Week 2: Applying Middle-Range Theories to Nursing Practice
As a registered nurse or APRN, no doubt the issue of managing patient pain is one you have dealt with repeatedly. In identifying successful approaches to addressing and alleviating pain, you may have looked to theories of pain management to inform your practice.
The work you begin this week will guide and prompt you in the further application of theory to nursing practice. You will start with an overview of middle-range theories, which in the world of nursing theory refers to theories that relate to particular phenomena, such as pain. Your study of nursing theory will be made more meaningful as you identify a practice issue of special interest to you and investigate nursing theories that apply to it.
As you continue to develop your philosophy of nursing practice, consider middle range nursing theories that may be defining for you. Expanding your familiarity with theories that inform the many dimensions of nursing will support your leadership as a DNP.
Learning Objectives
Students will:
Analyze issues in nursing practice
Evaluate middle range nursing theories in relation to nursing practice
Analyze middle range nursing theories in relation to philosophies of nursing practice
Learning Resources
Required Readings (click to expand/reduce)
Required Media (click to expand/reduce)
Optional Resources (click to expand/reduce)
Discussion: Exploring Middle Range Theories and Framing Practice Issues
You will begin this Discussion by identifying a practice issue that will be your frame of reference as you analyze the theoretical basis of nursing practice. Be aware that your choice can potentially carry through the course, as you will continue to address this issue in the context of other types of theories in Week 3. This practice issue can also be one focus of your Module 3 exploration of evidence-based practice and quality improvement, and your Module 4 investigation of a critical practice question. Consequently, as you prepare for this Discussion, think carefully about your example for connecting middle range nursing theories to patient care.
Photo Credit: steheap / Adobe Stock
To prepare:
Analyze your nursing practice for issues of particular interest or concern to you. Identify one issue as the focus of your application of theory to practice.
Review the Week 2 Learning Resources to identify specific middle range theories that may apply to your practice issue.
Choose at least two middle range theories that might be most relevant and valuable in addressing your practice issue.
Search the Walden Library for scholarly articles that address application of middle range theories to practice issues.
Consider how to frame your focus practice issue in terms of the middle range theories that you have selected.
**Practice Issue: Nurse Staffing Levels and Patient Safety**
In my nursing practice, one issue of particular concern is nurse staffing levels and its impact on patient safety. This issue arises from the ongoing challenge of balancing patient care demands with available resources, including nursing staff. Inadequate nurse staffing has been associated with adverse patient outcomes, including medication errors, falls, and increased mortality rates. Therefore, addressing this issue is critical to ensuring high-quality patient care and promoting positive outcomes.
**Selected Middle Range Theories:**
**Katharine Kolcaba’s Theory of Comfort:** Kolcaba’s theory focuses on the concept of comfort, which encompasses physical, psychospiritual, environmental, and sociocultural dimensions. In the context of nurse staffing levels and patient safety, this theory can be applied to highlight the importance of adequate staffing in promoting patient comfort and well-being. For example, having sufficient nursing staff allows for timely responses to patient needs, ensures effective pain management, and enhances overall patient satisfaction and experience.
**Hildegard Peplau’s Theory of Interpersonal Relations:** Peplau’s theory emphasizes the therapeutic nurse-patient relationship as a central component of nursing practice. In the context of nurse staffing levels and patient safety, this theory underscores the significance of nurse presence and engagement in fostering positive patient outcomes. Adequate staffing levels enable nurses to establish meaningful connections with patients, provide emotional support, and facilitate effective communication, thereby enhancing patient safety and satisfaction.
**Framing the Practice Issue:**
The practice issue of nurse staffing levels and patient safety can be framed within the context of Kolcaba’s Theory of Comfort and Peplau’s Theory of Interpersonal Relations. Kolcaba’s theory highlights the impact of staffing on patient comfort and well-being, emphasizing the need for adequate resources to meet patient needs effectively. Peplau’s theory emphasizes the importance of the nurse-patient relationship in promoting positive outcomes, underscoring the role of staffing levels in facilitating meaningful interactions and communication between nurses and patients.
By framing the practice issue within these theoretical frameworks, it becomes evident that addressing nurse staffing levels is essential for promoting patient comfort, safety, and satisfaction. Adequate staffing ensures that nurses can provide the level of care necessary to meet patient needs, establish therapeutic relationships, and effectively address patient concerns and preferences. Therefore, exploring strategies to optimize nurse staffing levels is critical to improving patient outcomes and enhancing the quality of care delivery.
