DNP-815A Connecting Nursing Theory and Evidence-Based Change Models
Grand Canyon University DNP-815A Connecting Nursing Theory and Evidence-Based Change Models-Step-By-Step Guide
This guide will demonstrate how to complete the DNP-815A Connecting Nursing Theory and Evidence-Based Change Models assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.
How to Research and Prepare for DNP-815A Connecting Nursing Theory and Evidence-Based Change Models
Whether one passes or fails an academic assignment such as the Grand Canyon University DNP-815A Connecting Nursing Theory and Evidence-Based Change Models depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.
After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.
How to Write the Introduction for DNP-815A Connecting Nursing Theory and Evidence-Based Change Models
The introduction for the Grand Canyon University DNP-815A Connecting Nursing Theory and Evidence-Based Change Models is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.
How to Write the Body for DNP-815A Connecting Nursing Theory and Evidence-Based Change Models
After the introduction, move into the main part of the DNP-815A Connecting Nursing Theory and Evidence-Based Change Models assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.
Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.
How to Write the Conclusion for DNP-815A Connecting Nursing Theory and Evidence-Based Change Models
After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.
How to Format the References List for DNP-815A Connecting Nursing Theory and Evidence-Based Change Models
The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.
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Directions:
This section identifies and describes the nursing theory and evidence-based change model to be used as the theoretical foundations for the DPI Project.
Following the “Connecting Nursing Theory and Evidence-Based Change Models” template, the following sections are required to be completed substantively:
Write a paper (1,500-2000 words) discussing the nursing theory and evidence-based change model to be used as the theoretical foundations for the DPI Project. Refer to the “Connecting Nursing Theory and Evidence-Based Change Models” template to complete this section.
The proposed project focuses on the reduction of patient falls, focusing specifically on post-operative patients in a post-operative rehabilitation center. Traditionally, health professionals rely solely on clinical fall prevention strategies; thinking of ways of optimizing patient outcomes in this respect, it has been determined that more than traditional strategies is needed. The intention is therefore to determine whether or not combining specific patient-centered interventins with clinical fall prevention strategies succeeds in achieving significant reductions in patient falls over a two-month period. In this regard, the project will be based on the patient-centered nursing strategy, and also on the application of Lewin’s change model, specifying how each of this model’s stages will entail.
Theoretical Foundations
This section will expand on the theoretical underpinnings of this project. This will require deling into the specific nursing theory to be applied (i.e. the patient-centered nursing theory). It will also require delving into the proposed evidence-based change model for implementing the proposed intervention (i.e. Lewin’s change model).
Nursing Theory
Patient-centered nursing theory proposes moving away from the actual disease or condition, and instead moving towards the patient as an individual or human being. This is valuable to the extent that it leads health professionals towards seeing patients, not as statsitics or cases to be solved, but rather as human beings in need of comprehensive, personalized care. This humanizes the profession of nursing, and it also facilitates the establishment of rapport, trust and collaboration between nurses and patients.
Patient-centered nursing theory. This particular theory is based on human needs theory; it hinges on the nursing professional’s ability to identify the patient’s problem(s) and subsequently develop a specific typology of treatment for that patient. The process to be followed in the application of this nursing theory integrates a sequence of steps. It all starts with the nurse knowing the patient, and then sorting out the relevant, significant information (Ortiz, 2018). The process also calls for the patient and their family needs to be included in treatment and the nurse needs to engage in introspection to determine their own feelings relative to the patient prior to discussing a comprehensive care plan (Eklund et al., 2019).
Clinical Question. To what degree does the implementation of the patient-centered approach to nursing impacts the reduction of patient falls when compared to solely relying on clinical fall prevention strategies among post-operative patients in a post-operative rehabilitation center in (state)?
Synthesis of Theory. Patient-centered nursing has been applied in different cases or domains, including the area of interest of the proposed project, i.e. patient fall prevention. Other than this, it has been applied, and successfully so, in elderly patient care, e.g. in cases of dementia (Burton et al., 2018). In the domain of nurses, research has found application of this theory to promote interprofessional collaboration, improve patient-nurse relationships, and greater patient empowerment (and advocacy) in decision-making processes (Eklund et al., 2019).
