...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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...Formal Writing Assignment Final Draft: Nursing Case Study SITUATION: You have a very sick patient. You are using this patient for your case study. The patient has a sister who is a nurse- Lori. Lori has been a nurse for many years, and because your patient is her sister, she is very concerned and even a bit suspicious about the illness and hospital care. She writes a letter to you, expressing concerns about her sister. She copies the letter to the Director of Student Nurses. AUDIENCE: You are writing Lori’s letter to you (a student nurse) with a copy to the Director of student nurses. You are writing your response letter to Lori and copying it as a report to the Director of student Nurses. MAIN POINT AND PURPOSE: In this assignment you will demonstrate your ability to: • identify the correct priority problem and nursing diagnosis for a patient • reflect on a patient’s perspective to accurately assess and analyze a condition or problem • use nursing research to identify a priority nursing problem for a case study • utilize research to formulate a nursing diagnosis and plan of care • apply APA format to the writing of a research paper TASK: 1. Write Lori’s letter (1 page). In the letter: • Describe Lori’s biggest concern/issue with the hospitalization or illness of her sister. • Explain why she thinks this is a big problem. • Include a brief description of the events that led to the hospitalization of her sister and information...
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...issues in nursing practice. Caldwell, E., Lu, H., & Harding, T. (2010). Encompassing multiple moral paradigms: a challenge for nursing educators. Nursing Ethics 17(2), 189-199. Retrieved August3, 2010, from Health Source: Nursing/Academic Edition Database. Aim: As society becomes increasingly globalised, it is imperative to include international educational perspectives in the nursing profession (Robinson, Sportsman, Eschiti, Bradshaw and Bol, (2006). Caldwell, Lu & Harding (2010) argue that the quality of nursing care necessitates nurses to reflect on nursing ethics in relation to their individual principled way of life. Cadwell, Lu & Harding (2010) paper explores these ideas. Summary: The fundamental nature of professional development implies personal development (Glen, 2005). ‘Encompassing multiple moral paradigms: a challenge for nursing educators’, is an in-depth analysis of nursing ethical dilemmas; the efforts that are undertaken to implement professional development through reflection, self-monitoring and self-control; and the challenges for nurse educators to integrate the syllabus into real-life clinical practice situations. Caldwell, Lu & Harding (2010) study analyses nursing ethics, Chinese ethical philosophies, and Judeo/Christian traditions as they endeavour to demonstrate the real-life issues of morally conflicting situations in nursing practice within these groups and the possible legal consequences. Relevant to topic yes/no? This paper clearly outlines...
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...just about 50,000 cases every year, in that, during 2008–2009, there were 36,097 reported cases of Clostridium difficile (Health Protection Agency, 2009). Almost the same rate is listed for Germany, highlighting a clear need for decisive action. This research examines the main causes if HCAIs, and discusses the relationship between compliance with hand hygiene guidelines and stress among nursing professionals in one German hospital (Knoll, Lautenschlaeger, & Borneff-Lipp, 2010). This paper explores the factors associated with hand hygiene compliance of nurses during routine clinical practice. The purpose of this research was to clarify whether external factors such as ward capacity, or level of nursing intensity had an influence on nursing staff compliance with hand hygiene guidelines. The research questions in this study are; does hand hygiene between healthcare workers decrease healthcare associated infections (HCAIs)? Does exterior factors influence on nurses compliance with hand hygiene guidelines? The hypothesis of this study is; workload factors like maximum ward capacity, severity of patient cases, have an influence on nurse’s compliance with proper hand hygiene guidelines. Study Variables A total of nine variants were used in this paper. Records from the descriptive interviews were used as dependent variables. The ward-specific workloads considered on one side as the rate of used ward capacity, and on the other as the degree of nursing intensity which were...
