Identify an outcome of nursing practice in your area of practice 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.

Identify an outcome of nursing practice in your area of practice that can be improved.

Identify an outcome of nursing practice in your area of practice

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 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.

Briefly support why it is a problem with evidence from the literature. This is not the major focus of the assignment so do not elaborate.

Create a clinical nursing (not medical) theory in the form Concept A | Proposition | Concept B. Think of the structure like two nouns and a verb. While the term proposition is much more complex in the dictionary, in our use it is the connecting term between the two concepts. Examples include Concept A improves Concept B, Concept A is related to Concept B, when Concept A increases then Concept B also increases, etc. When you get to research, you will explore this further as you develop independent and dependent variables. How to use these statistically will come in research and statistics courses.

This clinical theory is identified as an empirical theory when you get to the C-T-E model later in this course. It is empirical in that they can be measured.

Identify and define your concepts. Identify how they could be measured in a research study. Be careful that you do not use compound concepts. If you find the words “and” or “or” in your theory, you are probably too complex.

If you research your question and seek funding, you will need a theoretical model to guide the research. In our assignment, we are using Watson. You will identify the concepts in Watson’s theories that are represented by the concepts you are using in your clinical theory. Match the proposition in her theory with your proposition. To help, the 10 Caritas Processes are Concept A. Choose the one that matches your concept. To clarify, let’s look at Caritas 1 Embrace and use it in middle-range theory. Sustaining humanistic-altruistic values by the practice of loving-kindness, compassion, and equanimity with self/others (Concept A – Very complex and abstract) improves (Proposition) subjective inner healing (Concept B).

Remember that the paper is not about the problem. It is about constructing a clinical theory and matching it to a middle-range theory and conceptual model your clinical theory represents.

Conclude the paper with your discoveries made in your readings and the impact on the nursing profession of your discoveries. Explore, briefly, discovered questions that require further research. Summarize the paper in the conclusion.

Present your outcome in an APA formatted paper that meets the University’s standards for a written assignment.

Expectations

• Due: Monday, 11:59 pm PT
• Length: 5 to 7 pages including title and reference pages
• References: 3 to 10.  There should be enough to support the links between the concepts of the problem and the concepts of Watson’s Theory of Caring.

Application of Concepts from Caring Science – Sample Answer

Nursing theories are critical components of the healthcare sector and can be used to shape the nature of care. Different nursing theories can be used to help shape the nursing profession (Butts & Rich, 2022). The use of the theories is critical in any situation and their application makes the difference between success and failure. This paper will focus on a nursing issue and develop a theory that can be used to help address the issue. The paper will also address the correlation of the created theory with the Jean Watson theory of human caring.

Problem Identification

The clinical situation that this paper will focus on is the issue of patient falls among elderly patients and the role of nurses in reducing the issue (Alshammari et al., 2018). The issue of patient falls in the healthcare sector is a critical issue affecting a wide number of people. The elderly population often visit healthcare facilities to seek medication, consultation, and checkups due to the nature of their age. One of the main determinants of health is the issue of age (‌Grillo et al., 2019).

In this regard, as a person gets old, they begin to experience weaknesses in various organs and functional fatigue. For instance, the majority of the elderly population may experience weakness of joints and frail bones which leads to general weakness and fatigue. As a consequence, they are easily susceptible to falls and injuries. The problem is a key issue and there is a need for an efficient intervention to help address the issue. The use of theories that can guide the nursing profession to make informed decisions is key (Alshammari et al., 2018).

Creation of the Theory

Clinical theories are essential to ensuring that care providers adhere to a specific set of rules and regulations. The format of clinical nursing theories takes the form of the initial Concept A followed by a proposition and then a final Concept B. in retrospect, Concept A provides and cause while Concept B offers the effect and the proposition ties the two concepts into a single entity that forms the theory (Butts & Rich, 2022).

The issue of patient falls can be a major concern to the entire healthcare sector since it affects both the healthcare facility and the patient in equal measure. Patients might be faced with injuries and even death while the facility will be forced to incur costs if it is determined that they were negligent in ensuring patient safety.

