Middle Range Theory Concepts in Health and Health Care Delivery The theory is important in the nursing profession, and it differentiates according to philosophy, perspective, and scope. Nursing uses conceptual frameworks to guide practice. The middle range is more focused and concrete. It is used to explain precisely or predict a phenomenon. Middle range theory is more amenable to in clinical research and has few concepts used to generate the hypothesis. (McEwen, M. & Wills, E.M. (2014).). Pender used Middle range theory to introduce the health promotion model(HPM). They used personal, biological, psychological and cultural aspects to provide care in clinical settings. (Penda, 1975). Middle range theories will provide growth and development …show more content…
Fawcett and Garrity (2009) explain that use of the evidenced-based practice in clinical practices is not a new phenomenon in health care delivery. DNPs reduce the research-to-practice gap. They have understandings on the use of research findings in clinical settings to provide quality of care to patients (Vincent et al., 2010). DNP nurse searches for strategies to produce a good outcome in care delivery models using concepts from quality improvement, psychosocial and cultural ideas. The DNP scholarly project, identifies, evaluates care delivery models and the need for change. In My role as a DNP practice scholar, I will address the critical skills essential for translating the evidence-based care into practice with the aim of improving systems of care within the clinical setting (Vincent, Johnson, Velasquez, & Rigney, 2010). Besides, the practice competencies and research I will use the nursing skills to measure the outcomes of the affected population as well as communities. I will apply both clinical investigation and theory with affected individuals and families and implement nursing strategies to improve patient outcomes in nursing homes. I will achieve this by focusing on evidence-based practice, evaluation of results from nursing practices, and focusing on quality improvement (Vincent et al., 2010). As a DNP practice scholar, I will conduct research as a means of creating new knowledge within the nursing home clinical settings. The new knowledge can be applied to improving standards of practice (Vincent et al.,
Discussion Post NURS 6531 Week One Nurse Practitioner Competencies Quality As we further our education to become advanced practice nurses (APNs), it is crucial that we understand the behaviors or core competencies expected of all APNs. For the purpose of this discussion, I will evaluate the core competency of quality and how I will integrate this behavior into my daily practice.
A family nurse practitioner could apply theory, information from research, and knowledge learned in class to formulate patient education strategies as well as to create patient education material. The nursing profession advocates for evidence-based practice. This requires the nurse to know, in order to provide proper care. Therefore, it is important to link research to nursing practice because the data collected through research makes it easier to make clinical decisions (Pipe, Wellik, Buchda, Hansen, & Martyn, 2005). An understanding of nursing theory would also prove important in handling nursing dilemmas by offering a systematic guide for handling nursing issues.
My knowledge in the Doctor of Nursing Practice (DNP) continues to expand as I progress through the DNP program. The knowledge I have attained while in the study of the DNP I and DNP II is priceless. For example, recognizing stakeholders and utilizing networking has helped me to progress on my DNP project (Gokenbach, 2012). I also have a better understanding as well as the purpose of a DNP project. My mentors have been great in directing me in remaining on the right track.
Middle Range Theories, a book written by Sandra Peterson and Timothy Bredow (2013), describes the SNPPM model as a middle range theory. Middle range theories address specific phenomena and are more limited in scope, in comparison to grand theories. They are defined as “relatively concrete concepts that are operationally defined and can be empirically tested. They are less abstract than grand theory and more abstract than empirical generalizations or micro theory” (Elo & Kaariainen, 2013). The SNPPM is middle range because it tries to answer questions surrounding the nurse practitioner.
The goal of this literature review is to show the importance of incorporating evidence based practice (EBP) into the clinical and education setting of nursing. EBP education needs to be added to yearly nursing competencies in all settings of healthcare delivery. While EBP and protocols should never replace clinical critical thinking on an individual, patient to patient level, the community deserves the best care, which is current evidence-based. Nurses are accountable for their choices in practice, EBP empowers nurses to question rationale of protocols and physician orders. There has been an attempt to implement EBP into the clinical practice of the healthcare system nationwide.
