Application of Concept Analysis to Clinical Practice
Authors Walker and Avant (2011) defined concept analysis as an “approach to clarify the meaning of the term, and to define the term so that writers and readers shared a common language” (McEwen & Wills, 2014, p. 58). The purpose of this peer-reviewed concept analysis article was to analyze the conceptual meaning of patient’s vulnerability perioperatively using Walker and Avant’s (2005) eight stages of concept analysis framework (Cousley, Martin, & Hoy, 2014). The authors of this article presented each stage of the concept analysis with definition, and a thorough explanation was illustrated. Moreover, this writer selected this article for her to gain knowledge about the concept analysis
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Hence, they are vulnerable due to the possible risk of injury, and from any actual or potential complications related to anesthesia and surgery (Cousley, Martin, & Hoy, 2014). Researchers A. Cousely, D.S.E. Martin, and L. Hoy conducted a study, entitled ‘Vulnerabililty in the perioperative patient: a concept analysis,’ using Walker and Avant’s (2005) concept analysis framework. According to the researchers, Walker and Avant (2005) formulated an eight-stage process of concept analysis, in order to delineate the fundamental element of a concept. This methodology was to generate a consistent description so that a concept has validity in nursing practice (Cousley, Martin, & Hoy, 2014). The first step of the analysis was to choose a concept and identify the aims or purposes of analysis. In this step, researchers selected vulnerability concept as it was correlated to a perioperative patient. The purpose of this selection was to examine and analyze comprehensively the concept (Cousley, …show more content…
In relation to the perioperative patient, social aspects consisted of demographic data on age, gender, ethnic background, health status, and perceived danger. Psychological aspects of vulnerability in a perioperative state involved patient’s response to stress that causes anxiety and dependence by exposure to planned anesthesia and surgery. Physical vulnerability was resulted through physiological signs, and symptoms of anxiety, which triggered to release a surge of hormones, in order to combat stress (Cousley, Martin, & Hoy, 2014). Researchers also considered personal factors can heighten vulnerability. They noted that the person’s characteristics, such as genetic makeup, behavior, susceptibility to illness, and demographic data, and the acquired characteristics, such as experiences, how the patient responds to unforeseen situations, and the use of coping mechanisms, were also identified (Cousley, Martin, & Hoy, 2014). In addition, vulnerability was exhibited in a perioperative intervention through manifestations of various emotions from fear of the unknown, fear of being sick, and fear for one’s life (Cousley, Martin, & Hoy,
As a post-anesthesia care unit (PACU) Registered Nurse (RN), I care for patients of all races, ages, gender and ethnic backgrounds. However, a majority of the people I care for are of advanced age. Therefore, one must be aware of changes in the body related to aging. The purpose of this discussion is to present a case that addresses the considerations and issues of the perioperative care of an elderly patient.
This essay will discuss the risks for patients during the preoperative, intraoperative and postoperative stages of the perioperative journey and how both patients and healthcare professionals involved in the perioperative stages can work together to prevent perioperative hypothermia.
Weld, K., & Garmon Bibb, S. (2009). Concept analysis: malpractice and modern-day nursing practice. Nursing Forum, 44(1), 2-10. doi:10.1111/j.1744-6198.2009.00121.x
The term “safety comes first” or more simply put, “safety first,” is a message that patients not only want to hear, but also want to know is the focus of the professionals that are caring for them; in particular, when they are under anesthesia and have limited or no ability to speak up or lookout for themselves. The National Patient Safety Agency (NPSA) has implemented two initiatives; Rocognising and Responding Appropriately to Early Signs of Deterioration in Hospitalised Patients (NPSA, 2007) and How to Guide: Five Steps to Safer Surgery (NPSA, 2010). Understanding that human beings make up the healthcare professional workforce, it is evident that tools and checklist can and will only be as good as the how people utilize and follow them. Thus, these initiatives “have been developed with consideration of human factors” (Beaumont & Russell, 2012). I know firsthand, that if my healthcare team would have followed these standards, I would have avoided torture, fear, and long term side effects from a routine hysterectomy procedure.
Stomberg, M., Sjöström, B., & Haljamäe, H. (2003). The Role of the Nurse Anesthetist in the Planning of Postoperative Pain Management. AANA Journal, 71(3), 197.
