Lecture 5 - Nursing Theory and Research

purposeful set of assumptions or propositions that identify the relationship between concepts

communicates a systematic view for explaining, predicting, and prescribing nursing care • needed to determine the focus and scope of nursing, how it is unique from other health care professionals, and discipline-specific knowledge for professional nursing practice

nursing theory

a unique body of knowledge about the practice of nursing

• Assessment • (Nursing) Diagnosis • Planning • Intervention • Evaluation

• Nursing Metaparadigm • Grand Theories • Middle-Range Theories • Practice Level theories

Illustrates the relationships between: • Nursing - the attributes, characteristics, and actions a nurse provides on behalf of their patient • The Person - the individual receiving care • Health - the degree of wellness or well-being that a person experiences • Environment/ Situation - the person is a part of and interacts with their internal and external environment

Provide a general guide for nurses to follow in abstract, broad situations –> does not provide a specific intervention ex. the general idea that nursing care can be utilized to improve patient care and outcomes

nursing theories that are more limited in scope and present explanations of, or guidelines to follow in more specific situations ex. The Theory of Human Caring - describes that the primary concern of nursing is to “promote health, prevent illness, care for the sick, and restore health”

situation-specific theories that are narrow in scope, focusing on a specific population at a specific time ex. nursing care aimed at lowering incidence of drug use among underage mothers in Ottawa

used to describe phenomena, identify its properties and conditions or factors that predict its occurrence –> DOES NOT ATTEMPT to produce change, only recognize situations ex. if A occurs, then B is likely to follow –> if aseptic procedure’s are not followed, the patient is likely to contract an infection

address nursing actions for a phenomenon, guide practice, and predict consequences –> ATTEMPTS to produce change ex. If A occurs, then B is likely to follow, so C will be implemented to prevent it –> if aseptic procedures are not followed, the patient is likely to contract an infection, so monitoring of aseptic procedures will be implement to prevent this outcome

nursing theories help recognize what should set the foundation of practice by describing the purpose, roles, and responsibility of nurses in the health care setting • serve as rationale or scientific reasons for nursing intervention and the knowledge base for nursing actions

Patterns of knowledge in nursing practice • Empirics - the science of nursing (objective) • Esthetics - the art of nursing (being with people, connectedness) • Personal Knowledge - personal contribution to the field, attentiveness, mindfulness of others • Ethics - the moral component • Emancipatory Knowledge - the social, economic, and political component

the foundation for nursing practice - outlines competencies that entry-level nurses are required to possess upon initial registration with the CNO prior to working as a licensed RN in Ontario

• Entry-level RNs are beginning practitioners - they should not be expected to function at the same level as a senior RN • Entry-level RNs work within the registered nursing scope of practice - they must only work within what they are trained to do, if there is a situation beyond their scope of practice, they are expected to seek guidance • Entry-level RNs must have the requisite skills and abilities to attain the entry-level competencies

professional responsibility and accountability, knowledge-based practice, ethical practice, service to the public and self-regulation EXAM QUESTION

an approach to decision making (about treatment plans) in which the clinician uses the best evidence available, in consultation with the patient, to decide what course of action suits the patient best evidence + medical experience + patient’s preferences = unique treatment plan

• Ask a question that presents the clinical problem • Collect evidence • Critique evidence collected to determined if it can appropriately implemented into the patient’s care • Integrate the evidence into the care plan, along with clinical experience and patient preferences • Evaluation - evaluate the outcome of the care plan and modify if necessary • Disseminate the outcome of the care plan –> pass the knowledge onto others so they can use it too

P - patient population of interest I - intervention of interest C - comparison of interest O - outcome T - time

nursing research is a way to identify new knowledge, improve professional education and practice (skills, treatment plans), and use resources more effectively

poses a question about nursing phenomena that CANNOT be measured and quantified –> requires an understanding of the person in the situation Examples: - ethnography - examining cultures - phenomenology - study of human consciousness and the nature of being - grounded theory - investigates the meanings of peoples interactions and experiences - symbolic interactionism - subjective meanings people attach to things

poses a question about nursing phenomena that CAN be precisely measured and quantified –> does not require an understanding of the person in the situation (only data) Examples: - non-experimental or experimental - cohort - case studies - surveys

the collecting of data on health outcomes in order to gauge the quality of care provided –> can be used to implement better patient care, improve health care provider knowledge and skills, and improve or create new policies