screening and referrals develop into IHPs and IEPs that are tailored to the individual’s needs. This would seem to fit best with engaging the entire intraprofessional team in working with the student and the family in implementing interventions.
Theory Used by Mentor
“I suppose I engage some level of nursing theory with each response in the work setting, protocol development, policy revision, and the like. When looking at the two theories you shared, I would probably most closely align myself with Imogene King’s Goal Attainment Theory. Nursing is a major system within the health care system, with vast and significant impact on individuals, families/groups, and communities (local, regional, national, and world)” (P. Anderson, personal communication, August 19, 2019).
“I’ve consistently landed on the historical (and I think still relevant) dimensions of health: physical, social, emotional, intellectual, spiritual. The individual, embracing, reflecting, and continuously balancing these five dimensions, can engage in self-responsibility and decision-making relative to the three fundamental needs identified in King’ theory: health information, illness prevention, and care in times of illness ~ expressing needs, wants, and goals” (P. Anderson, personal communication, August 19, 2019).
Change Theory. (2011). Retrieved from http://currentnursing.com/nursing_theory/change_theory.html
Gragera, Jen. Imogene King: Goal Attainment Theory. (2013). Retrieved from https://www.slideshare.net/jen316/imogene-king-23548267
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Dq 5 19359215
/in Uncategorized /by developerMeet with the human resources director or the hiring person at your site. (If there is no one with that title, speak with whoever does some of the interviews of prospective new employees.) Ask that person at least five questions to find out his/her best and worst interview experiences. Describe the five questions that you asked and the answers that you received when you met with the human resources director or hiring person at your site.
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Dq And Assignment 19078251
/in Uncategorized /by developerDQ:
Select a topic for your Topic 3 Executive Summary assignment. Post your idea and basic thoughts about the topic using the Topic 3 Executive Summary assignment details. You should provide thoughts to your peers about their topics and ideas that may assist them in completing their projects.
Assignment:(topic 3 executive summary )
In this assignment, you will select a program, quality improvement initiative, or other project from your place of employment. Assume you are presenting this program to the board for approval of funding. Write an executive summary (850-1,000 words) to present to the board, from which they will make their decision to fund your program or project. The summary should include:
Share your written proposal with your manager, supervisor or other colleague in a formal leadership position within a health care organization. Request their feedback using the following questions as prompts:
Submit the written proposal along with the “Executive Summary Feedback Form.”
Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
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 LopesWrite. Please refer to the directions in the Student Success Center.
NRS451V. ExecutiveSummaryFeedbackForm_2-24-24.doc
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Dq And Assignment
/in Uncategorized /by developerChange Leadership: Risk Management, Safety, and Environment
Youngberg (2011) conveys the transformation needed for effective health care quality, risk management, and regulatory compliance on behalf of health care leaders following the release of IOM reports (p. 293). The author stresses the importance of learning from other industries, constructing high reliability organizations (p. 294), developing trust and transparency (p. 296), promoting justice and accountability (p.298), and committing to a culture of safety (p. 300); additionally, Youngberg emphasizes the new principles for high reliability-high performing health care organizations (p. 302).
In your initial post to this discussion:
In your initial post, include APA-formatted in-text citations and accompanying, congruent APA-formatted references.
Response Guidelines
Respond to the posts of other learners according to the Faculty Expectations Response Guidelines. If possible, respond to one learner who has a perspective, background, or goals that are similar to yours, and to one learner whose perspective, background, or goals are different. Peer responses should be substantive, and need to include one peer-reviewed source that aligns with the discussion thread. You may feel free to add an additional source that is new or provides a completely different perspective. “I agree” and “Thanks for sharing your insights” are examples of responses that do not contribute content for enhanced learning, and are not acceptable. The goal is quality, substantive feedback that demonstrates higher-order critical thinking and evaluation of peers’ initial posts.
Reference
Youngberg, B. J. (2011). Principles of risk management and patient safety. Sudbury, MA: Jones and Bartlett.
