Potential Theoretical Foundations.

Posted: January 9th, 2023

Potential Theoretical Foundations.

Decreasing 30 day readmission rates with COPD population
Decreasing 30 day readmission rates with Chronic Obstructive Pulmonary Disease (COPD) population dissertation is governed by multiple theoretical foundations. Theories that support this research include the Lewin’s change theory, Orem’s self-care theory and the situation-specific theory.

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The Lewin’s change Theory
The Lewin’s change theory is a change model characterized by three steps which include unfreezing, changing and refreezing. In this case, the change entails the creation of a perception concerning the necessity of the change, engaging the right behavior and development of a norm through solidification of the new behaviors. The primary concepts of Lewin’s theory are driving forces, restraining forces, and equilibrium.Driving forces direct actions towards a particular direction of change regarding the patient. They shift the balance towards the achievement of positive changes while restraining forces counter the forces that drive change and hence they push the patient into the direction against the desired change. Equilibrium ensures a balance is maintained between the restraining forces and the driving forces and prevents the occurrence of changes.
Orem’s Self-care Theory
The self-care deficit nursing theory by Dorothea Orem bases its argument on the ability of human beings to adapt to the environment. It majors on self-reliance and care responsibility and it seeks to help the nurses in understanding the patient’s better whose engagement in care improves the effectiveness of patient’s outcomes and overall health. Being introduced as a component of self-care, this theory is essential in the implementation of healthcare changes which seek to improve healthcare quality and reduce patient readmissions (George, 2011). Orem’s theory is patient-centered encouraging patients to be part of their own care. Therefore, the improvement of chronic illness patient care and quality of life is enhanced by this theory through motivation to familiarize with self-care skills, empowerment, acceptance of healthcare responsibility and acceptance of the illness to enhance positive living.
Situation-specific theory
The situation-specific theory informs the research in that it will focus on the specific changes implementable in the reduction of 30 day readmission rates with COPD population. Its application is limited to particular nursing practices and specific populations and therefore, it is an essential theoretical framework for this research. The situation-specific theories link practice, theory and research, inform the nursing perspective and provide conceptual schemes based on the external and internal dialogues (Meleis, 2010). In this case, the situation specific theory used will focus on the COPD patient population and the effective interventions and changes to implement to reduce readmission rates.
Theory Applications
Lewin’s change theory stipulates that disequilibrium occurs from the shift of balance between the driving forces and the restraining forces. This in turn results in unfreezing which imposes pressure on the patients and the nurses considering that people do not appreciate instant changes. As such, Lewin theory is applied in the decrease of admissions among COPD patients through the development of systematic processes with a transparent direction and clear communication to optimize the benefits of positive behavior as well as manage the consequences of negative behavior (Eyegue-Sandy, 2017). For instance, it can be used to report non-compliant patients being discharged through the help of electronic medical records. This will limit them from readmissions as a consequence of their previous bad behavior that discourages recovery.
Consequently, Orem’s self-care theory is applicable in various aspects of the research. For instance, patients can only be discharged from the hospital in stable health conditions. Patients are also expected to adhere to the discharge plans to prevent admission. This is achieved through self-care concepts which facilitate the active involvement of the patient in their care, treatment and recovery process. Moreover, this theory is used in management of chronic diseases to impart self-care skills, motivation, provide counselling and empowerment of patients. Therefore, its application in this research is evident in informing the nurses on the effective approaches to apply while engaging, counseling and empowering the COPD patient population featured in the study to prevent the increase of readmissions
The situation specific theory for Chronic Obstructive Pulmonary Disease (COPD) is applicable in various ways in this research. It will be applied in the validation of information and actions affecting the increase in readmission cases of patients as well as in sharing information among different hospital departments to increase efficiency in record keeping which prevents errors (Alligood, 2013). In addition, this theory is applicable in exploration of multiple sources to determine and identify the causes of increased readmissions of COPD population and eventually help in devising a solution to the problem. Its utilization of scientific facts will provide substantiated explanations for the increase of readmissions and inform the formulation of essential approaches to reduce the cases to less than 30 days.
Viability of the Theories
The three theoretical frameworks examined in this dissertation are effective and critical in the research. They explore the causes of a 30 day readmission rates and informs the probable changes that can help in decreasing the number of days. Nursing theories are well- substantiated explanations of a situation, its occurrence and the possible resolutions to the problems that pose healthcare challenges. They also provide systematic processes that entail the behaviors, feelings and thoughts movement towards imposing positive changes in the healthcare system to decrease the 30 day readmission rates in COPD patients. For example, the self-care theoretical framework examines the chronic illness process and change initiated by the patient themselves. The engagement of the patient in care helps determine their pain and other factors that could result in frequent readmission rates.
On the other hand, Lewin theoretical framework explores organizational changes and their management through maintenance of equilibrium to prevent extreme negative impacts and consequences.it is thus important in this study as it helps identify positive and negative behaviors associated with the changes in the healthcare organizations that eventually affects the readmission of patients. More so, the situation specific theory for COPD is particular in investigating the phenomenon related to readmission and the essential probable approaches to implement to achieve a reduction on 30 day admission rates of this specific population.
Limitations of Application
The application of self-care theory of Dorothy Orem can be limited by its ambiguity. This means that it might provide inaccurate findings since it does not focus on all the aspects of care. Additionally, the fact that this theory is influenced by environmental factors, the occurrence of adverse weather conditions during the research will limit the self-care practices. The situation-specific theory has no limitations since it is specific and applicable to the chronic obstructive pulmonary disease. The Lewin’s change theory application will be limited by the difficulty to unfreeze changes in the system. It also ignores the political and power roles in healthcare organizations. The organization also applies transformational leadership which limits the use of the theory since it ignores the radical and transformational changes.

