Nursing Theoretical Framework
A nursing theoretical framework includes ideas, definitions, and assumptions explaining the nursing practice. It organizes and guides nursing practice and research and helps nurses systematically approach care. Nursing theoretical frameworks are built on the idea that nursing has its knowledge and abilities. The framework usually includes Nursing Philosophy: The framework’s values, beliefs, and principles. It defines nursing practice and the nurse’s role in healthcare. Nursing theory: This component explains nursing ideas and links. It helps nurses comprehend health, sickness, and nursing treatments and organize and analyze data. The nursing process assesses plans, implements, and evaluates nursing care. It contains patient care using nursing theory and philosophy. Nurses follow these criteria to deliver safe, effective, and ethical care. They guarantee consistent, evidence-based nursing practice based on nursing philosophy and theory. Nursing research: The scientific approach helps nurses create and evaluate nursing theories and actions. Nursing advancement and patient outcomes depend on it. A nursing theoretical framework allows nurses to construct a coherent, evidence-based care plan. It organizes and guides nursing practice and research, ensuring safe, effective, patient-centred care.
This change project will use the Plan-Do-Study-Act (PDSA) cycle and two different nursing theories, namely, the Rogers (1995) Diffusion of Innovations theory. This theory will lead the change project by identifying variables that impact healthcare practice adoption. The Diffusion of Innovations hypothesis describes five innovation adoption stages: knowledge, persuasion, choice, execution, and confirmation. This theory is used in the change project to identify variables impacting the acceptance of the new discharge planning procedure and adjust the implementation to meet those concerns (Cowden, Cummings & McCue, 2021). Orem’s Self-Care Deficit Theory (1995) will be used next. This idea stresses patient participation in treatment and is pertinent to discharge planning. This notion is used in the change project to empower patients by giving them the information and skills to maintain their health after discharge.
The change project will be implemented and evaluated using the Plan-Do-Study-Act (PDSA) quality improvement technique. Plan, do, research, Act. The planning process encompasses issue identification, target formulation, and improvement planning. Small-scale plan implementation is the do phase (Hesselink et al., 2012). The research stage evaluates outcomes and identifies areas for improvement. Acting includes scaling up the adjustments and monitoring the consequences. The change initiative will be organized and evidence-based using these three frameworks, improving patient outcomes and discharge planning efficiency.
Change Project
The change initiative improves interprofessional discharge planning teamwork to improve patient outcomes and satisfaction. The clinical microsystem method will identify areas for improvement, create a strategy, execute the change, and constantly review and adapt the process. Rogers’ 1995 Diffusion of Innovations theory and Orem’s 1995 Self-Care Deficit Theory will lead the transformation endeavour. Discharge planning adjustments will be tested and implemented using the PDSA cycle. The change initiative aims to enhance healthcare professional communication, patient satisfaction with discharge, and readmission rates. Patient results, staff input, and satisfaction surveys will determine project success. The transformation initiative will leverage staff education and training, standardized discharge practices, and technology to enhance healthcare professional communication and information sharing. The change initiative aims to enhance patient care during discharge by improving healthcare professional teamwork and ensuring patients have the tools and assistance to maintain their health at home.
Diffusion of Innovations theory by Rogers (1995)
Everett Rogers’ 1995 Diffusion of Innovations theory explains how new ideas, goods, and technology spread. The hypothesis claims that innovations are adopted predictably, which may assist people and organizations in promoting and embracing new ideas. The theory states that five key factors affect the adoption process: the innovation itself, the communication channels used to promote it, the social system in which it is introduced, the characteristics of those adopting it, and the time needed for adoption.
This change initiative will use Rogers’s Diffusion of Innovations theory. First, the theory will identify essential stakeholders in the transformation project. These stakeholders will be evaluated for their openness to new ideas and technology. This will assist in identifying change project advocates and early adopters (Jankowska-Polańska et al., 2019). The approach stresses communication routes and networks in spreading new ideas and breakthroughs. The change project must establish clinical microsystem communication channels and networks to communicate the new discharge planning procedure successfully.