Summary
This section focused on outlining patient-centered nursing theory, highlighting some of its applications. The following section will delve into the actual evidence-based change model to be applied. Namely, this is Lewin’s change model.
Evidence-based Change Model
The proposed change model is Lewin’s change model, which offers a simplified approach to change implementation. This model proposes three fundamental strategies, i.e. unfreezing, movement and refreezing. This is considered valuable for successful implementation.
Lewin’s Change Model.
This model, as previously mentioned, contemplates three distinct stages. The first is refreezing, which supposes disruption. It supposes creating awareness about the need for change, thereby promoting support for said change. The second stage is movement, which means deciding on how to proceed with actual implementation of the change intervention. The third and final stage, i.e. refreezing, implies assimilating and normalizing the change intervention as standard practice (Teguh et al., 2019).
Clinical Question. The clinical question aligns with Lewin’s change model in that it supposes a change of the fall prevention paradigm. Through this change model, the idea is to move away from solely implementing fall prevention strategies, and moving towards the combination of said strategies with patient-centered interventions.
Synthesis of Evidence-based Change Model. The proposed change model has been successfully impeleented in different nursing areas, including fall prevention. Other applications include hand hygiene among health professionals, in the management of patient-nurse relationships, and in a wide array of security protocols (e.g. prescription management).
Summary
This section outlined Lewin’s change model. Also, it outlined how the proposed change model fits in with the proposed clinical question. Therefore, the purpose of this quantitative quasi-experimental project was to determine if or to what degree the implementation of patient centered fall prevention intervention would impact fall reduction when compared to relying only on current clinical fall preventive practice utilized among post operative patients in a Rehab Unit in the District of Columbia over eight weeks.
References
Burton, E., Lewin, G., O’Connell, H., Petrich, M., Boyle, E., & Hill, K. D. (2018). Can community care workers deliver a falls prevention exercise program? A feasibility study. Clinical Interventions in Aging, 13, 485-495.
Eklund, J. H., Holmström, I. K., Kumlin, T., Kaminsky, E., Skoglund, K., Höglander, J., … & Meranius, M. S. (2019). “Same same or different?” A review of reviews of person-centered and patient-centered care. Patient Education and Counseling, 102(1), 3-11.
Ortiz, M. R. (2018). Patient-centered care: Nursing knowledge and policy. Nursing Science Quarterly, 31(3), 291-295.
Teguh, A., Hariyati, R. T. S., & Muhaeriwati, T. (2019). Applicability of Lewin’s change management model for optimization management function in nursing delegation between head nurse and team leader: A mini project in Jakarta military hospital. International Journal of Nursing and Health Services (IJNHS), 2(2), 66-74.
I, , verify that I have completed and logged 8 clock hours in association with the goals and objectives for this assignment. I also have tracked said practice immersion hours in the Lopes Activity Tracker for verification purposes and will be sure that all approvals are in place from my faculty and practice immersion preceptor/mentor before the end of the course.
In recent years, evidence-based practice has formed the backbone of nursing practice and has been integral in improving patient outcomes. With evidence-based practice as the basis, a direct practice improvement project is applied to measurable patient outcomes to ensure better patient outcomes. The implementation of direct practice improvement is most effective when guided by both an EBP change model and a nursing theory (Smith, 2019). The implication is that the individual has to choose the right theory and model that can effectively guide the project. As such, the purpose of this write-up is to explore an EBP change model and a nursing theory that will form the basis of the DPI project. The project focuses on exploring the impact of permanent supportive housing among homeless patients in reducing substance abuse. The next section focuses on the theoretical foundations.
Theoretical Foundations
The theoretical frameworks applied in nursing are usually based on nursing theory. Nursing theory helps in improving practice as it enables professionals to explore and translate evidence into practice which in most cases seeks to bring change in practice for positive patient outcomes (Butts & Rich, 2018). While the nursing theories are developed to support practice, the formulated nursing theory has to be validated in the nursing practice. From the earlier discussion, it was evident that the project focuses on the impact of permanent supportive housing among homeless patients in reducing substance abuse. Therefore, the nursing theory chosen to guide this project is Dorothea Orem’s Self-Care theory.
