NR 451 Week 6: Implementing Change Despite Resistance Discusssion

Chamberlain University NR 451 Week 6: Implementing Change Despite Resistance Discusssion– Step-By-Step Guide

This guide will demonstrate how to complete the Chamberlain University NR 451 Week 6: Implementing Change Despite Resistance Discusssion   assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for NR 451 Week 6: Implementing Change Despite Resistance Discusssion              

Whether one passes or fails an academic assignment such as the Chamberlain University NR 451 Week 6: Implementing Change Despite Resistance Discusssion  depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for NR 451 Week 6: Implementing Change Despite Resistance Discusssion              

The introduction for the Chamberlain University NR 451 Week 6: Implementing Change Despite Resistance Discusssion  is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for NR 451 Week 6: Implementing Change Despite Resistance Discusssion              

After the introduction, move into the main part of the NR 451 Week 6: Implementing Change Despite Resistance Discusssion assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for NR 451 Week 6: Implementing Change Despite Resistance Discusssion              

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for NR 451 Week 6: Implementing Change Despite Resistance Discusssion              

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for NR 451 Week 6: Implementing Change Despite Resistance Discusssion

Change in any setting is difficult, we go through changes every day, new laws, new way of doing things, new technology and so forth.  Some embrace change as inevitable and others just refuse to change.  My mother is an avid reader and has literally hundreds of books, trust me I know I have moved her twice in the past 10 years and know all the books she has.  I bought my mother a nook several years ago and taught her how to use it.  Instead of embracing this new-found way of reading thousands of books that are stored in one place, she chose to hide the nook and claim it was lost.  Recently she started having trouble with her eye site and could not read regular print books so I searched her apartment and found the nook, I charged it and set the font to large type and re-oriented her to its use.  Again, she stashed it away saying it would not charge.  Now I know that was not true, she just will not change to use of new technology, she will not learn to use a computer or tablet, she has no interest in doing that.  Change scares her and that is the bottom line. As nurses, we are a lot like my mother, afraid of change, and this fear holds us back in our practice and in safe quality care and positive outcomes for our patients.  

There are several major barriers to the advancement of EBP which would bring about change in nursing.  These include:

• Lack of knowledge and skill
  • Low comfort level with search techniques
  • Perceived lack of time-REAL LACK OF TIME
  • Challenges with critically appraising research
  • Lack of organizational/administrative support
  • Educational programs that continue to teach research the “traditional way” with focus on producing instead of using evidence
  • Negative attitudes-skeptics and fear

I had one negative encounter with implementation of change early after I earned my masters’ degree.  My barrier with leadership and their lack of knowledge and insecurity with staff effecting change.  I was basically told after my presentation of my idea for change that I was hired as a staff nurse and nothing more.  Their insecurity with staff effecting change that could improve patient outcomes along with their lack of knowledge in nursing research became the barriers to positive patient outcomes.  In the past year, the culture at that facility has changed and nursing research that includes the staff has been implemented. 

Tell the class about the barriers you may encounter in your practice if you were to attempt to implement a change?  It could be from staff or leadership or both.  

Feeg, D. V., Suny Downstate Medical Center Department of Nursing , Nursing Research and Evidence-Based Practice 
     Conference, May 26, 2010; Strategies for Overcoming Barriers in Implementing Evidence-Based Practice; retrieved from
     http://www.downstate.edu/icl/Feeg-Downstate2010Presentation-BarrierstoEBP.pdf

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Sample Answer 2 for NR 451 Week 6: Implementing Change Despite Resistance Discusssion

In the medical field, I have always heard “the only constant around here is change”. This is very true. The medical field is constantly changing as more and more research is developed to find better, more effective care for patients. Some nurses like to say, “that is not the way we have always done it” or “why change something that isn’t broken?” The reason for change is simple. There is a cause for change. With the new technology, we have a better ability to track results in an effort to find out what works, what works well, and what really does not work.

 If I were to implement my project, complete skin assessments on all patients admitted from the Emergency Department and the development of an Interdisciplinary Wound Care Team, I would expect to meet resistance. Emergency nurses would insist that they did not have time to do a thorough skin assessment on admitted patients. They would make statements like, “I was too busy keeping the patient from dying to worry about the status of his skin” or “just more time treating the computer and not the patient”. They are right, of course. “Long and variable hours, heavy patient loads, and complex care needs that require multi-tasking are just some of the challenges that nurses face every day” (American Nurses Association, 2015, p. 22). It is difficult to explain to staff members why they need to do even more work.