The proposed theory that can be used to address the issue can be, “adherence to professional duty (Concept A) can lead to (Propositions) better patient outcome and quality of care (Concept B).” The proposed theory can be called the Theory of Professional Duty since it focuses on the correlation between good practice and the quality of the outcome.

Patient falls are a major issue in the healthcare sector and form one of the healthcare quality issues. The quality of patient outcomes can be undermined by falls which might lead to reduced patient satisfaction. The theory address how professional duty demonstrated with the role that nurses can play in caring for the patients goes a long way in mitigating the issues of patient falls as a quality issue.

Measuring the Concept

The theory of professional duty can be measured and evaluated to analyze whether it is effective and can help address the issue of patient falls. Concept A of the theory identifies the element of professional duties (Butts & Rich, 2022). Nurses are professional individuals and as such, have a role to play in the healthcare sector.

As a nurse, one of the duties is to ensure that the needs of the patient are addressed and also offer bedside care. Nurses can conduct actions like doing rounds and engaging in patient education. These duties are some of the interventions that nurses can take to help address the issue and improve the outcome of care. The duties of the nurse can then be measured based on the effect it has on the patients.

Concept B of the theory focuses on the effect which includes the rate of patient outcome and overall quality of care (Butts & Rich, 2022). The correlation indicated that when the nurses conduct that which is required of them, they can deliver a good quality outcome. However, discrepancies in the outcome can help measure the efficiency of the nurses in conducting their tasks.

While there are other variables to be included, the model can be used to help measure how the intervention put in place by the nurse can be used to improve the quality of care and ultimately reduced the number of patient falls (Butts & Rich, 2022). Patient education as an effect can help improve patient awareness on the risk factors associated with patient falls and how to avoid them altogether.

Correlation with Watson’s Theory

The created theory of Professional Duty can be correlated with Watson’s theory in different forms. In my theory, the main focus is on the roles and responsibilities of a nurse in ensuring quality while Watson focuses on how nurses can embrace human caring (Watson, 2022). My theory related to Watson based on Caritas 6 which denotes that efficient patient outcomes can be attained through “Engaging in transpersonal teaching and learning within the context of a caring relationship; staying within other’s frame of reference-shift toward coaching model for expanded health/wellness” (Watson, 2022).

Caritas 6 contends that when a nurse makes it an initiative to engage with the patients through educational strategies and a caring relationship, there is a high chance that the outcome would be expanded wellness. In the created theory of professional duty, nurses can perceive their interaction with patients through education and caring relationship as a form of engagement (Watson, 2022). The resultant outcome would then be observed through a steady reduction in the rate of patient falls.

The two theories make use of Caritas 6 to depict the need for a better patient outcome. Nurses have a duty and role to play in the healthcare sector and efficient implementation would yield the desired results. Caritas provides specific strategies that the care providers can use to implement the strategy (Watson, 2022). The theories advocate for efficient nursing processes that can be used to improve the nature in which healthcare professionals ensure efficiency.

Conclusion

This paper focused on a nursing issue and develop a theory that can be used to help address the issue. The paper also addressed the correlation of the created theory with the Jean Watson theory of human caring. The created theory was referred to as the theory of professional Duty and it stated that “adherence to professional duty (Concept A) can lead to (Propositions) better patient outcome and quality of care (Concept B).

” The theory that was created was aimed at addressing the issue of patient falls in the healthcare sector. The theory correlates with Jean Watson’s theory of human caring through Caritas 6 which emphasizes the engagement between nurses and patients to improve quality outcomes.

References

Alshammari, S. A., Alhassan, A. M., Aldawsari, M. A., Bazuhair, F. O., Alotaibi, F. K., Aldakhil, A. A., & Abdulfattah, F. W. (2018). Falls among elderly and its relation with their health problems and surrounding environmental factors in Riyadh. Journal of family & community medicine, 25(1), 29.