Decreasing 30 day readmission rates with COPD population
Decreasing 30 day readmission rates with Chronic Obstructive Pulmonary Disease (COPD) population dissertation is governed by multiple theoretical foundations. Theories that support this research include the Lewin’s change theory, Orem’s self-care theory and the situation-specific theory.
The Lewin’s change Theory
The Lewin’s change theory is a change model characterized by three steps which include unfreezing, changing and refreezing. In this case, the change entails the creation of a perception concerning the necessity of the change, engaging the right behavior and development of a norm through solidification of the new behaviors. The primary concepts of Lewin’s theory are driving forces, restraining forces, and equilibrium.Driving forces direct actions towards a particular direction of change regarding the patient. They shift the balance towards the achievement of positive changes while restraining forces counter the forces that drive change and hence they push the patient into the direction against the desired change. Equilibrium ensures a balance is maintained between the restraining forces and the driving forces and prevents the occurrence of changes.
Orem’s Self-care Theory
The self-care deficit nursing theory by Dorothea Orem bases its argument on the ability of human beings to adapt to the environment. It majors on self-reliance and care responsibility and it seeks to help the nurses in understanding the patient’s better whose engagement in care improves the effectiveness of patient’s outcomes and overall health. Being introduced as a component of self-care, this theory is essential in the implementation of healthcare changes which seek to improve healthcare quality and reduce patient readmissions (George, 2011). Orem’s theory is patient-centered encouraging patients to be part of their own care. Therefore, the improvement of chronic illness patient care and quality of life is enhanced by this theory through motivation to familiarize with self-care skills, empowerment, acceptance of healthcare responsibility and acceptance of the illness to enhance positive living.
Situation-specific theory
The situation-specific theory informs the research in that it will focus on the specific changes implementable in the reduction of 30 day readmission rates with COPD population. Its application is limited to particular nursing practices and specific populations and therefore, it is an essential theoretical framework for this research. The situation-specific theories link practice, theory and research, inform the nursing perspective and provide conceptual schemes based on the external and internal dialogues (Meleis, 2010). In this case, the situation specific theory used will focus on the COPD patient population and the effective interventions and changes to implement to reduce readmission rates.
Theory Applications
Lewin’s change theory stipulates that disequilibrium occurs from the shift of balance between the driving forces and the restraining forces. This in turn results in unfreezing which imposes pressure on the patients and the nurses considering that people do not appreciate instant changes. As such, Lewin theory is applied in the decrease of admissions among COPD patients through the development of systematic processes with a transparent direction and clear communication to optimize the benefits of positive behavior as well as manage the consequences of negative behavior (Eyegue-Sandy, 2017). For instance, it can be used to report non-compliant patients being discharged through the help of electronic medical records. This will limit them from readmissions as a consequence of their previous bad behavior that discourages recovery.
Consequently, Orem’s self-care theory is applicable in various aspects of the research. For instance, patients can only be discharged from the hospital in stable health conditions. Patients are also expected to adhere to the discharge plans to prevent admission. This is achieved through self-care concepts which facilitate the active involvement of the patient in their care, treatment and recovery process. Moreover, this theory is used in management of chronic diseases to impart self-care skills, motivation, provide counselling and empowerment of patients. Therefore, its application in this research is evident in informing the nurses on the effective approaches to apply while engaging, counseling and empowering the COPD patient population featured in the study to prevent the increase of readmissions
The situation specific theory for Chronic Obstructive Pulmonary Disease (COPD) is applicable in various ways in this research. It will be applied in the validation of information and actions affecting the increase in readmission cases of patients as well as in sharing information among different hospital departments to increase efficiency in record keeping which prevents errors (Alligood, 2013). In addition, this theory is applicable in exploration of multiple sources to determine and identify the causes of increased readmissions of COPD population and eventually help in devising a solution to the problem. Its utilization of scientific facts will provide substantiated explanations for the increase of readmissions and inform the formulation of essential approaches to reduce the cases to less than 30 days.
Viability of the Theories
The three theoretical frameworks examined in this dissertation are effective and critical in the research. They explore the causes of a 30 day readmission rates and informs the probable changes that can help in decreasing the number of days. Nursing theories are well- substantiated explanations of a situation, its occurrence and the possible resolutions to the problems that pose healthcare challenges. They also provide systematic processes that entail the behaviors, feelings and thoughts movement towards imposing positive changes in the healthcare system to decrease the 30 day readmission rates in COPD patients. For example, the self-care theoretical framework examines the chronic illness process and change initiated by the patient themselves. The engagement of the patient in care helps determine their pain and other factors that could result in frequent readmission rates.
On the other hand, Lewin theoretical framework explores organizational changes and their management through maintenance of equilibrium to prevent extreme negative impacts and consequences.it is thus important in this study as it helps identify positive and negative behaviors associated with the changes in the healthcare organizations that eventually affects the readmission of patients. More so, the situation specific theory for COPD is particular in investigating the phenomenon related to readmission and the essential probable approaches to implement to achieve a reduction on 30 day admission rates of this specific population.
Limitations of Application
The application of self-care theory of Dorothy Orem can be limited by its ambiguity. This means that it might provide inaccurate findings since it does not focus on all the aspects of care. Additionally, the fact that this theory is influenced by environmental factors, the occurrence of adverse weather conditions during the research will limit the self-care practices. The situation-specific theory has no limitations since it is specific and applicable to the chronic obstructive pulmonary disease. The Lewin’s change theory application will be limited by the difficulty to unfreeze changes in the system. It also ignores the political and power roles in healthcare organizations. The organization also applies transformational leadership which limits the use of the theory since it ignores the radical and transformational changes.