Use the information on the “plan change paper” to make a Poster and Abstract. Poster should be single spaced, while abtstract should be doubled spaceNB: Attached are:Plan change project paperChange project poster and Abstract instruction RubricChange template posterExample of a change poster (on bedside handover)Change Project Poster, Abstract and VNS Instructions & Rubrics
Poster Instructions: Use your change paper to fill in bullet points of each area of the change template (find in
the content area of D2L). Be sure to include everything the rubric asks for. Be sure to incorporate instructor
feedback from your paper as appropriate.
IMPORTANT: Be sure your poster addresses every single check
box of the rubric in order to avoid losing points
Problem that Creates a Need for Change include citations
Element Insufficiently
Poster Rubric
 Introduce the change-what is it? What are the key
 Impetus& Justification for change including evidence
 Expected outcomes
6 pts
 Description of Setting of change
 Describe Stakeholders: Those impacted by the
change (Internal & External)
2.5 pts
Communication networks/strategies
 How change will be communicated
 Specific leadership support needed
2.5 pts
Change Process:
 Apply each step of your chosen theory to the actual
change (be sure to cite the change theory)
5 pts
Managing Resources

Confidence & Concerns
Impact Assessment-how you will measure outcomes
Conclusion-summary of results & impacts
Poster Design
 Use appropriate size font (everything must fit in
template & be easy to read)
 Uses images and or diagrams, graphs, etc. to help
add interest/explanation *See notes below regarding
Format according to guidelines, proper APA format,
spelling & grammar, references
Total Points
*Images you use in your presentation must be Creative Commons (CC) or Copyright free and must be given proper
attribution (citation). Follow these steps to ensure that you have both of these requirements:
1. Find your images at sites that have CC licensing or are open sources/copyright free:
2. Provide proper attribution for your images-a must:
• How to give attribution
• Best practices for attribution
• If image is not a CC image, must state “courtesy of” and source
Abstract Instructions: Abstracts should be 300 words or less, use Times New Roman 12-point font, and
written in past tense (see examples in content area of D2L)
Format and content for the abstracts is as follows:
• Description of the project or study. Include a statement of the problem and the population addressed
• Method(s) used (literature review, model/theory, practice change/improvement)
• Analysis of results to support project or summary of results
• Discussion of implications for practice and future recommendations.
• Objectives: list 2-3 measurable learning objectives for the audience of your Poster presentation, e.g.
“learners will…” or “attendees will…” Please check out this resource for measurable verbs you may use in
your objectives (as well as verbs to avoid)
Note: some verbs such as “understand” are not measurable.
Element Insufficiently
 Description of the project or study. Includes a statement of the
problem and the population addressed (.5 point)
Abstract Rubric
 Discussion of the method(s) used (study method, literature
review, model/theory, practice change/improvement) (.5 point)
 Analysis of evidence to support project or summary of results
(1 point)
 Discussion of implications for practice and recommendations.
(1 point)
 Objectives: lists 2-3 measurable learning objectives for the
audience (1.5 point)
 Title page & abstract format according to guidelines, proper
spelling & grammar
Total Points
Virtual Nursing Symposium (VNS) Instructions: You will be responsible for posting the presentation in the
VNS found in the Courseroom in the discussion area by 11:59PM the date listed in the course calendar.
Then, during the next two days when the symposium is held, ask at least four of your peers a profound
question about their chosen Change Project. The presenter(s) is responsible for checking into their
presentation thread once daily both days of the symposium to answer any questions posted by
 Asks at least four peers a profound question about their
chosen Change Project some time during the two days the
symposium is scheduled (see calendar).
 Checks Symposium both days & responds to questions asked
by others of own presentation
Total Points
Element Insufficiently
Symposium Participation Rubric (Professor will Grade)
Title of Change Project
Student Name, RN, BS Completion Student
Minnesota State University-Mankato, School of Nursing
Problem that Creates a Need for
Description of Setting
Change Process
Resource Management
Those impacted by Change
Impact Assessment
Communication Networks
PowerPoint Template ©2009 Texas Christian University, Center for Instructional Services. For Educational Use Only. Content is the property of the presenter and their resources.