Resources
Scorecard Analysis: Process Improvement Report
To prepare to complete this assignment, review the following materials from the study activity in Unit 8, which are also linked in the Resources:
The goal of this assignment is to generate recommendations for process improvement and organizational fitness. You will make your recommendations for the organization you selected in Unit 7 for the balanced scorecard PowerPoint presentation and which you presented in the Unit 8 assignment. Apply the concepts of balanced scorecards to create your recommendations.
To complete the assignment, write a paper in which you:
Assignment Requirements
Note: Your instructor may also use the Writing Feedback Tool to provide feedback on your writing. In the tool, click the linked resources for helpful writing information.
Portfolio Prompt: You are required to save this learning activity to your ePortfolio.
Resources
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Dq Auestion
/in Uncategorized /by developerAfter discussion with your mentor, name one financial aspect, one quality aspect, and one clinical aspect that need to be taken into account for developing the evidence-based practice project. Explain how your proposal will directly and indirectly impact each of the aspects.
the capstone topic is handwashing in health care system
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Dq Reponse
/in Uncategorized /by developerLife and the health care system are dominated by technology, and most of the impact that technology has on health care is positive. However, according to Taylor (2013) there are also risks involved with the extensive use of technology in healthcare. For example, communication errors and breach in confidentiality can quickly happen through the widespread use of technology (Taylor, 2013).
Technology is an integral supportive and integrative part of my project implementation process. The project focus is development and implementation of a formal unit-based preceptor program. Following are some ways that computer technology will be used for my change project initiative:
Since computer technology is already an integral part of the work process on the unit that this project initiative will be implemented, I see no barriers that would prevent the use of it for the focused project change. Many computer technology advances in health care will continue to be used to provide safe environments for patients and their families (Taylor, 2013).
Reference
Taylor, K. (2013). Technology in general practice—is it risky business? Practice Nurse,
43(5), 10-11. Retrieved from https://search-ebscohost-
com.lopes.idm.oclc.org/login.aspx?direct=true&db=a9h&AN=87833894&site=eds-
live&scope=site
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Dq Response 19326399
/in Uncategorized /by developerLewin’s Change Theory has three concepts that includes “driving forces,” “restraining forces,” and “equilibrium.” As the driving force implies, there are forces that push or cause things to change, shifting the equilibrium. Restraining forces fight against the driving forces which also causes shifts in equilibrium. Equilibrium can be described when no changes occur due to equal amount of force applied. There are three stages in his theory and that is “unfreezing,” “change,” and “refreezing.” Unfreezing is getting out of the rut of behaviors that are not healthy or productive. This requires fortitude to break out of the individual mindset and group conformity. This can be accomplished by either increasing the driving forces that direct behaviors away from the current norm or by decreasing the restraining forces that negatively affect movement away from equilibrium. A third alternative would be a combination of both. The change stage is producing growth and moving to a new level. It is evidenced by new thought, feeling and/or behavior changes. The refreezing stage is making the new patterns set as the new normal. Once they are “frozen,” it helps to prevent falling back into old unhealthy patterns (Change Theory, 2011).
Imogene King: Goal Attainment Theory has an emphasis on interaction theory vs systems theory. The concepts are based on an open system framework that honors nursing as a major system within the health care system, and places high emphasis on interpersonal processes. In the conceptual framework are three systems; the Personal (individual), Interpersonal (individuals interacting with each other) and the Social where groups of people in a community or society share common goals, interests, and values and is studied as a whole vs isolated parts. The practice of nursing is differentiated from other healthcare professions in that interpersonal systems are in place and this is reflected in the nurse-client relationship. The individual is viewed as a spiritual being, rational thinker, and records own history through own language, and expresses individual needs, wants, and goals. Humans have three fundamental needs: access to health information, illness prevention, care in times of illness. Health is dependent on continuous adjustment to stressors in the internal and external environments with use of ones resources to achieve maximum potential (Gragera, 2013).
Theory for EBP Project
The Goal Attainment Theory seems to be the best fit for the Capstone project. Results of screening and referrals develop into IHPs and IEPs that are tailored to the individual’s needs. This would seem to fit best with engaging the entire intraprofessional team in working with the student and the family in implementing interventions.
