Nursing Theory Reflection Paper

Nursing Theory Reflection Paper

Nursing Theory Reflection Paper Reflection

Nursing theories attempt to narrate, predict and explain different phenomena of nursing. Theories provide the underlying principles of nursing practice in addition to generating further knowledge and indicating in which bearing the future nursing should develop. According to Hickman (2019), the augmentation of nursing disciplinary’s knowledge is dependent upon the evolution of nursing theory that in turn influences the direction of scientific exploration and empiric support for evidence-based nursing care. Nursing theory has significantly impacted overall health.

Nursing Theory Reflection Paper

Jean Watson’s Theory of Human Caring, for instance, formed the foundation of nursing care as well as the basis for nursing programs in various institutions. The 10 carative factors from this theory when put in practice have been associated with increased patient satisfaction and quality patient care (Pajnkihar et al., 2017 Nursing Theory Reflection Paper). The theory further emphasizes the well-being of the caring staff which in turn improves the morale, productivity, and efficiency of the caring personnel.

As a nurse informatics specialist, adopting Jean Watson’s theory of caring into the nursing practice can significantly contribute to evidence-based practice. The field of nursing informatics is faced with a lot of challenges including patient confidentiality and privacy. Incorporating carative factors such as the development of humanistic and altruistic behaviors can aid prevent illegal access to patient information and sharing of patient information with unauthorized personnel (Hussey & Hannah, 2021 Nursing Theory Reflection Paper). The Theory of Human Caring also encourages nurses to be open to mystery. This has resulted in advancements in technologies that have been incorporated into the caring process.

Applying technology to existing knowledge, skills and expertise can help identify potential patients’ problems earlier (Hussey & Hannah, 2021). Electronic documentation for example has been crucial in the early identification of alterations in patient status and subsequent interventions. Similarly, the theory encourages transpersonal learning that has led to the integration of technical and clinical language into one and therefore enhanced communication and involvement of patients in decision making. Nursing Theory Reflection Paper

Nursing Theory Reflection Paper References

Hickman, R. L. (2019). Nursing theory and research: The path forward. ANS. Advances in Nursing Science, 42(1), 85–86. https://doi.org/10.1097/ans.0000000000000255

Hussey, P., & Hannah, K. J. (2021). Nursing informatics: A core competency for the profession. In Health Informatics (pp. 55–85). Springer International Publishing. https://doi.org/10.1007/978-3-030-58740-6_3

Pajnkihar, M., Štiglic, G., & Vrbnjak, D. (2017). The concept of Watson’s carative factors in nursing and their (dis)harmony with patient satisfaction. PeerJ, 5(e2940), e2940. https://doi.org/10.7717/peerj.2940

Nursing Theory Reflection Paper Instructions

Reflect on your nursing theory class .Explain the importance of theory in nursing practice. How will you use a current theory such as Jean Watson theory of caring or envision a new theory that can be used to support evidence-based change related to your practice as nurse informatics specialist.

Nursing philosophy and my opinion about the future of nursing

Correction: this paper will be my nursing philosophy based on the nursing theory. What is my nursing philosophy and how am I gonna use it as nurse in the field. It is not about the movie. I apologize.
Intro : about philosophy, body: what is my philosophy and how am I gonna apply to my career. Conclusion: summery?

It should be APA format.

PICOT question with education for post heart attack patient care.

I have to make PICOT question with Education of the post heart attack patients

 my professor wants to us look for 10 articles/researches and write papers based on my PICOT question.

PICOT Question for Education in Post Heart Attack Sample

Background information and Problem Statement

Like other organs of the body, the heart requires blood supply to support its metabolic function as well sere other systems of the body effectively. Coronary arteries are the major arteries that supply oxygenated blood and other nutrients to heart muscles (M. Kim et al., 2021). Therefore, any pathology that narrows the coronary arteries blocks the supply to heart muscles resulting in ischemia, hypoxia, and death of heart muscles; a condition commonly referred to as myocardial infarction (MI), otherwise heart attack or coronary artery disease (CAD). Nursing Theory Reflection Paper

CAD is a common cardiac condition that affects several individuals worldwide. In addition is a healthcare burden in terms of mortality, morbidity, cost of care, and hospitalization due to complications. According to M. Kim et al. (2021), the United States reports up to 785,000 new cases of CAD and 470,000 recurrent cases of CAD annually. In addition, according to the same report, 2.4 million people are admitted due to CAD-related complications compared to 2.3 million cases in the United Kingdom during the same period. These include depression, anxiety, angina pectoris, shortness of breath, congestive heart disease, and sequelae. Consequently, a lot of funds are used in caring for these patients.

For instance, it is estimated that up to $21,500 is spent on caring for a single patient on average for 5 days, summated to $494 billion annually, yet readmissions are not accounted for properly (Beatty et al., 2018). Sadly, up to 1.8 million patients die due to CAD and its related complications (Beatty et al., 2018). Therefore, appropriate evidence-based management techniques are required to reduce the healthcare burden and improve the quality of life for patients, increase life expectancy, and improve patient outcomes while reducing hospitalization. Nursing Theory Reflection Paper

The evidence-based practice management guidelines advocate for using both pharmacological and non-pharmacological methods in CAD to improve patient outcomes. Pharmacologic approaches aim at symptomatic relief of symptoms and improving the quality of life (QoL). Common medications include antihypertensives, lipid-lowering medications, vasodilators, and pain medications. Non-pharmacological interventions, on the other hand, aim at improving QoL, reducing the recurrence of symptoms, and reducing the risk factors for a cardiovascular event. Educating patients before, during, and after an attack is a method widely used to rehabilitate patients.

Provision of education to patients as part of cardiac rehabilitation is vital for all healthcare providers who care for patients with CAD. Nonetheless, the effectiveness of the education is dependent on the knowledge of healthcare about the subject and the steps taken by the patient to implement the teachings. Notably, post-heart attack education is as essential as pre-heart attack teachings.

According to Anderson et al. (2017), after MI, the patient should be educated about various subjects, including adherence to prescribed medications, seeking prompt medical care, lifestyle modifications, exercise programs, and rehabilitation. Lifestyle modification strategies include dietary modifications such as reduced salt and fat intake, increased intake of vegetables, cessation of alcohol drinking and smoking tobacco, and weight reduction through exercise. Nursing Theory Reflection Paper

The recommended exercise includes moderate 30-minute fitness, including walking, jogging, and dancing. Evidently, these methods have improved patient outcomes and reduced hospital admission in centers where the information was adequately provided while the patients adhered to protocols. As a result of the success rate reported for education in post-heart attack patients, I came up with a PICOT question that will help me find more information regarding the subject. It is stated hereafter.

PICOT:  Among patients with coronary artery disease (P), how effective is the provision of education in post-heart attack (I) compared to no education (C) reduce admission and mortality rate (O) in 6 months (T)?

Evidence Search and Literature Review.

Several levels of evidence exist that provide evidence-based practice (EBP) guidelines that can effectively be applied to offer quality care. These include meta-analyses, randomized control trials, and systemic reviews. Furthermore, EBP knowledge can be in reputable sources, including PubMed, Google Scholar, CINAHL, Medline Plus, NCBI, Embase, and Scopus, among others. Keywords used include acute heart disease, the role of education in CAD, acute myocardial infarction, treatment of MI, and reducing MI complications were used. Consequently, ten different sources were identified to provide in-depth information about the subject. Their description and findings are hereafter. Nursing Theory Reflection Paper

The first study by Khan et al. (2021) is a systemic review. A literature search from reputable sources was used. The study aimed to identify various risk factors for CAD and the role of rehabilitation post-MI in preventing depression and anxiety among patients. Depression is a known complication of CAD and can lead to increased admission, reduced patient outcomes, and increased risk of mortality and morbidity, as well as increased recurrence of a cardiovascular event. The study showed that post-heart attack education led to decreased depression rate as supported by an incidence of 3% in those who received rehabilitative education, unlike 14% in the pre-education period.

