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Evidenced-Based Practice - Environment
There are perhaps few environments and professions within which change is both as important and as difficult as it is within health care. While there are many barriers to the change process, there are at least an equal amount of drivers that indicate the necessity for change. In evidence-based practice, nursing practitioners, administration personnel, management personnel, and all involved in the health care profession need to form teams with patients and family members in order to ensure an optimal environment for change. This is not a process that will happen overnight, especially in the hospital and nursing home settings, where recognizing the need for change is often subordinate to more immediate and severe problems such as personnel and funding shortages.
The readiness for change in the hospital and nursing home environment is often subordinate to practical day-to-day challenges, including severe personnel and funding shortages. These create an environment within which adequate services cannot be provided. Nurses tend to be so overworked by the care that residents require that they cannot spare the time for research to maintain a current perspective on the nursing environment and evidence-based practice.
Another significant barrier to change is resistance (White, 2012, p. 50). Such resistance, according to White, is usually related to two basic paradigms: (1) The threat of disturbance to the status quo or equilibrium, which generally involves...
The first stem in overcoming these barriers is to analyze them. For this purpose, my first framework will be Lewin's Force Field Analysis (White, 2012, p. 51). At its basis, this analysis recognizes three basic components that relate to change. In the middle, there is the desired or current state, while driving forces occur to the left and restraining forces to the right. As mentioned above, the main restraining forces to change within the hospitals and nursing homes within which I conduct my work are a lack of funding, personnel shortages, and a lack of recognition that change is required.
The driving forces for change include the conditions currently experienced by patients and residents who do not receive adequate care. Complaints from family members who often pay high fees for nursing home residents have been on the increase. Research conducted in nursing homes and hospitals has also shown a lack of the quality care that people in nursing homes and hospitals merit.
To analyze these driving and restraining forces adequately, it is important to implement Lewin's three stages (Current Nursing, 2011). First, there is the "unfreezing stage," during which old, unproductive patterns are discarded. This can be a very long process, depending upon the…
References
Current Nursing (2011). Change Theory: Kurt Lewin. Retrieved from: http://currentnursing.com/nursing_theory/change_theory.html
Dudley-Brown, S. (2012. Challenges and Barriers in Translation. Translation of Evidence Into Nursing and Health Care Practice edited by Kathleen M. White and Sharon Dudley-Brown. New York: Springer Publishing Co.
Pipe, T.B., Wellik, K.E., Buchda, V.L., Hansen, C.M., and Martyn, D.R. (2005). Implementing Evidence-Based Nursing Practice. Urologic Nursing 25(5). Retrieved from: http://www.medscape.com/viewarticle/514532_5
White, K.M. (2012). Change Theory and Models: Framework for Translation. Translation of Evidence Into Nursing and Health Care Practice edited by Kathleen M. White and Sharon Dudley-Brown. New York: Springer Publishing Co.
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