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Dorothea orem: self-care deficit theory in practice
How does nursing theory impact patient care
Dorothea orems self-care deficit theory and how its used today
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Nursing theories represent abstract ideas relating to the concepts of person, environment, health/illness and nursing. Many nursing leaders provide unique perspectives on the nursing process in relation to the whole of the metaparadigm. Nurses apply the concepts and frameworks described in various nursing theories as a baseline for critical thinking and decision making. (Creasia & Friberg, 2011). The nursing theory that best supports this writer’s proposed solution of using case management and remote monitoring to decrease readmission rates within 30 days is, Dorothea Orem’s self-care deficit theory (SCDT).
Orem’s SCDT is designed from the basic thought that people want to take care of their needs or those of dependent others (Fawcett,
Hospital readmission can impact the patient, nursing practice, the hospital, and the health care system. The patient’s quality of life can be altered physically, psychologically, and economically (Whittaker, 2014) and recurrent hospitalization is a good predictor of increased risk of mortality (Hummel, Katrapati, Gillespie, DeFranco, & Koellig, 2013). Moreover, a patient in an acute care setting has an increased risk of contracting hospital-acquired infections such urinary tract infections, sepsis, C. difficile, and methicillin resistant Staphylococcus aureus (medicare.gov|Hospital Compare, 2013). Nursing practice is impacted as patients spend the majority of their acute care stay with the bedside nursing staff. According to...
Following the QSEN model, this problem is a concern that falls under the safety category. The Institute of Medicine defines safety as, “minimizes risk of harm to patients and providers through both system effectiveness and individual performance” (IOM, 2003). A nurse manager must address this problem because without nurses who are able to work, patients cannot be taken care of in a safe and effective way. As a nurse manager, it would be ...
In the most fundamental form the theory is put into practice using two general steps, modeling then role-modeling. Modeling can be done by acquiring information about how the patient perceives their health in relation to their life, allowing the nurse to see through the patient’s perspective (Campbell, Finch, Allport, Erickson, & Swain, 1985). Once the nurse is aware of the patient’s level of understanding of illness, acceptance level of illness, stage of dev...
Morgan read over each patient assessment in their chart, as well as rounding on each patient daily to gather her own assessment. With all of the data, she came up with diagnosis that was required from her. Morgan stated the nursing diagnosis she most frequently uses is risk for falls. Goals are then set depending on individual needs. By collaborating with the interdisciplinary team in a therapeutic way, interventions are implemented to meet each patient’s needs. Evaluations are performed daily by case managers through interdisciplinary rounding and the goals that were made are assessed and any changed to the plan of care are made. Case managers will follow up with outside facilities that patients transfer to after a hospital admission to evaluate their progress. If a patient is readmitted to the hospital within 30 days of discharge, a reevaluation is
The aim of this essay is to discuss the nature of illness and dependence in relation to the issues that the nurse should take into account when providing evidence-based care. The issues that will be analysed are the nursing process and nursing models, the implications of nursing technology on the nurse, the patient and their family, the psychological issues for the patient and their family, the consequences of disability and chronic illness and the importance of patient-centred nursing. These issues will be discussed, for the most part, in relation to the patient care received by patients admitted to a ‘high tech’ area. The ‘high tech’ area will be, on the whole, focused in a medical high dependency unit in a local general hospital.
How nurses view the patients and the kinds of problems that the nurses manage in practice while they engage in patient care? They need to be certain, precise and just in front of the patients. Their reasoning is sufficient for their expected purpose. All reasoning can be assessed considering these standards, plus as nurses reflect upon their quality of their thinking, they begin to detect when they are being imprecise, unclear, inaccurate or vague. Nurses utilize language to lucidly communicate exhaustive information, which is substantial to nursing care. Therefore, they cannot be focused upon the irrelevant or trivial. Nurses, who think critically, wage all their reasoning and views to these principles, and the assertions of others in that the nurse's thinking quality improves throughout time, therefore, eliminating ambiguity and confusion in the understanding and presentation of ...
Around the 1960s, nursing educational leaders wanted to formulate a nursing theory that contained knowledge and basic principles to guide future nurses’ in their practice (Thorne, 2010, p.64). Thus, Jacqueline Fawcett introduced the metaparadigm of nursing. Metaparadigm “identifies the concepts central to the discipline without relating them to the assumptions of a particular world view” (MacIntyre & Mcdonald, 2014). Fawcett’s metaparadigm of nursing included concepts of person, environment, health, and nursing that were interrelated. The metaparadigm ultimately contributed to conceptual framework to guide nurses to perform critical thinking and the nursing process in everyday experiences in clinical settings.