Nursing Theory
Nursing theories have formed an integral part of nursing practice as they help in guiding nursing practice. In this project, Dorothea Orem’s Self-Care theory will be used. This theory was developed and propagated by Dorothea Orem. She defined the theory in broad terms as an act of helping others in terms of offering and managing self-care to maintain or enhance human functioning at the home level effectiveness (Butts & Rich, 2018). This theory focuses on an individual as well as the type of activities that a person can start and engage in on their own behalf to maintain well-being, health, and life.
Dorothea Orem’s Self-Care theory
As earlier indicated, this theory focuses on an individual as well as the type of activities that a person can start and engage in on their own behalf to maintain well-being, health, and life. Sometimes known as the self-care deficit theory of nursing, this theory is composed of three interconnected sub-theories. The three sub-theories include the theory of nursing systems, the self-care deficit theory, and the theory of self-care (Butts & Rich, 2018). The theory is also based on the requirement for nursing in an individual in the absence of the ability to have a sufficient amount of therapeutic self-care capable of sustaining health and life as well as recovering from injury or disease or even having to cope with the impacts of the disease.
Orem’s theory has various assumptions. One of the assumptions is that in order for an individual to remain functional and sustain life, they have to be involved in communication with each other and connect with both humans and the environment. The other assumption is that the power to deliberately act is exercised in the needs identification as well as arriving at the best judgment. The other assumption is that human beings have various experiences, such as privations which take the form of action both in caring for others and self and entail performing function-regulating and life-sustaining actions (Butts & Rich, 2018). The next assumption is that the human agency is fulfilled through the discovery, development, and transmission of strategies for identifying the needs of others and, in some cases, in self. The final assumption is that individuals with structured relationships group tasks and assigned responsibilities for offering care to various group members.
Orem proposed various concepts that support the theory. The concepts include self-care, health, environment, humans, and nursing. From her definition, nursing entails an art through which a nurse professional offers a specialized service to a person with some disabilities. Therefore, such assistance is not just ordinary but meets self-care needs. Humans entail children, women, and men who are cared for. The environment has various biological, chemical, and physical features entailing the community, culture, and the family (Butts & Rich, 2018). In addition, health refers to functional and structural soundness or wholeness and entails the health of groups and individuals.
Orem’s theory can be key in supporting the proposed project since, by offering the permanent supportive housing; it is hoped that the self-care efforts and aspects of the identified patients will be boosted to help fight the effects of substance abuse for better patients outcomes (Butts & Rich, 2018). Through the use of the theory, the identified patients will be offered supportive housing solutions which offer a conducive and enabling environment. The enabling environment can then be key in helping the patients keep off the substance and drug abuse. Through the theory, the patients will also be trained and supported to participate in self-care activities that can positively impact their health.
Orem’s theory has widely been applied in nursing, and therefore, many research articles have been published regarding the same theory. Some of these sources are seminal sources. For example, a publication by Denye et al. 2001. This publication is quarterly, and Orem is one of the main contributors. The source explores Orem’s theory of self-care and presents it as a foundational science. This source also brings in other aspects of self-care requisites as well as what is needed to meet the standards.
Clinical Question.
To what degree does the implementation of permanent supportive housing impact substance abuse among homeless patients when compared to no intervention in the clinical patient setting in twelve months?
Synthesis of Theory.
As earlier indicated, Orem’s theory has widely been used in various aspects of evidence-based practice. Therefore, it has been applied in peer-reviewed projects, research projects, and evidence-based articles. For example, not long ago, Orem’s theory was applied by Si et al. (2021). These researchers applied this theory in research involving patients with stroke. The theory was focused on improving their cognitive function, neurological function, and the day to day living activities. By the end of the study, the researchers noted that the patients experienced notable improvements in terms of cognitive function, neurological function, and living activities.