Contact Information

Student Name, RN, BS Completion Student

Implementing Bedside Shift Report
Student Name, RN, BS Completion Student
Minnesota State University-Mankato, School of Nursing
Problem that Creates a Need for
• “The most frequent period of
professional communication in acute
care hospitals is the shift-to-shift
report by nurses” (Evans et al., 2012,
p. 281)
• Currently, shift report takes place at
the nurses station or in the hallways
which involves distractions and
interruptions while not including the
• The change needed is implementing
bedside shift report (BSR) as standard
practice to improve communication,
actively involve patients in their care,
and reduce overtime
• BSR will “positively influence staff
satisfaction, offer beneficial financial
effects by reducing nurses’ overtime
and allow direct patient care to start
earlier” (Malfait et al., 2017, 483)
• The goal and expected outcomes of
this planned change include respecting
patient confidentiality, promoting a
calm and quiet environment
throughout the hospital unit,
improving “patient satisfaction, better
clinical outcomes, improvement of
health education, and enhanced team
coherence” (Malfait et al., 2017, p.
PowerPoint Template ©2009 Texas Christian University, Center for Instructional Services. For Educational Use Only. Content is the property of the presenter and their resources.
Description of Setting
• Medical/Surgical/Oncology Unit (18
Beds) in Woodwinds Health Campus
• The unit consists of two nurse
managers, one staff educator, thirtytwo Registered Nurses, and twenty
Certified Nursing Assistants.
Those impacted by Change
• Directly impacted: Registered Nurses
and patients
• Indirectly impacted: Nursing
assistants, social work/care
management, spiritual care, integrative
therapists, phlebotomists, and
physical/occupational therapists
Plan-Do-Study-Act Model

Aim: Nurses on the Medical/Surgical/Oncology
unit will conduct bedside shift report ninety
percent of the time or more by February 1st, 2018
Plan: Replace current shift report practice, identify
objectives and guidelines, and policy is written
Do: Email staff informing them of change, create
poster introducing plan, and educate staff and
proposed change is implemented
Study: The change is evaluated through random
audits and patient/nurse surveys
Act: Review audits and surveys to determine
compliance rate and finalize implementation of
the plan
Resource Management

Obtain sufficient evidence and research on

Present findings and idea for the purposed
change to nurse managers and staff

Introduce the proposal to the charge nurses

Create a template to be used for BSR

Introduce the proposal of implementing
BSR to the nurses

Follow-up with the nurses on a continuous
Impact Assessment

Audits and surveys

Monitor overtime through overtime
reasoning forms

Safety and fall events will be monitored
to look for trends

Patient satisfaction surveys
Image courtesy of
Communication Networks
• The planned change will be
communicated to staff through email
followed by an in-service directed by
the implementing team
• The implementing team consists of the
two nurse managers, the staff educator,
and the charge nurses on the unit
• Following the in-service all floor
nurses will use the teach-back method
with a member of the implementing
• For this planned change to take place
and sustain, leaders will need to step
up as role models and implement,
encourage, and support the change
• Caruso, E. (2007). The evolution of nurse-to-nurse bedside report on a medical-surgical
cardiology unit. MEDSURG Nursing, 16(1), 17-22. Retrieved from
• Evans, D., Grunawait, J., McClish, D., Wood, W., & Friese, C. R. (2012). Bedside shift-toshift nursing report: Implementation and outcomes. MEDSURG Nursing, 21(5), 281-292.
Retrieved from
• Guide to patient and family engagement in hospital quality and safety. (2013). The Joint
Commission. Retrieved from
• HealthEast Infonet. (2017). Retrieved from
• Kelly, P., Vottero, B. A., & Christie-McAuliffe, C. A. (2014). Introduction to quality and
safety education for nurses: Core competencies. New York, NY: Springer
• Lacey, S. R. (2017). Driving organizational change from the bedside: The AACN clinical
scene investigator academy. Critical Care Nurses, 37(4), e12-e25. doi:10.4037/ccn2017749
• Malfait, S., Eeckloo, K., Van Hecke, A., Van Biesen, W., & Lust, E. (2017). Feasibility,
appropriateness, meaningfulness and effectiveness of patient participation at bedside shift
reporting: Mixed-method research protocol. Journal Of Advanced Nursing, 73(2), 482-494.
• Marquis, B. L., & Huston, C. J., (2017). Leadership roles and management functions in
nursing: Theory and application, 9th edition. Philadelphia: Lippincott, Williams & Wilkins.
• McMurray, A., Chaboyer, W., Wallis, M., & Fetherston, C. (2010). Implementing bedside
handover: Strategies for change management. Journal Of Clinical Nursing, 19(17/18),
2580-2589. doi:10.1111/j.1365-2702.2009.03033.x
• Module 4. Approaches to quality improvement. (2013). Agency for Healthcare Research
and Quality. Retrieved from
• Tobiano, G., Whitty, J. A., Bucknall, T., & Chaboyer, W. (2017). Nurses’ perceived barriers
to bedside handover and their implication for clinical practice. Worldviews On EvidenceBased Nursing. 14(5), 343-349. doi:10.1111/wvn.12241

