Application of Concepts from Caring Science Paper

Application of Concepts from Caring Science Paper

Application of Concepts from Caring Science Paper

The caring aspect of nursing is profound in improving healthcare quality and patient safety since it emphasizes the need to foster meaningful relationships with care recipients and incorporate a humanistic perspective into nursing practices. According to Karlsson & Pennbrant (2020), increased complexities in healthcare, such as time constraints, increase the risk of nursing practice becoming more technical without the “caring” aspect. As a result, healthcare professionals should understand concepts of caring that underpin the knowledge about the innermost essence of caring reality, including relationship building, cultivating trust, and upholding ethos.

It is essential to note that the science of caring obtains backing from a plethora of grand, middle-range, and practice-level theories. Younas & Quennell (2019) contend that nursing theories allow nurses to articulate nursing practices and justify care interventions. Since nursing theories support the essential concept of evidence-based practice (EBP), this paper elaborates on how theoretical concepts apply to nursing practice and in the realization of desired care outcomes. Further, the paper focuses on pressure ulcers (PU) as a clinical practice problem and nurse training as the ideal preventive intervention while giving special attention to Jean Watson’s theory of human caring.

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An Outcome of Nursing Practice

An outcome of nursing practice that forms the basis of quality improvement initiatives is a high prevalence of pressure ulcers in hospitalized patients. In this sense, pressure ulcers (PU) are among nursing-sensitive quality indicators (NSQI) that prompt collective, evidence-based practices for addressing root causes and risk factors. A plethora of scholarly studies explores the detrimental consequences of pressure ulcers and the associated risk factors. According to Lavallée et al. (2019), pressure injuries (ulcers) are “areas of localized damage to the skin and underlying tissue” caused by prolonged pressure, shear force, and intense periods of pressure. In the same breath, Getie et al. (2020) present pressure ulcers as lesions, injuries to the skin o,r underlying tissues emanating from unrelieved pressure, shear, or friction that occur over a bony prominence. Based on these contentions, it is essential to note that prolonged hospitalization, lack of mobility, limited ability to change positions and ergonomic factors can exacerbate the prevalence of pressure ulcer incidences.

As profound nursing-sensitive quality indicators, pressure ulcers result in overwhelming ramifications if preventive measures are inadequate. According to Getie et al. (2020), skin lesions and injuries to the underlying tissues can be potentially life-threatening and severe. In this sense, a 2017 National Pressure Injury Advisory Panel (NPIAP) report revealed that approximately 2.5 million patients develop pressure ulcers, while 60000 patients succumb to health complications associated with these injuries. Besides contributing to a high mortality rate, pressure ulcers result in pain, discomfort, compromised quality of life, prolonged hospitalization, and delayed recovery (Getie et al., 2020). Finally, they inflict a massive financial burden on healthcare systems. From this perspective, the estimated financial expenditure for tackling pressure ulcers and associated complications ranges from $750 million to $ 1 billion. These ramifications prompt healthcare professionals to implement evidence-based, theory-guided preventive interventions.

A Clinical Nursing Theory

A typical clinical nursing theory contains concepts and propositions that define a theory, describe a phenomenon, and establish the structure and boundaries of the clinical theory. According to Wayne (2023), concepts are words that describe objects or events and form the basic components of the theory. On the other hand, propositions are statements that describe the relationship and interactions between theoretical concepts. For example, my clinical theory entails implementing nurse training programs to prevent pressure ulcers. In this sense, pressure ulcers (PU) prevalence and nurse training are the profound concepts of the clinical practice theory, while prevention of these pressure ulcers is the theoretical proposition since it establishes the impact of concept A (nurse training) to concept B (pressure ulcers).

Measurements of Concepts

Undeniably, nurse training is a crucial strategy for preventing pressure ulcers since it allows healthcare professionals to familiarize themselves with effective practices for addressing risk factors for pressure ulcers, appropriate interventions for positioning patients, and environmental modification approaches. According to Yan et al. (2020), nurse training programs should focus on pressure injury classification, problem-solving, and practical application skills. Similarly, Ebi et al. (2019) argue that structured, organized, and comprehensive training programs for nurses would enhance their knowledge and update their competencies for incorporating new evidence and technologies into collective interventions for preventing pressure ulcers. Therefore, the relationship between nurse training and reduced incidences of pressure ulcers is correlational.

