Investigation of supporting and restraining factors for instituting collaborative practice in a community hospital

The purpose of this study was to determine the feasibility of instituting collaborative practice in the Intensive Care Unit of a community hospital. The conceptual framework for the study was based on Kurt Lewin's theory of Force Field Analysis. Determining the forces involved in a setting, and categorizing them as restraining or supporting forces provide information for effecting change. From a force field analysis, a determination can be made of whether or not a change is actually possible. Restraining and supporting forces were identified by administering questionnaires to nurses, physicians, and administrative personnel who would be involved in or affect by change. Evaluations of the questionnaires as to supporting, restraining or neutral were completed by a panel of six judges. The panel included a Director of Nursing, Director of Continuing Education, Clinical Nurse Specialist, Medical director of an Intensive Care Unit, a physician who was one of the highest admitters to an Intensive Care Unit over a period of one year, and the Director of Institutional Research in the hospital being studied. Results of the study supported the feasibility of implementing collaborative practice in a small community hospital in Ogden, Utah.