Patient satisfaction scores will increase,
safety/fall events will decrease, and staff
overtime will decrease with the
implementation of BSR which will greatly
benefit the Medical/Surgical/Oncology unit

Contact Information

Student name, RN, BS Completion Student

Implementing Early Ambulation After Surgery
Minnesota State University, Mankato
Change is typically inevitable not only for the healthcare industry but also in every working
institution. The unavoidable could be due to revised professional standards and policies, an aging
workforce, advanced medical care practice concerning novice technological platforms, shortage
of labor, and a rise in treatment costs. Ambulation is the act of walking from one point to another
independently with or without assistive devices. Early ambulation after surgery is a critical
activity that patients can do to prevent postoperative complications. The patient’s ambulation
following surgery needs early planning and interdisciplinary link to address potential patient,
structural, and cultural barriers that may block early ambulation. Barriers and hospitalization
result in decreased patient mobility, activity level, and decline in functional organs. The decrease
in mobility results in pressure ulcers (bed sores), blood clots, osteoporosis, dehydration,
malnutrition, delirium, sensory deprivation, isolation, sheering forces on the skin, and urinary
incontinence in-patient. Therefore, with these problems that emerge due to lack of ambulation, it
is necessary to embrace change in the health care system. The change required is the
implementation of early ambulation after surgery as a standard of practice through management.
Early ambulation involves a low-intensity activity of walking in patients who are recovering
from surgery. It promotes sufficient blood circulation and oxygen throughout the body; it
prevents the development of stroke-causing blood clots and improves blood flow that helps in
quicker wound healing.
To effect change is necessary to consider the Plan, Check, Do, Act model (PCDA) and
Lewin’s theory. Lewin’s change theory is the vital theory used in the health care institution. This
change theory is categorized into three phases to enhance effectiveness for change. The phases
include unfreezing, changing, and refreezing. The unfreezing stage marks the creation of
problem awareness by making it possible for individuals to embrace change. The changing phase
involves seeking alternatives and illustrating the need and importance of change. According to
Shirley (2013), refreezing is the third stage of the theory that integrates and stabilizes the new
equilibrium and embeds it into the system. It becomes a habit and resists further change. The
planned change will be implemented on the surgical unit to have better clinical outcomes and
improved patient mobility to be reproducible and quantifiable for general status such as pain
control, improved respiratory and cardiac function, and patient satisfaction.
Justification for Change
Implementing early ambulation after surgery will not significantly impact the nurses’
workload and workforce since the current practice incorporates ambulation practices. The
planned change includes having the method rendered early enough to avoid postoperative pain
instead of focusing on perioperative care, including early ambulation, a constraint of narcotics,
and fluid balance maintenance to aid in pain control and patient satisfaction. According to the
research conducted by Liu et al. (2015) on pneumonia patients, the report illustrated a significant
reduction in pneumonia rates from 5% to 0.6% after the application of T-ERA (Thoracic-Early
Recovery with Ambulation After Surgery). Early ambulation after surgery aids in reducing postoperation thrombosis and improves blood flow to the abdomen and hips that rejuvenates the
muscle and increases muscle tone and strength since, after surgery, muscles tend to crump
become stiff.
The anticipated change will impact the economic approach since nurses will require training
and skill concerning early mobilization; nevertheless, early ambulation after surgery will
decrease complications leading to a decrease in LOS (Length of Stay) and costs. Research from
Europe and North America have quantified early ambulation after surgery to be cost savings; for
instance, liver, pancreas, and colorectal surgery in the whole provincial healthcare system in
North America demonstrated net cost savings ranging from $ 2900 to $2900 per patient.
Therefore, early ambulation is cost-beneficial and cost-effective concerning a decrease in
complications resulting in a positive impact on economic growth. The change is linked to
regulatory requirements, quality, and health safety to realize early ambulation benefits after
Social justice is the concept of equality and human rights and access to how human rights are
manifested in individuals’ lives. It redresses the inequalities based on gender, race, religion, and
age. Factors such as socioeconomic status, environment, employment, and education are among
social justice examples in healthcare. The healthcare management can offer nurses training to
ensure they are culturally competent, advocate for patient rights, and provide a significant
medical care level to all individuals. The health care workers can eradicate disparities by creating
diverse care delivery models and deploying virtual care tactics due to advances in technology
despite some devices used in early mobilization are tagged to TechNet. The proposed planned
