Relationships between Nursing Theory and the Care Plan
Measurable nursing outcome
Patient will maintain open, clear airways as evidenced by normal breathing sounds after suctioning.
The nursing theory that aligns with the plan of care is Levine’s Conservation Model in Nursing Practice.
Levine’s Conservation Model in Nursing Practice concedes that nursing intervention is a conservation activity whose primary concern is to conserve energy. In this case, nursing interventions are prioritized at the level of the person so that the patient’s social, personal and structural integrity as well as energy is conserved. At the core of the theory is the understanding that every patient is unique (patients vary based on personal factors that include illness, gender and age) so that different adaptive processes mediated by nurses are required for each patient. In applying the theory, the patient is guided in applying the least amount of effort to adapt to the health challenges (Alligood, 2022). Relationships between Nursing Theory and the Care Plan
In applying this theory, the nursing intervention would ensure that the patient avoids excessive fatigue by balancing energy input and output through adequate nutrition, and proper sleep pattern and rest. This creates a safe balance between nursing intervention and patient participation/adaptation thus ensuring conservation of energy. In addition, the nursing intervention would recognize that the patient strives for self-determination, selfhood, self-awareness, respect and recognition. This involves preserving and acknowledging the space needs of the patient. This makes certain that the patient has a sense of self-definition and identity with the nursing intervention being based on the patient’s personal identity thus ensuring conservation of personal integrity. Besides that, the nursing intervention would restore or maintain the body’s structure, promote healing and prevent physical breakdown. This involves placing the patient on a ventilator to assist in breathing, conducting suctioning and preserving the patient’s personal hygiene. This focuses on restoring the structural integrity of the patient through nursing interventions that maintain structural integrity and promote healing thus ensuring conservation of structural integrity (Smith, 2020).
Also, the nursing intervention would recognize that the patient is part of a family, community, ethnic group, political system, religious group, and nation. This involves the patient’s place in the group being preserved through allowing family to visit, observing cultural norms, and allowing a religious leader to visit. This focuses on making sure that the patient has a life’s meaning that is gained from interacting with others with the nursing intervention helping to maintain the relationships thus ensuring conservation of social integrity (McEwan & Wills, 2021).
The measurable nursing outcome is: patient will maintain open, clear airways as evidenced by normal breathing sounds after suctioning. Breathing should come effortlessly and naturally to every person. Nonetheless, our patient is incapable of keeping his airways clear and lungs healthy. Maintaining this patient’s airway is vital for his life. Towards this end, a ventilator is used to help the patient in breathing. However, there is a concern that the patient has developed ventilator associated pneumonia (VAP). An assessment will determine if the patient has developed VAP, in which case the appropriate treatment will be provided. Conversely, if the patient has not developed VAP, then five nursing strategies will be applied to help in preventing VAP and conserving structural integrity (Boltey, Yakusheva & Costa, 2017).
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First, minimize ventilator exposure by advocating for and encouraging the use of noninvasive ventilator approaches, such as continuous positive airway pressure and bi-level positive airway press. If the mechanical ventilator cannot be avoided, then its duration of use should be minimized. This should be accompanied by the application of a ventilator weaning protocol that includes spontaneous breathing trials. Second, providing excellent oral hygiene care as intubation can cause the patient to have a dry mouth and sustain injuries to oral mucosa. These injuries alongside compromised immune system can increase bacteria colonization in the oral mucosa with the ventilation tube providing a direct route for the bacteria to access the lungs. Adequate oral care reduces bacterial colonization in the mouth thus reducing risk of VAP (Boltey, Yakusheva & Costa, 2017).
Third, coordinating care for subglottic suctioning. VAP can result from aspirating the secretions that accumulate around the endotracheal tube. Subglottic suctioning reduces risk of VAP. Fourth, maintaining optimal positioning and encouraging mobility. This is important for reducing gastric reflux and subsequent VAP risk. As long as the patient is not sedated, nursing protocols on early mobility should be applied with a focus on progressive mobility approaches. This can begin with dangling at the edge of the bed, transitioning to standing at the edge of the bed, to matching in place, and then ambulating when the patient is able to tolerate higher activity levels. Finally, ensuring that there is adequate nurse staffing. This helps to prevent VAP by providing nurses with the resources, opportunity and time to implement nursing care practices that reduce risk of VAP. For instance, more nursing staff means that nurses spend more time with patients so that they can identify VAP in the early stages and provide adequate treatment promptly (Boltey, Yakusheva & Costa, 2017). Overall, the application of Levine’s Conservation Model in Nursing Practice guides nursing practice and helps to achieve the measurable nursing outcome of: patient will maintain open, clear airways as evidenced by normal breathing sounds after suctioning.
Alligood, M. R. (2022). Nursing Theorists and Their Work (10th ed.). Elsevier, Inc.
Boltey, E., Yakusheva, O., & Costa, D. K. (2017). 5 Nursing strategies to prevent ventilator-associated pneumonia. American Nurse Today, 12(6), 42-43. https://www.ncbi.nlm.nih.gov/pubmed/29201265
McEwan, M., & Wills, E. M. (2021). Theoretical Basis for Nursing (6th ed.). Wolters Kluwer Health.
Smith, M. C. (2020). Nursing Theories and Nursing Practice (5th ed.). F.A. Davis Company.
Summative Assessment: Critical Thinking Case – Concept Map and Summary
In this assignment, you will be looking at a case study of a real-world situation. You will decide on the outcome goal for the patient and select a theory that aligns to the care plan and facilitates the desired outcomes. You will then create a concept map depicting the relationships between the nursing theory and the care plan. And finally, you will summarize the contents of the concept map
Read the following case study:
You are a staff nurse working in an intensive care unit and assigned to care for a 75-year-old Native American man who had coronary artery bypass graft surgery 4 days ago. The patient has a history of chronic obstructive pulmonary disease exacerbated by heavy smoking. His postoperative course has been difficult, and he has suffered several setbacks. Staff members, despite their diligent efforts, have not been able to wean him off the ventilator since the surgery. He has required frequent suctioning throughout the shift, and he is being evaluated for the development of ventilator-associated pneumonia.
In 1 or 2 sentences, describe the measurable nursing outcome desired related to the improvement of the patient’s condition. Example: Patient will have a respiratory rate of less than 30 breaths per minute.
Identify a nursing theory to align with the plan of care to improve this patient’s outcome.
Create a concept map in which you show the relationship among the concepts of the nursing theory and alignment of nursing practice (including the critical thinking and clinical decision-making processes) for an improved the nursing care plan.
Provide a 700- to 875-word summary explaining the following from the concept map:
- How the nursing theory concepts align to nursing practice, critical thinking, and the clinical decision-making process
- How alignment of nursing theory concepts and nursing practice, critical thinking, and clinical decision-making processes can improve the nursing care plan
Include the measurable nursing outcome and the nursing theory you identified on the same document as the summary.
Include at least 2 scholarly resources from the University of Phoenix Library to support you work.
Cite and format your sources according to APA guidelines. Relationships between Nursing Theory and the Care Plan