Tag: Development Of Evidence-Based Practice Change Proposal II

The theory developed by the American philosopher Kurt Lewin (18901947), the so-called three-step change theory, examines behavior as a product of driving and suppression of forces acting in opposite directions(Schein,E.H.1996). Promoters or motivators are positive and encourage people to act or act in the directions they need. Restrictive forces, on the other hand, undermine team change by moving individuals in the opposite direction.
In Lewin’s three-step change theory, the first step in a person’s behavioral change begins with thawing or destroying the current state (thawing is essential to eradicate bad habits). This can be achieved by using a variety of techniques, including increasing motivational factors and reducing limiting aspects. As a general rule, people switch only when they are dissatisfied with their current state, so it is important to motivate people to move into new situations. The second stage of behavioral change theory involves exercise. Providing people with proper training and orderly methodologies for new processes is very important. Change means adopting and discovering new values ​​and attitudes. To reach the next level, you need to overcome ineffective behavior by moving into a state of change. This process is time consuming and labor intensive, as not everyone wants to change past habits, especially those who have benefited from their previous state, in various ways, such as persuading. The third step in Lewin’s theory of change involves freezing. This involves adjusting the individual to permanently accept the desired changes so that they do not revert to their original behavior. This final step is to stabilize a new state of sustaining tissue. This moment is known as equilibrium, and its success requires the support of stakeholders such as company rules, company culture, and organizational structure. To stabilize the new situation, German psychologists have asserted that relieving previous tensions is the best way to reinforce new changes. With this in mind, Lewin’s three-tiered theory of change focuses on the role of force promotion and restraint in changing people’s behavior.
The second theory of change is social cognitive theory, which emphasizes the importance of environment, personality, and attitude in changing an individual’s behavior (Neumeier, M. (2013). Individuals need to be motivated and self-efficacy for behavioral changes to occur. This means confidence in your determination for your ability to embrace certain changes and self-motivation to go through the transformation process. According to cognitive theory, humans are more complex than a series of responses to external stimuli. Social cognitive theory emphasizes that behavior is influenced by environmental and personal factors. A person’s behavior can be influenced by his beliefs, attitudes, and perceptions. The central concept of social cognition theory is related to skill and self-efficacy. If a person receives an incentive in connection with a particular behavior, he believes he can do it (self-efficacy). If the operation is successful, it is likely that this operation will be repeated in the future.
Comparison and Contrast Two Theories of Change
Social cognition theory is based on the assumption that behavior is motivated by results. Therefore, the expected results serve as an incentive to accept and maintain behavior. This is the difference between social cognitive theory and Lewin’s three-step change theory. Lewin’s theory of change is practical, balanced, and goal-oriented. This is because it does not consider a person’s personality or characteristics, but considers factors other than behavioral changes. However, both theories take into account the role of external factors that influence individual behavioral changes.
Which theory is more sensitive to implementing your particular EBP intervention. The modified model proposed by
Lewin is characterized by its logic and lightness. Lewin’s three-step theory of change is best implemented in my field of work. This is because Change Theory (EBP) is more rational and practical because it takes into account the dynamic external factors that appear in nursing practice.
The decisive factor in my project is to improve health by warming surgical patients and thereby minimizing the occurrence of hypothermia.
Did your tutor use any of the theories, and what are the consequences?
My preceptor applied Lewin’s three-step theory of change with positive results. The results are evidence-based recommended practices by implementing a theory like Nora Pender on health promotion aimed at educating individuals to adopt illness prevention attitudes so that society has higher health indicators. It was strengthened by retraining and motivating nurses to adopt.

Compare and contrast two change theories, and determine which theory makes the most sense for implementing your specific EBP intervention. Why? Has your preceptor used either theory, and to what result?

Kurt Lewin’s change theory is a three-step model. It used driving forces to facilitate change by pushing employees in a desired direction to replace and reject prior practice (Current Nursing, 2020). The first step is unfreezing or disruption of the equilibrium state. The second step would be to help employees understand the need and benefits from the change and encourage them to make this change happen. The final step is establishing the change as the new equilibrium and then freezing it to remain the new norm. For this change theory to be successful is uses a driving force.

Roger’s five state change theory; knowledge, persuasion, decision, implementation, and confirmation is based on five personality traits. The five personality traits he looked at were innovators, early adopters, early majority, late majority, and laggards (Agency for Clinical Innovation, 2015). This change theory was successful when employees who ignored the proposed change earlier adopt it because they see other employees, the innovators, adopt it well.

After consulting with Rebekah, my preceptor, she informed me that she has not implemented either of these change theories in the hospital setting, but that she would like to use Kurt Lewin’s change theory. If labor and delivery nurse are required to take a breastfeeding class and use the learned knowledge, they can be better prepared to help their patients when they face breastfeeding challenges. If prenatal care offices are required to provide information regarding the Healthy Beginings Clinic, which offers breastfeeding classes, CPR classes, well baby checkups, prenatal classes, the patients can be more aware of the different types of resources available to new mothers and babies. This can also help them feel more supported when it comes to breastfeeding challenges.
Compare and contrast two change theories, and determine which theory makes the most sense for implementing your specific EBP intervention. Why? Has your preceptor used either theory, and to what result?

Why is understanding the health care system at the local level important to consider when planning an EBP implementation? Conduct research and solicit anecdotal evidence from your course preceptor that you will take into consideration for your own change project.

Evidence-based practices are one of the current health practices that have improved health habits and thus improved patient outcomes. Evidence-based practices give healthcare providers high-quality service based on evidence, clinical knowledge, and patient needs. This allows patients to meet their medical preferences and improve results. Changes to evidence-based practice require critical attention through in-depth research to identify and analyze the problem in order to apply the correct evidence to clinical practice by assessing the outcome (New Horiz. 1998).

Implementing the EBP is very complex because it requires team collaboration and partnerships. Therefore, it is important to understand the system at the local level when implementing and planning EBP changes. Understanding will help you identify the availability of the teams involved in the process. Nurses, doctors and other healthcare providers need to be involved during the implementation. Understanding your local system will help you understand the people available to support your implementation and successful implementation. On the other hand, funds must be made available during the implementation of such changes. Understanding the local level allows researchers to budget appropriately and allocate the knowledge necessary for successful implementation. In addition, understanding the local system allows researchers to understand the organizational culture, develop the cultural practices of the necessary changes that fit the local system structure, and successfully implement it. In addition, understanding the local system can involve the local community, participate in the process, and know the needs that need to be included in the implementation process to ensure success. Above all, leadership is very important in making and implementing changes. Understanding the local level makes it easier for managers to join the system and implement successfully.
Evidence-based practice is one of the biggest changes in health care as it improves quality of service and patient outcomes e. Understanding the local level during implementation can improve leadership, resource mobilization, cultural respect and successful change (J Nurs Scholarsh. 2001).