Middle Range or interdisciplinary Theory Evaluation

MiddleRange or interdisciplinary Theory Evaluation

MiddleRange or interdisciplinary Theory Evaluation

Brain trauma injury remains to be a crucial health concern when itcomes to clinical practice. Nurses face significant challenges caringfor patients who have suffered from traumatic injury. Such patientspresent with a challenging problem considering its sensitivity.Nurses entrusted with the mandate of caring for such patients need toexercise extreme caution to see to it that they realize the bestoutcomes despite the sensitive nature. Notably, because the brain isinvolved, it is essential that the nurse’s in-charge employ themost appropriate measures and approved theories to help in dealingwith the problem. The adverse effects linked to traumatic injurynegates the need to adopt an appropriate form of treatment to attainthe best patient outcomes (Fegin et al., 2013). Various approachescan be adopted by the nurses to deal with the issue. However, theapplication of proven theories is essential in helping deal with theclinical practice problem (Butts, Bandhauer, &amp Rich, 2013).

Summary of the Selected Theories

The adoption of theories in nursing practice has been instrumental insignificantly improving the provision of care by the patients. Thefirst model selected is the comfort theory that was developed byKatharine Kolcaba in the 1990s (Krinsky, Murillo, &amp Johnson,2014). It is a middle range theory that focuses on health practice.The theory reiterates the need to ensure that the individual patientneeds are met. Kolcaba provides an example of a patient who has justundergone surgery and is experiencing pain (Goodwin &amp Candela,2013). Under the circumstances, it is essential that the patient isgiven pain relievers to help in the management of the condition. Thetheory further illustrates that the patient must be made to feelcomfortable at any given moment that they are receiving treatment.Through the same, the chances are that the patient will be in abetter position to attain improved outcomes. Also, the theoryindicates the need to aim at achieving contentment when providingcare to the patients. It is essential to determine the perception ofpatients after addressing the problem facing them.

The quality caring model is the other middle range theory proposed byJoanne Duffy (Edmundson, 2012). The theory identifies the need toapply the best form of care to attain effective patient outcomes. Thetheory was developed out of the need to remind nurses theirfundamental role when it comes to the provision of quality care.Duffy acknowledges the fact that nurses have a daunting task when itcomes to the delivery of care to patients (Duffy, 2013). They have tobalance between coordination of healthcare services and supervisionof other personnel. Because of the same, it becomes difficult for thenurses to establish a good rapport with the patients. Nurses havelittle time to interact and create meaningful relationships withpatients. Duffy states that regardless of the difficulties associatedwith the nursing practice, it is imperative for nurses to ensure thatthey provide the best care to the patients. The theory focuses on thesignificance of the creation of a caring relationship with thepatients pointing it out as a “central tenet of practice” (Duffy,2013). The adoption of a quality caring strategy in caring for thepatients helps in patient satisfaction while at the same timeboosting the outcome of treatment. Quality care theory emphasizes therole played by nurses when it comes to the provision of services topatients (Edmundson, 2012). The behaviors adopted by nurses in apractice environment should be one that focuses on quality care.Through the same, the possibility to attain the best patient outcomesis highly likely.

Evaluationof the Theories

The QualityCaring Model

The quality-caring model illustrates the hidden value of nursingwhich is caring, guiding practice and establishes the application ofevidence-based care. The model is appropriate in the approach ittakes when it comes to caring for patients. Notably, it integratesthe aspect of evidence-based practice in providing services topatients. The model can be used in a typical hospital environmentconsidering the framework that it adopts when it comes to serviceprovision. It identifies quality care provision to be the primaryconcern of each nurse. Notably, the model has three major aspects tobe applied by the nurses when providing services to the patients.They include the caring values, behaviors, and attitude (Smith, &ampParker, 2015). They have been identified as the dominant factors whenit comes to caring for patients. The integration of the three factorsis essential in helping achieve the best outcomes of treatment.

