Change Theories in Nursing by NgoRN

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									                              Change Theories in Nursing

         Change theories are used in nursing to bring about planned change. Planned
change involves, recognizing a problem and creating a plan to address it. There are
various change theories that can be applied to change projects in nursing. Choosing the
right change theory is important as all change theories do not fit every change project.
Some change theories used in nursing are Lewin’s, Lippitt’s, and Havelock’s theories of
         The change theory by Kurt Lewin is widely used in nursing and involves three
stages. The first stage in Lewin's change theory is the unfreezing stage. In this stage,
the need for change is recognized, the process of creating awareness for change is
begun and acceptance of the proposed change is developed. The second stage is
moving, during which the need for change is accepted and implemented. The third stage
is refreezing and during this stage, the new change is made permanent. Lewin's theory
depends on the presence of a driving and resistant force. The driving force are
facilitators of change and the change agents who are pushing employees in the direction
of change. The resistant forces are the employees or nurses who do not want the
proposed change. For this theory to be successful, the driving force has to dominate the
resistant force.
         Lippitt’s theory is based on bringing in an external change agent to put a plan in
place to effect change. There are seven stages in this theory and they are diagnose the
problem, assess motivation, assess change agent’s motivation and resources, select
progressive change objects, choose change agent role, maintain change, terminate
helping relationships. The first three stages correspond to Lewin's unfreezing stage, the
next two to his moving stage and the final two to his freezing change. In this theory,
there is a lot of focus on the change agent. The third stage assesses the change agent’s
stamina, commitment to change and power to make change happen. The fifth stage
describes what the change agent’s role will be so that it is understood by all the parties
involved and everyone will know what to expect from him. At the last stage, the change
agent separates himself from the change project. By this time, the change has become
         Havelock's change theory has six stages and is a modification of the Lewin's
theory of change. The six stages are building a relationship, diagnosing the problem,
gathering resources, choosing the solution, gaining acceptance and self renewal. In this
theory, there is a lot of information gathering in the initial stages of change during which
staff nurses may realize the need for change and be willing to accept any changes that
are implemented. The first three stages are described by Lewin's unfreezing stage the
next two by his moving stage and the last by the freezing stage.

       Written and copyrighted By Ngozi RN.

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