Utilizing a change theory can help Doctoral of Nursing Practice (DNP) students or DNP prepared nurses to facilitate change and successfully implement best practice changes, policies or workflow changes. Despite the differences in change theories, they are all divided into three stages; pre-change, change and post-change (Barrow et al., 2022). Lewin's Theory of Planned Change was one of the original change theories which later theorists have continued to build upon. Lewin's theory discusses three stages of change: unfreezing, moving and refreezing (Barrow et al., 2022). In the unfreezing stage, the need for change must be recognized and understood and to reflect upon the problem at baseline (Harrison et al., 2021). During the moving stage, the change is implemented and in the refreezing stage the change data is collected and analyzed, whilst allowing for the change to become established as the new norm (Barrow et al., 2022; Harrison et al., 2021). Lewin's Theory of Change provides the fundamentals for change and has been utilized throughout nursing for changes at the bedside such as implementation of new protocols including being instrumental in the adaptation of bedside shift report (Harrison et al., 2021). Stages of Change Theory, also known as the transtheoretical model, has five, easy to follow steps for making a change (Raihan & Cogburn, 2023). The stages are: precontemplation, contemplation, preparation, action and maintenance (Raihan & Cogburn, 2023). During the precontemplation stage, patients are usually reluctant to change or are unaware of the need for change which is followed by awareness and acknowledgement for the need of change, however there is uncertainty towards making the change (Raihan & Cogburn, 2023). Preparation begins the commitment to change along with gathering information in preparation to change such as self-help books, counseling etc (Raihan & Cogburn, 2023). Action is the initiation of changes, usually less than 6 months, followed by sustaining the change during the maintenance stage (Raihan & Cogburn, 2023). The Stages of Change Theory is most commonly used for behavioral modifications such as smoking cessation, weight management with diet and exercise but can also be used for preventive measures such as screening for cancer (Raihan & Cogburn, 2023).
a. Lewin's Theory of Planned Change
b. Stages of Change Theory (transtheoretical model)
c. Pre-change, change, and post-change stages
d. Unfreezing, moving, and refreezing stages