Working in a private physician group, transition of care is one of the several issues that this practice is facing currently. Transition can be defined as the transfer of a patient from the hospital to home. When patients are discharged from the hospital after being treated for a chronic illness, ineffective transition can be a challenge. We have created several programs to assist our patients with effective transition of care. The purpose of this paper is to demonstrate how we can use a middle range theory to help solve the issue of ineffective transition of care at the clinic where i practice. Effective transition of care is important to patient care because it create less confusion, patients concerned are answered and their …show more content…
Description of a middle range theory that could be applied to the problem
After reading about several middle range theory, I choose to use the theory of transition by Afaf Ibrahim Meleis . She is a well-known educator and nurse sociology. Afaf is the founder of the transition theory (McEwen &Wills, p 236 , 2014). The transition theory which is a theory that tries to identify individuals experiencing life changes and then finding interventions to assist them. We all know that transitions can have positive or negative impact on a patient‘s health. When nurses are able to identify the period of transition, nurses can create individual appropriate plan of care that can benefit the patient in achieving positive outcomes. She described that the transition theory evolved over the course of about four decades. Her theory main focus is to explain the interactions between nurses and
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Meleis’ transitions theory can be applied to any patient who has been admitted to the hospital and is discharged home or discharge to a skilled facility . This theory helps us understand that every patient is unique in the way he or she handle transition. For example a newly diabetic show readiness to go home demonstrate how he can monitor his blood sugar with confidence. On the other hand, a patient who is an elderly newly diabetic, can’t read, live alone after been admitted to the hospital and treated for CVA and elevated blood sugar .This patient might not be ready for discharge home because it might be difficult for him to adjust in the community. The nurse caring for patients at discharge must ensure that patient are discharged safe home. They also need to do follow up call to ensure that patient follow up with their primary care physician. In addition, from Afaf theory, one can learn that environment and family support can adversely impact the patient transition from one setting to the next setting. For example, a patient who is discharged from hospital to home, with no family support, forgetful and noncompliant with medical regimen .This patient might stay home and never follow up with PCP. However, if the family support was present, the patient could have motivated to go for his follow up apt and be more
At the multidisciplinary meeting, the nurse will collect and assess the information provided by the other disciplines and family members stating that the patient is not at her prior level of functioning and then analyze the information to develop a diagnosis of deconditioning. Next, the nurse identifies outcomes for the patient to get stronger, achieve prior level of function, have activities of daily living (ADL’s) met in a safe environment by planning for home health, equipment, and 24/7 supervision through family or placement in a facility. This will be implemented by coordinating delivery of a walker and a 3 in 1 chair prior to discharge to daughter’s home with the home health agency nurse, physical therapist, and aide scheduled to start that day. In a week, the nurse evaluates that outcomes are being met by following up with patient, daughter, and home health agency evaluating that the patient is getting stronger, ADL’s are being met, and will soon be able to return to living independently. To achieve these standards of practice, every nurse should be aware of her own nurse practice act to ensure to be functioning with in the laws of the nurse’s state and to ensure the best outcomes and safety of the patients. In closing, it is every nurses duty to be the best nurse they are capable of being by looking at the scope of nursing practice which gives us the framework to achieve
Transition shock or reality shock in the NGN is the stress faced whilst moving from the university study phase to hospital based professional practice (Kramer, Brewer & Maguire, 2013). The NGN faces various challenging transition issues, mostly in the first twelve months of their entry into the profession.... ... middle of paper ... ...
Marriner-Tomey, A., & Alligood, M. R. (2006). Nursing theorists and their work. St. Louis, Mo: Mosby/Elsevier.
Choose a caring theory or nurse-patient relationship theory. Provide an overview of the selected theory.
Walker, L.O., & Avant, K.C. (2005). Strategies for theory construction in nursing. Upper Saddle River, NJ: Pearson Prentice Hall.
Walker, L. O., & Avant, K. C. (1995). Strategies for theory construction in nursing (3rd ed.). Norwalk, CT:
Schoening, A. M. (2013). From bedside to classroom: the nurse educator transition model. Nursing Education Research/Educator Transition, 34(3), 167-172.
The nursing key challenges chosen for this essay include professionalism, preparation, personal factors, competency factors, patient-centered care and job satisfaction. These nursing challenges will be thoroughly discussed and supported by current evidence-based research and nursing literature. Transition is defined as a process or period of change from one state or condition to another (Oxford, 2016). In relation to nursing students, it is also defined as students transitioning from one program to another (Oxford, 2016). It is important that students have the ability to be competent in a clinical setting.
& Willis, E. M. explains the middle-range theories were first introduced in sociology in 1960’s then were offered in nursing in 1974 focusing on emerging disciplines because they were available to introduce through research in compare to grand theories. Middle-range nursing theory was established fifteen years later, and is reinforced by repeated criticism of the summary of grand theories and their difficulties in use to research and practice. The reason of middle-range theory is to define, clarify, and predict occurrences that easer to apply in practical situations, and potentially to direct nursing interventions, change circumstances of situations to improve the care and potentially best outcome. Focus on middle-range theory is supported by theoretical framework for research studies, tested by research and use in practice, and scientific end product expressing nursing knowledge. (McEwen, M. & Willis, E. M.,
When a nurse is providing patient care, he/she creates a safe environment for the patient and enables the choice to establish a relationship on a human to human interaction or on a transpersonal level. The patient will be acknowledged as a person with the wholeness of their soul despite their illness or number on the bed. The ten carative factors in this theory are used as an education tool for nurses around the world and should be applied to the different care situations in practice. Nurses use the factors to promote growth in themselves and within the patient. A nurse should respect the patient’s decisions and take the time to fully be present in the moments with the patient. A lot of nurses complain about the time limitations they have and do not provide the necessary amount of time to listen and gather the patient’s perspective of the situation. Another way this theory can be applied to practice is by recognizing the caring moment between you and the patient. This will determine how the relationship will
Walker, L. O. & Avant, K. C. (2011). Strategies for theory construction in nursing. Upper Saddle River, NJ: Pearson Education, Inc.
Parker M. E., & Smith M. C. (2010). Nursing theories and nursing practice (3rd ed.).
McEwen, M., & Wills, E. (2011). Theoretical Basis for Nursing (3 ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.
Theory’s responsibility is to provide nurses with standards that reinforce practice, as well as, for future nursing understanding and delivery. Basically, it provides nursing professionals with a tested way of thought on how to handle certain situations with proven results. The importance of nursing theories to nursing research is the knowledge offered gives nurses the foundation for communicating with others and best practice. Middle range theory according to McEwen & Wills (2011, p 35) are theories that have concrete concepts, that are specific, incorporate a measured number of concepts and characteristics of the real world and are tested for accuracy.
According to nursingjounrnal (2005) Middle range theories are applicable to each aspect of the nurse profession from administration, education, and direct patient care. Since middle range theory lie between grand theory and specific situation theory. Most nurses believed that middle range theory intervention are more specific on solving problem and if implemented at the bedside as intended they will always bring positive outcomes to the patients . The focus on improved patient outcome and patient satisfaction will be the future development in nurse theory and middle range theories lend to this development. Evidence based practice developed through the use of research studies and theory will lead the nurse in to the future practice. According to Meleis (2012) “Middle-range theories are at those levels of conceptualization that could inform nursing practice and research, and thus continue the cycle of advancing foundational knowledge and enhancing quality care”. To understand responses to health and