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...as “the act of moving power or responsibility from one person or group to another (Oxford Advanced Learner’s Dictionary of Current English 2005)”. In healthcare and clinical context, the term “handover” applies to the transferring of a patient’s information between two health care providers, when the patient receives care in a different location, or when another healthcare provider is responsible of the patient (ACSQHC 2005). The American word “handoff” also signifies the same meaning. Nursing handovers are often being described as a ritual, which stemmed from the medical concept preliminarily in the 1880s, whereby the nursing sister would direct the nurses on duty after hearing reports from the night shift nurses and the doctors’ rounds (Walsh and Ford 1989). The repetitive characteristic of the traditional handover does not encourage nurses to think critically or share different views, therefore depicted as a “ritual” (Kerr et al 2011). 1.1 BACKGROUND OFTHE STUDY The aim of a nursing shift handover is to precisely inform the patient’s general condition, care plan, treatment and expectations in a timely manner (Runy 2008). The process, if made without a systematic standardized method, would lead to errors and jeopardizes patient’s safety (ACSQHC 2010). Reported adverse events from handovers include unnecessary procedure and investigations, delayed diagnosis or treatments, prolonged hospitalization, increased cost, and dissatisfied patients (Patterson and Wears 2010). ...
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...While writing a Nursing critique paper, attention should be paid to the qualitative and quantitative figures in the findings, in order to analyze the context of such findings. This aspect of critiquing nursing research is crucial, in that it enables nurses to provide the highest quality care to their patients. There are various approaches used in the critique of a nursing article. For instance, the best approach requires an individual to begin with an introduction where the purpose of critiquing such an article is stated. They then state the job together with other details of the author of the nursing study. This is done in order to prove whether, or not, the given author has credibility in the nursing world. The next step followed in writing a nursing critique paper is commenting on the title of the article. This gives a clear outline of the topic, depending on whether it properly characterizes and covers the presented content, together with the subject matter. This step could also include details on whether the presented research is supporting a particular need in the health sector. If such an article is able to meet the key points stated above, then it will make a high quality nursing document. The third step followed, in order to write a good nursing critique paper, is ensuring that all the stated case studies have participants with great records and achievements in the medical sector. The other step that is followed, in this case, includes judging the abstract on the basis...
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...Evidence Based Practice Task 1 Western Governors University Evidence Based Practice and Applied Nursing Research The nursing topic of interest is bedside handover, which is the concept of conducting shift handover at the patient’s bed instead of doing it at the front desk. Part A The article being analysed is: Tobiano, G., Chaboyer, W. & Murray, A. (2012). Family Members’ Perceptions of the Nursing Bedside Handover. Journal of Clinical Nursing, 22, 192-200. The analysis of the primary research report is done in the form of a graph (figure 1). Each of the four analysis areas is rated within a scale of 1-10; 1 denotes extremely weak while 10 denotes very strong. Table 1 then gives justifications for the rating by explaining why each area of analysis was rated that way in the analysis chart. [pic] Figure 1 Table 1 |A1 Article: Tobiano, G., Chaboyer, W. & Murray, A. (2012). Family Members’ Perceptions of the Nursing Bedside Handover. Journal | |of Clinical Nursing, 22, 192-200. | |A2 Background or introduction |The researchers provided an in depth introduction of the research topic outlining | | |important issues, previous research on the topic and their findings. The introduction | | ...
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...Running Head: Ethical and Legal Issues Paper Learning Team A 1 Ethical and Legal Issues Paper NUR 391 University of Phoenix Francesca Beebe, Amanda Carvalho, Ricci Cornell, Shannon King Ethical and Legal Issues Learning Team A 2 Ethical and Legal Issues Paper How can the American Nurses Association (ANA) Code of Ethics influence a final decision in each of the case studies: Case Study A: End of life, Case Study B: Nursing Negligence? In regard to Case Study A, the ANA has a clearly stated position on end of life care and initiating a Do Not Resuscitate (DNR) with end of life decision making. It states, “Nursing care is directed toward meeting the comprehensive needs of patients and their families across the continuum of care. This is particularly vital in the care of patients and families at the end of life to prevent and relieve the cascade of symptoms and suffering that are commonly associated with dying. Nurses are leaders and vigilant advocates for the delivery of dignified and humane care. Nurses actively participate in assessing and assuring the responsible and appropriate use of interventions in order to minimize unwarranted or unwanted treatment and patient...