 Gesme and Wiseman explain that “resistance to change usually comes from fear, on one of three levels—what will happen to me in my world, how will my relations to my colleagues change, or how will our practice and our patients be affected” (Gesme and Wiseman, 2010). To lessen the resistance, I will focus on these three levels of fear. I will educate each staff member involved of what his / her direct role will be and what is expected of him / her. I will explain to staff that this change should cause no changes to relationships with colleagues. I will educate the staff on how the change will affect nursing practice and how the patient will benefit from the few extra minutes that the skin assessment and charting will take. I will also thoroughly educate staff on the causes and preventive measure for pressure wounds. After staff receive education, I feel that they will be more receptive to the change.

References:

American Nurses Association. (2015). Nursing: Scope and standards of practice (3rd ed.). Silver Spring, MD: Author.

Gesme, D., & Wiseman, M. (2010). How to Implement Change in Practice. Journal of Oncology Practice, 6(5), 257–259. http://doi.org/10.1200/JOP.000089Links to an external site.

Sample Answer 3 for NR 451 Week 6: Implementing Change Despite Resistance Discusssion

Change is very difficult to embrace, it requires a change in mindset, behavior, and routine. We all become comfortable with routine and when something new is introduced, that means more work, charting or time in learning a new skill. Nursing is constantly evolving and change is discussed almost daily in my unit, almost like alarm fatigue. You hear it so much, it becomes mute. 

One way change is successful is changing policy. For example, we have a crises in nursing with medication errors and sentinel events. In order to combat this Congress passed HITECH for hospitals to change over to EHR. They paid out billions for facilities to incorporate EHRs in their facilities (Blumenthal,D., 2010). Nurses can make a difference when we stick together and join groups like ANA.

Another way to embrace change is to get the team involved. Generally if people see the benefit for themselves or even their patients, they may be more willing to change. A decision cannot be made if it is poorly communicated or understood. When team members can understand why there is a problem and understand how there is a solution to better patient outcomes, they will be more willing to embrace change (Finkelman,A., 2016).  

If I were to introduce my project, early education for better patient outcomes in the ICU, I would reeducate the nursing staff via staff meeting and visual aid, on how to document in EPIC on education, care plans and effective documentation. I audited several charts with my Managers permission and checked admission data bases on education and follow up. I learned most nurses over 70% on my unit do not know how to navigate EPIC in charting education. I believe it is difficult to navigate the page and nurses become frustrated and just don’t utilize it.

Refernces

American Nurses Association. (2015). Nursing: Scope and standards of practice (3rd ed.). Silver Spring, MD: Author.

Blumenthal,D.,(2010).  New England Journal of Medicine: The “Meaningful Use” Regulation for Electronic Health Records: August 5, 2010; 363:501-504 DOI: 10.1056/NEJMp1006114

Finkelman,A.,(2016).Leadership and management for Nurses: Core Competencies for Quality Care,(3rd ed.) Pearson

Sample Answer 4 for NR 451 Week 6: Implementing Change Despite Resistance Discusssion

According to Lesson 6 Week 6: Strategies for Effective Change, “When the innovation moves from the pilot study stage to practice integration, careful education of affected healthcare professionals must take place. Preparing staff members for implementation of the innovation is similar to the education of personnel who took part in the pilot study. This education can and should take many forms. Again, you need the endorsement of the participants and those impacted by the change in order to ensure that the innovation is implemented successfully.All innovations will have some impact on the official policies and standards in the organization. It is important that the new policies or procedures are explicitly included in the official documents of the organization. In other words, innovation should not be just in practice but also institutionalized through official policy to ensure that the change in structure, process, or outcome will be maintained. Outcomes of projects are meant for incorporation into practice.”

There would be some expected resistance from the staff when implementing the planning from the Preplanning to Prevent Hospital Readmissions. The staff can always be resistance on changes in normal routine. The biggest resistance would come from the nursing staff, with the family training that is scheduled for them. This would be scheduled at the same time as the therapist family training and would be held for the nurses after the therapists. The nurses would resist about the times their session with family training is being scheduled. They will stated that this is in their medication passing times, or they do not have time today to do training, or they have already had this done, why is it needed again. The education with the patients and the families need to repeated so that the information is absorbed and this is what keeps the patient from readmission. 

