DQ 1: Which science-based theories do you think are the most useful to the DNP-prepared nurse?
DNP 815 Topic 8 DQ 1
Which science-based theories do you think are the most useful to the DNP-prepared nurse? Why?
REPLY TO DISCUSSION
Nursing theories are a set of predictive models that support nursing practice today. These theories are essential to nursing practice, scientific research and education because they help in determining what is known and any additional skills and knowledge that is needed.
The first strength of the leadership theory is that there is follower inclusivity whereby, once the employees see the leader’s dedication, they will follow them. There is the discouragement of unproductive behavior (Burkus, 2020). When the leader serves the employees well, they, in turn, offer customer satisfaction. Secondly, there is a positive work environment as the leader supports and builds a shared goal (Whitney, 2018). Another strength is that servant leadership helps boost morale in an organization. Contrarily, there are weaknesses to the theory; the first weakness is that it is challenging to explain and communicate the concept of servant leadership (Burkus, 2020). The next one is that retaining servant leaders in the healthcare system is challenging and time-consuming. Another weakness is that followers view servant leaders as weak; therefore, it may be hard to heed their rules (Burkus, 2020). Servant leadership is hard to achieve as it requires an individual with high authenticity levels.
Lewin’s Kurt change model proposes three fundamental strategies, i.e., unfreezing, movement and refreezing. The first is unfreezing, 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 refreezing, implies assimilating and normalizing the change intervention as standard practice (Teguh et al., 2019). Orem’s nursing care deficit theory describes how the patient’s self-care needs will be met by the nurse, the patient, or by both. Orem’s theory on the other hand is comprised of three related parts: theory of self-care; theory of self-care deficit; and theory of nursing system. The steps in the approach are thought of as the technical component of the nursing process. Orem emphasizes that the technological component “must be coordinated with interpersonal and social pressures within nursing situations.
The DNP prepared nurse will be more equipped when utilizing these two nursing theories because they provide a guidance to nursing. It allows the nurse to provide current best practice care to their patients while also impacting them beyond the bedside. Theories help guide evidence-based research which then leads to best practices and policies. This gives the DNP prepared nurse the opportunity to organize principles that will help evaluate patient care and improve the nursing interventions based on the evaluation findings. The theories can also provide nurses with basis or rationale for making decisions.
References
Nursing Theories(2021) Orem’s self care deficit nursing theory . available https://nursing-theory.org/theories-and-models/orem-self-care-deficit-theory.php
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.
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Replies
You have a laudable post here. In response to your instructive post, nursing science provides the avenue for nurses to
play the essential role of caring because practices are underpinned by theories in the form of evidence-based practice. Fawcett (2020) noted that nurses are at the center of most health professional teams, and they play significant roles in the promotion of health, prevention of disease and treatment. Patient engagement in the clinic facilitates the development of a partnership whereby solid communication is established in patient-nurse relationship (Welch & Fournier, 2018). A theory that validates the establishment of this partnership should guide a DNP project. And one of such theories is the Faith Community Nursing Theory proposed by Alligood and Fawcett (2017). Due to the fostering of patient-nurse relationship in the delivery of quality health care, I am using the theory as one of the theories that will guide my DNP project.
Also Check Out: DQ 2: Select two theories and describe their relevance to your role as a DNP-prepared nurse
Thanks for sharing.
References
Fawcett, J. (2020). Thoughts About Nursing Science and Nursing Sciencing Revisited. Nursing Science Quarterly, 33(1), 97–99. https://doi.org/10.1177/0894318419882029
Welch, J., & Fournier, A. (2018). Patient Engagement Through Informed Nurse Caring. International Journal for Human Caring, 22(1), 1–10. https://doi-org.lopes.idm.oclc.org/10.20467/1091-5710.22.1.pg5
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The nursing profession has remained a unique and evolving specialty, but its development has been complicated by the ever-changing healthcare delivery system. Doctor of Nursing Practice programs prepares nurse leaders for unique roles to address healthcare needs across the quality spectrum (Reynolds et al., 2021). As DNP-prepared nurses, we will have the opportunity to evaluate current practices and implement strategies directed to improve health care within an evidence-based framework. The focus is on translating nursing research into evidence-based standards of care and practice.