change is related to quality and health safety policy concerning enhanced recovery through
evidence-based perioperative care and published protocols for procedure-specific recovery
The best practice evidence to support the proposed change is through the PICO question, a
derivative of (P) is the in-patient population, (I)is the data obtained from the early postoperative
ambulation, (C) is the data attained from the comparison to delayed ambulation whereas (O) is
the length of hospital stay and decrease complication. The nurses can achieve the implications
for the practice of PICO question through implementing nurse-driven mobility protocols
whereby forms are populated with markers to flag whether or not patient ambulate on
postoperative day zero and early alimentation to suggest whether or not the patient is at an
advanced state to have postoperative gastrointestinal and pulmonary complications. Enhanced
Recovery Ambulation within 1-3 days following admission is highly endorsed to improve patient
outcomes and decrease hospital stay length in postoperative patients. This practice enhances the
patient’s physical function and enriches their lives’ psychological concept, for instance, increased
quality of life and autonomy in their lives (Kelly, 2014). The other strategy to support the
planned change is through having signage hung in the patient room to facilitate goal setting and
reminding him/her of the physician’s expectations. Preoperative education has shown a positive
effect on early ambulation since the patient can know and understand the benefits of ambulation
and complications of not participating.
Description of Health Care Setting
Duke University Hospital is ranked as one of the best in America, and it is known globally for
its exceptional care and groundbreaking research. It is a research institute where medical
advances are generated and utilized and a teaching hospital for medical students, nursing, and
related health sciences. The hospital has almost 8700 employees and 900 in-patient beds. The
hospital offers comprehensive diagnostic and therapeutic facilities, such as the regional
emergency or trauma center, surgery suite comprising 40 operating rooms, an endosurgery
center, an ambulatory surgery center with eight operating rooms, and an extensive diagnostic and
interventional radiology area. The projected change will take place on the all-surgical unit at
Duke University Hospital.
Description of Those Impacted by Change
The nurse manager, staff educator, and nurse-in-charge are the facilitators of the projected
planned change. The mentioned individuals will steer the change and act as role models during
the change process. Therefore, they will initiate preoperative education schemes when the
moment of change dawns on other staff by providing recent research and evidence to support the
intended change. The change directly impacts these individuals due to responsibilities such as
initiating and coordinating the planned change. Nurses on the surgical unit will be directly
affected by the outlined change of implementing early ambulation after surgery. The possible
legal and ethical concerns may arise if early ambulation after surgery is conducted unethically,
breaching patient confidentiality to others.
Communication strategies
The hospital administrator makes the decisions. The organizational structure used is the
functional organizational structure, characterized by a pyramid hierarchy that describes the roles
carried out and the central management positions supposed to carry out the functions (Pilgrim,
2019). The health organization’s size and complexity will determine the structure’s outlook. This
helps in identifying and carrying out the different services required to deliver. Changes can result
in uncertainty, so management should understand the need to communicate changes in structure
and policies in their respective organizations. Effective communication can be done by
identifying the influencers in different segments of the organization. These are people who are
most heard; thus, they can be used to communicate the gains that can be achieved from the
change. Having constant communication with internal and external audiences enables
management to set the pace for everyone. Having everyone understand the changes helps
develop goodwill, thus contributing to a successful transformation. The leadership support
necessary to support this change includes having them act as role models, manage to get support
and buy-ins from other sectors within the organization, and appoint people who can help manage
the initiative. They also need to allocate the relevant resources towards the change.
I will prepare by engaging with colleagues and every other person to identify and
accomplish shared objectives. It is essential that all members within the organization share in
their practice, especially in collaborative management. Working together with other practitioners
can develop accountability while mitigating errors. Some of the concerns to include in the
change strategy are generating a healthy work environment and ensuring staff retention and
engagement. During these changes, staff engagement may reduce, affecting their ability to
manage and function with new procedures, limiting the ability to get the intended results. The
change will be successful since it clearly shows innovative ways of carrying out different
operations within the new structure. It describes the role leadership and the rest of the
organization plays in implementing the change and the processes involved efficiently. The