Orem’s theory also formed the central part of the research focused on improving outcomes for patients living with type 1 diabetes. Using the theory, the researchers embarked on finding out how the parents of the children with type 1 diabetes were offering care for their children. Through the theory, they were able to offer training and education on how well and best they could obtain self-care and independence (Rumahorbo et al., 2021). Ali et al. (2018) also applied Orem’s theory among psychiatric patients. Through the use of the theory, the researchers realized that these patients need constant support to undertake everyday care activities. The use of the theory by the nurses enabled the patients to care for themselves. In addition, Orem’s theory was key in helping the care team identify what the patients needed and coming up with relevant strategies to care for them.
Summary
Orem’s theoretical underpinnings make it suitable to be applied in various projects as the basis of the theoretical framework. It is, therefore, not surprising that the theory has widely been applied in nursing practice, patient care, and education. It is important that the theory’s concepts fit in well with the proposed project of lowering the incidences of substance abuse among homeless patients through the use of supportive permanent housing. The next section focuses on the evidence-based change model that can be used together with the theory to support the project.
Evidence-based Change Model
Nursing practice heavily hinges on nursing research. Through the use of change models, professionals can translate research into practice. This project proposes to use the Plan-Do-Study-Act model as the change model.
The Plan-Do-Study-Act Model
This model is one of the most famous models which was majorly applied in the business world but has since found its way into nursing practice. This model has four major phases, plan, do, study and act. This model is appropriate for the project as the four phases can be used in implementing various aspects of the project (England, 2021). The first phase will entail identifying the homeless patients exposed to the potential substance and drug abuse. Do phase then entails coming up with proposals on how to offer the supportive permanent housing plans. The study phase will involve considering the possible impacts; in addition, The Act phase will involve the actual implementation of the process. Among the possible seminal sources for this model is Taylor et al., 2014. The researchers published a systematic review focusing on the model and how it has been applied in various published literature
Clinical Question.
To what degree does the implementation of permanent supportive housing impact substance abuse among homeless patients when compared to no intervention in the clinical patient setting in twelve months?
Synthesis of Evidence-based Change Model.
The Plan-Do-Study-Act model has also been applied widely and therefore is common in peer-reviewed projects, research projects, and evidence-based articles. Recently, Nuss et al., 2020 applied the model in research involving emergency transfers to the intensive care units involving children suffering from sepsis. Another research article is that of Kim et al. (2019). This research entailed enhancing the quality of life among patients with cardiac arrest. Through the model, the researchers focused on improving bystander cardiopulmonary resuscitation. Si et al. also combined this model with Orem’s theory to improve the patient outcomes among patients living with stroke.
Summary
The Plan-Do-Study-Act model is key in implementing quality improvement projects. It is envisioned that the model will be used together with Dorothea Orem’s theory as a basis for the proposed direct practice improvement project. The concepts in the model and the theory will be key in guiding the proposed project. The next section deals with how the change model and the nursing theory are linked with the proposed direct practice improvement project.
Linking Nursing Theory, Change, Model, to the Direct Practice Improvement Project
Homelessness is a major public concern in many countries, the USA included; patients who happen to be homeless are exposed to various adverse things such as substance abuse. The gap that exists is that the impact of permanent supportive housing on these individuals remains largely unexplored. Therefore, the purpose of this project was to determine if or to what degree the implementation of permanent supportive housing would impact substance abuse when compared to no intervention among homeless patients in the primary care setting over twelve months.
Conclusion
Homeless patients require support to help them have better outcomes. For example, the various forms of support such as permanent supportive housing help them overcome problems such as substance abuse. Orem’s theory and the Plan-Do-Study-Act model will be used in supporting the project since the patients will be needed to engage in self-care acts while the project will be implemented in stages. It is known that homeless individuals may lack the self-care activities capable of sustaining health and reducing the chances of substance abuse, so the theory will be key in this respect. The other example is that the aspect of the environment will be modified by offering supportive housing for better outcomes. As such, both the model and the theory support the project.