Theories serve as a guide and influence how we practice nursing. Kurt Lewin’s three-step theory is highly applicable and widely used, and I think this is the most useful for me as I navigate through this journey. Unfreezing is the first stage of Lewin’s theory wherein the anticipated change must first “unfreeze” the mindset to prepare that change is necessary. Moving is the second stage that follows implementing the change that has been identified. Finally, “refreezing” occurs when the change is successful and stabilized.
DNP-prepared nurses should be able to work productively with other key personnel within the organization and be able to share critical information regarding evidence-based practice with the frontline staff and advocate for the patient’s needs within the complexity of the health care systems (Doyle & Kwong, 2018). As we cross many milestones on this journey, with the ever-changing health care environment at high speed and become systems-level experts, we will have the opportunities to identify quality improvement projects, identify gaps needing improvement, implement strategies, and occurrence of organizational change.
References:
Doyle-Lindrud, S., & Kwong, J. (2018). “Leadership skill set for the advance practice registered nurse.” DNP Education, Practice, and Policy: Redesigning Advanced Practice for the 21st Century, 147.
Memon, F. A. (2021). Improving employee’s engagement in change: reassessing Kurt Lewin’s Model, City University Research Journal, 11(1).
https://www.cusitjournals.com/index.php/CURJ/article/view/282
Reynolds, S. S., Howard, V., Uzarski, D., Granger, B. B., Fuchs, M. A., Mason, L., & Broome, M. E. (2021). An innovative DNP post-doctorate program to improve quality improvement and implementation science skills. Journal of Professional Nursing, 37(1), 48–52.
https://doi-org.lopes.idm.oclc.org/10.1016/j.profnurs.2020.12.005
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In this course, the focus was placed on theories and how they assist the proposed direct practice improvement project. In nursing, it defines what nurses do and why they practice in a particular way. The frameworks create guides for practice and make nurses unique to other roles in medicine. Other functions they entail are prediction and control. It establishes direction and knowledge as a tool in practice, research, and education. Nurses can understand their purpose in health care without being identified as a task-oriented occupation. Theories provide scientific reasoning and rationale. Levels exist in the order of abstract to more specific. Grand theories are the most abstract, followed by the middle range theories and the practice level theories, which are more specific. In the grand category, there is no particular guidance to intervention but rather more general frameworks. Middle ranges are more limited and address specific phenomena. In this category, testing is feasible. Practice levels are situation specific. It is only appropriate for respective populations within a particular frame of time. Despite their specificity, they are intercorrelated with concepts from the other two levels.
Taking the time to discuss the learned material specific to theory is essential. It allows for reflection on how this material is relevant to the project and its usefulness. As reviewed above, there is a purpose to each one of them. It makes it difficult to assume which one is most useful. It can only be identified based on the purpose of the project and its population. Throughout the implementation process, more than one theory can be beneficial. The nurse’s role is also to be considered. For instance, Callista (2021) supports that the increased knowledge development from these tools has also increased nursing roles. Reports need to continue to improve application and evidence of their usefulness. Implementation and research are not easy to accomplish, but their need in nursing is essential to reinforce the importance of nursing and support the what and the why. The process and its usefulness begin in undergrad work. However, further research is needed to understand why some argue that curriculums to do emphasize the importance ( Soyoung & Ju-Eun Song, 2021).
References:
Callista, S. (2021). Nursing theory makes a practice turn in the 21st century. Aquichan, 21(4), 1–11. https://doi.org/10.5294/aqui.2021.21.4.2
Soyoung Yu, & Ju-Eun Song. (2021). Essential role of theory in nursing research for advancement of nursing science. Journal of Korean Academy of Nursing, 51(4), 391–394. https://doi.org/10.4040/jkan.51401
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In nursing science-based theories are mainly focusing on the organization of knowledge based ideas defining the scope of nursing. The breadth of scope of these science-based theories varies to nursing constitutes and tasks provided to nurses and the reasons for the placement of those tasks.
