Change is common and important in improving patient outcomes in the current healthcare market. Because of the tremendous increase in credible research and publication of research findings, clinicians now use evidence-based findings to guide their practice. The rapid changes in the healthcare environment require effective leaders that can implement change strategies to improve patient outcomes. Evidence has shown that clinicians may have difficulty integrating new knowledge into clinical practice. The advanced practice nurse (APN) equipped with advanced clinical knowledge and knowledge of the change process is perfectly situated in the healthcare setting to be an agent of change. This article focuses on the specific steps of the change process APNs can use to effect change in practice in their institutions. An example from the author’s own clinical practice in implementing an intensive insulin drip protocol is outlined. The key elements important in successful development and implementation of a change in practice are presented. By improving the understanding of the change process, APNs as change agents can meet the challenge of leading the way to change in their clinical setting.
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Leadership| April 01 2004
Leadership in Action: Creating a Change in Practice
Denise Buonocore, MSN, APRN-BC, CCRN
From the Heart Institute at Bridgeport Hospital, Bridgeport, and Yale University School of Nursing, New Haven, Ct.
Reprint requests to: Denise Buonocore, MSN, APRN-BC, CCRN, 51 Thompson St, Milford, CT 06460 (Denise. firstname.lastname@example.org).
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AACN Adv Crit Care (2004) 15 (2): 170–181.
Denise Buonocore; Leadership in Action: Creating a Change in Practice. AACN Adv Crit Care 1 April 2004; 15 (2): 170–181. doi:
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