Integrative and Transformative Theories in Practice

The nursing theory that resembles and relates to my current practice as a Post-Anesthesia Recovery Nurse at a surgery center is Dorthea Orem’s Self-Care Deficit Nursing Theory (SCDNT). The SCDNT theory has the purpose of increasing patient’s ability to care for themselves (Afrasiabifar et al., 2016). This theory is applicable because I can incorporate all three categories of the Theory of Nursing Systems. This theory is a part of the four constituent theories within the Self-Care Deficit Nursing Theory. It encompasses the Theory of Dependent Care, Self-Care Deficit, and Self-Care.

The Theory of Nursing Systems states that the system will vary depending on the nurse’s nurse’s amount of care (Smith, 2020). The Theory of Nursing Systems consists of three systems; wholly compensatory nursing system, partially compensatory nursing system, and supportive-educative compensatory nursing system. The nurse will apply the system of care dependent upon the abilities and limitations of the patient (Malekzadeh et al., 2018).  During the initial recovery phase following a procedure, a patient is considered in the wholly compensatory system. They are sedated, need airway assistance, and their vital signs must be monitored closely. Following a procedure, the patient’s safety is of the highest priority as every individual responds differently to general anesthesia. As the anesthesia begins to subside, the nurse will enter into the partially compensatory system. The patient begins rehabilitation and recovery. We continue to monitor vital signs, assess and treat pain, nausea, and possible post-operative bleeding. The patient progresses to a more oriented state and, we allow the patient to get dressed and sit with their family member or driver, who will receive their discharge instructions. This stage of the recovery process allows the nurse to enter into the supportive-educative system (Smith, 2020).  Prior to the procedure, we assess the patient’s motivation levels, how the patient learns best, and provide education accordingly. While we direct our discharge instructions to the family due to the patient being under the influence of medication related to sedation, we teach the patient as much as possible to stimulate self-care and improve patient outcomes following the procedure. As Orem describes the concepts of the Self-Care Deficit Nursing Theory, she defines self-care or dependent care. Self-care is an act that individuals perform by themselves to maintain life, health, and well-being. (Smith, 2020). During the first 24-hours following surgery, the patient must be monitored by a care provider for their own safety. This places the patient in a socially dependent relationship and allows their caregiver to develop a dependent care agency. This allows caregivers to develop their abilities in order to be able to meet the self-care needs of their loved ones due to their health-associated limitations (Smith, 2020).

Another recent study of the effects of Dorothea Orem’s Nursing Theory is demonstrated on patients in Iran performed in 2015. This involved a quasi-experimental study of eighty patients with hypertension. The study aimed to evaluate the effect of the Self-care theory and its relation to the quality of life in patients with hypertension (Khademian et al., 2020). While this study has been conducted on groups with a chronic illness, this has not been conducted on a group with hypertension. According to Orem’s theory, self-care is behavior or acts that individuals engage in to maintain, improve, or restore their health. Nurses view their patients as strong, resilient, and capable of performing individual tasks geared toward bettering their health. The study began by assessing the universal and health deviation self-care requisites. Universal deviation self-care requisites are needs that must be met in order to maintain function, such as oxygen and water. Health deviation requisites occur due to diagnosis or treatment (Khademian et al., 2020). The control group received four 45-minute sessions of training weekly in addition to routine intervention. Following this intervention, the self-questionnaires returned at the end of the study demonstrated an increase in quality of life compared to the previous results. The study concluded that implementing Orem’s Self-Care Nursing Theory can be beneficial for patients with hypertension and lead to an improved quality of life (Khademian et al., 2020).

References

Afrasiabifar, A., Mehri, Z., Javad Sadat, S., & Ghaffarian Shirazi, H. R. (2016). The Effect of Orem’s Self-Care Model on Fatigue in Patients With Multiple Sclerosis: A Single-Blind Randomized Clinical Trial Study. Iranian Red Crescent medical journal, 18(8), e31955. https://doi.org/10.5812/ircmj.31955

Links to an external site.

Khademian, Z., Kazemi Ara, F., & Gholamzadeh, S. (2020). The Effect of Self Care Education Based on Orem’s Nursing Theory on Quality of Life and Self-Efficacy in Patients with Hypertension: A Quasi-Experimental Study. International journal of community-based nursing and midwifery, 8(2), 140–149. https://doi.org/10.30476/IJCBNM.2020.81690.0

Links to an external site.

Malekzadeh, J., Amouzeshi, Z., & Mazlom, S. R. (2018). A quasi-experimental study of the effect of teaching Orem’s self-care model on nursing students’ clinical performance and patient satisfaction. Nursing open, 5(3), 370–375. https://doi.org/10.1002/nop2.151

Links to an external site.

Smith, M. C. (2020). Nursing theories and nursing practice (5th ed.). F.A. Davis.

