Work Changes Plan: A Lewis Change Model
Instructions:
Review the following nursing scenario from the Agency for Healthcare Research and Quality:
A 60-year-old female is admitted to the ward with a 2-day history of severe left lower abdominal pain and leukocytosis. Her white count is 13,000, and she has WBCs in her urinalysis. Two hours after admission, she begins to experience an acute exacerbation of her abdominal pain and is believed to have a diverticular perforation and acute abdomen. At this point, her physician decides to send her to the OR. The unit clerk is aware of the plan, but the patient’s nurse is not. The patient is transported to the OR. Moments later, the OR calls to report that the patient has no permits signed, nor have any other pre-op protocols been completed.
Create a plan using Lewin’s change model, documenting strategies needed to support followership and empowerment.
Submit the assignment according to your facilitator’s instructions.
Solution.
Work Changes Plan: A Lewis Change Model
Description of the Changes to Improve Patient’s situation
The patient experiences lower blood count due to her elderly age as well as her illness. According to a classic article by Dutton and Duncan (1987) regarding a momentum change, the physician advice might entail a clear liquid diet. Additionally, the physician should administer a prescription of 8-10 days oral broad-spectrum antimicrobial treatment. Conclusively, the patient diet must be enhanced actively within 2-3 days of the commencement of diagnosis.
Rationale for Changes
The presence of a diverticular in the left colon is common with older patients because of the low number of fibers (Camilleri et al., 2000). As such, these changes in the situation of the patient take place due to constipation or obesity issues. Also, the colon has the inflamed sensation because the materials that pass through it strain due to fewer fibers (Comparato et al., 2007).
Utilizing Lewis Change Model
As a nurse practitioner, it is imperative to comprehend all the details regarding patient’s health care information with no room for assumptions. The healthcare organization must ensure proper verification of patient’s document at the start of therapy to avoid delays in admissions and emergency rooms. Also, the organization must possess an active reception that is respectful of patients’ verification before being attended by the physician.
According to Kurt Lewin Change Model, it stipulates that for ultimate care, the organization must utilize the three stages; ‘unfreeze,’ ‘change,’ and refreeze, for better patients’ outcome after intervention. The model stipulates that change can be achieved by creating a perception to create change, a move to the new or the desired behavior and solidifying the new behavior so as the patient can perceive it as a norm (Burnes*, 2004).
Step 1: Unfreeze: At this stage, as a nurse, I will comprehend the information about the patient and the pertinent medical history to create a perception that needs change. As such, the patient needs to be healed from the abdominal pains as a major complaint and be healed of leukocytosis.
Step 2: Change: At this stage, the organization must be able to respond to the trend of diseases, emergencies, other organizational changes, and accessing information for better strategic handling of patient’s situation. Here is where therapy is offered to the patient as mentioned above.
Step 3: Refreeze: Nurses play a significant role at this stage as they are obliged to motivate the patient to stick to the diet as mentioned and attend to the drugs prescribed within the therapy.
Course of Action for Change
Recognition of the emerging trends in diseases is imperative, and the physician must take actions immediately during emergency cases as the above. Also, a theoretical comprehension to explain changes at the initial stages of the strategic issue in diagnosis phase is important.
Reinforcing Changes
In
this case, the patient is supposed to undertake a clear liquid diet that has to
be monitored by the family or a care professional. Therefore, nurses must
exercise high motivational skills so as to convince the patient to adhere to
the intervention plan.
References
Burnes*, B. (2004, February 17). Kurt Lewin and complexity theories: back to the future? Journal of change management, 4(4), 309-325. doi:10.1080/1469701042000303811
Camilleri, M., Lee, J. S., Viramontes, B., Bharucha, A. E., & Tangalos, E. G. (2000). Insights into the pathophysiology and mechanisms of constipation, irritable bowel syndrome, and diverticulosis in older people. Journal of the American Geriatrics Society, 48(9), 1142-1150. doi:10.1111/j.1532-5415.2000.tb04793.x
Comparato, G., Pilotto, A., Franze, A., Franceschi, M., & Di Mario, F. (2007). Diverticular disease in the elderly. Digestive Diseases, 25(2), 151-159.
Dutton, J. E., & Duncan, R. B. (1987). The creation of momentum for change through the process of strategic issue diagnosis. Strategic Management Journal, 8(3), 279-295. doi:10.1002/smj.4250080306
