PURPOSE:

It is important to understand how borrowed theory can help you in your everyday environment as a nurse. In the previous assignment, you identified a practical problem that emerged from the evidence in the extant literature or professional practice, and you explored how middle-range theory could be applied to solve the problem. In this assignment, you will explore and apply borrowed theory to solve the specific problem that you identified previously, and you will synthesize the applications of the middle-range theory and the borrowed theory into the most appropriate solution to the problem.

DIRECTIONS:

Consider the problem that you described in the previous assignments and the instructor feedback about those assignments.

Write a paper (1,750 to 2,000 words) that describes how borrowed theory can be applied to the identified problem. The paper should include the following:

1. A brief summary of the problem including the potential middle-range theory that could be applied.
2. A description of a borrowed theory that could be applied to the problem. Is this borrowed theory appropriate to your identified problem?
3. A brief history of the borrowed theory’s origins.
4. A discussion of how the borrowed theory has been previously applied.
5. A discussion of the application of the borrowed theory to the identified problem. How would your practice change by incorporating this theory?
6. A discussion of how application of both the borrowed theory and the middle-range theory can be integrated to create the most appropriate solution to the identified problem.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

Please read the previous 2 essay and apply it to this assignment, apa format, at least 1700 to 2000 word, 3 reference

1 previous essay

Neuman’s System Model and Use in Psychiatric Facilities

Student’s Name:

Institution Affiliation:

 The problem description summary

Psychiatric and mental health nursing deals with the care of the patients with emotional and mental health problems that include and not limited to depression, anxiety, mood disorders, addictions, and stress and various developmental disorders (Phillips, 2016). In this case, the nursing professionals play a significant role in offering both nursing and medical care to the individuals, groups, communities, and even families to promote emotional and mental health. The primary problem experienced in a psychiatric nursing workplace setting is the patient violence that significantly affects the quality of care given and the nursing management outcome (Phillips, 2016). The patient violence particularly occurs in the acute setting of the psychiatric facilities and is believed to result from the nature of the patient condition. This problem remains a global concern and mainly affects the nurses because they remain the primary care givers in the psychiatric facilities and have long hours exposed to the mentally ill patients. A research conducted by Phillips (2016), indicates that over 20%of all psychiatric patients possess violent behavior in a variety of ways ranging from verbal to physical abuse. Various triggers are believed to precipitate the violent behavior and hence proper training, administration, policy making, and proper practice development remain pillars of early detection and prevention of patient violence (Phillips, 2016).

Betty Neuman’s systems model

Middle range theories are highly useful in addressing various nursing problems especially the vulnerable groups, families, or even individuals. In this case, the Betty Neuman’s system model gives a comprehensive system based and holistic approach to nursing with an element of flexibility. This theory primarily focuses on the patient’s response to the existing potential environmental stressors and the utilization of the primary, secondary and the tertiary nursing prevention interventions for maintenance of patient system wellness (Neuman & Fawcett, 2002).

The Neuman’s system theory has various assumptions to put into consideration in its application. The model assumes that a patient system is a unique with composite factors, existence of many universal stressors influencing the patient system stability, each patient has range of responses to the environment, and the interrelations of the patient with care givers at any time can affect the degree to which the client is protected (Neuman & Fawcett, 2002). The model also assumes that the client remains a dynamic system of interrelationships of the existing variables in either state of wellness or illness. In addition, a secondary prevention relates to the symptoms following a behavior or even a reaction and appropriate measuring of the priorities of the intervention and the treatment offered reduces their bad or noxious effects. The primary concepts applied in this model include a person, health, environment, and nursing. This model is highly useful in my identified problem of patient violence in the psychiatric facilities. In this case, the systematic nature of this theory can help the nursing team to do thorough patient management and help reduce the cases of mentally ill patient’s violence against nurses (Neuman & Fawcett, 2002).

Betty Neuman’s systems model origins

Betty Neuman’s theorist was born in the year 1924 in Ohio. She completed her bachelor’s degree in nursing in 1957 and, master’s degree in mental health public health consultation in 1966 from UCLA and hold a doctorate degree in psychology (Neuman & Fawcett, 2002). Neuman started the development of her health system model while a community health nursing lecturer at the University of California in Los Angeles (Neuman & Fawcett, 2002). In this case, the model was published in 1972 involving the teaching of total patient problems approach in the nursing research where it was refined in 1974 and published in the first edition of conceptual models for the nursing practice. This theory was influenced by various philosophers and finally contributed to the body of knowledge validated through research (Neuman & Fawcett, 2002).

Neuman’s systems model previous application

The systems theory has previously been utilized by professionals in the management of various patient conditions. In this case, the professionals focus on the use of the primary, secondary, and the tertiary prevention interventions and have viewed the nursing practice based on the degree of reaction to stressors. The model utilizes the six steps involved in patient management that include the assessment, nursing diagnosis, setting goals, planning, and implementation using the three levels of intervention (Neuman & Fawcett, 2002). Finally, an evaluation is conducted and state of balance restored.  Previously, the model has been utilized in the United States intensive care units. In this case, intensive care has very sick patients who need to be considered holistically by involving their families for quality system functioning. The nurses in such units do a comprehensive patient assessment to come up with the most accurate and correct diagnosis that will help improve the care given to the patient. Proper assessment helps in offering the best prevention intervention to the patient, families, and even the communities. This systematic model prevents the nurses from exhaustion, burn out and psychological trauma (Neuman & Fawcett, 2002).