Furthermore, the admission rate was subsequently reduced. Another systemic review was performed by Anderson et al. (2017) to assess the effects of patient education on mortality, morbidity, healthcare cost, and QoL. Randomized RCTs were used in the review. Findings suggested that education reduces non-fatal cardiovascular events and improved QoL in participant groups compared to the non-participating group. In addition, the study recommended a combination of education on exercise and physiological therapy.

In another study by Sunamtgura et al. (2018), a randomized control trial (RCT) study was done on 1159 patients who had undergone primary percutaneous coronary intervention (pPCI) for CAD. The aim was to assess the effectiveness of a multidisciplinary cardiac rehabilitation (CR) on 10-year survival after the intervention. The study found that patients who underwent CR had a 46% mortality rate compared to the control group. Notably, the findings support the need for education to improve outcomes.

Also, a study by Xiao et al. (2021) yielded the same results. In this study, 164 patients who had undergone pPCI were divided into control and study groups. The study group was involved in a rehabilitation program involving supervised training for 3 months, 9 months of community-based training, and self-training thereafter. Patient outcomes were measured in terms of major adverse cardiac events (MACE), left ejection fraction, laboratory values, and a 6-minute walk. The study findings include a lower incidence of MACE, more significant left ejection fraction, improved 6-minute walk, and improved laboratory values. As a result, patient outcomes were enhanced with a reduction in admission rates and mortality rates, thanks to a rehabilitation program.

Likewise, in another RCT study by Beatty et al. (2018), among veterans who had undergone pPCI, the authors sought to assess the effectiveness of CR in patient survival. The findings from this study concurred with that of Sunamura et al. (2018). CR participants had a 33% reduced mortality rate compared to the control group. Nonetheless, the findings from these two studies are further supported by findings from (Krishnamurthi et al., 2020). In their study among veterans, readmission rates and mortality were reduced among members who underwent the CR program.

Similarly, in another retrospective cohort study by Kim et al. (2020), the authors investigated the effects of CR on patient prognosis in Korea. 6743 patients from 11 tertiary hospitals within Korea were used. The findings from the study showed that the 5-year survival rate among the CR group was 96.9%, compared to 93.3% in the control group. Furthermore, the rate of readmission, revascularization, and recurrence of MI among the CR group was greatly reduced compared to the non-CR group. Interestingly, the mortality rate was reduced by 59% among the CR group.

Similarly, another retrospective cohort study by Ohtera et al. (2021) affirmed the need for pharmacologic education, nutrition, and exercise education for patients with CAD to prevent cardiovascular events and improve patient outcomes. Furthermore, findings from Ogata et al. (2019) affirmed that cardiovascular rehabilitation through continuous exercise, use of pharmacologic, and adherence to risk reduction behaviors such as cessation of alcohol and smoking tobacco contributed to a reduction in cardiovascular-related deaths and morbidity.

Finally, a study by Tulppo et al. (2020) affirmed the need for education in the treatment of CAD. The study aimed at identifying the relationship between leisure-time physical activity (LTPA) and the risk of sudden cardiac death (SCD). According to LTPA, patients were grouped into four as either active, irregularly active, or highly active. The findings from the study showed that inactive patients, unlike the active groups, were at increased risk of SCD.

Conclusion

Despite the increasing number of CAD cases, EBP provides proven techniques for caring for patients to reduce readmission, mortality, and morbidity from the disease process. Interventions for CAD combine both pharmacological, surgical, and non-pharmacological methods. However, none of the interventions is superior to another but can be used in combination. Patient education post-heart attack has been used in combination with other EBP methods to increase patient outcomes while improving the QoL and reducing the healthcare burden, as evidenced by several scholarly articles. Therefore, every healthcare provider should understand the needs of their patients and formulate a better education plan that enhances quality care while improving patient outcomes.

