Metaparadigm and Nursing
Take one component in the Metaparadigm of Nursing, identify and discuss the concept or concepts of Watson’s Theory of Caring that support that Watson wrote a theory of nursing based on the criteria established in the Metaparadigm of Nursing.
Nursing theories usually explain the main pillars that guide nursing practice. Theoretically, all relevant evidence-based therapies used by nurses in the course of patient care should be sound. Conceptual frameworks, which are found exclusively in nursing theories, supply them.
As a result, conceptual frameworks serve as the foundation for solid evidence-based practice, or EBP. Nursing theoretical concepts guide, direct, and steer practice in the same manner that a lighthouse at sea guides, directs, and steers a ship to avoid hazards and obstructions that may render interventions inefficient and useless.
There are three types of nursing theories, each with its own level of abstraction in terms of concepts. All nursing theories, according to Wayne (2020), will be grand theories, mid-range theories, or practice-level theories. Grand theories are the most abstract of the three, while practice-level theories are the least abstract.
Practice-level theories are simple and direct, but middle-range theories are narrower in scope and are the most common type of nursing theory (Risjord, 2018). Environmental Theory, Transcultural Nursing (TCN) Theory, Self-Care Deficit Theory (SCDT), and Watson’s Theory of Human Caring are some of the most well-known and frequently discussed nursing theories (Alharbi & Baker, 2020; Gonzalo, 2019a; Gonzalo, 2019b; Pajnkihar et al., 2017; Borji et al., 2017 ).
This paper presents a theory about the formation of pressure ulcers (concept A) and the causality relationship that this has with the actions of nurses providing care (concept B), while giving the correlative proposition linking the two together at the same time.
In my area of practice, I have observed that rates of pressure ulcer development usually go down when particular measures are practiced consistently over time by the nurses. The theory I have come up with is that a positive relationship exists between performing these acts and obtaining favorable patient outcomes.
This is a relationship of causality because these actions by nurses directly result in improved quality of care and reduced hospital stay.
The actions include:
- Elevating the head of the bed at an inclination of less than 30° (Burk & Grap, 2012).
- Keeping everything clean and dry, proper diet and hydration to keep skin healthy, and frequent repositioning
- Using appropriate pressure-relieving support surfaces such as special mattresses, and
- Performing pressure area care (massaging and applying baby powder) every two hours for bed-ridden patients (Angmorterh et al., 2019; Gaspar et al., 2019; Nixon et al., 2019; Baron et al., 2016).
The main point of discussion is the theory that the omissions and commissions of nurses are responsible for the causation of pressure injuries. As the above evidence stated portray, that there are evidence-based interventions that will prevent the development of pressure ulcers if nurses implement them consistently.
This deduction is made from the proposition that a correlation exists between the actions/ inaction of nurses and the formation of the pressure injuries in bed-ridden patients.
Nurses perform pressure area care every two hours to bed-ridden patients., keeping skin dry and clean. Proper nutrition / hydration. They also turn the patients, make them lay on comfortable support surfaces, and elevate the head of the bed (Angmorterh et al., 2019; Gaspar et al., 2019).
Pressure ulcer rates drop significantly as a consequence of the actions of the nurses as outlined in concept A (Nixon et al., 2019; Baron et al., 2016).
Proposition: The actions in concept A by the nurses have a clear bearing on the reality in concept B.
The actions result in the reduction of the number of bed-ridden patients developing pressure sores (Kottner et al., 2019). In other words, there is a direct relationship between the actions of the nurses and the improvement in the quality of nursing care.
The concept explained above is drawn from clinical practice and informed by what has been observed. Pressure ulcers are one of the occurrences that put a dent in the quality of care.
Finding a theory that explains their prevention is therefore important for evidence-based practice. Concept A is related to concept B and the proposition in-between has been clearly explained.
Alharbi, K.N., & Baker, O.G., (2020). Jean Watson’s middle range Theory of Human Caring: A critique. International Journal of Advanced Multidisciplinary Scientific Research, 3(1), 1-14. https://doi.org/10.31426/ijamsr.2020.3.1.3011
Angmorterh, S. K., England, A., Webb, J., Szczepura, K., Stephens, M., Anaman-Torgbor, J., … & Hogg, P. (2019). An investigation of pressure ulcer risk, comfort, and pain in medical imaging. Journal of Medical Imaging and Radiation Sciences, 50(1), 43-52. http://dx.doi.org/10.1016/j.jmir.2018.07.003
Baron, M. V., Reuter, C. P., Burgos, M. S., Cavalli, V., Brandenburg, C., & Krug, S. B. F. (2016). Experimental study with nursing staff related to the knowledge about pressure ulcers. Revista Latino-Americana de Enfermagem, 24. https://doi.org/10.1590/1518-8345.1134.2831
Borji, M., Otaghi, M. & Kazembeigi, S. (2017). The impact of Orem’s self-care model on the quality of life in patients with type II diabetes. Biomedical & Pharmacology Journal, 10(1), 213-220, http://dx.doi.org/10.13005/bpj/1100
Burk, R.S., & Grap, M.J. (2012). Backrest position in prevention of pressure ulcers and ventilator-associated pneumonia: Conflicting recommendations. Heart & Lung: The Journal of Acute and Critical Care, 41(6), 536–545. https://doi.org/10.1016/j.hrtlng.2012.05.008
Gaspar, S., Peralta, M., Marques, A., Budri, A., & Gaspar de Matos, M. (2019). Effectiveness on hospital-acquired pressure ulcers prevention: A systematic review. International Wound Journal, 16(5), 1087-1102. http://dx.doi.org/10.1111/iwj.13147
Gonzalo, A. (2019a). Madeleine Leininger: Transcultural nursing theory. https://nurseslabs.com/madeleine-leininger-transcultural-nursing-theory/
Gonzalo, A. (2019b). Florence Nightingale: Environmental theory. Nurses Labs. https://nurseslabs.com/florence-nightingales-environmental-theory/#:~:text=The%20Environmental%20Theory%20by%20Florence,health%2C%20and%20that%20external%20factors
Kottner, J., Cuddigan, J., Carville, K., Balzer, K., Berlowitz, D., Law, S., … & Sigaudo-Roussel, D. (2019). Prevention and treatment of pressure ulcers/injuries: The protocol for the second update of the international Clinical Practice Guideline 2019. Journal of Tissue Viability, 28(2), 51-58. https://doi.org/10.1016/j.jtv.2019.01.001
Nixon, J., Smith, I. L., Brown, S., McGinnis, E., Vargas-Palacios, A., Nelson, E. A., … & Henderson, V. (2019).
Pressure relieving support surfaces for pressure ulcer prevention (PRESSURE 2): Clinical and health economic results of a randomized controlled trial. EClinicalMedicine, 14, 42-52. http://dx.doi.org/10.1016/j.eclinm.2019.07.018
Pajnkihar, M., McKenna, H.P., Stiglic, G., & Vrbnjak, D. (2017). Fit for practice: Analysis and evaluation of Watson’s theory of human caring. Nursing Science Quarterly, 30(3). https://doi.org/10.1177/0894318417708409
Risjord, M. (2018). Middle-range theories as models: New criteria for analysis and evaluation. Nursing Philosophy, 1-10. https://doi.org/10.1111/nup.12225
Wayne, G. (2020). Nursing theories and theorists. Nurses Labs. https://nurseslabs.com/nursingtheories/#:~:text=There%20are%20three%20major%20categories,%2C%20and%20practice%2Dlevel%20theory