Use of Neuman’s model in psychiatric facilities

In nearly all instances, violence erupts with some warning signs displayed by the psychiatric patients. In this case, the nursing professional working at the mental health facilities can utilize the Neuman’s systems model to reduce the cases of violence in such facilities (Richter & Whittington, 2006).  The systems model provides guidelines to use that utilizes the three classes of prevention interventions. Thorough patient assessment holistically helps in early detection of any warning signs or identifying all the precipitators of patient violence. In this case, the nursing care givers identify the patient stressors and address the whole person and hence the holistic perspective (Richter & Whittington, 2006).

According to Neuman and Fawcett (2002), the nurse perception must be assessed in addition to assessing the patient because it influences the kind of care plan that he or she makes for a patient. It views the function of the nurse based on reactions to the stressors and the use of all the prevention interventions outlined by this model. After comprehensive assessment to identify the stressors, warning signs, and symptoms of violence, the nurse is required to make a nursing diagnosis, set goals, planning of care, intervening, and finally doing an evaluation of the care given (Neuman & Fawcett, 2002). The primary intervention of this model is the prevention intervention. In this case, prevention of patient violence is essential and can be achieved through proper training, comprehensive attitude, and perception towards the care, proper policy making can aid in the prevention of the patient violence (Neuman & Fawcett, 2002). 

References

Neuman, B. M., & Fawcett, J. (2002). The Neuman systems model. Pearson Education, Incorporated.

Phillips, J. P. (2016). Workplace violence against health care workers in the United States. New England journal of medicine, 374(17), 1661-1669.

Richter, D., & Whittington, R. (2006). Violence in mental health settings: Causes, consequences, management. New York: Springer.

 2 previous essay

PSYCHIATRIC PATIENT VIOLENCE AND RESEARCH                        

Diane Boll

Grand Canyon University: NUR 502

08-30-2017

                                                             Problem description

The nurses working in psychiatric units experience various problems. In this case, these problems impact significantly on the quality of care given by such professionals. One of the problems faced in the psychiatric workplace setting is patient violence that influences and affects the outcome of nursing management (Arnetz et al, 2015). These cases mostly happen in the acute psychiatric settings. The patient violence against the nursing professionals in their work areas remains a global problem and happens particularly in the mental health care facilities. In this case, the violence results from the nature of the patient condition that results in harm to the self and others. This problem is prevalent to nurses because, it is the nurses who take care of the patient and exposed for long hours (Arnetz et al, 2015). Nurse professional is the first and the primary health care provider in psychiatric facilities and hence a high risk of violence. The violence varies from physical to non-physical violence. A research indicates that about 20% of patients admitted to the psychiatric facilities possess violent behaviors in a variety of ways. The violence behaviors may be associated with various triggers that the only the nurses who has known the patient for a long time can understand (Arnetz et al, 2015).

                                Literature supported rationale for significance of the problem

According to Richter and Whittington (2006), patient violence significantly affects both the health professionals and the quality of health they receive. The results of these violent behaviors translate to longer hospital stay and readmission. It also results to work related stress, blame, fear, post traumatic events and the feeling of abuse and insult. The patient violence against the health professional has a great significance and can be used to help manage the problem and prevent its future occurrence (Richter & Whittington, 2006).

A study conducted by Richter and Whittington (2006), offers a significant administration, nursing education, practice development, and policy making. More training and proper practice development are associated with helping in dealing with the violent patients. In this case, the training and proper practice offer the nurses and other health professionals to understand the triggers and the signs of violence that psychiatric patient may display for the anticipation of care. Policy making was found to be of great significance in psychiatric nursing. Overburdening of health facilities, overcrowding and climates of cynicism were found to be great causes of violence in such patients. The De-escalation techniques dealing with fewer skills of physical restraints and focus more on competent and skilled interactions respecting the patient perspectives (Richter & Whittington, 2006).

Violence rarely erupts or happens without any warning, the staff need or require optimal training of pre-planned care criteria of when to set various limits because patients remain optimal in any intervention (Phillips, 2016). Detecting and monitoring early warnings and signs helps in allowing for early detection and intervention while the frustration level of the frustration is still low. This remains an empirical evidence because recidivist clients show warning signs prior to performing acts of violence in the psychiatric wards (Phillips, 2016). The violence prevention benefits largely from comprehensive accurate and proper monitoring of patients and violence precipitators (Phillips, 2016).

In conclusion, the current research plays an essential role in various aspects of violence prevention in the psychiatric facilities. In this case, literature has indicated that preventing the violence against staff can be reduced through proper administration, comprehensive training for triggers and warning signs detection, practice development and proper policy making remain the pillars of reducing and managing the patient violence of all types in the psychiatric facilities.

                                                                    References

Arnetz, J. E., Hamblin, L., Essenmacher, L., Upfal, M. J., Ager, J., & Luborsky, M. (2015). Understanding patient‐to‐worker violence in hospitals: a qualitative analysis of documented incident reports. Journal of advanced nursing, 71(2), 338-348.

Phillips, J. P. (2016). Workplace violence against health care workers in the United States. New England journal of medicine, 374(17), 1661-1669.

Richter, D., & Whittington, R. (2006). Violence in mental health settings: Causes, consequences, management. New York: Springer.