Question 1

The nursing supervisor identifies ineffective communication as a problem among the managers. According to Lippitt's phases of change, which action by the supervisor reflects the final stage of improving this issue?

Accepted Answer

1. Evaluating the amount of change would occur before the final stage.
2. According to Lippitt's phases of change, the final stage is terminating the helping relationship.
3. Maintaining the change is the next to last of Lippitt's stages.
4. Looking for persons who may be sabotaging change efforts is not the last of Lippitt's stages.

Question 2

The novice nurse manager is acting in the role of change agent for the unit. Which statement indicates that this manager needs further training in regard to change?

Accepted Answer

1. The ability to retain a big-picture focus while dealing with each part of the change is a desirable trait for a change agent.
2. The change agent must have sufficient flexibility to modify ideas when this will improve the change, but enough persistence to resist nonproductive tampering with the planned change.
3. It is likely that those who are resistant will adapt to the change if given enough time and support.
4. Staying available the whole time is not realistic and will make it difficult for the change agent to maintain the energy it will take to make the change more successful.

Question 3

When faced with the prospect of change, the nurse states, "We have always done it this way and never had any problems." A few weeks later, the same nurse remarks, "This new way seems to work better than the old way did." This statement is characteristic of which type of change response?

Accepted Answer

The nurse initially resists change and is a laggard. However, the statement that the new way works better indicates a shift towards acceptance and a willingness to adopt the change, placing the nurse in the early majority category.

Question 4

The nurse manager is planning to initiate new policies in the department and is reviewing several change theories. Which step of Havelock's model will the nurse find most closely resembles Lewin's moving stage?

Accepted Answer

1. Self-renewal and stabilization occur during the final stage and are most like Lewin's refreezing stage of change.
2. Choosing a solution and gaining acceptance are most like Lewin's moving stage. Previous to this stage in both models, the work is to convince participants that change is necessary and to secure resources for the change. After solutions are identified and implemented, the final stage begins.
3. The first three steps of Havelock's theory are building a relationship, diagnosing the problem, and acquiring resources. These three steps are most like Lewin's unfreezing stage.
4. The first step of Havelock's model is building relationships among participants. This is one of the steps that are equivalent to Lewin's unfreezing stage.

Question 5

Which action will have the greatest impact on the successful implementation of a planned change?

Accepted Answer

Creating a supportive environment for those undergoing the change will have the greatest impact on successful implementation of a planned change. It is important to provide support to individuals who are undergoing change as it can be a difficult and stressful process. This will increase their willingness to adopt and adapt to the change, leading to successful implementation. Disciplining individuals who continue to be resisters or ignoring them may lead to further resistance and pockets of disagreement, which can hinder the implementation of the change.

Question 6

Which factor best represents a driving force in the process of change?

Accepted Answer

The financial deficit of millions of dollars can be a strong motivating factor for change as it impacts the overall sustainability and success of the organization. Other factors such as an ineffective nurse manager, long-term administration or staff may also require change, but may not have the same level of urgency and impact as a significant financial deficit.

Question 7

The nurse administrator has been asked to work with other administrators to make a change in a long-standing hospital policy. What should be the nurse's first action?

Accepted Answer

Before any change can be made, it is important to thoroughly research the options and consider how they will impact the nursing staff and the hospital as a whole. This will ensure that any changes made are in the best interest of everyone involved.

Question 8

The nursing committee is planning a change in the unit's organization. Which statement reflects the priority expected outcome of these change agents' work?

Accepted Answer

The overall priority expected outcome of the nursing committee's work is to improve client care on the unit. While it is important for the nurses involved to have management skills and agree with the change, these are not the ultimate goals of the change. The change should guide nursing practice on the unit but only insofar as it improves client care.

Question 9

A new IV pump has just been purchased by the facility. Which statement by the nurse manager reflects Rogers' first step in making the change to this new equipment?

Accepted Answer

Rogers' first step in making a change is the awareness stage, where the individual gathers information about the innovation. Therefore, the nurse manager sharing information about the new IV pump with the staff is the first step in the process. Option A is incorrect because it suggests that the decision is solely up to the nursing staff, while the change management process involves different stakeholders. Option B is incorrect because a 3-month test run is part of the trial stage, which comes after the awareness stage. Option C is incorrect because the nurse manager's personal opinion is not relevant in the first step of the change process.

Question 10

The health care facility has elected to make a significant change in organization strategy. The change has been thoroughly researched and all levels of leadership have been included in the decision. Which roles are commonly undertaken by the nurse manager when such a change is necessary?

Accepted Answer

The answer of The health care facility has elected to...

Question 11

A proposed change in a health care organization is controversial and will require cooperation from all parties involved. Which change strategy should the change agent use?