References
Ali, B. H. I. (2018). Application of Orem self-care deficit theory on psychiatric patient. Annals of Nursing and Practice, 5(1), 1-3. https://www.semanticscholar.org/paper/Application-of-Orem-Self-Care-Deficit-Theory-on-Ali/d9791850e0d3f114e45f46c28be350095c5138b3.
Butts, J. B., & Rich, K. L. (2018). Philosophies and theories for advanced nursing practice. Jones & Bartlett Publishers.
Denyes, M. J., Orem, D. E., & Bekel, G. (2001). Self-care: A foundational science. Nursing science quarterly, 14(1), 48-54. https://doi.org/10.1177%2F089431840101400113.
England, N. H. S. (2021). Plan, Do, Study, Act (PDSA) cycles and the model for improvement. https://www.england.nhs.uk/wp-content/uploads/2022/01/qsir-pdsa-cycles-model-for-improvement.pdf
Kim, J. Y., Cho, H., Park, J. H., Song, J. H., Moon, S., Lee, H., … & Lewis, R. J. (2020). Application of the “plan-do-study-act” model to improve survival after cardiac arrest in Korea: a case study. Prehospital and disaster medicine, 35(1), 46-54. https://doi.org/10.1017/S1049023X19005156
Rumahorbo, H., Karjatin, A., & Hamzah, A. (2021). INKOLA based on Orem’s Self-Care Model and its effectiveness on the quality of life and HbA1C in children with type 1 diabetes mellitus. Family Medicine & Primary Care Review, 23(3), 341-346. https://doi.org/10.5114/fmpcr.2021.108201.
Nuss, K. E., Kunar, J. S., & Ahrens, E. A. (2020). Plan-Do-Study-Act Methodology: Refining an Inpatient Pediatric Sepsis Screening Process. Pediatric Quality & Safety, 5(5). https://dx.doi.org/10.1097%2Fpq9.0000000000000338
Si, Y., Yuan, H., Ji, P., & Chen, X. (2021). The combinative effects of orem self-care theory and PDCA nursing on cognitive function, neurological function and daily living ability in acute stroke. American Journal of Translational Research, 13(9), 10493. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8507085/
Smith, M. C. (2019). Nursing theories and nursing practice. FA Davis.
Taylor, M. J., McNicholas, C., Nicolay, C., Darzi, A., Bell, D., & Reed, J. E. (2014). Systematic review of the application of the plan–do–study–act method to improve quality in healthcare. BMJ quality & safety, 23(4), 290-298. http://dx.doi.org/10.1136/bmjqs-2013-001862
Routinely, nurses encounter patients with varying needs, concerns, and attitudes to care. Despite the impacts of these variables on patient care, nurses must continually identify opportunities for change and address issues appropriately. Quality improvement projects utilize different nursing theories and frameworks. The current project seeks to improve outcomes among the elderly and debilitated patients using a preventive bundle to reduce pressure ulcers. Accordingly, the purpose of this paper is to describe the theoretical foundations, evidence-based change model, and the connection between the theory, change model and the direct practice improvement project. The section that follows describes the theoretical foundations.
Theoretical Foundations
Nurses borrow ideas of improving care quality from nursing theories. Grand and middle-range nursing theories are widely applied in direct practice improvement project. This section outlines the selected theory, clinical question, and how the theory has been applied in other practice areas.
Nursing Theory
A nursing theory is an organized body of knowledge that defines what nursing entails. Given this, nursing theories describe why nurses practice nursing and how they should approach different situations. According to Smith (2019), nursing theories provide baseline knowledge of care concepts that explain what nursing professionals should do for patients and the rationale for their actions. Such an approach to care is crucial in the ever-evolving practice since nurses should articulate evidence that validates their practice methodologies.
