DNP 815 Which science-based theories do you think are the most useful to the DNP-prepared nurse?
DNP 815 Which science-based theories do you think are the most useful to the DNP-prepared nurse?
Nursing theories are a set of predictive models that support nursing practice today. These theories are essential to nursing practice, scientific research and education because they help in determining what is known and any additional skills and knowledge that is needed.
Lewin’s Kurt change model proposes three fundamental strategies, i.e., unfreezing, movement and refreezing. The first is unfreezing, which supposes disruption. It supposes creating awareness about the need for change, thereby promoting support for said change. The second stage is movement, which means deciding on how to proceed with actual implementation of the change intervention. The third and final stage refreezing, implies assimilating and normalizing the change intervention as standard practice (Teguh et al., 2019). Orem’s nursing care deficit theory describes how the patient’s self-care needs will be met by the nurse, the patient, or by both. Orem’s theory on the other hand is comprised of three related parts: theory of self-care; theory of self-care deficit; and theory of nursing system. The steps in the approach are thought of as the technical component of the nursing process. Orem emphasizes that the technological component “must be coordinated with interpersonal and social pressures within nursing situations.
The DNP prepared nurse will be more equipped when utilizing these two nursing theories because they provide a guidance to nursing. It allows the nurse to provide current best practice care to their patients while also impacting them beyond the bedside. Theories help guide evidence-based research which then leads to best practices and policies. This gives the DNP prepared nurse the opportunity to organize principles that will help evaluate patient care and improve the nursing interventions based on the evaluation findings. The theories can also provide nurses with basis or rationale for making decisions.
Nursing Theories(2021) Orem’s self care deficit nursing theory . available https://nursing-theory.org/theories-and-models/orem-self-care-deficit-theory.php
Teguh, A., Hariyati, R. T. S., & Muhaeriwati, T. (2019). Applicability of Lewin’s change management model for optimization management function in nursing delegation between head nurse and team leader: A mini project in Jakarta military hospital. International Journal of Nursing and Health Services (IJNHS), 2(2), 66-74.
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The nursing profession has remained a unique and evolving specialty, but its development has been complicated by the ever-changing healthcare delivery system. Doctor of Nursing Practice programs prepares nurse leaders for unique roles to address healthcare needs across the quality spectrum (Reynolds et al., 2021). As DNP-prepared nurses, we will have the opportunity to evaluate current practices and implement strategies directed to improve health care within an evidence-based framework. The focus is on translating nursing research into evidence-based standards of care and practice.
Theories serve as a guide and influence how we practice nursing. Kurt Lewin’s three-step theory is highly applicable and widely used, and I think this is the most useful for me as I navigate through this journey. Unfreezing is the first stage of Lewin’s theory wherein the anticipated change must first “unfreeze” the mindset to prepare that change is necessary. Moving is the second stage that follows implementing the change that has been identified. Finally, “refreezing” occurs when the change is successful and stabilized.
DNP-prepared nurses should be able to work productively with other key personnel within the organization and be able to share critical information regarding evidence-based practice with the frontline staff and advocate for the patient’s needs within the complexity of the health care systems (Doyle & Kwong, 2018). As we cross many milestones on this journey, with the ever-changing health care environment at high speed and become systems-level experts, we will have the opportunities to identify quality improvement projects, identify gaps needing improvement, implement strategies, and occurrence of organizational change.
Doyle-Lindrud, S., & Kwong, J. (2018). “Leadership skill set for the advance practice registered nurse.” DNP Education, Practice, and Policy: Redesigning Advanced Practice for the 21st Century, 147.
Memon, F. A. (2021). Improving employee’s engagement in change: reassessing Kurt Lewin’s Model, City University Research Journal, 11(1).
Reynolds, S. S., Howard, V., Uzarski, D., Granger, B. B., Fuchs, M. A., Mason, L., & Broome, M. E. (2021). An innovative DNP post-doctorate program to improve quality improvement and implementation science skills. Journal of Professional Nursing, 37(1), 48–52.
In this course, the focus was placed on theories and how they assist the proposed direct practice improvement project. In nursing, it defines what nurses do and why they practice in a particular way. The frameworks create guides for practice and make nurses unique to other roles in medicine. Other functions they entail are prediction and control. It establishes direction and knowledge as a tool in practice, research, and education. Nurses can understand their purpose in health care without being identified as a task-oriented occupation. Theories provide scientific reasoning and rationale. Levels exist in the order of abstract to more specific. Grand theories are the most abstract, followed by the middle range theories and the practice level theories, which are more specific. In the grand category, there is no particular guidance to intervention but rather more general frameworks. Middle ranges are more limited and address specific phenomena. In this category, testing is feasible. Practice levels are situation specific. It is only appropriate for respective populations within a particular frame of time. Despite their specificity, they are intercorrelated with concepts from the other two levels.