Second, the theory will determine what stakeholders would like about the invention. These include the change project’s relative benefit over current practices, compliance with existing values and norms, complexity, trialability, and observability. By recognizing these traits, the change project may be tailored to stakeholder requirements and preferences, making it more likely to be embraced and spread across the business. According to the notion, opinion leaders and early adopters drive innovative uptake and spread. The change project must identify clinical microsystem opinion leaders and early adopters to promote the new discharge planning procedure and assist in executing it. The change project must show the new discharge planning process’s benefits over the old one and its consistency with the clinical microsystem’s values and aims. The project must also guarantee that the new procedure is simple, trialable, and visible to stakeholders.
Third, the theory will change the project communication and distribution plan. The plan will target the project stakeholders mentioned previously. It will use channels and messaging that match stakeholders’ innovativeness and traits. This approach will raise awareness of the change project and offer stakeholders the information and assistance they need to accept and execute it. The approach emphasizes societal norms and values in innovation acceptance and spread. The change project must address clinical microsystem social norms and values that may prevent the new discharge planning method from being adopted. The initiative must also use societal norms and values to promote the new approach.
Finally, the theory will assess change project success. According to the theory, awareness, interest, appraisal, trial, adoption, and maintenance are the phases of invention dissemination. These phases may be used to track the change project’s adoption and spread across the company. This data may be utilized to adapt the change project or duplicate its success elsewhere in the company. The Diffusion of breakthroughs idea may help healthcare organizations accept and spread innovative breakthroughs. The change project team may use this theory to identify variables that may help or impede the acceptance and implementation of the new discharge planning procedure and design strategies to address them.
In conclusion, using Rogers’s (1995) Diffusion of Innovations theory in this change project will require that the innovation outperform the discharge planning procedure and enhance patient outcomes, readmissions, and satisfaction. Second, innovation promotion requires excellent communication networks. Nursing staff, doctors, and other healthcare practitioners should be informed of the advantages of the training program. Thirdly, examine the social system where the invention is presented. To promote the standardized discharge planning education and training program, opinion leaders and prominent healthcare team members should be included in the implementation. Fourth, consider the people who will embrace the invention. The training program should accommodate diverse learning styles and provide hands-on experience to simplify and boost uptake. Finally, consider adoption time. Implementation should be planned with schedules and benchmarks to track progress and success. The Diffusion of Innovations ideas may assist spread the standardized discharge planning education and training program, improving patient outcomes, satisfaction, and readmissions. It organizes and guides implementation to ensure the change project is evidence-based, patient-centred, and compatible with nursing best practices.
Orem’s Self-Care Deficit Theory (1995)
Nursing theorist Dorothea Orem’s Self-Care Deficit Theory helps explain and promote self-care. According to this belief, people want to care for themselves but need help. Orem’s theory of self-care includes agency, requisites, and shortfalls. The self-care agency is an individual’s capacity to execute self-care activities, whereas self-care requisites are health-promoting acts and behaviours (Jankowska-Polańska et al., 2019). Self-care deficit arises when a person lacks self-care agency or fails to satisfy self-care needs. Nursing interventions may be needed to encourage self-care and avoid health issues. Orem’s philosophy stresses recognizing an individual’s self-care requirements and talents to give appropriate care. It emphasizes the nurse’s responsibility in evaluating and encouraging self-care. This change initiative might emphasize patients’ self-care using Orem’s Self-Care Deficit Theory (1995). According to this viewpoint, nurses may assist self-care by offering knowledge, support, and resources.
Incorporating self-care into discharge planning applies Orem’s theory to the change project. Giving patients the information and tools to monitor their illness and recovery beyond discharge empowers them to take responsibility for their treatment. The discharge planning team may help patients identify self-care needs such as medication management, wound care, and food. Orem’s perspective highlights the nurse-patient relationship’s role in self-care. Nurses may educate, coach, and inspire patients to self-care in this change effort. The discharge planning team may assist patients in managing their health and rehabilitation after hospitalization by encouraging collaboration and empowerment.
Orem’s Self-Care Deficit Theory will be utilized to design patient and family teaching materials and guide discharge planning. Orem’s idea states that people want to care for themselves but need help (Hesselink et al., 2021). Thus, nursing care encourages self-care and provides assistance and resources. The nursing team will work with patients and their families to identify and correct self-care weaknesses during discharge preparation. Orem’s hypothesis will help nurses evaluate patients’ self-care skills and requirements. They will identify areas of education and assistance, such as medication management and wound care, with patients and their families. The team will assist patients in setting and accomplishing self-care objectives. Community options like support groups or home health services may help people manage their care at home.
