My clinical setting is primarily intraprocedural nursing, and my secondary is PACU nurse. In both settings, my end goal as a nurse is to focus on the patient’s successful recovery. There are many circumstances where recovery is not possible due to various obstacles. For example, knowledge deficit, language barrier, lack of family support, homelessness, lack of finances, and religious and cultural boundaries are a few to name. Education is a critical factor in the recovery process. Then follows the reinforcement and follow through. The organizations need to improve on follow-up. Their primary focus is to get the patient in for surgery and discharge them in stable condition; what happens after the fact is neglected. My heart is in that follow-up phone call to check on the patient and listen to what is happening. Then, involve a social worker to see if this patient’s needs can be met.
In the above-stated situation, Virginia Henderson’s theory suits the best per my understanding. “As a patient receives treatment and is on the road to recovery, it’s important that the patient can take care of him or herself after being released from medical care. To that end, nurses should be caring for the patient while, at the same time, helping the patient become more independent and reach goals and milestones on the road to health (Petiprin, 2022).” This theory focuses on the problem I encounter in my daily practice.
My area of specialty is hemodialysis. The majority of the patients I care for are of the low-income, elderly, African-American population. One of the problems faced with care is patient education on disease management and prevention. The main causes of kidney disease in this population are poorly managed diabetes and hypertension. One solution to this problem is to improve patient education interventions. As healthcare providers, we have a major role in improving patient teaching regarding disease management and illness prevention. Several nursing theories focus on patient education for health promotion. One of those theories is The Self-Efficacy Theory.
The Self-Efficacy Theory, or Social Cognitive Theory, was developed in 1977 by a psychologist named Albert Bandura. Self-efficacy is one’s belief that their behaviors can produce desired effects. Bandura defined self-efficacy as “the individual’s perception of one’s ability to perform particular behaviors through four processes including cognitive, motivational, affective, and selection processes” (Shorey & Lopez, 2021). Behavior changes play a major role in disease management and illness prevention. Bandura felt that a person’s self-efficacy determines how they respond to problems. Persons with high efficacy are more likely to succeed when dealing with problems. Bandura listed three factors that make up a person’s self-efficacy; behavior, environment, and cognitive factors (Petiprin, 2023). When dealing with patient teaching, nurses must determine the patient’s level of cognition. Nurses should also determine what is the self-efficacy of their patients and tailor their teaching plans accordingly. Shorey and Lopez found that for patients with chronic medical conditions, higher levels of self-efficacy to manage their chronic conditions are related to higher health-related quality of life, reduced perceived stress, lesser anxiety and depressive symptoms, and lower symptom severity (2021).
Petiprin, A. (2023). Self-Efficacy Theory. Nursing Theory. https://nursing-theory.org/theories-and-models/self-efficacy-theory.php
Shorey, S. & Lopez, V. (2021). Self-Efficacy in a Nursing Context. In G. Haugan & M. Eriksson (Eds), Health Promotion in Health Care-Vital Theories and Research (Chapter 12). Cham Springer. https://www.ncbi.nlm.nih.gov/books/NBK585659/
DQ 1: During this program, you will complete an evidence-based practice project addressing a problem, issue, or concern in your specialty area of professional practice
NUR 513 Topic 5 DQ 1
During this program, you will complete an evidence-based practice project addressing a problem, issue, or concern in your specialty area of professional practice. Consider an area in your specialty that you believe needs improvement. Which nursing theories could you apply to this problem? Why is this the best theory?
Unread
My area of specialty is hemodialysis. The majority of the patients I care for are of the low-income, elderly, African-American population. One of the problems faced with care is patient education on disease management and prevention. The main causes of kidney disease in this population are poorly managed diabetes and hypertension. One solution to this problem is to improve patient education interventions. As healthcare providers, we have a major role in improving patient teaching regarding disease management and illness prevention. Several nursing theories focus on patient education for health promotion. One of those theories is The Self-Efficacy Theory.
The Self-Efficacy Theory, or Social Cognitive Theory, was developed in 1977 by a psychologist named Albert Bandura. Self-efficacy is one’s belief that their behaviors can produce desired effects. Bandura defined self-efficacy as “the individual’s perception of one’s ability to perform particular behaviors through four processes including cognitive, motivational, affective, and selection processes” (Shorey & Lopez, 2021). Behavior changes play a major role in disease management and illness prevention. Bandura felt that a person’s self-efficacy determines how they respond to problems. Persons with high efficacy are more likely to succeed when dealing with problems. Bandura listed three factors that make up a person’s self-efficacy; behavior, environment, and cognitive factors (Petiprin, 2023). When dealing with patient teaching, nurses must determine the patient’s level of cognition. Nurses should also determine what is the self-efficacy of their patients and tailor their teaching plans accordingly. Shorey and Lopez found that for patients with chronic medical conditions, higher levels of self-efficacy to manage their chronic conditions are related to higher health-related quality of life, reduced perceived stress, lesser anxiety and depressive symptoms, and lower symptom severity (2021).
