DNP-815A Topic 2 DQ 2 Select a nursing model or theory from the Philosophies and Theories for Advanced Nursing textbook to use for your DNP Project

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Topic 2 DQ 2

Jul 14-18, 2022

Select a nursing model or theory from the Philosophies and Theories for Advanced Nursing textbook to use for your DNP Project. What are the key concepts and components of the nursing theory that you selected and how are they defined? Create an example describing the application to an area of your DNP Project. Provide examples and literature support.

REPLY TO DISCUSSION

Ruby Minda Dangan

Jul 18, 2022, 11:24 PM

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Replies to Ruby Minda Dangan

For my DNP project, I selected the theory of Crosby on his attention to transforming the quality culture in the field of quality management. Crosby’s theory emphasized the importance of systems knowledge and improvement, failure of inspection, and the importance of statistical quality control with four basic absolutes or concepts of a quality improvement process (Butts & Rich, 2018).

The first absolute is “the definition of quality is conformance to requirements” where management has the basic tasks of establishing the requirements (Butts & Rich, 2018). The direct practice improvement that I’m working on is the prevention of central venous catheter (CVC) infection for patients receiving hemodialysis patients. The second absolute is “the system of quality is prevention” where prevention is successful when key processes are understood (Butts & Rich, 2018). Central Line-Associated Blood Stream Infections (CLABSI) is a highly prevalent problem that only through established protocol adherence, and best practices can reduce infections.

The third absolute is that “the performance standard is zero defect” (Butts & Rich, 2018). One of the clinical measures of The End-Stage Renal Disease (ESRD) Quality Improvement Program (QIP) is zero infection. This metric can be preventable with surveillance, proper aseptic technique, and management strategies. Mitigating risks and brainstorming solutions establish a culture of safety. The fourth absolute is “the measurement of quality is the price of nonconformance” (Butts & Rich, 2018). The Centers for Medicare & Medicaid Services (CMS) administers ESRD QIP to promote high-quality services in renal dialysis facilities and reduce payments for those who do not meet or exceed performance standards.

Quality management is a key element allowing operational performance improvement, product quality, and organizational performance (Negron, 2020). As doctoral-prepared nurses in dynamic roles, we are poised to interface and simultaneously lead within our professional sphere.

References

Butts, J.B., & Rich, K.L. (2018). Philosophies and theories for advanced nursing practice (3rd ed.) Jones & Barlett Learning.

Negron, L.A. (2020). Relationship between quality management practices, performance and maturity quality management, a contingency approach. Quality Management Journal, 27 (4), 215-228.

https://doi.org/10.1080/10686967.2020.1809582

Diana Goulart

replied toRuby Minda Dangan

Jul 19, 2022, 7:58 PM

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Replies to Ruby Minda Dangan

Great job on your post. I really like your project idea as infection is a major concern when it comes to central venous catheters. In a study done by Xiong and Chen in 2018, it was shown that better compliance, even in the eighty percent range, leads to a decrease in CVC infections (Xiong & Chen, 2018). But prior to this, proper education on what to comply with is absolutely necessary. I remember a few years ago there was a huge push on increasing foley catheter education to increase sterile practice compliance and thus decrease UTIs amongst hospitalized clients. This is similar to what I see your project doing. I am excited to see the results and I wish you all the best.

References

Xiong, Z., & Chen, H. (2018). Interventions to reduce unnecessary central venous catheter use to prevent central-line-associated bloodstream infections in adults: A systematic review. Infection control and hospital epidemiology, 39(12), 1442–1448. https://doi.org/10.1017/ice.2018.250

Yolanda Cooke

replied toRuby Minda Dangan

Jul 20, 2022, 5:43 PM

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Replies to Ruby Minda Dangan

Great topic Ruby,

I know many of us in our profession seeks to improve quality of care provided to the patient. I believe CVC infections are a low hanging fruit and we can definitely prevent these. Preventing nosocomial infections pose a great challenge in ICU, because of the multi-drug resistant organisms treated with broad-spectrum antibiotics. Clinical practice guidelines from various organizations are available for prevention of vascular catheter related infections. one of the most convenient and cost effective way if to perform adequate hand hygiene. Hand Hygiene prevents the transmission of pathogens and is a universal strategy to prevent all nosocomial infections. There is a risk of acquiring a blood stream infection both during the insertion and maintenance care of CVCs.

