Kotter’s change theory in bedside handoff
Kotter identified eight steps for implementing change. There is a need to implement a beside handoff to improve the patients’ outcomes by involving the patients in the treatment process. As indicated above, there is undeniable evidence of the potential of the sentinel events in the bedside handoff procedures has led to poor patient outcomes (Small et al., 2016). Thus, there is an urgent need to implement the beside handoff changes.
A guiding coalition is necessary to make the essential beside handoff changes. The guiding coalition must include the change manager (nurse director), and members including nurse educator, clinical advisor, administrative, clinical supervisor, resource nurses, and senior bedside nurses committed to bedside report handoff to help in guiding process (Small et al., 2016). Nurse leaders must be educated on Kotter’s eight steps of implementing the desired changes.
The third step of the plan is to create a vision for the project. The vision of the change project is to improve patients’ outcomes and communication among the care givers, patients and families at the beside (Small et al., 2016). The ultimate outcomes of the proposed changes are to improve quality of care provided by improving families and patients in the treatment process to increase patients’ satisfaction.
The guiding coalition cannot implement the change alone and thus require buy-ins from other key players like the entire nursing team to make the changes necessary. The guiding coalition needs to empower others to implement the vision. Therefore, anyone critical in implementing the changes should be educated on the vision and the processes that will be changing and then given the autonomy to carry out these changes (Small et al., 2016). thus, each nurse must understand the need for effective communication at the end of each shift.
It is important for the guiding coalition to ensure that they maintain the change momentum in the entire process by creating quick wins. The team is to make visible and clear wins (Small et al., 2016). In this case, nurses can identify some of the problems that were as a result of beside handoff management such as missed medications, and nurses inefficiently completing their shift and leaving work late because of a tedious bedside handoff process. Addressing these problems are an example of quick wins that can lead to the motivation towards the success of the entire process.
After ensuring the change process’s success, the nursing department has the responsibility to institutionalize the change. The process needs to become a norm, and in the long run, it becomes an organizational culture (Small et al., 2016). Thus, the bedside handoff process should also be integrated into the orientation of new nurses and the education of float nurses.
Reflection
The change affects the nursing profession in various ways. The process can impact nursing education and training. Making such changes in nursing practice helps in improving the patient’s outcome. Thus, the process can be included in evidence-based practice theory for nursing students and training for interns. The process also influences the continuous education of float nurses as well as part of orientation for new nurses. The changes will affect the communication process of the nurse during a shift change. Thus, nurses will be required to practice effective communication through various channels such as face to face communication, or the use of electronic means. It will also ensure on-time leaving and arrival time for nurses. It will also act as a good guideline for other beneficial changes in the nursing profession.
References
Small, A., Gist, D., Souza, D., Dalton, J., Magny-Normilus, C., & David, D. (2016). Using Kotter’s change model for implementing bedside handoff: a quality improvement project. Journal of nursing care quality, 31(4), 304-309.
Palumbo, J. (2015). Implementing Bedside Shift Report: An Evaluation of Change in Practice.