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Change Proposal
Jessica E. Valdes
NUR 4020
Linda Strommen
October 7, 2007
Change Proposal 2
Change Proposal
A nursing problem that currently exists is the amount of documentation nurses must
endure. Nurses continually document on patients and although documenting is a very important
aspect of nursing care often times [spelling error -- the preceding two words should be
spelled as one word] nurses are left overwhelmed and with the feeling that [Use a form of
"believe," which is more accurate (and not a cliché)] most of the day was spent charting.
According to Gugerty, et al. (2007), “Nurses routinely spend 15-25% of their workday
documenting patient care, and in some cases considerably more.” The article also stated that
often times [spelling error -- the preceding two words should be spelled as one word] much
Changing the amount of time nurses take to document would affect many aspects of the
organization. First and foremost [Redundancy, consider "first."] [Eliminate clichés (tired,
overused phrases) and colloquial (informal) language for more effective academic writing.
(See page 37 in the APA Publication Manual.) ] patient satisfaction would increase
because nurses would have more time to provide direct patient care and better quality of care.
There would be less stress on the nurse; since there is [Expletive construction--"there is,"
"there are," "there was," "there were," "it is," or "it was" are phrases that mean nothing.
Change Proposal 3
Unless "there" or "it" is a place or a thing, the composition will be much more concise if
rewritten to eliminate such phrases.] less to document, work would be done in a timelier
manner.
Nursing Documentation Work Group, Gugerty, et al. (2007), “more than 1/3 of the nurses
reported routinely staying beyond their scheduled work hours to complete documentation and
almost 2/3 of these were paid for the “stay over period.” Decreasing documentation time would
decrease the amount of time nurses spent charting by 25 percent [Use the % sign with
numerals.] and would cut cost by approximately $94,000,000 per year in the state of Maryland
this would not only allow nurses to provide more direct care but would improve nurse
Using the Havelock six step change model to implement change would help overcome
construction--"there is," "there are," "there was," "there were," "it is," or "it was" are
phrases that mean nothing. Unless "there" or "it" is a place or a thing, the composition will
be much more concise if rewritten to eliminate such phrases.] ["It" must refer to a specific
word in the sentence or the reader can become confused by the vague pronoun reference.
Example – It demonstrated his recent achievement. (This usage is incorrect because "it"
does not refer to a specific element in the sentence.) When Victoria received her diploma,
she put it in a frame. ("It" clearly refers to the diploma.)] important to execute a
documentation reduction committee. According to Gugerty, et al. (2007), the committee should
include nurses and nursing superiors, “nurse informaticians, nurse executives, nurse managers
and direct care nurses can dialog about the issues identified.” This can be compared to the
Change Proposal 4
assessment portion of the nursing process. First you [Word choice—using the second-person
pronoun "you" is inappropriate in academic writing. Except within a direct quote, rewrite
with third-person pronouns (he, she, it, they).] gather a committee of nurses build a trusting
relationship and diagnose/assess the problem. What are the current problems that exist regarding
the documentation process and what can be done to reduce documentation the process? During
this time it is [Expletive construction--"there is," "there are," "there was," "there were,"
"it is," or "it was" are phrases that mean nothing. Unless "there" or "it" is a place or a
thing, the composition will be much more concise if rewritten to eliminate such phrases.]
important to address the current documentation process and the changes that can be implemented
to reduce documentation time. This can be achieved by reducing sections of the nursing notes
After the assessment is complete and the problems are identified changes need to be
made there maybe more than one solution to the problem using trial and error and allowing the
nursing staff to be part of the research can aid in finding the best solution. It is [Expletive
construction--"there is," "there are," "there was," "there were," "it is," or "it was" are
phrases that mean nothing. Unless "there" or "it" is a place or a thing, the composition will
be much more concise if rewritten to eliminate such phrases.] important to allow the nurses
to give feedback in order to decide what the best approach is. As Gugerty, et al. (2007) states
“encourage the involvement of nurse executives and direct care nurses in the formulation of
documentation policies, selection of software, planning, and implementation.” This will assist
gaining acceptance to the change because everyone is involved in improving the nursing process
of documentation. Havelock emphasized that the change agent needs to support involvement of
Change Proposal 5
the people participating the more the people affected by the change participate the more they are
In order to implement this change the leader involved in making the change needs to be
honest and trustworthy. The leaders must take the initiative to implement positive changes and
not hesitate to the show the way. The leader must be an authority figure implementing a median
is," "there are," "there was," "there were," "it is," or "it was" are phrases that mean
nothing. Unless "there" or "it" is a place or a thing, the composition will be much more
concise if rewritten to eliminate such phrases.] important for the leader to use centralized
decision making without using power to command others but the leader needs to be influential
are," "there was," "there were," "it is," or "it was" are phrases that mean nothing. Unless
"there" or "it" is a place or a thing, the composition will be much more concise if rewritten
to eliminate such phrases.] important to show the benefits of decreasing documentation. This
and how it improves nursing and patient care overall. Emphasize that this is a project that can not
work without their participation and it’s a change that needs to be executed with their assistance,
The change would have a positive affect on the organization and on nursing in general.
Increase in patient satisfaction would improve the hospital. “Increasing patient satisfaction is a
critical goal for healthcare organizations of all types, especially in these times of increased
competition, scrutiny and demand for services” (Waneless, 2007). Moreover it would help
Change Proposal 6
decrease the nursing shortage because nurses would have weight lifted off their shoulders.
“Nurses working in most healthcare settings have identified the excessive burden of
In order to gain support allowing the nurses to voice their opinion is an essential
component. Allowing the committee to not only feel involved but be involved is of topmost
importance especially since they are the key component to making recommendations.