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
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.
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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.
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
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.
Chapter 10, “Introduction to Middle Range Nursing Theories” (pp. 207–222) [PDF]
Theoretical Basis for Nursing, 5th Edition by McEwen, M.; Wills, E. Copyright 2019 by Wolters Kluwer. Reprinted by permission of Wolters Kluwer via the Copyright Clearance Center. Licensed in 2020.
McEwen, M., & Wills, E. M. (2019). Theoretical basis for nursing (5th ed.). Wolters Kluwer.
Chapter 11, “Overview of Selected Middle Range Nursing Theories” (pp. 223–252) [PDF]
Theoretical Basis for Nursing, 5th Edition by McEwen, M.; Wills, E. Copyright 2019 by Wolters Kluwer. Reprinted by permission of Wolters Kluwer via the Copyright Clearance Center. Licensed in 2020.
McEwen, M., & Wills, E. M. (2019). Theoretical basis for nursing (5th ed.). Wolters Kluwer.
Chapter 19, “Application of Theory in Nursing Practice” (pp. 434–451) [PDF]
Theoretical Basis for Nursing, 5th Edition by McEwen, M.; Wills, E. Copyright 2019 by Wolters Kluwer. Reprinted by permission of Wolters Kluwer via the Copyright Clearance Center. Licensed in 2020.
Document: Writing a Philosophy of Nursing Practice (Word document)
(Review from Week 1)
Required Media (click to expand/reduce)
Walden University. (2021). DNP glossary [Interactive media]. Walden University Blackboard. https://class.waldenu.edu
Optional Resources (click to expand/reduce)
Walden University Library. (2020, March 16). Mysteries of the library: Revealed! Finding specific articles [Webinar]. https://academicguides.waldenu.edu/library/transcripts/MysteriesFindSpecificArticles-Mar162020
Walden University Library. (n.d.). Databases A-Z: Nursing. https://academicguides.waldenu.edu/az.php?s=19981
Walden University Writing Center. (n.d.). Webinars: Scholarly writing. https://academicguides.waldenu.edu/writingcenter/webinars/scholarlywriting#s-lg-box-9094031
Walden University Writing Center. (n.d.). Writing as a process. https://academicguides.waldenu.edu/writingcenter/doctoral/capstone/preproposal/writingasaprocess
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Week 2 discussion – Middle Range Theories
COLLAPSE
Nurs 8114 Week 2 discussion
Nursing practice is providing nursing care using the nursing process and this is based on a specific nursing theory selected in consideration with the care setting and the population served. I believe that nursing should be practice in holistic environment. I have special inspiration to provide care to those struggling with mental illness and avoid accessing care because of prevailing stigma. The most widely accepted framework for nursing practice currently in use is the nursing process of assessment, diagnosis, planning, intervention, and evaluation. My biggest concern in this area is the issue of over reliance on medication and insufficient attention to other psychotherapeutic modalities. That someone gets diagnosed with depression does not imply that the person be placed on anti-depressant without a plan for transition into skills that would enable the individual deal with the issue and transition away from medication
Middle range nursing theories provide the frame of reference for daily nursing practice and provides a reality view that is grounded in nursing research studies (McEwin & Wills, 2019). These theories are more case specific and tackle immediate real-world issue (McEwin & Wills, 2019). Middle range theories address (nursing, person, health, environment, medication administration, preoperative teaching, electrolyte management, fall prevention (McEwin & Wills, 2019). Middle range theories emerge from combining research and practice and building on the work of others (McEwin & Wills, 2019). Middle theories arise from literature reviews, qualitative research, field studies, conceptual models, taxonomies of nursing diagnosis and interventions, clinical practice guidelines, theories from other disciplines, and statistical analysis of empirical date (McEwin & Wills, 2019). The middle range theories that interest me include Applied Theory in Nursing Practice, Kolcaba theory of comfort and Hildegard Peplau’s Interpersonal Relations.
