DNP 815 Describe the application of a change theory from the perspective of a DNP-prepared nurse in relation to the proposed changes in your DNP Project

DNP 815 Describe the application of a change theory from the perspective of a DNP-prepared nurse in relation to the proposed changes in your DNP Project

DNP 815 Describe the application of a change theory from the perspective of a DNP-prepared nurse in relation to the proposed changes in your DNP Project

Change is inevitable in health care. A significant problem specific to health care is that almost two-thirds of all change projects fail for many reasons, such as poor planning, unmotivated staff, deficient communication, or excessively frequent changes. (Barrow, et al 2021). All healthcare providers, at the bedside to the boardroom, have a role in ensuring effective change. Using best practices derived from change theories can help improve the odds of success and subsequent practice improvement

Lewin.s change theory  singled out unfreezing, moving, and refreezing as significant phases of change.  The existing hospital fall prevention program with limited exercise/physical therapy is not efficient. Awareness of the problem leads to the demand for change. Thus, it is supposed that interventions of patient education and regular exercises can be effective for senior hospitalized patients. The second stage of the theory will contribute to the development of a detailed plan of patient education interventions. Moreover, this stage defines the responsible parties and outlines the expected outcomes. Also, it is important to assess the possible risks of the planned interventions. Finally, the third stage of the theory is used to manage the assessment of the planned interventions. In case they are efficient, it is possible to use them on a regular basis. On the whole, Lewin’s Three-Step Change Theory is useful for managing the process of change in nursing because it helps to follow all-important stages and make the change project more efficient.


Barrow, J. M., Annamaraju, P., & Toney-Butler, T. J. (2021). Change Management. In StatPearls. StatPearls Publishing

The planned behavior theory predicts an individual’s intention to engage in a behavior at a specific time and place. The theory was intended to explain all behaviors over which people have the ability to exert self-control. The key component to this model is behavioral intent which are influenced by the attitude about the likelihood that the behavior will have the expected outcome and the subjective evaluation of the risks and benefits of that outcome.

Hence for this to be applied to my proposed DPI project on patient centered fall prevention the patient needs motivation and ability to perform. the patient is expected to have actual control over the behavior, this theory has been applied in a wide range of health behaviors and intentions including smoking, drinking, health services utilization, breastfeeding, and substance use, among others with great success and I believe it can be achievable through education and communication if applied to patients at fall risks who has certain behaviors that needs a change in attitudes (such as use of call lights,). and ability to exert self-control.

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The proposed change model is Lewin’s change model, which offers a simplified approach to change implementation. This model proposes three fundamental strategies, i.e. unfreezing, movement and refreezing. This is considered valuable for successful implementation. This change model contemplates three distinct stages. The first is refreezing, which supposes disruption. It supposes creating awareness about the need for change, thereby promoting support for said change. The second stage is movement, which means deciding on how to proceed with actual implementation of the change intervention. The third and final stage, i.e., refreezing, implies assimilating and normalizing the change intervention as standard practice (Teguh et al., 2019).


For this change model to be achievable and successful been open to feedbacks , regular communication , education and getting everyone involved is the key .


Teguh, A., Hariyati, R. T. S., & Muhaeriwati, T. (2019). Applicability of Lewin’s change management model for optimization management function in nursing delegation between head nurse and team leader: A mini project in Jakarta military hospital. International Journal of Nursing and Health Services (IJNHS)2(2), 66-74.

Chronic diseases such as hypertension, diabetes, and end-stage renal disease are a few of the complex chronic

DNP 815 Describe the application of a change theory from the perspective of a DNP-prepared nurse in relation to the proposed changes in your DNP Project
DNP 815 Describe the application of a change theory from the perspective of a DNP-prepared nurse in relation to the proposed changes in your DNP Project

conditions with high costs of chronic care, and health care organizations continuously demonstrate implementation of program designs to manage chronic conditions (Gilman, 2021). Chronic care management is a highly complex phenomenon requiring innovative frameworks. Complex adaptive systems (CASs) as a means of interactions within chronic care environments and understanding relationships can help develop a more comprehensive chronic care model to improve service excellence, quality of care, and quality of life of individuals with chronic conditions (Gilman, 2021).

Complex adaptive systems (CAS), as a framework for an integrated patient-care model, incorporates a holistic approach to strategies to improve health outcomes, improve quality of life, and decreased health care costs. The healthcare burden of chronic disease remains high, wherein the healthcare system’s resources continue to be challenged. Patient engagement in health care results to lower healthcare costs and better clinical outcomes. The self-care theory of Virginia Henderson would definitely benefit the population of patients with chronic conditions such as adherence to nutrition, lifestyle, and compliance with medications, and patients would feel empowered by their self-managed care actions (Santana, 2020).


As DNP-prepared nurses, we need to identify any areas for improvement and develop care models and innovative programs to promote quality of life and improve health care quality for individuals with chronic conditions and continually assess best strategies or explore new horizons to decrease or reduce health care costs.



Gilman, P. (2021). Complex adaptive systems: a framework for an integrated chronic care model. Advances in Nursing, 44 (4), 330-339.


Santana, M.B.A., Vieira da Silva, D.M.G., Echevarria-Guanilo, M.E., Lopes, S.G.R., Romanoski, P.J., & Boelli, J.E.W. (2020). Self-care in individuals with chronic kidney disease on hemodialysis. Revista Gaucha de Enfermagem, 41.

A DNP-prepared nurse is equipped with adaptive features of leadership, restructuring of healthcare services, and transformation of research into clinical practices. It is, however, supposed that DNP nurses are having the capacity of generating innovative techniques through the integration of nursing knowledge and skills into nursing practice for the attainment of quality improvement outcomes in the clinical environment. The major requirement of healthcare

services is collaboration at a professional level and among different disciplines while addressing complicated issues leading to the application of advanced practices, processes, and actions.

Normally, the intra-professional collaboration is built on certain theories and strategies to sustain change management in addition to the application of continuous quality improvement in healthcare services (Andersen & Rovik, 2015).

Change theory is based on three stages known as unfreezing, moving, and re-freezing. Following the supposed changes in the DNP project, a DNP-prepared nurse can apply the change theory not only to manage transformation in the framework of the healthcare system but also to cope up with the dynamics in nursing. The nurse can utilize the concept of the first stage of change theory to overcome the overall resistance and facilitating the acceptance of change

among responsible individuals (Edwards et al., 2018). In this way, the proposed changes in the

DNP project can be accepted broadly and let the nurse find out a successful framework while strengthening the driving forces and reducing the restraining factors. Hence, the utilization of a positive attitude and less use of restraining activities which are negatively affecting the achievement of the project can help the nurse to meet up the requirements of proposed changes.

Furthermore, the change can be acquired effectively when an individual can bring change in his behavior or his or her attitude. The perceptions of the individuals can be changed along with the encouragement to view the problem or the issue and their retrospective solutions. Furthermore, the nurses can create an affirmative environment to change through the dissemination of relevant information supporting the change. Similarly, the connectivity among

the powerful leaders can help the nurses to bring out the change process. Hence, the presence of supportive team members and inter-team communication can help the nurses to acquire their desired results.


Andersen, H., & Rovik, K. A. . (2015). Lost in translation: A case study of the travel of lean thinking in a hospital. BMC Health Services Research, 401. DOI: 10.1186/s12913-015-1081-z.

Edwards, N., Coddington, J. and Erler, C. (2018). The Impact of the Role of Doctor of Nursing Practice Nurses. Nancy E. Edwards Medical Research Archives, 1-11.