Strategies for Concept Development and Analysis

As indicated in this week’s Learning Resources, concept analysis is an essential step in research and has significant implications for theory development.

Concepts may be abstract (e.g., caring) or relatively concrete (e.g., touch)—yet, in either case, the meaning of a concept depends on context. It is therefore critical to clearly define a concept that serves as a component of research or theory so that a shared language and common understanding can be developed.

For this Discussion, you will select a concept related to a practice problem of interest to you. You will then have an opportunity to explore how concept analysis applies to research involving this practice problem. Next week, you will consider how concept analysis relates to theory development.

To prepare:

• Brainstorm a list of concepts you use or see in practice that pertain to a practice problem of interest to you. Then select one concept to focus on for this Discussion.
• Using the concept analysis strategies presented in the Learning Resources, analyze your selected concept and clarify its meaning.
• With your selected concept in mind, formulate a research topic to address the related practice problem.

By Day 3 post a cohesive response that addresses the following:

• Identify the concept and the related practice problem that you have selected for this Discussion.
• Provide a summary of your concept analysis (sharing your clarified concept) and the related research topic.
• Describe the importance of this concept and research topic to nursing practice.

The patient is a 68-year-old man who sustained a head injury after falling in the bathroom. He arrives in the emergency department (ED) cheerful, alert, and oriented to person. On physical examination, he has a large hematoma on his left forehead. He reports a headache in the left temporal area, which he rates as an 8/10. His wife was present during the incident. Admission vital signs are: blood pressure, 170/92 mm Hg; pulse, 92 beats/min; respirations, 14 breaths/min; and temperature, 98.7° F. The physician orders a one-time dose of acetaminophen 650 mg orally for the patient’s headache, which the nurse promptly administers. The patient reports a pain level of 5/10 at 1 hour after the intervention. 

1. Why is it important to determine the circumstances of the fall for this patient? 

2. Discuss the importance of obtaining baseline behavior and information from the wife. 

3. The ED physician orders computed tomography (CT) of the brain for the patient. What is the purpose of this test, and what are the nursing responsibilities in preparing the patient for this procedure? 

4. Because the patient is at risk for increased intracranial pressure, explain how the patient should be positioned and moved in bed.

5. The CT and other diagnostic results are negative and the patient is diagnosed with a minor head injury and contusion to the right extremity. He is discharged to home. Review the patient teaching instructions that should be given to the patient and his wife. 

6. The wife appears unwilling to take her husband home and she states that she doesn’t understand the discharge instructions. What can the nurse do in this situation? 

7. Use the focus charting method (also known as the DAR method—data, action, response) to document the administration of acetaminophen, including appropriate follow-up. 

 one paragraph response for this post , add comment , information with citation and reference 

One of the opportunities that I see in the clinical setting that needs to be improved is staffing. Of course 2020 and COVID hit us hard for the year but some facilities were already in shambles before the pandemic. Staffing is one of those things that can breakdown a facility to its inner most core. You have to hire and provide the unit with appropriate and knowledgeable staff that can handle the unit and the patient acuity. This helps with providing the best care for the patient and it gives the nursing staff time to provide the best care to the patient they are caring for. When staffing levels aren’t met, patient mortality increases. According to Rebecca Paulsen she stresses quality of care to achieve patient outcomes, which, in turn, can lead to higher reimbursement from the insurance company. Nurse-to-patient ratios are substantially important when trying to keep infection rates, potential drug reactions, and medication errors at a minimum (Paulson, 2018). Hospital reimbursement is based on performance. If units don’t adequately staff enough professionals to provide the care that patients need based on their acuity level, reimbursement may significantly be affected (Ashe, 2018). When units have higher turnover rates, including admissions, discharges, and transfers, additional nursing time isn’t recognized in shift variability when considering staffing needs and nurse-to-patient ratios(Ashe, 2018). This is way having the unit or clinical area staffed accordingly makes the unit and the level of stress, burnout, depression among staff decrease.

