FP4012 Response Plan ESSAY

Response Plan for Inpatient Nephrology UnitThe primary driving force for change on the nephrology medical surgical unit is the lack of consistent documentation of intake/output and daily weights. This has resulted in extended hospital stays for patients. Change Theory for Nephrology MedicalIn evaluating the lack of care that has resulted in patients having extended hospital stays, it will be necessary to start this change process by “unfreezing”. According to the Lewin’s Theory of Change, “Unfreezing” is a method used to find a way to make it possible for people to let go of learned ways that have been counterproductive. This involves overcoming resistance (Shirey, M. R. 2013). In, this situation “unfreezing”, leadership will work with nursing staff to be more concerned with getting the clinical tasks done, rather than wanting to push the work onto the other shift. This will be done by finding the driving force that directs behavior away from the primary issue- lack of consistent intake and output, and daily weights. Analyzing the workload, staffing ratios, clinical best practices will be necessary. This information can be used to put together a protocol to drive the change and decrease the resistance from staff. I had a similar experience while working in family practice. Our clinic had consistently low childhood immunization rates. Our practice depended on the primary care provider to recommend vaccinations at the time of an office visit or to return recommend the parent to bring the child back for a well child exam and vaccinations. While working towards accreditation, it was identified that a best practice was to implement standing orders to provide vaccinations. Initially, there was considerable resistance from some of the providers and the nursing staff.
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PROFESSIONAL DEVELOPMENT NEEDS ASSESSMENT3The nursing staff was concerned that they may not have enough time to vaccinate in the day to day workflow. The Associate Health Director did an overview of the plan, the rationale for implementing the standing orders into practice, reviewed success in other practices that had implemented the protocol into practice, and implemented a screening tool in morning huddle to identify children that would need vaccinations. Authoritative leadership was used in this situation to implement the change in the wo…………………..

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