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Maintain Change in Practice

The writer will have to read each of this post and react to them by
commenting, analyzing and supporting with relevant articles. The writer will
have to read carefully before giving constructive comments on the post. The
writer should write a one paragraph of at least 150 words. APA and in text
citation must be use as each respond to the two post must have in text
citations. The writer will have to use an article to supports his comments in
each of the article. Address the content of each post below in a one paragraph
each, analysis and evaluation of the topic, as well as the integration of relevant

Article 1

Maintain Change in Practice

Planned change is a calculated decision by the organization to move forward with a
design or strategy that will expectantly cause growth, advancement, and success of the
organization. Although the success is desired, it is not certain. It is important to identify who
will be committed to the success of this change. According to Execuquest (2014), traditional
hierarchical organizations (and most of them still are) engage in the change process under the
assumption of controlling the process by involving only those individuals in influential or
powerful positions. It is important to have a team working together, and a leader that will
make sure it is carried out. To aid in the success of the planned change it is imperative that a
timeframe is set for change, neutralize those opposed to change, build a strong support system
of like-mined people, choose your change agent and key personnel carefully, control
expectation of proposed change, identify discrepancies with the organization, and be clear
about what the change and plan is (Stanley, 2006). These principles are key to assist in the
success of the planned change.

 Referring to the Kotter and Cohen’s 8 Steps to Change, step one speaks of creating an
excitement and urgency for this change (Kotter International, 2016). This can be applied to
my proposal in that, it can be shown what a lack of this change has resulted to and show the
benefits that can arise, not only to the patients but also to the company. Step two encourage
assembling a group. Within the change proposal key personnel and change champions such as
the office staff members, office manager, medical assistants, and skills of the nurses and
practitioners work together to make this change successful. Step three focuses on shaping the
vision. In this proposal the vision is made clear, which is to control the patient’s blood
pressure while decreasing the risk of adverse drug reaction and morbidity. The key personnel
are also crucial to step four. They will drive this change.
The barriers to change that are discussed in step five would be the resistance of the
staff to change. This can be removed through education. Step six is can be applied to the
planned change in that the patient is monitored throughout, and small accomplishments and
improvement can be seen and celebrated, which increases motivation to continue. The success
of the change will continue to motivate those involved which will sustain acceleration and
motivation as described in step seven. According to Izumi & Taylor (2000), changes to the
structure of the organization or the functions within it are used to propel growth and
development. Finally step eight is accomplished in the beginning of my proposal. The benefits
of the change for the company are made clear.  The proposal provides a positive correlation
between the new behaviors and organizational success.
My understanding of planned change is that it is imperative for a successful change
proposal. It is a calculated attempt to introduce modifications to a company. When actions are

carefully planned and presented, this increases the chance of acceptance by the organization
of the proposal and success in implementation.

Execuquest (2014). Simple principles of planned change.

There is a need of providing the area of change that is being discussed in the introductory
part of the paper. On the other hand, use evidence to support that uses an early warning system of
communication and scoring that triggers the need for change within an organization (Mitchell,
2013). An effective change needs to draw focus in the areas that need to be developed and
adapted through the inclusion of an ongoing cycle of evidence, research and theory. As change
in practice is prompted by research, there is a need for the development of theories from research
that act as evidence in producing and maintaining change in practice.

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

Article two

Planned change is a purposeful, calculated and collaborative effort to make an organization
better with the use of change agents (Mitchell, 2013).  Nurses are held to using the best
evidenced based practices which means there are always going to be a need to update or change
their practices however making changes in an organization is not always as easy as it may seem
(Mitchell, 2013).  Sometimes it takes many unsuccessful tries to achieve the desired change
within an organization.
According to Mitchell (2013) two-thirds of organizational change projects fail.  This tells us that
using change models and change processes is highly recommended to ensure that evidenced
based project proposals are effectively implemented.  There are many forces that drive changes
in the health profession including costs of treatments, staffing shortages, professional
obligations, scientific advances, aging society, potential to increase patient satisfaction, and
promotion of patient and staff safety. Other forces include poorly created action plans, staff who
are not motivated, ineffective communication styles, and inappropriate leadership (Mitchell,
Kotter International has also developed a planned change process that helps organizations
effectively implement change.  I like the first step of creating urgency among the staff that
change should happen (Kotter International, 2015).  It reminds me of  those late night, off-
commercials that place a countdown clock saying that you will only get the “special price for the
next 5 minutes” and if you do order you will get double for the price of one.  I’m not sure if this
is a good comparison but my point is that the commercial gets “some” people to act in an urgent
manner.  If organizations understand that, as in my project, antimicrobial resistance is getting
worse and that providers may not be able to cure their UTIs (as an example) in the future because
we may become resistant to Bactrim then staff may react more urgently to start the change
process. Or if they are provided incentives to the initiative this may create a sense of urgency.
The 8 step process seems very comprehensive including each dynamic from start to finish.  The
other part of the process I particularly find useful is gathering an army to help steer the change.  I
believe that this committee should involve all levels of the organization being sure to include a
staff member that is directly affected by the change and one who is very knowledgeable in the
topic.  For example, my EBP project involves antimicrobial resistance so I would be sure to
include a prescribing clinician (NP, MD, PA) and also someone from infectious disease who is
very knowledgeable with treating microbes so that the change can be comprehensive.  Dr.
Schoech (2005) stated that the more stages of the change process that are completed effectively
the greater the chance of success.  

