Framework Concepts and Program Outcomes Paper
The provision of patient-centered care has become essential in recent nursing practice settings. Patient-centered care is achieved by healthcare organizations and healthcare providers focusing on what the patient values and designing the care based on such values (Edgman-Levitan & Schoenbaum, 2021). This means healthcare providers consider the paradigms of a person, their environment, and their health status in designing the care plan. These, together with the paradigm of nursing, form the core concepts of the metaparadigm of nursing. As such, this article discusses a program framework for providing holistic and patient-centered care with a focus on the core concepts of the nursing metaparadigm, which include person, nursing, health, and environment, as well as an additional concept of empowerment. It defines these five concepts, discusses how they are interrelated, develops program outcomes based on the AACN Essentials of Baccalaureate Education, and the influence of peer collaboration on the final program framework.
Framework Concepts
The nursing metaparadigm, first classified by Jacqueline Fawcett, identifies person, health, environment, and nursing as the core concepts of nursing that guide nursing practice and the attitudes of nursing professionals toward patients and nursing care (Nikfarid et al., 2018). These paradigms or concepts are critical in the development of the nursing professional as they guide the student to understand patients and their needs and incorporate scientific evidence into practice to help provide the best quality and safe patient care. As the focus of nursing practice underpinned by Jacqueline Fawcett’s nursing metaparadigm is to provide nursing care from the patient’s perspective, an additional paradigm to achieve such kind of nursing care is patient empowerment. Notably, this section of the article defines the four core concepts of the nursing metaparadigm with an additional concept of empowerment as a key concept in the framework for delivering holistic and patient-centered care. It will then proceed to discuss how these five concepts are interrelated.
Person
“Person” within the Program Framework is defined as the individual or individuals who is or are at the center of or who is or are the focus of the provided nursing care. As per the framework, the person concept may encompass an individual patient, a family, or a community that has specific and unique needs and care preferences. For a deeper understanding and appreciation of the person as the key concept in delivering holistic and patient-centered care, the framework views the person within the dimensions of their physical body, mind, emotions, and spiritual nature (Nikfarid et al., 2018). These dimensions of the person concept help one understand each individual, family, or community as a whole. Thus, it is easier to define, understand, and appreciate the person’s unique needs, demands, and experiences that define their overall health.
Nursing
The nursing concept within the framework is defined as the profession in healthcare that is entirely dedicated to the promotion of health, prevention of illness, and provision of holistic care. Nursing is also the use of clinical knowledge, evidence from research, and other aspects of an individual patient to tailor care to the needs of the patient. According to the American Nurses Association (ANA) (n.d.), nursing is the diagnosis and treatment of human health needs and the advocacy for individuals, families, groups, communities, and populations from a humane perspective. Further, as a metaparadigm concept, nursing includes the actions, roles, and responsibilities aimed at preventing injury and ill health and optimizing the well-being of the individual. It also includes the skills, knowledge, and attitudes that enable the caregiver the capacity to care for an individual, meet their needs, and alleviate their suffering.
Health
The health concept in the Program Framework is defined as the dynamic state of an individual’s physical, mental, and social well-being. Such a state of well-being goes beyond the absence of disease to include an individual’s experiences at a specific point in their current or continuum of existence, including points of optimal health or illness. The health concept within the Program Framework emphasizes promoting health and well-being, preventing disease, and achieving equitable access to and utilization of healthcare resources.
Environment
The environment is the context within which the person exists that influences their health status and outcomes. The environment encompasses the physical, social, cultural, and economic factors that determine the health of the individual. From the perspective of the Human Caring Theory, the environment includes both the internal and external factors that help a person to heal, including self-healing (Nikfarid et al., 2018).
Additional Concept: Empowerment
Besides the four main concepts, an additional concept that has been identified and is suggested in the framework for delivering holistic and patient-centered care is empowerment. Empowerment within the Framework is defined as creating an environment that fosters self-efficacy, autonomy, and informed decision-making and enables individuals, families, and communities to take control of their health. Empowerment involves patients and communities getting more informed, developing their competencies and attitudes toward their health, and becoming more engaged, collaborative, and committed to their own health (Pekonen et al., 2020).
Relationship Between the Concepts
The five concepts of the framework are closely related and complement each other. Designing such patient-centered nursing care must consider the individual, their environment, their current health status and needs, nursing skills and knowledge, and the patient’s levels of empowerment. For instance, the entirety of nursing practice and care is focused on the individual receiving care. It is through nursing efforts and input that the person is able to achieve healing and maintain their health and well-being. Nurses are also responsible for creating supportive environments where patients can be empowered to take charge of their health.
The environment, especially the built environment, is a major determinant of health and health outcomes for individuals, families, and entire populations as it defines health behaviors and exposure to health risks (Frank et al., 2019). The environment also determines individual and community access to health resources, including direct care resources and education resources that empower patients. Such a close relationship between the environment and health and patient empowerment necessitates the creation of an inclusive and supportive environment to achieve the best care outcomes and empower patients.
The empowerment concept is related to all concepts of the framework; it enables patients and individuals to be actively involved in and committed to their care. Empowerment fosters more patient autonomy and self-determination. It also contributes to the patient-centeredness of care, enhancing patients’ competencies, attitudes, and behaviors towards their health and care, fostering more involvement and commitment in personal healthcare, and leading to better health outcomes (Hickmann et al., 2022).
Program Outcomes
The focus of the program is to ensure nursing students and graduates develop effective nursing competencies to deliver holistic and patient-centered care. The outcomes of the program are based on the AACN Essentials of Baccalaureate Education. The program outcomes include:
- Improved competencies to make informed clinical judgments and decisions. At the end of the program, the learner will be able to deliver safe and effective nursing care guided by clinical reasoning and evidence-based knowledge. This program outcome aligns with Essential III of the AACN Essentials of Baccalaureate Education: Scholarship for Evidence-based Practice, which pushes for nursing practice to be grounded on current evidence (American Association of Colleges of Nursing (AACN), 2008).