Accepted Answer

The normative-reeducative change strategy is the best choice in this scenario because it emphasizes the need for cooperation and collaboration from all parties involved. This strategy involves promoting the desired behavior through education and communication, and creating a supportive environment for change. It is a participative approach that encourages individuals to share their ideas, opinions, and concerns, and promotes collective problem-solving. This strategy is appropriate for achieving controversial changes that require buy-in and commitment from all stakeholders. The other strategies, empirical-rational and power-coercive, are less effective in achieving cooperation and collaboration, as they rely primarily on incentives or authority to drive change. The empirical-reeducative strategy is also effective in promoting cooperation, but it focuses more on addressing knowledge and skill gaps rather than promoting social norms and values.

Question 12

The CEO of the hospital approaches the chief nurse with a request that the nurse act as the primary change agent in the implementation of a new hospital-wide policy. Why would the nurse be a good choice for this assignment?

Accepted Answer

Nurses routinely interact with multiple disciplines, including physicians, allied health professionals, support staff, patients, and families. This experience positions them well to lead change initiatives that require coordination and collaboration across multiple stakeholder groups.

Question 13

The nurse manager knows that maximum power will be needed to achieve a desired change and has identified a key person on the organizational chart who will be affected by the change. What is important for the nurse manager to do?

Accepted Answer

It is important for the nurse manager to pay attention to the people above and below this person on the organizational chart as they may have an impact on the success of the change as well. It is also important to address the concerns and potential resistance of the key person, but minimizing the impact or finding leverage against them is not a productive approach. Bypassing them and going to their supervisor may also create a negative relationship and limit the effectiveness of the change.

Question 14

The new chairperson of the nursing department has determined that the faculty's teaching is stagnant and outmoded. The chairperson would like to encourage the faculty to adopt more innovative teaching strategies. According to Lewin, what is the first step in initiating this plan?

Accepted Answer

According to Lewin's change management model, the first step in initiating a change is to involve the people who will be affected by the change. In this case, involving the faculty in identifying problems related to teaching strategies would be the best first step. Once the problems are identified, the faculty can work together to develop a plan for implementing new teaching strategies. Bringing in an expert or implementing interventions without involving the faculty first may not be successful in creating sustainable change.

Question 15

Computerized charting will be initiated on select units of the hospital. Orientation to this new system will be provided to each nurse by a team of nurses educated in nursing informatics. This is an example of which type of change strategy?

Accepted Answer

1. Normative-reeducative strategies focus on people's roles and relationships, perceptual orientations, and attitudes that influence their acceptance of change.
2. Lippitt's phases of change are a seven-step process of change that involves participants in every step of the process.
3. The assumption of the empirical-rational model is that people are rational and will follow their rational self-interest if that self-interest is made clear to them. In this instance, when the nurses have the knowledge to use the charting system and have a chance to try it, it will become clear that it is in their best interest to adopt the new system.
4. Power-coercive strategies are based on the application of power by legitimate authority, economic sanctions, or political influence.

Question 16

Which statements by the nurse manager would demonstrate effective change management?

Accepted Answer

Effective change management involves aligning changes with the organization's mission and values (D) and ensuring support from leadership (E) to facilitate successful implementation.

Question 17

Hospital administrators are considering changing from the traditional method of creating work schedules to a system in which the nurses will choose their own workdays. Choices will be made according to seniority. Which change strategy would likely be best for this endeavor?

Accepted Answer

A normative-reeducative strategy would be the best choice for this endeavor as it focuses on changing attitudes and behavior through education and participation. This strategy encourages individuals to actively participate in decision-making and can encourage buy-in from the nurses, who will ultimately be responsible for choosing their own work schedules. By involving the nurses in this process, they may feel more ownership and accountability for their schedules and may be more likely to adhere to them. Additionally, basing the scheduling choices on seniority can help to ensure fairness and equity in the process.

Question 18

The nurse is working on a committee tasked with making a major organizational change. Which comments by the nurse would help to advance the work of this committee?

Accepted Answer

Comments B, C, and D show a commitment to thoroughness, problem-solving, and inclusivity, which are essential for making effective organizational changes. Comments A and E prioritize speed over quality, which may lead to short-term progress but long-term problems.

Question 19

A nursing administrator overhears nurses conversing during a break in a seminar on change. The administrator would interpret which statement as meaning that the nurse who made it is ready to become a change agent?

Accepted Answer

The answer of A nursing administrator overhears nurses conversing during...

Question 20

The nurse manager feels that changing the unit's method of assigning break times would benefit the flow of client care. What should be the manager's first action associated with this idea?

Accepted Answer

The manager should first collect and analyze information about how the current system of assigning break times is working. This will provide a baseline for determining whether or not the proposed change is an improvement. Simply announcing a change without first assessing the situation may result in resistance from staff or unintended negative consequences. It is also important for the manager to identify how they will know if the change is benefiting the unit, so option D is also a valid consideration. Options A and C do not provide any concrete steps for implementing a change and may create unnecessary anxiety for staff or negative perceptions of the current system.

Quiz 5: Initiating and Managing Change