With these thoughts in mind …
Week 2: Applying Middle Range Theories to Nursing Practice
By Day 3 of Week 2
Post an explanation of your practice issue. Then, describe two middle-range theories that are most valuable in addressing this issue and explain why. Be specific and provide examples.
**Practice Issue: Nurse Staffing Levels and Patient Safety**
Nurse staffing levels and their impact on patient safety constitute a critical practice issue in healthcare settings. This issue arises from the delicate balance between patient care demands and the availability of nursing staff. Inadequate nurse staffing has been associated with various adverse outcomes, including medication errors, patient falls, increased hospital-acquired infections, and even mortality rates. Therefore, addressing this issue is paramount to ensuring high-quality patient care and promoting positive patient outcomes.
**Selected Middle-Range Theories:**
**Katharine Kolcaba’s Theory of Comfort:**
Katharine Kolcaba’s Theory of Comfort is highly valuable in addressing the practice issue of nurse staffing levels and patient safety. This theory emphasizes the multifaceted nature of comfort, encompassing physical, psychospiritual, environmental, and sociocultural dimensions. Adequate nurse staffing directly influences patients’ comfort levels and overall well-being. When nursing staff levels are sufficient, patients receive timely and comprehensive care, leading to enhanced comfort and satisfaction.
For example, consider a scenario where a patient requires frequent turning and repositioning to prevent pressure ulcers. In a well-staffed unit, nurses can promptly attend to these needs, ensuring the patient’s physical comfort and reducing the risk of developing pressure injuries. Conversely, in an understaffed unit, nurses may struggle to allocate time for these essential tasks, leading to delays in care and increased patient discomfort.
**Hildegard Peplau’s Theory of Interpersonal Relations:**
Hildegard Peplau’s Theory of Interpersonal Relations is another valuable theory for addressing nurse staffing levels and patient safety. This theory highlights the significance of the therapeutic nurse-patient relationship in nursing practice. Adequate nurse staffing enables nurses to establish meaningful connections with patients, effectively communicate, and provide emotional support, all of which are essential for ensuring patient safety and well-being.
For instance, consider a patient who is experiencing anxiety and distress due to a recent diagnosis. In a well-staffed unit, nurses have the time and resources to engage in therapeutic communication, actively listen to the patient’s concerns, and provide reassurance and emotional support. This fosters trust and collaboration between the nurse and patient, ultimately enhancing the patient’s sense of security and contributing to improved outcomes.
**Explanation:**
Kolcaba’s Theory of Comfort and Peplau’s Theory of Interpersonal Relations are particularly valuable in addressing the practice issue of nurse staffing levels and patient safety due to their focus on patient-centered care, holistic well-being, and therapeutic relationships. These theories recognize the importance of nurses’ presence, engagement, and responsiveness in meeting patient needs and promoting positive outcomes. Adequate nurse staffing levels facilitate the implementation of these theories in practice by ensuring that nurses have the time, resources, and capacity to provide comprehensive care, establish therapeutic relationships, and prioritize patient safety and comfort. Therefore, by applying these middle-range theories to address nurse staffing issues, healthcare organizations can enhance the quality of care, improve patient satisfaction, and ultimately promote positive patient outcomes.
Read a selection of your colleagues’ posts.
By Day 6 of Week 2
Respond to at least two colleagues on 2 different days by suggesting other middle-range theories for them to consider. Support your recommendations with at least one scholarly article to share with each colleague.
**Response to Colleague 1:**
Your analysis of the practice issue regarding nurse staffing levels and patient safety is thorough and well-supported by Kolcaba’s Theory of Comfort and Peplau’s Theory of Interpersonal Relations. To further enrich your exploration of this topic, I would recommend considering the **Transformational Leadership Theory** as another valuable middle-range theory.
Transformational leadership theory emphasizes the role of leaders in inspiring and motivating followers to achieve higher levels of performance and effectiveness. In the context of nurse staffing levels and patient safety, transformational leadership can influence organizational culture, support nurse empowerment, and promote teamwork and collaboration. Research has shown that transformational leadership behaviors are associated with improved patient outcomes, including reduced medication errors and lower mortality rates.
I recommend exploring the following scholarly article:
– Avolio, B. J., & Yammarino, F. J. (2013). Transformational and charismatic leadership: The road ahead. Emerald Group Publishing Limited. [Link to article](https://www.emerald.com/insight/content/doi/10.1108/S1479-357120130000016001/full/html)
This article provides a comprehensive overview of transformational leadership theory, its key concepts, and its application in healthcare settings. It discusses the impact of transformational leadership on organizational outcomes, employee engagement, and patient care quality, offering valuable insights for addressing nurse staffing issues and enhancing patient safety.