The model is appropriate and can be applied by nurses in a typicalhospital environment to offer care to patients. It reiterates theneed for nurses to embrace the identified concepts and ensure theyachieve the best care. Mainly, it states that nurses need to createmeaningful relationships with patients as a way of ensuring that theyget the best outcomes of treatment. The placement of nurse-patientrelationships as a hallmark of the therapeutic process makes themodel appropriate for use in treatment. Through the application ofthe model, patients get the feeling that they are indeed special andthat they are cared for by the service providers. Through the same,it becomes easier to achieve the best outcomes. The identifiedaspects of the quality care model make it applicable in nursingpractice and can be embraced by nurses for use in the discharge ofservices to patients.

The ComfortTheory

The ability to provide quality care that results in the best patientoutcomes is determined by the foundations laid down by the comforttheory. The theory, adopted by Boudiab and Kolcaba (2015) states thatrelief, transcendence and ease to be crucial aspects to be focused onwhen providing care to the patients. The theory has its strengths andweaknesses but can equally be adopted in caring for the patients. Thefact that it emphasizes the need to have patients be comfortablemakes it applicable considering that some patients suffer fromvarious ailments affecting them. The theory can mainly be applied topatients with conditions such as cancer that are exceedingly painful.For example, under the sub-area of ease, the focus is made onunderstanding how a particular patient feels after the introductionof an appropriate intervention. Indeed, the theory will be helpful inenabling patients to get to appreciate the efforts being put inmaking them feel comfortable despite the pain they are suffering fromthe disease.

The comfort theory is equally helpful about the sub-area oftranscendence. Notably, it provides the patient the ability to riseabove the challenge they are facing through efforts presented by thenurse (Boudiab, &amp Kolcaba, 2015). The approach is essential inthe realization of the best patient outcomes making it appropriatefor use when providing care. However, the comfort theory may not bevalid in a case where some patients get to realize the relief thatthey desire. Further, it’s hard to ascertain whether or not thepatient has indeed had the relief of pain and have been able toovercome the challenge affecting them. In such a scenario, thecomfort theory may not be entirely applicable in addressing theproblems at hand.

The Quality-care Theory in Addressing the Clinical PracticeProblem (Traumatic Injury)

Duffy’s quality care model is essential in dealing with the problemof brain trauma caused by injury (Duffy, 2013). The sensitive natureof the condition negates the application of quality care to ensurethe achievement of the best patient outcomes. Quality care goesbeyond the use of the best treatment methods rather, the creation ofa good relationship with the patients to help them in the recoveryprocess (Edmundson, 2012). Patients who have suffered brain injurycould develop anxious feelings regarding the condition as most ofthem are worried about the detrimental effects associated with thecondition. The nurse practitioner can employ the quality care modelto reassure the patient of the chances that they have for recovery.

The quality care theory identifies the need to adopt the bestpractices when it comes to execution of nursing practice. Itsapplication in nursing practice, particularly in caring for patientswho have suffered from traumatic brain injury could lead to theachievement of the best outcomes of treatment. The theory has beenproposed in such a way that it addresses the contemporary issues innursing practice. The theory can be used to help in dealing withtraumatic brain injuries and the introduction of ways to which theproblem can be addressed. Different methods have been adopted when itcomes to the provision of care. However, the use of quality caremodel helps in ensuring that patients get well as soon as possible.It is vital that his application of the quality care model be alignedwith the hospital practice environment. Patients who have beendiagnosed with the condition need a combination of various factorsalready being used in the hospital to attain the best treatment.Nursing behavior that has typically been identified as beingessential in the provision of services should be linked with qualityof care model to help patients suffering from brain injury. Theapplication of quality care model helps in the creation of a goodrapport with the rest of the clients (Duffy, 2013). It is a theorythat would be instrumental in helping attain the most desired patientoutcomes.

