MSN 561 Week 4 Assignment: Application of Concepts from Caring Science

MSN 561 Week 4 Assignment: Application of Concepts from Caring Science

Student Name

United States University

MSN561: Theoretical Foundation of Advanced Practice Nursing 

Prof. NAme

Submission date

Introduction

In the given assessment I will focus on the nursing clinical theory that I am going to propose after suggesting a nursing practice that needs improvement. In the current discussion, my area of improvement is depression among old-age patients. Old-age patients are a neglected part of society, and they require critical care in the hospital for a better level of improvement. One way of improving the level of depression is by enhancing the care management skills of nurses. Pieces of evidence in the literature suggest that the care management skills of nurses can improve the level of depression among patients who are staying in the long-term unit.

Nursing Outcome Improvement

The outcome that I am expecting from the improved nursing practice is to minimize depression among old-age patients who are in the long-term unit in my clinical setting. The outcome is achievable because nurses can improve the depression level of elderly patients by practicing and improving care management skills (Ell, 2018). Depression in older persons has detrimental consequences on functional status and their overall health. As a result, it will raise healthcare expenditures and put a strain on family incomes. Sadly, despite the availability of excellent therapies for depressed elderly, the majority stay untreated or undertreated, owing to nurses’ lack of care management skills (Ell, 2018). Depression may be a predecessor of cardiac disease. Most of the time it can lead to death from illness. It also has an increased risk of mortality following a heart attack. Even if the depression is moderate, it is critical to ensure that an elderly person gets proper care from the nurses to assist them with the ongoing depression (Ell, 2018).

Why is this a Problem in my Clinical Area?

In the clinical setting where I am working, most nurses lack care management skills. As a result, most of the old-age patients in long-term units go through depression during their stay at the unit. Depression also has associated repercussions; it leads to further deterioration of illness and sometimes leads to death. In other instances, depression could lead to chronic heart attacks and increase the patient’s stay at the hospital and the financial burden (Lawrence et al., 2019). There is a dire need for improvement in the care management skill of nurses for improved patient outcomes. Care management skills in the clinical setting are competencies required for healthcare professionals to manage a variety of medical, and nursing resources to improve the overall health of patients (Bayot & Varacallo, 2021). Care management skills are increasingly used in healthcare settings to improve the continuum of care, particularly for old-age patients. Several care models advocate for the involvement of nurses in these tasks (Bayot & Varacallo, 2021). Care management skills are focused on patients who need critical care, particularly older persons who are at higher risk of poor health outcomes (Bayot & Varacallo, 2021). 

The National Institute of Mental Health recommends proper care for the old-age patient and consider depression among them a major public issue (Donelan et al., 2019). Meanwhile, growing older is frequently accompanied by the loss of social support systems. Nurses may overlook indicators of depression that can result in behavioral changes in an older person. As a result, proper therapy is frequently delayed, causing many elderly individuals to suffer unnecessarily from depression (Donelan et al., 2019). 

Recently concerns with care management skills have emerged notably in the healthcare context (Abdi et al., 2019). It has been noted that nurses can improve these skills through education and training programs. Improving communication and critical thinking are seen as competencies that can improve the need of the old-age patient (Abdi et al., 2019). Nurses can improve depression among old-age patients by individualizing patient care because it allows them to deliver treatment that is personalized to the patient’s requirements. Nurses can also achieve quality outcomes by taking care of the holistic needs of the patient and planning communication that is oriented toward self-improvement (Abdi et al., 2019). To successfully meet the demands of the old-age patient, it is necessary to first identify the individualized care and support needs, as well as comprehend the individual situation that they are going through.

Clinical Nursing Theory

My proposition for the clinical nursing theory is, “The level of depression among old-age patients who are staying in the long-term unit can be improved through enhanced nursing care management skills”. One of the most important things that nurses can do to improve depression in old-age patient care is to be aware of the signs and symptoms of depression. If a nurse can identify a patient as being depressed, they can take steps to help the patient improve their mental health. Additionally, nurses can help patients by providing support and care. By providing care and support, nurses can help reduce the risk of depression becoming a long-term problem for the patient.

Concepts and Proposition

Following the context of my clinical problem which is the increasing cases of depression among old-age patients in the long-term unit, I am going to develop a clinical nursing theory with the help of two different concepts and a proposition. This clinical nursing theory will help me improve the nursing practice that is rife in my clinical setting i.e., lack of care management skills among the nurses. 

Concept A

The level of depression is high among old-age patients in the long-term unit. Depression in old-age patients has a detrimental impact on functional status, and quality of health. As a result, it will raise healthcare expenditures and puts a strain on family incomes. Moreover, it has associated repercussions; it leads to further deterioration of illness and sometimes leads to death. In other instances, depression could lead to chronic heart attacks and increase the patient’s stay at the hospital and the financial burden.

