NR 501 Week 5 Application of Theory Assignment

Introduction

NR 501 Week 5 Application of Theory Assignment

Patient-centered care is an evolved nursing paradigm, which allows nurses to practice in a way, which suits patients and their needs. This type of care empowers both nurses as well as the patient (McCormack et al., 2015). Also, it reduces the cost of treatment as each individual will get a treatment, which suits him or her (van der Cingel et al., 2016). Person-Centered Nursing (PCN) Framework identifies the importance of person-centred care in healthcare. This paper aims to analyze the PCN model in terms of nursing metaparadigms to check whether this theory acts as a nursing framework and whether it has clinical application in nursing. 

NR 501 Week 5 Application of Theory Assignment

Overview of Selected Model

PCN model is a five-layered model developed by McCormack and McCance in the research paper Development of a framework for person-centered nursing in 2006 (van der Cingel et al., 2016). The model was based on individual care through nursing practice. Authors define patient-centered care as a nursing practice to form and foster the healthful relationship between all healthcare providers, intermediaries, service users, patients, and others who signed in bettering the health of individuals. Initially, this model had only four constructs (McCormack et al., 2016). They are prerequisites, person-centered processes, care environments, and outcomes. The macro context was later added in the revised publication in 2017 by McCormack and McCance in the research paper Person-centred Practice Framework. The constructs are represented in circular form. The outermost layer represents Macro context and innermost layer represents the patient-centred outcome (Wolstenholme, Ross, Cobb & Bowen, 2017). To get the best care and to provide best, healthcare and patient needs to go from outer layer to inner layer. 

The model covers all four nursing metaparadigms: person, environment, nursing, and health. 

NR 501 Week 5 Application of Theory Assignment

Person:

Person is the patient who needs nursing care. Van der Cingel et al. (2016) highlights that patient is the center of the model as nurses have to consider individual characteristics, history, preferences, and disease to provide care or treatment. When using PCN, it is very important to know the significance of individualized treatment, care along with the knowledge out the person’s medical requirements. Further, the opinion of the patient has to be considered in the process. 

Environment:

According to PCN model, the environment is not related to just physical aspects but also other external factors, which affects the patient. They can be socioeconomic status, culture, beliefs, spirituality, religion, and family (Wolstenholme, Ross, Cobb & Bowen, 2017). Before deciding on treatment method, nurses have to consider these factors associated with the patient. 

Health:

PCN model identifies positive health recovery as the outcome of the treatment. It is the innermost layer of the model (Wolstenholme, Ross, Cobb & Bowen, 2017). It is the obligation of the nurse and healthcare to provide holistic care where patent recovers from the illness by providing basic needs such as food, water, shelter, comfort, and warmth. Nurses and healthcare staff has to identify the problems and treat the patient (Riddett, 2017). 

NR 501 Week 5 Application of Theory Assignment

Nursing:

PCN is considered as a framework or tool for nursing practice. Nurses have to use the constructs of PCN to identify health barriers and treat the patient. This framework assists nurses to understand the different aspects of individuals. Further, nursing is a healthcare service provided to the patients and family (van der Cingel et al., 2016). This model established inter-relation between different intermediaries and family to provide holistic care through nursing practice for the best outcomes. 

Appraisal of the Model as a Nursing Theory

PCN framework has high generalizability and moderate complexity level. However, with better integration between its five constructs, it is possible to lower the complexity. This is nothing but collaboration. As PCN framework considers patients and their needs as a central aspect, nurses can understand the patient and disease better before implementing a treatment plan (McCormack & McCance, 2006). Further, it also considers external factors, which affect patient outcome (Verbeek, van Rossum, Zwakhalen, Kempen & Hamers, 2008). As a result, the nurse gathers the information for holistic care (van der Cingel et al., 2016). Also, the theory proposes evaluation and improvement in the treatment process or nursing (Wolstenholme, Ross, Cobb & Bowen, 2017). As it explains all the nursing metaparadigms and considers both individual and organizational level responsibilities, this theory helps nurses to practice better. 

