DNP-835 Quality and Sustainability Paper: Part 2

Grand Canyon University DNP-835 Quality and Sustainability Paper: Part 2  – Step-By-Step Guide

This guide will demonstrate how to complete the Grand Canyon University DNP-835 Quality and Sustainability Paper: Part 2  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 DNP-835 Quality and Sustainability Paper: Part 2          

Whether one passes or fails an academic assignment such as the Grand Canyon University DNP-835 Quality and Sustainability Paper: Part 2  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 DNP-835 Quality and Sustainability Paper: Part 2          

The introduction for the Grand Canyon University DNP-835 Quality and Sustainability Paper: Part 2    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 DNP-835 Quality and Sustainability Paper: Part 2          

After the introduction, move into the main part of the DNP-835 Quality and Sustainability Paper: Part 2     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 DNP-835 Quality and Sustainability Paper: Part 2          

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 DNP-835 Quality and Sustainability Paper: Part 2          

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 DNP-835 Quality and Sustainability Paper: Part 2

Improved and better patient care outcomes entail the major focus of healthcare sectors and nurses. As such, nurses engage in various activities which enhance patient outcomes by improving patient care services and ensuring patient safety in the patient care environment. However, various events in hospitals and other patient care environments threaten patient safety hence the potential for patient harm (Lawati et al.,2018). As such, quality improvement and patient safety programs are used to solve such problems and improve outcomes. In the previous weeks, a healthcare entity/issue was identified and explored. In addition, a suitable solution was identified. Therefore, the purpose of this assignment is to determine the requirements for promoting a successful implementation and sustainability of the quality program.

Evaluation of The Current Evidence-Based Quality Program Designs That Can Be Implemented to Improve the Quality Outcomes

The identified quality or safety issue in the organization of choice is catheter-associated urinary tract infections (CAUTI).  CAUTIs form part of the nosocomial infections in healthcare settings which have been associated with various adverse impacts, such as enhanced rates of mortality and morbidity in the US. The majority of urinary tract infections are related to catheter use which further increases in case of prolonged use of urinary catheters. CAUTIs have been connected with higher healthcare costs and prolonged hospitalizations, hence a need to control them (Russell & Watters, 2019).

The adverse outcomes of CAUTI have led to sustained research on finding strategies that can be implemented to improve quality. One of the current EBP-based strategies is the use of nurse-driven protocols for removing indwelling urinary catheters. Such interventions involve data collection regarding catheter use, which then informs the nurses to immediately remove the urinary catheters when they are no longer needed by the patients (Zurmehly, 2018). A related intervention is the use of a hospital-wide policy on indwelling urinary catheter insertion can care. Such policies require that the nurses get trained as appropriate on how to insert the catheters appropriately and how to care for the patients when they use the indwelling catheters. The other aspect is the use of external catheters, which catheters to minimize the chances of infections. One of the most current and common strategies is the use of a CAUTI care bundle (Fritsch et al.,2019). Such care bundles contain a collection of activities geared towards reducing the rates of CAUTI. For example, a bundle may consist of using the right and recommended catheter insertion techniques, prompt removal of catheters when not needed, removal techniques, appropriate use of drainage system, and staff education, among others.

From the evaluation of the current EBP strategies, the proposed strategy for the quality improvement project is the use of the CAUTI bundle. Recent research has shown that the use of a CAUTI bundle care has a greater impact as compared to the use of a single intervention approach. Currently, the facility is using a bundle care approach with three major activities including a catheter removal protocol, an electronic checklist, and staff education. However, such an approach can be enhanced by including more activities in the care bundle. Therefore, a 5-Step care bundle is proposed. This 5-Step bundle includes various activities such as consistent staff education, the stabilization of the bladder catheter, offering patient and caregiver education, and ensuring that the collection bag is kept below the bladder and above the flow. The other activity is conducting a daily evaluation for discontinuation (Elkbuli et al.,2018).