Applied Theory in Nursing Practice
Applying Saint Arnault empirical evidence has shaped me in my practice. He employs a theory synthesis approach to explore cultural determinants of help-seeking behavior, seeking ultimately to reduce health disparities (Algase, 2009). Most of my patient have struggled with complex trauma, sometimes intergenerational. They have dealt with systemic structural issues, cycled through jail/prison when the real issue was mental health related and have one type of mental misdiagnosis. Some come here and were placed on one-on-one suicide watch as a suicide precaution when certain self-injurious behavior or verbalization happen. This simple precaution and head count has helped reduced suicide.
Katherine Kolcaba comfort theory which insists that the purpose of nursing is to ensure that patients are provided with all resources to be comfortable. The theory wants nurses to prioritize patients’ needs and ease them of any discomfort. For example, attending to a mentally ill patient who is throwing feces on staff and trying to hurt others or kill self by given PRN medication as ordered. Research has shown the efficacy of this mode of interventions with a pattern of comorbidities including depression, alcoholism, substance abuse, and suicide attempts and success with women who have been victims of domestic violence (McEwin & Wills,2019). This theory has helped me in working with my patients and educating staff and patient to call for immediate help with escalation of negative symptoms.
Hildegard Peplau’s Interpersonal Relations highlights the nurse patient relationship as the groundwork of nursing practice. The theory supports the nurse and the patient’s equal participation in working to attain a mutual goal. Peplau see’s nurse-patient relationships passing through three phases encompassing: (a) orientation, (b) working, and (c) termination (Hagerty, et al. 2017).
The article “Patient engagement through informed nurse caring” by (Welch and Fournier, 2018) defines caring as a nurturing way of relating to a valued other toward whom one feels a personal sense of commitment and responsibility. The Nursing Alliance for quality care suggests that engage patients enter a partnership with nurses though which there is a mutual sharing of information (Welch & Fournier, 2018). This article discusses the promotion of patient engagement as informed caring practice within the framework of a middle range theory of caring which supported the middle range theories that I I have enumerated above. Caring in nursing is well established as fundamental to the nurse–patient relationship
Reference
Algase, D. (2009). The Centrality of Theoretical Thinking and the Value of Empirical Evidence.
Research and Theory for Nursing Practice; New York, 23(4): 251-2
Hagerty, T. A., Samuels, W., Norcini-Pala, A., & Gigliotti, E. (2017). Peplau’s Theory of
Interpersonal Relations: An Alternate Factor Structure for Patient Experience Data?
Nursing science quarterly, 30(2), 160–167. https://doi.org/10.1177/0894318417693286
McEwin, M., & Wills, E. M. (2019). Theoretical basis for nursing. (5th ed.) Philadelphia, PA:
Wolters Kluwer Health.
WELCH, J.; FOURNIER, A. Patient Engagement Through Informed Nurse
Caring. International Journal for Human Caring, [s. l.], v. 22, n. 1, p. 1–10, 2018.
DOI 10.20467/1091-5710.22.1.pg5. Disponível em: https://search-ebscohost-
com.ezp.waldenulibrary.org/login.aspx?direct=true&db=rzh&AN=134822546&site=eds-
live&scope=site. Acesso em: 9 set. 2021.
Nurs 8114 Week 2 discussion
Nursing practice is providing nursing care using the nursing process and this is based on a specific nursing theory selected in consideration with the care setting and the population served. I believe that nursing should be practice in holistic environment. I have special inspiration to provide care to those struggling with mental illness and avoid accessing care because of prevailing stigma. The most widely accepted framework for nursing practice currently in use is the nursing process of assessment, diagnosis, planning, intervention, and evaluation. My biggest concern in this area is the issue of over reliance on medication and insufficient attention to other psychotherapeutic modalities. That someone gets diagnosed with depression does not imply that the person be placed on anti-depressant without a plan for transition into skills that would enable the individual deal with the issue and transition away from medication
Middle range nursing theories provide the frame of reference for daily nursing practice and provides a reality view that is grounded in nursing research studies (McEwin & Wills, 2019). These theories are more case specific and tackle immediate real-world issue (McEwin & Wills, 2019). Middle range theories address (nursing, person, health, environment, medication administration, preoperative teaching, electrolyte management, fall prevention (McEwin & Wills, 2019). Middle range theories emerge from combining research and practice and building on the work of others (McEwin & Wills, 2019). Middle theories arise from literature reviews, qualitative research, field studies, conceptual models, taxonomies of nursing diagnosis and interventions, clinical practice guidelines, theories from other disciplines, and statistical analysis of empirical date (McEwin & Wills, 2019). The middle range theories that interest me include Applied Theory in Nursing Practice, Kolcaba theory of comfort and Hildegard Peplau’s Interpersonal Relations.
