AACN Roadmap for Implementing Change
 ABCDE Bundle
Change is a fact of life, and that can be a good thing. Taking something we’ve learned – such as new evidence-based care practices – and
introducing it within our workplace to enhance patient care and improve outcomes is a change for the better. However, change is often a
difficult process. AACN Roadmap for Implementing Change is a tool intended to assist you in sharing and implementing new learning and
practices within your unit and hospital. This Roadmap serves as guide to assessing your unit’s level of readiness for change and identifying
strategies for implementation. It is best used once you and your team have determined a specific practice or area to change.
Action Steps
Supporting Resources
Key Stakeholders
Unit and Staff Assessment
Assess your unit’s structure and readiness to
support change
 Schedule meeting of key stakeholders
 Discuss reason for the assessment
 Distribute assessment tool – set
completion date for one week
 Schedule follow-up meeting to discuss
results and determine level of
engagement
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Change Readiness Assessment
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Unit leadership (may include managers,
charge nurses, council chairs, CNS,
educator, etc.)
Staff nurses
Multidisciplinary team members (as
determined by the change initiative)
Action Steps
Supporting Resources
Key Stakeholders
Assess current knowledge of problem, practice
or procedure
 Schedule a meeting of identified
stakeholders (three or four)
 Discuss reason for completing the gap
analysis (e.g., What is the problem we
are trying to solve?)
 Distribute analysis tool – set completion
date for one week
 Schedule follow-up meeting to discuss
results, determine practice gaps, and
identify the high priority needs
 Discuss Critical Care Nurse article on
the ABCDE Bundle at the next journal
club meeting
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Complete Unit Gap Analysis
Survey Monkey survey
Informal discussion
PI data
Discuss article at journal club – Balas
M, Vasilevskis E et al. “Critical care
nurses’ role in implementing the
‘ABCDE Bundle’ Into Practice.” Crit
Care Nurse 2012;32:35-47
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Nursing staff
Nurse Manager
Clinical Nurse Specialist
Nurse Practitioners
Quality improvement teams
Physicians
Other members of multidisciplinary team
(as determined by the change initiative)
Evaluate results of assessments
 Formulate the team
 Gather all assessments and determine
change readiness and areas targeted for
change
 Identify change strategies based on the
assessments
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Discuss at unit council meeting
Discuss with unit leadership (manager,
CNS, physician director)
Engage PI/Quality department
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Nursing staff
Nurse Manager
Clinical Nurse Specialist
Nurse Practitioners
Quality improvement teams
Physicians
Other members of multidisciplinary team
(as determined by the change initiative)
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AACN Roadmap for Implementing Change – ABCDE Bundle
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Action Steps
Supporting Resources
Key Stakeholders
Determine Change Strategies
Readiness Level: Low
 Raise awareness, advocacy
o Create tools
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Information sharing
Email blast (see sample)
Posting flyers (see sample)
Materials to hospital or unit journal club
Huddle (see sample)
Newsletter write- up (see sample)
Tell a peer
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Unit staff nurses
Clinical Nurse Specialist
Nurse Educator
Physicians
Readiness Level: Medium
 Education
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All “Low” level resources
PowerPoint
Lunch & Learn
Staff meeting
Poster presentation
Competency Day
Compliance audit
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Nurse Educator
Advanced Practice Nurses
Nurse Manager
Unit staff nurses
Physicians
Readiness Level: High
 Implement change initiative
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All “Low” and “Medium” level resources
Form/participate on a committee
Evidence-based project initiation
Identify a leadership champion
Inter-professional task force
Roll-out plan
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Nurse Educator
Advanced Practice Nurses
Nurse Manager
Unit staff nurses
Physicians
Multidisciplinary team leaders
AACN Roadmap for Implementing Change – ABCDE Bundle
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Action Steps
Supporting Resources
Key Stakeholders
Measure Success
Evaluate efforts: Awareness/advocacy level
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Monitor dialogue
Discuss at future staff meeting or huddle
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Quality improvement team
Staff nurses
Evaluate efforts: Education level
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Knowledge checks
Competency validation
Assess use of audit tools
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Quality improvement team
Nurse Manager
Clinical Nurse Specialist
Educator
Evaluate efforts: Implementing change level
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Compliance audits
Quality indicators (such as patient
outcomes)
Satisfaction: staff, patient, team
Length of stay
Cost
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Quality improvement team
Nurse Manager
CNS
Educator
Unit quality team
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Monitor outcomes regularly
Report outcomes to unit leadership
Continually audit for compliance
Re-educate as needed
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Quality improvement team
Nurse Manager
Clinical Nurse Specialist
Educator
Unit quality team
Evaluate efforts: Sustained change over time
AACN Roadmap for Implementing Change – ABCDE Bundle
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Action Steps
Supporting Resources
Key Stakeholders
Disseminate Findings
Share learning
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Quality improvement team
Nurse Manager
Clinical Nurse Specialist
Educator
Unit quality team
Scale the recognition for the level of
success
Evaluate recognition mechanisms
Involve staff in selecting recognition
methods
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Quality improvement team
Nurse Manager
Clinical Nurse Specialist
Educator
Unit quality team
Submit a poster or abstract for
presentation at NTI
Send an email to practice@aacn.org
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Nursing staff
Quality improvement team
Nurse Manager
Clinical Nurse Specialist
Educator
Unit quality team
Discuss at organizational critical care
team meetings
Share with other units and/or
organizational practice councils
Hospital newsletter
Poster presentation or educational
session at local or national professional
meetings
Submit for publication
Celebrate Success
Determine meaningful recognition
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Tell AACN your story
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