Change Proposal: Reimplementation of Bedside Shift Report
I. Introduction
A. Background and rationale for the change proposal
B. Statement of the problem
II. Implementation Plan
A. Assessing factors that affect implementation
1. Staff resistance to change
a. Evidence-based rationale: Resistance to change is a common barrier in healthcare settings (Burke et al., 2017). Research has shown that involving staff in the change process, providing education and training, and addressing concerns can help mitigate resistance (Burke et al., 2017; Parmelli et al., 2017).
b. Recommended activities:
i. Hold staff meetings to discuss the benefits of bedside shift report and address any concerns or misconceptions.
ii. Provide education and training on the proper implementation of bedside shift report and its potential impact on patient outcomes.
iii. Engage nurses in the decision-making process to increase their ownership and sense of control over the change (Parmelli et al., 2017).
2. Lack of resources and time constraints
a. Evidence-based rationale: Limited resources and time constraints are common challenges in healthcare (Parmelli et al., 2017). Evidence suggests that providing adequate resources and support can facilitate the implementation process (Parmelli et al., 2017).
b. Recommended activities:
i. Allocate necessary resources, such as technology (e.g., mobile devices for bedside reporting) and additional staff if needed, to ensure smooth implementation.
ii. Develop a detailed timeline and schedule to allocate time for bedside shift report without compromising other patient care activities.
iii. Monitor and evaluate the impact of the change on resource utilization and workflow efficiencies to make necessary adjustments.
3. Organizational culture and leadership support
a. Evidence-based rationale: Organizational culture and leadership support play crucial roles in successful change implementation (Patterson et al., 2018). Research suggests that fostering a culture of open communication, collaboration, and innovation, as well as securing leadership support, can enhance implementation efforts (Patterson et al., 2018).
b. Recommended activities:
i. Engage leaders and managers in supporting the implementation of bedside shift report through clear communication and expression of expectations.
ii. Foster an environment of collaboration and teamwork by involving multiple stakeholders, including nurses, patients, and families, in decision-making processes related to bedside shift report.
iii. Recognize and reward staff who actively participate and contribute to the successful implementation of bedside shift report.
B. Proposed change theory: The Transtheoretical Model of Change
1. Evidence-based rationale: The Transtheoretical Model of Change suggests that individuals go through different stages when adopting a new behavior, including the precontemplation, contemplation, preparation, action, and maintenance stages (Prochaska et al., 2018). Applying this model to the implementation of bedside shift report can help identify and address individual and organizational barriers to change at each stage.
2. Implementation activities:
a. Precontemplation stage: Assess the readiness of nurses and the organization for change. Identify potential barriers and develop strategies to overcome them.
b. Contemplation stage: Provide information and education to increase awareness of the benefits of bedside shift report and address concerns or misconceptions.
c. Preparation stage: Develop a plan for implementation, including resource allocation, training, and timeline.
d. Action stage: Implement bedside shift report with ongoing monitoring, feedback, and support.
e. Maintenance stage: Evaluate the sustainability and outcomes of bedside shift report implementation. Provide continued support and reinforcement to ensure ongoing use.
III. Conclusion
A. Summary of the implementation plan
B. Anticipated benefits and impact of the proposed change
C. Call to action for stakeholders to support and participate in the implementation process
