Unit 1 Nursing Principles and Concepts - DNIN 4113 (PDF)

FON 1: Introduction on Nursing DNIN 4113 DNIN 4113: INTRODUCTION ON NURSING COURSE LEARNING OUTCOMES: 1. Explain knowledge of nursing history in relation to Fundamental of Nursing, Nursing Care Plan & Critical Thinking 2. Demonstrate the vital sign and patient...

FON 1: Introduction on Nursing DNIN 4113 DNIN 4113: INTRODUCTION ON NURSING COURSE LEARNING OUTCOMES: 1. Explain knowledge of nursing history in relation to Fundamental of Nursing, Nursing Care Plan & Critical Thinking 2. Demonstrate the vital sign and patient assessment procedure 3. Explain Nursing Care Plan in relation to the patient nursing diagnosis 4. Develop Nursing Care Plan and Critical Thinking in providing nursing care DNIN 4113: INTRODUCTION ON NURSING  UNIT 1 NURSING PRINCIPLES AND CONCEPT COURSE TITTLE DNIN 4113: INTRODUCTION ON NURSING LEARNING OUTCOMES By the end of the session, students will be able to : 1. State relevant nursing theories related to nursing aspect. 2. Explain the important of Maslow Hierarchy need related to patient condition. 3. Explain the important of Activity of Daily Living which disrupted the quality life of patient. 4. Perform basic nursing skills such as nursing assessment, physical examination, vital sign assessment accurately and safely. 5. Explain the effective communication therapeutically with patients, families, and members of the healthcare team. 6. Demonstrate an understanding of the nursing process by applying it to patient care scenarios. DNIN 4113: INTRODUCTION ON NURSING UNIT 1: NURSING PRINCIPLES AND CONCEPTS 1. Introduction of Nursing 2. Global development of nursing 3. History of nursing in Malaysia - Florence Nightingale (Environment) - Virginia Henderson (14 activities of ADL) - Dorothea Orem - Nancy Roper - Rufaida Al-Aslamia 4. Maslow’s hierarchy of needs 5. Nurses as healthcare providers INTRODUCTION ON NURSING DEFINITION OF A NURSE A person , usually a woman, trained to care for the sick. ( Kozier et.al, 1998) DEFINITION OF NURSING Nursing is an art and science. Florence Nightingale has define nursing as the act of utilizing an environment of the patient to assist him in his recovery. ( Kozier et.al, 1998) Nursing is a diagnosis and treatment of human responses to an actual or potential health problems DNIN 4113: INTRODUCTION ON NURSING (ANA , 1980 ) GLOBAL DEVELOPMENT OF NURSING Economics Changes in economic climates Escalating of healthcare costs due to growing aging population, insured and uninsured persons, and increased use of technology. Changing demands for nurses An increased number of nurses outside acute care setting An increased need for highly technically skilled nurses DNIN 4113: INTRODUCTION ON NURSING GLOBAL DEVELOPMENT OF NURSING Consumer Demands Consumer of nursing service become an increasingly forces in changing of nursing practice. People are better educated and have moreknowledge about health illness than in the past Awareness in theneeds of care Family Structures New family structure influencing the needs of nursing services Separation among generations created a void in care available to the young and the old DNIN 4113: INTRODUCTION ON NURSING GLOBAL DEVELOPMENT OF NURSING Science and Technology Advance in science and technology affect nursing practice Nurses acquire complementary knowledge and skills as to adapt the new needs of clients Legislation Changes in Legislation relating to health Example , PATIENT SELF DETERMINATION ACT (PSDA ) 1991 every competent adult be inform in writing upon admission to a health care institution about their rights to accept or refuse treatment. DNIN 4113: INTRODUCTION ON NURSING GLOBAL DEVELOPMENT OF NURSING Demography Study of population, including statistic distribution of age, place, mortality (death)and morbidity (diseases) Nursing Association Malaysian Nursing Association – nurse practice act A group of professional nurses organized formally to promote political action in the nursing and healthcare setting DNIN 4113: INTRODUCTION ON NURSING DNIN 4113: INTRODUCTION ON NURSING HISTORY OF NURSING IN MALAYSIA The history of nursing in Malaysia began from about the year 1800 with the formation of the East India Company when hospital for the sick were established in Penang and Singapore. Nursing was carried out by Catholic nuns and later on replaced by English nurses from England. Nursing practice in the pre-war period in Malaya then was carried out by nurses who received ―on the job trainingǁ with lectures given by expatriates i.e. by European DNIN sisters, matrons and Doctors at 4113: INTRODUCTION ON NURSING  After Independence, health services became mainly a central government responsibility with delegation of service delivery through