How Licensed Practical Nurses Can Implement Change in Their Department

Healthcare is an ever-changing industry. Many procedures that were once commonplace are now obsolete. Some changes require organizations to work collaboratively and are very complex. There are, however, lots of other changes in practice that make a big difference to patients that licensed practical nurses can do within a clinical team. Here’s how to make a change in a department.

Review the Idea

One of the first things to do when planning a change is to check out the evidence for it. This includes reviewing any research studies and whether any other clinical teams have done it previously. If another hospital has changed the same thing such as the type of dressing used on a surgical ward, the licensed practical nurse should check out how they did it and review their results. It also builds networks and connections in other areas to share good practice with other medical professionals.

Get Permission

If a licensed practical nurse is planning a change in a department they need to get permission. There are many policies and guidelines for medical professionals, and the licensed practical nurse will want to abide by them. It is vital to approach the departmental head to get permission but to also check whether any other approval is needed.


When making a change in a clinical department it is very important the medical team is informed and engaged. If they are expected to do something different, the sooner they are aware of the project the better. The licensed practical nurse can inform the team at a department meeting and also provide regular updates. This also gives the opportunity for other medical staff to offer feedback on the project and processes which can be helpful. When medical staff are well informed about a change and have the opportunity to get involved, they are more likely to be supportive and help implement the idea.

Plan, Do, Study, Act

One of the fundamental aspects of quality improvement changes is the change cycle itself. The Plan-Do-Study-Act Model, proposed by the Institute for Healthcare Improvement, is commonly used in healthcare. This model is designed to give structure to the process. Planning is the first stage. During the planning stage the project is set up, key metrics are agreed upon to measure a difference, and the actual change itself is defined. The licensed practical nurse needs to be focused on a goal. For example, a licensed practical nurse is interested in discharging some people one day earlier from the hospital than current practice. The planning stage will include identifying criteria to select patients, communicating the change, and deciding how a change will be measured. The goal can be the number of patients discharged from the hospital successfully a day earlier than usual.

The next stage is “Do” where the change is tested. An agreed time-period is defined when the change will be piloted. This could see all adults under 65 having a specific type of surgery sent home a day earlier.

“Study” involves reviewing the data and results of the pilot study. This will look at whether the change was successful and whether anything needs to change and be retested. In the example, adult patients under 65 being sent home a day earlier following surgery. Studying the results would include seeing whether any of the patients had problems or were readmitted to the hospital. It may be that everything was fine and there were no issues. In this case the change can continue to be implemented and monitored. But what if there was a problem, such as those living alone who found going home a day earlier problematic? This would require a further change of the plan to address this issue.

The project then moves to the “Act”stage. If a new change like excluding people who live alone from the early discharge criteria needs to be trialed then the cycle starts again, adjusting the project to accommodate for a new test. If it looks as though it is successful with no problems, then it can continue to be implemented. New projects need to continue to be monitored for issues. The longer the project continues the more data will be collected, enabling the licensed practical nurse to see the difference the change has made. A final decision will be made to close the project, embedding the change into mainstream work.

Share Practice

If the change is a success, then it should be shared with others medical professionals that are considering similar changes. This can be done within a hospital or clinic as the change may be transferable to other clinical specialties. Another way of sharing practice is to submit a poster or oral presentation to a relevant conference where the innovation can be presented to a wider audience. Licensed practical nurses should also consider publishing their project in a peer reviewed journal. This shares good practice and is also an example of good professional development for the licensed practical nurse.

Sharing practice goes further than the actual change and subject. It is also important for the licensed practical nurse to reflect on what went well and what could be done in a different way on another project. This will help implement innovation more successfully in the future.

In healthcare, change is a continuous process. By using a structured change method, licensed practical nurses can implement innovative changes into their departments which have beneficial outcomes for patients and their families.

Did learning about change interest you? Are you ready to become a licensed practical nurse? Gwinnett Institute in Orlando offers a Practical Nursing diploma program that trains LPN students for positions delivering basic bedside care to patients.  The Practical Nursing diploma program provides the didactic and skills training needed to take the NCLEX-PN examination.*  

*While Gwinnett Institute provides test preparation and review assistance to college students, it cannot guarantee any college student will be able to take or pass any type of licensure exam.  College students must be mindful throughout their entire school training program that licensure is a required pre-requisite for employment as a nurse and to diligently prepare themselves to meet this important requirement.

Contact us today to learn more about becoming a license practical nurse at Gwinnett College.