The most common science-based theories in nursing can be categorized as grand nursing theories, mid-range nursing theories, and practice-level nursing theories. The concept of these theories is important in nursing and can provide foundation skills for nurses essential in their nursing practice and to take care of their patients. The significance of this science-based nursing theory for a DNP-prepared nurse becomes important when they need articulating evidence during their practice and need to justify the methodology used by them (McNett et al., 2021).
The science-based nursing theories are used to define the framework effective for the nurses to follow and to shape the parameters for patient care. In absence of science-based nursing theories, the concept of nursing is lacking linear foci and nurses lack of ability to organically pointing back to patients during the process of treatment and meeting their health-related demands.
The DNP-prepared nurse can best utilize these theories to shape the strategies of healthcare facilities for patients while aligning the expected results. For instance, the use of grand theories helps nurses in the establishment of a framework. The governance process becomes easy for nurses when they follow mid-range and practice level theories in the specific scenarios of healthcare services. The Healthcare systems developed based on science-based theories help nurses to take care of the patients holistically while depending upon the needs of the patient.
For instance, the use of child health assessment interaction theory reinforces the DNP-prepared nurses to develop the parent-infant relationship for the sake of quality caregiving services, creating an environment and adaptation of influencing attitude. This theory can also be used by the DNP nurses to provide healthcare services to adult patients while devising advanced treatment strategies to meet the demand of the patients and strengthening the patient-physician bonding.
Applying science-based theories in nursing enables nurses to combine their expertise, knowledge, and skills with scientific evidence, enhancing their capacity to provide high-quality, safe, and efficient care to their patients. Similarly, science-based nursing theory guide DNP-prepared nurses in their advanced nursing practices.
The most useful science-based theory for the DNP-prepared nurse is the Science of Unitary Human Beings, developed by Martha Rogers. This nursing model emphasizes the profession’s scientific nature and humanitarian components (Phillips, 2019). One of the most significant elements of this model emphasizes treating each individual as irreducible since every person has unique features that exceed the working mechanism of the human body. Roger’s theory considers nursing and sciences as interconnected fields since individuals have the power to influence their environments, making nursing a scientific field naturally. Rogers emphasized the significance of maintaining patient safety and effective communication between nurse practitioners and patients in a healthcare organization. Thus, DNP-prepared nurses can apply this theory in their advanced practice in addressing clinical issues that compromise patient safety, such as nurses’ burnout. According to Garcia et al. (2019), nurses’ burnout dramatically increases preventable adverse health outcomes such as medical errors in healthcare organizations. This trend is associated with nurses’ inability to provide high-quality and safe patient care due to work-related distress and fatigue. Therefore, by applying Roger’s theory, DNP-prepared nurses will reduce preventable adverse health outcomes associated with nurses’ burnout in their healthcare settings.
Another science-based theory useful to the DNP-prepared nurse is Watson’s Nursing Theory. Watson’s theory of human caring emphasizes caring as the center of nursing practice (Pajnkihar et al., 2017). This model emphasizes the connection between nursing practice and scientific knowledge in caring for various patient populations (Pajnkihar, Štiglic, & Vrbnjak, 2017). Watson’s theory of human caring holds that caring leads to superior outcomes for nurses and the care recipient. Thus, nurses implement scientific knowledge and approach to preventing illnesses that can affect themselves and their patients and promoting their health and that of their patients, presenting caring as a holistic element of the nursing profession. DNP-prepared nurses apply Watson’s theory in promoting their and their patients’ health via scientific-based interventions and knowledge.
