The practice of nursing is based on various nursing theories. Applicable theories come together in patient care and are collectively known as "evidence based practice." This allows nurses to look at each patient individually, and make use of their clinical experience and education to make treatment decisions.
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The purpose of nursing theories in practice is to help nurses understand, treat, and predict outcomes for patients in their care. Theories help establish the procedures and standards of care for nurses.
Every state has a Nurse Practice Act, which defines the procedures nurses can perform. However, it does not describe how a nurse should approach or organise care for each patient. Nurses use a variety of theories to determine the best approaches for each situation.
In 1859, Florence Nightingale's judgments and ideas on how to improve nursing were compiled in a book. Her insights on how to care for patients have become the bedrock on which other theories are built.
Another important theory, Maslow's Hierarchy, was published in 1954. This theory enables nurses to prioritise care based on the patient's physiological and psychological needs. According to Maslow, physical needs, such as food and water, come before mental needs, such as self-esteem. However, all are important to a person's overall health.
There are four main types of nursing theories: descriptive, explanatory, predictive and prescriptive. Descriptive theories use facts and variables to analyse progress and direct nurses to outcomes. Explanatory theories assign treatment based on a patient's existing well-being. Predictive theories use the typical disease progression to predict outcomes, and base treatment around these outcomes. Finally, prescriptive theories puts into practice the nurse-to-patient relationship and uses it as a means of therapy and treatment.
The nursing process is the core that brings theory and practice together in nursing. It consists of five parts: assessment, diagnosis, planning, implementation and evaluation.
Assessment of the patient allows nurses to identify a nursing diagnosis---a problem that needs to be taken care of. Nurses then write a care plan around this diagnosis, implement actions to take care of it and evaluate their actions to see if the desired outcome was met.
Nurses using theory along with their clinical experiences are better able to predict patient outcomes and provide care based on this knowledge.
This also helps them prevent issues from occurring in the first place. For example, if a nurse knows that theory dictates that patients are more likely to encounter blood clots after surgery, the nurse can put in place preventive measures immediately to help post-surgical patients avoid this problem.
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