 

#1Nursing Theory as a Conceptual Framework*

1 — Instructions: Search online for a nursing research article on a nursing topic that interests you. Write a 2 page paper addressing the following:
1. Explain the Nursing Theory represented by the journal article.
2. Determine if the theory was a grand, middle-range, or situation-specific nursing theory. Discuss.
2. Summarize the findings of the article.

The paper must be written in APA 7th edition format. Use at least 2 references in addition no older than 5 years. DO a page with a presentation with the name and topic. Be careful with plagiarism because if u submit has Turnitin report

#2Discussion Question:

·         Discover which agencies, in your state, are responsible for public health of citizens.

·         Research if there are centralized or decentralized management of state responsibilities?

·         Determine minimum 3 key indicators of health.

·         Review the agency sites and upload the links to the Moodleroom, week #1 (THE DOCUMENT IS ABOVE IN THE UPLOAD FILE )APA FORMAT

#3Discussion Forum:

Topics- from Learning by Experience and Reflection:

· Develop your vision of the ideal health care system.

·  List some of the characteristics that constitute such a system. What would be the goal or goals of your ideal system?

· Think about how you would go about implementing your ideal system.

· Consider some of the problems you are likely to encounter

Chapter 1 Responsibilities for Care in Community/Public Health Nursing Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of Elsevier Inc. What Are the Distinguishing Features of Community/Public Health Nursing? • Healthful communities • Empowerment for health promotion Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of Elsevier Inc. 2 Which Theories Are Used with Community/Public Health Nursing? • General systems theory: A system is greater than the sum of its parts • Nursing theory: Includes self-care & environment • Public health: Health of human populations Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of Elsevier Inc. 3 What Is Public Health Nursing? • The practice of promoting and protecting the health of populations using knowledge from nursing, social, and public health sciences (APHA, 1996). • Population-focused, community-oriented nursing practice (Quad Council, 1999). Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of Elsevier Inc. 4 What Is Community Health Nursing? • A synthesis of nursing practice and public health practice applied to promoting and preserving the health of populations (ANA, 1980). Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of Elsevier Inc. 5 Visions and Commitments • Visions: Broad statements describing what we desire something to be • Commitments: Agreements we make with ourselves that pledge our energies for or toward our visions Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of Elsevier Inc. 6 Commitments of Public Health Practice • Equitable distribution of health care • Basic standard of living that supports the health and wellbeing of all persons • Healthful physical environment Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of Elsevier Inc. 7 Commitments of Public Health Practice • Promoting health • Creating a just economic environment • Preventing illnesses • Providing the greatest good for the greatest number • Educating others Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of Elsevier Inc. 8 Distinguishing Features of C/PHN • Care provided by nurses in a particular place and time and directed toward promoting, restoring, and preserving the health of the total population or community Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of Elsevier Inc. 9 Distinguishing Features of C/PHN (cont’d) • Families, groups, and populations as focus • Care for individuals and families • Vision of a healthful community • Nursing for social betterment Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of Elsevier Inc. 10 The C/PHN & Healthful Communities • Empowers individuals, families, groups, organizations, & professionals to participate in creating healthful communities Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of Elsevier Inc. 11 Empowerment • Assists others to uncover abilities, strengths, & spirit • Possibilities & opportunities revealed • Fosters hope Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of Elsevier Inc. 12 Nursing Ethics and Social Justice • Ethics: Respecting autonomy, doing good, avoiding harm, treating people fairly • Utilitarianism: Greatest good for the greatest number • Social justice: All persons are entitled to have their basic human needs met Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of Elsevier Inc. 13 PHN Scope & Standards of Practice (ANA, 2007) • The C/PHN applies the nursing process to promote the health of the public ➢ Uses demographic and epidemiological data ➢ Incorporates community resources Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of Elsevier Inc. 14 PHN Standards of Care (ANA, 2007) • Assessment • Population Diagnosis and Priorities • Outcomes Identification • Planning • Implementation • Coordination • Health Education and Health Promotion • Consultation • Regulatory Activities • Evaluation Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of Elsevier Inc. 15 Direct & Indirect C/PHN Care • Direct care: Involves face-to-face management & coordination of care • Indirect care: Does not involve interpersonal relationships with all persons who benefit from care (ANA, 1980) Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of Elsevier Inc. 16 Responsibilities of C/PHN • Providing care • Maintaining healthful environments • Teaching • Preventing abuse • Advocating for adequate standards of living • Identifying needs & referring for services • Professional development • Collaborating • Ensuring quality of care Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of Elsevier Inc. 17 Direct Care of Ill Clients at Home • Increasing need for home care ➢ Aging population ➢ Chronic diseases ➢ Payment for skilled home care ➢ Reduced time in hospitals ➢ Reducing hospital costs Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of Elsevier Inc. 18 Coordination of Care • Coordination: Bringing together the parts of a plan into a common whole • Case management: Developing & coordinating a plan of care for a client • Case load management: Time & resource management for clients Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of Elsevier Inc. 19 Partnerships and Collaboration • Interdisciplinary teams: Assist communities in planning to improve their health • Collaboration: Working together with equal influence Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of Elsevier Inc. 20 Core Functions of Public Health (IOM, 1988) • Core Functions of Public Health: ➢ Assess the community ➢ Ensure services are provided ➢ Health policy development Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of Elsevier Inc. 21 Exerting Influence to Promote Change • Coalition building: Developing linkages • Political action: Use of power to influence decisions • Policy development: Places health issues & plans of action on decision makers’ agendas Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of Elsevier Inc. 22 Standards of Professional Performance for CHN (ANA, 2007) • Evaluate populationfocused practice • Maintain up-to-date knowledge/compete ncy • Evaluate one’s practice • Advocacy • Leadership • Resource utilization • Establish and maintain partnerships • Contribute to students’ and colleagues’ development • Apply ethical standards • Integrate research findings Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of Elsevier Inc. 23 Summary • Promote the health of populations • Empower persons to achieve potential • Apply the nursing process with individuals, families, groups, and populations • Use a variety of nursing interventions Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of Elsevier Inc. 24

