Exemplar II

Aneesah Santiago Cyber Quest Mission II Exemplar Jacksonville University MSN Educational Technology April 2012

Exemplar II Nursing Theory Nursing theories are utilized to describe, explain, or predict various occurrences and relationships by providing concepts, definitions, and assumptions. The website http://currentnursing.com/nursing_theory/nursing_theories_overview.html provides an overview of the history, purpose, and classification of nursing theories utilized in the explanation and prediction of events and to guide practice. Theories are creative ways to reason and structure ideas in professional nursing practice. Theories serve as a basis for testable hypothesis and are logical and generalizable in order to increase the body of knowledge within a discipline through validated research. Theories provide a means for practitioners to guide and improve their practice by validating theories, laws and principles. Theories utilized by and basic to nursing concepts are general system theory, adaptation theory, and developmental theory. General system theory illustrates how to break whole items down into parts and figure out how these parts work together in systems. Adaptation theory describes how humans continuously evolve, change and respond within the environment, internally, socially, and physically. Developmental theory outlines the orderly and unique growth and development of each individual, taking into account heredity, temperament, environment, experiences, and health. The most common determinants of nursing practice are the person, environment, health, and nursing goals, roles, and functions. The main focus of nursing theory and practice is that of the individual person. Metatheory identifies phenomena through concepts. Grand theory provides a framework with which the specific concepts and

principles may be defined. Middle range theory is a more precise theory and only looks at a particular situation with a limited amount of variables. Practice theory identifies

Exemplar II specific goals and details within nursing practice and evaluates how these goals could possible be achieved. Needs theory is based on assisting individuals achieve their physical and mental needs. Interaction theory focuses on the relationships nurses form

and develop with their patients. Outcome theories empower the nurse to become a change agent and also empower their patients to cope with health. Humanistic theory focuses on the individuals self- determination and potential for health and growth. With the continued application and development of nursing theory, the field of nursing will continue to expand and grow (Current Nursing, 2012). Cultural Aspects of Nursing Practice The United States of America is a country comprised of people from many diverse races, cultures, and backgrounds. The beliefs of these people should be respected at all times. The website http://www.emfp.org/DocVault/Publications/John-LoweCultural-Diversity-The-Intention-of-Nursing.aspx highlights the importance of incorporating cultural diversity in the nursing discipline. Every 27 seconds there is one international migrant to the United States. By the year 2050 the minority population will comprise 50% of the workforce. The discipline of nursing strives to embrace and integrate cultural diversity and care to not only the diverse patient populations that are cared for, but also to the diverse nurses that comprise the field. On an ongoing basis nurses are challenged to be culturally aware and include the diverse needs of their patient populations in the everyday care that is provided to the patient and their families. In order to reach the goal set by the United States Department of Health and Human Services to eliminate health disparities nurses must strive to provide culturally competent care to all people no matter their age, gender, ethnicity, socioeconomic background, disability, or

Exemplar II sexual orientation. Transcultural nursing is a means to incorporate and combine culture into all aspects of nursing care and education. Transcultural nursing helps the nurse to become aware of differences in their own beliefs and the beliefs of their patients. This helps the nurse to gain a respect for the values and beliefs of their various patient populations. Nursing education should continue to find innovative ways to incorporate cultural diversity education in the clinical setting and in teaching methods and

curriculum. Further research and evaluation needs to be performed to discover the effects of cultural diversity on physiological, psychological, spiritual, and social factors (Lowe, Archibald, 2009). Healthcare Reform and Nursing The buzz of the upcoming healthcare reform is in the air all around the country. The field of nursing is apprehensive about the effects the reform will have on the profession. The website http://www.healthcarefinancenews.com/news/healthcare-reformrequires-transformation-nursing-profession-iom-says focuses on ways healthcare reform will possibly transform the nursing profession. The nurses individual responsibilities and education will change greatly in order to meet the increased healthcare demand brought by the reform. Nurses should collaborate with other healthcare professionals and take on leadership roles in redesigning the healthcare field. Nursing residency training and attainment of higher education degrees should be encouraged with incentives. Present regulatory limits should be lifted so that the advanced expertise of patient care knowledge of nurses can be utilized to the fullest extent possible. Nurses should be seen as partners in the healthcare reform and lead the advances made to the future healthcare system and needs of patients. Nurses not only comprise the largest profession in the healthcare field,

Exemplar II

but also spend the greatest amount of time at the bedside delivering hands on patient care. This fact gives nurses the ability to contribute and collaborate with other healthcare professionals to improve and influence the quality and safety of patient care with the healthcare reform (Manos, 2010). Patient Education In a guide provided by the National Institute of Child Health & Human Development on the website http://www.nichd.nih.gov/publications/pubs/gest_diabetes/, patients are given an opportunity to receive education and support when diagnosed with gestational diabetes. If a woman is diagnosed with diabetes only when she is pregnant then it is referred to as gestational diabetes. Gestational diabetes is one of the most common problems for pregnant women. By maintaining a controlled blood sugar, consuming a healthy diet, participating in moderate physical activity, and maintaining a healthy weight, women that are diagnosed with gestational diabetes are able to deliver healthy infants without complications. Complications that may occur from gestational diabetes are macrosomia, hypoglycemia, jaundice, respiratory distress syndrome, and low calcium and magnesium levels in the infant. Gestational diabetes may put the mother at risk of blood sugar and insulin imbalance, early delivery, preeclampsia, or cesarean delivery. The educational site provides education for the women and her family on how to prevent these complications from occurring. The way to practice carbohydrate counting and the exchange system are defined and explained for the patient. Meals and snacks should be consumed on a regular schedule throughout the day according to the meal plan set by the patients healthcare professional. Smaller amounts of carbohydrates should be spread out during meals throughout the day. Healthy nighttime snacks should

Exemplar II be incorporated in the meal plan as allowed. Measuring fasting blood sugar and postprandial blood sugar can give the patient critical information on the amount of food the patient can eat, foods that affect the glucose levels, the times when the glucose level is high or low, and the times that activity is more likely to keep the glucose levels in the

target range. The fasting glucose level should not be higher than 95. One hour after eating the glucose should not be higher than 140. Two hours after eating the glucose should not be higher than 120. If the glucose is unable to be controlled with the initial interventions, the healthcare professional may find it necessary to utilize insulin. The method on how to take the blood glucose is reviewed on the website and illustrations are provided. The website was accurate and informative. It not only educated the patients on all aspects of gestational diabetes, but also provided emotional support. The text and wording was easily understandable and illustrations were provided as well. The website also provided helpful diagrams, menus and tracking sheets to be utilized by the patient and her family during the pregnancy.

Exemplar II References Current Nursing. (2012, February). Nursing theories: An overview. Retrieved from http://currentnursing.com/nursing_theory/nursing_theories_overview.html Guttmacher, A. (2012, January). Managing gestational diabetes: A patients guide to a healthy pregnancy. National Institute of Child Health & Human Development. Retrieved from http://www.nichd.nih.gov/publications/pubs/gest_diabetes/ Lowe, J., Archibald, C. (2009). Cultural diversity: The intention of nursing. Nursing Forum. 44. (1). 11-18. Retrieved from

http://www.emfp.org/DocVault/Publications/John-Lowe-Cultural-Diversity-TheIntention-of-Nursing.aspx Manos, D. (2010, October). Healthcare reform requires transformation of nursing Profession, IOM says. Healthcare Finance News. Retrieved from http://www.healthcarefinancenews.com/news/healthcare-reform-requirestransformation-nursing-profession-iom-says