The proposed 5-Step care bundles include more activities or action items to be used in ensuring that CAUTI rates are reduced. In place of the current three items or activities carried out in the facility, the new proposal will see an implementation of a five-step care bundle to help improve the care outcomes (Elkbuli et al.,2018). The implication is that the proposed intervention is likely to have a greater impact on CAUTI-related patient outcomes as compared to the current intervention. The nurses will be at the center stage of the intervention since they offer primary or basic care to patients who use indwelling urinary catheters.

Potential Obstacles and Ways to Overcome Them

Implementation of the proposed solution is envisioned to take the form of change efforts. Therefore, it is expected that various obstacles may exist. As such, there is a need to timeously come up with potential solutions which can be used to ensure that such obstacles are overcome. One of the expected obstacles is resistance to the proposed change (Mathieson et al.,2019). As earlier indicated, the change involves implementing the use of a five-step bundle involving additional care activities. Therefore, there is a possibility of nursing staff resisting the change for fear of having to follow increased protocols. Such a fear is understandable and the nurses should be involved in coming up with appropriate interventions. One way of overcoming such an obstacle is engaging the nurses from the onset of the program and assuring them that supporting mechanisms will be put in place to help them adapt to the demands of the new intervention.

Another potential barrier is financial constraints. The implementation of the five-step bundle may require additional financial resources, which have to be procured before implementation. In a case scenario where the financial resources are limited, then the success of the project may be compromised. The next potential barrier is the lack of sufficient support from the organization’s leaders (Mathieson et al.,2019). The success of the project heavily hinges on appropriate support from the organization’s leaders. However, a lack of support may be detrimental to the project’s success. This challenge can be overcome by aligning the project’s objectives with the organization’s vision and mission. Such a step will make the leaders have more interest in the proposed project hence better chances of success.

The Stakeholders For Collaboration

Stakeholders form an important part of a project and therefore, they should be identified in time, and if possible, meetings are conducted together with them. In addition, such meetings can also be used to assign roles and responsibilities (Dang et al.,2021). One of the stakeholders considered for the project and collaboration is the nurses offering care to the patients using indwelling urinary catheters. Nurses are at the forefront of catheterization and the removal of indwelling urinary catheters when they are no longer in use. As such, as part of the identified stakeholders, the nurses will be responsible for implementing the proposed change. The implication is that they will be at the center stage of the implementation of the five-step CAUTI care bundle.

 There are various leaders among nurses as part of the stakeholders. Among them are the nurse leaders who will be responsible for coordinating the implementation of the program and acting as a link between other staff members and the organization’s leaders (Dang et al.,2021). The unit leaders are also regarded as part of the nurse leaders as they will be responsible for availing the resources needed for implementing the project in every unit.

The other group of stakeholders is the physicians. Physicians are responsible for the treatment of various patients using indwelling urinary catheters. It will be key to collaborate with them since they are the ones who usually recommend the use of indwelling catheters and when to remove them (Dang et al.,2021). Collaboration with them will enhance nurses’ ability to identify when a patient needs to use indwelling catheters and when a patient doesn’t need any. In addition, such a collaboration will also be key to enhancing nurses’ knowledge regarding when to remove the indwelling urinary catheters, especially when the patient no longer needs the catheter. Minimization of the use of indwelling urinary catheters is part of the 5-step bundle hence it will help in reducing the incidences of CAUTI, which is one of the major aims.

The other group of stakeholders is the patients and their family members. Patients admitted to the facility for treatment and using indwelling urinary catheters. These are individuals who will receive the benefits of the program since the use of a five-step bundle will ensure that there is appropriate bundle care such as prompt removal and appropriate insertion of the catheter. The patient family members also form part of the stakeholders as they also stand to benefit (Dang et al.,2021). They are likely to spend fewer funds on the patients as incidences such as prolonged hospital stays will be reduced.