Theory Used by Mentor
“I suppose I engage some level of nursing theory with each response in the work setting, protocol development, policy revision, and the like. When looking at the two theories you shared, I would probably most closely align myself with Imogene King’s Goal Attainment Theory. Nursing is a major system within the health care system, with vast and significant impact on individuals, families/groups, and communities (local, regional, national, and world)” (P. Anderson, personal communication, August 19, 2019).
“I’ve consistently landed on the historical (and I think still relevant) dimensions of health: physical, social, emotional, intellectual, spiritual. The individual, embracing, reflecting, and continuously balancing these five dimensions, can engage in self-responsibility and decision-making relative to the three fundamental needs identified in King’ theory: health information, illness prevention, and care in times of illness ~ expressing needs, wants, and goals” (P. Anderson, personal communication, August 19, 2019).
Change Theory. (2011). Retrieved from http://currentnursing.com/nursing_theory/change_theory.html
Gragera, Jen. Imogene King: Goal Attainment Theory. (2013). Retrieved from https://www.slideshare.net/jen316/imogene-king-23548267
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Dq Response 19328281
/in Uncategorized /by developerStakeholder support is necessary for a successful change proposal project implementation. Consider your internal stakeholders, such as the facility, unit or health care setting where the change process is situated, and your external stakeholders, like an individual or group outside the health care setting. Why is their support necessary to the success of your project, and how you will go about securing that support?
anne kolsy replied
Internal Stakeholders: In my facility, the internal stakeholders include all the staff. This includes everyone from the custodian to the superintendent. All are affected by students who need services. For instance, students who are EBD (or similar) often destroy property and obviously need one-on-one attention from paras and teachers (Difference, 2017).
External Stakeholders: This includes clinics/hospitals, parents/guardians, local and state government, police, vendors, neighbors to the schools, churches and organizations, park and rec and more. The entire community is connected to the schools in some capacity (Difference, 2017).
How to Secure Support from All Stakeholders and Why It is Necessary
The number one skill to learn is to win support from all interested stakeholders. Starting with a “Stakeholder Analysis” is one methodology to use to help identify key people who will support the project. Listening to opinions and ideas helps to engage and give ownership to the changes. Gaining support from most powerful stakeholders can help gain more support in terms of money and time. It is important to keep them abreast of progress and plans. It is good to know your stakeholders and how they will react to certain news and ideas (Securing, 2017). For example, the custodians would be thrilled without a doubt about helping students to make better choices in the school setting. The custodians have expressed concerns and feelings of no support from administration when the students throw food on the floor, defecate on the floors, and break things (and so much more). It is quite certain that if better discipline and guidance were in place, the custodians would do just about anything to make things work better for everyone.
Difference Between Internal and External Stakeholders. (2017). Retrieved from
Securing stakeholder commitment. (2017). Retrieved from https://www.workpositive.ie/prepare/stakeholders
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Dq Response 19328289
/in Uncategorized /by developerRe: Topic 5 DQ 2 Technology is integral to successful implementation in many projects, through either support or integration or both. Name at least one technology that could improve the implementation process and the outcomes of your EBP project. Do you plan to use this technology? If not, what are the barriers that prevent its use?
ANSWER BY ANNE
Technology Support/Integration That Can Improve EBP Project
In the Nelson presentation (2015), one of the research questions put forth was, “Can a centralized, telephone-based model of early childhood developmental screening and care coordination improve quality of care for young children and their families” (Nelson, 2015). There are 211 Call centers that cover over 90% of the US population. In a LA based 211 developmental screening, over 11,000 early childhood screenings and coordinated care have been coordinated with appropriate services. The 211 potential advantages include time availability, standardized and validated online screening tools, extensive resource directory that includes care coordination, data collection and dissemination, continuity of care, and coordination with clinical settings. Of the children screened over 90% received some kind of referral. As the presenter reported, the American Academy of Pediatrics recommends universal screening and surveillance at every well visit, screening at 9, 18, and 24-30 months, autism-specific screening tool at 18 and 24-30 months, and prompt referral to evaluation and intervention services. The impact of early screening and intervention has evidence pointing to the improvement in developmental, social, educational, and health outcomes. Society benefits with a pronounced ROI in every dollar invested (Nelson, 2015).
