Case Study 11 Theory Practice Gap

Case Study 11

Read the following case study:

You are a staff nurse working in an intensive care unit and assigned to care for a 75-year-old African American man who had coronary artery bypass graft surgery four days ago. The patient has a history of chronic obstructive pulmonary disease exacerbated by heavy smoking. His postoperative course has been difficult, and he has suffered a number of setbacks. Staff members, despite their diligent efforts, have not been able to wean him off the ventilator since the surgery. He has required frequent suctioning throughout the shift, and he is being evaluated for the development of ventilator-associated (pneumonia.theory-practice gap CaseStudy-Essay Example)

Today, when returning from lunch, you observed that an experienced nurse was suctioning your patient. His secretions were thick, and you observed that the nurse was instilling saline into the patient’s endotracheal tube as she was suctioning him. The patient turned red and began coughing, and it was obvious he was in distress.(theory-practice gap CaseStudy-Essay Example)

Assignment

Identify the theory-practice gap in the case study above and describe how this potential gap can impact nursing practice and patient care.

Create a concept map that depicts your assumptions and findings of the theory-practice gap. Show alignment of nursing theory and its relation to the nursing process (including alignment with critical thinking and clinical decision-making) for an improved nursing care plan.

Write a 1200-word summary explaining how the concepts in nursing theory align to the nursing process, including alignment with critical thinking and clinical decision-making for an improved nursing care plan.

Include the following in the summary:

• The theory-practice gap that you identified in the case study and how this potential gap can impact nursing practice and patient care
• A plan to close the gaps in this scenario which will consist of how theory, research, and practice interact to create positive patient outcomes

theory-practice gap CaseStudy-Essay Example-Solution

Identify the theory-practice gap in the case study above and describe how this potential gap can impact nursing practice and patient care.(theory-practice gap CaseStudy-Essay Example)
The theory gap presented in this case study is on nurses’ attitudes toward care. Although nursing is based on research, theory, and different forms of known concepts focused on the art of care, proper guidance of practice through theoretical sciences is a significant challenge in the nursing practice (Salifu et al., 2019). Information presented in the case study shows that the involved nurses had varying attitudes and perceptions toward the care delivery process. The staff nurse needed to properly suction the patients despite knowing it was the most appropriate measure. According to Greenway et al. (2019), novice and advanced beginner nurses often have different attitudes toward the nursing profession, learning process, and service provision. Those with limited information about these concepts often need more precise job descriptions and prospects. Nurses’ attitudes toward care have negative impacts on the care delivery process. Specifically, Shoghi et al. (2019) report that nurses with negative attitudes toward care delivery often show less commitment to improving their patient’s quality of life. In this case, the staff nurse’s inability to properly care for the assigned patient exposed the patient to additional health problems, including ventilator-associated pneumonia.(theory-practice gap CaseStudy-Essay Example)

Create a concept map that depicts your assumptions and findings of the theory-practice gap. Show alignment of nursing theory and its relation to the nursing process (including alignment with critical thinking and clinical decision-making) for an improved nursing care plan. The theory-practice gap that you identified in the case study and how this potential gap can impact nursing practice and patient care(theory-practice gap CaseStudy-Essay Example)
Information presented in the provided case study shows that nurses’ attitudes toward care are an essential theory-practice gap within the care setting. Specifically, the attitude of staff nurses and other health providers initially caring for the patient toward the profession, learning, and care significantly influenced the gap. The influential factors presented in this case study are professional awareness and interests, a clinical environment encouraging learning, the engaging nature of theoretical knowledge, personal concern about learning, and motivation to improve patient outcomes(theory-practice gap CaseStudy-Essay Example). Although the staff nurse had tried to wean the patient off the ventilator after the surgery, this was unsuccessful, exposing the patient to additional health problems, including ventilator-associated pneumonia. Therefore, it is justifiable to note that the staff nurse showed negative attitudes toward nursing care by failing to seek help from experienced nurses. A previous study by Shoghi et al. (2019) identifies factors such as personal aptitudes, motivation, and confidence to promote clinical education on the student nurse’s side.(theory-practice gap CaseStudy-Essay Example)

On the other hand, Greenway et al. (2019) identify anxiety, lack of motivation, and fear of harming patients as primary mediating factors for poor patient outcomes. Concerning the information presented in the case study, it can be noted that the staff nurse failed to continue the suctioning process due to the fear of harming the patient or exposing him to additional health problems. Shoghi et al. (2019) argue that the sense of acceptance and attachment to the learning environment plays an essential role in influencing the ability of students to learn and apply theoretical knowledge of nursing into practice. Evidence from the case study shows that the staff nurse was unfamiliar with the practice and needed help to execute the nursing activities adequately. Therefore, experience in such situations led to dissociation from fear, profession, and anxiety.(theory-practice gap CaseStudy-Essay Example)

Evidence shows a positive relationship between nurses’ attitudes toward care and patient outcomes. Specifically, the study by Salifu et al. (2019) reports that nurses with positive safety attitudes recorded fewer incidences of patient falls, pressure injuries, medication errors, healthcare-associated infections, physical restraints, and vascular access device reactions compared to their colleagues with negative attitudes toward care(theory-practice gap CaseStudy-Essay Example). Therefore, positive safety attitudes among nurses could lead to higher patient satisfaction. Information from the case study shows that the patient experienced ventilator-associated pneumonia, which indicates that the quality of care provided to the patient was relatively low. With reference to the explanations by Greenway et al. (2019), the inability of nurses to pay attention to the patient’s needs may expose them to hospital-acquired infections. Therefore, the perceived negative attitude toward care among the nursing team might have told the patient to ventilator-associated pneumonia.(theory-practice gap CaseStudy-Essay Example)

Furthermore, the staff nurse has demonstrated a need for more ability to effectively relate the knowledge she acquired in academics and research work with practice. If the staff nurse could effectively apply theoretical knowledge in nursing practice, she could have effectively managed the case patient or sought assistance from experienced nurses in case she was experiencing challenges. In this case study, other essential factors that could have contributed to the reported theory-practice gap are limited supervision of the staff nurse’s work, little use of mentorships and other experienced nurses to evaluate student nurses, and the instructor’s negligence toward evaluation.(theory-practice gap CaseStudy-Essay Example)
A plan to close the gaps in this scenario which will consist of how theory, research, and practice interact to create positive patient outcomes.(theory-practice gap CaseStudy-Essay Example)

Theory-practice gap significantly impacts the professional image of involved nurses, which in the long term affects their self-esteem and professional growth and interrupts their personal development (Salifu et al., 2019). Evidence from the present case study shows a need to address the theory-practice gap to improve patient care quality. Watson’s Theory of Human Caring is an important theoretical framework for addressing the identified theory-practice gap in this case study.(theory-practice gap CaseStudy-Essay Example)

With reference to the explanations by Greenway et al. (2019), Watson’s Theory of Human Caring has been widely used in the nursing practice to improve the competency of nurses to execute their nursing roles and ensure quality patient outcomes. Therefore, Watson’s Theory of Human Caring can guide nurses in this case study on the best approach when handling patients who need suctioning. As reported in the study by Salifu et al. (2019), Watson’s Theory of Human Caring is based on the principle that nurses should use available resources to ensure the improved quality of care they offer to their clients. In the context of this case study, it is evident that the staff nurse failed to seek support from experienced nurses when caring for her patient. Therefore, there is a need to address these nurses’ overall attitude toward patient care and enlighten them on the importance of seeking support and guidance from experienced nurses when handling difficult patient situations.(theory-practice gap CaseStudy-Essay Example)

Consistent with the explanations by Shoghi et al. (2019), the constructivist approach can also be applied to close the theory-practice gap by providing experimental learning which would encourage nurses to be active participants when caring for the patients and apply the newly acquired knowledge in their actual nursing practice. Although the experienced nurse was able to suction the patient successfully, she failed to include the staff nurse in the process, limiting her ability to acquire new knowledge which she would use in the future when handling similar situations. Therefore, the theory-practice gap of negative nurses’ attitudes toward care can be closed by involving novice and advanced beginner nurses in practical nursing studies and explaining how to address different patient situations instead of waiting for them to make a mistake.(theory-practice gap CaseStudy-Essay Example)

The studies by Greenway et al. (2019) and Shoghi et al. (2019) further report that the theory-practice gap can be addressed by creating an appropriate context for nurses and nursing trainers to mutually learn and use pragmatic language in the form of clinical guidelines. In this case, the staff nurse was not provided with adequate support, which could have led to a negative attitude toward care and poor patient outcomes. Therefore, this gap can be addressed by continually providing novice and advanced beginner nurses with adequate support and advice on managing different patient situations.(theory-practice gap CaseStudy-Essay Example)

References

Greenway, K., Butt, G., & Walthall, H. (2019). What is a theory-practice gap? An exploration of the concept. Nurse education in practice, 34, 1-6.(theory-practice gap CaseStudy-Essay Example)
Salifu, D. A., Gross, J., Salifu, M. A., & Ninnoni, J. P. (2019). Experiences and perceptions of the theory‐practice gap in nursing in a resource‐constrained setting: A qualitative description study. Nursing Open, 6(1), 72-83.
Shoghi, M., Sajadi, M., Oskuie, F., Dehnad, A., & Borimnejad, L. (2019). Strategies for bridging the theory-practice gap from the perspective of nursing experts. Heliyon, 5(9), 25-32.

https://www.ncbi.nlm.nih.gov/