NURSING 4020 WALDEN UNIVERSITY

Implementing a Change Management Process for Ensuring Effective Cardiopulmonary Resuscitation across Patients Suffering from Cardiac Arrest
Name of the Student
Walden University
NURS 4020, Section 04, Organizational and Change Theory
December 21, 2016
Background
Nurses should incorporate evidence-based knowledge and changes for enhancing their professional competence. Hence, nurse leaders should facilitate the transition of evidence-based guidelines across staff nurses by implementing appropriate changes in practice settings (Berg et al., 2010). Compliance with appropriate changes not only ensures safe and quality healthcare but also increases the profitability and goodwill of the respective healthcare organization. The purpose of this paper is to portray the necessity and impact of implementing a change management process in the cardiac care unit of a tertiary care hospital.
Organizational and Change Management
Nurses have to implement effective interventions for managing patients suffering from cardiovascular diseases. One such intervention is cardiopulmonary resuscitation (CPR). CPR is often coupled with chest compression (CC) for managing patients suffering from cardiac arrest. Appropriate CPR and CC is strongly associated with a reduction in the prevalence of cardiovascular mortality. However, different studies indicate that most nurses fail to achieve the recommended depth and frequency of chest compression (Berg et al., 2010). Evidence-based guidelines have endorsed that the depth and frequency of chest compression should be at least 50mm and 100/min respectively (Berg et al.

, 2010). The major causes for non-compliance with evidence-based guidelines are attributed to lack of knowledge, physical limitations and lack of appropriate feedback systems. Studies indicate that only 65% nurses are aware regarding the recommended depth and frequency of chest compression. On the other hand, only 35% nurses could achieve the recommended depth and frequency of chest compression (Berg et al., 2010). Therefore, implementation of effective CPR is a potential concern across various healthcare organizations. Such observations matched the scenario of our cardiac care unit also. In our cardiac care unit, almost 28% nurses were unaware regarding the recommended depth and frequency of chest compression.
As a nurse leader, I ensured the awareness of my staff nurses on the recommended guidelines. I further ensured that appropriate staffing was deployed in the cardiac unit as per the physical capacity of the staff nurses. Individuals who failed to achieve the recommended depth and frequency of chest compression in simulation studies were reallocated in other departments. I also introduced an assisted-push technique for achieving effective chest compression. In this technique, two staff nurses were engaged in administering the necessary chest compressions (Kitamura et al., 2010). I shared the importance of achieving the recommended depth and frequency of chest compression with the hospital management and voiced for deploying male nurses at the cardiac care unit. The management agreed to my suggestions, and we deployed 15% male nurses in the cardiac care unit.
The implemented changes reduced the prevalence of mortality in our cardiac care unit. The awareness and compliance of the staff nurses were significantly increased after the appropriate changes were implemented in the cardiac care unit. . I shared the importance of achieving the recommended depth and frequency of chest compression with the hospital management and voiced for deploying male nurses at the cardiac care unit. The management agreed to my suggestions, and we deployed 15% male nurses in the cardiac care unit. The staff nurses accepted the changes and reciprocated the need for such awareness and skills. However, there were certain dilemmas and apprehensions regarding the proposed changes. Such apprehensions were successfully addressed through an effective change management model.
Effective Change
I would suggest that appropriate monitoring mechanisms should be installed for measuring the quality and effectiveness of chest compression achieved by our staff nurses. I propose that suitable biofeedback tools should be installed in our unit for enhancing the productivity of the staff nurses while administering CPR and CC. The proposed change might instigate certain dilemmas and apprehensions amongst concerned stakeholders. However, I would implement “Lewin’s Change Theory” for facilitating the necessary changes. I would sensitize the concerned stakeholders regarding the proposed changes and would explain them the benefits of implementing such changes for enhancing their professional competence.
Kurt Lewin introduced a three-stage model of change. This model is known as the unfreezing-change-refreeze model. The basic concept of such theory stems from driving forces that facilitate a change and shifts the equilibrium towards the direction of such change. On the other hand, restraining forces prevent the implementation of proposed changes. Unfreezing is the process that helps to reject ineffective methods and for overcoming individual challenges. In the “change” phase, the thoughts, feelings, and behavior of concerned stakeholders are modified. Finally “refreezing” involves the establishment of the proposed change in practice settings (Kritsonis, 2005).
Summary
Nurse leaders should ensure the development of updated and evidence-based knowledge amongst concerned stakeholders. Organizational change and change management are essential instruments for ensuring evidence-based care and quality healthcare. However, nurses and other healthcare professionals are often resistant to organizational change. The resistance to such changes stems from the dilemma between academic knowledge and evidence-based guidelines. Appropriate CPR and CC is strongly associated with a reduction in the prevalence of cardiovascular mortality. However, studies indicate that nurses fail to achieve the recommended depth and frequency of chest compression. Evidence-based guidelines have endorsed that the depth and frequency of chest compression should be at least 50mm and 100/min respectively. The major causes are attributed to lack of knowledge and awareness on the recommendations, physical limitations and lack of appropriate feedback systems. As a nurse leader, I ensured the awareness of my staff nurses on the recommended guidelines. I further ensured that appropriate staffing was deployed in the cardiac unit as per the physical capacity of the staff nurses. These changes reduced the prevalence of mortality amongst concerned stakeholders. I further recommend that suitable biofeedback tools should be installed in our unit for enhancing the productivity of the staff nurses while administering CPR and CC. Lewin’s Change theory could be used for implementing the proposed changes.
Reference
Berg R.A, Hemphill R, Abella B.S, Aufderheide T.P, Cave D.M, Hazinski M.F, Lerner
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