The Change Management Theory to be Used In the Implementation of the Program

Implementation of quality/safety improvement or evidence-based practice projects requires carefully formulated plans to accomplish. It is important to note that the implementation of such programs usually involves a change process. Implementing a change process or a change program requires the use of appropriate strategies since human beings are prone to resisting change since, in most cases, people prefer that things remain the way they are (Hussain et al.,2018). Therefore, for such a project to succeed, the change should appropriately be managed using change theories. Change theories offer frameworks upon which change efforts can be based and implemented. Using various theories, change can be implemented successfully by ensuring that all the stakeholders are part of the change and that they are supporting the change.

The proposed change management theory to be implemented for this project is Lewin’s change theory. This theory has widely been applied in various sectors such as healthcare to implement and manage various change initiatives. According to Lewin, change takes place in three stages or phases. The phases include unfreezing, change, and refreezing. While the phases may overlap with each other, each phase has distinct activities associated with it. According to this theory, there are forces that impact change, the driving force and restraining force (Hussain et al.,2018). While the driving force supports and enhances change, restraining forces are those forces that prevent change from taking place. As such, a change can only happen when the driving forces overcome the restraining forces.

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The unfreezing phase entails letting the stakeholders know the need to undertake a change initiative. At this stage, the change implementers create an urgent need for change implementation by letting the stakeholders know the impact of an identified problem and how it is impacting patient outcomes (Hussain et al.,2018). Therefore, the stakeholders will be informed of the need to reduce the CAUTI rates by using statistics showing the upward trends in the rates of CAUTI. Communication is key in this phase as all the stakeholders should be informed of the importance and the potential benefits of implementing the five-step bundle to control and reduce the rates of CAUTI. It is also important to create awareness and motivate individuals to be part of the change process.

The second phase is the change phase. It commences when individuals have been convinced that a change is necessary and they are ready to move (Crosby, 2020). Therefore, at this stage, the proposed intervention is implemented; in the case of this project, the five-stage CAUTI care bundle is implemented in the patient care setting to help improve patient outcomes. Since individuals may struggle with the new reality, it is important that communication remains strong. Individuals also learn new ways of thinking, processes, and new behaviors. In this project, the nursing staff will also be trained on the use of the proposed five-step CAUTI care bundle so that they become more familiar with the impending change. It is important to note that constant communication and explanation of the reasons behind making the change are key. The stakeholders are also reminded of the potential benefits of the CAUTI care bundle once the whole project has been implemented.

The last phase of change is the refreezing stage. This is the final stage of change management and is characterized by stabilizing, reinforcing, and solidifying the implemented change. The implication is that the implemented change forms part of the organization’s culture, structure, goals, and processes (Crosby, 2020). This phase is key since it is used to ensure that the staff does not revert to the old ways of doing things and ways of thinking. This phase is also characterized by acknowledging and rewarding individualized efforts made toward reinforcing the implemented change. The implemented change of the five-step CAUTI care bundle will form part of the organization’s culture and it will be used as daily care for patients who use the indwelling urinary catheters.

The Expected Outcomes and Ways of Sustaining the Expected Outcomes

As earlier highlighted, the facility has been observing an upsurge of CAUTIs hence poorer patient outcomes. As such, the use of five stages CAUTI care bundle has been proposed to help reduce the rates of CAUTI and prevent the potential occurrence of new cases (Davies et al.,2018). Therefore, it is important to identify potential outcomes and ways of sustaining the expected outcomes. One of the expected outcomes is reduced rates of CAUTI. It is expected that upon the implementation of the proposed five-step CAUTI care bundle, the organization will experience a 50% reduction in the rates of CAUTI and ensure that patients have improved outcomes.

The next expected projected outcome is the increased knowledge and efficiency of using the five-step CAUTI bundle among the nurses caring for the patient using the indwelling urinary catheters. As part of the project, the nurses are to be trained on how to use the proposed bundle (Davies et al.,2018). Such will be accomplished through an education session involving every staff member participating in offering care for patients using indwelling urinary catheters. It is expected that the nurses will have improved knowledge regarding when to use the indwelling catheters and when to remove them so that patients do not get an infection.

