DNP 815 Select two theories and describe their relevance to your role as a DNP-prepared nurse
DNP 815 Select two theories and describe their relevance to your role as a DNP-prepared nurse
The scientific underpinnings of DNP practice are not confined to nursing science and theory. Nursing theory improves our care by giving its unity and structure, by providing more efficient continuity of care, and by giving us a framework for the effectiveness of our interventions. When DNP-prepared nurses use theory to guide care, they achieve higher quality in their care while simultaneously elevating nursing professional standards, accountability, and autonomy (Zaccagnini & White, 2017). A nursing theory-guided practice is needed, and the DNP-prepared nurses’ responsibility is to become knowledgeable about a broad range of theoretical frameworks for clinical practice. Roy’s Adaptation Theory contains four essential elements: the person receiving care, the environment, health, and nursing. Roy’s model is applicable to all types of nursing practice and research. The other theory that I think it has relevance to our role as DNP-prepared nurses is King’s Theory of goal attainment in the nursing process, which strengthened the theory’s use and applicability in clinical practice.
The DNP-prepared nurses possess advanced competencies for increasingly complex leadership and clinical roles, enhanced knowledge to improve nursing practice and patient outcomes, enhanced leadership skills to strengthen practice and delivery, and manage collaborative efforts with other healthcare clinicians to improve health care (Astalos, 2023). In order for the DNP-prepared nurses to meet the changing healthcare demands, they should be proficient in the following skills:
· Delivering care
· Developing interdisciplinary standards
· Leading and managing clinical care and the healthcare system
· Solving healthcare dilemmas
· Developing healthcare policy
· Reducing disparities in healthcare
· Evaluating evidence-based practices for care
Philosophies and theories of nursing also guide research and practice.
Astalos, L. (2023). The doctor of nursing practice: a guidebook for role development and professional issues. Jones & Barlett Learning.
Zaccagnini, M.E. & White, K.W. (2017). The doctor of nursing practice essentials: a new model for advanced practice nursing. Jones & Barlette Learning.
The application of science-based theories in nursing represents an opportunity for nurses to combine experience-associated knowledge with evidence developed on the basis of scientific rigor. The nursing profession has evolved greatly over time. Moving from dependence upon total medical direction providing basic care into an independent practice modality.
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The central philosophy of the Self-Care Deficit Nursing Theory is that all patients want to care for themselves, and they are able to recover more quickly and holistically by performing their own self-care as much as they’re able (nursing theory,2021). This theory is particularly used in rehabilitation and primary care or other settings in which patients are encouraged to be independent.
A DNP prepared nurse can benefit from this theory(selfcare deficit) because it can easily be applied to a variety of nursing situations and patients. The generality of its principles and concepts makes it easily adaptable to different settings, and nurses and patients can work together to ensure that the patients receive the best care possible, but are also able to care for themselves. Patient education and communication as the main key to its goal attainment .
Another theory that can be beneficial to my DNP role is the theory of Planned Behavior which was developed to predict behaviors in which individuals have incomplete voluntary control. Taking self-esteem and self-efficacy into consideration, the TPB expands on the concept of perceived behavioral control. (keiba,2021). If a patient’s perceived control or self-efficacy or self-esteem is low, the perception and belief that he or she can influence own behaviors in a positive manner is undermined.
This theory enables the DNP prepared nurse to understand how individuals behave across different settings, scenarios and situations. Unlocking insight based on attitudes towards behaviors, norms and perceived control enable practitioners and marketers to understand where barriers exist and how to encourage a change in behavior.
Keiba L. Shaw(2021) patient education , motivation , compliance and adherence to physical activity , exercise and rehabilitation . Pathology and Intervention in Musculoskeletal Rehabilitation (Second Edition), 2016
Nursing Theories (2021) Dorothea Orem – Nursing theorists . Available from ; https://nursing-theory.org/nursing-theorists/Dorothea-E-Orem.php
Clinical nurse specialists apply theory by providing or directing patient care in their work as consultants to staff nurses, and as leaders influencing and facilitating system change. Knowledge of technology and pharmacology has far outpaced knowledge of how to facilitate health behavior change, and new theories are needed to better understand how practitioners can facilitate health behavior change. The Integrated Theory of Health Behavior Change is described, and an example of its use as foundation to intervention development is presented.
The Integrated Theory of Health Behavior Change suggests that health behavior change can be enhanced by fostering knowledge and beliefs, increasing self-regulation skills and abilities, and enhancing social facilitation. Engagement in self-management behaviors is seen as the proximal outcome influencing the long-term distal outcome of improved health status. Person-centered interventions are directed to increasing knowledge and beliefs, self-regulation skills and abilities, and social facilitation. Using a theoretical framework improves clinical nurse specialist practice by focusing assessments, directing the use of best-practice interventions, and improving patient outcomes. Using theory fosters improved communication with other disciplines and enhances the management of complex clinical conditions by providing holistic, comprehensive care.