Petiprin, A. (2023). Self-Efficacy Theory. Nursing Theory. https://nursing-theory.org/theories-and-models/self-efficacy-theory.php
Shorey, S. & Lopez, V. (2021). Self-Efficacy in a Nursing Context. In G. Haugan & M. Eriksson (Eds), Health Promotion in Health Care-Vital Theories and Research (Chapter 12). Cham Springer. https://www.ncbi.nlm.nih.gov/books/NBK585659/
REPLY TO DISCUSSION
Replies
Informatics nurses integrate nursing and computer sciences to interpret health data and information for effective decision and care interventions for physicians and nurse practitioners. As a medical-surgical nurse, understanding informatics nursing is essential, especially in critical care units like the emergency department, where nurses experience workplace violence or incivility, particularly from patients. Informatics will help develop better interventions to manage violence against healthcare workers in the medical-surgical unit and emergency department. The Joint Commission asserts that close to 75% of workplace violence happens in health care settings or hospitals. Further, healthcare workers are four times more likely to be victims of workplace violence than any other profession (TJC, 2018). Therefore, workplace violence in critical care settings is a rising concern that all stakeholders must address. Many nurses and other healthcare providers do not press charges, yet it is a growing concern that negatively affects healthcare workers. These professionals endure verbal and physical violence while working in their ED settings. As a victim of these events, most perpetrators are patients or their families and have altered mental health. However, there are some situations where the perpetrators do not have
mental issues.
The two primary theories that can be associated with the situation are Hildegard Peplau’s interpersonal theory and Nola Pender’s health promotion model. At the core of Peplau’s model is the need for effective communication between the nurse and the patient in care provision (Mudd et al., 2020). The Interpersonal emphasizes the need for a nurse to forge a better rapport with a patient based on their condition. On its part, Pender’s model is about promoting health that leads to better outcomes by focusing on the characteristics and behaviors of a patient. The proposed nursing intervention can help patients change and improve their interpersonal approaches and communication (Smith, 2019). These theories are appropriate as they illustrate a nurse’s ability to create effective rapport and interpersonal interactions to understand a patient’s problem, leading to their violent conduct and actions.
References
Mudd, A., Feo, R., Conroy, T., & Kitson, A. (2020). Where and how does fundamental care fit within seminal nursing theories: A narrative review and synthesis of key nursing concepts. Journal of Clinical Nursing, 29(19-20), 3652-3666. DOI: 10.1111/jocn.15420
Smith, M. C. (2019). Nursing theories and nursing practice. FA Davis.The Joint Commission (TJC). (2018, April 17). Sentinel Event Alert: Physical and verbal violence against healthcare workers. https://www.jointcommission.org/-/media/tjc/idev-imports/topics-assets/workplace-violence-prevention-implementing-strategies-for-safer-healthcare-organizations/sea_59_workplace_violence_4_13_18_finalpdf.pdf
REPLY
Read
Replies to Persius Bodzaku
Persius, I was incredibly surprised to read that workplace violence is four times higher for healthcare workers than
any other profession. Unfortunately, the incidence of workplace violence is high toward nurses and healthcare workers worldwide. This high prevalence of violence prompted nurses in the United States to come together to develop a nationwide policy to address ways to make healthier work environments for themselves and their coworkers (Bernardes et al, 2020). Nurses are exposed to a wide array of harassment and abuse due to the large amount of time that nurses spend with people that are experiencing severely stressful situations, for example, illness of themselves or a loved one, and physical or psychiatric emergencies. (Bernardes et al, 2020)
Reference:
Also Read: DQ 2: Select two different nursing theories and describe how they relate to patient care
Bernardes, M. L. G., Karino, M. E., Martins, J. T., Okubo, C. V. C., Galdino, M. J. Q., & Moreira, A. A. O. (2020). Workplace violence among nursing professionals. Revista Brasileira De Medicina do Trabalho, 18(3), 250-257. https://doi.org/10.47626/1679-4435-2020-531
Read
The area in public health nursing that needs improvement is that public health nurses (PHNs) need to be more visible and active within the communities in which they serve. I remember thinking multiple times during the pandemic, “Where are the public health nurses?” Dr. Fauci and other physicians were very visible, but public health nurses were not. I am sure that there were and are PHNs that are working behind the scenes during the pandemic, but since nurses are among the most trusted professions, I feel that it would have been beneficial to society if they played a more prominent and visible role. Kent (2018) makes the point that public health nurses are uniquely trained to view the big picture of the health issues and take into consideration the social determinants of health of the population effected.