It is also expected that the organization will adopt the new intervention and use it as an organization-wide strategy to help reduce the rates of CAUTI cases and improve patient outcomes. The project’s results will be used to inform the organization of the next step. For example, if the results are found to be positive, then the organization will adopt the five-step CAUTI care bundle as a new patient care strategy in the organization. It is important to ensure the sustainability of the project outcomes (Davies et al.,2018). Therefore, there is a need to use effective strategies. One of the strategies is evaluation and monitoring to ensure that the nurses are following the laid down protocols and guidelines for the care bundle. Frequent staff training will be used to ensure that the staff is up to date with the current methods of CAUTI prevention.

Conclusion

Quality improvement projects are important and can be used in improving patient outcomes. Therefore, it is important to formulate an appropriate quality improvement initiative depending on the identified clinical problem. The identified problem in this project is catheter-associated urinary tract infections which have been shown to negatively impact patient outcomes. Even though the organization has been trying various strategies to reduce the rates of infection, such rates are still high. As such, the use of a five-step CAUTI care bundle has been proposed. It is expected that upon the implementation of the CAUTI care bundle, the rates of CAUTI in the organization will reduce substantially.

References

Crosby, G. (2020). Planned change: Why Kurt Lewin’s social science is still best practice for business results, change management, and human progress. Productivity Press.

Dang, D., Dearholt, S. L., Bissett, K., Ascenzi, J., & Whalen, M. (2021). Johns Hopkins evidence-based practice for nurses and healthcare professionals: Model and guidelines. Sigma Theta Tau.

Davies, P. E., Daley, M. J., Hecht, J., Hobbs, A., Burger, C., Watkins, L., … & Brown, C. V. (2018). Effectiveness of a bundled approach to reduce urinary catheters and infection rates in trauma patients. American Journal of Infection Control, 46(7), 758-763. https://doi.org/10.1016/j.ajic.2017.11.032

Elkbuli, A., Miller, A., Boneva, D., Puyana, S., Bernal, E., Hai, S., & McKenney, M. (2018). Targeting catheter-associated urinary tract infections in a trauma population: a 5-S bundle preventive approach. Journal of Trauma Nursing| JTN, 25(6), 366-373. Doi: 10.1097/JTN.0000000000000403

Fritsch, P. F., Sutton, J., Roche, E., Berberi, V., Whidden, E., & Holder, C. (2019). Reinforcing a catheter-associated urinary tract infection (CAUTI) bundle compliance decreases overall catheter days and CAUTIs. American Journal of Infection Control, 47(6), S22. https://doi.org/10.1016/j.ajic.2019.04.035

Hussain, S. T., Lei, S., Akram, T., Haider, M. J., Hussain, S. H., & Ali, M. (2018). 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), 123-127.

Lawati, M. H. A., Dennis, S., Short, S. D., & Abdulhadi, N. N. (2018). Patient safety and safety culture in primary health care: a systematic review. BMC Family Practice, 19(1), 1-12. https://doi.org/10.1186/s12875-018-0793-7

Mathieson, A., Grande, G., & Luker, K. (2019). Strategies, facilitators and barriers to implementation of evidence-based practice in community nursing: a systematic mixed-studies review and qualitative synthesis. Primary Health Care Research & Development, 20, e6. Doi: 10.1017/S1463423618000488

Russell, J. A., & Watters, R. (2019). Implementation of a nurse-driven CAUTI prevention algorithm. Nursing Clinics, 54(1), 81-96. https://doi.org/10.1016/j.cnur.2018.11.001

Zurmehly, J. (2018). Implementing a nurse-driven protocol to reduce catheter-associated urinary tract infections in a long-term acute care hospital. The Journal of Continuing Education in Nursing, 49(8), 372-377. https://doi.org/10.3928/00220124-20180718-08

