Theory of Nursing

Interaction Theories

As described by Peplau (1988), these theories revolve around the relationships nurses form with patients.

Why is evidence based practice important and why

Changing patient demographics require new approaches to care. The evidence base for practice is rapidly expanding and growing in complexity for nursing and other disciplines. Guides nurses to make accurate timely clinical decisions

Outcome Theories

These portray the nurse as the changing force, who enables individuals to adapt to or cope with ill health (Roy 1980).

EBP (how to go about)

assess ask acquire appraise apply

Standards of Care

baseline description of quality

The main exponent of nursing

care

Why do we study the nursing theory

By giving nurses a sense of identity nursing theory can help patients, managers and other healthcare professionals to recognize the unique contribution that nurses make to the healthcare service.

conceptual model

The "symbolic representation of empiric experience in words, pictorial, or graphic diagram, mathematical notations or physical material."

Person

The recipient of care: Includes individual clients, families, and the community. Care should be individualized to the patient's needs.

clinical guidelines

broad-based reccommendations

How do student nurses begin to use nursing theory

by asking yourself two very important questions

protocols

detailed procedures on how to proceed with evaluation and treatment

Environment/Situation

All possible conditions affecting the client the setting in which health and health care needs occur. Continuous interaction between the client and their environment.

EBP involves

Identifying a clinical problem Searching the literature and critically evaluating research evidence Determining appropriate interventions EBP integrates research, theory, and practice.

nursing theories can be categorized as

These categories indicate the basic philosophical underpinnings of the theories. Need theories Interaction theories Outcome theories Humanistic theories

Needs Theories

These theories are based around helping individuals to fulfil their physical and mental needs. The basis of these theories is well-illustrated in Roper, Logan and Tierney's Model of Nursing.

Proposition

a statement that proposes a relationship between concepts. Propositional statements in a theory represent the theorist's view of which concepts fit together.

definitions

convey the general meaning of the concepts

The 2 questions are

what is the nature of knowledge needed for the practice of nursing? what does it mean to me to practice nursing?

A theory

"words or phrases (concepts) joined together in sentences, with an overall theme, to explain, describe, or predict something" A useful theory makes assumptions about a behavior, health problem, target population, or environment that are: Logical Consistent with everyday observations Similar to those used in previous successful programs and Supported by past research in the same area or related ideas.

Nursing theory in practice

Assist nurses to describe, explain, and predict everyday experiences. Serve to guide assessment, interventions, and evaluation of nursing care. Provide a rationale for collecting reliable and valid data about the health status of clients, which are essential for effective decision making and implementation. Help to describe criteria to measure the quality of nursing care. Help build a common nursing terminology to use in communicating with other health professionals. Ideas are developed and words are defined. Enhance autonomy (independence and self-governance) of nursing through defining its own independent functions

Health

Defined in different ways by the client, the clinical setting, and the health care profession The goal of nursing care Dynamic and continuously changing

Domain of Nursing

Domain of medicine is the diagnosis and treatment of disease. Domain of nursing is the identification and treatment of patient's health care needs at all levels of health and in all health care settings. history, knowledge

Nursing Theory

It helps to distinguish what should form the basis of practice by explicitly describing nursing. The benefits of having a defined body of theory in nursing include better patient care, enhanced professional status for nurses, improved communication between nurses, and guidance for research and education As medicine tries to make a move towards adopting a more multidisciplinary approach to health care, nursing continues to strive to establish a unique body of knowledge This can be seen as an attempt by the nursing profession to maintain its professional boundaries

Paradigm

Model that explains the linkages of science, philosophy, and theory accepted and applied by the discipline.

Barriers to Evidence-based practice

Overwhelming patient workloads Misperceptions about EBP and research Lack of time and resources to search for and appraise evidence Organizational constraints - lack of support Peer pressure to continue with practices that are steeped in tradition - "we've always done it this way and we are not changing now"

Nursing Paradigm

Person, health, environment/situation directs activity of nursing profession (education/philosophy)

quality improvement

Process that utilizes a system to monitor and evaluate the quality and appropriateness of care based on evidence-based practice and research i.e. when you medicate a patient for pain, make sure you seek a pain scale before and after administering medicine

the evolution of nursing theories

Since the early 1950s, many nursing theories have been systematically developed to help describe, explain, and predict the phenomena of concern to nursing. Nursing is always in a state of change. Nursing knowledge continues to expand in a multiplicity of ways. New theories will come from a global perspective and international nursing leaders in the 21st century.

Key points with EBP Process

Standards of Care Clinical Guidelines critical pathway protocol

Domain

View or perspective of the discipline. Contains the subject, central concepts, values & beliefs , phenomena of interest, and the central problems of the discipline

Key questions to ask when considering EBP

Why have we always done "it" this way? Do we have evidence-based rationale? Or, is this practice merely based on tradition? Is there a better (more effective, faster, safer, less expensive, more comfortable) method? What approach does the patient prefer? What do experts in this specialty recommend? What methods are used by leading/benchmark, organizations? Do the findings of recent research suggest an alternative method? Are organizational barriers inhibiting the application of best practices in this situation? Is there a review of the research on this topic? Are there nationally recognized standards of care, practice guidelines, or protocols that apply?

phenomenon

aspect of reality that can be consciously sensed or experienced

care

cannot be measured, it is vital to have the theory to analyze and explain what nurses do

Categories of Nursing Theories

client nurse health environment

What are the components of a theory?

concepts definitions assumptions phenomenon

concepts

ideas and mental images help to describe phenomena Building blocks of a theory Labels or names for phenomena/observable facts Assist us in formulating a mental image about an object or situation Theories are formed by linking concepts together. A conceptual framework links global concepts together.

critical pathways

identify key/critical activities that must occur in predictable fashion

Evidence-Based Practice

is based on the premise that health professionals should not base practice on tradition and belief but on information grounded in research. is not synonymous with research. Research focuses on discovery. EBP focuses on application.

Nursing Research

is the "systematic inquiry that uses disciplined methods to answer questions and solve problems" The major purpose of doing research is to expand nursing knowledge to improve patient care and outcomes. It helps to explain and predict care that nurses provide.

Theories

offer well rounded rationales for why and how nurses perform specific interventions

The theoretical foundation of nursing

provides the theoretical foundation of the profession. Theory defines what nursing is, what it does, and the goals or outcomes of nursing care. Nursing is the synthesis of many theories. . These theories allow nurses to examine human experiences and behavior responses closely. concepts definitions, relations and assumptions that view a systematic view of a phenomena, Theories are designed to explain a phenomenon, such as self-care or caring

assumptions

statements that describe concepts