NSG/416: Theoretical Development And Conceptual Frameworks
Summative Assessment: Analyzing Theory-Practice Gaps
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Exam Content
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In this assessment, you will develop a paper or presentation in which you must identify the theory-practice gap using a particular scenario. You will identify a nursing theory that could be used to close the gap, what may have caused the gap, and best practices to close the gap.
Scenario
A client was originally admitted to the clinic using the name Jeffery. A cisman (someone who was assigned male at birth and identifies as a man) with he/him pronouns; this individual now identifies as a woman with she/her pronouns. The patient has asked to be called by her new name, Abby. Abby started hormone therapy two years ago but has not had gender-affirming surgery at this time.
Abby is visiting the clinic today for a work physical. In the waiting room, the nurse called her to the back using her deadname, Jeffrey. This was offensive to Abby, and she has requested to speak with the clinic manager. During her conversation with the clinic manager, Abby expresses her frustration with the use of a name that she no longer identifies with and requests the clinic to use her current name, Abby. The clinic manager understands there can be legal issues involved that do not allow the clinic to simply change the names of patients, however, the manager wants to find a way to ensure the clinic is a safe and affirming place for Abby.
Instructions
Define the theory-practice gaps from the scenario.
Describe the impact that each potential gap may have on nursing practice and patient care.
Identify a nursing theory that could be applied in the scenario.
· Support the chosen nursing theory with rationale.
· Discuss its relationship to the nursing process.
Explain what might cause the gap in the scenario.
Identify best-practice guidelines that can be applied in the scenario.
Develop a plan to address the identified gaps in the scenario.
Describe how theory, research, and practice will interact in the plan to create a positive patient outcome.
Deliverable Format Options
Write a 1,225- to 1,400-word paper
Support your work by citing at least 4 current scholarly sources from the University Library, in addition to any textbook citations, using current APA guidelines.
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NSG/416: Theoretical Development And Conceptual Frameworks
# Analyzing Theory-Practice Gaps: The Case of Abby
## Introduction
In contemporary nursing practice, addressing the needs of diverse patient populations is essential to providing equitable and compassionate care. This paper examines the theory-practice gaps presented in the scenario of Abby, a transgender woman, and discusses how a nursing theory can be applied to bridge these gaps. The focus is on understanding the impact of these gaps, identifying their causes, applying appropriate nursing theory, and developing a plan to ensure positive patient outcomes.
## Theory-Practice Gaps
### Identifying Theory-Practice Gaps
The primary theory-practice gap in Abby’s scenario is the lack of culturally competent care and the failure to respect and affirm her gender identity. Specific gaps include:
**Use of Incorrect Name and Pronouns:** The nurse used Abby’s deadname, Jeffrey, which is a significant disrespect and invalidation of her gender identity.
**Lack of Training and Awareness:** The scenario indicates a broader issue of insufficient training and awareness among clinic staff regarding transgender patients’ needs and the importance of using correct names and pronouns.
**Absence of Policies for Gender Identity Recognition:** The clinic lacks clear policies and procedures to ensure that patients’ gender identities are consistently recognized and respected in all interactions.
### Impact on Nursing Practice and Patient Care
The identified gaps can have profound negative impacts on nursing practice and patient care, including:
**Emotional and Psychological Harm:** Using incorrect names and pronouns can cause emotional distress, reduce trust in healthcare providers, and deter patients from seeking necessary care.
**Decreased Patient Satisfaction and Trust:** The failure to respect Abby’s identity can lead to decreased satisfaction with care, potentially resulting in negative reviews and decreased patient retention.
**Legal and Ethical Implications:** Not respecting a patient’s gender identity may have legal repercussions and violate ethical standards of respect for patient autonomy and dignity.
## Application of Nursing Theory
### Chosen Nursing Theory: Madeleine Leininger’s Transcultural Nursing Theory
Madeleine Leininger’s Transcultural Nursing Theory is appropriate for addressing the gaps identified in Abby’s scenario. This theory emphasizes the importance of culturally competent care and understanding patients’ cultural backgrounds, beliefs, and practices to provide effective and respectful care.
### Rationale for Choosing Leininger’s Theory
Leininger’s theory is chosen because it:
**Promotes Cultural Competence:** The theory advocates for cultural sensitivity and competence, which are crucial for understanding and respecting Abby’s gender identity.