Sample Answer 2 for DNP-835 Quality and Sustainability Paper: Part 2

Individuals and communities encounter health problems varying in severity, type, and required interventions. Despite their health condition, patients visit health care facilities looking forward to comprehensive treatment and support that facilitate holistic healing. As a result, health care organizations and staff should be adequately prepared and resourced to address patient needs. Their ability varies with resources, specialization areas, and the complexity of illnesses. Although it is a universal obligation to provide high-quality and safe care, health care professionals’ capacity is often hampered by their wellness (Søvold et al., 2021). The implication is that health care staff should be physically, mentally, and emotionally optimal to provide patient-centered care. The purpose of this paper is to discuss an appropriate program for addressing a quality and safety issue based on a change management theory.

Proposed Evidence-Based Quality and/or Safety Program

Quality and safety issues vary across health care facilities, necessitating different interventions. In the reference health care facility (IHC), nurse burnout is the main issue hampering care quality and patient safety. According to Ryu and Shim (2021), a nursing shortage is the primary cause of nurse burnout since it increases nurses’ emotional, mental, and physical fatigue. Situations that increase the routine workload are also to blame for the increased rates of nurse burnout in health care facilities. While evaluating such situations and their implications in nursing practice, Krebs (2021) noted that nurse burnout has intensified since the COVID-19 outbreak due to the increased emotional and mental drain facing frontline workers. The impacts are severe hence the need for effective, evidence-based, and sustainable solutions.

From a health care perspective, quality and safety programs for enhancing outcomes at IHC should be multifaceted due to the multilayered nature of the problems. Regarding nurse burnout, intervention programs vary in goals, the severity of the problem, and projected outcomes. Organizational resources and the ability to sustain quality improvement programs determine the choice. Appropriate programs for nurse burnout include self-care opportunities, resilience training, and leadership support. Roux and Benita (2020) underlined the importance of self-care in addressing nurse burnout and recommended a holistic program. In this case, self-care should include physical, inner, and social self-care. Like self-care, resilience programs and leadership support help nurses cope with workplace stressors. Overall, their effectiveness depends on nurses’ participation and the intensity of burnout.

Program Selection

Among these programs and others, a comprehensive mental wellness program that focuses on resilience building is the most effective. In agreement with Søvold et al. (2021), nurses should be optimally healthy to diagnose and treat patients according to patient needs. The implication is that nurses’ ability to provide patient-centered care is determined by their mental wellness. However, optimal mental health is not the only requirement for nurses’ optimal performance. The current workplace also requires resilient nurses to cope with workplace stressors. According to Zhai et al. (2021), resilience building improves nurses’ resilience, improving their ability to cope with workplace stress and depression by improving their physical and emotional well-being. Improving nurses’ physical and emotional well-being is crucial to increasing their coping capacity, well-being, and preparedness to perform their everyday roles.

The comprehensive design of the mental wellness program will undoubtedly lead to better outcomes. Currently, IHC relies on a mental wellness program without the resilience aspect of responding to nurse burnout. The American Nurses Foundation (2022) reported that health care facilities design mental wellness programs to help nurses identify and reduce stress reactions before they develop into complex problems. A core component of such programs is assisting nurses in speaking about their experiences. This support can be provided by nurse leaders or mental health experts. The other vital component is providing nurses with anti-burnout resources. The proposed program will improve outcomes by improving nurses’ coping abilities at IHC. If the program is implemented effectively, it will ensure that the nursing staff is mentally, emotionally, and physically healthy to work happily and resiliently.

Potential Obstacles and Interventions

Quality and safety improvement programs encounter different obstacles depending on the designs, implementation timelines, and engagement level. A potential problem that may hinder the implementation of the mental wellness and resilience program is resources. Like other health care facilities, IHC operates on a budget. Therefore, introducing a program that consumes massive organizational resources may affect the implementation of other programs. Anti-burnout resources, resilience training, and the program’s sustainability require adequate financial support. Such support may not be available at IHC hence affecting the program’s implementation and timeliness. The other potential obstacle is the availability of the nursing staff. To save resources and time, nurses should attend the resilience training program as one or several organized groups. However, their routine roles and engagement levels may affect such formations. Indeed, this is a key barrier that can affect the overall planning, program cost, implementation timelines, and evaluation.