Myatra S. N. (2019). Improving Hand Hygiene Practices to Reduce CLABSI Rates: Nurses Education Integral for Success. Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine, 23(7), 291–293. https://doi.org/10.5005/jp-journals-10071-23200

Yolanda Cooke

Jul 18, 2022, 10:45 PM

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Nursing theory is ultimately the product of nursing practice. It is used to guide practice and close knowledge gaps. The theory that I will use from the Philosophies and Theories for Advanced Nursing textbook that I will use for my DNP project is Virginia Henderson’s Needs Theory. Butts (2018), does a great job discussing this theory. I loved when she proclaimed that Virginia Henderson believed that the beauty of nursing is the combination of your heart, your head and your hands and where you separate them, you diminish them. Some of the other key elements of this theory are defined within 14 components set up by the theorist.

Below the 14 components are broken down by its component category. The 14 components are built with the Maslowes Hierichy of needs in mind. Gonzalo (2022), does an amazing job placing them in their correct component category.

Physiological Components

1. Breathe normally
2. Eat and drink adequately
3. Eliminate body wastes
4. Move and maintain desirable postures
5. Sleep and rest
6. Select suitable clothes – dress and undress
7. Maintain body temperature within normal range by adjusting clothing and modifying environment
8. Keep the body clean and well-groomed and protect the integument
9. Avoid dangers in the environment and avoid injuring others

Psychological Aspects of Communicating and Learning

10. Communicate with others in expressing emotions, needs, fears, or opinions.
14. Learn, discover, or satisfy the curiosity that leads to normal development and health and use the available health facilities.

Spiritual and Moral

11. Worship according to one’s faith

Sociologically Oriented to Occupation and Recreation

12. Work in such a way that there is a sense of accomplishment
13. Play or participate in various forms of recreation

Henderson’s Needs Theory can be applied to nursing practice as a way for nurses to set goals based on Henderson’s 14 components. Meeting the goal of achieving the 14 needs of the client can be a great basis to further improve one’s performance towards nursing care. In nursing research, each of her 14 fundamental concepts can serve as a basis for research, they can assist with meeting your patients needs throughout their care.

Despite advances in the science of cardiopulmonary resuscitation over the past several decades, the odds of neurologically intact survival from in-hospital cardiac arrest remain low. When cardiac arrest occurs, a patient’s survival depends on both the immediate recognition of the event (as each minute delay from the time of cardiac arrest to the initiation of cardiopulmonary resuscitation (CPR) corresponds to a 10% decrease in the likelihood of survival), as well as aggressive resuscitation in the form of CPR, mechanical ventilation, administration of cardioactive medications and electrical defibrillation. I see the needs theory applies to this as it helps us to understand the basic fundamental needs of the patient to stay alive. According to Clark (2016), facilities tend to overlook fundamental aspects of the preparedness gap to accurately apprehend the true nature of cardiac arrest teams. Hospitals aspire to the model of ‘high reliability teams’ in which team members have a high degree of familiarity with each other and with their individual

DNP-815A Topic 2 DQ 2 Select a nursing model or theory from the Philosophies and Theories for Advanced Nursing textbook to use for your DNP Project

roles, and in which the leadership structure is mutually understood. They need to understand basic principles and the needs of their patients pre code to avoid codes themselves.