Butts, J. B., & Rich, K. L. (2022). Philosophies and theories for Advanced Nursing Practice. Jones & Bartlett Learning.

Watson, J. (2022). Watson’s Caring Science & Theory. Watson Caring Science Institute. https://www.watsoncaringscience.org/jean-bio/caring-science-theory/#10cp

‌Grillo, D. M., Firth, K. H., & Hatchel, K. (2019). Implementation of purposeful hourly rounds in addition to a fall bundle to prevent inpatient falls on a medical-surgical acute hospital unit. Medsurg Nursing, 28(4), 243-250.

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How to Identify and Improve Critical Nursing Practice Outcomes: A Comprehensive Guide for Healthcare Professionals

Introduction

Healthcare professionals continuously seek ways to enhance patient outcomes and optimize care delivery. Identifying specific nursing practice outcomes that can be improved is fundamental to advancing healthcare quality and patient safety. This comprehensive guide explores evidence-based approaches to recognizing, analyzing, and addressing nursing practice outcomes across various healthcare settings.

Understanding Nursing Practice Outcomes

What Are Nursing Practice Outcomes?

Nursing practice outcomes are measurable results that reflect the quality and effectiveness of nursing interventions. These outcomes directly impact patient safety, satisfaction, and overall healthcare delivery. They encompass various aspects of care, from clinical indicators to patient experience metrics.

Key Categories of Nursing Practice Outcomes

Common Nursing Practice Outcomes That Need Improvement

1. Fall Prevention in Healthcare Settings

The Problem: Falls represent one of the most significant safety concerns in healthcare, with approximately 700,000 to 1 million falls occurring in U.S. hospitals annually.

Key Statistics:

• 700,000 to 1 million hospitalized patients fall each year
• About 1 million fall-related hospitalizations among older adults occur each year
• The healthcare costs for slips and falls reach $50 billion annually
• Fall rates in US hospitals range from 3.3 to 11.5 falls per 1,000 patient days

Specific Outcomes to Improve:

• Reduce fall rates among high-risk patients
• Decrease fall-related injuries
• Improve fall risk assessment accuracy
• Enhance environmental safety measures

2. Medication Administration Safety

The Problem: Evidence-based practice and decision-making have been consistently linked to improved quality of care, patient safety, and many positive clinical outcomes, yet medication errors remain a significant concern in healthcare settings.

Areas for Improvement:

• Reduce medication administration errors
• Improve medication reconciliation processes
• Enhance patient education about medications
• Strengthen double-checking procedures

3. Infection Prevention and Control

The Problem: However, the key findings in a recent integrative review include fewer pressure ulcers and urinary tract infections, less likelihood of hospitalizations, decreased mortality, and improved quality measure such as falls and moderate to severe pain.

Key Focus Areas:

• Reduce catheter-associated urinary tract infections (CAUTIs)
• Decrease surgical site infections
• Improve hand hygiene compliance
• Enhance isolation precautions adherence

Setting-Specific Nursing Practice Outcomes

Home Health Care

Primary Concerns:

• Environmental Safety: Throw rug use by fall-risk patients
• Medication Compliance: Ensuring proper medication administration
• Emergency Preparedness: Quick access to emergency services
• Family Caregiver Education: Training family members in care techniques

Example Improvement Initiative: Problem: Throw rug use by fall-risk patients is too prevalent in home health settings. Solution: Implement a comprehensive home safety assessment program that includes:

• Environmental hazard identification
• Patient and family education
• Provision of safer alternatives
• Regular follow-up assessments

Hospital Settings

Critical Outcomes:

• Reduce patient falls
• Decrease pressure ulcer development
• Improve patient satisfaction with pain management
• Enhance discharge planning effectiveness

Long-Term Care

Focus Areas:

• Reduce medication errors
• Improve skin integrity
• Enhance quality of life measures
• Strengthen infection prevention protocols

Evidence-Based Approaches to Outcome Improvement

1. The Plan-Do-Study-Act (PDSA) Cycle

2. Root Cause Analysis

Steps for Effective Root Cause Analysis:

1. Define the problem clearly
2. Collect relevant data
3. Identify contributing factors
4. Determine root causes
5. Develop action plans
6. Implement solutions
7. Monitor effectiveness

3. Quality Improvement Methodologies

Lean Six Sigma in Nursing:

• Eliminate waste in processes
• Reduce variation in outcomes
• Focus on value-added activities
• Engage frontline staff in improvement efforts

Implementing Nursing Theory in Practice Improvement

Applying Caring Science Theory

Caring science theory, developed by Jean Watson, provides a framework for improving nursing practice outcomes by:

• Emphasizing the therapeutic relationship
• Focusing on holistic patient care
• Integrating evidence-based practice with compassionate care
• Promoting healing environments

Theory-Practice Integration Model

Data Collection and Measurement Strategies

Key Performance Indicators (KPIs)

Patient Safety KPIs:

• Fall rate per 1,000 patient days
• Medication error rate per 1,000 doses
• Hospital-acquired infection rate
• Patient safety event reporting rate

Quality KPIs:

• Patient satisfaction scores (HCAHPS)
• Clinical outcome measures
• Readmission rates
• Length of stay

Data Collection Methods

1. Electronic Health Records (EHR) Analysis
2. Direct Observation
3. Patient Surveys
4. Staff Assessments
5. Incident Reporting Systems

Technology Integration for Outcome Improvement

Digital Health Solutions

Electronic Health Records (EHR) Optimization:

• Clinical decision support systems
• Automated alerts and reminders
• Data analytics and reporting
• Care coordination tools

Mobile Health Applications:

• Patient monitoring devices
• Medication management apps
• Care coordination platforms
• Educational resources

Artificial Intelligence and Machine Learning

Applications in Nursing Practice:

• Predictive analytics for fall risk
• Early warning systems for clinical deterioration
• Automated documentation assistance
• Pattern recognition in patient data

Creating a Culture of Continuous Improvement

Leadership Engagement

Essential Leadership Behaviors:

• Champion quality improvement initiatives
• Provide necessary resources and support
• Recognize and reward improvement efforts
• Foster open communication about safety concerns

Staff Engagement Strategies

1. Education and Training Programs
2. Shared Decision-Making
3. Regular Feedback and Recognition
4. Professional Development Opportunities

Case Study: Improving Fall Prevention in Home Health

Background

A home health agency identified that 40% of their fall-risk patients had throw rugs in high-traffic areas of their homes, contributing to a fall rate of 8.2 per 1,000 patient visits.

Intervention Strategy

1. Assessment Protocol: Implemented standardized home safety assessments
2. Education Program: Developed patient and family education materials
3. Environmental Modifications: Provided alternative flooring solutions
4. Follow-up Monitoring: Established regular safety reassessments

Results

• Fall rates in US hospitals range from 3.3 to 11.5 falls per 1,000 patient days
• Each year, there are about 1 million fall-related hospitalizations among older adults
• The healthcare costs for slips and falls are quite serious too, with the CDC reporting $50 billion in annual costs
• Patient satisfaction with safety measures increased by 35%

Best Practices for Sustainable Improvement

1. Stakeholder Engagement

• Include patients and families in improvement planning
• Engage interdisciplinary team members
• Collaborate with organizational leadership
• Partner with community resources

2. Systematic Approach

• Use standardized improvement methodologies
• Implement evidence-based interventions
• Monitor progress with reliable metrics
• Adjust strategies based on outcomes

3. Continuous Learning

• Regular review of improvement efforts
• Sharing successes and lessons learned
• Staying current with best practices
• Fostering innovation and creativity

Future Directions in Nursing Practice Improvement

Emerging Trends

• Telehealth integration
• Precision medicine applications
• Value-based care models
• Population health management

Technology Advancements

• Internet of Things (IoT) devices
• Wearable health monitors
• Advanced analytics platforms
• Robotic process automation

Conclusion

Identifying and improving nursing practice outcomes is essential for delivering high-quality, safe, and effective healthcare. By focusing on evidence-based approaches, engaging stakeholders, and utilizing appropriate technologies, healthcare organizations can achieve significant improvements in patient outcomes while reducing costs and enhancing staff satisfaction.

