DNP 805 Topic 1 DQ 2 Select one informatics theory from the areas of Communication Theories, Change Theories, or Human Factors
DNP 805 Topic 1 DQ 2 Select one informatics theory from the areas of Communication Theories, Change Theories, or Human Factors
DNP 805 Topic 1 DQ 2 Select one informatics theory from the areas of Communication Theories, Change Theories, or Human Factors
Topic 1 DQ 2
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Select one informatics theory from the areas of Communication Theories, Change Theories, or Human Factors. Discuss how the application of the theory you select can guide the use of technology in advanced practice. What strengths does the theory possess that would make it useful to the DNP-prepared nurse? What weaknesses does the theory present that might prevent its use? Keep in mind the Christian worldview when preparing your submission.
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REPLY TO DISCUSSION
The study of human factor theory focuses on human interaction with equipment within an organization with the goal of increasing safety and satisfaction. Example: Theories on accident causation demonstrate that accidents can be caused by chains of human errors. Factors that can lead to human errors include lack of experience on how to do the job (Chung & Williamson, 2018).
Reference
Chung, A. Z. Q., Williamson, A. (2018). Theory versus practice in the human factors and ergonomics discipline: Trends in journal publications from 1960 to 2010 Academic Journal In Applied Ergonomics. 66:41-51. DOI: 10.1016/j.apergo.2017.07.003,
REPLY
Unfreezing, moving or transitioning, and refreezing are the three processes in Kurt Lewin’s Theory of Planned Change. The first stage, unfreezing, involves acknowledging that change is required and that the equilibrium will be disrupted (Chen, 2021). The initial stage is the most difficult and time-consuming because restraining factors might prevent the change from progressing (Chen, 2021). A great example would be introducing the electronic health record. During the first stage, the old ways such as paper charge would be let go. Unfreezing the necessity for the change to be discussed in dialogues and through educational sessions. The second phase is moving or transitioning. This phase necessitates a clear action plan and may create anxiety and worry (Chen, 2021). During this phase, it would be critical to work with the stakeholders (Daly, 2017). For instance, if a facility were to transition to electronic health records versus paper charting, this step is crucial as it enables the analysis of the present situation, new structures, and other processes that are put into place to attain the desired outcome (Daly, 2017). The last stage is refreezing, during which it is critical to reinforce and incorporate the change while also conducting an efficacy audit (Daly, 2017). The change is stabilized at this point, and a new equilibrium is established (Chen, 2021). In other words, the changes made are frozen in place and become part of the normal workflow. One of the strengths of Lewin’s change model is that it is simple for others to understand. Unfreezing, transition and refreezing are easy steps to follow when implementing a change within an organization (Daly, 2017). Although its simplicity is its strength, it can also be a downfall. Some changes need a more detailed process other than just unfreezing, transitioning, and refreezing (Chen, 2021).
References:
Chen, P. (2021). A new horizon: Transitioning from an experienced to novice nurse. Journal of Radiology Nursing, 40(4), 368–369. https://doi-org.lopes.idm.oclc.org/10.1016/j.jradnu.2021.08.007
Daly, S. (2017). Development and implementation of person-centered nursing documentation. International Journal of Integrated Care (IJIC), 17, 1–3.
REPLY
Thank you for your interesting post. Healthcare system is constantly changing and evolving. Changes can be challenging because they
contradict humans’ basic need for a stable environment and sometimes when you’re used to it already you don’t want to start a new one. The advent of New Public Management (NPM) has challenged the traditional professional dominance, introducing a logic of managerialism into health care, i.e. work should be organized and controlled by managers to achieve organizational goals of a cost-effective and efficient health care. Clinicians are expected to document their work accurately and participate in any advancement given by the management team.
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Reference:
Rafferty AE, Jimmieson NL. Subjective perceptions of organizational change and employee resistance to change: direct and mediated relationships with employee well-being. Br J Manage. 2017;28:248–264. doi: 10.1111/1467-8551.12200. [CrossRef] [Google Scholar]
REPLY
Very well done. I like the way you break down and apply Lewin’s Theory. Acknowledgment that changes need to happen, transitioning to the new technology, and stabilization of new technology. This theory is good and works to explain the change. In comparison to the Human Factor theory, the main thing to consider when implementing healthcare technology is to remember the people who actually use the programs/system. (Matthews & Proctor, 2021). In my experience as a nurse clinical and nonclinical, programs that have stakeholder support at the onset of change are most successful. Another factor when in the various stages is to ensure that staff that will be working with the change are instrumental from the beginning.
Matthews, S. D., & Proctor, M. D. (2021). Public Health Informatics, Human Factors and the End-Users. Health Services Research and Managerial Epidemiology. https://doi.org/10.1177/23333928211012226
REPLY
Hello,
I completely agree with you that the first step is unfreezing is the most difficult stage, but I would also add that it is arguably the most important step. This step is vital in setting the foundation for a successful change. This step is really about breaking the status quo (el-shafy et al., 2020). This starts the momentum for the change. While it is challenging as you mentioned, it is worth the effort that it takes.
