DNP 815 Topic 1 DQ1
Topic 1: Worldview And Foundations of Nursing Sciences
Objectives:
1. Analyze the role of nursing theory in practice.
2. Explain the historical development of nursing theory.
3. Analyze personal worldview and theoretical perspective of nursing practice.
Topic 1 DQ 1
Read the “Discussion Forum Philosophy” to acquaint yourself with the expectations of doctoral learners posting in the discussion forum. Define the process of theory building. Identify a historical change or event that had significant impact on the development of nursing theory. Discuss the effect of the change/event on nursing from that point forward, the contribution(s) to nursing that resulted, and how it relates now to successfully preparing the DNP for practice. Provide examples and literature support.
Topic 1 DQ 2
Select a nursing theory that you will use to guide your DNP Project. Define the nursing theory and explain its role and contribution to the profession of nursing and how this nursing theory will guide your DNP Project.
Reflective
Analysis Case Report Component Paper
In this assignment, learners are required to construct a reflective analysis incorporating a personal nursing philosophy. The Reflective Analysis Case Report Component Paper assignment may be written in first-person language as appropriate to express personal perspectives but must otherwise adhere to the guidelines below.
General Guidelines:
Use the following information to ensure successful completion of the assignment:
- Doctoral learners are required to use the current APA style for their essay writing
assignments. The current APA Style Guide is located in the Student Success Center. - This assignment uses a rubric. Review the rubric before beginning the
assignment to become familiar with the expectations for successful
completion. - A minimum of three peer-reviewed references published within the last 5 years is required.
- You are required to submit this assignment to Lopeswrite. A link to the Lopeswrite
technical support articles is located in Class Resources if you need
assistance.
Directions:
Compose a reflective analysis (1,000-1,250 words) incorporating your personal philosophy of nursing, including the following core elements:
1. What is your central belief about the individual person?
2. How does your personal worldview influence your approach
to patients?
3. What constitutes the environment?
4. How do the individual and the environment interact?
5. What is your view of health?
6. How does illness relate to health?
7. How do you think nursing leaders might serve others in ways that promote human flourishing?
8. What is the central reason for the existence of nursing?
Portfolio Practice Immersion Hours:
It may be possible to earn portfolio practice immersion hours for this assignment. Enter the
following after the References section of your paper:
Practice Immersion Hours
Completion Statement DNP-815A
I, (INSERT NAME), verify that I have completed and logged (NUMBER OF) clock hours in association with the goals and objectives for this assignment. I also have tracked said practice immersion hours in the Lopes Activity Tracker for verification purposes and will be sure
that all approvals are in place from my faculty and practice immersion
preceptor/mentor before the end of the course.
Sample 1 Topic 1 DQ1
A historical event that has had a significant impact on the development of a nursing theory goes back to the mid-1800s, the Crimean War.
Environmental Theory Change.
This theory is based on Florence Nightingale’s realization that environmental conditions are related to a patient’s prognosis. (Nursing Theory, nd). Providing equitable healthcare through addressing social determinants of health (SODH) can be increased when addressing patients’ environmental concerns. As with SODJ, patients are affected by unique problems with their illness, and providing care on an individual basis is important. Concepts of Environment Theory: ventilation and warming, light and noise, cleanliness of the area, the health of houses, bed and bedding, personal cleanliness, food. We often assume that these concepts are had by all patients. However, in my current practice, many of the population served are homeless. Poor health outcomes and high utilization are caused by people living in poor environmental conditions. Altering some environments is possible, but much work is needed especially when attempting to provide case management and utilization management to the homeless population.
Nursing theories are developed based on the need to improve practice. Theories are defined through using data from experience and on-site experience, and a passion for improving nursing. Each theory has the support of advocates, addressing changes in the health care system and the way people live. (Dewey, 2020). DNP-prepared nurses use Nightingales’ Modern Nursing theory by being specially educated for positions in healthcare to make changes in improving the quality of healthcare. (Nursing Theory, nd.)
