DQ 2: Select two theories and describe their relevance to your role as a DNP-prepared nurse
DNP 815 Topic 8 DQ 2
Explore various science-based theories. Select two theories and describe their relevance to your role as a DNP-prepared nurse.
In the post-anesthesia care unit (PACU), the five components of the nursing process are utilized (Dean, 2018). An example of this would be a patient who presents to the PACU after a shoulder arthroscopy. An initial assessment of the patient shows the patient to be moaning, wincing, as well as tachycardia and hypertensive; this is the first step in the nursing process. The second step would be to provide a diagnosis. What is the problem? The patient reports pain (as 8 on a scale of 0-10) as a result of surgery as seen by increased heart rate and blood pressure as well as pain score. The third step is planning/outcomes, what can the nurse implement as far as interventions and possible pharmacologic strategies to alleviate the patient’s pain and what could the outcomes of said implementations be? The fourth step is implementation. The nurse carries out the intervention that was previously evaluated, in this case the nurse decides to dim the lights, quiet the room, and provide the patient with pain medication per orders given by provider. The last step is evaluation. Did the intervention work? Is the patient’s pain alleviated? This step often requires another assessment to determine the effectiveness of the intervention. The Standards of Practice set forth by the BON guides this nurse process in that the nurse is able to evaluate the problem, consider options for implementing interventions then evaluating the outcomes, all based on the appropriate standards of care put in place.
REPLY TO DISCUSSION
The scientific underpinnings of DNP practice are not confined to nursing science and theory. Nursing theory improves our care by giving its unity and structure, by providing more efficient continuity of care, and by giving us a framework for the effectiveness of our interventions. When DNP-prepared nurses use theory to guide care, they achieve higher quality in their care while simultaneously elevating nursing professional standards, accountability, and autonomy (Zaccagnini & White, 2017). A nursing theory-guided practice is needed, and the DNP-prepared nurses’ responsibility is to become knowledgeable about a broad range of theoretical frameworks for clinical practice. Roy’s Adaptation Theory contains four essential elements: the person receiving care, the environment, health, and nursing. Roy’s model is applicable to all types of nursing practice and research. The other t
heory that I think it has relevance to our role as DNP-prepared nurses is King’s Theory of goal attainment in the nursing process, which strengthened the theory’s use and applicability in clinical practice.
The DNP-prepared nurses possess advanced competencies for increasingly complex leadership and clinical roles, enhanced knowledge to improve nursing practice and patient outcomes, enhanced leadership skills to strengthen practice and delivery, and manage collaborative efforts with other healthcare clinicians to improve health care (Astalos, 2023). In order for the DNP-prepared nurses to meet the changing healthcare demands, they should be proficient in the following skills:
- Delivering care
- Developing interdisciplinary standards
- Leading and managing clinical care and the healthcare system
- Solving healthcare dilemmas
- Developing healthcare policy
- Reducing disparities in healthcare
- Evaluating evidence-based practices for care
Philosophies and theories of nursing also guide research and practice.
References
Astalos, L. (2023). The doctor of nursing practice: a guidebook for role development and professional issues. Jones & Barlett Learning.
Zaccagnini, M.E. & White, K.W. (2017). The doctor of nursing practice essentials: a new model for advanced practice nursing. Jones & Barlette Learning.
The Doctor of Nursing Practice Essentials – Google Books
Unread
I must commend you for this post. I shall respond to your informative post by noting that critical to the nursing profession is caring, which is a role associated with patient engagement. Quality care is delivered when practice is
underpinned by a theory (Dewey, 2020). Patient engagement has been demonstrated to boost a partnership that encourage smooth and effective communication in clinical encounter with patients. The middle range theory of caring stimulates the partnership earlier discussed as it relates to nursing practice. Welch and Fournier (2018) suggests that the middle range theory provides clarity on the role of nurses in patient engagement. Further, the delivery of quality care, as provided for by the middle range theory, fosters the alignment between informed nurse caring and patient engagement, which reinvigorate the expression of nursing core values in clinical setting.
Thanks for sharing.
References
Dewey, J. (2020). Nursing theory. Salem Press Encyclopedia of Health.