NR 501 Week 5 Application of Theory Assignment

Application of the Model to Advanced Practice Nursing

The very first application of nursing theory is patient-centered care. For example, old age home nursing care is different compared to ICU care (Wolstenholme, Ross, Cobb & Bowen, 2017). Older people with chronic disease needs adaptive care. Next application is related to education and awareness (Verbeek, van Rossum, Zwakhalen, Kempen & Hamers, 2008). Use of PCN in preventing infections such as CAUTI, VAP, and bacterial secretion is effective as each patient needs a daily check-up. By providing patient-related information on the issue, nurses can use proper interventions (Feo & Kitson, 2016). Another application is culture-based care. Different individuals believe in a different culture. As a result, understanding their culture and system to provide care is an evidence-based approach (Wolstenholme, Ross, Cobb & Bowen, 2017). After the evaluation, nursing information can be documented for future reference if another patient with similar characteristics and belief system needs care. 

Nursing requires ethical decision-making in complex situations. With executive shared decision-making by including family and patient, many issues can be resolved (Feo & Kitson, 2016). Family Nurse Practitioners can consider gender, age, mental stability, and other factors while treating a patient especially children results in a better outcome. 

As a macro construct and environment deal with organizational values, this framework allows nurses to participate in policy making (Wolstenholme, Ross, Cobb & Bowen, 2017). For example, not all the time and at all places standardized guidelines work due to demographics, patient characteristics and external factors such as insurance and socioeconomic status. By proper recordings and documentation, new policies can be drafted (van der Cingel et al., 2016) related to medicine, education, insurance, and treatment plan. 

NR 501 Week 5 Application of Theory Assignment

Conclusion

PCN framework reduces complexities in the patient care, improves nurse interactions, knowledge-based care, policy-making assessment, treatment plan, and five-layered patient-centered treatment, it helps in educating nurses and empowering patients where healthcare can provide holistic care. This model can be implemented in all types of healthcare because it considers the patient as the center of nursing. 

References

McCormack, B., & McCance, T. (2006). Development of a framework for person-centred nursing. Journal Of Advanced Nursing, 56(5), 472-479. doi: 10.1111/j.1365-2648.2006.04042.x

McCormack, B., Borg, M., Cardiff, S., Dewin, J., Jacobs, G., & Janes, N. et al. (2015). Person-centredness: the ‘state’ of the art. International Journal Of Practice Development., 05(01). Retrieved from http://fons.org/ library/journal/volume5-person-centredness-suppl/article1

NR 501 Week 5 Application of Theory Assignment

McCormack, B., Dewing, J., Breslin, L., Coyne-Nevin, A., Kennedy, K., & Manning, M. et al. (2010). Developing person-centred practice: nursing outcomes arising from changes to the care environment in residential settings for older people. International Journal Of Older People Nursing, 5(2), 93-107. doi: 10.1111/j.1748-3743.2010.00216.x

Riddett, J. (2017). Person-Centred Practice in Nursing and Health Care: Theory and Practice (Second edition)McCormack Brendan and McCance Tanya (Eds) Person-Centred Practice in Nursing and Health Care: Theory and Practice (Second edition) 288pp £29.99 Wiley Blackwell 9781118990568 1118990560. Mental Health Practice, 20(6), 13-13. doi: 10.7748/mhp.20.6.13.s14

van der Cingel, M., Brandsma, L., van Dam, M., van Dorst, M., Verkaart, C., & van der Velde, C. (2016). Concepts of person-centred care: a framework analysis of five studies in daily care practices. International Practice Development Journal, 6(2), 1-17. doi: 10.19043/ipdj.62.006

Verbeek, H., van Rossum, E., Zwakhalen, S., Kempen, G., & Hamers, J. (2008). Small, homelike care environments for older people with dementia: a literature review. International Psychogeriatrics, 21(02), 252. doi: 10.1017/s104161020800820x

Wolstenholme, D., Ross, H., Cobb, M., & Bowen, S. (2017). Participatory design facilitates Person Centred Nursing in service improvement with older people: a secondary directed content analysis. Journal Of Clinical Nursing, 26(9-10), 1217-1225. doi: 10.1111/jocn.13385

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