REPONSE TO A PEER DISCUSSION BOARD! 150 words 1 reference within 5 yrs. APA format must have in text citations to match references. NO cover page needed.

To be an effective change agent the nurse practitioner must research change and its theories. All subsequent change theories are based on Kurt Lewin's change theory from 1951.

Lewin's change theory involved three steps; unfreezing, change and refreezing (Erne, 2016). Unfreezing if the process of getting ready for the change, this is where the nurse practitioner gathers research, scholarly supported competencies etc. and notifies of a change, change simply is the implementation of that change and freezing is keeping the new change as the norm (Erne, 2016).

These together with the nurse practitioner's ability to integrate knowledge from other disciplines can equate to a smooth change within an organization and also on a regulatory level to ensure the scope of practice is revised to address coming patient to provider disparities.

Yet internally the change goal is to improve the health outcome of a patient population and to do so an interdisciplinary approach will continue to be needed though the nurse practitioner could possibly be the primary provider.

An example of using Lewin's change theory for clinical practice change would be in regard to discussing life sustaining treatment wishes with critically ill patients upon admission instead of at the time of end of life or fatal status change. Evans et al (2016) did just this.

Obstacles found by the study were mostly in the realm of comfort level of the provider in speaking about end of life wishes with patients and families outside of an emergent situation.

Results of this study showed a decrease in family stress levels during emergent events, increased communication between nurse practitioner and patient and the identification of those providers and patients who need added education regarding the subject as a solution to the barrier identified.