Adding a Wound Care Nurse: Lippitt's Change Theory in Practice
This paper examines a nurse manager's proposal to add a certified wound care nurse to an orthopedic and post-trauma hospital floor. It begins by defining the specialized role of wound care nurses and identifying gaps in current patient care. The paper then outlines the interests of three key stakeholder groups — hospital administration, floor nurses, and patients — before applying Lippitt's seven phases of change theory as the implementation framework. Each phase is mapped to concrete actions, from diagnosing the problem and assessing resources to maintaining the change through feedback and gradually withdrawing managerial oversight. The analysis draws on evidence-based practice literature to support the case for specialization in wound management.
- Introduction: The Case for Specialized Wound Care: Defines wound care nursing and justifies specialization
- Hospital and Floor Description: Describes orthopedic floor's current wound care gaps
- Stakeholders and Their Interests: Analyzes board, nurse, and patient stake differences
- Change Theory: Lewin and Lippitt Compared: Contrasts two theories; selects Lippitt's model
- Implementing the Change: Lippitt's Seven Phases: Maps all seven Lippitt phases to hiring plan
- Conclusion: Summarizes benefits and acknowledges stakeholder challenges
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What makes this paper effective
- It grounds an abstract change theory in a concrete, real-world clinical scenario, making each of Lippitt's seven phases feel practical and actionable rather than purely theoretical.
- The stakeholder analysis is nuanced — rather than assuming all parties share identical interests, the paper surfaces tensions such as nurse autonomy concerns and board liability questions, adding analytical depth.
- The paper maintains a consistent first-person perspective appropriate for a reflective nursing management proposal, which strengthens its applied credibility.
Key academic technique demonstrated
The paper demonstrates structured application of a named theoretical framework. Rather than simply describing Lippitt's phases in the abstract, the author maps each phase explicitly onto the specific change being proposed — hiring a wound care nurse — producing a step-by-step implementation roadmap. This technique shows readers how to use theory as a practical planning tool, not merely as a citation.
Structure breakdown
The paper opens with a definition of wound care nursing and a rationale for specialization, then provides clinical context through a floor description. A stakeholder analysis section examines competing interests before a change theory section compares Lewin and Lippitt, justifying the choice of Lippitt's model. The longest section walks through all seven implementation phases in sequence. A brief conclusion synthesizes the benefits and acknowledges implementation challenges. This introduction-context-theory-application-conclusion structure is well-suited to nursing management proposals.
Introduction: The Case for Specialized Wound Care
Wound care nurses play a special role in the hospital environment, and hospitals without these specialized nurses may not be able to offer the same level of care as those that employ them. Wound care nurses, sometimes referred to as wound, ostomy, and continence (WOC) nurses, specialize in wound management — the monitoring and treatment of wounds due to injury, disease, or medical treatments. Their work promotes the safe and rapid healing of a wide variety of wounds, from chronic bed sores or ulcers to abscesses, feeding tube sites, and recent surgical openings (Nursing Schools, 2012).
While it may seem as if any nurse should be qualified to perform these functions, it is critical to recognize that wound care is a specialized field. Their main objectives are to assess wounds, develop a treatment plan, clean wounds, and monitor for signs of infection. If wounds worsen, these nurses must be able to recognize symptoms that could require surgical debridement or surgical drains. Wound care nurses also work with patients and other caregivers to educate them on wound prevention (Nursing Schools, 2012).
While it may be possible for other types of nurses to provide comparable care, it is unlikely that they can consistently match the level of care that wound care specialists deliver. Best practices therefore suggest that a hospital with a high number of wound patients should employ a dedicated wound care nurse to manage these injuries and engage in patient education. Because the floor where I work sees a high volume of serious wound patients, the hospital would benefit significantly from the addition of a wound care nurse. This paper uses Lippitt's phases of change theory to describe how to tackle the challenges of securing a certified wound care nurse for this hospital floor.
Hospital and Floor Description
At this time, I work in a hospital with no dedicated wound care nurse. I work on the orthopedic and post-trauma floor as a staff nurse, and part of my duties include wound care. However, some of the wounds seen on that floor are very serious and require specialized knowledge to treat properly. While the nurses on the floor are adequate at caring for wounds, providing appropriate care for the most serious cases sometimes requires additional research time, which delays services for all patients — not simply those with the serious wounds.
I believe that the addition of a wound care nurse would provide significant benefits to the hospital. Most importantly, a dedicated wound care nurse would increase the quality of patient care, which is the most critical consideration when evaluating additions to a hospital's nursing staff. Beyond patient benefits, a dedicated wound care nurse would reduce staffing concerns for nurse managers, decrease the burden on floor shift nurses, and more properly align nursing duties with industry standards for job performance.
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