Taking the time to discuss the learned material specific to theory is essential. It allows for reflection on how this material is relevant to the project and its usefulness. As reviewed above, there is a purpose to each one of them. It makes it difficult to assume which one is most useful. It can only be identified based on the purpose of the project and its population. Throughout the implementation process, more than one theory can be beneficial. The nurse’s role is also to be considered. For instance, Callista (2021) supports that the increased knowledge development from these tools has also increased nursing roles. Reports need to continue to improve application and evidence of their usefulness. Implementation and research are not easy to accomplish, but their need in nursing is essential to reinforce the importance of nursing and support the what and the why. The process and its usefulness begin in undergrad work. However, further research is needed to understand why some argue that curriculums to do emphasize the importance ( Soyoung & Ju-Eun Song, 2021).
Callista, S. (2021). Nursing theory makes a practice turn in the 21st century. Aquichan, 21(4), 1–11. https://doi.org/10.5294/aqui.2021.21.4.2
Soyoung Yu, & Ju-Eun Song. (2021). Essential role of theory in nursing research for advancement of nursing science. Journal of Korean Academy of Nursing, 51(4), 391–394. https://doi.org/10.4040/jkan.51401
In nursing science-based theories are mainly focusing on the organization of knowledge based ideas defining the scope of nursing. The breadth of scope of these science-based theories varies to nursing constitutes and tasks provided to nurses and the reasons for the placement of those tasks.
The most common science-based theories in nursing can be categorized as grand nursing theories, mid-range nursing theories, and practice-level nursing theories. The concept of these theories is important in nursing and can provide foundation skills for nurses essential in their nursing practice and to take care of their patients. The significance of this science-based nursing theory for a DNP-prepared nurse becomes important when they need articulating evidence during their practice and need to justify the methodology used by them (McNett et al., 2021).
The science-based nursing theories are used to define the framework effective for the nurses to follow and to shape the parameters for patient care. In absence of science-based nursing theories, the concept of nursing is lacking linear foci and nurses lack of ability to organically pointing back to patients during the process of treatment and meeting their health-related demands.
The DNP-prepared nurse can best utilize these theories to shape the strategies of healthcare facilities for patients while aligning the expected results. For instance, the use of grand theories helps nurses in the establishment of a framework. The governance process becomes easy for nurses when they follow mid-range and practice level theories in the specific scenarios of healthcare services. The Healthcare systems developed based on science-based theories help nurses to take care of the patients holistically while depending upon the needs of the patient.
For instance, the use of child health assessment interaction theory reinforces the DNP-prepared nurses to develop the parent-infant relationship for the sake of quality caregiving services, creating an environment and adaptation of influencing attitude. This theory can also be used by the DNP nurses to provide healthcare services to adult patients while devising advanced treatment strategies to meet the demand of the patients and strengthening the patient-physician bonding.
Dillon, D. (2020). Nursing Theories for Nurse Educators. American Journal of Nursing, 1-9.
McNett, M., Masciola, R., and Sievert, D. (2021). Advancing Evidence-Based Practice Through
Implementation Science: Critical Contributions of Doctor of Nursing Practice- and
Doctor of Philosophy-Prepared Nurses. Worldviews on Evidence-Based Nursing, 93-101
As nurses work towards their DNP, they may move further away from the patient at the bedside. However, the focus cannot move away from the patient. The DNP-prepared nurse may be required to look at processes at an organizational or system level, but we cannot forget our primary focus, which is the patient. In today’s healthcare environment, nurses deal with facilities being short-staffed, having higher acuity patients, and frequent staff turnover. There are days that they complete a checklist and may not be able to care for the patient in the way they would like. I feel Virginia Henderson’s Nursing Need theory is most beneficial to a DNP-prepared nurse.
Virginia Henderson’s Nursing Need theory is based on the basic needs of the patient and the required nursing components needed to care for the patient (Butts & Rich, 2017). These components include the individual, environment, health, and nursing. They can be used by the bedside nurse and the advanced practice nurse.
Some examples of the activities nurses can use to meet these needs include fluid balance, diet, exercise, rest, and prevention of further illness or injury. The intent is for the patient to reach a state of independence. The nurse has an influential role in helping patients reach this state of independence. Using the nursing methodology of assessment, analysis, diagnosis, implementation, and evaluation is not easy in the current healthcare environment (Lopez et al., 2020). As a DNP-prepared nurse, this learner must ensure that system policies, procedures, and processes allow the bedside nurse to continue meeting the required nursing components to enable the patient to reach independence. I feel strongly that we cannot forget the roots of why we entered this incredible profession, which is to care for our patients. That does not change regardless of our role as a DNP-prepared nurses.
Butts, J. B., & Rich, K. L. (2017). Philosophies theories and for advanced nursing practice (3rd ed.). Jones & Bartlett Learning.
Lopez, M., Jimenez, J.-M., Fernández-Castro, M., Martin-Gil, B., Garcia, S., Cao, M.-J., Frutos-Martin, M., & Castro, M.-J. (2020). Impact of Nursing Methodology Training Sessions on Completion of the Virginia Henderson Assessment Record. Nursing Reports, 10(2), 106–114. https://doi-org.lopes.idm.oclc.org/10.3390/nursrep1002001