Application of Concepts from Caring Science

Application of Concepts from Caring Science

Introduction

Nursing theoretical frameworks are the leading foundations that guide the nursing practice. All evidence-based strategies implemented by nurses and nurse practitioners when caring for patients are related to nursing theoretical frameworks. These theoretical frameworks provide the basis for developing evidence-based practices. They guide and direct nursing practice and any obstacles nurses may encounter when delivering healthcare services (Alligood, 2014). There are three main categories of nursing theories. They are divided into these categories based on the conceptual levels of the theories. The three levels of nursing theory are “ grand theories, mid-range theories, and practice-level theories.” Practice-level nursing theories address specific situations. They are easy to comprehend and apply and are more direct and precise. Hire our assignment writing services in case your assignment is devastating you. We offer assignment help with high professionalism.

On the other hand, mid-range theories are in between the other two theories and are the largest category (Alligood, 2014). Some of the well-known and clinically utilized nursing theories include the environmental theory by Florence Nightingale, the self-care deficit theory by Dorothea Orem, theory of human caring by Jean Watson, and the transcultural theory by Madeleine Leininger. Nurses can apply theoretical nursing frameworks to their clinical practice. Additionally, they can use Jean Watson’s theory of human caring in the clinical practice problem of postpartum hemorrhage in women in maternal wards.

The Outcome of Nursing Practice

The outcome of the nursing practice of interest is postpartum hemorrhage patients in maternal wards. This measurable healthcare metric represents the need to implement quality improvement initiatives in healthcare organizations with this problem. Accordingly, there is evidence from peer-reviewed articles that support the fact that postpartum hemorrhage is a significant nursing practice problem. Postpartum hemorrhage (PPH) is a leading cause of morbidity and death globally, with developing countries being affected more. It is associated with one maternal death every four months and a mortality rate of 14,000 deaths annually (Rani, 2017). PPH results in 5% of all maternal deaths, with the majority of mortalities occurring within a few hours of birth (Rani, 2017). Subsequently, PPH complications include anemia, postpartum pituitary necrosis, dilutional coagulopathy, orthostatic hypertension, myocardial ischemia, fatigue, and mortality (Evensen et al., 2017). PPH can be prevented by implementing nursing strategies. Nurses must thus be aware of evidence-based approaches to manage PPH and prevent maternal deaths associated with it.

A Clinical Nursing Theory

A clinical theory will be developed using concept A, proposition, and concept B within the context of the outcome of the nursing practice of postpartum hemorrhage in the maternal ward. The concept A- proposition- concept B theory will include the following:

Concept A

Rapid and excessive blood loss due to PPH can result in a severe blood pressure drop, resulting in hypovolemic shock and death if treatment measures are not implemented. PPH is entirely preventable. After delivery, there is uterine contraction to expel the uterus. These contractions compress the vessels where the placenta was initially attached. Failure to contract effectively is known as uterine atony. This is one of the leading causes of the most common cause of postpartum hemorrhage (Sahoo, 2018). Some women, in particular, have a greater risk of developing PPH compared to others. Some factors that enhance the risk for PPH are placental abruption, placenta previa, overdistended uterus, multiple pregnancies, preeclampsia, prolonged labour, infections, obesity, drugs that induce labour, drugs that stop contractions for preterm, vacuum-assisted delivery, and utilization of general anesthesia (Sahoo, 2018). Furthermore, women may experience PPH symptoms differently. PPH symptoms include tachycardia, hypotension, uncontrolled bleeding, decreases in hemoglobin, and swelling in the vaginal area (Sahoo, 2018).

Concept B

Active management of the third stage of labour (AMTSL) is one of the most efficacious evidence-based practices for preventing postpartum bleeding. AMTSL lowers the risk of postpartum maternal hematocrit levels and the need for manual placenta removal (Begley et al., 2019). AMTSL components include Pitocin administration in the anterior shoulder during delivery or soon after delivery, Brandt-Andrews maneuver in placental delivery, and uterine massage after placental delivery (Begley et al., 2019). Many studies have evaluated and compared the individual components of AMTSL. As a result, existing evidence shows that the most critical component of AMTSL is administering a uterotonic drug, preferably Pitocin. Picotin is the most preferred agent since it is efficacious and associated with minimal side effects (Salati et al., 2019). Significant PPH risk is reduced if Picotin is administered at the anterior shoulder after placental delivery instead of delivery time (Salati et al., 2019).