An effective intervention to address the resource barrier is actively engaging the management and looking for external support. As a key stakeholder, organizational management should be actively involved in program implementation. In this case, leaders should understand the feasibility of a program to support it fully (Hussain et al., 2018). The best way to overcome the availability of the nursing staff is to modify or customize the resilience training to ensure that nurses must not attend it physically. For instance, they can be trained via Zoom meetings and other online means after work. Online facilitation can also save costs since its main resource requirement is an internet connection.

Stakeholders and their Roles

Program implementation requires a collaborative approach since the tasks involved are diverse and of different complexity levels. Stakeholders’ role is critical due to their (stakeholders) interest in organizational change and quality improvement. One of the stakeholder groups within IHC needed to implement the program is organizational management. According to Sharma (2021), organizational management dictates an organization’s values and culture. Similarly, IHC has management that makes key decisions and must be involved in program implementation. The other key stakeholder group is nurse leaders and departmental leaders. They lead unit-level changes, and they have a massive influence on decision-making. The last important group is the nursing staff. The program cannot be successfully implemented without their input and active participation.

The role of each group and the engagement level vary with organizational rank and ability to influence change. The primary role of the management in program implementation is to provide an appropriate climate for changes to occur and support quality improvement through resources (Sharma, 2021). Among the managerial staff at IHC, the human resource manager can oversee the program’s implementation and serve as the link between the nurses and the management. Nurse leaders assess the needs of patients and nurses; thus, they understand the types and scope of interventions required to address problems hampering outcomes. As a result, their role is to design the scope of wellness programs and training required to improve nurses’ coping ability at IHC. The role of nurses in program implementation is to participate and apply the knowledge for self-development.

Change Management Theory

Health care organizations should continually address their problems to achieve better outcomes. Change management is critical to organizational success, and change usually succeeds in organizations that embrace continuous quality improvement. Hussain et al. (2018) described change management as the continuous renewal of an organization’s direction, structure, and capacities to enable it to respond to the customers’ ever-changing internal and external needs. Since change occurs rapidly in the health care sector, organizations must respond at the same speed. Change theories provide a framework for implementing change and evaluating its outcomes (Hussain et al., 2018). They are designed to help organizational leaders and managers to drive change appropriately and plan for it using a structure for quick response to internal and external environmental forces.

Among many change management theories, Kurt Lewin’s change management theory is the most appropriate to use in implementing the mental wellness and resilience program. Lewin’s change theory includes three fundamental concepts: driving forces, restraining forces, and equilibrium (Petiprin, 2023). In organizational change, driving forces are the organizational elements that favor change; they push the organization in the direction that causes change. Restraining forces are organizational factors that hamper change by countering the driving forces (Hussain et al., 2018). A suitable example is a culture resistance to change. A state of equilibrium is achieved when the driving forces balance with the restraining forces implying that change no longer occurs.

Kurt Lewin proposed that change occurs in three steps. Vital in procedural change implementation, the steps include unfreezing, changing, and refreezing (Petiprin, 2023). In the unfreezing stage, change leaders focus on making people discard old patterns that were somehow counterproductive. In IHC, unfreezing should be primarily about doing away with the current program for nurse burnout and moving towards a more effective program. However, this can only be achieved after identifying and addressing barriers to change. Petiprin (2023) suggested that resistance to change and group conformity are common barriers to change in the unfreezing stage. Change leaders should understand their dimensions and implications and address them appropriately.

