1st peer- Theoretical framework helps structure information in a way that helps analyze data (Wilson, 2015). My change project is aimed at reducing readmissions by using long-acting antipsychotics. There are variables that will be used in my change project that include independent variables and dependent variables. The dependent variable is the aimed outcome, and, in this case, it would be reduction in readmissions by 50%. The independent variable are the factors that influence change which are medication availability, access to services, adequate support from leadership, and training for the psychiatric nurse practitioner led team. To achieve the desired outcome, there are steps that can be used for planning and implementing. The first step would be to assess. This includes looking at the whole picture and understanding where things are and what might get in the way of achieving the desired outcome. The change project was thought of because there is a high rate of readmission or patients that have a history of multiple hospitalizations. Things that might get in the way of achieving the desired outcome include proper training, medication availability, compliance of long-acting injectables, and follow-up. The next step includes planning to organize, set goals, and define roles. This includes defining the role of the psychiatric nurse practitioner led team, identifying their duties, and their responsibilities. Part of the planning includes setting clear objectives. Designing interventions is the next step in the planning and implementing process. In the change project some interventions include training the psychiatric nurse practitioner led team. It is important to plan out how communication about which patients are receiving long acting injectables will be communicated, which patients are taking oral medications, how to contact the patients, and how all this information will be organized. The next step includes implementation in which there is execution of the plan. In the change project this looks like those that are part of the psychiatric nurse practitioner led team will start contacting patients, educating them on the benefits of long-acting injectables, offering the long-acting injectables, scheduling the patients to receive long-acting injectables, and following up with the patients to make sure they continue to receive their medications. Lastly, evaluation is the next step, and this is where there is assessment of the outcomes. The psychiatric nurse practitioner led team can look at the data and analyze if there has been a reduction of readmissions within a year time frame. The theoretical framework can help develop a clear and concise plan. 2nd peer- After discussing my theoretical framework in our previous Theoretical/conceptual framework assignment, I now have a clearer understanding of the rationale for predictions on the relationship among variables. The variables I will use in my change project for Normalization Process Theory (NPT) include coherence, cognitive participation, collective action, and reflexive monitoring. The Allostatic Load & Delirium in Hospitalized Elderly Model (ALDHE) variables include Allostatic load, stress factors, and risk of delirium. The specific steps that are necessary to implement my change project in my organization are the following: defining project scope and objectives, forming a multidisciplinary team, conducting a baseline assessment, training and education, developing and implementing screening protocols, integrating delirium prevention strategies, monitoring and evaluating implementation, having continuous improvement, fostering a culture of delirium awareness, reporting and dissemination. By following these many steps, I believe my organization can implement an effective change project. According to Harrison et al. (2021) “Change management methodologies were valued for providing guiding principles for change that are well suited to enable methodologies to be applied in the context of complex and unique healthcare contexts, and to be used in synergy with implementation and improvement methodologies.”
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