Proposition

An inverse correlation exists between Concept B and Concept A. Concept B directly reduces the risk for Concept A. Their correlation is inversely proportional. AMTSL directly reduces the risk of developing PPH. It reduces bleeding levels. In terms of research concepts, the independent variable, in this case, is AMTSL of using Picotin within the context of a maternal ward. The independent variable is not affected by other factors; it remains constant. The dependent variable is postpartum hemorrhage. Contrastingly, this variable is not constant and can change depending on the independent variable.AMTSL seeks to prevent PPH.

Therefore, the clinical nursing theory created for this nursing outcome is that AMTSL is an evidence-based practice that prevents postpartum hemorrhage.

A Comparison of the Created Clinical Nursing Theory with Watson’s Theory of Human Caring

Jean Watson’s theory of human caring opines that nurses must equip themselves with the skills and knowledge to adequately take care of their patients when they are most vulnerable. Applying knowledge to clinical practice is important to provide quality care to maternal patients. Watson’s theory of human caring refers to human beings as valued, fully functional persons who should be assisted, understood, respected, and nurtured (Najeh Alharbi & Ghazi Baker, 2020). Humans are viewed as greater than their individual parts. Additionally, Watson opines that nurses are accountable for interpreting information concerning the nursing process (Najeh Alharbi & Ghazi Baker, 2020). They must thus plan, implement and evaluate nursing care for maternal patients. Nurses must selflessly take care of their patients to preserve human dignity and restore well-being.

The proposition in Watson’s theory is that caring is the foundation of nursing science. Their moral obligation is to use their knowledge and skills to protect human dignity (Najeh Alharbi & Ghazi Baker, 2020). This proposition can be compared to the clinical nursing theory created above. Evidence-based practice for preventing PPH is AMTSL. This modality is determined and implemented from a patient advocacy point of view. AMTSL by nurses, such as Picotin administration, Brandt-Andrews maneuver, and uterine massage, will help prevent PPH (Evensen et al., 2017). These interventions prevent PPH, preserve human well-being and restore human dignity. Granted, the clinical theory created correlates with Watson’s theory.

Watson’s theory has ten Caritas. The theory related to concept B above in the created clinical theory is the systematic utilization of creative problem-solving nursing care (Najeh Alharbi & Ghazi Baker, 2020). Subsequently, Concept B states that AMTSL helps to reduce postpartum hemorrhage related to uterine atony (Begley et al., 2019). For this reason, the nurse must utilize the created problem-solving approach of AMTSL in maternal patients. Accordingly, nurses should use Picotin as indicated, use the Brandt-Andrews maneuver, and massage the placenta after delivery. These interventions are creative problem-solving approaches that will restore wellbeing.

After comparing Watson’s theory of human caring and the created nursing theory and the conformity between concept A, concept B, and proposition, it could be concluded that Watson’s theory of human caring is a nursing theoretical framework that is practical and applicable to many clinical scenarios and nursing problems. In the described nursing scenario, the created nursing theory for preventing postpartum hemorrhage is congruent with Jean Watson’s theory of human caring.

Discoveries Made and Their Impact on the Nursing Profession

Many discoveries have been made when preparing and looking for materials for this assignment. All the discoveries relate to nursing practice and its significance in patient care. Many mid-range nursing theories form the basis of the nursing profession. The nursing profession has evolved over the years, with many theorists developing conceptual frameworks to guide nurses. For example, Florence Nightingale, considered the founder of modern nursing, was the first nursing theorist. She developed the environmental theory. Besides, many other theorists have developed theoretical frameworks that have been critical in bettering the nursing profession. One of the theorists is Jean Watson, who developed the theory of human caring. As a result, the impact of nursing theories on clinical practice is immense.

The other discovery is that nursing interventions are evidence-based practices guided by theoretical frameworks. Evidence-based nursing practice incorporates research with nursing expertise and patients’ values and preferences when delivering care (Abu-Baker et al., 2021). Evidence-based interventions have a rationale for clinical use based on conceptual frameworks. An example is the use of AMTSL in the prevention of postpartum hemorrhage. The final discovery was that nursing is more of a calling than a practice. This has been attributed to the ten carative factors of the theory of human caring. A nurse must be selfless and be a patient advocate. Again, they must put patient wellbeing and dignity at the top of their priorities. Nevertheless, of the discoveries that have been discussed, one needs further research. This is the one that opines that conceptual frameworks guide nursing practice. Additional research should be done to investigate whether nursing conceptual frameworks guide nursing practice. The research must determine whether the theories apply to nursing practice.