The chaning stage primarily entails moving to a new level. According to Petiprin (2023), the change stage is characterized by significant changes in thoughts, processes, and behaviors. In other words, the change phase involves moving the organization and people to a more liberating and productive phase. In IHC, successful change will be marked by adopting a comprehensive wellness program that includes resilience building. The refreezing stage is critical in organizational change since it helps to establish change as a new habit (Hussain et al., 2018). Similarly, the new program should be supported to become the standard operating procedure. Therefore, techniques to sustain the program should be identified and executed to foster sustainable change.

From a change perspective, Lewin’s change theory is the most effective for implementing the proposed program since it facilitates procedural change. It ensures that change occurs in steps and activities in each step are clearly outlined. Organizational change is also easy to implement using Lewin’s change management theory since change occurs in only three steps. Importantly, Lewin stresses sustainable change. Hailemariam et al. (2019) described sustainable change as one that achieves long-lasting outcomes. In the same lens, IHC should strive to achieve lasting change to enjoy its benefits for a long time.

Health care research supports change management through Lewin’s change theory for promoting nurses’ mental wellness and in implementing other programs. For effective program implementation and to model desired behaviors, health care professionals should be involved in critical processes. Similarly, health care staff should be involved when implementing the mental wellness and resilience program at IHC. Hussain et al. (2018) stressed a similar approach as stressed under Lewin’s change model. When nurses are actively involved in the unfreezing phase, the change and refreezing phases become easier since barriers to change are minimal. Sovold et al. (2021) also stressed the importance of nurses’ engagement in programs to improve their mental well-being, as underlined in Lewin’s change theory. Irrespective of the type and scope of a program, a theory-based approach is crucial to ensure there is a framework that outlines basic change implementation steps, outcome evaluation, and strategies for achieving sustainable change.

Expected Outcomes of the Program and Sustainability Approaches

Expected Outcomes of Program Implementation

Health care professionals’ overall health determines their productivity immensely. Optimizing nurses’ mental wellness and making them more resilient will help to improve their overall productivity. As Ryu and Shim (2021) observed, nurse burnout hampers nurses’ productivity since it affects their concentration and physicality to cope with the workload. In this case, helping nurses at IHC to identify and effectively respond to nurse burnout will help them to be more resilient and encounter fatigue. From a performance dimension, burnout prevention enhances job satisfaction. As a result, cases of absenteeism will reduce profoundly, and work loss associated with absenteeism will reduce proportionately.

Besides improving employee productivity, the mental wellness and resilience program will promote cost-effective care. Besides high-quality and safe care, health care organizations have a professional and ethical mandate to provide cost-effective care. One way of achieving cost-effective care is preventing events that increase medical costs, such as medical errors. As a barrier to patient safety, nurse burnout increases medical errors and turnover rates (Brooks Carthon et al., 2019; Kelly et al., 2021). Medical errors are costly since they increase health complications and hospitalizations. A high turnover rate increases replacement costs. Preventing nurse burnout can help to avoid or reduce costs associated with medical errors and nurse turnover.

Sustaining the Outcomes

The current workforce and nurses joining the profession should be adequately assisted to cope with nurse burnout. Sustaining intervention programs will help to achieve long-term gains in IHC. The first appropriate strategy for achieving the projected outcomes is to adopt the mental wellness and resilience program as an organizational policy. Through such a policy, the management can set aside funds for yearly training of nurses on mental wellness and resilience. The other appropriate intervention is continuous resource facilitation for nurses. For instance, anti-burnout resources are highly effective in enabling nurses to cope with workplace fatigue (American Nurses Foundation, 2022). Handouts, interaction forums, and mental health apps that enhance coping are appropriate resources for supporting nurses. The last strategy is nurse orientation. In this case, new nurses joining IHC should be adequately oriented into the organization. An effective orientation component is cognitive rehearsal training that helps nurses identify and respond to stressors such as workplace incivility (Kousha et al., 2022). Jointly, these interventions will help to achieve the positive outcomes associated with the program for a long time.

