nursing theories

1. CHANGE THEORIES
By / MahmoudShaqria
‫شقريه‬‫محمد‬ ‫محمود‬

2. Objectives
Define change.
Define change agent.
List characteristics of effective change agent.
List reasons of change.
List target of change.
Identify types of change.
List characteristics of change process.

3. • Discuss change theories :
 Traditional change theories
 Emerging Theories of Change
• Resistance to change
 definition
 Causes of Resistance to Change
 Strategies to Overcome Resistance to Change

4.  Change responses
 References

5.  Moving from a known to unknown.
 Is an alternation haphazard or planned to make
something different.
 making something different from what it was
Definition of Change Agent:
 Is a person skilled in the theory and
implementation of planned change
Definition of Change

6.  Display leadership.
 Trusted by others.
 Empower others.
 Manage conflict.
 Understand change process.
Effective change agent characteristics in the
change

7.  Reasons for Change:
 Change occurs because of an intended effort by a
change agent to deliberately move the system.
 Change in order to solve a problem.
 Change to make work procedures more efficient.

8. Targets of change:
 Change of knowledge.
 Change of attitude.
 Change of behavior.

9. Types of Change
(1) Planned Change (leading):
 Is a change that results from a well-thought out and
deliberate effort to make something happen.
(2) Unplanned Change (by drift):
 Is a change that unplanned and occurs as a result of an
imbalance in the system.

11. Characteristics of Change Process:
 Is a natural social process.
 Involves individuals, groups, organizations and society.
 Is constant and accelerates at various rates
 Is inevitable and unpredictable.
 Varies from high complexity to low complexity

12. CHANGE THEORIES
A) Traditional change theories:
Lewin’s force-filed Change Model theory (1951).
Lippitt's phase model theory (1958).
Havelock`s model theory(1973)
Rogers`s theory (1995).
B) Emerging Theories of Change:
Chaos Theory
Theory Of Learning Organization

13. Traditional change theories

15. 1- Lewin’s force-filed Change Model theory (1951):
 Lewin provides a social-psychological view of the change process.
 He sees behavior as a dynamic balance of forces working in opposing
directions.
 Driving forces vs. Restraining forces.
 Status quo level is the person balanced state or state of equilibrium
between two forces. Process of change (phases)

16.  Lewin’s theory Three-Step Change Model:
• Unfreezing
• Moving
• Refreezing

18. 2-Lippitt`s phase model theory (1958):
 This theory extended Lewin's theory, focused more on what
the change agent must do than on the evolution of change
itself:
1-Diagnose the problem
2-Assessment of the change agent`s motivation and
resources

19. 3. Selecting progressive change objective: Develop the
action plan
4-Choosing appropriate role of the change agent
5-Maintenance of the change .
6-Termination of the helping relationship

20. 3-Havelock`s model theory (1973):
 This theory is also modification of Lewin’s theory; Havelock
describes an active change agent as one who uses a
participative approach.
 Six steps:
1. Building a relationship.
2. Diagnosis the problem.
3. Acquiring the relevant resources.
4. Choosing the solution.
5. Gaining acceptance.
6. Stabilization and self-renewal.

21. 4-Roger's planned change (1995):
 Roger identified five phases to the adoption of change:
1. Knowledge: Establish the person's awareness about the
need for change.
2. Persuasion: a favorable or unfavorable attitude toward the
change forms.

22. 3 -Decision Evaluation: activities lead to a decision to
adopt or reject the change.
4 -Implementation: the change is put to use.
5 -Conformation and Adoption: accept new status

23. Emerging Theories of Change

24. 1-Chaos theory(Chaos theory(McDaniel’s (1996)):
 Margaret Wheatley, 1992 Look at an organization as a
living organism
 Learn management from natural systems
 Basic Premise : Self-organization

25. Chaos Theory Principles:
• Information access
• Relationships
• Self-reference (The organizations core identity or purpose)

26. Chaos Theory Assessment:
• Goes against many traditional beliefs about role of managers
• Requires educated, involved employees
• Requires change in communication methods
• Clear vision/joint purpose is crucial

27. 2. Theory of learning(Peter Senge (1990):
 Organization Emphasize that the core of the learning
organizations based on five "learning disciplines" lifelong
programs of study and practice
1- Personal Mastery:
 Learning to expand our personal capacity to create the
results we most desire.

28. 2- Mental Models:
 Reflecting on, continually clarifying, and improving our
internal pictures of the world.
3- Shared Vision:
 Building a sense of commitment in a group by developing
shared images of the future we seek to create.

29. 4-Team Learning:
 Encouraging conversational and collective thinking skills.
5 -System Thinking:
A way of thinking about and understanding the forces and
interrelationships that shapes the behavior of systems.

30. Resistance to change
 Efforts by employees to block the intended change.
 Causes of resistance:
 Lack of trust.
 Perception that change is not necessary.
 Relatively high cost.
 Fear of personal failure.
 Threats to values and ideas.

31. Overcoming resistance:
 Communication and education
 Participation and involvement
 Facilitation
 Negotiation and agreement
 Cooptation and manipulation
 Power or coercive approach

34. Change Responses
(1) Human Side of Change:
 Resistance
 Innovators thrive on change.
 Early adopters
 Early majority
 Late majority
 Laggards

35. (2) Systems and Technologic Side of Change:
 Emerge : as a signs of more less efficiency.
 Initial response of confusion.
 Periods of adaptation.

36. References
 Esstenials of Nursing Leadership & Management Patricia Kelly,2010 Second Edition
CHAPTER 6 Change, Innovation, and Conflict 152-158
 Leadership and Management Skills for Long-Term Care-Springer Publishing Company
(2008) page 92-105
 Sullivan & Decker, 2005, p. 217
 Marquis and Huston BL. CJ. (2006): Leadership roles and management function, 5th
ed., California State University, Chico California, P 71; P. 182.
 Marquis and Huston BL. CJ. (1998): Management decision making for nurses, 3rd ed.,
California State University, Chico California.
 Wise PY. (2007): Learning and management in nursing, 4th ed.,, Texas Tech University
health services center Lubbock, Texas.
 https://www.prochange.com