Butts, J. B., & Rich, K. L. (Eds.). (2018). Philosophies and theories for advanced nursing practice (3rd ed.). Jones & Bartlett. ISBN-13: 9781284112245

Clarke, S., Carolina Apesoa-Varano, E., & Barton, J. (2016). Code Blue: methodology for a qualitative study of teamwork during simulated cardiac arrest. BMJ open, 6(1), e009259. https://doi.org/10.1136/bmjopen-2015-009259

Gonzalo, A. (2022). Virginia Henderson: Nursing Needs Theory. Nurselabs. https://nurseslabs.com/virginia-hendersons-need-theory/

Grading Rubric Guidelines

Performance Category	10	9	8	4	0
Scholarliness Demonstrates achievement of scholarly inquiry for professional and academic decisions.	Provides relevant evidence of scholarly inquiry clearly stating how the evidence informed or changed professional or academic decisions Evaluates literature resources to develop a comprehensive analysis or synthesis. Uses valid, relevant, and reliable outside sources to contribute to the threaded discussion	Provides relevant evidence of scholarly inquiry but does not clearly state how the evidence informed or changed professional or academic decisions. Evaluates information from source(s) to develop a coherent analysis or synthesis. Uses some valid, relevant, reliable outside sources to contribute to the threaded discussion.	Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions. Information is taken from source(s) with some interpretation/evaluation, but not enough to develop a coherent analysis or synthesis. Little valid, relevant, or reliable outside sources are used to contribute to the threaded discussion. Demonstrates little or no understanding of the topic.	Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions. Information is taken from source(s) without any interpretation/evaluation. The posting uses information that is not valid, relevant, or reliable	No evidence of the use of scholarly inquiry to inform or change professional or academic decisions. Information is not valid, relevant, or reliable
Performance Category	10	9	8	4	0
Application of Course Knowledge – Demonstrate the ability to analyze, synthesize, and/or apply principles and concepts learned in the course lesson and outside readings and relate them to real-life professional situations	Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources; Applies concepts to personal experience in the professional setting and or relevant application to real life.	Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources. Applies concepts to personal experience in their professional setting and or relevant application to real life Interactions with classmates are relevant to the discussion topic but do not make direct reference to lesson content	Posts are generally on topic but do not build knowledge by incorporating concepts and principles from the lesson. Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life Does not demonstrate a solid understanding of the principles and concepts presented in the lesson	Posts do not adequately address the question posed either by the discussion prompt or the instructor’s launch post. Posts are superficial and do not reflect an understanding of the lesson content Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life	Posts are not related to the topics provided by the discussion prompt or by the instructor; attempts by the instructor to redirect the student are ignored No discussion of lesson concepts to personal experience in the professional setting and or relevant application to real life
Performance Category	5	4	3	2	0
Interactive Dialogue Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days. *(5 points possible per graded thread)*	Exceeds minimum post requirements Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts three or more times in each graded thread, over three separate days. Replies to a post posed by faculty and to a peer Summarizes what was learned from the lesson, readings, and other student posts for the week.	Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days Replies to a question posed by a peer Summarizes what was learned from the lesson, readings, and other student posts for the week.	Meets expectations of 2 posts on 2 different days. The main post is not made by the Wednesday deadline Does not reply to a question posed by a peer or faculty	Has only one post for the week Discussion posts contain few, if any, new ideas or applications; often are a rehashing or summary of other students’ comments	Does not post to the thread No connections are made to the topic
	Minus 1 Point	Minus 2 Point	Minus 3 Point	Minus 4 Point	Minus 5 Point
Grammar, Syntax, APA Note: if there are only a few errors in these criteria, please note this for the student in as an area for improvement. If the student does not make the needed corrections in upcoming weeks, then points should be deducted. Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition	2-3 errors in APA format. Written responses have 2-3 grammatical, spelling, and punctuation errors. Writing style is generally clear, focused, and facilitates communication.	4-5 errors in APA format. Writing responses have 4-5 grammatical, spelling and punctuation errors. Writing style is somewhat focused.	6-7 errors in APA format. Writing responses have 6-7 grammatical, spelling and punctuation errors. Writing style is slightly focused making discussion difficult to understand.	8-10 errors in APA format. Writing responses have 8-10 grammatical, spelling and punctuation errors. Writing style is not focused, making discussion difficult to understand.	Post contains greater than 10 errors in APA format. Written responses have more than 10 grammatical, spelling and punctuation errors. Writing style does not facilitate communication. The student continues to make repeated mistakes in any of the above areas after written correction by the instructor
	0 points lost				-5 points lost
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