DNP-815A Topic 2 DQ 2 What are the key concepts and components of the nursing theory that you selected and how are they defined?
DNP-815A Topic 2 DQ 2
Select a nursing model or theory from the Philosophies and Theories for Advanced Nursing textbook to use for your DNP Project. What are the key concepts and components of the nursing theory that you selected and how are they defined? Create an example describing the application to an area of your DNP Project. Provide examples and literature support. DNP-815A Topic 2 DQ 2 What are the key concepts and components of the nursing theory that you selected and how are they defined?
For my DNP project, I selected the theory of Crosby on his attention to transforming the quality culture in the field of quality management. Crosby’s theory emphasized the importance of systems knowledge and improvement, failure of inspection, and the importance of statistical quality control with four basic absolutes or concepts of a quality improvement process (Butts & Rich, 2018).
The first absolute is “the definition of quality is conformance to requirements” where management has the basic tasks of establishing the requirements (Butts & Rich, 2018). The direct practice improvement that I’m working on is the prevention of central venous catheter (CVC) infection for patients receiving hemodialysis patients. The second absolute is “the system of quality is prevention” where prevention is successful when key processes are understood (Butts & Rich, 2018). Central Line-Associated Blood Stream Infections (CLABSI) is a highly prevalent problem that only through established protocol adherence, and best practices can reduce infections.
The third absolute is that “the performance standard is zero defect” (Butts & Rich, 2018). One of the clinical measures of The End-Stage Renal Disease (ESRD) Quality Improvement Program (QIP) is zero infection.
This metric can be preventable with surveillance, proper aseptic technique, and management strategies. Mitigating risks and brainstorming solutions establish a culture of safety. The fourth absolute is “the measurement of quality is the price of nonconformance” (Butts & Rich, 2018). The Centers for Medicare & Medicaid Services (CMS) administers ESRD QIP to promote high-quality services in renal dialysis facilities and reduce payments for those who do not meet or exceed performance standards.
Quality management is a key element allowing operational performance improvement, product quality, and organizational performance (Negron, 2020). As doctoral-prepared nurses in dynamic roles, we are poised to interface and simultaneously lead within our professional sphere.
References
Butts, J.B., & Rich, K.L. (2018). Philosophies and theories for advanced nursing practice (3rd ed.) Jones & Barlett Learning.
Negron, L.A. (2020). Relationship between quality management practices, performance and maturity quality management, a contingency approach. Quality Management Journal, 27 (4), 215-228.
https://doi.org/10.1080/10686967.2020.1809582
Henderson’s “need-based theory” is one of the most successful attempts to determine the role of nurses and explain the significant aspects of nursing care that must be offered to a patient. Henderson defines this as the unique function of the nurse to assist the individual, sick or healthy, in the performance of the activities contributing to health or recovery, including peaceful death that a person would perform unaided if he had the necessary strength or knowledge; and to do this in such a way as to help him gain independence as rapidly as possible (Henderson, 1964).
Research shows that the definition given by Henderson in the need theory was one of the most influential moments in nursing practice. She stated, “The unique function of the nurse is to assist the individual, sick or healthy, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge. Furthermore, to do this in such a way as to help him gain independence as rapidly as possible” (Henderson, 1964).
It created a global change in how nurses developed their services and improved patients’ health and wellbeing. Virginia Henderson used the scientific method, deductive reasoning, to develop the needs-based theory. According to Ahtisham, Y., & Jacoline (2015), Virginia Henderson’s utilized the physical, emotional, and mental (psychological components) to derive this theory related to Maslow’s theory. However, Henderson was unaware of the 14 sub-concepts that coincide with Maslow’s.
This theory is appropriate to my future practice setting as an advanced practice nurse (APN) caring for patients with end-stage renal disease (ESRD) in an outpatient patient hemodialysis facility. This theory is applicable within my practice setting because “meeting patient needs of respiration, nutrition, elimination, body mechanics, rest, and sleep, keeping clean and well groomed, controlling the environment, communication, human relations, work, play, and worship (Butts & Rich, p. 614), are all advanced nursing care that I will need to provide for my patient’s basic needs.
The common problems outlined by Virginia Henderson’s need-based theory include 14 components of fundamental nursing care and interventions that patients have or use as part of their independence and ADLs (Butts & Rich, p. 598). As a future APRN, the common resolved problems are 14 components that maintain the patient’s physical functions, safety, a sense of well-being, and finding oneself about where they see themselves in life (Butts & Rich, p. 615). As for advanced practice nursing fields,
Virginia Henderson was a proponent for nurses to be independent practitioners Ahtisham, Y., & Jacoline (2015), as well as well-defined concepts and propositions that characterize any theory or nursing model, Henderson’s need theory. It is not enough for nurses to care for patients and educate them. Ndiok & Ncama (2018) specify that Henderson focused on individual care through the prism of 14 components that explain the nursing role and preferred actions to preserve health. The nursing need theory aims to introduce a unique focus on nursing and prove its appropriateness.