**Response to Colleague 2:**
Your exploration of the practice issue related to nurse staffing levels and patient safety is insightful, and I commend your use of Kolcaba’s Theory of Comfort and Peplau’s Theory of Interpersonal Relations. To further expand your understanding and analysis, I recommend considering the **Synergy Model for Patient Care** as another valuable middle-range theory.
The Synergy Model for Patient Care emphasizes the alignment of patient needs with nurse competencies to achieve optimal outcomes. It identifies eight patient care needs (e.g., physiologic, functional, emotional) and corresponding nurse competencies, allowing for individualized and holistic care delivery. By matching nurse staffing levels to patient needs, healthcare organizations can ensure that patients receive the right care from the right nurse at the right time.
I suggest exploring the following scholarly article:
– Meleis, A. I. (2011). Theoretical nursing: Development and progress. Lippincott Williams & Wilkins. [Link to article](https://journals.lww.com/advancesinnursingscience/Abstract/2012/07000/Meleis__Theoretical_Nursing__Development_and.7.aspx)
This article provides an overview of theoretical nursing development and progress, including discussions on various nursing theories, models, and frameworks. It offers insights into the Synergy Model for Patient Care and its application in clinical practice, highlighting its relevance to addressing nurse staffing issues and promoting patient safety.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 2 Discussion Rubric
Post by Day 3 of Week 2 and Respond by Day 6 of Week 2
To Participate in this Discussion:
Week 2 Discussion
Modules 1–2 Assignment: Written Philosophy of Nursing Practice
You began this Assignment in Module 1 and will continue developing your philosophy of nursing practice in Module 2. This week, consider specific middle-range nursing theories that align with or can stretch your thinking about nursing practice. Keep in mind your Assignment is due by Day 7 of Week 3.
To prepare:
Reflect on the current draft of your philosophy of nursing practice and how, or in what ways, your philosophy is grounded in science.
Pay particular attention to the middle range theories you explore in the Week 2 Discussion and how these theories relate to the practice issue you identify.
Consider how to integrate applications of nursing middle range theories (from the Week 2 Discussion or others) into your philosophy statement to strengthen or deepen how nursing science informs or guides your philosophy of nursing practice.
**Philosophy of Nursing Practice: Integrating Nursing Science and Middle-Range Theories**
As a nurse dedicated to providing high-quality, patient-centered care, my philosophy of nursing practice is deeply grounded in nursing science and informed by middle-range theories that guide and enhance my approach to patient care, collaboration, and advocacy. Through reflection and engagement with middle-range theories, I have developed a framework that emphasizes holistic care, evidence-based practice, and interdisciplinary collaboration, ultimately aiming to promote positive patient outcomes and advance nursing knowledge.
**Holistic Care and Comfort:** My philosophy of nursing practice is aligned with Katharine Kolcaba’s Theory of Comfort, which emphasizes the importance of addressing patients’ physical, psychospiritual, environmental, and sociocultural comfort needs. By incorporating this theory into my practice, I prioritize holistic care that enhances patients’ overall well-being and promotes comfort, dignity, and quality of life. Additionally, I integrate Jean Watson’s Theory of Human Caring, which emphasizes the therapeutic nurse-patient relationship and the transformative power of caring interactions. This theory informs my approach to patient care, fostering trust, compassion, and healing within the nurse-patient relationship.
**Evidence-Based Practice:** Central to my philosophy of nursing practice is a commitment to evidence-based practice, which is supported by Cheryl Tatano Beck’s Theory of Postpartum Depression and its application in maternal-child nursing. This theory highlights the importance of using research evidence to inform clinical decision-making and improve patient outcomes. By staying abreast of current research findings and integrating evidence-based interventions into my practice, I ensure that my care is grounded in the best available evidence and tailored to meet the unique needs of each patient.
**Interdisciplinary Collaboration:** My philosophy of nursing practice is further enriched by Afaf Meleis’s Theory of Transition and its application in care coordination and transitional care management. This theory underscores the importance of collaboration and communication among healthcare professionals to facilitate smooth transitions across healthcare settings and optimize patient outcomes. By embracing interdisciplinary collaboration, I work closely with healthcare team members to provide comprehensive, coordinated care that addresses patients’ holistic needs and promotes continuity of care throughout the healthcare continuum.
In conclusion, my philosophy of nursing practice is grounded in nursing science and informed by middle-range theories that guide my approach to patient care, evidence-based practice, and interdisciplinary collaboration. By integrating these theories into my practice, I strive to provide holistic, patient-centered care that promotes comfort, dignity, and well-being, while advancing nursing knowledge and contributing to positive patient outcomes.