Nursing Theory Reflection Paper References

Anderson, L., Brown, J. P., Clark, A. M., Dalal, H., Rossau, H. K., Bridges, C., & Taylor, R. S. (2017). Patient education in the management of coronary heart disease. Cochrane Database of Systematic Reviews, 6(6), CD008895. https://doi.org/10.1002/14651858.CD008895.pub3

Beatty, A. L., Doll, J. A., Schopfer, D. W., Maynard, C., Plomondon, M. E., Shen, H., & Whooley, M. A. (2018). Cardiac rehabilitation participation and mortality after percutaneous coronary intervention: Insights from the Veterans Affairs Clinical Assessment, Reporting, and Tracking program. Journal of the American Heart Association, 7(19), e010010. https://doi.org/10.1161/JAHA.118.010010

Khan, Z., Musa, K., Abumedian, M., & Ibekwe, M. (2021). Prevalence of depression in patients with post-acute coronary syndrome and the role of cardiac rehabilitation in reducing the risk of depression: A systematic review. Cureus, 13(12), e20851. https://doi.org/10.7759/cureus.20851

Kim, C., Choi, I., Cho, S., Han, J.-Y., Kim, A.-R., Kim, W.-S., Jee, S., Lee, J. H., Joo, M. C., Bang, H. J., Joa, K.-L., Han, E. Y., Baek, S., Shim, J.-I., & Choi, J. A. (2020). Cardiac rehabilitation and 5-year mortality after acute myocardial infarction. Report from 11 tertiary hospitals in Korea (ETHIK Study). European Journal of Physical and Rehabilitation Medicine, 56(4), 489–495. https://doi.org/10.23736/S1973-9087.20.06081-5

Kim, M., Yang, P. S., Yu, H. T., Kim, T. H., Jang, E., Uhm, J. S., Pak, H. N., Lee, M. H., & Joung, B. (2021). Changes in cardiovascular health status and risk of sudden cardiac death in older adults. Yonsei Medical Journal, 62(4), 298–305. https://doi.org/10.3349/ymj.2021.62.4.298

Krishnamurthi, N., Schopfer, D. W., Shen, H., & Whooley, M. A. (2020). Association of cardiac rehabilitation with survival among US veterans. JAMA Network Open, 3(3), e201396. https://doi.org/10.1001/jamanetworkopen.2020.1396

Ogata, S., Nishimura, K., Guzman-Castillo, M., Sumita, Y., Nakai, M., Nakao, Y. M., Nishi, N., Noguchi, T., Sekikawa, A., Saito, Y., Watanabe, T., Kobayashi, Y., Okamura, T., Ogawa, H., Yasuda, S., Miyamoto, Y., Capewell, S., & O’Flaherty, M. (2019). Explaining the decline in coronary heart disease mortality rates in Japan: Contributions of changes in risk factors and evidence-based treatments between 1980 and 2012. International Journal of Cardiology, 291, 183–188. https://doi.org/10.1016/j.ijcard.2019.02.022

Ohtera, S., Kato, G., Ueshima, H., Mori, Y., Nakatani, Y., Ozasa, N., Nakayama, T., & Kuroda, T. (2021). A nationwide survey on participation in cardiac rehabilitation among patients with coronary heart disease using health claims data in Japan. Scientific Reports, 11(1), 20096. https://doi.org/10.1038/s41598-021-99516-1

Sunamura, M., ter Hoeve, N., van den Berg-Emons, R. J. G., Boersma, E., van Domburg, R. T., & Geleijnse, M. L. (2018). Cardiac rehabilitation in patients with the acute coronary syndrome with primary percutaneous coronary intervention is associated with an improved 10-year survival. European Heart Journal. Quality of Care & Clinical Outcomes, 4(3). https://doi.org/10.1093/ehjqcco/qcy001

Tulppo, M. P., Kiviniemi, A. M., Lahtinen, M., Ukkola, O., Toukola, T., Perkiömäki, J., Junttila, M. J., & Huikuri, H. V. (2020). Physical activity and the risk for sudden cardiac death in patients with coronary artery disease. Circulation. Arrhythmia and Electrophysiology, 13(6), e007908. https://doi.org/10.1161/CIRCEP.119.007908

Xiao, M., Li, Y., & Guan, X. (2021). Community-based physical rehabilitation after percutaneous coronary intervention for acute myocardial infarction. Texas Heart Institute Journal, 48(2). https://doi.org/10.14503/THIJ-19-7103