Nursing Theory Plan of Care
Nursing Theory Plan of Care
Transforming nursing research evidence into practice and policy is essential for the provision of quality care. Research utilization is defined as “the systematic process of transferring research knowledge into practice for the purpose of understanding, validating, enhancing, or changing practice” and has a potential to influence attitudes, beliefs, and behaviors of healthcare providers and recipients, alike (Matthew-Maich, Ploeg, Jack, & Dobbins, 2010). Most practical nursing disciplines create mechanisms of research utilization that, according to MacGuire (2006), can “clearly explicate the essential nature, meanings and ...view middle of the document...
The plan of care for Mr. Issler will be discussed using Dorothy Johnson’s Behavioral System Model (JBSM).
Dorothy Johnson proposes that a patient is perceived as a behavioral system, comprised of a group of subsystems to make up the practicing theory. This model focuses on caring for the whole patient with a nursing focus on the entire system of patient needs. Johnson believes that stressors can cause disequilibrium in a patient, leading to illness. If stressors are reduced, the patient can return to a state of equilibrium with nursing care focused on providing support of “the client’s natural defenses and adaptive processes” (George, 2011, p. 1).
In a medical model plan of care, the model needs to be analyzed for congruence to the behavioral model. Congruence meaning, in agreement with, or in harmony of, the elements of the subsystems, makes up the patient’s plan of care.
The first subsystem to be analyzed for congruence is Achievement. Mr. Issler’s condition shows that he has not taken proper care of himself and is in need of cognitive behavioral exercises to achieve a state of equilibrium. This subsystem is congruent with the plan of care.
Attachment-Affilliative subsystem addresses Mr. Issler’s social inclusion need. He has just lost his wife. He will need to establish a social bond with his daughter-in-law and will need assistance in achieving and maintaining equilibrium with his state-of-being. This subsystem is congruent with the plan of care for Mr. Issler’s behavioral needs.
Aggressive-Protective subsystem addresses Mr. Issler’s need to protect himself. He has not taken proper care of himself leading to the deterioration of his physical health. He will need assistance caring for himself. This subsystem also addresses his current issues and the necessary steps to take to achieve wellness making it congruent with his plan of care.
Dependency addresses Mr. Issler’s inability to live by himself and manage his health care regimen. Mr. Issler’s confusion about his prescribed medications is an example of his inability to manage his health. He requires help improving his self-esteem and regaining his sense of self. He needs approval and recognition as a worthwhile human being to accept assistance. This subsystem is congruent with Mr. Issler’s plan of care.
The Ingestive subsystem is visibly impaired and evidenced by the fact that Mr. Issler has been pale, short of breath, rather thin, and very weak since his arrival. An appropriate nursing intervention would be to assess if, since his wife passed, Mr. Issler has been skipping meals or forgetting to take his medications, causing deterioration in his health. These issues are physiological in nature and will require further assessment. Nursing intervention can include assisting him with his medication by making a chart or placing his medications in a more user-friendly container, rather than a large bag. The behavioral portion of encouraging Mr. Issler to eat a...