Falls in the Medical Surgical Unit Essay

Introduction

Planned change in medical-surgical nursing is essential for several reasons, but its implementation can be pose challenges to change agents. Understanding and utilizing a change theory context can assist change managers to increase the probability of success of a change project. This paper examines the problem of patient falls in the medical-surgical department, a change that can be made in the medical-surgical unit to address patient falls, how this change will be aligned with the mission, values, and vision of the organization. The paper also identifies a change theory to guide planning and implementation of the change and the involvement of nurse manager in initiation and management of change Falls in the Medical Surgical Unit Essay.

A problem within the medical-surgical unit

Patient falls in the medical-surgical unit is a common problem that results to patients sustaining minor abrasions and bruises and more serious injuries such as head injuries, fractures, laceration and at times death. Patient falling in the unit is caused by side effects of medication, newly transformed mobility, and regular toileting along with alteration of mental status in the unaccustomed environment. The costs connected with falls entail lengthy hospital stay, liability and increased care costs.

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A change that could be made to address patient falls in the medical-surgical unit

Alarm systems such as chair or bed alarms can be used to prevent patient falls through alerting staff when a patient at risk of falling tries to get out of a chair or bed without help. In addition, bad alarms might lessen the need for physically restraining patients. Majority of accidental falls among patients in the medical-surgical unit occur a patient ambulate from a toilet, bed or chair without sufficient help. Nurse Managers will be responsible for training personnel in the utilization of the new bed alarms and how they operate.

Aligning the change with the values, mission, vision and professional standards of the organization

Patient falling can be prevented through use of bed and chair alarms is likely to be successfully executed and sustained when it aligns to the organization’s priorities and patients’ best interests. The mission of the hospital is to offer the best care to patients and the objective of patient safety practices such as fall deterrence is to avert additional injury to patients while in hospital. Hospital staff need to deal with the problem that impelled admission of the patient, ensure patient safety and assist patient to function normally, both physically and mentally. Fall prevention through bed and chair alarms will be balanced against other organizational primacies. Prevention of falls will entail management of patients’ risks to fall and optimization of the environment and design of the hospital Falls in the Medical Surgical Unit Essay.

A change model that will guide change planning and implementation

There are several schemes of change implementation, Nevertheless, planned change, which is a determined, collaborative and calculated attempt to bring about desired improvements is the most used. Implementation of change is influenced by several restraining forces, including poorly motivated staff, poor action plans, inappropriate leadership and ineffective communication (Mitchell, 2013). I would use Lewin’s theory to identify people’s behavior as it connects with use of bed and chair alarms along with trends of opposition to change.

According to Sutherland. (2014), Lewin’s theory comprises of three stages called freezing, moving and refreezing/ freezing. The model enables a change agent recognize factors that can hinder implementation of installation and use of bed and chair alarms and forces that drive use of these alarms. A full understanding of behaviors that oppose or drive this change, I will work to strengthen driving forces to ensure change comes about successfully.

Steps that I would follow to facilitate the change

The first step would be the identification of the key players to be influenced by the change and communicating ideas. It will be vital to include all staff in the decision-making process to make them feel empowered and overcome resistance to change. The first step of Lewin’s change model is unfreezing, where a nurse leader recognizes the existence of a problem sees the need for change to address this problem and organizes followers to embrace the proposed change.

The next step will involve planning and implementing the change project and communicating with the nursing staff. In Lewin’s theory the second phase is moving, which involves viewing change as a procedure other than an occurrence. It is necessary to engage people to implement the proposed change. The last step will be an assessment of stability of change and its efficiency in the prevention of falls in the medical-surgical unit. Support of medical-surgical unit personnel will continue until a change is considered. The third phase of Lewin’s theory which entails stabilization of change to embed it into the present schemes like practices, policies and culture (Shirey, 2013) Falls in the Medical Surgical Unit Essay.

An explanation of who would be involved in managing change and the characteristics and skills necessary for change facilitation

Nurse Managers are involved in managing change. Change agents or managers have the obligation of recognizing a suitable change theory to offer a framework for implementation, management and evaluation of change. Prior to initiating change, nurse managers must reflect their weaknesses and strengths in regard to leadership skills which greatly impact the success of a change plan (Mitchell, 2013).

As Marquis and Houston (2017) as nurse managers are obliged to prompt transformations in clinical setting and the attributes of managers are equally important. Nurse Managers must be skillful in the model and enactment of planned change. Team working, effective communication and leadership are significant aspects for planned change. Managers should be skillful in offering support, vision and inspiration to all people involved in the change project (Mitchell, 2013).

Conclusion

Implementation of bed and chair alarms can prevent patient falls in the medical-surgical unit. Lewin’s theory of planned change management is an influential model to guide planning and implementation of bed and chair alarms to prevent patient falls. Nurse managers can assist promote acknowledgment by nursing staff by engaging them in every aspect of preparation and execution. Through the application of Lewin’s theory, nurse managers can assist minimize unit personnel’s resistance of change through actively engaging them in the change practice.

References

Marquis, L., & Huston, J. (2017). Leadership roles and management functions in nursing: Theory and application (9th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.

Mitchell, G. (2013). Selecting the best theory to implement planned change. Nursing Management, 20(1): 32-37.

Shirey, R. (2013). Lewin’s Theory of Planned Change as a strategic resource. The Journal of Nursing Administration, 43(2):69-72.

Sutherland. (2014). Applying Lewin’s Change Management Theory to the Implementation of Bar-Coded Medication Administration. Canadian Journal of Nursing Informatics. 8(1):1-6 Falls in the Medical Surgical Unit Essay.

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