References
Dewey, J. (2020). Nursing theory. https://eds-p-ebscohost-com.lopes.idm.oclc.org/eds/detail/detail?vid=0&sid=71ad8585-65e3-4d3d-9e4b-17b85b85a1be%40redis&bdata=JnNpdGU9ZWRzLWxpdmUmc2NvcGU9c2l0ZQ%3d%3d#AN=113931268&db=ers
Nursing Theory. (nd). Nightingale’s environment theory. https://nursing-theory.org/theories-and-models/nightingale-environment-theory.php
Sample 2 Topic 1 DQ1
Theories for health care, research, and consumers have expanded and evolved rapidly. Many technologies developed in healthcare lack theoretical grounding and scientific evidence to support their need, safety, and efficacy (Smith, & Johnson, 2018). Theories are mechanisms for synthesizing and guiding knowledge generation for the discipline of nursing, including the design, implementation, and evaluation of sensors and related technologies such as artificial
intelligence and machine learning (Smith, & Johnson, 2018). Organizational theories with diverse epistemological roots guide decision-making on components and mechanisms by which change is expected to work and possible outcomes (Smith, & Johnson, 2018).
Rogers’ Innovation-Decision process change theory explained that diffusion of innovation is communicated over time through networks to reach individuals in an organization. stages of change include knowledge of innovation, persuasion, decision to adopt or reject, implementation, and confirmation to adopt or reverse the innovation. The Organizational Theory focuses on the impact of change on organizations and explains how a complex and unpredictable system behaves (Demir, et al. 2022). Organizational theory is made up of System Theory, Complexity and Complex Adaptive System Theory, Chaos Theory, and Learning organizational theory (Demir, et al. 2022). In the Chaos Theory, it is impossible to understand and predict all the dynamic systems, where small changes in a system lead to a more remarkable change in the process. COVID-19 pandemic led to changes in technology which will alter system behavior
long-term and have an effect on all fields of science in the 21st century (Demir, et al. 2022). An organization is a living system and must have the flexibility to adapt to the environment (Demir, et al. 2022). Individuals work together to share ideas, learn, adapt, and offer support in uncertainties and chaos. Chaos Theory in health care focuses on the treatment and care initiatives for meeting the health needs of nurses, patients, or healthy individuals who face challenges within the health care system (Demir, et al. 2022).
Theories have a significant impact on nursing research and have made a major contribution to
the development of nursing knowledge. The organizational Theory model facilitates understanding and promotes the use of the methodology in nursing when it is appropriate to the research question posed (Smith, & Johnson, 2018). Nurse leaders working in complex and chaotic healthcare environments use change theory to move organizations forward to improve patient outcomes, staff competency, safety, quality, regulatory compliance, fiscal outcomes, and ultimately the health of populations (Smith, & Johnson, 2018). Challenges in Chaos theory present themselves in the form of staff that appear resistant or unmotivated to change, limited innovation, complexity in our organizations, quality/safety issues, and internal/external pressures (Smith, & Johnson, 2018). Nurse scientists provide specific examples of chaos theory-guided by, the who, what, where, when, why, AND why NOT theories should be used in health care. Nursing education must promote theoretically grounded and evidence-based theories that are transparent and accountable to health care. As leaders, nurses need to develop general leadership and discipline-specific competencies in nursing professional development (Smith,
& Johnson, 2018).
References
Smith, C. M.., Johnson, C. S. (2018). Preparing Nurse Leaders in Nursing Professional Development: Theories Applied to Leadership in Nursing Professional Development. Journal for Nurses in Professional Development, 34(1), 38-40 DOI: 10.1097/NND.0000000000000404
Demir, Muhammet Sait; Karaman, Ahmet; Oztekin, Seher Deniz. (2022). Chaos Theory and Nursing. International Journal of Caring Sciences, V12 (2), p1225-1228.
Sample 1 Topic 1 DQ2
Florence Nightingale pioneered nursing theory that continues to translate to practice especially in
terms of the quality of care and environmental influences on patient healing. Nightingale’s environmental model and theory of nursing suggests that the patient’s physical and social environment impacts the ability to heal and receive care (Rich & Butts, 2018). This concept holds true today through the ongoing work done in both the acute care and outpatient setting to optimize the physical environment and social circumstances that impact health. Human being, environment, health and nursing are described in Nightingale’s environmental theory. A healthy environment is necessary for healing and often requires modification to meet the changing needs of the patient (Mughal & Ali, 2019).
