Theory, research and evidence based practice

Hendersons decent ion of nursing

Unique function of the nurse is to assist the individual in the performance of those activities contributing to health or it's recovery

Hendersons idea

Nurses deserve to know what it means to be a nurse. She identified 14 basic needs that are addressed by nursing care

Examples that demonstrate how important theory and research are In nursing

The Framingham studies, Watson's science of human caring and Berbers novice to expert

Nine concepts that describe how a theory influences choice of nursing activities

1. Holistic nursing 2. Honoring personhood 3. Transpersonal caring moments 4. Personal presence 5.Comfort 6. Listening 7. Spiritual care 8. Caring for the family 9. Cultural competence

Full spectrum nurses participate in research by doing the following

1. Identifying ideas that should be examined 2. Assisting in designing or performing research 3. Use research as basis for practice

Examples of clinical practice theory

1. Nightengales theory with env 2. I.R theory on bereavement of older women 3. N.P basis for most health promotion teaching 4. K.K holistic comfort

Baccalaureate degree in nursing

1.Critique research 2.identify nursing research problems 3.apply research to establish sound clinical practice

Associate degree and diploma nursing

1.be aware of importance of research 2.help identify problem areas 3. Help collect data 4. Use evidence based practice

To begin developing a theory

A nurse has an idea that seems worth exploring through research

Definition

A statement of the meaning of a term or concept that sets forth the concepts characteristics or indicators

Why learn about research

Ability to read and use nursing research enhances the ability to give quality care

Nursing research encompasses

All clinical practice arenas, nursing education and nursing administration

System theory

All complex phenomena have some principles, laws and organization in commen.

The terms theory model and framework

All refer to a group of related concepts. They differ in meaning. Theory has higher level of research, detail and organization

Holistic nursing care

Allows nurses to examine the complete person and his context when making h.c decisions

Practice, theory and research

Are interrelated. A nurse has an idea, conducts research to test the idea And finally develops a theory

Simple, concrete concepts

Are those you can observe directly. Height, weight, gender

Validation theory

Arises from social work and provides a way to communicate with elders who have dimentia

Phenomena

Aspects of reality that you can observe and experience. Subject matter of discipline. Makes one unique from another

Nursing theories serve as a guide for

Assessment, problem identification, and choosing nursing interventions

Theories are made up of

Assumptions, phenomena, concepts, definitions and statements

Input

Energy, info, or materials that enter the system

Two growth needs that must be met

Before reaching self actualization. Cognitive and aesthetic. Cognitive is to know, understand and explore Aesthetic is for symmetry and beauty

Novice

Beginning nurse, new to nursing profession

Professional organizations

Established research priorities that will assist nursing to build a strong knowledge base in areas of importance to society

One Important competency is

Evidence based practice, ability to integrate the best available current evidence with clinical expertise and patient preferences

Stress and adaptation theory

Certain amount of stress is good for people, it keeps them motivated and alert. Too much results in illness

Maslows hierarchy of basic human needs

Certain human needs are common to all people, some are more basic than others. The lower level needs must be met before moving up

Meta analysis

Combines and analyzes the data from several different studies

Self esteem needs

Comes through a sense of accomplishment and recognition from others and brings confidence and independence

Reasoning

Connecting ideas in a way that makes sense

Throughput

Consists of the processes the system uses to convert input into output

Grand theory

Covers broad areas of concern with discipline. Usually abstract and doesn't outline specific nursing interventions, deals with relations

Madeleine leininger

Cultural care diversity and universality theory. Caring theory.

Madeleines theory focuses on

Cultural competence, using knowledge of cultures and of nursing to provide culturally congruent and responsible care

How do nurses use theories

In practice, education, and research

Theories help generate

New knowledge by suggesting questions for researchers to study. Researchers us theories as a framework for structuring study

Benners novice to expert

Describes progression of a beginning nurse to increasing levels of expertise

Watson's science of human caring

Describes what caring means from a nursing perspective. Watson believed nurses need to be taught how to care

Frameworks are not

Developed using research processes. They are more broader and philosophical than theories

Peplaus research showed

Developing a interpersonal relationship with psychiatric patients does make their treatment more effective.

Transcendence of self

Drive to connect to something beyond ones self and to help others realize their potential

Safety and security needs

Either physical or emotional needs. Physical safety means protection from physical harm and having shelter. Emotional safety involves freedom from anxiety

Open systems

Exchange info and energy freely with the environment. They care capable of growth and adaptation

Nursing theories try to

Explain, describe and predict human behavior

The inductions and deductions are not

Facts or truth but rather that they point you in the direction to go in seeking truth. Makes connections between ideas

A theory helps us

Find meaning in experiences, organize our thinking and develop new ideas. Theory is not a fact .