A patient needs autonomy in personal care, and a nurse is a person for professional assistance (Fernandes et al., 2019). In terms of the chosen model, all the fourteen needs of patients may be divided into four groups, including biological or physiological, moral or spiritual, psychological, and social (Fernandes et al., 2019). DNP-815A Topic 2 DQ 2 What are the key concepts and components of the nursing theory that you selected and how are they defined?
According to (Fernandes et al., 2019), there are seventeen assumptions of the Needs theory that were implicated in Henderson’s theory. Nurses must assist people with illnesses; nurses must collaborate within an interdisciplinary team and become independent professionally from the physician; 14 concepts of nursing describe patient needs and complete nursing functions; DNP-815A Topic 2 DQ 2 What are the key concepts and components of the nursing theory that you selected and how are they defined?
goals are achieved with a symbiotic relationship between patient and nurse with health promotion as the nurse’s primary goal; patient and family are one with mind and body being one within the person; assist patient with independence while the patient controls their physiological and psychological harmony; people function in health at all times and must maintain independence and relationships; people maintain health status with knowledge and awareness; illness effects environment conditions and nurses should maintain a safe environment;
nurses must be culturally competent and must maintain best practice methods while relying on evidence-based research methods. These are all relevant elements to me as an APRN as these can be used to assess my patient’s independence level and to assess the patient’s assistance in obtaining or maintaining activities of daily living for basic needs (Fernandes et al., 2019). Being an APRN in the outpatient dialysis center, Virginia Henderson’s needs theory applies to my discipline of nursing and various practice scopes.
Utilizing this theory and putting it into action within the practice is adaptable and allows one to reflect on their nursing competency when it involves maintaining a person’s health promotion and independence level. As stated by Durepos, P. et al. (2015), with Henderson’s philosophy of applying best practice methods that involve evidence-based research, advanced practice application of theory can be a foundation for the nursing process. DNP-815A Topic 2 DQ 2 What are the key concepts and components of the nursing theory that you selected and how are they defined?
References
Ahtisham, Y., & Jacoline, S. (2015). Integrating nursing theory and process into practice; Virginia’s Henderson needs theory. International Journal of Caring Sciences, 8(2), 443-450.
Butts, J. B., & Rich, K. L. (Eds.). (2018). Philosophies and theories for advanced nursing practice (3rd ed.). Jones & Bartlett. ISBN-13: 9781284112245
Durepos, P., Orr, E., Ploeg, J., & Kaasalainen, S. (2018). The value of measurement for development of nursing knowledge: Underlying philosophy, contributions and critiques. Journal of Advanced Nursing, 74(10), 2290-2300. Web.
Fernandes, B. K. C., Clares, J. W. B., Borges, C. L., da Nóbrega, M. M. L., & de Freitas, M. C. (2019). Nursing diagnoses for institutionalized elderly people based on Henderson’s theory. Revista Da Escola de Enfermagem Da USP, 53. Web.
Henderson, V. (1964). The nature of nursing. American Journal of Nursing, 64, 62–68. Web.
Masters, K. (2018). Models and theories focused on nursing goals and functions. In J. B. Butts & DNP-815A Topic 2 DQ 2 What are the key concepts and components of the nursing theory that you selected and how are they defined?
Ndiok, A., & Ncama, B. (2018). Assessment of palliative care needs of patients/families living with cancer in a developing country. Scandinavian Journal of Caring Sciences. Web.
Vera, M. (2014). Virginia henderson’s nursing need theory. Retrieved July 17, 2022, from http://nurseslabs.com/virginia-hendersons-need-theory/
Within the discipline of nursing, certain nursing middle-range theories that guide practice, in addition to forming the foundation for nursing practice. Nursing theories attempts to describe, predict, or explain phenomena consistent with nursing’s perspective (Butts & Rich, 2017), It is important to stress that the product of nursing science is nursing practice. Within a theory resides concepts that are related by proposition Butts and Rich (2017) that provide a clear description between two or more concepts.
The middle-range theory will guide or serve as theoretical lens for my DNP project. The limited, narrower, and more applicable scope of this theory inform the rationale for the choice of the theory. Also, the understanding and application of this theory is critical to closing the theory-gap. DNP-815A Topic 2 DQ 2 What are the key concepts and components of the nursing theory that you selected and how are they defined?
