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Design for Change

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Draft Design for Change
Emily Molina
Chamberlain College of Nursing
Dr. Bonnie Smith
NR 451 Capstone Course

Draft Design for Change

Introduction
A patient is admitted to a psychiatric unit on an involuntary basis or on voluntary basis. When a patient is deemed dangerous to himself/herself or others, they are admitted to the psychiatric unit against their wishes, or involuntarily. When a person goes to the hospital on their own to get help, they are admitted on a voluntary basis. In both cases, the patient is evaluated, stabilized in the Psychiatric ER, and then sent to the inpatient unit. Once they’re in the in-patient unit, they refuse treatment and become non-compliant to medication. The longer they refuse, the sicker they get, and begin to act out. The last option is to force medicate the patient, and that is not a pretty picture. Before it escalates to the point of forcing medication, are there any interventions a nurse can employ to lead a patient to compliance? Strategies/interventions nurses used for non-compliant patients were engagement, formulating a therapeutic relationship, and finding out why. (Vuckovich, 2009). Self-determination was a concept discussed by Corrigan et al. (2012). Interventions that promoted self-determination led to patient compliance. This paper will explore those interventions, and how they can achieve compliance to treatment in psychiatric patients.
Change Model Overview Rosswurm and Larrabee (1999) proposed a model for change based on theoretical and research literature, related to evidence-based practice, research utilization, standardized language, and change theory. This model for change is a guide used to develop and integrate an evidence-based change. It is a six step systematic process that helps nurses or practitioners facilitate change. The model is very useful in disseminating the

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