In nursing, change projects or planned changes are implemented with the use of change theories. Spradley's theory of change is based on a widely used change theory in nursing called Lewin's theory of change. Spradley's theory emphasizes constant monitoring of the change project.

Recognize the symptoms. This is the first step in Spradley's change theory. In this case, the change agent -- that is the person who brings about change -- notices signs that a problem exists. The change agent could be a nurse leader, staff nurse, student nurse or other personnel.

Diagnose the problem. This is the second stage, where the change agent looks at all the existing issues and then comes up with a name that describes what the problem is exactly.

Come up with solutions. The third stage of this change theory is alternative solutions, where you meet with others to propose solutions for the identified problem. Each proposed solution should have resources and possible obstacles outlined for all to see.

Select a solution. Pick one solution from all the proposed ones and make sure that it will be affordable, as well as address the identified problem. Be aware of any obstacle to the solution and make plans to manage them.

Plan the change. Write a plan that includes detailed steps that will be taken to bring about change. The plan should include milestones, actions, a time line or timetable, needed resources, a budget and method of evaluation.

Implement the change. Put your plan into action. Visit the milestones you outlined to make sure the project is on budget and on time. Provide all necessary resources required for the plan to keep moving forward.

Evaluate the change. Check to see if the expected outcome for the change project materialized. Analyze your environment for reduction or elimination of the problem diagnosed initially. Do this through a questionnaire, quiz or monitoring of the environment.

Stabilize the change. If the outcome of the change project is reached, then you can make your change permanent.