Chapter 1 Theory and Professional Practice PDF

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Definition of Nursing Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations. (AN...

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! Definition of Nursing Nursing • is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations. (ANA) #! •Nursing standards are a minimum set of criteria of practice to provide quality care.! Nursing • is seen as a holistic (treating the patient’s physical, mental, emotional, spiritual, and social self) profession that addresses the many dimensions necessary to fully care for a patient. #! A • profession is an occupation that requires at a minimum specialized training and a specialized body of knowledge. #! •Nurses build upon their broad education and understanding of illness to promote wellness and health maintenance.!

Primary Roles and Functions of the Nurse • Care provider! • Educator - informing pts about meds! • Advocate - promoting and supporting ! • Leader - provide direction and purpose to others! • Change agent! • Manager - supervises/oversees staff! •Researcher - determine care concerns and ask questions about nursing practices ! • Collaborator

Patient education and health literacy Health • Literacy = the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions#! Low • health literacy is associated with increased hospitalization, greater emergency care use, lower use of mammography and lower receipt of influenza vaccine. ! Evidence-based Practice (EBP) EBP • = an integration of the best-available research evidence with clinical judgment about a specific patient situation. ! • Components:#!

• Began in religious and military service#! • In 1860, Florence Nightingale—founder of modern nursing—raised the profile of nursing#!

‣ working, consisting of two sub-phases:!

•Betty Neuman’s Systems Model includes a holistic concept and an open-system approach. !

Imogene • King developed a general systems framework based on the importance of interaction between the nurses and pts for goal attainment tha incorporates three levels of systems:!

growth and development, time, and personal space. ! In ‣ this theory, both the nurse and the patient work together to achieve the goals in the continuous adjustment to stressors.! Virginia • Henderson described the nurse’s role as substitutive (doing for the person), supplementary (helping the person), or complementary (working with the person), with the goal of independence for the patient. !

•Dorothea Dix was the head of the U.S. Sanitary Commission, which was a forerunner of the Army Nurse Corps.! •Linda Richards was America’s first trained nurse, graduating from Boston’s Women’s Hospital in 1873.! •Lena Higbee, superintendent of the U.S. Navy Nurse Corps, was awarded the Navy Cross in 1918.! •Roy’s Adaptation Model is based on the human being as an adaptive open system. !

Parse’s • theory is called the Human Becoming School of Thought. Parse formulated the Theory of Human Becoming by combining concepts from Martha Rogers’ Science of Unitary Human Beings with existential-phenomenologic thought. !

Nursing Theories: Terminology •Discipline: a specific field of study or branch of instruction or learning. #! •Metaparadigm: a global set of concepts that identify and describe the central phenomena of the discipline !

• Philosophy: a statement about the beliefs and values of nursing #! Conceptual framework or model: a collection of interrelated concepts that provides direction for nursing practice, research, and education! • Nursing theory: represents a group of concepts that can be tested in practice and can be derived from a conceptual model#! • • Grand theory: a global conceptual framework that defines broad perspectives for nursing practice and provides ways of looking at nursing phenomena from a distinct nursing perspective#! •Middle-range theory: moderately abstract theory with a limited number of variables!

Non-Nursing Theories ! • Maslow’s Hierarchy of Needs!

‣ Self-esteem! ‣ Love and belonging! ‣ Safety and security ! ‣ Physiologic needs! • Erikson’s Psychosocial Theory!

• Paul’s Critical Thinking Theory#!

‣Perceived severity of the seriousness of the condition and its potential consequences! ‣Perceived barriers of the influences that facilitate or discourage adoption of the promoted behavior! ‣Perceived benefits of the positive consequences of adopting the behavior

Criteria for a Profession • Altruism - public service over personal gain! • Body of knowledge and research ! • Accountability! • Higher education! • Autonomy! • Code of ethics! • Professional organization! • Licensure! • Diversity!

Diversity Considerations • Cultural and linguistic competence#!

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• Competence#! • Cultural competence #! patients.!

Practice Guidelines •The profession of nursing is guided by standards of practice and nurse practice acts. #! The • Standards of Nursing Practice published by the ANA help to ensure quality care and serve as legal criteria for adequate patient care. #!

‣ diagnosis#! ‣ outcomes identification#! ‣ planning#! ‣ implementation#! ‣ evaluation •The second part of Standards of Nursing Practice focuses on professional performance. #!

Socialization • to professional nursing is a process that involves learning the theory and skills necessary for the role of nurse. #! • Benner’s Novice to Expert Model:#!

Nursing (AACN). #! • National League for Nursing (NLN) competencies:#!

• Licensed Practical Nurse or Licensed Vocational Nurse#! • Registered Nurse#!

Licensed Practical Nurse or Licensed Vocational Nurse • Two types of licensed nurses:#!

• LPN/LVN: #!

• To obtain the RN credential, a person must#!

• program or a 3-year diploma program. #!

• Master of Science in Nursing (MSN)#!

RN • who has met advanced educational and clinical practice requirements at a minimum of a master’s degree level and provides at least some level of direct care to patient populations.!

• Doctor of Philosophy (PhD) and Doctor of Nursing Practice (DNP)!

Certifications • Nurses may become certified in a specialty. #! •Each nursing certification has minimum work experience and education requirements. #! After • meeting required criteria, nurses must pass an examination and maintain specific continuing education and work requirements. #! •There are certifications for RNs as well as nurses with master’s degrees and other APNs.!

Professional Nursing Organizations The • American Nurses Credentialing Center (ANCC) awards Magnet Recognition to hospitals that have shown excellence and innovation in nursing. •The ANA is a professional organization that provides standards of nursing practice. ! The • National League for Nursing (NLN) outlines and updates competencies for practical, associate, baccalaureate, and graduate nursing education programs. ! •The Joint Commission is the accrediting organization for health care facilities in the United States.!

Future Directions • People worldwide are living longer and healthier lives.#! •Larger portions of the population are in retirement, with a consequent strain on both health and pension systems. #! As • the 21st century began, many organizations worked to make safety in health care a priority: AACN, IOM, TJC.

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Nursing Shortage •WHO: 70% of countries that participated in the survey were experiencing a nursing and midwifery shortage. #! • It has been forecast that in the United States, the shortage of nurses could reach 500,000 by 2025. #! With • an insufficient number of nurses to care for patients, nurses face an increased level of stress, which can be expected to have an adverse impact on job satisfaction.

Quality and Safety Education (QSEN) for Nurses! •The QSEN for Nurses initiative adapted the IOM competencies for nursing. #! • The IOM report outlined five core areas of proficiency: !

The • Essentials of Baccalaureate Education for Professional Nursing Practice are provided and updated by the American Association of Colleges of Nursing (AACN) (2008). !

programs.!

Institute of Medicine Report • Nurses should practice to the full extent of their education and training. #! • Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression. #! • Nurses should be full partners with physicians and other health care professionals in redesigning health care in the United States. # Effective workforce planning and policy making require better data collection and an improved information infrastructure.!

National Patient Safety Goals • • • • • •

Identify patients correctly #! Improve staff communication #! Use medicines safely #! Use alarms safely #! Prevent infection #! Identify patient safety risks #!

! Independent Nursing Practice • Prevent mistakes in surgery

• Nurses have attained a certain degree of autonomy. #! • Nursing has a code of ethics that reflects current issues.#! As • employees of organizations, nurses do not always have full freedom in deciding on patient care within the defined scope of nursing practice. #! • NPs are increasing independence in their practice. !

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