Summary: A theory can be used to guide practice. This assignment is an exercise in supporting a clinical practice with theory and evidence.
Directions: Identify an outcome of nursing practice in your area of practice (Psych) that can be improved. For example, if you work in home health, you may identify that throw rug use by fall risk patients is too prevalent. You may be able to use the problem that inspired the theory concepts that you developed in week two. Identify the concept in Watson’s Theory of Caring that could represent or include the outcome. In our example, the outcome would be the changes in self through the change in the patient’s floor covering practice. Identify a practice that can be changed or implemented that may influence the outcome.
Identify the concept in Watson’s Theory of Caring that includes the practice. In our example, the practice could be to improve the understanding of fall hazards through the engagement in a teaching-learning experience, one of Watson’s Caritas Processes. Identify exactly how these two concepts will be measured with their operational definitions. Develop a proposition between the two. Present your outcome in an APA formatted paper meeting the University’s standards for a written assignment.
Application of concepts from Caring Science
Theories establish relationships among concepts in a model, which, if not accompanied by evidence-based practice, maybe considered biased and irrelevant. In this case, evidence-based practice helps provide substantial research and information-based mitigation strategies that can be integrated into solving medical problems and informing effective decision-making that maximizes quality care among patients. The purpose of accompanying theories with measuring factors helps validate the approach and strengthen the relationships of concepts previously established (Melnyk, 2018). In this assignment, a nursing practice outcome is determined and thoroughly discussed in relation to Watson’s Caring Theory. The theory contends that caring is a critical and core concept in holistic and psychological nursing (Vrbnjak, 2017). The theory alleges that effective care among patients requires nurses with both scientific knowledge and aesthetic training. Thus, Watson’s theory of caring helps identify the reason for the development of the outcome, effective mitigation options, and measuring factors to validate the theoretical result identified. This will help define and establish whether links and relationships found are robust, showing if the nursing practice outcome is a null or alternative hypothesis.
Nursing Practice Outcome
The identified nursing practice outcome involves the association of loose rugs and carpets with increased slipping and tripping levels among seniors and education levels. Previously, the determined theoretical foundation of this case was that, “Education among the elderly on throwaway rugs found in their homes prevents unintentional falls and injuries.” According to research, unintentional injuries among elders of 65 years and older results from many accidental falls they encounter in their homesteads. Noonan et al. (2013) through a retrospective analysis and survey finds that among 37,9991 adults treated for falls and unintentional injuries 54.2% of the falls were associated with carpets and the rest 45.8% were associated with throw away rugs (Noonan, 2013). Women were associated to present the highest number of falls resulting in 80.2% of the unintentional fall injuries while the remaining 19.8% were men. Moreover, areas in the house where these falls were mostly experienced were recorded to be in bathrooms having a record of 35.7% of the cases. The survey further concludes that unintentional falls and injuries among the elderly, especially women were associated with throwaway rugs and carpets found in their homes or bathrooms. Noonan et al. recommended that caregivers and physician provide education to the elderly on the risks associated with these falls and association with the rags, while describing them as environmental hazards that require modifications (Noonan, 2013). The study further shows that reduction of fall injuries among the elderly caused by loose rugs and mats can be achieved through educational and adjustment oriented programs including adopting preventive measures. Moreover, in another article, the author advocates for educating the older adults on fitting these rugs where they are firmly held on the floors and bathrooms, and installing modifications such as handrails by stairways to help easier climbing and minimizing risk levels.
Watson’s Caring Theory
Watson’s Caring Theory contends that caring is a critical and core concept in holistic and psychological nursing. The theory argues that effective care among patients requires nurses with both scientific knowledge and aesthetic training. (Vrbnjak, 2017) Watson’s Theory of Caring is one of the highly utilized theories in nursing practice, which provide for four paradigms of the concepts of nursing, society, human beings, and health. Through these factors, relationships are expressed with the development of ten carative elements used in enhancing human caring and experience. These carative factors include developing value systems that improve humanism and altruism, systems that instill hope among patients, and that cultivate sensitivity of self and others (Gonzalo, 2019). These three factors form a philosophical background that explains the science of caring in nursing practice. The remaining elements involve establishing trustworthy relations, creating an environment that patients can express feelings, using aesthetic strategies to solve problems and make decisions, and ensuring a learning and teaching environment (Gonzalo, 2019). Watson’s theory further provides for developing a supportive milieu characterized by teaching and learning. Thus, nursing outcomes, such as the one identified above, can be mitigated effectively and efficiently.
Core concepts of Watson’s theory that represent the outcome identified above include the concept of human being and sub-concept of self. The concept of the human being according to the theory, states that human beings should be cared for, understood, and nurtured. Through nursing, health is promoted and restored (Gonzalo, 2019). While referring to the self-concept, decisions to have rugs and mats in homes and bathrooms among patients result in unintentional falls and injuries that profoundly affect their health and overall wellbeing. Moreover, the carative factor of cultivating sensitivity of self and others helps understand this outcome. The growth and development of self-influence an individual’s tastes, values, and feelings that eventually evolve, resulting in showing the compassion of life experiences (Clark, 2016). Moreover, the changes and evolution of self, which involve older adults results in changes and preferences or values such as those of covering their floors with rugs and carpets.