Success in nursing practice improvement requires commitment, systematic approaches, and continuous learning. Whether addressing fall prevention in home health settings, medication safety in hospitals, or infection control in long-term care facilities, the principles and strategies outlined in this guide provide a foundation for meaningful and sustainable improvement.

Remember that improvement is an ongoing process that requires regular assessment, adaptation, and innovation. By maintaining focus on patient-centered care and evidence-based practice, nursing professionals can continue to advance the quality and safety of healthcare delivery.

References

1. Connor, L., Dean, J., McNett, M., Tydings, D. M., Shrout, A., Gorsuch, A., … & Melnyk, B. M. (2023). Evidence‐based practice improves patient outcomes and healthcare system return on investment: Findings from a scoping review. Worldviews on Evidence-Based Nursing, 20(1), 6-15. https://sigmapubs.onlinelibrary.wiley.com/doi/10.1111/wvn.12621
2. Agency for Healthcare Research and Quality. (2024). Nursing and Patient Safety. PSNet Patient Safety Network. https://psnet.ahrq.gov/primer/nursing-and-patient-safety
3. American Nurses Association. (2024, February 15). How Nurses Can Affect Positive Patient Outcomes. https://www.nursingworld.org/content-hub/resources/nursing-leadership/positive-patient-outcomes/
4. Centers for Disease Control and Prevention. (2024, June 10). Facts About Falls. https://www.cdc.gov/falls/data-research/facts-stats/index.html
5. Agency for Healthcare Research and Quality. (2024). Falls. PSNet Patient Safety Network. https://psnet.ahrq.gov/primer/falls
6. Definitive Healthcare. (2024). Slip and fall cases | Hospital + patient falls statistics. https://www.definitivehc.com/resources/healthcare-insights/slip-and-fall-statistics-healthcare-facilities
7. Bouldin, E. L., Andresen, E. M., Dunton, N. E., Simon, M., Waters, T. M., Liu, M., … & Shorr, R. I. (2013). Falls among adult patients hospitalized in the United States: prevalence and trends. Journal of Patient Safety, 9(1), 13-17. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3572247/
8. Xavier University. (2023, October 5). Evidence-Based Practice in Nursing and Patient Outcomes. https://online.xavier.edu/evidence-based-practice-in-nursing-and-patient-outcomes/
9. Northern Kentucky University. (2023, October 10). The Importance of Nursing Research for Improving Practice and Patient Health Outcomes. https://onlinedegrees.nku.edu/programs/healthcare/rn-to-bsn/nursing-research-patient-health-outcomes/
10. Heslop, L., & Lu, S. (2014). Nursing-sensitive indicators: a concept analysis. Journal of Advanced Nursing, 70(11), 2469-2482. https://www.ncbi.nlm.nih.gov/books/NBK589676/
11. Donabedian, A. (1988). The quality of care: how can it be assessed? JAMA, 260(12), 1743-1748. https://pmc.ncbi.nlm.nih.gov/articles/PMC2856593/
12. Southern New Hampshire University. (2024). What is Quality Improvement in Healthcare? https://www.snhu.edu/about-us/newsroom/health/what-is-quality-improvement-in-healthcare
13. Performance Health. (2025, February 7). The State of Patient Safety 2024. https://www.performancehealthus.com/blog/state-of-patient-safety-2024
14. Zanconato, S. (2005). Evidence-based practices for pressure ulcer prevention. Journal of Nursing Administration, 35(3), 142-145. https://www.interesjournals.org/articles/nursing-research-and-evidencebased-practice-using-data-to-improve-patient-outcomes-97368.html
15. Joint Commission. (2024). Sentinel Event Data 2023 Annual Review. https://www.jointcommission.org/-/media/tjc/documents/resources/patient-safety-topics/sentinel-event/2024/2024_sentinel-event-_annual-review_published-2024.pdf