Sleep deprivation influences the phycological and physiological well-being of patients who are
hospitalized. Environmental factors play a role in the amount and quality of sleep in hospitalized patients. Some of the most common modifiable environmental factors include noise and light (Koçak & Arslan, 2020). Supported by Nightingale’s environmental theory, adjusting these factors can help patients maintain a health circadian rhythm and promote healing. While it may not always be possible to create an ideal environment for sleep for patient’s, improvement can be made using tools that counteract expected noise and light in the hospital. Nightingale discusses the harm of noise to patient healing and acknowledges the pivotal role the nurse plays in optimizing that environment (Rich & Butts, 2018).
References
Koçak, A. T., & Arslan, S. (2020). The effect of using eye masks and earplugs on intensive care
patients quality of sleep and vital signs. Journal of Neuroscience Nursing, 53(1), 29–33. https://doi.org/10.1097/jnn.0000000000000562
Mughal, F. B., & Ali, B. H. I. (2019). Enhancing patient well-being: Apply positive psychology in
nursing practice. Journal of Clinical Review & Case Reports, 4(8). https://doi.org/10.33140/jcrc.04.08.03
Rich, K. L., & Butts, J. B. (2018). Philosophies and theories for Advanced Nursing Practice (3rd ed.). Jones and Bartlett Learning.
Sample 2 Topic 1 DQ2
The Doctor of Nursing (DNP) project selected is a focus on preventing hospital-acquired pressure
injury (HAPI) development. Many nursing theories can be utilized to guide this project from Henderson’s 14 components of nursing to Lydia Hall’s care, core, cure theory. There are also different levels of theoretical works that can apply to nursing practice on injury prevention from philosophies to middle range theories. “Although middle-range theories address specific phenomena within nursing practice, the theories are broad enough to be applied to a variety of patient populations and across many practice settings” (Chesnay & Anderson, 2020).
However, there is a specific theory that speaks to the nature of illness prevention through promoting wellness and that is from Betty Neuman. The Neuman System’s Model is based on general system theory; as well as, drawing from Gestalt theory. It has become a comprehensive guide for nursing practice and has the potential for unifying health-related theories through the examination of nursing intervention and patient responses to stressors as a relationship (Butts &
Rich, 2018). The role of this model over time has evolved into a widely used nursing theory that reflects the nature of living organisms and their environments. The major concepts of this theory include a holistic approach, open system, client system, health, stressors, degree of reaction, prevention, and reconstitution. The concept of prevention as an intervention is a major contributor to the nursing profession as we know preventing a negative event is better than one occurring.
This theory will guide the DNP project in a variety of ways but the true focus on the Neuman system model concept of wellness, more specifically prevention as an intervention. The DNP project intervention focused on early identification and prevention of pressure injury. Thereby reducing the incidence in the hospital environment. The metaparadigm concepts within the model includes the environment, health, nursing, and human beings (Butts & Rich, 2108). The best thing about the model as it impacts the DPI project it’s notion that all variables affecting a client’s response to environmental stressors can help enable nurses to know about another system with a goal to obtain wellness through retention of client system stability (Butts & Rich, 2018). Neuman and Fawcett described nursing practice using prevention as intervention, with the nurse providing care at three levels of primary, secondary, and tertiary prevention (Vanaki & Rafiei, 2020). Essentially the role of improving the environment (i.e., reducing pressure ulcer risk through modifications) and understanding the impact that one system affects another (for example a pressure injury can lead to infection), this theory supports the need for wellness in the patient
through preventing pressure injuries. The end result is wellness.
References
Butts, J., & Rich, K. (2018). Philosophies and theories for advanced nursing practice (3rd
ed.) Jones & Bartlett.
Chesnay, M. & Anderson, B. (2020). Caring for the Vulnerable: Perspectives in Nursing Theory, Practice, and Research (5th ed). Jones & Bartlett Learning.
Vanaki, Z., & Rafiei, H. (2020). Application of Betty Neuman system theory in management of pressure Injury in patients following stroke. MEDSURG Nursing, 29(2), 129–133.
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