Hand Hygiene Implementation Plan Using Lewin's Change Model
This paper presents an implementation plan for improving hand hygiene compliance among nursing staff in an ICU setting, using Lewin's three-stage model of change as the organizing framework. The plan outlines how staff must first "unfreeze" existing attitudes toward hand washing, adopt new evidence-based practices, and then "refreeze" those practices into the unit's collective culture. The paper also identifies the physical and human resources required, including a multidisciplinary committee and standardized questionnaires, and addresses the methods and feasibility considerations necessary for the plan to succeed in reducing hospital-acquired infections such as CAUTIs.
- Introduction to the Implementation Plan: Lewin's change model guides the implementation approach
- Resources Needed: Committee formation and procedural resources required
- Methods for Sustaining Change: Continuing education and leadership drive compliance
- Feasibility of the Plan: Simplicity and communication determine plan success
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What makes this paper effective
- Grounds the implementation strategy in a well-established theoretical framework (Lewin's change model), giving the practical recommendations clear academic support.
- Integrates direct quotations from peer-reviewed and professional nursing sources to substantiate each stage of the plan, lending credibility to the argument.
- Maintains a logical, sequential structure — moving from theory to resources to methods to feasibility — which mirrors how a real implementation plan would be executed.
Key academic technique demonstrated
The paper demonstrates applied theory integration: rather than describing Lewin's change model in the abstract, the author maps each stage of the model directly onto the nursing context (unfreezing attitudes about hand washing, implementing new practices, refreezing them into institutional culture). This technique shows how theoretical frameworks function as practical planning tools in healthcare settings.
Structure breakdown
The paper is organized into four clearly labeled sections. The introduction establishes theoretical grounding with Lewin's model. The resources section identifies the human and procedural infrastructure required. The methods section emphasizes continuing education and leadership. The feasibility section argues that simplicity and clear communication are the keys to successful implementation. Each section builds on the last, creating a coherent action plan.
Introduction to the Implementation Plan
It is important to understand that plans do not simply manifest themselves into existence — a specific implementation effort is needed to ensure that the evidence presented in research can be applied to practical ends. Although the solution appears clear and succinct, putting this plan into action requires a plan of its own. To do this effectively, Lewin's model of change theory can assist in describing how this plan will be put into action and significantly complement what needs to be done in order to realize success.
The plan itself is simple and revolves around Lewin's trinity of components in his change model. Lewin essentially proposed that change occurs in three distinct stages: an old idea is "unfrozen," then processed, and eventually "refrozen." This model of understanding mental processes applies at both a collective and an individual level, signifying the importance and effectiveness of this approach. The model must make use of identifying constraints that push and pull toward the poles of defined boundaries, and an equilibrium point must also be identified to locate the practical benefits of the model and create a system with known and tangible boundaries.
In this case, the first step of change requires the nursing staff to "unfreeze" their previous conceptions about the efficacy of hand washing and its importance in the healing process. Jeanes (2009) suggested that this first step of change is ultimately very important and requires a marketing or selling effort. She wrote, "Hospital-acquired infections are an important cause of morbidity and mortality in hospitals. Hand hygiene is a vital measure in the prevention of these infections, but attaining compliance with hand hygiene requirements can be difficult. Our approach of 'selling' hand hygiene to staff by adopting traditional marketing methods produced a sustained effect. Work is now taking place to measure compliance with the use of the hand-cleansing products." Once established, this mindset can be changed within the hearts and minds of the nursing staff, and a new idea may be formed and frozen into the collective psyche of the hospital ward.
References
Jansson, I. et al. (2010). Factors and conditions that influence the implementation of standardized nursing care plans. The Open Nursing Journal, 10 Oct 2010. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3024554/
Jeanes, A. (2009). Improving hand hygiene compliance. Nursing Times, 18 Feb 2009. Retrieved from
Knutsen, R. (2013). Nurses, hand hygiene and infection control. Advanced Health Care Network, 6 Feb 2013. Retrieved from http://nursing.advanceweb.com/Features/Articles/Nurses-Hand-Hygiene-Infection-Control.aspx
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