• Grid View

		Excellent	Good	Fair	Poor
Main Posting		45 (45%) – 50 (50%)  Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.   Supported by at least three current, credible sources.   Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.	40 (40%) – 44 (44%)  Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.   At least 75% of post has exceptional depth and breadth.   Supported by at least three credible sources.   Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.	35 (35%) – 39 (39%)  Responds to some of the discussion question(s).   One or two criteria are not addressed or are superficially addressed.   Is somewhat lacking reflection and critical analysis and synthesis.   Somewhat represents knowledge gained from the course readings for the module.   Post is cited with two credible sources.   Written somewhat concisely; may contain more than two spelling or grammatical errors.   Contains some APA formatting errors.	0 (0%) – 34 (34%)  Does not respond to the discussion question(s) adequately.   Lacks depth or superficially addresses criteria.   Lacks reflection and critical analysis and synthesis.   Does not represent knowledge gained from the course readings for the module.   Contains only one or no credible sources.   Not written clearly or concisely.   Contains more than two spelling or grammatical errors.   Does not adhere to current APA manual writing rules and style.
Main Post: Timeliness		10 (10%) – 10 (10%)  Posts main post by day 3.	0 (0%) – 0 (0%)	0 (0%) – 0 (0%)	0 (0%) – 0 (0%)  Does not post by day 3.
First Response		17 (17%) – 18 (18%)  Response exhibits synthesis, critical thinking, and application to practice settings.   Responds fully to questions posed by faculty.   Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.   Demonstrates synthesis and understanding of learning objectives.   Communication is professional and respectful to colleagues.   Responses to faculty questions are fully answered, if posed.   Response is effectively written in standard, edited English.	15 (15%) – 16 (16%)  Response exhibits critical thinking and application to practice settings.   Communication is professional and respectful to colleagues.   Responses to faculty questions are answered, if posed.   Provides clear, concise opinions and ideas that are supported by two or more credible sources.   Response is effectively written in standard, edited English.	13 (13%) – 14 (14%)  Response is on topic and may have some depth.   Responses posted in the discussion may lack effective professional communication.   Responses to faculty questions are somewhat answered, if posed.   Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.	0 (0%) – 12 (12%)  Response may not be on topic and lacks depth.   Responses posted in the discussion lack effective professional communication.   Responses to faculty questions are missing.   No credible sources are cited.
Second Response		16 (16%) – 17 (17%)  Response exhibits synthesis, critical thinking, and application to practice settings.   Responds fully to questions posed by faculty.   Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.   Demonstrates synthesis and understanding of learning objectives.   Communication is professional and respectful to colleagues.   Responses to faculty questions are fully answered, if posed.   Response is effectively written in standard, edited English.	14 (14%) – 15 (15%)  Response exhibits critical thinking and application to practice settings.   Communication is professional and respectful to colleagues.   Responses to faculty questions are answered, if posed.   Provides clear, concise opinions and ideas that are supported by two or more credible sources.   Response is effectively written in standard, edited English.	12 (12%) – 13 (13%)  Response is on topic and may have some depth.   Responses posted in the discussion may lack effective professional communication.   Responses to faculty questions are somewhat answered, if posed.   Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.	0 (0%) – 11 (11%)  Response may not be on topic and lacks depth.   Responses posted in the discussion lack effective professional communication.   Responses to faculty questions are missing.   No credible sources are cited.
Participation		5 (5%) – 5 (5%)  Meets requirements for participation by posting on three different days.	0 (0%) – 0 (0%)	0 (0%) – 0 (0%)	0 (0%) – 0 (0%)  Does not meet requirements for participation by posting on 3 different days.
Total Points: 100