Conclusion

Nursing theories are essential to the clinical nursing practice. These theoretical frameworks guide nursing practice and the implementation of evidence-based strategies. An example of an evidence-based approach guided by nursing theories is AMTSL in postpartum hemorrhage. PPH is a leading cause of maternal death and morbidity globally. Watson’s theory of human caring can be applied in the prevention of PPH. Jean Watson’s theory opines that nurses should use creative problem-solving approaches when caring for patients. One such problem-solving approach is the use of AMTSL. Several discoveries have revealed the critical role of nursing theoretical frameworks. More research, however, needs to be done to determine if they can be applied in clinical nursing situations. Despite this, nurses should always be guided by these conceptual frameworks. They must try as much as possible to apply the nursing theories in clinical practice to improve patient outcomes and enhance patient satisfaction.

References

Abu-Baker, N. N., AbuAlrub, S., Obeidat, R. F., & Assmairan, K. (2021). Evidence-based practice beliefs and implementations: A cross-sectional study among undergraduate nursing students. BMC Nursing, 20(1). https://doi.org/10.1186/s12912-020-00522-x

Alligood, M. R. (2014). Nursing theory: Utilization & application (5th ed.). Mosby.

Begley, C. M., Gyte, G. M., Devane, D., McGuire, W., Weeks, A., & Biesty, L. M. (2019). Active versus expectant management for women in the third stage of labour. The Cochrane database of systematic reviews, 2(2), CD007412. https://doi.org/10.1002/14651858.CD007412.pub5

Evensen, A., Anderson, J. M., & Fontaine, P. (2017, April 1). Postpartum hemorrhage: Prevention and treatment. AAFP American Academy of Family Physicians. https://www.aafp.org/afp/2017/0401/p442.html

Najeh Alharbi, M. K., & Ghazi Baker, O. (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

Rani, P. R. (2017). Recent advances in the management of major postpartum haemorrhage – A review. JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 11(2), QE01-QE05. https://doi.org/10.7860/jcdr/2017/22659.9463

Sahoo, G. (2018). Postpartum hemorrhage—The present scenario, how far we have succeeded and the way forward. Manual of Postpartum Hemorrhage and High-Risk Pregnancy, 3-3. https://doi.org/10.5005/jp/books/18024_2

Salati, J. A., Leathersich, S. J., Williams, M. J., Cuthbert, A., & Tolosa, J. E. (2019). Prophylactic oxytocin for the third stage of labour to prevent postpartum haemorrhage. Cochrane Database of Systematic Reviews, 2019(4). https://doi.org/10.1002/14651858.cd001808.pub3

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A theory can be used to guide practice. This assignment is an exercise in supporting a clinical practice with theory and evidence.

Directions: Identify an outcome of nursing practice in your area of practice that can be improved. For example, if you work in home health, you may identify that throw rug use by fall risk patients is too prevalent. You may be able to use the problem that inspired the theory concepts that you developed in week two.

(I work in the maternal ward)
Briefly support why it is a problem with evidence from the literature. This is not the major focus of the assignment so do not elaborate.
Create a clinical nursing (not medical) theory in the form of Concept A | Proposition | Concept B. Think of the structure like two nouns and a verb. While the term proposition is much more complex in the dictionary, in our use it is the connecting term between the two concepts. Examples include Concept A improves Concept B, Concept A is related to Concept B, when Concept A increases then Concept B also increases, etc. When you get to research, you will explore this further as you develop independent and dependent variables. How to use these statistically will come in research and statistics courses.

This clinical theory is identified as an empirical theory when you get to the C-T-E model later in this course. It is empirical in that they can be measured.

Identify and define your concepts. Identify how they could be measured in a research study. Be careful that you do not use compound concepts. If you find the words “and” or “or” in your theory, you are probably too complex.

If you research your question and seek funding, you will need a theoretical model to guide the research. In our assignment, we are using Watson. You will identify the concepts in Watson’s theories that are represented by the concepts you are using in your clinical theory. Match the proposition in her theory with your proposition. To help, the 10 Caritas Processes are Concept A. Choose the one that matches your concept. To clarify, let’s look at Caritas 1 Embrace and use it in middle-range theory. Sustaining humanistic-altruistic values by the practice of loving-kindness, compassion, and equanimity with self/others (Concept A – Very complex and abstract) improves (Proposition) subjective inner healing (Concept B).

Remember that the paper is not about the problem. It is about constructing a clinical theory and matching it to a middle-range theory and conceptual model your clinical theory represents.

Conclude the paper with your discoveries made in your readings and the impact on the nursing profession of your discoveries. Explore, briefly discover questions that require further research. Summarize the paper in the conclusion.

Present your outcome in an APA formatted paper that meets the University’s standards for a written assignment.

Expectations
Length: 6 pages including title and reference pages
References: 3 to 10. There should be enough to support the links between the concepts of the problem and the concepts of Watson’s Theory of Caring.