title: Moving beyond resistance to restraint minimization: a case study of change management in aged care.
abstract: OBJECTIVE
  This case study describes a quality initiative to minimize restraint in an Australian residential aged care facility.
  
  
  METHODS
  The process of improving practice is examined with reference to the literature on implementation of research into practice and change management. The differences between planned and emergent approaches to change management are discussed. The concepts of resistance and attractors are explored in relation to our experiences of managing the change process in this initiative. The importance of the interpersonal interactions that were involved in facilitating the change process is highlighted.
  
  
  CONCLUSIONS
  Recommendations are offered for dealing with change management processes in clinical environments, particularly the need to move beyond an individual mind-set to a systems-based approach for quality initiatives in residential aged care.
authors.affiliation: School of Nursing, Deakin University-Southern Health Nursing Research Centre, 221 Burwood Hwy., Burwood, Victoria 3125, Australia. susan.johnson@deakin.edu.au
authors.forename: Susan
authors.initials: S
authors.lastname: Johnson
authors.forename: Joan
authors.initials: J
authors.lastname: Ostaszkiewicz
authors.forename: Beverly
authors.initials: B
authors.lastname: O'Connell
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data; D000368:Aged; D001291:Attitude of Health Personnel; D001315:Australia; D003704:Dementia / Q000451:nursing; D055318:Evidence-Based Nursing / Q000193:education; D005851:Geriatric Nursing / Q000193:education*; D006707:Homes for the Aged / Q000458:organization & administration*; D006801:Humans; D015403:Nursing Evaluation Research; D019982:Organizational Case Studies; D009936:Organizational Innovation; D010348:Patient Care Team; D017410:Practice Guidelines as Topic; D012149:Restraint, Physical / Q000592:standards / Q000706:statistics & numerical data; D013192:Staff Development / Q000379:methods*