Orem’s theory will also drive discharge planning process assessment. The nursing team will monitor patients’ self-care objectives and update the plan to ensure they have the necessary assistance and resources (Cowden et al., 2021). Orem’s idea may assist nurses in improving patient outcomes and home care management by guiding discharge planning.
In conclusion, Employing Orem’s Self-Care Deficit Theory will significantly impact the change project. The theory emphasizes the importance of individual responsibility and self-care for maintaining health and preventing illness. By incorporating this theory into the change project, the focus will shift towards empowering patients to control their health and well-being through education, support, and resources. This can improve patient outcomes, increase patient satisfaction, and reduce healthcare costs. The theory also emphasizes the importance of collaboration between patients and healthcare professionals, which can improve communication and trust between both parties. Utilizing Orem’s Self-Care Deficit Theory can help promote a patient-centred approach to care and improve the overall quality of healthcare services.
Plan-Do-Study-Act (PDSA) cycle
The Plan-Do-Study-Act (PDSA) quality improvement cycle organizes change. Plan, Do, Study, Act—the PDSA cycle; each cycle informs the next. This change project will deploy and assess the new discharge planning procedure using the PDSA cycle.
Plan: The project team will identify the issue and provide a solution. The team will set project goals, values, and objectives. The team will also identify discharge planning process improvements. The team will plan the modifications’ deadlines, responsibilities, and resources.
Do: The project team will adopt Plan stage adjustments in the second stage. The team will teach workers about the new discharge planning procedure and oversee implementation to ensure improvements are made as intended.
Study: The project team will test the revised discharge planning procedure in the third stage. The team will review process modification data to see whether it improves patient outcomes and satisfaction. The team will also handle any unexpected results or difficulties.
Act: The project team will implement study findings in the fourth stage. The team will execute successful improvements throughout the company. The team will determine why the improvements failed and rework the strategy. To maintain improvements, the team will create a sustainability strategy. The PDSA cycle will help implement and assess the new discharge planning procedure. The cycle will enable the project team to detect difficulties early and make modifications to guarantee project success. The PDSA cycle will be utilized throughout the change project to improve the discharge process continuously. Using this iterative approach, the team will be able to identify improvement areas and quickly make changes. This will help ensure that the change project succeeds and that patients receive high-quality care during discharge.
The change project will assess the intervention’s efficacy using the Plan-Do-Study-Act (PDSA) cycle. The PDSA cycle is a quality improvement framework that organizes clinical change testing and implementation (Langley et al., 2009). Each step of the PDSA cycle—Plan, Do, Study, and Act—has particular tasks to promote ongoing progress. A significant metropolitan hospital’s medical-surgical unit will host the investigation. The quasi-experimental research will assess pre-and post-intervention. This design compares discharge results before and after the change effort to assess its efficacy. All eligible patients will be recruited through convenience sampling. The Plan stage will entail formulating goals and objectives, identifying key stakeholders, and creating a timeframe for the change project. Implementing the intervention entails teaching staff about the new discharge procedure, creating and applying the Five Ds checklist, and monitoring the process (Kharrazi et al., 2018). Comparing discharge outcomes before and after the change project will assess the intervention’s efficacy. Staff comments, patient records, and satisfaction questionnaires will provide data. Based on research results, the Act stage will include modifying the intervention and monitoring its efficacy (Redley, Botti & Howell, 2019). Finally, the PDSA cycle is crucial for change project evaluation. Convenience sampling will choose people for quasi-experimental research using pre- and post-intervention measurements (Li & Stelfox, 2019). The Plan stage will involve creating an implementation plan, the Do stage will involve implementing the intervention, the Study stage will evaluate its effectiveness, and the Act stage will implement any necessary changes based on the study findings.
Conclusion
In conclusion, clinical microsystem discharge planning education and training may enhance patient outcomes, staff satisfaction, and cost-effective resource usage. The change initiative uses Rogers and Orem’s Self-Care Deficit hypothesis’s Diffusion of Innovations hypothesis to promote patient-centred care and evidence-based practices. The Plan-Do-Study-Act (PDSA) cycle improves quality and feedback to boost change project effectiveness. Patients, relatives, healthcare practitioners, and administrative personnel must work together to complete the project. Inter-professional teamwork, communication, and education may foster a culture of safety and quality in healthcare institutions, improving patient outcomes and satisfaction.
References
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