For the DPI project the nursing theory selected is the Neuman’s nursing theory based on her systems model; and the specific model for the DPI application to practice is Kurt Lewin’s change theory. Per Butts & Rich (2018), a driving force pushes participants, in the case the hospital, toward change and this dynamic balance of forces that Lewin outlines as steps, apply to changing existing nursing practice. For example, the hospital acquired pressure injury (HAPI) rate is continuously not being met by the hospital despite all the resources and time they have thrown at this main problem. Lewin’s change theory can apply to this DPI by identifying the driving and restraining forces. Additionally, the stages to make change happen based on the intervention requires unfreezing, which is the act of destabilizing old behaviors, then to a stage of moving, and refreezing (Butts & Rich, 2018). There needs to be a culture change and use of new, evidenced-based interventions to drive the HAPI rate down and keep it down.
Lewin’s model includes three major concepts, or stages, that are forces within the organization that provides a basis for planned change. These include unfreezing, moving, and refreezing. The goal is to achieve affective change within an organization, and this is surroundings concepts such as driving forces and restraining forces. “Though Lewin only uses the labels unfreezing, moving, and freezing in three of his final publications, the origins of his three-step model can be found in his application of field theory to studying child psychology in the 1920s” (Burnes, 2020). For the change to be successful, the new quasi-stationary equilibrium has to be safe from regression (Burnes, 2020). A driving force facilitates movement into new direction, in this case for the DPI that new direction is a decreased HAPI rate to meet the organization’s goal to help improve patient care. An opposite force, the restraining force can block or impede progress toward the goal. This can come in many forms from an organizations’ culture to financial resources. It is important to note that change takes time, and it is a process. The purpose of this DPI is translational research but no matter what topic or intervention it will still produce a change to an organization and that is a delicate process. Understanding and applying Lewin’s change model to the process can help create a stabilization and equilibrium of positive results from the change to keep it in place and then that change can be assimilated into the organization.
Reference
Burnes, B. (2020). The origins of Lewin’s three-step model of change. Journal of Applied Behavioral
Science, 56(1), 32–59. https://doi.org/10.1177/0021886319892685
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