Furthermore, nursing theories have been demonstrated to be useful in real world and proven to be logical in the provision of the rationales for nursing actions that resulted in predictable outcomes. Alligood and Fawcett (2020) noted that compared to grand theories that are broader in scope and can sometimes not easily translated into practice, middle-range theories are more concrete and narrower and applicable to clinical practice.
Therefore, the filling the theory-practice gap is essential to nursing practice and can be realized when nursing practice is guided by tested and trusted middle-range theories. This is how the theory can contribute the nursing profession of nursing and guide my DNP Project. DNP-815A Topic 2 DQ 2 What are the key concepts and components of the nursing theory that you selected and how are they defined?
Reference DNP-815A Topic 2 DQ 2 What are the key concepts and components of the nursing theory that you selected and how are they defined?
Butts, J. B., & Rich, K. L. (2017). Philosophies theories and for advanced nursing practice (3rd ed.). Jones & Bartlett Learning.
Dewey, J. (2020). Nursing theory. Salem Press Encyclopedia of Health.
Orem in her self-care deficit nursing theory defined self-care as the practice of activities that individuals initiate and perform on their own behalf in maintaining life, health, and well-being. (Hartweg & Metcalfe,2022) .Throughout five decades, Orem refined the description of nursing for this purpose to empower patients and their families to care for themselves .
The self-care deficit nursing theory separates four key operations within professional practice which are diagnostic, prescriptive, treatment or regulatory, and case management (Yip ,2021) .Within the self-care deficit nursing theory, diagnostic operations refer to the diagnosis and prediction of self-care requisites, which must consider the effect of foundational capabilities and dispositions on the patient’s self-care ability and determine the practical actions required based on the patient’s state of health, manner of daily living, and environmental constraints, and health or other goals
This theory will be appropriate for my DPI project that is focused on fall preventive measures among hospitalized patient in a Skilled Rehabilitation Nursing Facility. As an ARPN I can offer help and advice in matters such as adjusting a patient’s environment in the facility and even at home when discharged and ensuring that they have the necessary knowledge and skills to accomplish the prescribed actions. DNP-815A Topic 2 DQ 2 What are the key concepts and components of the nursing theory that you selected and how are they defined?
Self-care deficit theory entails the initiation of self-care for patients who are hospitalized that cannot perform certain cares for themselves while in the hospital and after discharge , the incorporation of Orem’s theory on self-care deficit and ways to bridge the gap will empower patients and their families to care for themselves and these can be achieved through, patient education for those that lack the knowledge , assessments so as to know limitations and strength and plan of care with associated goals will be established to enable the initiation of activities on the patient thus promoting life, health and wellbeing .
Within the self-care deficit nursing theory, the role of the ARPN is to apply practical nursing knowledge by determining how a patient can best undertake self-care within the boundaries of their living arrangements and support facilities. DNP-815A Topic 2 DQ 2 What are the key concepts and components of the nursing theory that you selected and how are they defined?
These initiatives are called people centered care which provides a framework to empower and engage people in their healthcare to improve health and well-being. People centered care consciously adopts individual, careers, families’ and communities’ perspectives as participants in, and beneficiaries of, trusted health systems that respond to their needs and preferences in humane and holistic ways (Yip,2021).
All these can be achieved by establishing an integrated partnership between the patient and all providers of care which will in return will encourage co-designing and delivery of personalized care in an efficient and effective way. The goal is better health and well-being outcomes across levels of care.
DNP-815A Topic 2 DQ 2 What are the key concepts and components of the nursing theory that you selected and how are they defined?
References
Hartweg, D. L., & Metcalfe, S. A. (2022). Orem’s Self-Care Deficit Nursing Theory: Relevance and Need for Refinement. Nursing Science Quarterly, 35(1), 70–76. https://doi.org/10.1177/08943184211051369
Yip, J. Y. C. (2021). Theory-Based Advanced Nursing Practice: A Practice Update on the Application of Orem’s Self-Care Deficit Nursing Theory. SAGE Open Nursing. https://doi.org/10.1177/23779608211011993
Henderson’s “need-based theory” is one of the most successful attempts to determine the role of nurses and explain the significant aspects of nursing care that must be offered to a patient. Henderson defines this as the unique function of the nurse to assist the individual, sick or healthy, in the performance of the activities contributing to health or recovery, including peaceful death that a person would perform unaided if he had the necessary strength or knowledge; and to do this in such a way as to help him gain independence as rapidly as possible (Henderson, 1964). Research shows that the definition given by Henderson in the need theory was one of the most influential moments in nursing practice. She stated, “The unique function of the nurse is to assist the individual, sick or healthy, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge. Furthermore, to do this in such a way as to help him gain independence as rapidly as possible” (Henderson, 1964). It created a global change in how nurses developed their services and improved patients’ health and wellbeing. Virginia Henderson used the scientific method, deductive reasoning, to develop the needs-based theory. According to Ahtisham, Y., & Jacoline (2015), Virginia Henderson’s utilized the physical, emotional, and mental (psychological components) to derive this theory related to Maslow’s theory. However, Henderson was unaware of the 14 sub-concepts that coincide with Maslow’s.
