Change Strategy And Implementation


Analyze a professional environment and relevant data, (SEE SCENARIO BELOW) and develop a change strategy (3 pages) and discuss how to implement it successfully.

· 1. Develop a data table that accurately reflects the current and desired states of one or more clinical outcomes.

· 2. Propose change strategies that will help to achieve the desired state of one or more clinical outcomes.

· 3. Justify the specific change strategies used to achieve desired outcomes.

· 4. Explain how change strategies will lead to quality improvement with regard to safety and equitable care.

· 5. Explain how change strategies will utilize interprofessional considerations to ensure successful implementation.

Cite a minimum of 3 sources of scholarly or professional evidence no more than 5 years old.


The scenario:

You are an ICU nurse (black male) at St. Anthony Medical Center. You have been assigned Mrs. Smith (black female), a 52-year-old with a history of Type II Diabetes Mellitus, who was admitted this morning with high glucose levels and Acute Renal Failure.

Nurse: I see that your HA1C is at 8.5. Can you give me a history of your blood glucose readings over the last 2 weeks?

Mrs. Smith: My fasting blood sugars have been running around 200 with it getting as high as 350+ after each meal. I can tell that I wasn’t feeling very good, and I am swelling in my legs more than usual. I also have some blurred vision and I am very tired.

Nurse: Are you experiencing any other symptoms?

Mrs. Smith: Yes, I think so but I’m not sure if they are related.

Nurse: What are some of the other things going on?

Mrs. Smith: I have not voided as often as before, and I feel a little short of breath when I get up to walk to the mailbox. I also feel weak and even a little nauseous.

Now you are a home health nurse for St. Anthony Medical Center Home Health Agency. You have been assigned Mrs. Smith (black female), a 52-year-old with a history of Type II Diabetes Mellitus, who was discharged from ICU this morning after being admitted with high glucose levels and Acute Renal Failure. She is to be followed by Home Health for 6 weeks.

HOME HEALTH NURSE: Good afternoon Mrs. Smith! I see that your blood sugar levels were very high prior to being admitted to ICU. Can you tell me what they are running since this morning?


Mrs. Smith: Yes, I can. My fasting blood sugar was 125 this morning, and I checked it 2 hours after breakfast with a result of 140. I am so glad to be home! I am being more careful on my diet since I came home. Hopefully, I will know enough to keep my diet good, so my blood sugars stay normal.

NURSE: How are you voiding now?

Mrs. Smith: My kidneys are working great! I am able to get up to void without any problems. I void several times a day now and it is a pale-yellow color with no odor. Can you see that my ankles aren’t too swollen? They look much better. I can wear socks and even put some shoes on now

NURSE: Do you have someone in the home that helps you with your meals and care?


Mrs. Smith: a. Well…my daughter tries to come by every evening, but she has 3 kids and work, so I don’t expect her to come every day. If she is unable to come and cook, I usually just make a sandwich or have a bowl of cereal. Those are easy for me to make, but I don’t cook as much as I used to.