Nursing Assessment for Predicting Obstructive Sleep Apnea: Community Hospital Approach

Angela P. Halpin, MN, CNS, RN; Jennifer M. Bunting, AAS; Paul A. Selecky, MD; Suzette G. Bosveld, RN, BSN, MSN, CCNS, NP-C; Derrick Hong, MD


Topics in Advanced Practice Nursing eJournal. 2008;8(1) 

In This Article


Kurt Lewin's Planned Change Theory is applicable for implementation of this new aspect of nursing assessment. This theory identifies 3 stages of change[16]:

  • Unfreezing;

  • Moving; and

  • Refreezing.

It also conceptualizes field and force defined as:

  • "Field" -- the organization; and

  • The driving "force" -- the collaborative team that directs change within the organization.

In the "unfreezing" stage, the model identifies a clinical issue that requires a change in practice. As the process is implemented, the organization is said to be in disequilibrium. The organizational team addresses this issue by educating nursing staff and physicians on the rationale for the change. In the case of sleep assessment, questions are added to the patient history of the nursing assessment. This demonstrates the utilization of the new assessment tool in order to increase understanding and minimize anxiety level.

During the "moving" stage, evidence is presented to show that the addition of patient questions on the nursing assessment is possible and that the preliminary findings are suggestive of positive outcomes. Once consensus is achieved, "refreezing" is the last stage of change when the intervention is made permanent. During this stage, the team incorporates the new sleep assessment tool into the organization's policies and procedures, and the organization returns to a state of equilibrium.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as: