Module 8 Overview:
This module will examine several issues related to the application of theory in nursing practice, research, management, and education. The relationship between theory and practice and the concept of theory-based practice will be described, and the perceived theory-practice gap will be explored. Practice theories will be presented, as well as the concept of evidence-based practice.
This module will also examine a number of issues related to the interface of research and theory in the discipline of nursing. Topics covered include the relationship between research and theory, types of theory and corresponding research, how theory is used in the research process, and the issue of borrowed versus unique theory for nursing. How theory should be addressed in a research report and in the discipline’s research agenda will also be detailed.
Specific applications of administration and management theories, models, and frameworks in nursing and health care will also be explored. These concepts include organizational design, shared governance, transformational leadership, patient care delivery models, case management, disease/chronic illness management, quality management/performance improvement process tools and techniques, and evidence-based practice. Finally, this module will detail how theory influences and is influenced by nursing education—both to determine the content and structure of a program’s curriculum, and to determine the instructional processes and strategies used by faculty to teach students.
To improve the practice of nursing, nurses need to search the literature, critically appraise research findings, and synthesize empirically and contextually relevant theoretical information to be applied in practice. Theory and practice are intertwined and symbiotic: practice is the basis for nursing theory development, and nursing theory must be validated in practice. Despite this reciprocal relationship, many purport that a theory-practice gap exists, and the interaction remains fragmented or unrecognized. Several strategies to close the theory practice gap were presented. Practice theories, which are clinically specific and reflect a particular context, are easily applied in nursing research and practice. Evidence-based practice, defined as the conscientious, explicit, and judicious use of the current best evidence in making decisions about the care of individual patients, is often used by nurses in their delivery of care and exemplifies the union of theory and practice.
Theory is also integral to the process of research. It is paramount to use theory as a framework to provide direction regarding selection of the research design, identify approaches to measurement and methods of data analysis, and specify criteria for acceptability of findings as valid. The types of theory (descriptive, explanatory, and predictive) were summarized, with examples provided from nursing literature. Lastly, the three ways that theory is used in research were introduced: theory-generating, theory-testing, and theory as a conceptual framework. Nursing’s research agenda was identified, which respond to important issues from nursing practice, administration and management, and education.
Nursing practice is shaped and influenced by models and principles of leadership, management, and administration. It is important for advanced practice nurses to recognize and adapt to the specific organizational characteristics that define the organization in which they practice. The structure of an organization provides a framework in which management processes occur. Management strategists have formulated six elements of organizational structure: work specialization, chain of command, span of control, authority and responsibility, centralization, and departmentalization. Shared governance and transformational leadership were also discussed. Patient care delivery models adapt in response to changing needs of patients, society, and nurses. The patient care delivery models discussed in this module include functional nursing, team nursing, primary nursing, and patient-focused care. Case management, quality management, and disease/chronic illness management were also addressed with illustrative nursing applications.
Theoretical principles, concepts, and models are used in two ways in nursing. First, they are used to determine the content and structure of a program’s curriculum. Second, they are used to determine the instructional processes and strategies used by faculty to teach students. Technology plays an increasingly important role in nursing education, and incorporates distance learning methodologies and virtual reality simulation.
Discussion Question:
Visit an Internet resource devoted to evidence-based practice (Cochrane Collaboration, AHRQ’s National Guideline Clearinghouse, or Bandolier Evidence Based Journal). Review a summary systematic review on a topic of interest. Present your findings to your classmates, and illustrate how this may or may not be used in practice.
Your initial posting should be 250 to 350 words in length and utilize at least one scholarly source other than the textbook.
