...Chamberlain College of Nursing NR501: Theoretical Basis in Advanced Nursing September 2015 Orem’s Theory and Leadership Nursing theory can be used to help solve problems in any aspect of nursing. It can solve problems in general nursing as well as leadership and management issues. The topic or specialty is not necessarily the basis on which nursing theory should be used to solve the problem because many different theories double to cover multiple disciplines. In this paper we are going to discuss Orem’s theory. Orem’s general nursing theory encompasses the ideas that self-care is necessary for the benefit of health and that as nurses we are designated to assess and find the self-care deficits and recognize who is needed to be able to perform the action (nursing) for the individual, and this relates to many nursing issues because it basically defines the role of the nurse to the patient in recognition to total care of the patient. And no matter what specialty you are in the main goal is adequate patient care. This paper will discuss a problem that happens far too often in home health. Patients are turned away daily because of assessment. Nurses in leadership positions such as administrators, directors, and admissions nurses are turning away patients because their needs are not expressed well in referrals and discharge / admission assessments. Also, discussed, will be the strategy to fix this problem by using the middle range theory on self-care deficit by Orem. Problem...
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...Frameworks: A care plan for Mrs Ashton. The following essay will outline and describe the assessment, care plans and evaluation for an adult patient using Orem’s model of nursing. The patient’s name has been changed in order to protect her right to confidentiality which is a requirement of the NMC code of conduct (NMC 2008). Mrs Ashton is 71 years old and she was admitted to hospital following an episode of severe shortness of breath. She suffers from Asthma and has a history of recurrent chest infections and bouts of bronchitis, which she takes antibiotics for in the winter. She takes Salbutamol 100mgs three times a day. However, over the last week she has been feeling very tired and reports an inability to sleep because of the tightness in her chest, coughing up sputum and wheezing. She has lost her appetite and is unable to carry out her usual activities because she experiences difficulty breathing. Mrs Ashton lives alone in a first floor flat. Her husband died five years ago, her only son lives a few miles away and he visits once a week with his children. Mrs Ashton’s difficulty breathing was noticeable during the initial assessment as she had to take long pauses while communicating, her respiration rate was rapid and wheezing was audible. The care plan for Mrs Ashton will be informed by Orem’s Self Care Model. This model takes an individual and holistic approach to health care; it is underpinned by three inter connected concepts namely: the theory of self care, self...
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...the enrolled nurse Introduction Description of Enrolled Nurse National Competency Standards Assessing Competence Glossary of Terms Introduction The Australian Nursing and Midwifery Council (ANMC) is a peak national nursing and midwifery organisation established in 1992 with the purpose of developing a national approach to nursing and midwifery regulation. The ANMC works in conjunction with the state and territory nursing and midwifery regulatory authorities (NMRAs) to produce national standards which are an integral component of the regulatory framework to assist nurses and midwives to deliver safe and competent care. The standards include the national competency standards for enrolled nurses which were first adopted by the ANMC in the early 1990s. These have been reviewed and revised regularly since then. Other standards developed by the ANMC for implementation by the NMRAs include the competency standards for registered nurses, midwives and nurse practitioners, codes of professional conduct and ethics, and a range of position statements and guidelines. The full list of standards, position papers and guidelines produced by the ANMC can be viewed on the website. The national competency standards for the enrolled nurse are scheduled for review in 2007. This review will be undertaken by a team of expert nursing consultants and will include extensive consultation with nurses around Australia. The purpose underpinning the review will be to contemporise the standards to reflect...
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...WORD COUNT 4399 The assignment will discuss a critical incident from a nursing management perspective, being an admission assessment experienced during placement. It is not a care study. There will be an overview of the nurse-managers responsibilities during the admission assessment and attention drawn to local and government policy. Particular consideration is given to risk assessment, Essence of Care (DoH 2001) in respect of the Waterlow Pressure Damage Assessment (1985), pressure sores, nutritional screening and delegation. Other issues considered will be communication, partnership working, the therapeutic relationship, and the nurse as an agent of change. Findings will be supported by literature. Identifying factors have been changed to respect patient confidentiality. Mary had no previous psychiatric history. She was eighty-four and lived in residential accommodation. She had two adult daughters who were unable to attend Mary’s admission. Prior to admission Mary’s behaviour had changed over several weeks and she had been refusing to get out of bed during the day. During admission she showed occasional signs of confusion but was able to give consent. Physically, Mary was in a wheelchair, had a history of falls, pressure damage, skin flaps. and needed full assistance with mobility. My mentor facilitated her admission assessment. I observed this in preparation of undertaking future ones myself whilst under supervision. From a management perspective my mentor who was the...