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...Belongingness: A prerequisite for nursing students’ clinical learning Tracy Levett-Jones a a,* , Judith Lathlean b,1 School of Nursing and Midwifery, The University of Newcastle, Callaghan, NSW 2308, Australia School of Nursing and Midwifery, The University of Southampton, Nightingale Building (67), University Road, Highfield, Southampton SO17 1BJ, United Kingdom b Accepted 4 April 2007 KEYWORDS Belongingness; Nursing student; Learning; Clinical placement Introduction Summary The concept of belongingness has intuitive appeal. Human beings are social creatures; the need to belong and be accepted is fundamental, and social exclusion can be devastating. This paper reports on the selected findings from the qualitative phase of mixed-methods study that explored nursing students’ experience of belongingness while on clinical placements. The 18 interview participants in this study were from Australia and the United Kingdom. They provided a range of perspectives on belongingness and how it influenced their placement experience. Central to this discussion was their strong belief that belonging is a prerequisite for clinical learning. This theme dominated all of the interviews. Given that the primary purpose of clinical placements is for students to learn to nurse, there needs to be a clear understanding of the relationship between belongingness and learning. With reference to the published literature and excerpts from interview transcripts, this paper proposes that reconceptualising...
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...that are indispensable to learning Study Skills for Nursing Students These suggestions for study skills for nursing students came from nursing faculty and students. Use what you can and if you would like one-to-one guidance to refine your learning skills for nursing courses, call the Student Academic Resource Center at 8235130 and make an appointment with the learning skills counselor. From Sue Wickham, Academic Achievement Center Instructor at Des Moines Area Community College: “Although I haven't designed study skills workshops specifically for nursing students, I have worked extensively on an individual basis with students in our nursing program. What's helped me most in giving study skills advice has been reviewing tests with students to identify the sources of their errors. Based on those interactions, here are a few topics you should emphasize: 1. 2. Time management is a HUGE issue for nursing students. Many of them are parents (often single parents) holding down jobs with odd hours (they're likely to be CNAs). Study groups are an absolute necessity in this program. Students need to rehearse the material actively, honing their teamwork skills, and combine a little social life with academics. The standard suggestions for taking multiple choice tests (e.g. watch out for absolutes) don't go very far. Students need to be made aware of the importance of applying concepts to particular cases, not just memorizing definitions. As they study their texts, they should be alert for...
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...Nurses Manage Patients Who Refuse Nursing Care Procedures Grand Canyon University: NRS 433V March 9, 2014 Nurses Mange Patients Who Refuse Nursing Care Procedures This paper will critique a qualitative research study about how nurses manage patients who refuse nursing care procedures. These articles also explains how nurses view informed consent as not being essential to nursing care procedures. PROBLEM STATEMENT The clinical problem being examined in the research study is the way in which nurses obtain consent prior to administering nursing care procedures, and the way nurses manage patients who refuse any nursing care procedures. By stating that nurses “do not regard obtaining consent as an absolute requirement” also stating that “consent is preferred but no considered essential” the significance is established and a clinical problem identified (Aveyard, 2004). The author identifies the need for further education of nurses on the need to obtain informed consent for nursing care procedures, and the need for more research of this topic. The role of persuasion in situations of informed consent has been widely commented on. Many commentators argue that the health care provider has a duty not only to give information but also to persuade the recipient of care to accept the course of action considered most appropriate for the patients’ safety. PURPOSE and RESEARCH QUESTIONS The study clearly identifies the aim of the study as “to examine the way in which nurses...
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...XXXX-XXXXX XXXXXXXXX RECOGNIZING AND ACTING ON CLINICAL DETERIORATION Assignment NUR2100 Due date: April 29, 2013 Computer word count: 1,913 XXXX-XXXXX XXXXXXXXX RECOGNIZING AND ACTING ON CLINICAL DETERIORATION Introduction Nursing has always been a profession that embraces diversity towards rendering holistic patient care. However, with the constant changes in nursing practice; patient safety has been at risk due to nurse’s competence towards detecting impending patient deterioration that may lead to further complications or even death. It is said that the most important practical lesson that can be given to nurses, is to teach them what to observe (Nightingale 1969). Having the ability to observe and interpret critical situations are the essential key features applied in clinical practice. Effective observation of ward patients is the first step in identifying the deteriorating patient and effectively managing their care (Odell, Victor & Oliver 2009, p. 1993). Studies have shown that poor vital sign recording, lack of knowledge, failure to respond to abnormal signs, lack of knowledge, lack of supervision and failure to report deterioration or seek advice, have all contributed to the suboptimal care of ward patients (Odell, Victor & Oliver, cited in McGloin et al. 1999; McQuilla et al. 1998; Smith & Wood 1998; Hodgetts et al. 2002, p. 1993). With constant observation established, patient safety is implemented and surveillance is then incorporated to be able to...
