Nursing Theory Applied to Research
• How the selected nursing theory is relevant to your area of interest
• A brief description of the issue/concern
• How the selected nursing theory can be used to guide the resolution of the issue/concern
Include an example from the literature or your own experience to illustrate your points. Remember to include at least one outside scholarly source.
Nursing Theory Applied to Research
One thing in nursing that is near and dear to me is providing patients with quality care which will lend itself to better patient outcomes and organizational sustainability with a value-based healthcare system. As a current healthcare leader, it is only fitting to gain more knowledge through a master’s program that has a nurse executive focus. Dorothea Orem’s self-care deficit nursing theory (SCDNT) directly relates to and influences overall quality of care delivered by addressing three essential elements. Orem’s SCDNT elements are theory of self-care, theory of self-care deficit, and theory of nursing systems (O’Shaughnessy, 2014). This theory’s major assumption is the patient has a desire to be independent and care for his or her self. Theory of nursing systems refers to the fundamental conditioning factors being met, how they are met, and by whom they are met. There are three categories of nursing systems, which include wholly compensatory system, partially compensatory system, and supportive-education system (Smith & Parker, 2015). The end goal is to change the patient care from nursing centered to self-care focused and provide the best healthcare outcomes possible. As such, it is vital to identify issues related to care outcomes, to find ways to enhance the effectiveness of care delivery by applying Orem’s theory concepts and principles and develop ways of assessing and assuring organizations are providing quality care to the communities in which they serve.
Nursing Theory Applied to Research
The issue of enhancing healthcare systems effectiveness of care delivery has resulted in a need to develop ways of assessing and assuring a certain quality of care is delivered in acute care settings. Healthcare systems are designed and moving more towards optimization of health through a continuum of care, it is important to identify processes and structures within that continuum that fail or produce poor results. Nursing leadership has a responsibility to maintain certain metrics and part of that being quality care. They are required to have systems in place to monitor care and assess the quality being delivered. Many healthcare organizations are implementing projects that address things like reduction of hospital-acquired conditions, patient engagement, and the integration of mobile technologies and other informatics solutions to improve clinical workflows and increase registered nurses’ access to knowledge resources (Weston & Roberts, 2013). There is strong support in nursing literature that strong leadership and promoting trust and independence in nursing not only increases patient satisfaction, but can also have a positive impact on delivery of care and the outcomes related to that care (Zamora, Patel, Doherty, Alperstein, & Devito, 2015).
Orem’s SCDNT can be used to resolve quality concerns in various ways but truly starts with the leaders leading and managing the need for change. As in assessing patients’ needs or care deficits, a leader must see problems as opportunities for improvement and identify probable root causes. This takes strategy. Mobilizing processes for change takes a conscious calculated effort. Leaders affect the direction of strategic change in the healthcare sector (Salmela, Eriksson, & Fagerstrom, 2012). As a leader, you will need to help your teams learn and grow. Guiding, supporting, acting for or doing for, providing an environment that promotes growth and development, and teaching are those principles. Orem’s five methods of helping are stated in leadership books as well in a different context. You can look at Orem’s wholly, partly, and supportive system and apply all three as a leader. An example of the SCDNT as it relates to a cancer patient one study showed that self-care is determined by attributes; education, interaction, self-control, and self-reliance (Hasanpour-Dehkordi, 2016). The study identified three antecedents present which were client-related such as self-esteem, system related such as adequate sources and cultural factors, and healthcare professionals related such as participation (Hasanpour-Dehkordi, 2016). It placed emphasis on the importance of educating cancer patients on self-care due to the positive impact on quality of life and outcomes. The article stated that educating on self-care is essential to this patient population for self-management and self-treatment and those lacking this education were hospitalized more frequently (Hasanpour-Dehkordi, 2016). It is the leader’s responsibility to ensure that this education is happening. Validation on leader rounding will help assure all parties are accountable. Data shows that leader rounding promotes “increased levels of teamwork and communication by transforming the entire organization into a cohesive team that’s motivated to achieve the same goals” (Winter & Tjiong, 2015, p. 26). Ultimately, you must have the right leaders in place first and foremost. Leaders must be able to identify lack of quality or need for process change. They must be aware and consciously try to engage and educate their team and the result will only benefit the patient.