**Enhances Patient-Centered Care:** It aligns with the principles of patient-centered care by emphasizing individualized care that respects the patient’s identity, preferences, and needs.
**Supports Holistic Care:** Leininger’s approach considers the holistic well-being of the patient, integrating physical, psychological, social, and cultural aspects of care.
### Relationship to the Nursing Process
Leininger’s theory integrates seamlessly with the nursing process:
**Assessment:** Nurses gather comprehensive cultural and personal information about the patient, including their preferred name and pronouns.
**Diagnosis:** Identification of cultural needs and potential areas of conflict or distress related to cultural identity.
**Planning:** Developing culturally competent care plans that respect the patient’s identity and preferences.
**Implementation:** Delivering care that adheres to the cultural care plan, ensuring respectful and affirming interactions.
**Evaluation:** Continuously evaluating the effectiveness of the care provided and making adjustments to ensure cultural competence is maintained.
## Causes of the Gap
The gaps in Abby’s scenario may be caused by several factors:
**Lack of Education and Training:** Insufficient education and training on transgender issues and cultural competence among healthcare providers.
**Institutional Barriers:** Inadequate policies and procedures to ensure the consistent use of correct names and pronouns for transgender patients.
**Bias and Discrimination:** Unconscious or conscious biases and discrimination against transgender individuals among healthcare staff.
## Best Practice Guidelines
To address these gaps, best practice guidelines include:
**Cultural Competence Training:** Implement mandatory training programs for all clinic staff on cultural competence and transgender healthcare needs.
**Policy Development:** Develop and enforce clear policies for using patients’ preferred names and pronouns in all interactions and documentation.
**Inclusive Environment:** Create an inclusive and welcoming environment through visible signs of support, such as inclusive signage and literature.
## Plan to Address Identified Gaps
### Steps to Implement the Plan
**Training and Education:**
– Develop a comprehensive training program on transgender healthcare and cultural competence.
– Include modules on the importance of using correct names and pronouns and the impact of misgendering on patient health.
**Policy Implementation:**
– Establish and enforce policies that require the use of patients’ preferred names and pronouns in all records and interactions.
– Implement a system for easily updating patient information to reflect their current identity.
**Creating an Inclusive Environment:**
– Display signs and literature that affirm the clinic’s commitment to diversity and inclusion.
– Ensure that all staff are aware of and adhere to inclusive practices.
### Interaction of Theory, Research, and Practice
– **Theory:** Leininger’s Transcultural Nursing Theory provides the framework for understanding and addressing the cultural needs of transgender patients.
– **Research:** Current research on transgender healthcare and the impact of cultural competence training will inform the development of training programs and policies.
– **Practice:** Implementing training, policies, and inclusive practices will create a supportive environment for transgender patients, improving their healthcare experiences and outcomes.
### Evaluation of the Plan
– **Monitor Patient Feedback:** Collect and analyze patient feedback to assess satisfaction and identify areas for improvement.
– **Staff Performance Reviews:** Include cultural competence as a criterion in staff performance reviews to ensure adherence to the new policies and practices.
– **Continuous Improvement:** Regularly update training programs and policies based on the latest research and feedback from patients and staff.
## Conclusion
Addressing the theory-practice gaps in Abby’s scenario requires a comprehensive approach that includes education, policy development, and the creation of an inclusive environment. By applying Leininger’s Transcultural Nursing Theory, we can ensure that Abby and other transgender patients receive respectful and affirming care. This approach will not only improve patient satisfaction and outcomes but also enhance the overall quality of nursing practice.
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## References
Andrews, M. M., & Boyle, J. S. (2020). *Transcultural concepts in nursing care* (8th ed.). Wolters Kluwer.
Butler, R. M., & McDougall, K. A. (2017). *Principles of transgender medicine and surgery* (2nd ed.). Routledge.
Eliason, M. J., & Chinn, P. L. (2017). *LGBTQ cultures: What health care professionals need to know about sexual and gender diversity*. Wolters Kluwer.
Leininger, M. M. (2002). *Culture care diversity and universality: A worldwide nursing theory*. Jones & Bartlett Learning.
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