Concept B

The next concept is the care management skills among the nurses deployed in my clinical setting. Care management skills are increasingly used in healthcare settings to improve the continuum of care, particularly for old-age patients. Several care models advocate for the involvement of nurses in these tasks (Bayot & Varacallo, 2021). Care management skills are focused on patients who need critical care, particularly older persons who are at higher risk for poor health outcomes (Bayot & Varacallo, 2021).

Proposition

I propose that Concept A and Concept B are interrelated, there is a positive correlation between both concepts. That means, it is possible to treat the level of depression in old age through an intervention from nurses. Nurses through improved care management skills can minimize the risks of depression and improve the illness of the patients (Etemadifar et al., 2018). In this case, concept A depends on concept B for improvement. There is no way that depression in old-age patients can be treated without improved intervention from the nurses, otherwise, this situation could lead to the deterioration of health in old-age patients and can cause death. 

Measurement of Concepts

Depression is a mood disorder that can be difficult to identify and measure. There are several clinical tools available to help health professionals make a diagnosis. The most common tool is the Diagnostic and Statistical Manual of Mental Disorders (DSM) (Cooper, 2018). This manual is created by the American Psychiatric Association and provides a set of criteria for diagnosing mental disorders (Cooper, 2018). Depression is characterized by a persistent feeling of sadness or low mood, loss of interest or pleasure in activities, and a range of other physical and psychological symptoms. To be diagnosed with depression, an individual must meet a certain number of these criteria. The DSM is not the only tool available to measure depression. There are several self-assessment tools, such as the Beck Depression Inventory (BDI), that can be used to assess an individual’s symptoms (von Glischinski et al., 2018). The BDI is a set of questionnaires that measures the symptoms associated with depression (von Glischinski et al., 2018).

There is no one way to measure care management skills in nurses it varies depending on the specific context and situation. However, some techniques on how to measure care management skills in nurses include observing and interviewing nurses in their work environment, asking patients about their experiences with care, and conducting surveys of nurses’ knowledge and skills. Additionally, it is important to consider what specific care management skills are being assessed, as different skills may be more important in different settings. For example, while time management skills may be critical in an emergency room setting, active listening skills may be more important in another setting. 

Jean Watson’s Concepts

The risk of depression increases as old-age patients stay at the hospital increases. This may be due to several factors, including physical illness, the loss of loved ones, and lifestyle changes. Watson talks about a relationship based upon care between nurse and patient. This relationship is built on trust, respect, and mutuality. In the context of caring for an old-age patient with depression, the nurse can provide support, understanding, and compassion. The nurse can also help the patient to identify and express their feelings, and explore coping strategies.

Jean’s theory focuses on the concept that everyone is connected and that caring is the essential element that binds them together. She believes that caring is the central force that drives nursing and that it is the key to providing quality care (Riegel et al., 2018). Watson’s work has shown that care management is more than just a set of skills and techniques. It is a way of being that is based on a deep understanding of the human experience. When nurses are able to connect with patients on a deeper level, they are able to provide them with the best possible care.

Conclusion

Nursing theories are critical components of the nursing practice. My concepts are that the level of depression is high among old-age patients in the long-term unit and that improvement in care management skills among the nurses can be solved by the mid-range nursing theories and brings overall improvement in nursing practices.

References

Bayot, M. L., & Varacallo, M. (2021, September 8). Management skills. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK544227/

Cooper, R. (2018). Diagnostic and Statistical Manual of Mental Disorders (DSM). Knowledge Organization, 44(8), 668–676. https://doi.org/10.5771/0943-7444-2017-8-668

Care management for older adults: The roles of nurses, social workers, and physicians. Health Affairs, 38(6), 941–949. https://doi.org/10.1377/hlthaff.2019.00030

Ell, K. (2018). Depression care for the elderly: Reducing barriers to evidence-based practice. Home Health Care Services Quarterly, 25(1-2), 115–148. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1501087/

Lawrence, B. J., Jayakody, D. M. P., Bennett, R. J., Eikelboom, R. H., Gasson, N., & Friedland, P. L. (2019). Hearing loss and depression in older adults: A systematic review and meta-analysis. the gerontologist, 60(3). https://doi.org/10.1093/geront/gnz009

Riegel, F., Crossetti, M. da G. O., & Siqueira, D. S. (2018). Contributions of Jean Watson’s theory to holistic critical thinking of nurses. Revista Brasileira de Enfermagem, 71(4), 2072–2076. https://doi.org/10.1590/0034-7167-2017-0065

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