In your peer responses, offer suggestions and other thoughts for your colleagues to consider. 1, Responds to this post in half a page 1) Models bridge the gap between theory and practice (McCrae, 2012). Nursing models are based on assumptions about human nature and nurture and extending to the wider socio-environmental context of practice (McCrae, 2012). Nursing models enable nurses to become more autonomous and accountable in their clinical decisions and more involved in the organization of care (McCrae, 2012). Models also help push the development of nursing as a discipline (McCrae, 2012). 2) Models can be described in three dimensions (McKenna, 2006). One-dimensional models tend to be at an elevated level of abstraction (McKenna, 2006). They cannot be taken apart or explicitly observed, but they can be thought about and mentally manipulated (McKenna, 2006). Two-dimensional models include diagrams, drawings, graphs, or pictures (McKenna, 2006). Most nursing started as one dimensional idea and were developed into two-dimensional formats (McKenna, 2006). Three dimensional models are physical models (McKenna, 2006). 3) A model commonly used at my practice is the Roys Adaptation Model (RAM). RAM was developed by Sister Callista Roy in 1964 (Cunningham, 2002). The RAM views the person as an adaptive system in constant interaction with an internal and external environment (Cunningham, 2002). The key concepts of Roys Adaptation Model are made up of four components including person, health, environment, and nursing (Cunningham, 2002). The model describes three types of stimuli that form the environment and affect adaptation (Cunningham, 2002). These stimuli include focal, contextual, and residual (Cunningham, 2002). Focal is what is immediately confronting the patient (Cunningham, 2002). Contextual is all other stimuli in the situation (Cunningham, 2002). Residual is the factors influencing behaviors that cannot be verified (Cunningham, 2002). People respond to the stimuli by coping mechanisms and control processes (Cunningham, 2002). Roy defines coping mechanisms as either regulator or cognator subsystems (Cunningham, 2002). The coping mechanisms of the regulator subsystem occur through neural, chemical, and endocrine processes (Cunningham, 2002). The coping mechanisms of the cognator subsystem occur through cognitive processes (Cunningham, 2002). Ray defines four adaptive modes including physiological, self-concept, role function, and interdependence adaptive modes (Cunningham, 2002). Roy notes adaptation leads to optimum health, well-being, and to the highest quality of life possible (Cunningham, 2002). We use Roys model when treating and assessing menopausal women or treating people aesthetically. For menopausal women, the focal stimuli are the symptoms of menopause or the disease process. Contextual stimuli include physical symptoms including joint pain, vaginal dryness due to lack of hormones and more. The phycological symptoms including anxiety and depression from the menopausal symptoms are the residual stimulus. When assessing someone’s skin and developing the best aesthetic plan of care, the same process applies. The focal stimuli are the wrinkles and sagging skin, the contextual stimuli is the breakdown of collagen and elastin causing the saggy skin, the residual stimuli are the self-esteem issues and insecurities caused by the skin issues and aging process. Cunningham, D. A. (2002). Application of Roy’s adaptation model when caring for a group of women coping with menopause. Journal of Community Health Nursing, 19(1), 49-60. McCrae, N. (2012). Whither nursing models? The value of nursing theory in the context of evidence?based practice and multidisciplinary health care. Journal of Advanced Nursing, 68(1), :// McKenna, H. (2006). Nursing theories and models. Routledge. In your peer responses, offer suggestions and other thoughts for your colleagues to consider. 2, Responds to this post in half a page Summarize the commonalities (similarities) of the models. The models this discussion will be based upon are the Advancing Research and Clinical practice through close Collaboration, Larrabee Model, PARIHS Framework, Steven’s ACE Star Model of Knowledge Transformation, and Iowa Model. The models of this week’s material are based upon evidence-based practices. Evidence-based practice model combines the best research evidence with clinical practice and patient value to facilitate clinical decision-making (Melnyk et al., 2012). Clinicians stay up-to-date on the newest practices, knowledge, and medications based on evidence-based research. Evidence-based practice shows that clinical decision-making, integration of customer/patient processes, and environmental factors should be based on reliable evidence (Chinn & Kramer, 2018). Inter-professional teams should use evidence-based practices to achieve, improve and maintain the best patient outcomes (Speroni et al., 2020). Evidence-based practices improve the quality-of-care patients receive, patient outcomes, and overall costs of healthcare (Melnyk et al., 2012). Identify a minimum of two ways the models differed. Many different characteristics make each model unique. The PARIHS Framework is designed to provide a method to implement research by exploring interactions utilizing evidence, context, and facilitation (Rycroft-Malone, 2004). The Iowa Model focuses on the entire healthcare to implement and guide practice decisions based on the best available research and evidence. The main focus of the ARCC model is to enhance the integration of research and clinical practice on a local and national level in acute-care and community health (Fineout-Overholt & Melnyk, 2004). Describe which model reflects the formal or informal processes at the professional organization you are employed at when a practice change has been implemented. In your response, provide at least two specific detailed examples. Unfortunately, at my place of employment, no model reflects the formal or informal processes that occur when a practice change has been implemented. Most of the changes implemented in our office come from recommendations of the partnering hospital and county health department. Much of the evidence-based practices that are utilized come from individual medical providers. References Chinn, P. L., & Kramer, M. K. (2018). Knowledge development in nursing theory and process (10 ed.). Elsevier. Fineout-Overholt, E., Levin, R. F., & Melnyk, B. M. (2004). Strategies for advancing evidence-based practice in clinical settings. Journal of the New York State Nurses Association, 35(2), 28-32. Melnyk, B. M., Fineout-Overholt, E., Gallagher-Ford, L., & Kaplan, L. (2012). The state of evidence-based practice in US nurses. JONA: The Journal of Nursing Administration, 42(9), 410417. Rycroft-Malone, J. (2004). The PARIHS frameworka framework for guiding the implementation of evidence-based practice. Journal of Nursing Care Quality, 19(4), 297304. Speroni, K. G., McLaughlin, M. K., & Friesen, M. A. (2020). Use of evidence?based practice models and research findings in magnet?designated hospitals across the United States: National survey results. Worldviews on Evidence-Based Nursing, 17(2), 98107.Show more