The nurse’s ability to comprehensively assess the needs of patients and provide evidenced based practice benefits patients by improving outcomes. The use of evidenced based practices assists facilities with achieving accreditation requirements (Grove, Burns, Gray, 2013). Most importantly, nurses receive self-gratification for their
“Concept clarification is an important step in developing useful and useable knowledge in nursing science.” (Tofthagen, 2010). Within the home health field of nursing one of the major and most significant concepts is team work. Simply stated, concept analysis incorporates a method or approach by which concepts that are of interest to a discipline are examined in order to clarify their characteristics or attributes” (Cronin, 2010). Within a home health care team there are Registered Nurses, Physical Therapists, Home Health Aides, Medical Social Workers, Managed Care Coordinators, and Clinical Managers.
Nursing theories greatly influence nursing practices and education. Grand theory and Middle Range theory are the two main subcategories that they fall under. While Grand Theory and Middle Range Theory strive to promote nursing knowledge and patient care, their breadth, abstraction, and practical applicability are very different. Risjord (2019) states that grand theories are broad, abstract frameworks that explain important nursing practice occurrences. Although they cover various nursing care topics, they might not be applicable in some clinical contexts.
The term six research theory course, NURS 495, emphasized the importance of nurse leadership and how nurses can influence positive changes in health care delivery to patients with chronic illness. It also explored the contradictions that exist in nursing practice and encouraged the students to develop a critical and pragmatic approach to client care. The co-requisite clinical course, NURS 499, integrated nursing theory and current best practice on an acute care nursing unit at Medicine Hat Regional Hospital. In this consolidated learning analysis, I will explore a nursing practice event that will illustrate the major issues surrounding the treatment of competing mental health comorbidities in a patient with hoarding behaviors.
The goal is to improve the health and safety of patient while also providing care in a cost-effective manner to improve the outcome for both the patient and the health care system at large. According to Melyn and Fineout-overholt(2005)Evidence-based practice should be a problem-solving approach to clinical practice that integrates a systematic search for critical appraisal of the most relevant evidence to answer a burning clinical question.
In the clinical setting, the nurses’ expertise can be used to make clinical assessments and recommendations for routine care at a lower cost than a physician visit. This would increase the number of patients seen and increase the quality of the care provided. The advance practice nurse would be able to hone in on preventative measures and increase patient education. The advance practice nurse can also make recommendations about practice changes needed to facilitate better health outcomes through the use of evidence-based practice. Nursing leaders are aware of how important nursing science is to provide needed evidence to transform practice, even though, finding the time and resources to support any research activity is often challenging (Stone, 2017).
The practice of nursing evolves daily from theories and philosophies that are proven by researchers, resulting in growth of the medical profession and advanced evidence based knowledge. Philosophies According to Alligood (2014b), philosophies are specific theories that focus on one or more metaparadigm concepts in a wide spectrum philosophical way (p. 43). For a person to understand philosophies it is required to understand the knowledge type, metaparadigms. Metaparadigm Metaparadigm is the vast perspective of a discipline and a way to describe a concern specifically to a profession or department (Alligood, 2014b, p.42).
Before EBP was imbedded into healthcare, nurses relied in the advice of senior nurses and what they learned through education and trial and error. Floranc enightengal ……. However, it wasn’t until the mid-1800s that evidence-based medicine had its beginnings, but did not come into play until the year of 1972. Through many years different modifications, various groups of nurses have drafted their own versions of evidence-based practice guidelines into play.
o The theory is limited to 13 sub-concepts. o It lacks the specific definitions for the concepts and sub-concepts (Dossey, 2010). • Strengths: o Nightingale’s creation of complete nursing care. o Theory’s sub-concepts are timeless.
Giving care to a patient is not a straightforward process because a patient is made up of advanced systems. Symptoms and the severity of a disease process are dependent on a particular patient, and it may not always be uniform from patient to patient. Because of this, nurses must be able to use their knowledge appropriately to help a patient. Nurses use techniques, such as Evidence Based Practice, in order to integrate new and advanced knowledge into their patient care (Canada, 2016). By exercising evidence based practice, nurses effectively seek knowledge, take experience from past situations, and apply this intelligence to best give patient care (Canada, 2016).