The outcome identified is expressed as a theory stating, “Education among the elderly on throwaway rugs found in their homes prevents unintentional falls and injuries.” This assumption targets one of Watson’s carative factors and processes, namely promoting the transpersonal teaching-learning factor. According to the theory, the process accompanying this carative factor involves engaging in actual teaching and learning experiences, which in this case, would involve teaching and education from caregivers and physicians and learning among the elderly on how to fit in loose rugs and mats as well as the risks associated with having mats in the house. The essence of this process is maintaining the unity of being and meaning while fitting in the framework of others. This factor aligns with Noonan et al. recommendation on caregivers and physician providing education to the elderly on the risks associated with these falls and rags, through educational and adjustment oriented programs, including adopting preventive measures (Noonan, 2013).
Concisely, the identified nursing practice outcome establishes and expresses relationships between falls among the elderly and loose throwaway rugs as well as education on mats and the prevention of falls. Educating the elderly on the possibility of unintentional falls rug-facilitated would maximize individual caution, thus, preventing slipping, tripping, and fall injuries (Noonan, 2013). Physicians and caregivers can teach the older adults on firmly fitting these rugs where they are securely held on the floors and bathrooms, and installing modifications such as handrails by stairways to help easier climbing and minimizing risk levels. Since the bathrooms are identified as the most common areas of accidents, teaching and letting the elderly know how to purchase and fit in non-slip mats would highly result in decreased accidental falls. Moreover, a learning and teaching environment expands options of having mats or installing modifications such as the identified handrails to offer support.
A learning and teaching environment should be comprehensive and inclusive of alternative consequences of the outcome. Elders must be educated on the advantages and disadvantages of having mats and throwaway rugs as some scholars establish the link between reduced fall hazards when mats are used in houses. This is a valid assumption, as it means that throwing away these mats would increase tripping and fall hazard in homes. However, it is essential to show that having these mats equally promotes fall hazards as they bunch up and elders can be tackled, thus falling (Johnson, 2018). In that case, the learning and teaching carative process, according to Watson’s Caring Theory should ensure useful and conclusive information that provides better mitigation strategies such as teaching them to buy non-slip mats, instigating having modifications, and ensuring mats are firmly held on floors to prevent fall hazards.
Primarily, as identified above, the main argument is that “Education among the elderly on throwaway rugs found in their homes prevents unintentional falls and injuries.” Nursing practice outcome establishes and expresses relationships between falls among the elderly and loose throwaway rugs as well as education on mats and the prevention of falls. This means that having loose mats in homes causes high chances of unintentional fall hazards among the elderly. However, this can be mitigated through effective, sufficient, and compressive education. As through awareness and knowledge, the elderly can change their preferences and self-concept by making informed mat purchase decisions such as buying non-slip mats, having modifications such as handrails on staircases, and having the mats fitted firmly on the floors and bathrooms.
The debate established is that are unintentional falls among educated older adults on throwaway rugs associated fall hazards more or less. In addition, are fall hazards among unaware older adults on throwaway rugs associated falls more or less? These questions help establish measuring factors that can help validate the hypothesis of whether to be null or alternative. Hence, when measuring the effectiveness or applicability of this theory, during treatment of falls among the elderly, nurses can examine patients with falls of the floor type and determine their knowledge on whether rugs can cause falls and injuries. If most of the answers indicate unintentional fall due to objects on the floor such as carpets or throwaway rugs, then the theory is valid. It becomes the alternative hypothesis if the cases of fall hazards are less among educated adults while high among unaware older adults, as the educated and aware elders know that rugs and mats can cause unintentional falls and vice versa.
In conclusion, the theory and hypothesis that “Education among the elderly on throwaway rugs found in their homes prevents unintentional falls and injuries,” can be defined as an alternative hypothesis with valid, evidence-based information and data acquired from the identified measuring factors. It is plausible that cases of fall hazards among educated and aware older adults are less while they are high among unaware older adults, due to the difference in education and knowledge acquisition. It is psychological and expected that educated people are cautious about things they are warned against by their physicians, but those lacking the knowledge and awareness are likely to lack purchase knowledge on the hazards associated with mats and rugs hence cannot buy non-slip mats or make modifications in their house.
Clark, C. S. (2016). Watson’s Human Caring Theory: Pertinent. MDPI.
Gonzalo, A. (2019, September 12). Jean Watson: Theory of Human Caring. Retrieved from Nurseslabs: https://nurseslabs.com/jean-watsons-philosophy-theory-transpersonal-caring/#theory_of_human_caring_of_jean_watson
Johnson, S. G. (2018). Geriatrics, An Issue of Physician Assistant Clinics E-Book. Philadelphia: Elsevier.
Melnyk, B. M.-O. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia: Wolters Kluwer.
Noonan, T. R. (2013). Slipping and tripping: fall injuries in adults associated with rugs and carpets. Journal of Injury Violence Research, Vol 5(1), pp; 61-69.
Vrbnjak, M. P. (2017). The concept of Watson’s carative factors in nursing and their (dis)harmony with patient satisfaction. Peer Journal.
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