An electrocardiogram (ECG) is one of the primary assessments concluded on patients who are believed to be suffering from cardiac complications. It involves a series of leads attached to the patient which measure the electrical activity of the heart and can be used to detect abnormalities in the heart function. The ECG is virtually always permanently abnormal after an acute myocardial infarction (Julian, Cowan & Mclenachan, 2005). Julies ECG showed an ST segment elevation which is the earliest indication that a myocardial infarction had in fact taken place. The Resuscitation Council (2006) recommends that clinical staff use a systematic approach when assessing and treating an acutely ill patient. Therefore the ABCDE framework would be used to assess Julie. This stands for airways, breathing, circulation, disability and elimination. On admission to A&E staff introduced themselves to Julie and asked her a series of questions about what had happened to which she responded. As she was able to communicate effectively this indicates that her airways are patent. Julie looked extremely pale and short of breath and frequently complained about a feeling of heaviness which radiated from her chest to her left arm. The nurses sat Julie in an upright in order to assess her breathing. The rate of respiration will vary with age and gender. For a healthy adult, respiratory rate of 12-18 breaths per minute is considered to be normal (Blows, 2001). High rates, and especially increasing rates, are markers of illness and a warning that the patient may suddenly deteriorate. Julie’s respiratory rates were recorded to be 21 breaths per minute and regular which can be described as tachypnoea. Julies chest wall appeared to expand equally and symmetrical on each side with each breath taken. Julies SP02 levels which are an estimation of oxygen
In the operating room, there are many things that come into play to keep the patient and staff safe at all times. The safety checks that are double-checked before the surgery are extensive and they are
While this study does not directly identify a conceptual or theoretical framework, it could be implied based on the inclusion of background nursing research literature in which concept analysis and various themes were discussed in conducting similar qualitative studies. The concepts or themes surrounding this study include vulnerability and suffering, introduction and interaction with the patient, moral responsibility, as well as feelings and sensitivity (Roberts & Thorup, 2012). Conceptual models are less structured than theories and broadly demonstrate concepts of interrelated phenomena (Be...
The PICOT model creates a template for clinicians that allow them to break down clinical questions related to a specific population. With this model, clinicians find information via online databases and journals to gather accurate data. Often, health care providers have the capacity and interest in formulating a question, however they lack research strategy (Riva, Malik, Burnie, Endicott & Busse, 2012). The PICOT model helps bridge the gap between questions and answers. A concern of mine in health care deals with mistakes made in the operating room. The proposed research question is “Does the implementation of the World Health Organization’s Surgical Safety Checklist, in its entirety, reduce the rate of surgical mistakes and increase positive results compared to surgeries that do not follow all aspects of the surgical safety checklist; especially in lower income countries or emergency surgery situations where time is not
“She will sleep the sleep of death,” said Ghoneim (2001) in his book Awareness during Anesthesia (p. 55). Patient recall is a frightening and fascinating concept describing how a patient could remember events while under anesthesia during surgery. It is a rising concern in the medical field because of its traumatic effects on the patients. Patient awareness involves the patient under anesthesia experiencing pain, vaguely remembering music or remembering the physicians talking as if the patient were dreaming. This topic is very controversial in that there are not very many cases in which a patient experienced recall or brought it to the anesthetist’s attention. Throughout this essay, I am aiming to discuss anesthesia as well as patient recall and the ways in which we can solve this issue. Patient recall involves patients with preconceived notions as well as poorly trained professionals who make mistakes, to solve this issue both patients and anesthesia providers must work together.
The concept of pain management will be explored in relationship to patients that are post-operative. A problem has been identified on one of the floors in a hospital that I work on with patients that are post-operative after having joint replacement surgery. The patients are coming to the floor with pain and it is difficult to control their pain level. The result is patients that are unsatisfied with their pain management during their hospital stay.
It is important for health care organisations to have policies and guidelines on the safe management of vulnerable patients in the community and hospital for health care professionals, including more specifically the perioperative environment for operating department practitioners (ODPs). This awareness of these patients, policies and guidelines is needed in order to act in a manner to protect and safeguard. Health care professionals must also have the appropriate training in caring for these vulnerable patients, for example professionals caring for children should have up to date qualifications in paediatric care and be able to communicate efficiently with the child and parent/carer. The Royal College of Nursing, RCN (2011) consider that this should a...
Scanlon, A., & Lee, G. (2007). The use of the term vulnerability in acute care: why does it differ
Westhead, C. (2007). Perioperative Nursing Management of the Elderly Patient. Canadian Operating Room Nursing Journal, 25(3), 34-41. Retrieved from http://gateway.library.qut.edu.au/login?url=http://search.proquest.com.ezp01.library.qut.edu.au/docview/274594603?accountid=13380.
Although students were not allowed in the recovery unit, I was able to talk to one of the recovery nurses. I learned that a nurse’s duty of care includes monitoring the patient’s vital signs and level of consciousness, and maintaining airway patency. Assessing pain and the effectiveness of pain management is also necessary. Once patients are transferred to the surgical ward, the goal is to assist in the recovery process, as well as providing referral details and education on care required when the patient returns home (Hamlin, 2010).