Frequent measurements of the two concepts are crucial in identifying areas of improvement and optimizing the outcomes of the theoretical intervention. Firstly, it is possible to measure the impacts and effectiveness of nurse training programs by using Pressure Ulcer Knowledge Assessment Tool (PUKAT), which assigns knowledge scores to nurses (Ebi et al., 2019). A low knowledge score indicates the need for proper structuring and implementation of training programs. In the same vein, measuring pre-and post-intervention rates of pressure ulcer incidences is crucial. According to Weller et al. (2018), multiple statistical indicators, including point prevalence, incidence density, period prevalence, and incidence, are profound measurement approaches for pressure ulcer rates. Similarly, regular risk assessment practices and accurate examination at the time of administration are crucial interventions for measuring pre-and post-intervention rates of pressure ulcers.

The Clinical Nursing Theory and Watson’s Theory of Human Caring

Nurse training programs can improve nurses’ knowledge and awareness of the intricacies and demands of preventing pressure ulcers and caring for affected patients. It is essential to note that preventing pressure ulcers through nurse training is crucial in cultivating a healing environment that facilitates recovery and averts negative consequences that can compromise patients’ quality of life, dignity, and well-being. Therefore, this proposition aligns with Caritas 8 of Jean Watson’s theory of human caring. According to Gonzalo (2023), carative factor number eight entails “the provision of the supportive, protective, and (or) corrective mental, physical, societal, and spiritual environment.” Further, this element of care entails various processes, including creating a healing environment at all levels, ensuring patient comfort, protecting the dignity of care recipients, and potentiating peace (Gonzalo, 2023). It is vital to note that improving nurses’ knowledge of preventive interventions for pressure ulcers, as well as an evidence-based practice for caring for affected patients, averts the adverse ramifications of pressure injuries that jeopardize patient safety and well-being.

Nurses must understand the standards for preventing pressure ulcers and facilitating the recovery of the affected patients. Lavallée et al. (2019) contend that the current scientific and clinical guidelines recommend a range of evidence-based interventions for pressure injury prevention. These approaches include risk assessment, skin assessment, care, appropriate use of pressure redistributing devices, accurate documentation, repositioning, and correction of compromised hydration and nourishment. Training programs for nurses emphasize these guidelines and equip healthcare professionals with adequate knowledge and awareness of preventive and responsive interventions. As a result, it is valid to attribute nurse training programs to the aspect of creating a supportive environment at all levels.

Discoveries from Readings and the Impact on the Nursing Profession

Upon reviewing scholarly evidence that supports my clinical practice theory, I discovered that nursing theories justify interventions for addressing clinical problems. Secondly, I realized that the current intricacies and challenges in care delivery increase the risk of overlooking the “caring” aspect of the nursing profession. The two discoveries have had positive impacts on my nursing profession. Firstly, theory-guided nursing practice underpins the concept of evidence-based practice (EBP), which emerges as an advanced approach to improving care quality, patient safety, and clinical outcomes. As a nurse, my ability to utilize theoretical concepts and justify practices with the current evidence will translate to improved decisions and practices. Secondly, incorporating the “caring” aspect of nursing necessitates a more humanistic approach to care delivery. In this sense, nurses are responsible for expressing empathy, developing meaningful relationships with patients, advocating for patients, and acting as social, psychological, and emotional support systems rather than over-emphasizing the technical aspect of nursing.

Conclusion

Nurse training is crucial in preventing pressure ulcers by enabling nurses to familiarize themselves with guidelines for preventing incidences of pressure injuries and caring for the affected patients. This theoretical proposition obtains backing from Jean Watson’s theory of human caring which emphasizes the need to provide a supportive, protective, and corrective mental, physical, societal, and spiritual environment. Watson’s theory emphasizes the “caring” aspect of nursing, which entails the formation of humanistic-altruistic systems of values, relationships, faith, hope, and sensitivity to other people’s health needs. The science of caring is essential when developing clinical practice theories in the current healthcare systems.