Imogene King Goal Attainment Theory: broadly, Imogene King’s goal attainment theory is established on the principle that nurses and patients should set mutual goals and the care process should be transactional. As Butts and Rich (2021) explained, the goal attainment theory recognizes the importance of identifying a problem through effective nurse-patient communication and setting goals that must be achieved reciprocally. The implication is that the care process is not one-sided; thus, nurses and patients must be active partners. Butts and Rich (2021) further explained that nurses use their experience and skills to initiate action, reaction, and appropriate interactions between them and care recipients. To achieve the desired outcomes, nurses must share essential information about their perceptions of the situations and care processed to enable both parties to recognize specific goals and implement mechanisms to achieve them with a clear purpose. In summary, the care process through the goal attainment theory involves five concepts/steps: identifying a problem, mutual goal setting, shared roles to attain the goal, agreeing on how to accomplish the goals, and transaction/goal attainment.
The current project involves implementing a pressure preventive bundle to reduce pressure injury incidence among elderly and debilitated patients. The first concept of the goal attainment theory is problem identification through actions and interactions. The problem is clear, and both nurses and patients understand its implications. The second concept is mutual goal setting. The patients must be involved in setting goals to ensure they understand the projected benefits of the preventive bundle and their role in making the project a success. For instance, they can set reminders for repositioning to ensure they are awake as repositioning occurs. Seeking ways to achieve the goal should also be a joint exercise since patients must understand why and when each activity occurs. Mutual goal setting will ensure the nurse and patient’s goals align.
Clinical Question: to what degree does the implementation of a pressure preventive bundle impacts pressure injury incidence when compared to routine care among elderly and debilitated patients in a long-term care facility in suburban Maryland City?
Implementing the pressure preventive bundle is expected to reduce pressure injury incidence in the long-term care facility. The nurse and patients should set mutual goals and identify measures to achieve these goals as the goal attainment theory recommends. Failing to engage the patients implies that the process will not be transactional, and the projected goals will not be achieved.
Synthesis of Theory
Imogene King’s goal attainment theory has been widely applied to set patient goals and optimize care outcomes in nursing research and evidence-based practice. Araújo et al. (2018) evaluated the effectiveness of nursing interventions based on goal attainment theory on patient care outcomes among diabetic people. In this quasi-experimental study, sixty patients were divided into intervention and control groups. In the experimental group, health goals were formulated based on King’s theory and measures to enhance adherence to treatment identified mutually between nurses and patients. The control group did not receive nursing consultations. The primary finding was high adherence to treatment in the intervention group since patients felt co-responsible for the treatment and with high decisive power (Araujo et al., 2018). Nursing consultations that improved interactions further improved adherence.
In a different study, Payamani et al. (2022) explored the impacts of applying the nursing process guided by the goal attainment theory’s concepts on patients with multiple sclerosis. In this study, the authors examined the impacts of the nursing process on patients’ quality of life (QOL) and activities of daily living (ADL) when the nursing process is based on the theory of goal attainment. Seventy patients were divided into the intervention and control groups, and the concepts of goal attainment theory were implemented in the intervention group. Payamani et al. (2022) found that the intervention group achieved a higher number of prioritized goals than the control group and reported higher QOL and instrumental ADL. The positive results underscored the effectiveness of goal attainment theory in promoting goal attainment, QOL, and instrumental ADL for patients.
King’s theory of goal attainment can also improve relationships if implemented effectively. Relationship building is pivotal in enhancing cooperation, adherence, and positivity in general and specialized care. To understand these connections, Adib-Hajbaghery and Tahmouresi (2018) assessed the use of King’s goal attainment theory in the nurse-patient relationship. For nurses to achieve optimal care, processes must be based on the tenet that nursing is enabling healthy interactions and building relationships to attain health and improve well-being. Such an understanding allows nurses to perceive patient care as a process whose ultimate goal is to attain health. Viewing care as an interactive process builds healthy nurse-patient relationships since nurses incorporate patients in goal setting and support them to interact positively with the immediate environment.
Summary
The above section on theoretical foundations explores the chosen nursing theory and its application in other nursing areas. As discussed in detail, Imogene King’s fundamental concepts include nurses and patients engaging in a transactional process to set mutual goals and identify ways of achieving them. The clinical question aligns with the goal attainment theory since nurses and patients should set mutual goals and engage in a transactional process to reduce the incidence of pressure ulcers. The next section analyzes the evidence-based change model.