- Deliver more patient-centered and ethical nursing care. At the end of the program, nurses will be able to design and deliver care that is centered on the patient’s values, beliefs, and preferences, as well as remain professional and ethical in care delivery. This program outcome aligns with Essential I: Liberal Education for Baccalaureate Generalist Nursing Practice and Essential II: Basic Organizational and Systems Leadership for Quality Care and Patient Safety, which focus on patient care delivery guided by collaboration with patients and other professionals, ethical decision-making, and quality outcomes (American Association of Colleges of Nursing (AACN), 2008).
- Improved collaboration and communication competencies. At the end of the program, the student will be able to effectively communicate with other healthcare professionals, patients, and their families and collaborate with them to ensure that delivered patient care is safe and effective. This outcome aligns with Essential I: Liberal Education for Baccalaureate Generalist Nursing Practice, Essential II: Basic Organizational and Systems Leadership for Quality Care and Patient Safety, Essential III: Scholarship for Evidence-based Practice, and Essential VI: Interprofessional Communication and Collaboration for improving patient health outcomes of the AACN Essentials of Baccalaureate Education (American Association of Colleges of Nursing (AACN), 2008).
- Create nurses who are actively engaged in health promotion and disease prevention. At the end of the program, the nurses will be equipped with skills and knowledge to support health promotion and disease prevention at the individual and community levels. This outcome specifically aligns with Essential VII: Clinical Prevention and Population Health.
- The graduates at the end of the program will also be able to act as professionals, observe ethics in nursing, and be inspired to pursue lifelong learning for better nursing in accordance with Essential VIII: Professionalism and Professional Values of the AACN Essentials of Baccalaureate Education (American Association of Colleges of Nursing (AACN), 2008).
Peer Collaboration
The final organizing framework, concepts, and program outcomes were developed and reviewed through a peer review and consultative process. The entire development process has been posted on the discussion panel, attracting peer critique and suggestions. Engagement in discussions and review of other peer programs have also created new insights on the organizing framework and to further review and develop the program, concepts, and its outcomes. Other resourceful sources have been a review of scholarly resources, including peer-reviewed journals on nursing curriculum development, current evidence, and research focused on gaps and limitations in nursing education programs.
Conclusion
The nursing metaparadigm guides the delivery of holistic and patient-centered care. Additionally, as patient engagement and involvement in their care are critical in designing patient-centered care plans, patient empowerment is identified as a critical paradigm in nursing care. Nursing professionals must understand and appreciate the interrelationship between the concepts of the metaparadigm of nursing, person, nursing, health, and environment and the new empowerment paradigm in designing and delivering holistic and patient-centered nursing care. Therefore, by clearly defining these concepts and how they interrelate and designing programs guided by a framework of the concepts, it is possible to sustainably develop and improve nursing competencies necessary for effective nursing practice.
References
American Association of Colleges of Nursing (AACN). (2008). The essentials of baccalaureate education for professional nursing practice. https://www.aacnnursing.org/portals/42/publications/baccessentials08.pdf
American Nurses Association (ANA). (n.d.). What is nursing? https://www.nursingworld.org/practice-policy/workforce/what-is-nursing
Edgman-Levitan, S., & Schoenbaum, S. C. (2021). Patient-centered care: achieving higher quality by designing care through the patient’s eyes. Israel Journal of Health Policy Research, 10(1). https://doi.org/10.1186/S13584-021-00459-9
Frank, L. D., Iroz-Elardo, N., MacLeod, K. E., & Hong, A. (2019). Pathways from the built environment to health: A conceptual framework linking behavior and exposure-based impacts. Journal of Transport & Health, 12, 319–335. https://doi.org/10.1016/J.JTH.2018.11.008
Hickmann, E., Richter, P., & Schlieter, H. (2022). All together now – patient engagement, patient empowerment, and associated terms in personal healthcare. BMC Health Services Research, 22(1), 1–11. https://doi.org/10.1186/S12913-022-08501-5/FIGURES/4
Nikfarid, L., Hekmat, N., Vedad, A., & Rajabi, A. (2018). The main nursing metaparadigm concepts in human caring theory and Persian mysticism: A comparative study. Journal of Medical Ethics and History of Medicine, 11(6). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6150916/
Pekonen, A., Eloranta, S., Stolt, M., Virolainen, P., & Leino-Kilpi, H. (2020). Measuring patient empowerment – A systematic review. Patient Education and Counseling, 103(4), 777–787. https://doi.org/10.1016/
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Question 
Purpose
The purpose of this assignment is to (a) develop concepts included in an organizing framework for an institution, (b) discuss the relationship between the concepts, (c) develop program outcomes, and (d) demonstrate skills in the development and articulation of ideas in a scholarly manner.
Framework Concepts and Program Outcomes Paper
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Requirements
Assignment Criteria for the Paper
A brief introduction to the concepts selected for the framework
The concepts in the framework are clearly defined. The concepts included in the metaparadigm of nursing (person, nursing, health, and environment) must be included.
The relationship between the concepts is demonstrated.
Develop program outcomes for your institution that incorporate the following:
Program outcomes should be described as characteristics expected of graduates by the end of the program
Program outcomes are based on either the AACN Essentials of Baccalaureate Education OR the NLN Competencies for graduates of Associate Degree Programs OR the current The Joint Commission Hospital National Patient Safety Goals.
Changes to the initial framework concepts and program outcomes are identified, based on peer collaboration.