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
The application of science-based theories in nursing represents an opportunity for nurses to combine experience-associated knowledge with evidence developed on the basis of scientific rigor. The nursing profession has evolved greatly over time. Moving from dependence upon total medical direction providing basic care into an independent practice modality.
Also Check Out: DQ 1: Which science-based theories do you think are the most useful to the DNP-prepared nurse?
The central philosophy of the Self-Care Deficit Nursing Theory is that all patients want to care for themselves, and they are able to recover more quickly and holistically by performing their own self-care as much as they’re able (nursing theory,2021). This theory is particularly used in rehabilitation and primary care or other settings in which patients are encouraged to be independent.
A DNP prepared nurse can benefit from this theory(selfcare deficit) because it can easily be applied to a variety of nursing situations and patients. The generality of its principles and concepts makes it easily adaptable to different settings, and nurses and patients can work together to ensure that the patients receive the best care possible, but are also able to care for themselves. Patient education and communication as the main key to its goal attainment .
Another theory that can be beneficial to my DNP role is the theory of Planned Behavior which was developed to predict behaviors in which individuals have incomplete voluntary control. Taking self-esteem and self-efficacy into consideration, the TPB expands on the concept of perceived behavioral control. (keiba,2021). If a patient’s perceived control or self-efficacy or self-esteem is low, the perception and belief that he or she can influence own behaviors in a positive manner is undermined.
This theory enables the DNP prepared nurse to understand how individuals behave across different settings, scenarios and situations. Unlocking insight based on attitudes towards behaviors, norms and perceived control enable practitioners and marketers to understand where barriers exist and how to encourage a change in behavior.
References
Keiba L. Shaw(2021) patient education , motivation , compliance and adherence to physical activity , exercise and rehabilitation . Pathology and Intervention in Musculoskeletal Rehabilitation (Second Edition), 2016
Nursing Theories (2021) Dorothea Orem – Nursing theorists . Available from ; https://nursing-theory.org/nursing-theorists/Dorothea-E-Orem.php
Unread
Replies
Clinical nurse specialists apply theory by providing or directing patient care in their work as consultants to staff nurses, and as leaders influencing and facilitating system change. Knowledge of technology and pharmacology has far outpaced knowledge of how to facilitate health behavior change, and new theories are needed to better understand how practitioners can facilitate health behavior change. The Integrated Theory of Health Behavior Change is described, and an example of its use as foundation to intervention development is presented.
The Integrated Theory of Health Behavior Change suggests that health behavior change can be enhanced by fostering knowledge and beliefs, increasing self-regulation skills and abilities, and enhancing social facilitation. Engagement in self-management behaviors is seen as the proximal outcome influencing the long-term distal outcome of improved health status. Person-centered interventions are directed to increasing knowledge and beliefs, self-regulation skills and abilities, and social facilitation. Using a theoretical framework improves clinical nurse specialist practice by focusing assessments, directing the use of best-practice interventions, and improving patient outcomes. Using theory fosters improved communication with other disciplines and enhances the management of complex clinical conditions by providing holistic, comprehensive care.
Patient participation in transitional care is largely based on perceptions of self-efficacy, confidence, and skill. Patient-centric transitional care interventions targeting these factors and delivered beyond the hospital setting may improve care outcomes. Implications and direction for further studies includes conceptual clarity, the study of a broader-reaching patient population demographic, and use of multidisciplinary interventions.
Reference
Bailey, A., Mallow, J., & Theeke, L. (2022). Perceived Self-Efficacy, Confidence, and Skill Among Factors of Adult Patient Participation in Transitional Care: A Systematic Review of Quantitative Studies. SAGE open nursing, 8, 23779608221074658. https://doi.org/10.1177/23779608221074658
Unread
Replies
Many science-based theories have been categorized as grand nursing theories, mid-range, and practice level theories. These theories have not only been involved in shaping the concepts of nursing but are also important in the delivery of healthcare services. The nursing theories tend to assist the nurses in providing quality healthcare services through the integration of skills and knowledge for the achievement of efficiency and efficacy in services (Dillon, 2020). The
implementation of nursing theories in various situations is the need for time to meet the changing demands of the patients. Science-based theories are committed to providing a theoretical framework to support the principles and basic concepts in nursing. The following two theories have been selected to predict the related role of DNP- prepared nurses.
