NURS 8114 Exploring Middle Range Theories and Framing Practice Issues
NURS 8114 Exploring Middle Range Theories and Framing Practice Issues
NURS 8114 Exploring Middle Range Theories and Framing Practice Issues
Diabetes-related complications are a clinical issue of concern in nursing practice. Management of diabetes in most patients has been a challenge resulting in increased complications. The most common complications include blindness secondary to cataracts, cardiovascular disease, neuropathy, kidney disease, and lower-extremity amputation (Papatheodorou et al., 2018). These complications have been a major cause of increased morbidity and mortality among individuals with diabetes. They have also placed a heavy economic burden on the US health care system.
Middle-range theories most valuable in addressing diabetes-related complications include the Health Promotion Model and Comfort Theory. The Health Promotion Model explains the variables that determine the chances that a person will engage in health-promoting behavior, including cognitive-perceptual factors, modifying factors, and cues to action (Peterson & Bredow, 2019). The Health promotion model can help address the practice issue by understanding patients’ attitudes and beliefs regarding diabetes and perceived vulnerability. The model can be used to modify patients’ cognitive-perceptual factors in order to increase their health-promoting behaviors (Peterson & Bredow, 2019). This can improve their diabetes self-management and health-seeking attitude and ultimately improve health outcomes.
In the Comfort theory, the nurse identifies patients’ needs that have not been met. The needs are modified by dominant variables, which are factors that the nurse cannot change. With this in mind, the nurse develops a comfort care plan, which aims to enhance comfort over a measurement of baseline comfort (Peterson & Bredow, 2019). When patients’ comfort is improved, they can engage more in health-seeking behaviors. The Comfort theory can address the diabetes issue by having nurses identify patients’ needs that have not been met, such as education, nutrition, and exercise needs (Peterson & Bredow, 2019). Nurses can then develop a comfort care plan for patients with diabetes. When the comfort is improved, patients can engage more in healthy behaviors such as physical exercises and attending diabetes clinics.
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NURS 8114 Exploring Middle Range Theories and Framing Practice Issues References
Papatheodorou, K., Banach, M., Bekiari, E., Rizzo, M., & Edmonds, M. (2018). Complications of Diabetes 2017. Journal of diabetes research, 2018, 3086167. https://doi.org/10.1155/2018/3086167
Peterson, S., & Bredow, T. S. (2019). Middle range theories: Application to nursing research and practice. Lippincott Williams & Wilkins.
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.
With these thoughts in mind …
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.
Read a selection of your colleagues’ posts.
Providing high-quality patient care and pursuing perfection in nursing practice are of utmost significance. The problem of nurse staffing has caught my attention and caused much worry inside the organization because of its direct impact on the quality of care delivered. The capacity of healthcare organizations to provide safe and high-quality patient care is greatly impacted by the practice problem of nurse staffing levels, according to researchers Griffiths et al. (2018). Nursing staffing is essential for timely and proper treatment, which affects patient outcomes. Insufficient nurses may increase workload, weariness, and burnout, jeopardizing patient safety and satisfaction (Griffiths et al., 2018). Thus, this theory-to-practice application seeks to optimize nurse staffing levels to improve patient care.
The American Association of Critical-Care Nurses (AACN) Synergy Model and June H. Larrabee’s Quality of Nursing Care Theory is our promising middle-range nursing theory for this problem. According to the Synergy Model, patient outcomes are optimal when nurse qualities and abilities meet patient requirements. This idea stresses nurse-patient synergy and recommends matching nurses with unique skills and experience to patients with specific care needs (American Association of Critical-Care Nurses, 2022). This approach may be utilized by assessing each patient’s requirements and connecting them with qualified nurses. A severely sick patient needing sophisticated treatments might get assistance from a critical care nurse, assuring optimum care.
Quality of Nursing Care Theory states that patient outcomes assess nursing care quality. It stresses the need for ongoing quality improvement to improve patient care (Allen-Duck et al., 2017). This idea suggests that healthcare companies constantly assess nurse staffing levels about patient outcomes. Organizations may change nurse staffing based on patient outcomes, including infection rates, prescription mistakes, and patient satisfaction. For instance, if understaffing increases prescription mistakes, a hospital might justify employing more nurses to enhance patient safety. The Synergy Model and Quality of Nursing Care Theory address nurse staffing and encourages patient-centered care and continual improvement in nursing practice. These intermediate-range theories provide practical and quantitative notions that connect theoretical understanding with clinical practice.
References
Allen‐Duck, A., Robinson, J. C., & Stewart, M. W. (2017, October). Healthcare quality: A concept analysis. In Nursing forum (Vol. 52, No. 4, pp. 377-386).
American Association of Critical-Care Nurses. (2022). AACN Synergy Model for Patient Care. Retrieved from https://www.aacn.org/nursing-excellence/aacn-standards/synergy-modelLinks to an external site.
Griffiths, P., Recio‐Saucedo, A., Dall’Ora, C., Briggs, J., Maruotti, A., Meredith, P., … & Missed Care Study Group. (2018). The association between nurse staffing and omissions in nursing care: A systematic review. Journal of advanced nursing, 74(7), 1474-1487.
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.
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
NURS 8114 Exploring Middle Range Theories and Framing Practice Issues 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
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)
McEwen, M., & Wills, E. M. (2019). Theoretical basis for nursing (5th ed.). Wolters Kluwer.
McEwen, M., & Wills, E. M. (2019). Theoretical basis for nursing (5th ed.). Wolters Kluwer.
McEwen, M., & Wills, E. M. (2019). Theoretical basis for nursing (5th ed.). Wolters Kluwer.
