Elements of Change

Case Study, Learning Unit 6: Change Theory and Elements of Change
As a new nurse leader, you have decided that you would like to make changes to the procedure for end of shift report because you have received several complaints that the report is time-consuming and causes frustration among the staff members, and many of the staff have asked you to consider revising the current method.

You inform the charge nurses that you would like to have a meeting regarding this change, and you would like their input. One of the charge nurses states, “Why fix something that isn’t broken? I really don’t have time for this. I’ve worked here longer than you. Don’t you think we would have changed it before you got here?” The charge nurse walks away.

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Related question #1

What do you feel may be at the root of her resistance?

Related question #2

What can you do to lower this resistance?

Related question #3

When designing this change, what questions should you be asking yourself?

Unfolding Case Study, Learning Unit 6: Change Theory and Elements of Change

(Based on case in Module 6.2)

Part I

Derek decided that he wanted his staff at the same-day surgery facility to start an evidence-based article club. He thought it would be brilliant if all the nurses could conduct research, exchange evidence-based studies, and discuss the findings on a monthly basis. Derek cares a lot about the community and was sure this was a great idea!

Derek told the staff nurses that this would be mandatory. He also informed all staff members that they must meet the first Friday of every month from 1800 to 1900 because the unit closes at 1730 on Fridays. Derek held the first mandatory club meeting, and he was astonished that less than 20% of the staff attended. Derek is extremely upset and is about to cancel the club.
Derek decides that since the journal club is unsuccessful, a web-based journal club might be the answer.

Related question #1

How should Derek facilitate the change process if he wants the web-based journal club to be successful?

Related question #2
Why do you think that Derek is so persistent in implementing this type of change?

Part II

Derek understands the importance of professional development in relation to evidence-based practice. Nurses are lifelong learners and should engage in professional education to stay current in nursing practice.

Derek pilots the journal club discussion board he created over a 6-week period. He educates the staff on how to navigate to the website. He asks them to read one of the journal articles he posted and respond via the discussion board. He gives the staff 6 weeks to complete their one discussion. Derek created an online survey for the staff to complete after they have finished their practice session. The survey will provide him with valuable information about their web-based journal experience. He is surprised that the survey results are mostly positive.

Related question #3

What actions did Derek take that may have led to a high possible response rate?

Related question #4

As a nurse leader, how would you implement a journal club? Do you feel it would be worth your time and effort? Identify obstacles or challenges you may face when implementing this type of change.

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