During a discussion among hospital supervisors, changes are being considered. Which of the following responses is an example of an internal force for change?

Question

1. "We're finding that the client acuity level in the Progressive Care Unit has increased dramatically over the last year."
2. "The amount of money that is being reimbursed by Medicare for knee replacement surgery has decreased $250 over the last 2 years."
3. "The number of people residing in this area who are at or below poverty level has increased to 32%."
4. "The local community college lost its accreditation by the National League of Nursing again, and is dismantling its nursing program."

Answer 1

Answer: 1

Rationale: Internal and external forces influence changes to nursing practice. Internal forces for changes are those that come from inside the organization. A change in a unit-specific client acuity level is an example of an internal force for change. Changes in reimbursement rates by Medicare, local socioeconomic factors, and area nursing programs are examples of external forces for change. The internal and external forces for change interact dynamically and influence all segments of health care.