Plans for Use and Barriers to Implement
The idea of starting a similar resource would be fantastic. It is an idea that could potentially be integrated into the school district and county for which I work. The same barriers I see from making it happen are the same barriers that the article mentioned, and that is the 211 has limited documentation. The same concerns that plague us now are the same for 211 regarding lag time between referral and service implantation. Eligibility and participation in services are always the big hinderances to making this work, and of course the age-old question of who will pay for this service (Nelson, 2015).
Nelson, B. (2015). Clinical-community partnerships and 2-1-1 technology to improve early childhood
developmental screening and care. [PowerPoint slides]. Retrieved from
http://www.publichealthsystems.org/sites/default/files/PHS4/PresBioProjInfo_Nov%2019_Nelson%20UC
LA.pdf
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Dq Response 19330239
/in Uncategorized /by developerSmithson Carrie reply
Stakeholder support is necessary for a successful change proposal project implementation. There are internal and external stakeholders to consider. Their support is necessary in the success of my project of tobacco dependency and cessation. Examples of internal stakeholders are management, facility, employees, and the unit that is affected. To find intermediate stakeholders, you first look within the immediate team in the department or unit and then in other groups that may connect you to the project. The support that comes from internal stakeholders is important because they are the people being directly affected. “Employees want to earn money and stay employed. Owners are interested in maximizing the profit the business makes. Investors are concerned about earning income from their investment” (Boundless, 2018, para. 3). Since internal stakeholders are going to be affected by the change, they need to be onboard and up-to-date on the change process and upcoming policies. Having their satisfaction and participation is important to prevent staff turnover and patient safety. External stakeholders are the suppliers, society, government, shareholders, and customers. These stakeholders are not within the facility, but are directly affected by what we do in the facility. The patients (customers) want the facility to provide safe and remarkable care at a reasonable cost. “Suppliers want the business to continue to purchase from them. Creditors want to be repaid on time and in full. The community wants the business to contribute positively to its local environment and population” (Boundless, 2018, para. 4). It is important to have support from these stakeholders because you need them to work alongside you to succeed. They provide the resources outside of the workplace. External stakeholders will help spread the word about the project change and will help reach the people in the community through primary prevention. It is always good to receive opinions from both stakeholders to take into consideration with you project going forward. Without internal and external stakeholders, the change process would be much more difficult to implement and be successful.
Resource
Boundless. (2018). Boundless Accounting.
https://courses.lumenlearning.com/boundless-
accounting/chapter/overview-of-key-elements-of-the-business/
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Dq Response 19330273
/in Uncategorized /by developerQuestions
Technology is integral to successful implementation in many projects, through either support or integration or both. Name at least one technology that could improve the implementation process and the outcomes of your EBP project. Do you plan to use this technology? If not, what are the barriers that prevent its use?
Anne response
Technology is an important part of ensuring success in implementing change projects. This is especially true in the case of implementing a postpartum hemorrhage bundle. Postpartum hemorrhage is considered a high-risk low-volume event which means it does not occur often, but when it does there is much at stake (Lutgendorf et al., 2017). Technology will be utilized to successfully implement the postpartum hemorrhage bundle. The main way we will use technology is during simulation training. Simulation trainings using the Noelle mannequin offer life-like scenarios in the department where patient care occurs. Using simulation allows staff to work as they would in real life but does not put patient safety at risk. It also allows for debriefing afterward and identifies gaps in the workflow (Lutgendorf et al., 2017). We can also use technology to help us track postpartum hemorrhage data. We are developing a spreadsheet that tracks the number of patients who experienced hemorrhage and need for transfusion. This allows us to validate the effectiveness of our postpartum hemorrhage bundle.
Reference
Lutgendorf, M. A., Spalding, C., Drake, E., Spence, D., Heaton, J. O., & Morocco, K. V.
(2017). Multidisciplinary in situ simulation-based training as a postpartum
hemorrhage quality improvement project. Military Medicine, 182(3/4)
e1762–e1766. doi:10.7205/MILMED-D-16-00030
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