According to Lawrence (1969), there are 5 ways to help with resistance, “1. A solution which has become increasingly popular for dealing with resistance to change is to get the people involved to “participate” in making the change. But as a practical matter “participation” as a device is not a good way for management to think about the problem. In fact, it may lead to trouble.

2. The key to the problem is to understand the true nature of resistance. Actually, what employees resist is usually not technical change but social change—the change in their human relationships that generally accompanies technical change.
3. Resistance is usually created because of certain blind spots and attitudes which staff specialists have as a result of their preoccupation with the technical aspects of new ideas.
4. Management can take concrete steps to deal constructively with these staff attitudes. The steps include emphasizing new standards of performance for staff specialists and encouraging them to think in different ways, as well as making use of the fact that signs of resistance can serve as a practical warning signal in directing and timing technological changes.
5. Top executives can also make their own efforts more effective at meetings of staff and operating groups where change is being discussed. They can do this by shifting their attention from the facts of schedules, technical details, work assignments, and so forth, to what the discussion of these items indicates in regard to developing resistance and receptiveness to change.”

After finding these recommendations I would look towards the charge nurse in the stakeholders for more assistances with having the nurses input toward these changes in my project. Also receive their input about the social changes that this will cause,and also clarify any questions or concerns they have with the project. The nurses will need encouragement to think in a way that was not done before to complete the steps of the new model/project to preplan. And then have follow up meeting with the staff after the project is started to get their input on the changes and what they believe would help make the project better on the second rotation of the project. 

References:

Lawrence, Paul R. (1969, January). How to deal with Resistance. Harvard Buisness Review.Received from https://hbr.org/1969/01/how-to-deal-with-resistance-to-change.

NR 451 Week 6: Implementing Change Despite Resistance Discussion 

Change in any setting is difficult, we go through changes every day, new laws, new way of doing things, new technology and so forth.  Some embrace change as inevitable and others just refuse to change.  My mother is an avid reader and has literally hundreds of books, trust me I know I have moved her twice in the past 10 years and know all the books she has.  I bought my mother a nook several years ago and taught her how to use it.  Instead of embracing this new-found way of reading thousands of books that are stored in one place, she chose to hide the nook and claim it was lost.  Recently she started having trouble with her eye site and could not read regular print books so I searched her apartment and found the nook, I charged it and set the font to large type and re-oriented her to its use.  Again, she stashed it away saying it would not charge.  Now I know that was not true, she just will not change to use of new technology, she will not learn to use a computer or tablet, she has no interest in doing that.  Change scares her and that is the bottom line. As nurses, we are a lot like my mother, afraid of change, and this fear holds us back in our practice and in safe quality care and positive outcomes for our patients.   
 
There are several major barriers to the advancement of EBP which would bring about change in nursing.  These include: 

• Lack of knowledge and skill 

• Low comfort level with search techniques 

• Perceived lack of time-REAL LACK OF TIME 

• Challenges with critically appraising research 

• Lack of organizational/administrative support 

• Educational programs that continue to teach research the “traditional way” with focus on producing instead of using evidence 

• Negative attitudes-skeptics and fear 

I had one negative encounter with implementation of change early after I earned my masters’ degree.  My barrier with leadership and their lack of knowledge and insecurity with staff effecting change.  I was basically told after my presentation of my idea for change that I was hired as a staff nurse and nothing more.  Their insecurity with staff effecting change that could improve patient outcomes along with their lack of knowledge in nursing research became the barriers to positive patient outcomes.  In the past year, the culture at that facility has changed and nursing research that includes the staff has been implemented.  
 
Tell the class about the barriers you may encounter in your practice if you were to attempt to implement a change?  It could be from staff or leadership or both.   
 
Feeg, D. V., Suny Downstate Medical Center Department of Nursing , Nursing Research and Evidence-Based Practice  
     Conference, May 26, 2010; Strategies for Overcoming Barriers in Implementing Evidence-Based Practice; retrieved from 
     http://www.downstate.edu/icl/Feeg-Downstate2010Presentation-BarrierstoEBP.pdf