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...TREATING A PATIENT WITH CANCER: MAINTAINING PATIENT QUALITY OF LIFE Introduction Cancer is one of the most prevalent diseases in the U.S. Case (2011) noted that the 2010 report of the American Cancer Society (ACS) indicated that more than a million an d a half new cases of cancer are diagnosed every year. Along with physical disease, cancer also brings a significant impact on the patient’s overall quality of life (QOL). This paper asserts that for optimal patient outcome, healthcare workers, particularly nurses, need to attend to the cancer patient’s overall QOL rather than simply focusing on the physical disease of cancer. This essay will first address the issue of understanding what constitutes the patient’s QOL. Then key factors that directly affect the QOL are reviewed in the context of current best evidence. That will be followed by a section that addresses the nursing implications of this subject. The paper concludes with a brief summary and conclusion about the importance of maintaining patient QOL in cancer patients. The first element, is thus to define what is meant by “quality of life.” The next section of this paper addresses that specific issue. Defining Patient Quality of Life Before patient QOL can be addressed in a nursing practice, it is essential to understand what is meant by QOL. Bahrami (2011) has noted that no specific, well accepted definition of patient QOL exists. One reason for this lack of consensus on QOL is that life quality is a highly...
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...vs. Baccalaureate Level Nursing- Patient Case Scenario Name: Ogunniran Sesan Grand Canyon University: NRS-430V-O104 August 10, 2013 Education has an important effect on all nurse clinicians, as it does for all health care providers today, and one should be able to move forward as one learn every day .This paper will focus on the differences between an Associate degree nurse (ADN) and a Baccalaureate degree nurse (BSN). Using a clinical case scenario, this paper will also discuss the differences in approach, and the roles that experience and skills play in clinical decisions made by a BSN and an ADN nurse. Associate Degree Nursing An associate degree nurse can be defined as a nurse with two to three years nursing training, usually at a community college. A graduate of this program is qualified to take the National Council Licensure Examination (NCLEX), to become a registered nurse (RN). ADN was founded by Mildred Montage (a nurse educator) in 1956, due to the severity of nursing shortage in the post war years. Friberg, (2011). This program was offered to reduce the nursing shortages and the success of the program was measured in terms of satisfactory level of clinical nursing skills and graduates pass rate on the NCLEX. Baccalaureate Degree Nurses A baccalaureate degree nurse can be defined as a nurse with four to five year nursing training, that consist of a two year general education, followed by 3 year of nursing program. Graduates of this...
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...Do X-rays Requested By Triage Nurses Decrease Waiting Times? Research in Health and Social Care Introduction: Since 1991 when the patient’s charter (Department of Health 1991) was introduced, Accident and Emergency (A&E) departments have been under pressure to see, treat and discharge patients within a certain time period. In 1991 75% of walking wounded who presented to the department had to be discharged within one hour. It was subsequently changed in 2004 when the government decided that 98% of all patients attending an A&E department should be in the department no longer than four hours (Department of Health 2004). And again in 2011 when the department of health introduced the clinical care indicators that relaxed the target to 95% seen, treated and discharged or admitted in 4 hours (Department of Health 2011). Triage nurses within the accident and emergency department are one of the first people to assess the patients who present with an injury or illness. The patient’s condition is assessed and their need for how quickly they require treatment is prioritised. Triage nurses are usually experienced A&E nurses who have many years A&E experience (Dolan et al 2007). Patients are then placed in queues to await assessment by a Doctor or Emergency Nurse Practitioner. Once seen they are then put in another queue to await x-ray if necessary before waiting again to see the doctor/ENP that will interpret their x-ray and decided on the best course of treatment...
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