Applied Theory in Nursing Practice
Applying Saint Arnault empirical evidence has shaped me in my practice. He employs a theory synthesis approach to explore cultural determinants of help-seeking behavior, seeking ultimately to reduce health disparities (Algase, 2009). Most of my patient have struggled with complex trauma, sometimes intergenerational. They have dealt with systemic structural issues, cycled through jail/prison when the real issue was mental health related and have one type of mental misdiagnosis. Some come here and were placed on one-on-one suicide watch as a suicide precaution when certain self-injurious behavior or verbalization happen. This simple precaution and head count has helped reduced suicide.
Katherine Kolcaba comfort theory which insists that the purpose of nursing is to ensure that patients are provided with all resources to be comfortable. The theory wants nurses to prioritize patients’ needs and ease them of any discomfort. For example, attending to a mentally ill patient who is throwing feces on staff and trying to hurt others or kill self by given PRN medication as ordered. Research has shown the efficacy of this mode of interventions with a pattern of comorbidities including depression, alcoholism, substance abuse, and suicide attempts and success with women who have been victims of domestic violence (McEwin & Wills,2019). This theory has helped me in working with my patients and educating staff and patient to call for immediate help with escalation of negative symptoms.
Hildegard Peplau’s Interpersonal Relations highlights the nurse patient relationship as the groundwork of nursing practice. The theory supports the nurse and the patient’s equal participation in working to attain a mutual goal. Peplau see’s nurse-patient relationships passing through three phases encompassing: (a) orientation, (b) working, and (c) termination (Hagerty, et al. 2017).
The article “Patient engagement through informed nurse caring” by (Welch and Fournier, 2018) defines caring as a nurturing way of relating to a valued other toward whom one feels a personal sense of commitment and responsibility. The Nursing Alliance for quality care suggests that engage patients enter a partnership with nurses though which there is a mutual sharing of information (Welch & Fournier, 2018). This article discusses the promotion of patient engagement as informed caring practice within the framework of a middle range theory of caring which supported the middle range theories that I I have enumerated above. Caring in nursing is well established as fundamental to the nurse–patient relationship
Reference
Algase, D. (2009). The Centrality of Theoretical Thinking and the Value of Empirical Evidence.
Research and Theory for Nursing Practice; New York, 23(4): 251-2
Hagerty, T. A., Samuels, W., Norcini-Pala, A., & Gigliotti, E. (2017). Peplau’s Theory of
Interpersonal Relations: An Alternate Factor Structure for Patient Experience Data?
Nursing science quarterly, 30(2), 160–167. https://doi.org/10.1177/0894318417693286
McEwin, M., & Wills, E. M. (2019). Theoretical basis for nursing. (5th ed.) Philadelphia, PA:
Wolters Kluwer Health.
WELCH, J.; FOURNIER, A. Patient Engagement Through Informed Nurse
Caring. International Journal for Human Caring, [s. l.], v. 22, n. 1, p. 1–10, 2018.
DOI 10.20467/1091-5710.22.1.pg5. Disponível em: https://search-ebscohost-
com.ezp.waldenulibrary.org/login.aspx?direct=true&db=rzh&AN=134822546&site=eds-
live&scope=site. Acesso em: 9 set. 2021.
NURS 8114 Exploring Middle Range Theories and Framing Practice Issues
Rubric Detail
Select Grid View or List View to change the rubric’s layout.
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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