Patients who have suffered a traumatic injury are at risk ofdeveloping other brain-related disorders. The situation couldescalate and cause more problems to the patient especially if cautionis not taken to provide the best care. The adoption of quality caremodel by nurses caring for the particular patient is essential inachieving the best outcomes. Notably, the application of theory willfocus on prevention of other confounding diseases likely tojeopardize treatment. Duffy identified the need to have nurses aim atthe realization of the best patient outcomes by the application ofthe theory (Duffy, 2013). For example, there is the aspect ofestablishing a good relationship with the patients affected. Theapproach is particularly useful in helping the affected patientsunderstand the best approach to dealing with the condition. Theestablishment of a good relationship with the patients makes iteasier to provide instructions on how to manage the condition afterbeing discharged from the hospital. Nurses adhering to the qualitycare model will make it their responsibility to provide the best careto the patient who has suffered from traumatic injury. The approachwill be instrumental in protecting them and assisting fasterrecovery.

of Why the Theory was selected

The quality caring theory has indeed illustrated its appropriatenesswhen it comes to nursing practice. Nurses have the mandate to ensurethat they provide the best care to the patient for the realization ofdesirable outcomes. However, the service providers have not been ableto do so considering the nature of the job they do and the challengesassociated with the same. The theory was selected because itacknowledges the challenges faced by the nurses while at the sametime reminding them of the duty to employ the best therapeuticapproaches regardless of the situation facing them. The theory hasalso been selected because of the factors that it identifies as beingcrucial in a practice environment. It insists on the need for nursesto aim at the realization of the best patient outcomes (Duffy, 2013).Notably, there is the aspect of nurses adopting the right attitude,behavior and value for caring for patients as they execute theirpractice duties. Indeed, the theory can be used by the nurses becauseit is simple and can be implemented in a typical hospitalenvironment. For example, despite the challenges faced in the courseof service provision, with the adoption of the right attitude andbehavior, it is possible to ensure that the best patient outcomes areequally realized. The theory is useful since it puts a priority onthe realization of the best outcomes for patients while at the sametime acknowledging that nurses operate in a demanding environment.The fact that it encourages nurses to give their best in caring forthe patients could serve as a motivating factor to raise the staffmorale in executing tasks assigned to them.

Refining of the Clinical Practice Problem

The adoption of quality caring model in treating patients withtraumatic injury is appropriate over other medical approaches appliedbefore in the achievement of the best patient outcomes after adefined duration of time.

Integrationof Sociological and Behavioral Theories

Sociological and behavioral theories have found much application inadvanced nursing practice in recent times. The theories have beenadopted to guide in the provision of services to patients. Thetheories have been integrated with the day to day practice to ensurethe achievement of the best patient outcomes. The social cognitivetheory, for example, has been used when it comes to facilitatingcommunication among the healthcare providers. The theory is in linewith behavioral models since it illustrates the concept of change.The theories can be used by nurses to guide practice.

Significance of biomedical theories or models to health and healthcare delivery

Biomedical theories have found important application when it comes tohealthcare delivery. The importance of the theories emanates from thefact that they guide decision-making and the manner in which nursepractitioners execute their duties. Nurses applying the biomedicaltheories are in a better position to provide quality care to thepatients. The models also guide how nurses relate to each other. Themodels are particularly influential when it comes to the concept ofleadership in the practice environment. The models have an impact onhealth and healthcare delivery.

Application of Theory to Practice and Nursing Research

Indeed, the application of theory to nursing practice has becomecommon when it comes to the provision of healthcare services topatients (Fawcett, 2012). My awareness of the concept has grownover the recent weeks as I learn how nurses have applied the samewhen it comes to the provision of quality care to the patients.However, questions continue to arise regarding the concept. Forexample, there is the aspect of the level of expertise needed byparticular nurses to effectively apply the same in nursing.


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Butts, J. B., Bandhauer, D., &amp Rich, K. L. (2013). Philosophiesand theories for advanced nursing practice. Jones &amp BartlettPublishers.

Edmundson, E. (2012). The Quality Caring Nursing Model: A Journey toSelection and Implementation. Journal of Pediatric Nursing.http://doi.org/10.1016/j.pedn.2011.09.007

Fawcett, J. (2012). Thoughts about evidence-based nursing practice.Nursing Science Quarterly, 25(2), 199–200.http://doi.org/10.1177/0894318412437967

Goodwin, M., &amp Candela, L. (2013). Outcomes of newly practicingnurses who applied principles of holistic comfort theory during thetransition from school to practice: A qualitative study. NurseEducation Today, 33(6), 614–619.http://doi.org/10.1016/j.nedt.2012.07.013

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