borrowed theories 1 answer below »


It is important to understand how borrowed theory can help you in your everyday environment as a nurse. In the previous assignment, you identified a practical problem ( affordable care Act caused increased work load of the nurses and poor patient outcomes) that emerged from the evidence in the extant literature or professional practice, and you explored how middle-range theory could be applied to solve the problem. In this assignment, you will explore and apply borrowed theory to solve the specific problem that you identified previously, and you will synthesize the applications of the middle-range theory and the borrowed theory into the most appropriate solution to the problem.

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Consider the problem that you described in the previous assignments and the instructor feedback about those assignments.

Write a paper (1,750 to 2,000 words) that describes how borrowed theory can be applied to the identified problem. The paper should include the following: A brief summary of the problem including the potential middle-range theory that could be applied.A description of a borrowed theory that could be applied to the problem. Is this borrowed theory appropriate to your identified problem?A brief history of the borrowed theory's origins.A discussion of how the borrowed theory has been previously applied.A discussion of the application of the borrowed theory to the identified problem. How would your practice change by incorporating this theory?A discussion of how application of both the borrowed theory and the middle-range theory can be integrated to create the most appropriate solution to the identified problem.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

I am also posting my previous assignment and you can base from that assignment how you will write this assignment. see below for my previous week assignment. I am doing my masters degree in nursing. please help me at masters level writing.

Overview of Health care

The Affordable Care Act is a once-in-a-generation change to the U.S. health system. ACA prohibit denying coverage for children based on pre-existing conditions. This law allows small businesses to receive tax -credits to help them provide insurance benefits to their workers. Under this law Medicare prescription drug coverage( Part D) will be more affordable till the gap is closed in 2020. The consumers of health care can receive free preventative services like mammograms, colonoscopies, and education on cigarette smoking, and obesity. This Act assists in cracking down health care frauds. Affordable Care Act extends coverage for young adults, and they are allowed to stay under their parent’s coverage until they are 26 years old. Funding and scholarship for doctors, nurses and physician Assistants to increase the availability of health care services in underserved area and will not have to pay taxes on those payments. This law pays increased amounts of payments to rural payments to rural providers. Assists in improving care of seniors after they leave hospital through community care transition programs to prevent unnecessary admissions. Also this act increase access to services at home and in the community. Provide incentives to hospitals to improve the quality of care. Encourage integrated health system, expanding authority to bundle payments.

Today’s problem

With the benefits of the ACA there are problems associated with Affordable care Act. Amongst the many health care related problems like nursing shortage, burn-outs, nursing turn-over, negative health care environment, the biggest problem in acute care setting for nurses is the increase in the number of admissions and discharges in one shift. ED department in U.S. hospital saw that highest number of patients ever in 2011. I work on the medical/surgical/telemetry/Onchology unit of an acute care hospital. The biggest problem I face is that due to the bundle payment system the work- load of the bedside nurses has significantly increased without any change in the nurse to patient ratio. The nurse to patient ratio was 1:5 before affordable care ACT and today the nurse to patient ratio remains the same. Because of short stay of the patients in the hospitals the physicians are prescribing more tests in short periods of time and nurses are more busy helping patients and family members assisting with the health care management. Because they do not have much time to educate the patients about the illness and the significance of medication and various tests to be performed, they are not promoting health. Sometimes to save cost the patients are discharged in the communities with higher acute needs and nurses are pressured to discharge patients home. This not only jeopardizes the health of the patients and increases the burden on care- taker but also lead to job dissatisfaction and disbelief in health care system.

Kolcaba’s Theory

To correct the problem of patient dissatisfaction and poor patient outcomes and nurse burn out I will choose I will choose Katherine Kolcaba’s theory of comfort. In nursing practice Kolcaba defined comfort as “ satisfaction” of human needs for ease, relief, or transcendence that arise from stressful heath care situations.” Comfort is experienced in physical, psychospiritual, environmental, and sociocultural contexts. The physical context pertains bodily sensations and homeostasis. The psychospirituality is about having self- awareness. The external situations and conditions determine the environmental affecting comfort. The interpersonal and societal relationships reflect the sociocultural domain of comfort (Kolcaba & Fisher, 1996). According to Kolcaba, with an increase in comfort measures, negative tension reduced leading to an increase in positive tension. When comfort is increased then patient look for healthy behaviors. When patients are seeking health, then nurses and other health care members seek new measures to provide comfort. The comfort needs of the patients are identified by the nurses and members of the health care team. Then the nurses assist in the development of new policies and procedures to promote comfort. Once comfort is achieved, patients, nurses, and other health care team members seek healthy behavior to promote health.. This can cause better health outcomes, patient satisfaction, lower nurse burnouts and prevent nurse turnovers and nurse shortage. When patients are satisfied, staff is satisfied, public acknowledge the health care organization for the contribution to the health of the communities. This leads to the development and success of the organization.

Application of Kolcaba Theory

A practical application of Katharine Kolcaba's comfort theory to cardiac patients addresses Kolcaba's four contexts of comfort: physical, psychospiritual, environmental and sociocultural. If a patient is experiencing chest pain then the nurse can relieve the physical symptoms of pain by pharmacological and holistic interventions. The psychospiritual approach can be by relieving the anxiety by being supportive and calm in the middle of the related to the fear of having a big heart attack. A nurse can provide environmental comfort context by minimizing the alarms, noises and keeping privacy and limiting interruptions and finally can meet the sociocultural needs of the patient by communicating with the patient, family and interdisciplinary team, and by advocating for the patient.

Plan for problem

I would present the plan to enhance better patient outcome and prevent nursepr burnout, turnover rate and improve quality care to the administration so the institution will remain viable and flourish. The review of outcome data of 15,000 patients in 51 U.S. hospitals discovered that patients had 68% less chances to acquire preventable infections with higher RN staffing will be presented to the administration. I will also make health care administration aware that Agency for Healthcare Research and Quality, May 2007, concluded that the addition of one patient to a RN can lead to7% increase in the risk of hospital- acquired pneumonia, a 53% increase in respiratory failure, and a 17% increase in medical complications. High stress levels and mental exhaustion among nurses can lead to an increase in mistakes and accidents. This can cause failure of health care organization.


Hopefully, my administration and department of Medicare and Medicaid will pay careful attention to the above – mentioned statistics. It is true that Affordable Care Act will provide health service to our communities but at the same time Medicare and Medicaid agencies should understand its impact on the emergency departments and acute care settings. To meet the comfort needs of the patients and promote health the nurse to patient ration be decreased so positive outcome increased by adopting Kolcaba’s Theory of Comfort to nursing practice. The complex health care will impact nursing staff leading to nursing shortage and poor patient outcomes and decrease in health seeking behavior and ultimately increase the health care costs.

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