Therefore, applying science-based theories enables DNP-prepared nurses to utilize scientific knowledge and interventions in their advanced nursing practices. DNP-prepared nurses apply scientific findings in addressing various clinical issues facing nurses or patients, achieving high-quality, safe, or efficient patient care. Additionally, scientific-based evidence enables these nurses to prevent diseases and promote their health and that of their patients, improving overall patient outcomes, health-related quality of life, and well-being.
References
Garcia, C. D. L., Abreu, L. C. D., Ramos, J. L. S., Castro, C. F. D. D., Smiderle, F. R. N., Santos, J. A. D., & Bezerra, I. M. P. (2019). Influence of burnout on patient safety: systematic review and meta-analysis. Medicina, 55(9), 553. Doi: 10.3390/medicina55090553.
Pajnkihar, M., McKenna, H. P., Štiglic, G., & Vrbnjak, D. (2017). Fit for practice: analysis and evaluation of Watson’s theory of human caring. Nursing Science Quarterly, 30(3), 243-252.
Pajnkihar, M., Štiglic, G., & Vrbnjak, D. (2017). The concept of Watson’s carative factors in nursing and their (dis)harmony with patient satisfaction. PeerJ, 5, e2940.
Phillips, J. R. (2019). Unitariology and the changing frontiers of the science of unitary human beings. Nursing Science Quarterly, 32(3), 207–213.
Theories are ubiquitous throughout scientific disciplines. Scientific theories make attempts to describe, explain or predict various phenomena (Butts & Rich, 2018). This type of theory has clear definitions and characteristics which can be attributed to an event or situation. As such, nursing theories are scientifically based on defined and testable concepts that attempt to lead to an explanation or prediction. Theories help to guide and solidify ideas or concepts in various professions. The incredible consideration for nursing theory is the combination of science with the person. These two items can not be siloed as any theory in nursing will ultimately impact the people under nursing care. As a DNP, scientific theories transition knowledge and research into practice.
There are numerous theories within the nursing profession and the most appropriate theory will be dependent on the situation it is being applied. Maslow’s Hierarchy of Needs can be applied in most situations and tends to the physical demands and psychological needs of a person in order to grow and develop. Lower level needs must be obtained before higher level needs can be met. Maslow’s Hierarchy of Needs was evident during the pandemic. The initial needs of COVID-positive patients were physical, considering impaired oxygenation and perfusion. However, this can be applicable to nurses as well. When COVID started, nurses were operating in a crisis and trying to meet physiological needs and safety. With support and encouragement from the organization, nurses could grow to the top level of self-actualization where innovation was supported and nurses rose to the challenge (Hayre-Kwan et al., 2021).
The Neuman Systems Model (NSM) is another beneficial theory for DNP nurses to use. This model views how an organism (which could be a person, family, group, community, or larger group) interacts with each other and with different environmental groups (Ahmadi & Sadeghi, 2017). NSM is similar to Maslow’s model as it looks at the physiological and psychological dimensions of an individual. There are certain needs that must be addressed to survive. But NMS also discusses the environmental factors that may impact a person, including internal, external, and created influences. Both of these theories address the person holistically and include basic needs and higher-level needs which is helpful considerations for DNPs.
References
Ahmadi, Z. & Sadeghi, T. (2017). Application of the Betty Neuman systems model in the nursing care of patients/clients with multiple sclerosis. Multiple Sclerosis Journal – Experimental, Translational and Clinical, 3(3), 2055217317726789. Doi: 10.1177/2055217317726798
Butts, J. B., & Rich, K. L. (2022). Philosophies and theories for Advanced Nursing Practice. Jones & Bartlett Learning.
Hayre-Kwan, S., Quinn, B., Chu, T., Orr, P., & Snoke, J. (2021). Nursing and Maslow’s Hierarchy: A Health Care Pyramid Approach to Safety and Security During a Global Pandemic. Nurse Leader, 19(6), 590–595. https://doi-org.lopes.idm.oclc.org/10.1016/j.mnl.2021.08.013.