Patient participation in transitional care is largely based on perceptions of self-efficacy, confidence, and skill. Patient-centric transitional care interventions targeting these factors and delivered beyond the hospital setting may improve care outcomes. Implications and direction for further studies includes conceptual clarity, the study of a broader-reaching patient population demographic, and use of multidisciplinary interventions.
Bailey, A., Mallow, J., & Theeke, L. (2022). Perceived Self-Efficacy, Confidence, and Skill Among Factors of Adult Patient Participation in Transitional Care: A Systematic Review of Quantitative Studies. SAGE open nursing, 8, 23779608221074658. https://doi.org/10.1177/23779608221074658
Many science-based theories have been categorized as grand nursing theories, mid-range, and practice level theories. These theories have not only been involved in shaping the concepts of nursing but are also important in the delivery of healthcare services. The nursing theories tend to assist the nurses in providing quality healthcare services through the integration of skills and knowledge for the achievement of efficiency and efficacy in services (Dillon, 2020). The
implementation of nursing theories in various situations is the need for time to meet the changing demands of the patients. Science-based theories are committed to providing a theoretical framework to support the principles and basic concepts in nursing. The following two theories have been selected to predict the related role of DNP- prepared nurses.
The self-care theory supports the DNP-prepared nursed to focus on strengthening their ability of quality caring the patients by being self-sufficient and responsive. For the provision of appropriate healthcare services, the patient must have some knowledge about self-care.
The concept of self-care is dependent on self-care deficit theory, the theory of self-care, and the theory of the nursing system. The theory is relevant to my role as a DNP- a prepared nurse in terms of providing self-management education to patients suffering from chronic diseases. In the successful application of the self-care concept, there is a high need of knowing about the disease and its relevant remedies.
The second theory that has been selected for this discussion is the culture care theory. The conceptual framework of this theory is based on the importance of the presence of cultural and care knowledge for the provision of quality healthcare services to patients of a different culture. Being a DNP-prepared nurse, the knowledge about trans -culture, will support me to effectively treat patients from different cultures and identities.
The nurse can better perform by following their beliefs about treatment and perceptions about medicines (Rivaz et al., 2021). The nurses with transcultural knowledge and experience can help patients in making the right decision about their health issues and taking the benefits of quality services and affiliation of the physicians. Hence, the presence of specific cultural knowledge can help in the retention of core cultural values relevant to healthcare services.
Rivaz, M., Shokrollahi, P., Setoodegan, E. (2021). Exploring the necessity of establishing a doctor of nursing practice program from experts’ views: a qualitative study. BMC Med Educ, 328 https://doi.org/10.1186/s12909-021-02758-w.
The very foundation of theory building is scientific knowledge. A better grasp of scientific knowledge requires the understanding of philosophy of science, a way the world is seen (Butts & Rich, 2017). Theory deployed to underpin a research is often viewed as a theoretical lens. Nursing theories are examples of scientific theories that underpinned nursing practice, making nurses to be familiar with the term scientific method. Faith Community Nursing Theory is one important science-based theory worth mentioning. Underpinning the study carried out by Rutherford (2019), the theory provides insight into quality of life and overall health of patients. The Faith Community Nursing Theory is another example of science-based theory that has gained momentum in the nursing field. Further, the Health Behavior Theory is also another science-based theory that has gained traction in clinical research and practice.
Furthermore, for my DNP project, the Faith Community Nursing Theory and Behavioral theory are two science-based theories that I hope to deploy as theoretical prisms. My choice of Faith Community Theory to underpin my DNP project is premised on the rationale that everything about practice in nursing is health outcomes (Dewey, 2017). For effective nurse-patient relationship, the Faith Community Nursing Theory assures the this, bringing to focus a relationship deep in trust and solid communication. The Health Behavior Theory is the second theory that will underpin my DNP project. The theory comprises of interrelated variables that explain and predict human behavior in any situation (Alligood & Fawcett, 2017). Additionally, the theory guides the understanding nursing practice toward enduring nurse-patient relationship.
Alligood, M. R., & Fawcett, J. (2017). The Theory of the Art of Nursing and the Practice of Human Care Quality. Visions: The Journal of Rogerian Nursing Science, 23(1), 4–12.
Butts, J. B., & Rich, K. L. (2017). Philosophies theories and for advanced nursing practice (3rd ed.). Jones & Bartlett Learning.
Dewey, J. (2020). Nursing theory. Salem Press Encyclopedia of Health.