Closed systems

Fixed, automatic relations among their components and little give and take with the enviroment

Some important nursing theorists

Florence nightengale, Virginia Henderson , and hildegard peplau

All systems have some common elements

Goal is to process input, output, throughput, feedback, open systems and closed systems

Honoring personhood

Honor for individuality in behavior

Assumptions

Ideas that we take for granted. The researcher presumes Idea to be true and does not test research

Caring for the family

Importance of including the family of the person who is receiving care

Two types of logical reasoning

Inductive and deductive reasoning

The results of the Framington studies

Influenced h.c practices for diabetes, breast cancer, heart disease, and osteoporosis. Improved h.c for women by inc use of mammography

Heldegard peplau

Influenced the advancement of standards in nursing edu, promoted self regulation in nursing through credentialing and was a sting advocate

Feedback

Info about some aspect of the processing that is used to monitor the system and make it's performance effective

Conceptual model

Is a model that is expressed in language. The symbols are words

A theory

Is an organized set of related ideas and concepts. A way of viewing phenomena

System

Is made up of separate components or subsystems which constantly interact with each other and other systems

Spiritual care

Know what an individuals spiritual needs are and make appropriate plans to meet them

Theories are developed through

Logical reasoning, which develops an argument or statement based on evidence that will result in a logical conclusion

The Framington studies

Longitudinal, multidisciplinary research project. Consists of several studies to identify health and h.c practices of the community

Developmental theories

Look at life stages that people progress through over time. These theories identify norms and expectations at various stages

A few borrows theories used in nursing

Maslows, validation, stress and adaptation, developmental and system theory

Concepts

Mental image of a phenomenon. Formed by generalizing an abstract idea from your experience and obs. Exists as a symbol

Physiological needs

Most basic, those met to maintain life. Food, air, water, temp, elimination and rest

Self actualization needs

Need to reach your full potential and to act unselfishly

Transpersonal caring moments

Occur when an actual caring occasion or caring relation exists between the nurse and patient

Comfort

Occurs in four contexts : physical, psychospiritual, social and environmental

Inductive reasoning

Often used In the nursing process. Moves from the specific to the general. Gather separate pieces of info, recognize a pattern and form generalization

Three caring theorists

Patricia Benners, Madeleine leininger and Jean Watson

Any nursing theory should address four basic concepts

Person, environment, health and nursing. These concepts represent phenomena of concern for nursing

Patricia Benner

Primacy of caring model. Caring is central to the model and helps the client cope with stressors

Output

Product or service that results from the systems through put

Virginia Henderson

Questioned mechanistic nursing care she was taught, as we'll as being expected to be a handmaiden

History of nursing research

Records nightengale kept while nursing soldiers began formalized research.

Theoretical definition

Refers to conceptual meaning of a term

Listening

Requires you to quiet your mind and truly listen with your mind and heart

Florence nightengale

Revolutionized nursing. Idea was that clean env would improve the health of patients. Dramatically reduced death of soilders

Conceptual framework

Set of concepts that are related to form a whole or pattern

Love and belonging needs

Social or affiliation needs. Person strives for meaningful relations with others. If needs are not met may feel isolated

Clinical practice theories

Specifically guide what you do each day. Limited in scope

Operational definition

Specifies how you would observe or measure the concept.

Deductive reasoning

Starts with the general premise and moves to specific deduction

Model

Symbolic representation of a framework or concept. Diagram, graph

Statements or propositions

Systematically describe the linkages and interactions among the concepts of a theory. As a whole, make up the theory

Nursing research

Systemic, objective process of analyzing phenomena of importance to nursing.

The point is

That a theory can change the focus of nursing. Caring theories demonstrate the value of the non task oriented aspects of nursing

Florence nightengale Stated

That nursing theories describe and explain what is and what is not nursing

In Madeleines theory

The person is the ind with cultural beliefs, nurse is professional who values cultural diversity, env is wherever the nurse and person are together

ANA standards of professional performance include four criterias

The registered nurse utilizes current evidence based knowledge, incorporates evidence, participates in formulation of evidence based practice and shares findings

A meaningful nursing theory defines

These four puzzle pieces and explains how they are related to each other

Abstract concepts

Those you must infer from many direct and indirect observations. Self esteem, wellness

Abstract and complex concepts

Those you observe indirectly. Brain activity, nutritional status

Some school of nursing

Use theories to guide curriculum planning, programs and projects

Paradigm

Worldview or ideology of a discipline. Broadest most global conceptual framework of a discipline

Personal presence

You and nurse are emotionally and physically with the patient for the time you are there. Not thinking of meds

To be an effective professional nurse

You need to understand the basic principles of nursing research and their powerful impact on h.c and the nursing profession

The purpose of research

develop knowledge on issues important in nursing