Theories of change represent purposeful models that explain how initiatives or projects contribute to the intended result through a chain of early and intermediate outcomes. Several theories have been applied to the nursing process to represent various ways in which a particular initiative can be carried out. Specifically, Lewin’s Change Theory involves such stages as unfreezing, moving, and refreezing, which depend on the presence of resistant and driving forces, with the latter dominating over the former (Cummings et al., 2016). Spradley’s Change Theory is a modification of Lewin’s approach and implies continuous change process evaluation for ensuring success. It involves symptoms recognition, problem diagnosis, alternative solutions analysis, changes selection, change planning, implementation, evaluation, and stabilization.
Spradley’s theory is suitable for addressing the EBP concerning travelling with CHF and avoiding exacerbations. The model is comprehensive enough to include specific steps to be carried out during program implementation as well as allow investigate of different alternatives. In addition, as the change is being carried out, there is a possibility of continuous evaluation that increases the chances of implementing relevant and practical solutions. As to the use of either of the theories, the preceptor used Lewin’s model of change and did not get the desired results. The issue with the model was that it was not detailed enough and could be interpreted differently by practitioners, which led to misunderstanding and delays in progress. Besides, it was rigid and did not reflect the modern healthcare context, as well as was rather combative instead of nurturing (Oguejiofo, 2018). Because change implementation needs a positive and nurturing environment, it is best to select models that account for this and can be used effectively.
References
Cummings, S., Bridgman, T., & Brown, K. (2016). Unfreezing change as three steps: Rethinking Kurt Lewin’s legacy for change management. Human Relations, 69(1), 33-60.
Oguejiofo, N. (2018).Change theories in nursing.