state and district health administrations. Prior to the war, each straits/settlement organized and ran their own nursing services. All states were responsible to the director of medical services. The nurses receives lectures in practice and theory of nursing from the matron or assistant matron of the hospital. DNIN 4113: INTRODUCTION ON NURSING  The doctors gave lectures to both nurses and hospital assistant. They sat for their own state examination and the standards varies from one state to another. On completion from training, nurses were promoted to staff nurse and later in considered suitable they become senior staff nurse. The expansion of medical and nursing services were greatly hindered during the emergency situations. DNIN 4113: INTRODUCTION ON NURSING  In 1959, most of the states in Malaya become free from communism and it marks the beginning of the development of health services throughout the country. By 1978, the element of Primary Health Care (PHC) strategies enunciated at Alma-Ata were already evident in the Malaysia Health Care System. Concern for reduction in equity in access to health care for increasing coverage formalized in 1971 with the government 20 years perspective plan. DNIN 4113: INTRODUCTION ON NURSING  1923 – Introduction of legislation for the control of the Practice of Midwifery and the training of midwifes in the Straits Settlement and subsequently in the other states of the Malay Peninsular. 1950 – Nursing Legislation Nurses Act and the establishment of the Nurses Registration Ordinance, to control the practice of nursing which provided for the setting up of the Nursing Board for controlling the training and registration as regards to the practice of nursing. DNIN 4113: INTRODUCTION ON NURSING  Development of syllabus and curriculum for the Basic Nurse Training. The regulation for the conduct of final examination. The issuing of the Nurse Training Certificate. The Regulation to control the practice of nursing though registration and issue of Nursing Registration Certificate and Registration Badge. DNIN 4113: INTRODUCTION ON NURSING  1956 – The Nurses Registration Regulation. 1961 – The first private nursing school in Malaysia was established at the Assunta Hospital. It was called the Tun Tan Cheng Lock College of Nursing. 1969 – Extension of the Act to Sarawak. 1978 – Extension of the Act to Sabah. 1985 – Nurses Registration Regulation 1985. Implementation of the Annual Practicing Certificate. DNIN 4113: INTRODUCTION ON NURSING  HISTORY OF NURSING IN MALAYSIA 1966 – The Midwives Act 1966 establishes a Midwifes Boards provides for the registration of nurse-midwifes and regulates the practice of midwifery in the country. 1971 – The Midwives (Registration) Regulation, 1971, requiring all midwives to apply for registration. (TBA, up to 1st August 1972) 1990 – Act Revised – 1990 (Reopened to TBA within the next 10 years). D NIN 4113: INTRODUCTION ON DNIN 4113: INTRODUCTION ON NURSIN G NURSING NURSING THEORIES Nursing theories address and specify relationship among four major concepts: 1. Person or client ( individual, family, community ) 2. Environment ( Internal and External Surrounding) 3. Health / illness ( Client’s state of well being ) 4. Nursing ( healthcare provider ) D NIN 4113: INTRODUCTION ON DNIN 4113: INTRODUCTION ON NURSIN G NURSING NURSING THEORIES Nightingale’s Environmental Theory (1960) First nursing theorist. Focused on Environment Linked to: 1. pure or fresh air 2. efficient drainage 3. cleanliness 4. light ( direct sunlight ) 5. quiet DNIN 4113: INTRODUCTION ON NURSING NURSING THEORIES NIGHTINGALE’S CONCEPT 1. Person: Patient who is acted on by a nurse. Affected by environment. Has reparative power. 2. Environment: Foundation of theory. Included everything, physical, psychological, and social. DNIN 4113: INTRODUCTION ON NURSING NURSING THEORIES NIGHTINGALE’S CONCEPT 3. Health: Maintaining well being by using a person’s powers. Maintained by control of environment. 4. Nursing: Provided fresh air, warmth, cleanliness, good diet, quiet to facilitate person’s reparative process. DNIN 4113: INTRODUCTION ON NURSING NURSING THEORIES Virginia Henderson’s Theory: (1955,1966,1969,1978) The Nightingale of Modern Nursing. “Modern-Day Mother of Nursing. Born in Kansas City, Missouri in 1897. She called her definition of nursing her “concept” (Henderson 1991). DNIN 4113: INTRODUCTION ON NURSING NURSING THEORIES She emphasized the importance of increasing the patient’s independence so that progress after hospitalization would not be delayed. She categorized nursing activities into 14 components, based on human needs. She described the nurse's role as substitutive (doing for the person), supplementary (helping the person), complementary (working with the person), with the goal of helping the person become as independent as possible. DNIN 4113: INTRODUCTION ON NURSING NURSING THEORIES 14 Fundamental needs ( 1966 ) 1. Breathing normally 2. Eating and drinking adequately 3. Eliminating Body waste 4. Moving and maintaining a position 5. Sleeping and resting 6. Selecting suitable clothes 7. Maintaining body temperature 8. Keeping the body clean and well groomed 9. Avoiding dangers and injury 10. Communicating with others 11. Worshipping according to one’s faith 12. Working in such a way that one feels a sense of accomplishment 13. Playing or participating in forms of recreation 14. Learning, discovering, or satisfying the curiosity NURSING THEORIES Dorothea Orem (1971) Self Care Deficit Theory -Organize nursing knowledge from pragmatic framework. -Focused on ―What is nursingǁ ; ―When do people need nursing care?ǁ -From this she derived that people need nursing when they are unable to care for themselves. DNIN 4113: INTRODUCTION ON NURSING NURSING THEORIES She presented the self-care deficit theory of nursing which is problem oriented. DNIN 4113: INTRODUCTION ON NURSING  NANCY ROPER WINIFRED W. LOGAN ALISON J. TIERNEY DNIN 4113: INTRODUCTION ON NURSING NURSING THEORIES Nancy Roper was a practical theorist. She produced a simple nursing theory, which has actually helped bedside nurses. Nancy Roper, nurse educationalist: born Wetheral, Cumberland 29 September 1918; died Edinburgh 5 October 2004. During the 1970s, as she pursued her graduate studies at The University of Edinburgh in Scotland, Roper found the ―identifiable commonalityǁ evident in every patient. DNIN 4113: INTRODUCTION ON NURSING NURSING THEORIES It reminded the nurse to look at the whole patient. Some activities were obvious, such as eating and drinking, but she taught nurses also to look further, and to expect, and be prepared to cope with sexuality in their patients and death and dying. In 1976, she discussed her beliefs about nursing in the publication Clinical Experience in Nurse Education. DNIN 4113: INTRODUCTION ON NURSING NURSING THEORIES Roper's research was a foundation for a model centered in nursing. The model was refined by nurse educator Winifred Logan, DSc, and nurse researcher Alison Tierney, PhD. The R-L-T Model of Nursing applies the nursing process - assessment, diagnosis, planning, intervention, and evaluation—and serves as a guide for the nurse to conduct a holistic patient assessment that serves as a basis for a care plan DNIN 4113: INTRODUCTION ON NURSING NURSING THEORIES Concepts Activities of Living Breathing (ALs) Eating and drinking There are 12 activities, Elimination some of which are essential such as Washing and dressing breathing and others Controlling temperature that which enhance the Mobilization quality of life. Working and playing Maintaining a safe Expressing sexuality environment Sleeping Communication Death and dying DNIN 4113: INTRODUCTION ON NURSING NURSING THEORIES Rufaida Al Aslamia Rufaida Al-Aslamia introduced nursing to the Muslim world 1, 200 years before Florence Nightingale who is known as the founder of modern nursing. Rufaida Al-Aslamia was recognized for her work in medical and social circles in the earliest days of Islam, and she was the first female Muslim nurse. DNIN 4113: INTRODUCTION ON NURSING NURSING THEORIES Rufaida Al-Aslamia is a role model for many women, empathetic nurse and a good organizer. With her clinical skills, she trained other women to be nurses and to work in the area of health care. She also worked as a social worker, helping to solve social problems associated with the disease. DNIN 4113: INTRODUCTION ON NURSING  MASLOW’S HIERRACHY OF NEEDS COURSE TITTLE DNIN 4113: INTRODUCTION ON NURSING MASLOW’S HIERARCHY OF NEEDS Psychologist Abraham Maslow defined basic human needs as a hierarchy, a progression from simple physical needs to more complex emotional needs Nurses use Maslow’s hierarchy of needs to understand the interrelationships of basic human needs. Basic human needs (e.g., food, water, safety, and love) are necessary for human survival and health. Although each person has unique needs, all people share basic human needs, and the extent to which people meet their basic needs is a major factor in determining their level of health. DNIN 4113: INTRODUCTION ON NURSING  MASLOW’S HIERARCHY OF NEEDS Five Level of Needs (1) Physiological--food, shelter, water, sleep, oxygen. (2) Safety and security, stability, order, physical safety. (3) Love and belonging--affection, identification, companionship. (4)Esteem and recognition--self-esteem, self-respect, prestige, success, esteem of others. (5) Self-actualization--self-fulfillment, achieving one's own capabilities. DNIN 4113: INTRODUCTION ON NURSING MASLOW’S HIERARCHY OF NEEDS The four lower levels are grouped together as deficiency needs associated with physiological needs The top level is termed growth needs associated with psychological needs. While deficiency needs must be met, growth needs are continually shaping behaviour. The basic concept is that the higher needs in this hierarchy only come into focus once all the needs that are lower down in the pyramid are mainly or entirely satisfied. DNIN 4113: INTRODUCTION ON NURSING  Maslow’s hierarchy of needs. (Redrawn from Maslow AH: Motivation and personality,ed 3, Upper Saddle River, NJ, 1970, Prentice Hall.) COURSE TITTLE DNIN 4113: INTRODUCTION ON NURSING MASLOW’S HIERARCHY OF NEEDS DNIN 4113: INTRODUCTION ON NURSING MASLOW’S HIERARCHY OF NEEDS DNIN 4113: INTRODUCTION ON NURSING Henderson’s theory and the four major concepts 1. Individual Have basic needs that are component of health. Requiring assistance to achieve health and independence or a peaceful death. Mind and body are inseparable and interrelated. Considers the biological, psychological, sociological, and spiritual components. The theory presents the patient as a sum of parts with bio-psychosocial needs. DNIN 4113: INTRODUCTION ON NURSING Henderson’s theory and the four major concepts 2. Environment Settings in which an individual learns unique pattern for living. All external conditions and influences that affect life and development. Individuals in relation to families Minimally discusses the impact of the community on the individual and family. Basic nursing care involves providing conditions under which the patient can perform the 14 activities unaided DNIN 4113: INTRODUCTION ON NURSING Henderson’s theory and the four major concepts 3. Health Definition based on individual’s ability to function independently as outlined in the 14 components. Nurses need to stress promotion of health and prevention and cure of disease. Good health is a challenge -affected by age, cultural background, physical, and intellectual capacities, and emotional balance Is the individual’s ability to meet these needs independently. DNIN 4113: INTRODUCTION ON NURSING 4. Nursing Temporarily assisting an individual who lacks the necessary strength, will and knowledge to satisfy 1 or more of 14 basic needs. Assists and supports the individual in life activities and the attainment of independence. Nurse serves to make patient ―completeǁ ―whole", or "independent." The nurse is expected to carry out physician’s therapeutic plan Individualized care is the result of the nurse’s creativity in planning for care. DNIN 4113: INTRODUCTION ON NURSING Nurses as health Care Provider Health care Delivery System Is a service offered by all health disciplines A Patient’s Bill of Rights ( AHA, 1973 ) - Respectful care - Privacy for the client - Communications regarding their care - Right decision making for their care DNIN 4113: INTRODUCTION ON NURSING Nurses as health Care Provider Types of Health Care Services Primary Service ( Health Promotion, preventive care, continuing care, Referral) Secondary care ( Surgery and services by specialist ) Tertiary Care (Advance Specialized diagnostic, therapeutic and rehabilitative care) DNIN 4113: INTRODUCTION ON NURSING Nurses as health Care Provider Providers Of Healthcare Nurse Dentist Pharmacist Dietitian or Nutritionist Physiotherapist Respiratory therapist Occupational therapist Paramedical technologist Social Worker DNIN 4113: INTRODUCTION ON NURSING Nurses as health Care Provider Nursing Organization Structure NURSE MANAGER NURSE EDUCATOR UNIT MANAGER UNIT MANAGER REGISTERED NURSE REGISTERED NURSE DNIN 4113: INTRODUCTION ON NURSING Nurses as health Care Provider Role of Nurses Caregiver Educator Advocate Leader andmanager Researcher DNIN 4113: INTRODUCTION ON NURSING Nurses as health Care Provider Role of Nurses: Nurses asa caregiver Provide support physically and psycho socially Provides holistic care not only to an individual but also to the family and community DNIN 4113: INTRODUCTION ON NURSING Nurses as health Care Provider Role of Nurses: Nurses as an Educator Providing information and explain with a very effective communication skill Continuous improvement in upgradingknowledge in patient care DNIN 4113: INTRODUCTION ON NURSING Nurses as health Care Provider Role of Nurses: Nurses as an Advocator Making the right decision for patient Respect patient’s right in the decision making DNIN 4113: INTRODUCTION ON NURSING Nurses as health Care Provider Role of Nurses: Nurses as a leader and manager Leading and managing the patient care Leading and managingthe health care system providers DNIN 4113: INTRODUCTION ON NURSING  THANK YOU COURSE TITTLE DNIN 4113: INTRODUCTION ON NURSING