References:

Ashe, Leah RN The importance of adequate staffing, Nursing Management (Springhouse): December 2018 – Volume 49 – Issue 12 – p 7 doi: 10.1097/01.NUMA.0000549519.47901.4f

Paulsen, Rebecca A. PhD(c), MS, RN, CPN Taking nurse staffing research to the unit level, Nursing Management (Springhouse): July 2018 – Volume 49 – Issue 7 – p 42-48 doi: 10.1097/01.NUMA.0000538915.53159.b5

 one paragraph response for this post , add comment , information with citation and reference 

One of the opportunities that I see in the clinical setting that needs to be improved is staffing. Of course 2020 and COVID hit us hard for the year but some facilities were already in shambles before the pandemic. Staffing is one of those things that can breakdown a facility to its inner most core. You have to hire and provide the unit with appropriate and knowledgeable staff that can handle the unit and the patient acuity. This helps with providing the best care for the patient and it gives the nursing staff time to provide the best care to the patient they are caring for. When staffing levels aren’t met, patient mortality increases. According to Rebecca Paulsen she stresses quality of care to achieve patient outcomes, which, in turn, can lead to higher reimbursement from the insurance company. Nurse-to-patient ratios are substantially important when trying to keep infection rates, potential drug reactions, and medication errors at a minimum (Paulson, 2018). Hospital reimbursement is based on performance. If units don’t adequately staff enough professionals to provide the care that patients need based on their acuity level, reimbursement may significantly be affected (Ashe, 2018). When units have higher turnover rates, including admissions, discharges, and transfers, additional nursing time isn’t recognized in shift variability when considering staffing needs and nurse-to-patient ratios(Ashe, 2018). This is way having the unit or clinical area staffed accordingly makes the unit and the level of stress, burnout, depression among staff decrease.

References:

Ashe, Leah RN The importance of adequate staffing, Nursing Management (Springhouse): December 2018 – Volume 49 – Issue 12 – p 7 doi: 10.1097/01.NUMA.0000549519.47901.4f

Paulsen, Rebecca A. PhD(c), MS, RN, CPN Taking nurse staffing research to the unit level, Nursing Management (Springhouse): July 2018 – Volume 49 – Issue 7 – p 42-48 doi: 10.1097/01.NUMA.0000538915.53159.b5

I NEED A RESPONSE TO THIS ASSIGNMENT

2 REFERENCES

According to the DSM-5 2013, Dependent Personality Disorder (DPD) is an excessive and pervasive need to be taken care of, submissive, clinging, needy behavior, and fear of separation beginning by early adulthood. Five or more of the following contexts may be expressed, such as difficulty making routine decisions without input, reassurance, and advice from others, requiring others to assume responsibilities that they should be attending, fear of disagreeing with others and risking disapproval. Difficulty starting projects without support from others, desperately seek another relationship when one ends, excessive need to obtain nurturance and support from others, even allowing others to impose themselves rather than risk rejection or disapproval, feels vulnerable and helpless when alone. (Diagnostic and Statistical Manual of Mental Disorders: DSM-5 2013).

Psychotherapy is the primary treatment for DPD, such as social skills training and CBT. Social skills training will help start a conversation, communicate, and understand verbal and no-verbal cues during interactions. Cognitive-behavioral therapy faces challenging situations and turns their negative thinking to positive. (Wheeler, 2015). cognitive behavioral therapy is a treatment method for DPD (Dependent PD) of various subtypes. Cognitive therapy enables a patient diagnosed with a personality disorder to understand his/her history, including childhood traumas. A patient’s treatment of relearning how to relate with his or her past facilitates the transformation of thinking from feeling inadequate to mentally strong men and women who view themselves as functionally adequate when alone. The self-sufficient capacity to fill themselves up, without a need to depend on others or have feelings of emptiness resolved by helping others, indicates successful treatment. (Ramsay & Jolayemi, 2020)

 The FDA approves no medication for DPD; however, patients with DPD are at risk for anxiety, depression, phobias, and drug abuse. Antidepressants or anxiety medications can be prescribed if the patient has depression or anxiety. (Stahl et al., 2017).

A patient with Dependent Personality Disorder will manifest clinical features like avoidance of personal responsibility, difficulty being alone, fear of abandonment when a relationship ends, difficulty in making daily decisions. (Diagnostic and Statistical Manual of Mental Disorders: DSM-5 2013).

References

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders: Dsm-5.

Ramsay, G., & Jolayemi, A. (2020, August 9). Personality Disorders Revisited: A Newly Proposed Mental Illness. Cureus. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7478931/.

   Stahl, S. M., Grady, M. M., & Muntner, N. (2017). Prescriber’s Guide: Stahl’s Essential psychopharmacology. Cambridge University Press.

       Wheeler, K. (2015). Psychotherapy for the advanced practice psychiatric nurse a how-to guide for evidence-based practice. Springer Publishing Company, LLC.