Chapter 1 Nursing, theory, and professional practice
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Theorist:
o Florence nightingale- environmental adaptation, hygiene, infection control
o Sister Callista Roy- adaptive open system
o Martha Rogers- energy fields
o Dorothea Orem- self care deficit
o Jean Watson- Caring, dedicated to health healing.
o Hildegard Peplau- relationship between patient/ nurse. Roles and phases;
o Virginia Henderson- gain independence
o Imogene King- Communication focus/ framework
o Betty Neuman- lines of defense/ open systems model
o Rosemarie Rizzo Parse- Human becoming, sum of more than our parts
Conceptual model addresses the 4 concepts of nursing metaparadigm:
o Optimal functioning of human being
o Interaction w/ environment
o Healing/ health promotion
o Nursing’s role
Nursing theories- group of concepts that can be tested and are derived from a conceptual model
Non-nursing theories w/ significant impact:
o Maslow’s hierarchy of needs:
▪ Must meet baser needs before can move on to next level of pyramid, helps ID
nursing diagnosis and prioritize care. From top to bottom:
▪ Self actualization- one’s potential/ growth/ autonomy
▪ Self esteem: self worth, self respect, independence
▪ Love and belonging: affection, intimacy, LOVE
▪ Safety and security: physiological/ psychological threats, stability, shelter/ home
▪ Baser needs- physiological needs: oxygen, water, food, elimination, temp
control, rest, comfort.
o Lewin’s change theory: 3 step process.
▪ Unfreezing: overcoming, changing mindset, right environment created for
change
▪ Moving/change: transition, confusion
▪ Refreezing: change is complete, reinforced, accepted
o Paul’s critical thinking theory:
▪ Nurses analyze data, generate patient care plans, implement plan of action,
evaluate plan of care
o Rosenstock’s health belief model:
▪ Why patients may not comply w/ health promotions, useful for patient
education.
● Perceived risk of getting condition
● Thoughts of severity of situation, consequences
● Barriers of influences that facilitate/ discourage adoption
● Perceived benefits of positive consequences of adopting behavior
o Criteria for nursing profession:
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▪ Altruism- public service, giving.
▪ Knowledge and research- publish/ communicate knowledge to further field
▪ Accountability
▪ Higher education
▪ Autonomy- decision making, self-regulating
▪ Code of ethics- right and wrong
▪ Professional organization- ANA- standards of practice
▪ Licensure
▪ Diversity
Practice guidelines ANA STANDARDS OF PROFESSIONAL PRACTICE
▪ ANA- quality care and serves as legal criteria for adequate patient care
● Standards of practice: responsibilities
o Assessment, diagnosis, outcome identification, planning,
implementation, evaluation
● Standards of professional performance:
o Ethics, advocacy, respectful and equitable practice,
communication, collaboration, leadership, education, scholarly
inquiry, quality of practice, professional practice evaluation,
resource stewardship, environmental health
▪ Nurse practice acts provide scope of practice defined by each state/ jurisdiction
and set legal limits of nursing practice
● Nursing ethics:
o Accountability, advocacy, autonomy, benefice (best interest of
patient), confidentiality, fidelity, justice, non maleficence (do no
harm), responsibility, and veracity (truthful)
▪ Nursing shortage: demographic changing, elderly population increasing, need
for new nurses grows, LACK OF FACULTY IS MAJOR CONCERN
▪ Quality and safety education for nurses (QSEN)
● Deliver patient centered care
● Work as part of interdisciplinary team
● Evidence based practice
● Quality improvement
● Using information technology
National patient safety goals:
▪ Improve accuracy of patient ID
▪ Improve effective communication among caregivers
▪ Improve safety of using meds
▪ Reduce potential for patient harm assoc. w/ anticoagulant therapy
▪ Maintain/ communicate accurate patient med info
▪ Reduce patient harm due to clinical alarm systems
▪ Reduce health care assoc. infections
▪ ID safety risks in hospitals patient population