References

Ebi, W. E., Hirko, G. F., & Mijena, D. A. (2019). Nurses’ knowledge of pressure ulcer prevention in public hospitals in Wollega: A cross-sectional study design. BMC Nursing, 18(1). https://doi.org/10.1186/s12912-019-0346-y

Getie, A., Baylie, A., Bante, A., Geda, B., & Mesfin, F. (2020). Pressure ulcer prevention practices and associated factors among nurses in public hospitals of Harari regional state and Dire Dawa city administration, Eastern Ethiopia. PLOS ONE, 15(12), e0243875. https://doi.org/10.1371/journal.pone.0243875

Gonzalo, A. (2023). Jean Watson’s theory of human caring. Nurseslabs. https://nurseslabs.com/jean-watsons-philosophy-theory-transpersonal-caring/

Karlsson, M., & Pennbrant, S. (2020). Ideas of caring in nursing practice. Nursing Philosophy, 21(4). https://doi.org/10.1111/nup.12325

Lavallée, J. F., Gray, T. A., Dumville, J. C., & Cullum, N. (2019). Preventing pressure injury in nursing homes: Developing a care bundle using the behavior change wheel. BMJ Open, 9(6), e026639. https://doi.org/10.1136/bmjopen-2018-026639

Wayne, G. (2023). Nursing theories and theorists: An ultimate guide for nurses. Nurseslabs. https://nurseslabs.com/nursing-theories/

Weller, C. D., Gershenzon, E. R., Evans, S. M., Team, V., & McNeil, J. J. (2018). Pressure injury identification, measurement, coding, and reporting: Key challenges and opportunities. International Wound Journal, 15(3), 417–423. https://doi.org/10.1111/iwj.12879

Yan, B., Dandan, H., & Xiangli, M. (2021). Effect of training programs on nurses’ ability to care for subjects with pressure injuries: A meta‐analysis. International Wound Journal. https://doi.org/10.1111/iwj.13627

Younas, A., & Quennell, S. (2019). Usefulness of nursing theory-guided practice: An integrative review. Scandinavian Journal of Caring Sciences, 33(3), 540–555. https://doi.org/10.1111/scs.12670

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Summary: A theory can be used to guide practice.  This assignment is an exercise in supporting a clinical practice with theory and evidence.

Directions: Identify an outcome of nursing practice in your area of practice that can be improved.  For example, if you work in home health, you may identify that throw rug use by fall risk patients is too prevalent.  You may be able to use the problem that inspired the theory concepts that you developed in week two.

Briefly support why it is a problem with evidence from the literature. This is not the major focus of the assignment so do not elaborate.

Create a clinical nursing (not medical) theory in the form Concept A | Proposition | Concept B. Think of the structure like two nouns and a verb. While the term proposition is much more complex in the dictionary, in our use it is the connecting term between the two concepts. Examples include Concept A improves Concept B, Concept A is related to Concept B, when Concept A increases then Concept B also increases, etc. When you get to research, you will explore this further as you develop independent and dependent variables. How to use these statistically will come in research and statistics courses.

This clinical theory is identified as an empirical theory when you get to the C-T-E model later in this course. It is empirical in that they can be measured.

Identify and define your concepts. Identify how they could be measured in a research study. Be careful that you do not use compound concepts. If you find the words “and” or “or” in your theory, you are probably too complex.

If you research your question and seek funding, you will need a theoretical model to guide the research. In our assignment, we are using Watson. You will identify the concepts in Watson’s theories that are represented by the concepts you are using in your clinical theory. Match the proposition in her theory with your proposition. To help, the 10 Caritas Processes are Concept A. Choose the one that matches your concept. To clarify, let’s look at Caritas 1 Embrace and use it in middle-range theory. Sustaining humanistic-altruistic values by the practice of loving-kindness, compassion, and equanimity with self/others (Concept A – Very complex and abstract) improves (Proposition) subjective inner healing (Concept B).

Remember that the paper is not about the problem. It is about constructing a clinical theory and matching it to a middle-range theory and conceptual model your clinical theory represents.

Conclude the paper with your discoveries made in your readings and the impact on the nursing profession of your discoveries. Explore, briefly, discovered questions that require further research. Summarize the paper in the conclusion.