exam 2: nurse as a change agent Flashcards
what is the goal of a nurse as a change agent
improve the quality of healthcare
nurse’s role in change
witness first-hand
work towards making the change
why does resistance to change occur
fear of the unknown, keep tradition, personal security threatened
what are some skills of effective change agents
patience, assertiveness, charisma
lewin’s force field model
behavioral approach; Change agents promote unfreezing, moving, refreezing steps throughout process
goal of lewin’s model
analyze restraining and driving forces and shift balance to support change
restraining force
elements that hinder change
driving force
elements that support change
unfreezing
Destabilizing the system, disconfirmation, guilt + anxiety
changing
Change put into place, new equilibrium, new info + behaviors
where do you start seeing road bumps in lewin’s model
changing phase
refreezing
Stabilizing the system, integrating change for regular function
where should you start reinforcement in lewin’s model
refreezing
lippit’s phases of change
ext of lewins, emphasis on COMMUNICATION
havelock’s model
modified lewins, emphasis on PARTICIPATIVE APPROACH
roger’s diffusion of innovation theory
broader than lewins, emphasis on PASSING FROM FIRST KNOWLEDGE TO CONFIRMATION/REJECTION
what is the adoption curve
spectrum that shows groups of people based on their role and ability in change
what are the 5 parts of the adoption curve
Innovator (2.5%), Early Adopter (12.5%), Early Majority (34%), Late Majority (34%), Laggerts
kotter’s model
more specific than lewins, ID lessons from organizations that were successful or failed
what are the steps of the change process
- ID problem
- collect data
- analyze data
- planning
- ID supporters and opps
- implement plan
- evaluate
what are the strategies for change agents (3)
power coercive
empirical ratoinal
normative re-educative
power coercive
- ex?
application of power by legitimate authority, economic, sanctions, or political clout
- ex: affordable care act
empirical rational
- ex?
power ingredient is KNOWLEDGE; people will follow if rational and self-interest is clear
- ex: education by charge nurse on how to use new pumps
normative re-educative
- ex?
people act in accordance with social norms and values, collaboration
- ex: nurse who is great in cultural competency
change
inevitable shift of process d/t environment, people, or situations
change agent
one who works to bring about change
transitions
periods of time between current situation and the time when change is implemented, good time to act