The PICOT tool is used to formulate questions in evidence based practice such as how do we truly develop processes that are necessary to aide in providing quality care. PICOT stands for problem, intervention, comparison, outcome, and time. I have attached a great reference tool for the class as I always love when my peers share tools that will aide in my practice! Orem’s SCDNT is an all-encompassing approach to treating health and wellness for an individual with the promotion of independence by educating and supporting. As a leader, this is applicable to both patient and staff. One question that will promote Orem’s theory is “How can I prevent adverse outcomes and improve quality of nursing care?”. Another question could be “What are the long-term effects of substandard delivery of care that result in poor quality and patient outcomes?”. Orem’s theory is all about assessing care needs and what interventions must be put in place to maximize patients full potential related to health and independence. Another question along that line would be “What is the best way to assess the patient for self-care and assess the nurse’s delivery of care in response to the patient’s needs?”. Then there is the component that the leader plays as I referenced in my original post, as in assessing patients’ needs or care deficits, a leader must see problems as opportunities for improvement and identify probable root causes. Another question would be “How can a nurse leader prevent or decrease occurrences of substandard care?”. So many questions could be generated using Orem’s theory and applying it to nursing care delivery and patient outcomes and the role in which they both play in conjunction with the nursing leader.
Nursing theory has an immense effect in the elaboration of nursing practice. It influences many different phases of the occupation. Theory provides nurses with solid concepts that can be applied in clinical practice in order to address specific issues and problems found in the clinical realm. Nursing theory provides a structure in which suitable nursing interventions can be encouraged and implemented into practice. Nursing theory is frequently applied to different areas of nursing such as advanced clinical practice, nursing education, nursing leadership, and nursing informatics (Shea, & Cavan, 2014).
Nurse staffing shortage has been recognized as a vital constituent in the proper delivery of patient care. The radical reductions in nursing budgets together with a drastic nursing shortage has caused less nurses caring for much sicker patients (Sales, 2015). Nurses as myself and my fellow classmates have been led to leave beside nursing due to the unhealthy, unsafe work conditions and the overwhelming stress that it causes. All these components have caused serious staffing issues in the nursing profession. Recent studies validate a direct association between nursing shortages and patient outcomes. The study exhibited that proper staffing ensures safety and quality nursing care for the patients, which in turn improves health outcomes. As an ANP, nurse staffing has been an ongoing challenge and the problem continues to rise. The biggest problem relating to nurse staffing stems from management seeking to be cost effective by fostering minimal staffing accommodations in their respective units (Sales, 2015). Additional research discovered that poor staffing negatively affects not only the work environment but also patient health outcomes in a negative manner and patient/nurse dissatisfaction. The study additionally identified an increase in sentinel events, accidental needle sticks, missed intravenous applications, and tasks that were missed due to the emotional exhaustion caused by additional patients (Castner, Wu, & Dean-Baar, 2015).
By incorporating Jean Watson’s theory of caring into advanced practice nursing and leadership, an innovative approach to the current issue of nurse staffing can be promoted. The fundamental suppositions of the theory of caring can also be applied and integrated to the leadership principles of an institution. In applying the concepts of caring to the staffing issues confronted in clinical practice and nursing leadership can improve clinical outcomes overall (Morrow, 2014).
In reviewing the literature, it is understood that nurse staffing can influence patient mortality and nursing care outcomes on a unit. The main obstacle relating to proper staffing onWhen utilizing Watson’s theory of caring in advanced clinical practice, management is then provided with moral and ethical standards when pertaining to staffing. The theory of caring provides an ethical framework, in which caring is seen as a right the patient has and is entitled to have. In order to ensure that the theory is applied and to gain its benefits accordingly, managers must provide adequate staffing and advocate that appropriate patient- nurse ratios are maintained. In promoting Jean Watson’s theory of caring, the presence of the nurse at bedside will be valued and appreciated. This will encourage nursing leadership and administration to conserve sufficient staffing of nurses in the clinical setting. By doing so will give management a glimpse of the ethical duty that the hospital as a whole has to ensure that nursing is providing quality effective care to the patients.
In reviewing the literature, it is understood that nurse staffing can influence patient mortality and nursing care outcomes on a unit. The main obstacle relating to proper staffing on any given unit has been attributed to economic factors involving upper management. Jean Watson’s theory of caring, provides an innovative approach to the issue most often complained of by all hospital units, which is staff shortages. This theory can provide a framework in which nurse leaders and organizations, can embed caring principles in the delivery of patient care. In promoting caring concepts in nursing, long term solutions can be implemented in the area of nurse staffing. Overall, staffing an adequate number of nurses on every shift promotes satisfied staff members, employee retention, quality patient care, higher satisfaction scores, and better clinical outcomes.