Theoretical Framework
This EBP project will be guided by the Dorothea Orem theory of nursing. The theory is divided into three parts namely theory of self care, theory of self care deficit, and theory of nursing system. According to Orem, self-care connotes practices initiated and performed by a person for personal benefits such as maintaining life, health, and wellness. On the other hand, the theory of self-care deficit specifies when nursing is required. In particular, it states that nursing is needed when an adult is incapable of providing continuous good self care. Therefore, Orem advances five nursing helping techniques including guiding others, teaching another, acting for and doing for others, providing a good environment to foster personal development to realize future demands, and supporting another. Finally, the theory of nursing systems illustrates the manner in which the self care needs of the patients will be met by the nurse, the patient, or both of them. Overall, the major assumptions of this theory are;
Essentially, the Orem’s theory is applicable in nursing practice as it assists nurses to enhance the health of patients by making them autonomous. In the present EBP project, providing ways to improve effective discharge teaching to enable patients leave the hospital with more confidence and better understanding of how to manage their health conforms to the provision of theory’s perspective that a patient has skills to create actions that meet personal needs of the patient becomes suitable for self care.
Literature Review
Over the past decade, the conversion from hospital to home care has been associated with increased risks, especially for older adults with intricate care needs. This risk is associated with many factors including patient’s lack of or poor understanding of discharge instructions. According to Waniga et al. (2016), the time of discharge from the hospital is extremely vulnerable for patients with nearly 19% of patients experiencing adverse events of post discharge such as uncertainty, anxiety, and lack of understanding about discharge instructions. All these lead to readmission rates, and influence the overall perception of the hospital experience. Therefore, non-sophisticated discharge instructions are vital to ensure seamless change from hospital to home, when the care responsibility changes from the providers to patients and care givers (Navanandan et al., 2017). Consequently, nurses play a crucial role in providing discharge instructions to patients.
Moreover, older adults face challenges such as functional capacity, inability for self care, and deteriorated health status. Therefore, before hospital discharge, it is imperative for nurses to provide discharge education that considers the perspectives of the adults to prevent challenges associated with self-care (Ghiasvand et al., 2017). One of the best discharge instructional methods is teach-back method. This method refers to a communication technique used by the nurses to verify whether or not a patient understands what they are told. If the patient understands, he or she is able to accurately teach-back the information. This method is crucial in enhancing the patient understanding of post-discharge care requirements (Griffey et al., 2015). Moreover, it is imperative for nurses to utilize written and visual materials to further increase patient understanding and appeal for various learning methods such as visual and auditory.
Data Collection Methods
The data will be collected using the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys. HCAHPS connotes a patient satisfaction survey recommended for all health care settings in America. It seeks to produce comparable data on the views of the patient on health care to facilitate objective and focused comparisons between facilities (Piper & Tallman, 2016). The other method entails the use of questionnaires, which consist of a set of questions that are intended to obtain information from respondents. Other methods that can be used include interviews, focused groups, and observations.
Analysis
After completing data collection, the data analysis will begin by manipulating the data in various ways including plotting the data out and seeking correlation or de
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