Imogene King’s Theory of Goal Attainment would have been especially beneficial to populations around the world during the early days of the pandemic. King’s theory promotes use of nurse’s clinical skills to assess the situation, communicate and share information, set goals, and take action to achieve those goals of patient care. (Gonzalo, A. 2021) Another nursing theory that would have been useful to implement on a national/ global level during the pandemic is Ida Jean Orlando’s nursing process. The nursing process that Orlando discusses provides a systematic approach to the nurse utilizing their knowledge to analyze the situation and determine the needs that must be addressed from a systemic community health perspective. (Wayne, G. 2022)
References:
Gonzalo, A. (2021). Imogene King: Theory of goal attainment. Nurseslabs. King- https://nurseslabs.com/imogene-m-kings-theory-goal-attainment/
Kent, J. (2018). Population health nurses require changes in education and practices. Health IT Analytics. https://healthitanalytics.com/news/population-health-nurses-require-changes-in-education-practices
Wayne, G. (2022). The nursing process: A comprehensive guide. Nurseslabs. https://nurseslabs.com/nursing-process/
REPLY
Read
Healthcare-associated infections, commonly referred to as hospital-acquired infections (HAI), are nosocomial acquired infections that are frequently absent or may be incubating at the time of admission. These infections typically develop after being admitted to the hospital and become apparent 48 hours later.Many different intrusive techniques and equipment are used in modern healthcare to treat patients and aid in their recovery. Treatments (like surgery) and the equipment used in such procedures, like catheters or ventilators, can both cause infections. Hospitals have been concerned about hospital-acquired infections for a while now. To lower the occurrence of hospital-acquired illnesses, several hospitals have put in place infection tracking and surveillance systems as well as effective prevention measures (Biswas, 2020). Due to their association with multidrug-resistant infections, the effects of hospital acquired infections are felt not only at the level of the individual patient but also at the community level. For the prevention and reduction of hospital acquired infections and multidrug-resistant illnesses, it is crucial to identify individuals who have these risk factors.
One nursing theory that can be instrumental in fighting the infections if Florence Nightingale’s Environmental theory. Thetheory is defined as an act of utilizing patient’s environment to help them in recovery. It requires the nurse to take the initiative to build up environmental conditions that are suitable for the patient’s progressive return to health and that outside influences connected to the patient’s surroundings have an impact on the patient’s development and life processes. She listed five environmental factors: fresh or sanitary air, pure water, effective drainage, and light or direct sunlight. When these factors are maintained at the requires standards, infections can be easily managed and this will help in reducing the burden of infections from the healthcare facility (Gilbert, 2020).
References
Biswas, P. A. (2020). Role of surveillance and prevention in hospital acquired infection and mortality. Journal of Medical Science And Clinical Research, 08(12). https://doi.org/10.18535/jmscr/v8i12.33
Gilbert, H. A. (2020). Florence Nightingale’s environmental theory and its influence on contemporary infection control. Collegian, 27(6), 626–633. https://doi.org/10.1016/j.colegn.2020.09.006
care patients. Patients risk pressure injuries due to decreased mobility, poor circulation, or fragile skin. Changes in cognitive or bowel and bladder function and insufficient intake of nutrients and liquids can also contribute to developing pressure injuries. During hospitalization, patients may also have various tubes, drains, and other healthcare equipment that can cause pressure injuries. The hospital-acquired infections can prevent by increasing mobility, adequate nutrition, and assisting in skin care and education.
Nursing theories are the basis of nursing practice today. Nursing theory guides knowledge development in many cases and directs education, research, and practice. For example, Virginia Henderson’s need theory is the appropriate nursing theory to help prevent hospital-acquired infection. Virginia Henderson developed the Nursing Need Theory to define the unique focus of nursing practice. The theory focuses on increasing the patient’s independence to hasten their progress in the hospital. Henderson’s theory emphasizes basic human needs and how nurses can meet those needs (Gonzalo,2021). Nurses temporarily assist an individual lacking the strength, will, and knowledge to satisfy one or more of the 14 basic needs. It will help to reduce the chances of developing hospital-required infections in high-acuity care patients.
References:
Angelo Gonzalo, B. S. N. (2021, March 5). Dorothea Orem: Self care deficit theory study guide. Nurseslabs. https://nurseslabs.com/dorothea-orems-self-care-theory/