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The Change Process and

Lewin's Theory
You must be the change you wish to
see in the world. - Mahatma Ghandi
If you want to truly understand
something, try to change it. - Kurt
Lewin

This learning activity is intended to provide


learners with the opportunity to:
1. Apply Lewin's Change and Force Field
Analysis theories to selected situations.
2. Identify driving and restraining forces that
influence change.
3.Apply basic change theories to nursing issues
and situations.

DRIVING FORCES

EQUILIBRIUM

RESTRAINING F.

Driving
forces
are
forces that push in a
direction that causes
change to occur.

Equilibrium is a state of
being where driving
forces equal restraining
forces and no change
occurs

Restraining forces are


forces
that
counter
driving forces.

Driving forces facilitate


change because they
push the person in the
desired direction.
They cause a shift in
the equilibrium towards
change

Restraining
forces
hinder change because
Equilibrium
can
be they push the person in
raised or lowered by the opposite direction.
changes
that
occur
between the driving and Restraining
forces
restraining forces.
cause a shift in the
equilibrium
which
opposes change

Lewin's change theory consists of three


distinct and vital stages:
Unfreezing
Moving to a New Level or Changing or
Transition
Refreezing.

UNFREEZING
Unfreezing is the process which involves finding
a method of making it possible for people to let
go of an old pattern that was counterproductive
in some way.
Unfreezing is necessary to overcome the strains
of individual resistance and group conformity.
Unfreezing can be achieved by:
First, increase the driving forces that direct behavior away from
the existing situation or status quo.
Second, decrease the restraining forces that negatively affect the
movement from the existing equilibrium.

CHANGING
Involves a process of change--in thoughts,
feelings, behavior, or all three, that is in some
way more liberating or more productive.

REFREEZING
Is establishing the change as a new habit,
so that it now becomes the "standard
operating procedure."
Without some process of refreezing, it is
easy to backslide into the old ways.

The manager receives information on a new wound care


protocol which has been shown to reduce development
of pressure ulcers and speed healing of existing wounds.
Nurses are happy with the current procedure and see no
need for change. To initiate the unfreezing stage, the
manager enlists the help of the charge nurses and
provides each a copy of the proposed protocol and
research articles supporting the change. After educating
the charge nurses a nursing staff meeting is called and
the manager introduces new protocol. Prior to sharing
the new policy/procedure the manager reviews the
Medicare
reimbursement
guidelines
regarding
nosocomial ulcer development and research showing
effectiveness of new procedure. The manager displays
posters and other educational materials throughout the
unit. After allowing the staff to look over the materials

and consider the changes another staff meeting


is called. The policy and procedure "go live" date
is announced. Mandatory education is
scheduled for all nursing staff. During the first 3
months of implementation the manager and
charge nurses closely monitor charts, do walking
rounds and discuss any difficulties the nurses
may be having regarding the new procedure;
each monthly staff meeting involves some
discussion of the new policy. Once the threemonth mark has been reached the oversight
continues to ensure compliance, all new staff are
educated and quarterly statistics are provided to
the nurses as encouragement and proof that the

new policy has been effective. Continued


oversight ensures that the freezing remains and
old habits do not slip back into practice.

The three stages of unfreezing-changerefreezing has successfully occurred. The


nurses are excited by the improved patient
outcomes and decreased time spent caring for
wounds and it has become a permanent change
on your nursing unit.