budgetary, space and human resources required to develop the new leadership structure will
depend on the benefits the structure can deliver. This information will primarily rely on the
skills, knowledge, and morale of those tasked with implementing the changes. There is a need to
balance the physical and human resources since they are significant in its success. They should
be handled differently due to their considerable differences. The change can be sustained through
implementing the identified performance goals. These involve focusing on coordination between
the various segments.
The stages of change include the unfreezing stage, which involves finding a procedure
that helps those within the organization change their previous patterns and encouraging them to
be compliant (Cummings, 2016). During this stage, there is disequilibrium meant to destabilize
the structure, thus making it possible to know the change’s driving force. This could take around
seven months to implement since it involves reducing the restraining forces that have a negative
impact on the current structure and increase the forces driving the organization towards the
appropriate equilibrium. The next stage consists of changing the company’s perception and
behavior, aligning with the new leadership structure. This involves convincing those within that
the structure previously is not practical, working with them to find ways to implement the
desired transitions, and connect with influential people within the organization who agree with
the desired change. This could take around five months.
The last stage is known as refreezing. It is crucial since it ensures the changes
implemented in the second stage are sustainable over time. The success of this stage will result in
stability. Using evidence, clinical reasoning, and different perspectives from other professionals,
baccalaureate-prepared nurses can develop new leadership structures through evidence-based
practice, clinical results management, and care integration. This will help them handle different
leadership structure domains like team coordination, disease management, and quality
management. Baccalaureate-prepared nurses exemplify professional and personal accountability
through making well-informed decisions that enable the patients’ well-being, treating colleagues
and patients as people with distinct beliefs, requirements, and values, and ensuring they uphold
honesty and integrity even during the most trying situations.
To determine if the changes are effective, those within the organization have to cause the
change. When they are allowed to participate in the changes, there are reduced chances of
encountering resistance. Having people participate in the change in uniformity ensures that
everyone becomes part of the change since they have a standard plan. Lastly, when they
understand the need for the changes, they will realize their importance and those they are
serving. This will reduce resistance. Ways to determine if the proposed changes will be effective
include specifying the performance metrics to analyze if the changes improve health outcomes
(Jacobson, 1999). By selecting measures that enable monitoring the steps involved in the
improvement method, the organization will assess whether care is improving after the changes.
Also, seeking various measures that address the significant aspects of the improvements
achieved can help determine the change’s effectiveness. The impact on the health of the
population can be determined through successful engagements with different stakeholders,
especially those who can act or spur action. The level of engagement is reliant on the specific
issues being addressed by the health organization.
To conclude, the planning process includes frequent and efficient communication with
everyone within the organization. Also, there is the fostering of team culture to align their roles
to the common goal. The next step is to identify and empower those working towards achieving
the specified objectives since they will be important in convincing others. Lastly, give feedback
so that everyone understands the impact of their actions. Creating a new leadership structure
enables people to stay committed to the organization and the safety of patients. This results in
enhanced quality of care and improved organizational culture. Creating a new leadership
structure increases coordinated care and clinical integration.
Cummings, S., Bridgman, T., & Brown, K. G. (2016). Unfreezing change as three steps:
Rethinking Kurt Lewin’s legacy for change management. Human relations, 69(1), 33-60.
Jacobson, N. S., Roberts, L. J., Berns, S. B., & McGlinchey, J. B. (1999). Methods for defining
and determining the clinical significance of treatment effects: description, application,
and alternatives. Journal of consulting and clinical psychology, 67(3), 300.
Kelly, P., Vottero, B. A., & Christie-McAuliffe, C. A. (2014). Introduction to quality and safety
education for nurses: Core competencies. Springer
Liu, Z., Tao, X., Chen, Y., Fan, Z., & Li, Y. (2015). Bed rest versus early ambulation with
Nursing Administration, 43(2), 69-72.
Pilgrim, K., & Bohnet-Joschko, S. (2019). Selling health and happiness how influencers
communicate on Instagram about dieting and exercise: Mixed methods research. BMC
Public Health, 19(1), 1-9.
Shirey, M. R. (2013). Lewin’s theory of planned change as a strategic resource. Journal of
standard anticoagulation in the management of deep vein thrombosis: a metaanalysis. PLoS One, 10(4), e0121388.

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