The nursing theories that are currently in place in the emergency room to promote professional growth and development are vital; however, there are other nursing theories that could be implemented to help improve professional growth and development. A theory that should be implemented to more effectively promote professional growth and development is Orem’s theory of self-care deficit. Orem’s theory is considered a “realistic reflection on nursing practice” (McEwen & Wills, 2014, p. 146). If the nurse is not taking care of him or herself, “stress [can] accumulate [and the] nurse can … become angry, exhausted, depressed, and sleepless” (Ruff & Hoffman, 2016, p. 8). By the nurse having these feelings he or she is not able to take care of him
Nursing is ever-evolving. Healthcare in general is becoming more sophisticated, which requires an increase in knowledge and education, as well as the need for nursing staff to be able to think critically. As medical advances are at an all-time high, reimbursement from state and private insurance has decreased. These factors lead to a greater need of autonomy and evidence-based research by RN’s (Huston, 2014)
Case management has become the standard method of managing health care delivery systems today. In recent decades, case management has become widespread throughout healthcare areas, professionals, and models in the United States; and it has been extended to a wide range of clients (Park & Huber, 2009). The primary goal of case management is to deliver quality care to patients in the most cost effective approach by managing human and material resources. The focus of this paper is on the concept of case management and how it developed historically, the definition of case management, the components of case management, and how it relates to other nursing care delivery models.
Nursing is a multidisciplinary career that encompasses many different aspects into one to be able to provide the best care possible for all patients. Nurses are caregivers, counselors, advisors, teachers, and more, but to be able to do the job of a nurse one must put into perspective the person or patient, the environment, health, and the nurse. These four concepts together create the Nursing Metaparadigm. These concepts directly influence how a nurse will perform care to a patient and the type of nursing practice that will be demonstrated by that nurse. Each concept above may vary from one theorist to another, but they are the most common concepts in all of the nursing theories. While some concepts are more important each concept will influence
Virginia Henderson developed the nursing need theory, which focuses on increasing the patient’s independence to speed up the recovery process (Alligood and Tomey, 2009). This is where my theory begins to connect with hers. Our main duty as nurses is to provide care for the patient while they are unable to care for themselves and facilitate them to be the best individual they can be. For this reason nursing is both a science and an art. It is a science in that nurses must understand the disease processes that are affecting the patient’s health, they must also practice based on evidence that is defended by science, and know how to operate equipment and machines. However, it is an art because it requires unique care for each patient, and each nurse is going to provide care in a slightly different way. The nurse is responsible for following the health care providers plan of care, but the nurse provides the creativity that provides the individualized care. The ultimate goal of nursing is to provide care to facilitate the patient in retaining or maintaining their maximal level of
The purpose of this theory is very specific to nursing and caring. Watson focused the purpose of this theory to the core concepts of nursing keeping both the patient and environment in mind. Each concept addressed in the theory focusing to promote, prevent, and restore health. The purpose of the theory applies to each of the concepts, assumptions, and factors. Watson implies that caring can assist the person to gain control, become knowledgeable, and promote health
Nursing theories are actions care that a nurse provides to a patient to prevent a sickness, maintain and promote health. Many of the theorists contribute to a frame work or a blueprint of how nurses should provide care to patients. Many these theories are part of nursing care and most of them they go hand in hand. Nursing theory aims to describe, predict and explain the phenomenon of nursing (Chinn and Jacobs1978).Nursing is apprehensive with laws and principles governing the life processes and functioning of sick or well human beings. Nursing theories are beneficial in understanding the knowledge of nursing and its application (Smith and Liehr, 2008).
One of the theories of nursing is Dorothea Orem’s self-care theory, also called the self-care deficit theory. Nursing theories are important for several reasons. The profession is strengthened when knowledge is built on sound theory (Black, 2014). Theory is important for reasoning, thinking, decision-making, and supporting excellence in practice (Black, 2014). Dorothea Orem’s theory is a conceptual model that provides a structure for critical thinking in the nursing process (Black, 2014). A conceptual model provides a comprehensive and holistic perspective of nursing (Black, 2014). Orem published her theory in 1959 and continued to develop her model, eventually formalizing three interrelated theories: theory of self-care, theory of self-care deficit, and theory of nursing system (Black, 2014). The focus of Orem’s model is the patient’s self-care capacity. The process helps to design a nursing process specific to each patient that will provide for the self-care deficit of the patient (Black, 2014). Self-care deficits exist when the patient has limitations and the self-care requirement is greater than he patient’s capacity (Manzini & Simonetti, 2009).