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...Application ORIGINAL XXX 1541-5147 ARTICLES International of Orem’s Self-Care Deficit Theory and Standardized Nursing Languages in a Case Study of a Woman With Diabetes IJNT Malden, USAJournal Inc Blackwell Publishing of Nursing Terminologies and Classifications Application of Orem’s Self-Care Deficit Theory and Standardized Nursing Languages in a Case Study of a Woman with Diabetes This paper aims to illustrate the process Coleen P. Kumar, RN, MSN, CNS, is Assistant Professor of Nursing, Kingsborough Community College, Brooklyn, New York. Introduction As the average lifespan is extended, more individuals are coping with chronic illnesses such as diabetes, which has reached epidemic proportions with more than 20 million people in the United States having this diagnosis (Gordois, Scuffham, Shearer, Oglesby, & Tobian, 2003). The American Diabetes Association (ADA) estimates that a million people will be diagnosed of diabetes every year (2004). Long-term complications of diabetes are costly to both the individual and the healthcare system. Over the past decade, diabetes research has focused on pharmacological approaches and lifestyle interventions to the illness (Odegard, Setter, & Iltz, 2006). Recent evidence in the forum of diabetes care revealed a need for healthcare professionals to assess and empower individuals in the self-management of this illness. For the purposes of this case study, health assessment by nurses was defined by Fuller and Schaller-Ayers (2000) as a process...
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...Journal of Nursing Research, 32(8), 1055-1072. This journal covers the important stages of the Learning needs assessment and how it impacts every educational process that is aimed to inform changes in practice and policy for continuing professional development. Professional opportunities have been widely used as a basis for the development of learning needs assessment. This article reports on the development of a learning needs assessment questionnaire for Community Health Nurses (CHNs). Exploratory and confirmatory factor analyses were conducted to examine the consistency of factors underpinning the Canadian Community Health Nursing (CCHN) Standards. Also, validity and reliability of the questionnaire were evaluated using appropriate techniques. This process resulted in a valid and reliable CHN learning needs assessment questionnaire to measure learning needs of large groups of practitioners, where other forms of measurement cannot be feasibly conducted. Aydin, A.K., & Karadaq, A. (September-October 2010). Assessment of nurses knowledge and practice in prevention and management of deep tissue injury and stage 1 pressure ulcer. Journal of Wound, Ostomy, and Continence Nursing, 37(5), 487-494. This is a good overview from a well-known nursing journal that focuses on a descriptive study on how to determine a nurses knowledge and usual practice and prevention of deep tissue injuries. It gives an in depth explanation on the methods and assessment tools used for nursing education...
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...Concept Comparison and Analysis across Theories UOP Theoretical Foundations of Nursing NUR/513 Concept Comparison and Analysis across Theories Nursing theory is relatively new and as such, it continues to evolve as new knowledge is gained. There are numerous theories of nursing, each of which took years to develop and most of which continue to evolve and adapt. There are commonalities between and among the existing theories although each may focus more heavily on different aspects of responsibilities. It has to do with the philosophical foundations for each theory. Moore, (Moore, 2008) reported a nursing metaparadigm of four basic concepts: "person, health, environment, and nursing." Another author suggested the core concepts of nursing theory and practice are caring, assessment, teaching and learning, collaboration, managing care, communication and professional behaviors, (Opperman Med Law Consulting, 2008). These core concepts as identified by these authors can be found in some fashion in all nursing theories. Orem commented that nurses could do nursing but they could not explain what nursing is (Hartweg, 1991). She was also interested in what conditions had to exist for a person to seek help from nurses (Hartweg, 1991). The first answer she determined was that people sought help when they could not care for themselves (Hartweg, 1991). Orem's work was inspired by those she considered big thinkers, like experts in philosophy, metaphysics and action...