Reference
el-shafy, I. A., Zapke, J., Sargeant, D., Prince, J. M., & Christopherson, N. A. M. (2019). Decreased Pediatric Trauma Length of Stay and Improved Disposition With Implementation of Lewin’s Change Model. Journal of Trauma Nursing, 26(2), 84–88. https://doi-org.lopes.idm.oclc.org/10.1097/JTN.0000000000000426
REPLY
Kotter’s change theory goes thru a series of eight steps on how to effectively prepare the team for change and to be adaptable to the change (Carpenter et al., 2021). This theory can be instrumental in the success of using technology in advanced practice. Without setting the environment for change. One example is how the change theory was used to in a healthcare system wide practice of primary care to reduce the overall amount of opioid prescriptions among patients with chronic pain. It was vital in starting and sustaining a change long term (Carpenter et al., 2021).
This theory really provide a solid framework with eight steps to follow for a sustainable change. It guides step by step how to prepare for the change, get buy in, and the solidify the change. This is easily used an any change planning. It is apparent that this would be successful in change implementation. This theory is so important because without the foundation work then it will not likely result in a lasting transformational change. The step that I find the most important to not miss is the development of short term wins. It is sometimes overlooked and can lead to discouragement resulting in and reverting to old practices. There are not any identified weaknesses to this theory. It is an excellent foundation to be used when planning an implementation of change.
Kotter’s change theory goes thru a series of eight steps on how to effectively prepare the team for change and to be adaptable to the change (Carpenter et al., 2021). This theory can be instrumental in the success of using technology in advanced practice. Without setting the environment for change. One example is how the change theory was used to in a healthcare system wide practice of primary care to reduce the overall amount of opioid prescriptions among patients with chronic pain. It was vital in starting and sustaining a change long term (Carpenter et al., 2021).
This theory really provide a solid framework with eight steps to follow for a sustainable change. It guides step by step how to prepare for the change, get buy in, and the solidify the change. This is easily used an any change planning. It is apparent that this would be successful in change implementation. This theory is so important because without the foundation work then it will not likely result in a lasting transformational change. The step that I find the most important to not miss is the development of short term wins. It is sometimes overlooked and can lead to discouragement resulting in and reverting to old practices. There are not any identified weaknesses to this theory. It is an excellent foundation to be used when planning an implementation of change.
References
Carpenter, R. E., Silberman, D., & Takemoto, J. K. (2021). Transforming prescription opioid practices in primary care with change theory. Health Services Insights, 14, 117863292110582. https://doi.org/10.1177/11786329211058283
Kurt Lewin developed Lewins Change Theory which had a three-phase model “that requires prior learning to be rejected and replaced” (Petiprin, 2020). The first stage of the change theory is unfreezing in which a person develops a method to assist in changing and redirecting an old process. This step may be challenging as individual resistance and conformity is difficult to attain. The second stage is change in which is a moving process that involves one’s feelings, behaviors, and thoughts. Lastly, the third stage is refreezing in which this change is now established as a new process and standard procedure. A person may be challenged to return to a past process if the refreezing stage is incomplete (Petiprin, 2020).
Change in an organization is crucial in order to apply evidence-based improvements for quality and safe patient care. Hussain et.al (2018) utilized Lewins Change Model for organizational change with employee involvement, knowledge sharing, leadership involvement and then the implementation of change. The study found that change can be highly encouraged by rewards, recognitions and using a transformational leadership approach along with the change model (Hussain et.al, 2018).
This theory has guided and can continue to guide change in practice with the number of technological developments occurring. Currently, there are multiple institutions transitioning into electronic health medical record. The most used EMR system is EPIC. The organization I work for transitioned to EPIC in 2011. During this transition, the unfreezing stage was extremely challenging for many staff members. The staff that worked in the organization for years and were accustomed to paper documentation refused to learn the electronic health system and comply with a new alternative. As an epic-super user, I had one-on-on interactions with the staff members to listen to their thoughts, gain their confidence and review documentation requirements at intervals to gain their trust and momentum into agreeing with the change. Today, most staff members do not recall the process of paper documentation and when the EMR system has downtime the departments tend to be extremely anxious.
The challenging aspect of the theory is ensuring a process does go into a standard procedure as many people would reflect to a previous process. Continuing education, evaluations and process reflections are needed when a change is implemented and throughout subsequent years to ensure the change continues to be feasible.
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
Petripin, A. (2020, July 19). Lewin’s change theory. Nursing Theory. Retrieved April 17, 2022, from https://nursing-theory.org/theories-and-models/lewin-change-theory.php