Bozak, M., (2003). Using Lewin’s force field analysis in implementing a nursing information system. Computers, Informatics, Nursing, 21(2), pp.80-85.
Bozak argues that the application of Lewin’s change management theory in nursing offers an opportunity to support the nurses via the transition as well as establishing the issues of strength and resistance before implementing the change. The failure to have a framework that offers guidance, the adoption of the new technology will be in futility and as a result threatening the safety of the patients.
Burnes, B. (2004) Kurt Lewin as well as the planned approach to change: A re-appraisal. Journal of Management Studies, 41, 977-1002.
The first phase of a theory according to Burnes entails the identification of the changing focus specifically focusing on the implementation of the change in the acute care setting. The principal component of this phase is the communication with the various stakeholders encompassing the frontline nurses, administration as well as the managers. In this case, all line of communication between the various parties should remain open as well as honest thus creating a sense of security in addition to trust in all the parties involved in the change process.
Carroll P. (2003). Medication errors: The bigger picture. R N, 66(1), 52-58.
Carroll holds that adopting the changes in healthcare makes it possible to verify the medications against the records of the medicine electronically thus significantly reducing the errors in medication. As it relates to any change, acceptance by the front line nursing personnel is very significant to facilitate a smooth transition to any the informatics project. In this case, many nurses can have uncertainty and thus resist the adoption of the new computer aided devices in their service delivery.
Dennison, R. (2007). The medication safety education intervention to minimize the risk of harm caused by medication malpractice. Journal Of CEN, 38(4), 176-184.
According to Dennison, the contemporary rapidly changing healthcare environment, advancements in technology, as well as the computer, assisted devices normally challenge the nurses in numerous ways. The implementation of change in the nursing environments can produce anxiety as well as the fear of failure among the nurses thus leading to resistance to the change.
DeYoung, J., Vanderkooi, M., & Barletta, J. (2009). The Effectiveness of technology assisted medication administration on medication error rates in an adult medical acute care unit. The American Journal of Pharmacy Health-System, 66(12), 1110-1115. doi:10.2146/ajhp080355
DeYoung’s believes that the management of change is always a challenging subject in healthcare facilities, with the new technologies normally resulting in a resistance from the nurses unable to find time for the completion of patient-related tasks. Some of the barriers identified in the implementation of the change include fear of utilizing new techniques, lack of cooperation from the staff as well as resisting the change in hope that the technology would disappear. The refusal by the psychiatric patients to wear the identification bands which is a necessary element acute care setting work is one of the barriers that could impact the efficiency of psychiatric hospitals.
Institute of Safe Medication Practices Canada, 2012.
The article postulates that the errors in medication in the hospitals in most cases result in devastating outcomes for the patients as well as the nurses and can significantly minimized via the utilization of technology. The adoption of technology in the healthcare makes it possible to improve the quality of patient care and at the same time save time for the nurses.
Koppel, R., Wetterneck, T., Telles, J.L., and Karsh, B., (2008). Workarounds relating to medication administration systems: Their Causes, occurrences, as well as threats to patient safety. Journal of AMI Association, 15, 408-423. doi: 10.1197/jamia.M2616
Some of the workarounds in the acute care setting encompass the administration of medication to the patients without the scanning of their wristbands as well as scanning the medication packages preceding the delivery and administration of medication. For the attainment of the objective of successfully implementing the bar-coding project, it is imperative to ensure that there is precise planning as well as identification of all the possible barriers.
Lee, T. (2006) Adopting a personal digital assistant system: application of Lewin’s change theory. Nursing and Healthcare Management and Policy, 487-496.
The refreezing phase according to Lee entails the adoption of stability as well as evaluation. The proceeding support by the front line nurses along with the technology to all the stakeholders should proceed until the change is considered complete with all the users comfortable with the technology.
Lehman, K., (2008). Management of Change: Mayhem or magic. Journal for Nurses in Staff Management, 24(4), 176-184.
According to the article by Lehman discussions around the table should be held with the objective of outlining the driving as well as restraining forces to assist in the identification of the barriers to overcome. The restraining forces could be the resistance by the staff to the utilization of the computerized devices. Additionally it could be as a result of lack of computer experience, failing to trust in the organization as well as a version relating to the utilization of new systems. The driving forces encompass the issues that help in moving the project to completion as support from the top level management, adequate financial investment along with the possibility of ease in the use of the systems.
Lomas J (2007). Formalized Informality: An action plan to spread proven health innovations. Wellington: Ministry of Health New Zealand.
The project relying on Lomas’ premises should encompass all the stakeholders especially the nursing staff to enhance the notion of ownership of the project thus the high likelihood of success. Areas to lay special focus include the timelines in the implementation, equipment reliability, education training needs, leadership, impacts on the workflow as well as organizational culture.
Mantzoukas S (2008). Reviewing the evidence-based practice, nursing research, reflection: Leveling the hierarchy‟, Journal of Clinical Nursing, Vol. 17 No. 2: pp 214- 22.
The moving stage according to Mantzoukas entails the period of the real change entailing the planning along with implementation phases of the project in the acute care facilities. The implementation of these changes will need continued efforts from diverse teams as the IT, clinical information services, nursing, pharmacy, clinical nurse educators as well as the administrators.
The National Council for Coordinating Medication Error Reporting as well as Prevention, (2012).
According to the article, the completion and overall operationalization of the change facilitates the attainment of a summary along with the evaluation of the encountered problems, attained successes implemented for future reference. Through these evaluations, there is an increased ease in the recording of the medical errors and consequently assisting in the development of mechanisms of preventing the errors.
Rack, L., Dudjak, L., & Wolf, G., (2011). Examination of the Nurse Workarounds in the Hospital Utilizing Bar Code Medication Administration Programs. Journal of Nursing Care Quality. 27(3) 232-239. doi: 10.1097/NCQ.0b013e318240a854
According the Rack, adoption of the bar coded administration of medication is one of the technological types using scanning devices for the comparison of bar codes on the patient identification bands having bar codes on the prescribed medications. Thus, the application of the coding systems helps in eliminating issues of workarounds for the nurses which risks the care for patients in acute settings.
Spetz, J., Burgess, J. F., & Phibbs, C. S. (2012). Issues are determining the success of the implementation of technology-based inpatient information systems in Hospitals. The American Journal of Managed Care, 18(3), 157-162.
Spetz advocates for the majority of healthcare facilities to employ the Kurt Lewin’s theory for the comprehension of human behavior and its relationship to change along with the patterns of resistance to change. The model focuses on the identification of the issues that will impede the change from taking place. Once the healthcare organizations conversant with the behaviors that oppose the change and consequently work to strengthen the positive driving forces, it makes it possible for the change to implement successfully.
Wilkins, K. & Shields, M., (2008). Medication challenges in hospitals.
The article by Wilkins posts that applicable barriers regarding the implementation of the change relates to the shortcuts some nurses employ to be able to save time including the pre-pouring of medication, contravening the nursing practice standards. The application of workarounds by nurses is normally the unprofessional endeavors by nurses to circumvent failures of computers as well as saving time. They are as a result of frustrations by the nurses when they have been unable to locate a solution to their immediate problem. The resultant impact is an increase in the medical errors as a result of the nurses’ acts.
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