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...Literature Review Patient Education for Post-Hospitalization Home Care Debra Scully Walden University NURS 6010-11 Advancing Nursing through Inquiry and Research April 8, 2012 Patient Education for Post-Hospitalization Home Care Changes in health care delivery brought on by financial constraints have affected the length of stay for certain patient procedures, resulting in an early discharge. Patients discharged from hospitals sooner than anticipated are finding themselves ill prepared, regarding insufficient education and instructions on self-management for home care, post-hospitalization. Patient education in nursing should be a focal priority, yet is often slighted due to time constraints, and lack of staff, preparation and materials. The purpose of this paper is to discuss the importance of sufficient patient education prior to discharge for patients with residual home care. Research on this topic could have beneficial implications for patient satisfaction pertaining to quality education for home care prior to discharge. Evidenced-based research has illustrated that the development of educational tools to aid nursing in providing succinct and pertinent information of discharge criteria has attributed to a rise in patient satisfaction. Considerations for educational materials were preferred language, specificity of patient concerns, and simplicity of educational materials. Summary Contemporary day surgery: patients’ experience of discharge and recovery ...
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...Introduction Health assessment means different things to different people. Barkauskas, Stoltenberg-Allen, Baumann and Darling-Fisher (2002) consider health assessment as the systematic collection of data that health professionals, such as nurses, can use to make decisions about how thy will intervene to promote, manintain or restore health. In this paper, discussion about nursing assessment form of Queen Elizabeth Hospital (figure 1) and Gordon’s functional health pattern (figure 2) are presented, and comparisons between these two assessments on the aspects of structure, comprehensiveness, and applicability will be explained. Comparison between hospital assessment and Gordon’s functional health patterns Queen Elizabeth Hospital admission assessment form and the Gordon’s functional health pattern assessment form also can showed the evaluation of Ms Wong’s condition, Ms Wong was admitted to QEH because of slip and fell with left patella fracture. Both assessment forms had clear subjective and objective data on health perception and elimination pattern. It can provide data for us to making nursing diagnosis and care plan. However, there are something difference in terms of structure, comprehensive and applicability of these two assessment. Structure The format of Gordon’s Functional Health Patterns Assessment form is simple categories and concise typology. This layout is clustering and is easier to understand and complete. However, hospital assessment forms but not...
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...e r 2 Nursing Process Words to Know actual diagnosis assessment collaborative problems critical thinking data base assessment diagnosis evaluation focus assessment goal implementation long-term goals nursing diagnosis nursing orders nursing process objective data planning possible diagnosis potential diagnosis short-term goals signs standards for care subjective data symptoms syndrome diagnosis wellness diagnosis Learning Objectives On completion of this chapter, the reader will: ● ● ● ● ● ● ● ● ● ● ● ● Define nursing process. Describe six characteristics of the nursing process. List five steps in the nursing process. Identify four sources for assessment data. Differentiate between a data base assessment and a focus assessment. Distinguish between a nursing diagnosis and a collaborative problem. List three parts of a nursing diagnostic statement. Describe the rationale for setting priorities. Discuss appropriate circumstances for short-term and long-term goals. Identify four ways to document a plan of care. Describe the information that is documented in reference to the plan of care. Discuss three outcomes that result from evaluation. n the distant past, nursing practice consisted of actions based mostly on common sense and the examples set by older, more experienced nurses. The actual care of clients tended to be limited to the physician’s medical orders. Although nurses today continue to work interdependently with physicians and other health care practitioners...
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...APPLICATION OF NURSING THEORY TO CLINICAL PRACTICE: THE SELF-CARE MODEL OF DOROTHEA OREM Introduction The purpose of this paper is to discuss the application of Dorothea Orem’s Self-Care Model of Nursing to clinical nurse practice. The central thesis of the paper is that Orem’s theory has strong utility for application to modern day clinical practice and can be applied to most any case in order to attain the desired medical and caring outcomes. The presented discussion will support this perspective of Orem’s theory. The paper begins with a brief overview of the theory which is then followed by a delineation of a non-nursing theory that supports one or more of Orem’s self-care notions. The next section of the paper presents a historical overview of the evolution of Orem’s theory, a delineation of the concepts central to the metaparadigm, and an exploration of the theory’s usefulness in education and research. The final section of the paper applies the theory to a particular case. A model of the theory is presented in Appendix A. Orem’s Self-Care Theory Alligood and Marriner-Tomey (2001) state that conceptual or theoretical models of nurse practice are pivotal to the field, providing the profession with a guide to patient care and with a general frame of reference that connects the structural environment to the patters of behavior and relationships within the organization. The Orem Self-Care Model of Nursing (Orem, Taylor & McLaughlin, 2003) is one such model. According...