Conclusion

Health care professionals work in complex care environments with varying work demands. A high workload is detrimental to their performance, as witnessed in IHC. Accordingly, organizational managers, nurse leaders, and other change agents should design and implement effective programs for enhancing performance. As discussed in this paper, a mental wellness and resilience program would improve outcomes among nurses in IHC. Its projected outcomes are improved coping, high job satisfaction, and high nurses’ ability to provide cost-effective care. Lewin’s change theory is the most appropriate to implement the program. The theory stresses the importance of sustainable change achieved in three steps: unfreezing, changing, and refreezing.

References

American Nurses Foundation. (2022). United Health Foundation launches $3.1 million partnership with American Nurses Foundation to fight nurse burnout and attrition. https://www.nursingworld.org/news/news-releases/2022-news-releases/united-health-foundation-launches-$3.1-million-partnership-with-american-nurses-foundation-to-fight-nurse-burnout-and-attrition/

Brooks Carthon, J. M., Hatfield, L., Plover, C., Dierkes, A., Davis, L., Hedgeland, T., Sanders, A. M., Visco, F., Holland, S., Ballinghoff, J., Del Guidice, M., & Aiken, L. H. (2019). Association of nurse engagement and nurse staffing on patient safety. Journal of Nursing Care Quality, 34(1), 40–46. https://doi.org/10.1097/NCQ.0000000000000334

Hailemariam, M., Bustos, T., Montgomery, B., Barajas, R., Evans, L. B., & Drahota, A. (2019). Evidence-based intervention sustainability strategies: a systematic review. Implementation Science, 14(1), 1-12. https://doi.org/10.1186/s13012-019-0910-6

Hussain, S. T., Lei, S., Akram, T., Haider, M. J., Hussain, S. H., & Ali, M. (2018). 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), 123-127. https://doi.org/10.1016/j.jik.2016.07.002

Kelly, L. A., Gee, P. M., & Butler, R. J. (2021). Impact of nurse burnout on organizational and position turnover. Nursing Outlook, 69(1), 96–102. https://doi.org/10.1016/j.outlook.2020.06.008

Kousha, S., Shahrami, A., Forouzanfar, M. M., Sanaie, N., Atashzadeh-Shoorideh, F., & Skerrett, V. (2022). Effectiveness of educational intervention and cognitive rehearsal on perceived incivility among emergency nurses: a randomized controlled trial. BMC Nursing, 21(1), 1-9. https://doi.org/10.1186/s12912-022-00930-1

Krebs, N. (2021). Amid rising COVID-19 hospitalizations, nurses face increasing risk of burnout. Indiana Public Media. https://indianapublicmedia.org/news/amid-rising-covid-19-hospitalizations,-nurses-face-increasing-risk-of-burnout.php

Petiprin, A. (2023). Lewin’s change theory. Nursing Theory. https://nursing-theory.org/theories-and-models/lewin-change-theory.php

Roux, N., & Benita, T. (2020). Best practices for burnout self-care. Nursing Management, 51(10), 30-35. doi: 10.1097/01.NUMA.0000698116.82355.0d

Ryu, I. S., & Shim, J. (2021). The influence of burnout on patient safety management activities of shift nurses: the mediating effect of compassion satisfaction. International Journal of Environmental Research and Public Health, 18(22), 12210.

Sharma, F. C. (2021). Organizational behavior. SBPD Publications.

Søvold, L. E., Naslund, J. A., Kousoulis, A. A., Saxena, S., Qoronfleh, M. W., Grobler, C., & Münter, L. (2021). Prioritizing the mental health and well-being of healthcare workers: an urgent global public health priority. Frontiers in Public Health, 9, 679397. https://doi.org/10.3389/fpubh.2021.679397

Zhai, X., Ren, L. N., Liu, Y., Liu, C. J., Su, X. G., & Feng, B. E. (2021). Resilience training for nurses: a meta-analysis. Journal of Hospice & Palliative Nursing, 23(6), 544-550. https://doi.org/10.1097/njh.0000000000000791