Addressing Pressure Ulcers With Kotter’s Framework

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Pressure ulcers affect the health of many recovering patients in intensive care units across the U.S. and the world. The issue also increases the cost of care by over fifty percent, according to Gefen (2020). Moreover, Minteer et al. (2020) note that medical insurance agencies in the U.S. hardly cover expenses related to pressure ulcers, leaving the burden on individuals and families of patients exhibiting the conditions. Americans spend about seven hundred million dollars yearly to cater to needs related to pressure ulcers, while the matter extends patients’ stay in hospitals by over fifty percent (Jakobsen et al., 2020). The aspect provokes immediate action by healthcare players, mainly the hospitals and care providers. Interventions that prevent the condition already exist, with others still emerging (Neziraj et al., 2021). Regular repositioning (every hour) is the evidence-based intervention advanced in the present work and the purpose of reducing pressure on the skin of bedridden patients to prevent pressure ulcers. The work proposes using Kotter’s change management model (KCMM) to realize the targeted outcomes.

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Selected Model of Change and Its Relevance in the Project

Kotter’s change management framework provides a significantly in-depth change administration scheme for organizations to realize comprehensive process change. The model adopts eight steps that organizations can implement serially until realizing the intended transformation. Kotter’s model is extensive and creates room for gradual but rapid change that can last for a long while (Schmutz, 2021). The model’s three initial phases assume a pre-intervention nature, with the last stage involving the transformation of organizational culture to support the intended long-term change.

Discussion of the Stages in the Model

Kotter’s change management system has a set of eight stages that organizations can implement one after the other. The model’s first three stages create a sense of resolution (urgency), coalition formation, and developing an appropriate organizational change vision (Schmutz, 2021). Plan communication, obstacles identification and elimination, short-term wins’ creation, change expansion, and anchoring changes on culture are the other five stages of the model. The model’s stages have a specific order for the change initiative to flow smoothly.

Stages’ Application in My Project

The current project involves a schedule, venue, activities, and players. The work assumes a pragmatic approach, where the project’s activities will apply to a real-life setting. About one hundred intensive care registered nurses in the selected two-hundred-bed capacity facility will participate in the project. The firm currently reports about two thousand severe cases of pressure ulcers each year, which significantly affects the quality of care and cost of care. Using factual data to convince the management and the selected nurses about the immediate need for change will constitute the initial stage of the model, as directed by Schmutz (2021). Giving the nurses and the management different tasks to embrace the change will then aid in forming a robust coalition for the project.

Creating the objectives, performance standards, and goals for the team will then take place to form a clear vision for the transformation activity. Communication planning will involve passing messages about the intended actions to all stakeholders and considering their feedback (Schmutz, 2021). Looking at the existing organizational policies or organizational culture issues that may hinder purposeful activities will form the obstacles’ elimination phase. The nine months project will also establish monthly targets whose realization will indicate short-term wins to motivate the team (Schmutz, 2021). New policies and operation standards will also be established based on what works to build on change. Lastly, the project will end by implementing essential values, beliefs, and means necessary to make the realized positive changes part of the corporate culture to make them lasting.


Gefen, A. (2020). Reduce the risk of pressure ulcers in the operating room utilizing a specialized inconspicuous different pressure overlap. Wounds Int, 11(2), 10-16.

Jakobsen, T. B. T., Pittureri, C., Seganti, P., Borissova, E., Balzani, I., Fabbri, S., Amati, P., Donigaglia, S., Gallina, S., & Fabbri, E. (2020). Incidence and prevalence of pressure ulcers in cancer patients admitted to hospice: a multicentre prospective cohort study. International Wound Journal, 17(3), 641–649. Web.

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Minteer, D.M., Simon, P., Taylor, D. P., Jia, W., Li, Y., Sun, M., & Rubin, J. P. (2020 ). Pressure ulcer monitoring platform – A prospective, human subject clinical study to validate patient repositioning monitoring device to prevent pressure ulcers. Progress in Wound Treatment, 9(1), 28 -33. Web.

Neziraj, M., Hellman, P., Kumlien, C., Andersson, M., & Axelsson, M. (2021). Prevalence of risk for pressure ulcers, malnutrition, poor oral health and falls – a register study among older persons receiving municipal health care in southern sweden. Bmc Geriatrics, 21(1), 265–265. Web.

Schmutz, J. B. (2021). Institutionalizing an interprofessional simulation education program: An organizational case study using a model of strategic change. Journal of Interprofessional Care, 1-11, 1–11. Web.

Appendix 1

Concept Map for the Implementation Model.

Stages Stage 1 Stage 2 Stage 3 Stage 4 Stage 5 Stage 6 Stage 7 Stage 8
Activity Creating
a sense of
Forming a powerful coalition Creating an organizational vision for change Communicating the plan Removing obstacles Creating short-term wins Build on the change Anchor the changes in the culture
Project Action Using
data to
Task division according to specialization and qualification Establishment of clear goals, objectives, and performance standards. Using appropriate media to pass message passing to stakeholders and feedback analysis Scrutiny of existing organizational policies, standards, and values Setting monthly targets Creation of new organizational policies and standards Creation of essential organizational values, beliefs, and standards

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NursingBird. "Addressing Pressure Ulcers With Kotter’s Framework." November 16, 2022.