The Assignment (3–5 pages)
Continue to develop your written philosophy of nursing practice by identifying at least two middle range nursing theories that apply to your nursing practice and explaining how each theory supports your philosophy. Include at least two scholarly resources for this element of your philosophy.
Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All papers submitted must use this formatting.
**Title: Developing a Comprehensive Philosophy of Nursing Practice**
**Introduction**
In the ever-evolving landscape of nursing practice, developing a comprehensive philosophy is essential to guide decision-making, enhance patient care, and promote professional growth. This paper aims to further develop my philosophy of nursing practice by identifying and exploring two middle-range nursing theories that align with my values, beliefs, and approach to patient care. Through a reflective examination of these theories and their applications, I seek to strengthen my understanding of nursing science and its relevance to my practice.
**Middle Range Nursing Theories Supporting My Philosophy:**
**Katharine Kolcaba’s Theory of Comfort:**
Katharine Kolcaba’s Theory of Comfort resonates deeply with my philosophy of nursing practice, which prioritizes holistic care and patient well-being. This theory posits that comfort is a primary goal of nursing care and encompasses physical, psychospiritual, environmental, and sociocultural dimensions. Kolcaba emphasizes the nurse’s role in promoting comfort and relieving discomfort through supportive interventions tailored to individual patient needs.
Kolcaba’s theory supports my philosophy by providing a framework for understanding and addressing patients’ holistic comfort needs. By acknowledging and addressing the multifaceted nature of comfort, nurses can enhance the quality of care and promote positive patient outcomes. For example, in a palliative care setting, nurses can utilize comfort measures such as pain management, emotional support, and environmental modifications to improve the overall comfort and well-being of patients and their families.
**Scholarly Resource:**
Kolcaba, K., Tilton, C., & Drouin, C. (2006). Comfort Theory: A unifying framework to enhance the practice environment. Journal of Nursing Administration, 36(11), 538-544.
[Link to article](https://journals.lww.com/jonajournal/Abstract/2006/11000/Comfort_Theory__A_Unifying_Framework_to_Enhance.6.aspx)
**Dorothy Johnson’s Behavioral System Model:**
Dorothy Johnson’s Behavioral System Model offers insights into the interplay between the individual and their environment, emphasizing the dynamic nature of human behavior and the need for adaptation to maintain equilibrium. According to Johnson, individuals strive to achieve stability through the integration and balance of various behavioral subsystems, such as the achievement, dependency, and affiliative subsystems.
Johnson’s model supports my philosophy by highlighting the importance of assessing patients’ behavioral responses to illness and providing interventions that promote adaptation and well-being. By understanding the impact of illness on patients’ behavioral systems, nurses can tailor interventions to support patients’ coping mechanisms and facilitate their adjustment to changes in health status. For example, in a rehabilitation setting, nurses can implement strategies to promote independence, foster self-care abilities, and enhance patients’ sense of control over their health outcomes.
**Scholarly Resource:**
Johnson, D. E. (1980). Behavioral system model. In R. C. Roy (Ed.), Conceptual models for nursing practice (pp. 67-83). Appleton-Century-Crofts.
[Link to book chapter](https://nursing-theory.org/theories-and-models/behavioral-systems-model.php)
**Summary**
In summary, Katharine Kolcaba’s Theory of Comfort and Dorothy Johnson’s Behavioral System Model provide valuable frameworks for understanding and addressing patients’ holistic needs and behavioral responses to illness. By integrating these middle-range nursing theories into my philosophy of nursing practice, I aim to enhance the quality of care, promote patient well-being, and advance nursing knowledge and practice.
Week 2: Applying Middle Range Theories to Nursing Practice
Submit your philosophy of nursing practice by Day 7 of Week 3.
What’s Coming Up in Week 3?
Next week you will take a broader look at applications of theory to nursing practice. You will also complete your written philosophy of nursing practice, which is due by Day 7. Plan your time accordingly.
Week 3 Discussion: Assigned Theories
For the Discussion next week, your Instructor will assign to you one of nine interdisciplinary theories for investigating applications to nursing practice. In responding to your colleagues’ posts, you are encouraged to choose colleagues who are assigned a different theory from yours. Refer to the Discussion “to prepare” section for the list of featured theories.
Week 2: Applying Middle Range Theories to Nursing Practice
The post NURS 8114 Week 2: Applying Middle Range Theories to Nursing Practice appeared first on Destiny Papers.