Tiana Proctor
Dr. Schoech. (2005). The planned change process: Community perspective.
Mitchell, G. (2013). Selecting the best theory to implement planned change. Nursing
Management – UK, 20(1), 32-376p
The change process needs an effective communication approach that communicates the
objectives and the need to achieve the process of change. It is in this case imperative to consider
that the change process requires the acquisition of professional expertise in culminating their
professional tasks in the achievement of goals (Low, Fletcher, Goodenough, Jeon, Etherton-Beer,
MacAndrew, Beattie, 2015). This stresses the need of an effective approach of communication I
order to achieve the objectives of the process.

Low, L., Fletcher, J., Goodenough, B., Jeon, Y., Etherton-Beer, C., MacAndrew, M., & Beattie,
E. (2015). A Systematic Review of Interventions to Change Staff Care Practices in Order
to Improve Resident Outcomes in Nursing Homes. Plos ONE, 10(10), 1-60.

Article 3

Managers just don’t go out and haphazardly perform their responsibilities. Good managers
discover how to master five basic functions: planning, organizing, staffing, leading, and
controlling (cliffnotes,com, 2016)

 Planning: This step involves mapping out exactly how to achieve a particular goal. Say,
for example, that the organization’s goal is to improve company sales. The manager first
needs to decide which steps are necessary to accomplish that goal. These steps may
include increasing advertising, inventory, and sales staff. These necessary steps are
developed into a plan. When the plan is in place, the manager can follow it to accomplish
the goal of improving company sales.

 Organizing: After a plan is in place, a manager needs to organize her team and materials
according to her plan. Assigning work and granting authority are two important elements
of organizing.

 Staffing: After a manager discerns his area’s needs, he may decide to beef up his staffing
by recruiting, selecting, training, and developing employees. A manager in a large
organization often works with the company’s human resources department to accomplish
this goal.

 Leading: A manager needs to do more than just plan, organize, and staff her team to
achieve a goal. She must also lead. Leading involves motivating, communicating,
guiding, and encouraging. It requires the manager to coach, assist, and problem solve
with employees.

 Controlling: After the other elements are in place, a manager’s job is not finished. He
needs to continuously check results against goals and take any corrective actions
necessary to make sure that his area’s plans remain on track.

Being as the organization for which I will be working is an independent, planning and
implementing change will not be a tremendous undertaking. According to Kotter, a major deficit
to change is a rapidly changing world and a plan that does not keep up the pace (Kotter and
Cohn, 2016) 
As we have noted in previous discussions, change is hard. One of the most baffling and
recalcitrant of the problems which business executives face is employee resistance to change.
Such resistance may take a number of forms—persistent reduction in output, increase in the
number of “quits” and requests for transfer, chronic quarrels, sullen hostility, wildcat or
slowdown strikes, and, of course, the expression of a lot of pseudological reasons why the
change will not work. Even the more petty forms of this resistance can be troublesome.
However, with vigilance and positive affirmation by the change champion, this process can
become a smooth transition instead of a rocky road.


There is need to employ the tact that is required in managing the complexities of the
process of change (McMillan, 2015). This would require that the processes of evaluation,

planning, and the implementation of the proponents of change are aligned to the functions of the
organization in order to achieve a lasting change.
McMillan, K. (2015). The Critical Bricolage: Uniquely Advancing Organizational and Nursing
Knowledge on the Subject of Rapid and Continuous Change in Health Care.
International Journal Of Qualitative Methods, 14(4), 1-8.

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