This theory is appropriate to my future practice setting as an advanced practice nurse (APN) caring for patients with end-stage renal disease (ESRD) in an outpatient patient hemodialysis facility. This theory is applicable within my practice setting because “meeting patient needs of respiration, nutrition, elimination, body mechanics, rest, and sleep, keeping clean and well groomed, controlling the environment, communication, human relations, work, play, and worship (Butts & Rich, p. 614), are all advanced nursing care that I will need to provide for my patient’s basic needs. The common problems outlined by Virginia Henderson’s need-based theory include 14 components of fundamental nursing care and interventions that patients have or use as part of their independence and ADLs (Butts & Rich, p. 598). As a future APRN, the common resolved problems are 14 components that maintain the patient’s physical functions, safety, a sense of well-being, and finding oneself about where they see themselves in life (Butts & Rich, p. 615). As for advanced practice nursing fields, Virginia Henderson was a proponent for nurses to be independent practitioners Ahtisham, Y., & Jacoline (2015), as well as well-defined concepts and propositions that characterize any theory or nursing model, Henderson’s need theory. It is not enough for nurses to care for patients and educate them. Ndiok & Ncama (2018) specify that Henderson focused on individual care through the prism of 14 components that explain the nursing role and preferred actions to preserve health. The nursing need theory aims to introduce a unique focus on nursing and prove its appropriateness. A patient needs autonomy in personal care, and a nurse is a person for professional assistance (Fernandes et al., 2019). In terms of the chosen model, all the fourteen needs of patients may be divided into four groups, including biological or physiological, moral or spiritual, psychological, and social (Fernandes et al., 2019).
According to (Fernandes et al., 2019), there are seventeen assumptions of the Needs theory that were implicated in Henderson’s theory. Nurses must assist people with illnesses; nurses must collaborate within an interdisciplinary team and become independent professionally from the physician; 14 concepts of nursing describe patient needs and complete nursing functions; goals are achieved with a symbiotic relationship between patient and nurse with health promotion as the nurse’s primary goal; patient and family are one with mind and body being one within the person; assist patient with independence while the patient controls their physiological and psychological harmony; people function in health at all times and must maintain independence and relationships; people maintain health status with knowledge and awareness; illness effects environment conditions and nurses should maintain a safe environment; nurses must be culturally competent and must maintain best practice methods while relying on evidence-based research methods. These are all relevant elements to me as an APRN as these can be used to assess my patient’s independence level and to assess the patient’s assistance in obtaining or maintaining activities of daily living for basic needs (Fernandes et al., 2019). Being an APRN in the outpatient dialysis center, Virginia Henderson’s needs theory applies to my discipline of nursing and various practice scopes. Utilizing this theory and putting it into action within the practice is adaptable and allows one to reflect on their nursing competency when it involves maintaining a person’s health promotion and independence level. As stated by Durepos, P. et al. (2015), with Henderson’s philosophy of applying best practice methods that involve evidence-based research, advanced practice application of theory can be a foundation for the nursing process.
References
Ahtisham, Y., & Jacoline, S. (2015). Integrating nursing theory and process into practice; Virginia’s Henderson needs theory. International Journal of Caring Sciences, 8(2), 443-450.
Butts, J. B., & Rich, K. L. (Eds.). (2018). Philosophies and theories for advanced nursing practice (3rd ed.). Jones & Bartlett. ISBN-13: 9781284112245
Durepos, P., Orr, E., Ploeg, J., & Kaasalainen, S. (2018). The value of measurement for development of nursing knowledge: Underlying philosophy, contributions and critiques. Journal of Advanced Nursing, 74(10), 2290-2300. Web.
Fernandes, B. K. C., Clares, J. W. B., Borges, C. L., da Nóbrega, M. M. L., & de Freitas, M. C. (2019). Nursing diagnoses for institutionalized elderly people based on Henderson’s theory. Revista Da Escola de Enfermagem Da USP, 53. Web.
Henderson, V. (1964). The nature of nursing. American Journal of Nursing, 64, 62–68. Web.
Masters, K. (2018). Models and theories focused on nursing goals and functions. In J. B. Butts &
Ndiok, A., & Ncama, B. (2018). Assessment of palliative care needs of patients/families living with cancer in a developing country. Scandinavian Journal of Caring Sciences. Web.
Vera, M. (2014). Virginia henderson’s nursing need theory. Retrieved July 17, 2022, from http://nurseslabs.com/virginia-hendersons-need-theory/