Review the following nursing scenario from the Agency for Healthcare Research and Quality:
A 60-year-old female is admitted to the ward with a 2-day history of severe left lower abdominal pain and leukocytosis.

Review the following nursing scenario from the Agency for Healthcare Research and Quality:
A 60-year-old female is admitted to the ward with a 2-day history of severe left lower abdominal pain and leukocytosis. Her white count is 13000 and she has WBCs in her urinalysis. Two hours after admission she begins to experience an acute exacerbation of her abdominal pain and is believed to have a diverticular perforation and acute abdomen. At this point her physician decides to send her to the OR. The unit clerk is aware of the plan but the patients nurse is not. The patient is transported to the OR. Moments later the OR calls to report that the patient has no permits signed nor have any other pre-op protocols been completed.
1- Create a plan using Lewins change model documenting strategies needed to support followership and empowerment
2- Used the following Reference:
Agency for Healthcare Research and Quality. (n.d.). TeamSTEPPS Instructor Guide: Specialty ScenariosMed-Surg [Webpage]. Retrieved from
CIN: Computers Informatics Nursing
March/April 2003
CIN: Computers Informatics Nursing Vol. 21 No. 2 80-85 2003 Lippincott Williams & Wilkins Inc.
Using Lewins Force
Field Analysis in
Implementing a
Nursing Information
Change is a regular occurrence in the healthcare
environment. The computerization of nursing systems is one aspect of the changes taking place in
the information revolution. As a result nurses
have widely varying attitudes toward computers
and change in the workplace. To transition the
nursing team effectively from one system to another the nurse informaticist must be aware of
the factors that encourage and those that impede
the change. Strategies must be developed to assist nurses in moving forward with the transition.
This article presents a theoretical discussion of
how Lewins Force Field Analysis Model could be
applied in the practice setting to implement a
nursing information system successfully.
From bar code technology for medication administration to wireless bedside documentation systems to clinical decision support systems technology is an integral
part of the daily workflow for nurses. Rapidly developing technologies are changing the way nurses manage
information and deliver care. In acute care settings
there is an increasing focus on managing both high-risk
patients and those with chronic diseases. Integrated delivery networks are moving to the forefront and the Internet is becoming a source of health and medical information for clinicians and patients alike.1
Many nurses are skeptical of information technology
and may resist learning or using a new system.1 Recognizing this resistance and planning strategies to work
through these barriers may be the key to implementing
a successful nursing information system in a complex
healthcare organization. As change becomes an increasingly common occurrence in the healthcare environment change theory offers one way of understanding
the dynamic interaction between individuals and social
As opposed to unplanned or accidental change
planned change is the direct result of a conscious effort
between the individual who works to bring about the
change and those on whom the change has a direct impact.2 By understanding the principles of change theory
the nurse informaticist can strategically plan and successfully implement the transition from one nursing system to another.
This article focuses on using Kurt Lewins model of
change to implement a nursing information system.
Field theory Change Information system
Nursing Attitudes
Lewins model can provide the guidance needed to analyze the process of change and assist in identifying
forces that either propel the change forward or create
barriers that stagnate the change.
Regarded as the father of change theory Kurt Lewin
concerned himself with offering a deeper explanation of
human behavior while uncovering ways to improve
human behavior.3 His theory of change provides the
structure for understanding nurses behavior during
times of change and ways to improve the behavior
when introducing change into the workplace.
Lewin4 stated that all change is the result of certain
forces in a field or particular environment. Although
field theory was developed originally in the physical sciences as a method of analyzing phenomena Lewin expanded the concept to the area of psychology.3 He in-
From the University of South Florida Tampa Florida.
Corresponding author: Marilynn Bozak RN MS OCN 10714
Carrollwood Drive Tampa FL 33618 (e-mail:
CIN: Computers Informatics Nursing
March/April 2003
cluded all psychological activity that confronts an individual and applied concepts of psychological movement
toward a particular goal. Simply stated field theory is a
method of identifying and analyzing causal relations
and applying scientific constructs to those relations.
Lewins operational framework for change is his
Force Field Analysis Model.3 This model provides an
understanding of individual and group behavior as determined by motivation and intention. Lewin4 identified