Change Theory
Change Theory’s Elements Fitting the Scenario
Nursing leadership is associated with the need to implement changes. Different change models contain such basic elements as making people aware of the problem, implementing the change, and making a new model a norm (Nilsen, Wallerstedt, Behm, & Ahlström, 2018). These frameworks can help in addressing various situations as they can guide the change from an ineffective practice to a winning model.
The three major pillars of change theory, such as the development of awareness, the trial implementation of the selected change, and the adoption of the change, can be applied to address the problem identified for the inpatient psychiatric unit. It is necessary to draw attention to the problem of weaknesses in inpatient discharge records prescribed by the Joint Commission as they lead to increasing seclusion hours.
Using Change Theory to Address the Conflict
To contribute to decreasing seclusion hours, it is essential to make nurses responsible for completing patient discharge records aware of the negative effects of seclusion in the unit. The staff of psychiatric units tends to overuse seclusion and neglect other strategies due to the lack of knowledge (Wilson, Rouse, Rae, & Kar Ray, 2018). The development of a training program for nurses regarding the Joint Commission guidelines will be the first phase of the change implementation (“Specifications Manual for Joint Commission national quality measures,” 2015). Nurses will improve their skills in working with patient discharge records. The development and adoption of improved policies based on the Joint Commission guidelines will be the final stage.
Strategies and Rationale
The rationale for Choosing a Leadership Style
Change implementation requires transformational leadership. The reason is that, in this case, nurses responsible for filling and providing discharge records need to become motivated to address weaknesses in their approaches and refer to the Joint Commission guidelines. Working with a transformational leader, nurses will feel empowered and motivated to take an active part in the process of change (Goh, Ang, & Della, 2018). Therefore, desired results regarding decreasing seclusion hours will be achieved.
Interventions
One of the interventions should be a training program for the nursing staff in the inpatient psychiatric unit. The program should include lectures on using the Joint Commission guidelines, discussions, and simulations (“Specifications Manual for Joint Commission national quality measures,” 2015). A transformational leader will help nurses learn the ways to deal with long seclusion hours and provide high-quality care to patients.
Expected Outcome
Measuring Success in Leadership
To measure the success of transformational leadership and implementing a training program for nurses in the inpatient psychiatric unit, it is necessary to monitor work with patient discharge records and estimate the number of seclusion hours. The number of errors in inpatient discharge records and minutes spent for filling in and sharing protocols should also be calculated (Wilson et al., 2018). As a result, it will be possible to measure how transformational leadership could influence nurses’ awareness of effective strategies to avoid patients’ seclusion and methods to address problems.
Barriers
The key barrier to the change implementation in the inpatient psychiatric unit is nurses’ resistance to change, as well as the lack of time and resources. Resistance can be addressed through communicating, raising nurses’ awareness of the issue of seclusion hours, and creating a sense of urgency. The unit’s administration should also allocate certain funds to ensure nurses have access to the required resources to work with discharge records.
Professional Standards
The development of the intervention, as well as the implementation of change, should be guided by and consistent with certain professional standards. In this case, the guidelines developed by the Joint Commission for inpatient psychiatric services are important to provide a nurse leader with information regarding the change implementation. Thus, these standards were used to identify deficiencies in the used procedure, and they can be included in the training plan to help nurses learn effective strategies and methods to work with discharge records and manage various situations that can take place in their psychiatry unit.
References
Goh, A. M. J., Ang, S. Y., & Della, P. R. (2018). Leadership style of nurse managers as perceived by registered nurses: A cross-sectional survey. Proceedings of Singapore Healthcare, 10(1), 1-6. Web.
Nilsen, P., Wallerstedt, B., Behm, L., & Ahlström, G. (2018). Towards evidence-based palliative care in nursing homes in Sweden: A qualitative study informed by the organizational readiness to change theory. Implementation Science, 13(1), 1-12. Web.
Specifications manual for Joint Commission national quality measures. (2015). Web.
Wilson, C., Rouse, L., Rae, S., & Kar Ray, M. (2018). Mental health inpatients’ and staff members’ suggestions for reducing physical restraint: A qualitative study. Journal of Psychiatric and Mental Health Nursing, 2(8), 1-12. Web.