The self-care theory supports the DNP-prepared nursed to focus on strengthening their ability of quality caring the patients by being self-sufficient and responsive. For the provision of appropriate healthcare services, the patient must have some knowledge about self-care.
The concept of self-care is dependent on self-care deficit theory, the theory of self-care, and the theory of the nursing system. The theory is relevant to my role as a DNP- a prepared nurse in terms of providing self-management education to patients suffering from chronic diseases. In the successful application of the self-care concept, there is a high need of knowing about the disease and its relevant remedies.
The second theory that has been selected for this discussion is the culture care theory. The conceptual framework of this theory is based on the importance of the presence of cultural and care knowledge for the provision of quality healthcare services to patients of a different culture. Being a DNP-prepared nurse, the knowledge about trans -culture, will support me to effectively treat patients from different cultures and identities.
The nurse can better perform by following their beliefs about treatment and perceptions about medicines (Rivaz et al., 2021). The nurses with transcultural knowledge and experience can help patients in making the right decision about their health issues and taking the benefits of quality services and affiliation of the physicians. Hence, the presence of specific cultural knowledge can help in the retention of core cultural values relevant to healthcare services.
A nurse promotes health and well-being in those that are ill. The Rogerian model, first introduced in 1970, approaches nursing care with a holistic and dynamic view. Roger’s identifies nursing as a science that is learned through research and knowledge and is then emphasized on the human experience. The Rogerian model has a framework that unites a human being and the environment (Themes, 2017). Roger’s stated that nursing promoted well-being in all aspects of human life, including dying. Her theory was derived from the concept that nurses and patients participate mutually in care to optimize potential (Malinski, 2018). The Rogerian model is often utilized in learning and sought to enable “free will”. Logue (2022) analyzed Rogerian focused models on student learning, educational practices, and quality in higher education. Logue discovered that the utilization of Roger’s model increased innovation, creativity, critical thinking, passion, enthusiasm, and inspiration.
Although a direct practice improvement project is focused on patient outcomes and quality of care, the approach to learning is emphasized as nurses play an important role in carrying out the implementation process. Teaching methods such as mentorship, support, feedback, professionalism, inspiration, and passion are needed to motivate a team towards new innovations and the need to improve. The Rogerian model emphasized the importance of a learner’s engagement and an instructor’s overview of the diversity of the audience. The conceptualization of the human and environmental energy field within the Rogerian model is a potential for process, change, and movement. Characteristics that drive energy are openness, patterns and pandimensionality (Themes, 2017). There are theories and frameworks that are based on Roger’s assumptions, however explore situations where inconsistencies arise rather than guiding learners though a clear pathway. In scenarios like these, multiple theories can aid a DPI implementation project such as the Theory of Perceived Dissonance. Leon Festinger published the theory of perceived Dissonance to examine psychological processes in individuals with disagreements and their values, attitudes, and beliefs. (Harmon-Jones & Mills, 2019).
Harmon-Jones, E., & Mills, J. (2019). An introduction to cognitive dissonance theory and an overview of current perspectives on the theory. In E. Harmon-Jones (Ed.), Cognitive dissonance: Reexamining a pivotal theory in psychology (pp. 3–24). American Psychological Association. https://doi.org/10.1037/0000135-001
Logue, P. (2022). Critical Evaluation of Rogerian Theoretical Perspectives on Student-centred Learning as Applied in Professional Practice. World Conference on Research. Retrieved September 21, 2022, from https://www.dpublication.com/wp-content/uploads/2022/03/8-6417.pdf
Malinski, V. (2018). The importance of a nursing theoretical framework for nursing practice: Rogers’ science of unitary human beings and Barrett’s theory of knowing participation in change as exemplars. Cultura Del Cuidado, 15(2), 6–13. https://doi.org/10.18041/1794-5232/cultrua.2018v15n2.5108
Themes, U. F. O. (2017, January 10). Rogers’ science of unitary human beings in nursing practice. Nurse Key. Retrieved September 20, 2022, from https://nursekey.com/rogers-science-of-unitary-human-beings-in-nursing-practice/