A Theoretical Framework to Guide an Evidence-Based Chance Practice Project

A theoretical framework is the application of models or underlying set of concepts from one and the same theory in an attempt to explain an event and insight into regarding specific phenomenon (Imenda, 2014). On the other hand, a conceptual framework is when a researcher opines that the research questions cannot be studied meaningfully within using the ideas embedded in one theory (Imenda, 2014). A scholar synthesizes the views from both empirical and theoretical literature to present an integrated way of focusing on the problem (Imenda, 2014).

How to Select the Best Framework to Guide Evidence-Based Change of Practice Project

Selecting the best framework to guide an evidence-based chance practice project entails understanding the variables involved and general concept being studied followed by comparing the various models (Melnyk & Fineout-Overholt, 2015). The analysis allows an individual to identify one that has been designed to maximize the likelihood of successful implementation of the evidence-based practice and program as well as results of the desired outcomes.

Examples of Models for Successful Individual Change

Some of the examples of models that can be used for successful individual change include health belief and social cognitive theory (Bonnel & Smith, 2017). However, organizational change theories, for instance, Lewin’s can be used effectively by psychiatric nurse practitioner.

Selected Theory of Change

Lewin’s theory of change is a pragmatic framework that describes how intervention affects transformation. Every transformation is innovation, and internal changes encompassing such elements as technology, people, primary tasks, and administrative structures are taken into account (Poghosyan & Aiken, 2015). The term ‘change’ is defined as a process that considers both external and internal factors. Other descriptions concentrate on scope or scale of change. As such, in another definition it is a radical process with a high magnitude that results in some type of transformation to the corporation. Therefore, change can also be classified in terms of intensity, for example, incremental which entails focusing on adaptive movements that improve aspects of firm instead of revolutionizing them (Swinton, 2016). There are three fundamental steps proposed in the literature: unfreezing, transforming and freezing. The first phase includes preparation for transformation. The stage encompasses conditioning the employees to the urgency of alteration commonly by the change agents who come from upper stakeholders and management. The period of unfreezing is characterized by instability and uncertainty. The challenges are mitigated through regular meetings to allow effective transformation. The process usually encounters considerable resistance from the employees. People often experience fear when they do not understand how change will affect them. In the freezing phase workers are made aware of the new routines and fresh systems of operation both at organizational and personal levels (Hussain, Lei, Akram, Haider, Hussain, & Ali, 2017). Therefore, the process involves consolidation of different behaviors. During the last stage, the organization focuses on establishing new standards and culture. Refreezing may be done to safeguard employees from regressing to the old traditions that were toxic to its operations. Theory of change defines the long-term goals and identifies the changes required showing each outcome in a logical relationship. It also provides a working model against which one can test assumptions or hypotheses about what actions will bring about the best result.

Component of the Framework

The theory of change was developed by Kurt Lewin and can be traced back in the 1930s. The model was further established by other scholars such as Kirkpatrick in 1950s. The primary components include driving and restraining forces as well as equilibrium. The driving forces are those pushed in a direction which causes the transformation.

For example, the driving force allows a patient to move in the desired direction. On the other hand, restraining forces work parallel to the driving push. They hamper change since the force causes a move in the opposite direction causing a negative change in equilibrium which is a state in which the driving and restraining forces are equal. In such situations, change does not occur (Lewin, 1947). Transformation can only be realized when it happens resulting in raising or lowering the equilibrium. Additionally, the theory of change includes other components such as indicators to understand whether transformation has been reached, interventions which refer to work undertaken to lead to desired change, rationale that entails explaining the positioning of the outcome, and highlighting the assumptions made (Lewin, 1947).

Description of whether the Framework Explains Phenomenon of Study

The phenomenon of study involves understanding implementation of bar-coding medication administration at psychiatric facilities. In the current era of technology, it is imperative to make changes to enable effective management of patients in hospitals and ensure their safety (Calder, 2013). In particular, it is crucial to understand how technological modification impacts psychiatric nursing practitioner. Without the system, a nurse is forced to check the medication against papers which increases the possibility of errors. Several barriers are involved when such change is proposed including lack of cooperation from medical personnel, resistance to transformation, for instance, patient refusing to wear the identification bands and fear of using new techniques (Anderson, Potočnik, & Zhou, 2014). Change theory explains the phenomenon since it takes into a pattern of resistance and identifies the factors that can impede change from happening.

Description of if the Framework Guides each Phase of Project

Lewin’s theory of change provides a procedure that guides each phase of the project. The difficulties related to the phenomenon above usually occur in the unfreezing stages. In particular, the theory offers components that should be followed when seeking to develop the best solutions or strategies (Chowhan, Pries & Mann, 2017). For example, the framework emphasizes the importance of identifying the key players such as staff and patients, the establishment of indicators, interventions, rationale, and assumptions. The guideline can allow the researcher to move from the unfreezing to freezing states successfully.

Description of whether the Framework Identifies Variables and Outcome to Measure

Lastly, the framework identifies the variables. The measures are determined using the concept of driving and restraining forces to enable the patient to move in the desired direction (Burnes, 2014). The variables include the behaviors that lead to resistance and indicators or measures of success. Additionally, Lewin’s theory of change takes into account the need for identifying conditions which must be present to achieve the long-term goal. The outcome component of the model allows nurses and patients to think about the overall positive objectives enabling them to embrace change. Therefore, the success of implementation of evidence-based practice can be measured.

References

Anderson, N., Potočnik, K., & Zhou, J. (2014). Innovation and creativity in organizations: A state-of-the-science review, prospective commentary, and guiding framework. Journal of Management, 40(5), 1297-1333.

Bonnel, W., & Smith, K. (2017). Proposal writing for clinical nursing and DNP projects. New York, NY: Springer.

Burnes, B. (2014). Kurt Lewin and the planned approach to change: A re‐appraisal. Journal of Management Studies, 41(6), 977-1002.

Calder, A. M. (2013). Organizational change: Models for successfully implementing change. Retrieved from https://digitalcommons.usu.edu/cgi/viewcontent.cgi?article=1142&context=honors

Chowhan, J., Pries, F., & Mann, S. (2017). Persistent innovation and the role of human resource management practices, work organization, and strategy. Journal of Management & Organization, 23(3), 456-471.

Hussain, S. T., Lei, S., Akram, T., Haider, M. J., Hussain, S. H., & Ali, M. (2017). Kurt Lewin’s change model : A critical review of the role of leadership and employee involvement in organizational change. Journal of Knowledge and Innovation, 1–7.

Imenda, S. (2014). Is there a conceptual difference between theoretical and conceptual frameworks? Journal of Social Sciences, 38(2), 185-195.

Lewin, K. (1947). Frontiers in group dynamics: Concept, method, and reality in social science; social equilibria and social change. Human relations, 1(1), 5-41.

Melnyk, B. M., & Fineout-Overholt, E. (2015). Evidence-based practice in nursing & healthcare. Philadelphia, PA: LWW.

Poghosyan, L., & Aiken, L. H. (2015). Maximizing nurse practitioners’ contributions to primary care through organizational changes. The Journal of Ambulatory Care Management, 38(2), 109-117.

Swinton, L. (2016). Kurt Lewin’s force field analysis : Decision making made easy. Retrieved from http://mftrou.com/wp-content/uploads/2016/11/lewins-force-field-analysis.pdf