Question

Peggy Vizente, a clinical nurse on a 57-bed internal medicine ward at a medium-sized teaching hospital in Pittsburgh, Pennsylvania, has identified a problem of wasted nursing time spent acquiring supplies for client care. Nurse Vizente begins keeping track of the time she spends locating supplies for her clients’ care. She notes that at least 30 minutes per day are spent gathering supplies for clients. Nurse Vizente identifies a list of those items that she most frequently has to acquire to perform care. Systematically, she begins to develop a plan to present to her nurse manager to correct this situation. Nurse Vizente designs a nurse server—a container built into the room—to hold essential supplies. She also develops a procedure for how the supplies will be stocked and by whom. She takes her ideas to the nurse manager and proposes a change in procedure and in equipment (nurse server).

1. (a) Would you describe Nurse Vizente’s proposed change as radical or systematic? (b) How would you relate her process to the concept of “organized abandonment”?
2. This change is going to require some adjustments, of course, by not only Vizente’s supervisor, but by all the nurses affected. Identify key stages they will most likely experience if they are to agree to and successfully adjust to this new system.
   1. First knowledge of an innovation's existence and functions
   2. Persuasion to form an attitude toward the innovation
   3. Decision to adopt or reject
   4. Implementation of the new idea
   5. Confirmation to reinforce or reverse the innova­tion decision
3. Nurse Vizente’s nurse manager likes the idea and encourages her to present it at the next staff nurse meeting. She does and for the most part, it seems to be well received, with a couple of questions raised: “How can we test this out, though, before we have to say yes or no? I mean, the container—the nurse server—has to be built in each area first, right? So what happens if we pay to have these things installed and then find that we don’t like the system?” This is a valid question. Which of Rogers’ five factors (for determining a successful planned change) does this nurse’s question reflect?

Answer 1

Nurse Vizente’s proposed change is  radical because

-radical change means moving past an existing practice and develop an entirely new one that suit to overcome  the problem identified.

-in the prsenet scenario,the nurse identifies a problem in nursing care delivery,i.e daily wastage of precious nursing time and find out a new solution to overcome it,i.e designs a nurse server.

Relating Nurse Vizente's process to the concept of “organized abandonment”

• Organized Abandonment is the  routine assessment ,identification and elimination of any actvity that are no longer suitable.
• Here,the nurse assesses with current practice for locating patient care articles and identifies that there is wastage of 30 minutes per day.So she makes a detailed plan and develops a new nurse server to keep essential supplies for patient care.

Rogers’ five factors (for determining a successful planned change) that this nurse’s question reflects

According to Roger, the five factors that determine a planned change are

1.Relative advantage

2.Compatability

3.degrre of complexity

4.Trialability

5.Observability

The nurses question reflects the factor/characteristic-Trailability bacause

Trialability means the chance to test or experiment the chnage /innovation and nurse's question starts as "How can we test this out...."?.

In addition the nurse with question belongs to "early adopters' as per Roger since she is very cautious in her approach and she is in persuation stage.