Document: Writing a Philosophy of Nursing Practice (Word document)
(Review from Week 1)
Required Media (click to expand/reduce)
Optional Resources (click to expand/reduce)
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NURS 8114 Exploring Middle Range Theories and Framing Practice Issues Rubric Detail
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Name: NURS_8114_Week2_Discussion_Rubric
Grid View
List View
Excellent
90%–100% Good
80%–89% Fair
70%–79% Poor
0%–69%
Main Posting:
Response to the Discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.
40 (40%) – 44 (44%)
Thoroughly responds to the Discussion question(s).
Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.
No less than 75% of post has exceptional depth and breadth.
Supported by at least three current credible sources.
35 (35%) – 39 (39%)
Responds to most of the Discussion question(s).
Is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module.
50% of the post has exceptional depth and breadth.
Supported by at least three credible references.
31 (31%) – 34 (34%)
Responds to some of the Discussion question(s).
One to two criteria are not addressed or are superficially addressed.
Is somewhat lacking reflection and critical analysis and synthesis.
Somewhat represents knowledge gained from the course readings for the module.
Cited with fewer than two credible references.
0 (0%) – 30 (30%)
Does not respond to the Discussion question(s). Lacks depth or superficially addresses criteria.
Lacks reflection and critical analysis and synthesis.
Does not represent knowledge gained from the course readings for the module.
Contains only one or no credible references.
Main Posting:
Writing
6 (6%) – 6 (6%)
Written clearly and concisely.
Contains no grammatical or spelling errors.
Adheres to current APA manual writing rules and style.
5 (5%) – 5 (5%)
Written concisely.
May contain one to two grammatical or spelling errors.
Adheres to current APA manual writing rules and style.
4 (4%) – 4 (4%)
Written somewhat concisely.
May contain more than two spelling or grammatical errors.
Contains some APA formatting errors.
0 (0%) – 3 (3%)
Not written clearly or concisely.
Contains more than two spelling or grammatical errors.
Does not adhere to current APA manual writing rules and style.
Main Posting:
Timely and full participation
9 (9%) – 10 (10%)
Meets requirements for timely, full, and active participation.
Posts main Discussion by due date.
8 (8%) – 8 (8%)
Meets requirements for full participation.
Posts main Discussion by due date.
7 (7%) – 7 (7%)
Posts main Discussion by due date.
0 (0%) – 6 (6%)
Does not meet requirements for full participation.
Does not post main Discussion by due date.
First Response:
Post to colleague’s main post that is reflective and justified with credible sources.
9 (9%) – 9 (9%)
Response exhibits critical thinking and application to practice settings.
Responds to questions posed by faculty.
The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.
8 (8%) – 8 (8%)
Response has some depth and may exhibit critical thinking or application to practice setting.
7 (7%) – 7 (7%)
Response is on topic and may have some depth.
0 (0%) – 6 (6%)
Response may not be on topic and lacks depth.
First Response:
Writing
6 (6%) – 6 (6%)
Communication is professional and respectful to colleagues.
Response to faculty questions are fully answered, if posed.
Provides clear, concise opinions and ideas that are supported by two or more credible sources.
Response is effectively written in standard, edited English.
5 (5%) – 5 (5%)
Communication is mostly professional and respectful to colleagues.
Response to faculty questions are mostly answered, if posed.
Provides opinions and ideas that are supported by few credible sources.
Response is written in standard, edited English.
4 (4%) – 4 (4%)
Response posed in the Discussion may lack effective professional communication.
Response to faculty questions are somewhat answered, if posed.
Few or no credible sources are cited.
0 (0%) – 3 (3%)
Responses posted in the Discussion lack effective communication.
Response to faculty questions are missing.
No credible sources are cited.
First Response:
Timely and full participation
5 (5%) – 5 (5%)
Meets requirements for timely, full, and active participation.
Posts by due date.
4 (4%) – 4 (4%)
Meets requirements for full participation.
Posts by due date.
3 (3%) – 3 (3%)
Posts by due date.
0 (0%) – 2 (2%)
Does not meet requirements for full participation.
Does not post by due date.
Second Response:
Post to colleague’s main post that is reflective and justified with credible sources.
9 (9%) – 9 (9%)
Response exhibits critical thinking and application to practice settings.
Responds to questions posed by faculty.
The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.
8 (8%) – 8 (8%)
Response has some depth and may exhibit critical thinking or application to practice setting.
7 (7%) – 7 (7%)
Response is on topic and may have some depth.
0 (0%) – 6 (6%)
Response may not be on topic and lacks depth.
Second Response:
Writing
6 (6%) – 6 (6%)
Communication is professional and respectful to colleagues.
Response to faculty questions are fully answered, if posed.
Provides clear, concise opinions and ideas that are supported by two or more credible sources.
Response is effectively written in standard, edited English.
5 (5%) – 5 (5%)
Communication is mostly professional and respectful to colleagues.
Response to faculty questions are mostly answered, if posed.
Provides opinions and ideas that are supported by few credible sources.
Response is written in standard, edited English.
4 (4%) – 4 (4%)
Response posed in the Discussion may lack effective professional communication.
Response to faculty questions are somewhat answered, if posed.
Few or no credible sources are cited.
0 (0%) – 3 (3%)
Responses posted in the Discussion lack effective communication.
Response to faculty questions are missing.
No credible sources are cited.
Second Response:
Timely and full participation
5 (5%) – 5 (5%)
Meets requirements for timely, full, and active participation.
Posts by due date.
4 (4%) – 4 (4%)
Meets requirements for full participation.
Posts by due date.
3 (3%) – 3 (3%)
Posts by due date.
0 (0%) – 2 (2%)
Does not meet requirements for full participation.
Does not post by due date.
Total Points: 100
Name: NURS_8114_Week2_Discussion_Rubric
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