Nr 501 Week 7 Discussion, Application Of Nursing Theory (Latest Update) Already Graded A+

NR 501 WEEK 7 DISCUSSION, APPLICATION OF NURSING THEORY This week we are focusing on the application of nursing theories to evidence-based practice. In NR 500, you explored an area of interest related to your selected specialty track. You then identified an issue/concern related to that area of interest. For this discussion: select a nursing theory or model that can be used as a framework to support the resolution of your identified issue/concern. In your initial response, address the following: • How the selected nursing theory or model is relevant to your specialty track • A brief description of the issue/concern • How the selected nursing theory or model can be used to guide the resolution of the issue/concern Include an example from the literature or your own experience to illustrate your points. Remember to include at least one outside scholarly source. Dr. Wass and classmates, An area of interest specific to family nurse practitioner is the impact of stress on health. In 2003, a study found that 60-80% of primary-care visits likely have has a stress-related component (Nerurkar, Bitton, Davis, Phillips, & Yeh, 2013). Additionally, 20% of adults in a nationally representative sample reported regularly experiencing stress that they would categorize as extreme (Galla, O'Reilly, Kitil, Smalley, & Black, 2015). While the flight-or-flight response of our sympathetic nervous system can be lifesaving when dealing with physical challenges – for example running from an attacking animal - our bodies react with this same response when dealing with emotional threats like our responses to traffic jams, stress at work, financial insecurity, 24-hour news, etc. This stress can potentially negatively impact ones health. McCormack and McCance's Person-Centered Nursing Framework (PCN) is a framework that evaluates patient-centered care outcomes for both the patient and practitioner. As PCN’s foundational premise is that nursing care begins with a focus on the individual person, it is an excellent theory in which to evaluate the impact of stress of an individual’s health. As a family nurse practitioner focuses on prevention and integrating healthy habits into the patient’s daily life, the PCN Framework can guide the practitioner in developing and evaluating outcomes of patient-centered interventions that reduce stress. Stress reduction and stress management can improve health and quality of life. Interventions can be both evidence-based and individualized. An example from my current practice as a bedside nurse that incorporates my knowledge of the impact of stress on a person’s physiological state and considers McCormack and McCance's PCN framework of considering the individual and their environment is the impact of stress on a patient’s blood pressure. When returning from a procedure, a patient’s vital signs are monitored frequently for 3 hours. It is often the case that initially their blood pressure is within normal limits within the first 15 to 30 minutes but then elevates. Upon entering the room due to the alarming blood pressure machine, I often observe that the television is now on and tuned to a news channel. After accessing that the patient is not under any pain or distress and that other vital signs are within normal limits, I comment to the patient that their increasing blood pressure is likely due to stress from watching the news. More often than not the patient does not believe this is the case. At which point I convince them to turn off the news or switch to a relaxing channel and recheck their blood pressure after 30 minutes. The next blood pressure check is almost always within normal limits and the patient expresses surprise and acceptance. Though this is anecdotal evidence, there is an increasing amount of evidence-based practice interventions on reducing stress and improving health. - Michelle Owen References Galla, B. M., O'Reilly, G. A., Jennifer Kitil, M., Smalley, S. L., & Black, D. S. (2015). Community-based mindfulness program for disease prevention and health promotion: Targeting stress reduction. American Journal of Health Promotion, 30(1), 36-41. doi:10.4278/ajhp.-QUAN-567 Nerurkar, A., Bitton, A., Davis, R. B., Phillips, R. S., & Yeh, G. (2013). When physicians counsel about stress: Results of a national study. JAMA Internal Medicine, 173(1), 76-77. doi:10.1001/nternmed.480 Dr. Wass, I am happy to hear that your nephew’s recovery is progressing in a positive direction. I cannot imagine the shock of a stroke at such a young age. In using McCormack and McCance’s Patient-Centered Nursing Framework to support a strategy of change in clinical practice I would apply the four constructs in considering the impact of stress on a patient’s health. There are four constructs in the PCN Framework: prerequisites, the care environment, person-centered process, and expected outcomes (McCormack et al., 2015). As prerequisites focus on the nurse (practitioner), I would ensure that I was prepared for the appointment reviewing my notes on the patient and having some personalized interventions ready to share, making sure that I was prepared to discuss any potentially sensitive topics in a respectful and thoughtful manner. As deciding on lifestyle changes that can reduce stress includes a discussion with the patient on their habits and choices, it is important to create a trusting, therapeutic environment. This will hopefully prevent the patient from feeling criticized and becoming defensive when identifying components of their life that produce stress that leads to negative health impacts. A person-centered approach to the appointment is essential, after introducing the topic of stress and health I would dedicate time to listening to the patient and having the patient identify their stressors and their associated feelings and goals. This would provide the foundation to developing a personalized, evidence-based care plan. Finally, in terms of expected outcomes I would conclude the appointment with a discussion of how the patient felt about their satisfaction and involvement in developing the care plan and their thoughts on if the experience was positive and if not, how to improve the process during future appointments. Reference McCormack, B., Borg, M., Cardiff, S., Dewing, J., Jacobs, G., Janes, N., Karlsson, B., McCance, T., Mekki, T., Porock, D., van Lieshout, F., & Wilson, V. (2015). Person-centeredness - The 'state' of the art. International Practice Development Journal, 5(Suppl. 