My goal behind getting this DNP is to hopefully have the knowledge and skill to step into a leadership role in the education realm of nursing. Preferably, I would like to lead undergraduate nursing education as this is the best place to begin a ripple of strong and knowledgeable nursing worldwide. The two theories I found that pertain to education in the nursing world are the Theory of Carative Caring and the Theory of caring. As said by Wayne in 2021, The Theory of Carative Caring, done by Katie Eriksson, is premised on taking care of humans during their times of need and is the basis of research, clinical practice, and education (Wayne, 2021). This is because the caring aspect of nursing is what drives nursing to begin with, not just the bedside practice but the education end of it as well. Nursing educators have a passion to teach the following generations of nurses this caring aspect to promote and protect human life. As said by Wayne in 2021, the other theory that pertains to education is the Theory of Caring done by Kristen Swanson, and is premised on caring for a valued other through a sense of commitment and responsibility. This theory offers a structure for improving nursing practice, research, and education (Wayne, 2021). This is what drives nursing educators to be the best versions of themselves and allows them to facilitate propre education. These two theories are what will help drive my future in nursing education as well as my future in nursing education leadership.
Wayne, G., B. S. N. (2021). Nursing theories and theorists: An ultimate guide for nurses. Nurseslabs. Retrieved August 26, 2022, from https://nurseslabs.com/nursing-theories/
Sister Callista Roy’s Adaptation Model of Nursing included major elements that included adaptation, person, environment, health, and the goal of nursing (Butts & Rich, 2017). In the goal of nursing, Roy highlighted the need to promote not just the individual’s health but society’s health. She indicated the need for nursing knowledge to focus on how individuals interact with their environment regardless of whether they are sick or not. This interaction with the environment allows the individual to have the best possible health outcomes. As a DNP-prepared nurse with an increased responsibility to look at health and wellbeing from a system level or working with community organizations, Roy’s theory aids in that outlook transition. Also, Roy’s adaptation theory has been used as a conceptual framework in nursing research, and middle-range theories have been developed from her work.
Betty Neuman’s System Model is another that will impact my role as a DNP-prepared nurse. Her model focuses on stressors and the stress response (Akhlaghi et al., 2020). As nurses, we should identify the factors impacting the patient’s response to stress. Those stressors can be interpersonal, intrapersonal, or extrapersonal. In looking at wellness, everything needs to be in harmony. In a leadership role, I must look at the staff I serve and identify their stressors. Working with the team, we can look at the ever-changing needs and stressors in healthcare and find solutions to keep them in a state of wellness. In the healthcare world today, staff are not in a state of wellness, and I hope that with all that I am learning now, I can be part of the solution at my organization.
Butts, J. B., & Rich, K. L. (2017). Philosophies theories and for advanced nursing practice (3rd ed.). Jones & Bartlett Learning.
Akhlaghi, E., Babaei, S., & Abolhassanr, S. (2020). Modifying Stressors Using Betty Neuman System Modeling in Coronary Artery Bypass Graft: a Randomized Clinical Trial. Journal of Caring Sciences, 9(1), 13-19. https://doi.org/10.34172/jcs.2020.003
Nursing theories exist on abstract levels to specific. For the learner in direct patient care, middle-range theories are more relevant as they are not abstract or specific. They address specifics in nursing and are testable. The category does not exclude grand theory work as it is based on its work. Approaching in this matter assists in testing, which optimizes knowledge. The benefits it holds can assist the learner as a guide for practice in various patient care situations. Reed (2022) describes it as a style that advances the understanding and allows one to practice the joy of knowing why something occurred.
A specific theory that was chosen during the proposed direct project is the theory of human caring. The necessity of caring in all aspects of life is a theory the learner finds of essence. It can be used with direct patient care and in the workplace. As health care demands increase, losing the sense of care can be all too easy. Factors adding to the stress include but are not limited to working understaffed, decreased support for coping skills, or learned culture. When this occurs, patients can be placed at risk, and the workplace can become hostile. Nurses, as health care providers, are known for their caring approach, but it does not entail that there is immunity to experiencing a difficult and unhealthy work setting. King et al. (2021) explains that despite nursing being known for its caring attributes, many experiences bullying. The study provides recommendations using the theory of human caring to decrease alienation and increase a sense of belonging.
Another theory that will be of benefit for direct patient care is Orem’s self-care. It focuses on patients’ ability to care for themselves. The model offers direction for practitioners when caring in the outpatient setting. As a primary care provider, this is important for the patient to meet health goals and management of chronic illness. Drevenhorn (2018) used this model with hypertensive patients. The study explains the importance of using this theory to assess patients’ needs and make plants more patient-centered. It suggested that professional knowledge is used, but concepts do not have to follow an order.