Evidence-Based Change Model
Implementing evidence-based practice (EBP) requires health care professionals to combine scientific evidence, clinical expertise, and patients’ values and preferences to improve patient care outcomes. EBP models provide concepts and frameworks for implementing scientific evidence to make positive changes in patient care (Duff et al., 2020). If differently stated, EBP change models help change leaders to demystify the process of research translation into clinical practice.
Imogene King’s Conceptual System Model
The conceptual system is established on the principle that human beings are open systems interacting continuously with the environment. According to Butts and Rich (2021), King’s model reflects humans, the environment, health, and nursing as systems. The concept of a person is the most critical and contains three systems: personal, interpersonal, and social. Butts and Rich (2021) further explained that the personal system includes people (patients) who respond and cope with stimuli based on their expectations. The interpersonal system includes roles, communication, and interaction that transpire during the nursing process. The social system includes the roles, practices, and behaviors developed to address the needs of patients. In the project, patients are perceived as a combination of systems whose fundamental principles must be implemented to reduce the incidence of pressure injuries in the long-term care facility. Much emphasis is on the interpersonal system where nurse-patient communication will enable nurses and patients to make the essential transactions such as goal setting and identify the strategies for attaining those goals to maintain their health.
Clinical Question
Perceptions shape how people interact between themselves and person-to-environment transactions. However, without effective communication, nurses cannot model the desired nurse-patient interactions. Using the interpersonal system principles, communication will be fundamental in enabling nurses and patients set mutual goals, choose common strategies, and work together to implement the preventive bundle to reduce pressure injury incidence. The implication is that the goal attainment theory will be successfully implemented through transactions and helping patients perceive the process positively through continuous communication and engagement.
Synthesis of Evidence-Based Change Model
Imogene King’s conceptual system model has been widely used in current and past research. Park (2021) studied the impacts of nurse-led intervention programs based on the personal and interpersonal systems that Imogene King proposed in the conceptual system model. The model was utilized by categorizing the study’s dependent variables into personal and interpersonal systems. Adib-Hajbaghery and Tahmouresi (2018) also conceptualized the influence of personal and interpersonal systems on nurse-patient interactions. They conjectured that the nurse-patient interaction could not be effective without the nurse and patient understanding each other. Adib-Hajbaghery and Tahmouresi (2018) further mentioned that nurse-patient relationships exemplify the interpersonal system of the King’s conceptual system. In another study, Joseph et al. (2019) analyzed how King’s conceptual system and a transactional process provide a framework for effective and efficient case management. They argued that perceiving patients as interpersonal systems leads to mutual satisfaction for patients, physicians, and families.
Summary
Change models provide frameworks for implementing scientific evidence in nursing practice. Imogene King’s conceptual system model outlines how to implement goal attainment theory’s fundamental principles. The above section illustrates the change model and how it has been applied in other articles. The next section links the nursing theory and change model to the project.
Linking Nursing Theory, Change Model, to the Direct Practice Improvement Project
Pressure injuries are a significant threat to patient outcomes since they threaten patient safety and care quality and increase morbidity and hospitalization. Addressing the problem will reduce the incidence of pressure injuries in the site that primarily relies on standard care practices. Therefore the purpose of this quantitative quasi-experimental project was to determine to what degree the implementation of a pressure preventive bundle would impact pressure injury incidence when compared to current practice among elderly and debilitated patients in a long-term care facility in Maryland within 60 days.
Conclusion
Imogene King’s theory of goal attainment theory presumes that nurses and patients set goals that must be achieved reciprocally. The transaction process enables the two crucial parties of the nursing process to set goals and navigate situations while communicating with a clear purpose. King’s conceptual system model provides a framework for implementing the goal attainment theory. Its interpersonal system principles will be instrumental in implementing the DPI project by ensuring the nurse-patient relationship is transactional, and each understands the other. The nurse theory supports the change model by establishing patient care as a transaction. The model supports the theory by affirming the importance of a transactional relationship and provides a framework for implementing the theory’s basic concepts. The theory and the model support the purpose of the project since nurse-patient communication, and mutual goal setting will be instrumental in the project’s success.
References
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