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...Transcultural Nursing Model Transcultural Nursing Theory Transcultural Nursing Theory was developed by Madeleine Leininger. The theory first appeared in Leininger’s publication in 1991 but the theory itself was developed in the 1950s. Early in her nursing practice, Madeleine Leininger through observation, recognized that there was an important component of patient care that was missing. She noticed the lack of recognition and integration of patient’s cultural background into their plan of care. She recognized that patient’s cultural background influences their responses to health and illness and more importantly she believed that part of viewing the patient as a whole is taking into account their culture and cultural background in developing a plan of care. Her theory attempts to provide culturally competent nursing care through “cognitively based assistive, supportive, facilitative, or enabling acts or decisions that are mostly tailor-made to fit with individual, groups, or institution’s cultural values, beliefs, and lifeways.” The goal is to improve health outcome for people who are of different cultural backgrounds. Transcultural Nursing Theory has 3 components to it, the assessment, nursing care plan and evaluation. Leininger believed that a culturally friendly care for the patient begins with a culturalogical assessment which take into consideration the cultural background of an individual patient in relation to his or her health experience. This assessment also require...
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...but says she has some allergies which she treats with herbs. Her colleague who brought her to the emergency room also claims that Jane has recently had difficulty breathing while taking the stairs up to the martial arts studio and she no longer rides her bicycle to the studio. Jane is in her second year at the local University where she is studying cellular biology. Jane is a bright student who studies a lot and also works part time in the Universities’ research center which gives her extra cash. She admits that she has been having a dry cough for some months which she associated with allergies. She also relates her inability to ride her bike to her allergies. Jane smokes at least one packet of cigarettes on a daily basis, and during assessment appears to be in the pre-contemplation stage. Jane had six months earlier tested positive for hepatitis B. This surprised her a lot because she was asymptomatic. Though she denies drug use, she admits to having multiple sexual partners. She does not want to be in a long-term relationship because she claims it could complicate her life. She also admits to not using protection on a regular basis. Erikson (Burke, 2010) described eight stages through which an individual passes through to adulthood. Every phase is established on successful completion of earlier phases of development. If the challenge is not completed it is expected to re appear in future as a new problem. The psychosocial crisis in later adolescence is individual identity...
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...first adopted by the Australian Nursing and Midwifery Council (ANMC) in the early 1990s. The ANMC was a peak national and midwifery organisation established in 1992 to develop a national approach to nursing and midwifery regulation. The ANMC worked in conjunction with the state and territory nursing and midwifery authorities (NMRAs) to produce national standards – an integral component of the regulatory framework – to help nurses and midwives deliver safe and competent care. educated overseas seeking to work in Australia involved in professional conduct matters. The National Board may also apply the competency standards in order to communicate to consumers the standards that they can expect from nurses. Universities also use the standards when developing nursing curricula, and to assess student and new graduate performance. The ANMC officially became the Australian Nursing and Midwifery Accreditation Council (ANMAC) on 24 November 2010. The name change reflected ANMC’s appointment as the independent accrediting authority for the nursing and midwifery professions under the new National Registration and Accreditation Scheme (the National Scheme) that came into effect on 1 July 2010 (18 October 2010 in Western Australia). These are YOUR standards — developed using the best possible evidence, and using information and feedback provided by nurses in a variety of settings. Included also are the principles of assessment to help you understand how these...
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...Assessment is the first stage of nursing process in which the nurse should carry out a complete and holistic nursing assessment of every patient’s needs, regardless of the reason for the encounter. Usually, an assessment framework, based on a nursing model is used. This assignment attempts to define the points of view of two different frameworks used to collect health assessment data, which are Majory Gordon’s Functional Health Pattern (1994) and The Roy Adaptation Model (2009). The next part would be mentioned about codes of professional, ethical and legal considerations. Finally, I would reflect myself regarding to how to collect and organise patient’s comprehensive health assessment data use these frameworks. The Functional Health Pattern assessment framework is particularly useful in collecting health data to formulate nursing diagnoses (Gordon, 1994, p. 69). Gordon has defined 11 functional health patterns that provide for a holistic client database (p.70). The first pattern is Health perception-health management pattern, is focused on the patient’s perceived level of health and well-being, and how to manage patient’s health. The next pattern is Nutritional –metabolic pattern. This assessment is focused on the pattern of food and fluid intake relative to metabolic need (pp. 80-82). The Elimination pattern is the third pattern. In this pattern, data collection is focused on excretory of the patient. Includes regularity and control of bowel and bladder habits...
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