Drevenhorn, E. (2018). A proposed middle-range theory of nursing in hypertension care. International Journal of Hypertension, 2018. https://doi.org/10.1155/2018/2858253
King, C., Rossetti, J., Smith, T. J., Smyth, S., Moscatel, S., Raison, M., Gorman, R., Gallegos, D., & Watson, J. (2021). Workplace incivility and nursing staff: An analysis through the lens of Jean Watson’s theory of human caring. International Journal for Human Caring, 25(4), 283–291. https://doi.org/10.20467/HumanCaring-D-20-00050
Reed, P. G. (2022). Midrange Theory Evaluation to Advance Nursing Knowledge. Nursing Science Quarterly, 35(3), 315–320. https://doi.org/10.1177/08943184221092426
As a DNP, my future practice will provide care to underserved populations; therefore, I will use theories that promote self-sufficiency to guide my practice (Nurselabs.com, 2021). Poverty is often a cyclic process; people living in poverty lack knowledge or awareness; thus, their uneducated choices often hinder their recovery. As a community health DNP, it is my job to empathize with the client’s circumstances while aiding them in overcoming obstacles (Nurselabs.com, 2021). For instance, women living in poverty have a lower breast cancer survival rate than their middle and upper-class counterparts. Health care disparities such as these are alleviated by applying Henderson’s theory (Nurselabs.com, 2021). Henderson’s belief that the DNP assists clients in performing health promotion activities that they would do alone, given the proper tools, is an example of my practice purpose (Nurselabs.com, 2021). Much like Henderson, I recognize that early detection is part of the breast cancer dilemma; gaining independence may require a community health fair with free mobile breast cancer screening (Nurselabs.com, 2021).
Another example of community health independence would include nutrition guidance. Poor patients often reside in food deserts and lack the resources necessary for healthy food choices. In this case, Orem recognizes the immediate issue of inadequate food choice selections, and although plans include a community food garden, patients still require nutrients during the growth process (Nurselabs.com, 2021). Hence, I believe Orem would provide weekly food pantry distributions with self-care incentives such as more significant portions or first selections for patients actively involved in gardening. In summary, my DNP practice includes patient personal responsibility and involvement (Nurselabs.com, 2021).
Nurselabs.com. (2021). Nursing-Theorist-Metaparadigm. Nurseslabs. https://nurseslabs.com
Watson’s Caring Model and Orem’s self-care deficit theory are two scientific models that have resonated with me early in my nursing education and practice. These theories align with my DPI project. Patients’ attitudes and beliefs toward health and sickness, autonomy, personality and traits, level of perceived vulnerability, hardiness, sense of coherence, locus of control, self-efficacy, and access to social support and network were presented. The use of counseling skills, patient advocacy, empowerment, professional knowledge, health education, and support of patients was discussed as the nursing application of theories and models for behavioral change. Orem’s nursing theory was integrated with the concepts of consultation, including communication, shared decision-making, concordance, coping, adherence, and self-care Drevenhorn, E. (2018). Strategies and education to improve self-efficacy, health motivation, and knowledge must be incorporated when designing self-care programs. Patients can participate in nursing interventions with their family members might facilitate improving self-care. Self-care was significantly correlated with learning, health motivation, self-efficacy, social support, and access to care. For patients, changing their lifestyle includes performing activities of daily living, including performing self-care.
Nursing science can utilize innovative technologies by integrating them into conceptual frameworks and metaparadigm. For instance, the paradigm of environment and nursing in self-care theory should be re-defined by including the notions of innovative technologies as supported tools for self-management, such as wearable health devices and robotics for real-time nursing monitoring and intervention (Henly et al., 2015). It is not only the technology that is comprised of e-science but also nursing practice in the new era will occur within more regulated related health care systems, with a much higher focus on the cost and the quality of the service that is delivered as patients will appear more complex illnesses and treatment regimens that will require to nurses to have appropriate levels of education, experience, and clinical specialization. Doctoral-prepared nurses are uniquely positioned to advance and apply the science of implementation in practice settings (Henly S. et al., 2015). Nurse scientists can generate evidence on practical strategies and outcomes among healthcare teams to successfully integrate evidence-based practices into routine care. Nurse leaders and educators can apply these findings and use an implementation science approach when leading clinical teams in evidence-based practice changes.
Drevenhorn, E. (2018). A Proposed Middle-Range Theory of Nursing in Hypertension Care. International Journal of Hypertension, 1–11. https://doi-org.lopes.idm.oclc.org/10.1155/2018/2858253
Henly, S. J., McCarthy, D. O., Wyman, J. F., Stone, P. W., Redeker, N. S., McCarthy, A. M., … & Conley, Y. P. (2015a). Integrating emerging areas of nursing science into Ph.D. programs. Nursing Outlook, 63(4), 408-416. https://doi.org/10.1016/j.outlook.2015.04.010