1), 1-15. Retrieved from There are four constructs in the PCN Framework: prerequisites, the care environment, person-centered process, and expected outcomes (McCormack et al., 2015). As deciding on lifestyle changes that can reduce stress includes a discussion with the patient on their habits and choices, it is important to create a trusting, therapeutic environment. This will hopefully prevent the patient from feeling criticized and becoming defensive when identifying components of their life that produce stress that leads to negative health impacts. The nurse-patient relationship is one of the foundations of nursing. A positive nurse-patient relationship develops through patient-centered communication style and building trust. Goal setting should be individualized and attained through interactive listening and learning between both the patient and the practitioner. Developing a plan is also a collaboration between the patient and the practitioner. Plan development considers the patient’s individual lifestyle, health status, intervention preferences, and personal needs in order to produce a plan of care that the patient believes can be implemented successfully and the practitioner considers effective and safe. and its framework being a means to evaluate outcomes of patient-focused care. I Evidence based practice (EBP) is essential to nursing practice as it provides a foundation in which to significantly contribute to sharing information and determining solutions within the clinical setting. Not only does EBP provide knowledge when discussing plan of care with the interdisciplinary healthcare team, it also provides confidence and manages expectations of patients. I have selected the Family Nurse Practitioner track in order to build long-term relationships with patients with a focus on prevention and integrating healthy habits into their daily life. I am very interested in Power point Nursing knowledge into practice to address a concern using a nursing theory as a framework to solve a problem - Offer a meaningful context for EBP r/t the issue/concern - - explain how the theory or model can be used to guide EBP to address the issue or concern - - discuss unique insights or perspective through applying the theory or model 2. Introduction slide - General information on what will be presented in this PPT - Identify the theory you have chosen - Identify the sections of the PPP 3. Theory or Model - Identify the theory or model that you have chosen to present in this PPT - Provide an overview of the theory or model - Provide discussion in speaker notes - Use in-text citations for scholarly support used to support this slide 4. Relevance to APN - Explain why it is relevant to your selected area of advanced practice nursing (bullet ponts) - Provide discussion in speaker notes - Use in-text citations for scholarly support used to support this slide (backing up what you say with EBP) 5. Issue or Concern - Describe one specific issue or concern within your specific specialty - Explain the imp[act of this issue or concern on heath outcomes - - validate the importanctr of the issue or concern with scholarly report - Provide discussion in speaker notes - Use in-text citations for scholarly support used to support this slide (backing up what you say with EBP) 6 & 7. Theory as Framework for EBP - Explain how the theory or model can serve as a framework to support evidence-based practice to address your issue or concern. How can I implement? 6. Application of Theory or Model - Discuss the unique insight ior perspective offered through applying this theory or model - Provide discussion in speaker notes - Use in-text citations for scholarly support used to support this slide (backing up what you say with EBP) 7. Conclusion - summary of key points Provide speaker notes Prefer use nursing theory but can use borrowed Reference Slide Think of as application of theory paper as theory guiding what you would d Week 5 post Dr. Wass and classmates, McCormack and McCance's Person-Centered Nursing Framework (PCN) is a mid-range theory. The origin of the theory was to develop a framework that evaluates patient-centered care with outcomes for both the patient and practitioner. To analyze the meaning of the model, concepts and relationships are identified. There are four constructs in PCN -prerequisites, the care environment, person-centered processes, and outcomes - with relationships between the constructs (McCormack & McCance, 2006). In terms of logical adequacy the content of this theory makes sense and does have predictive ability, making it useful in applying to nursing practice within a clinical setting. In addition to being useful the PCN is practical. I believe this is due to the straightforwardness of the four constructs, their connectivity in theory and practice, and emphasis on a holistic approach of recognizing the individuality of each patient. The PCN is specific to nursing practice but is highly generalizable as it can be utilized regarding patient centered situations as well as practice centered policies. As to the degree of parsimony in the model, though the four constructs can be stated simply, the details that make up the constructs are complex. The PCN can be supported with empirical data as empirical studies have illustrated that nurses can understand and apply the framework in daily practice (van der Cingel, Brandsma, van Dam, van Dorst & van der Velde, 2016). This is a valid theoretical framework for nursing practice due to its premise that nursing care begins with a focus on the individual person and its framework being a means to evaluate outcomes of patient-focused care. I feel it will be very useful in guiding my future practice as a family nurse practitioner. Nursing care quality as perceived by patients is correlated to person-centered care (Edvardsson, Watt & Pearce, 2017). Patient perception of high quality care is an important component of developing a positive patient-provider relationship and the PCN provides a framework in which to define and develop a holistic, patient-centered clinical practice. • Michelle Owen References Edvardsson, D., Watt, E., & Pearce, F. (2017). Patient experiences of caring and person-centredness are associated with perceived nursing care quality. Journal of Advanced Nursing, 73(1), 217-227. doi:10.1111/jan.13105 McCormack, B., & McCance, T. V. (2006). Development of a framework for person-centred nursing. Journal of Advanced Nursing, 56(5), 472-479. doi:10.1111/j..2006.04042.x Van der Cingel, M., Brandsma, L., van Dam, M., van Dorst, M., & van der Velde, C. (2016). Concepts of person-centred care: A framework analysis of five studies in daily care practices. International Practice Development Journal, 6(2),1-17. doi:10.19043/ipdj.62.006