Usefulness of a Nursing Mid-Range Theory in Solving a Practice Problem.

Mid-range nursing theories are theories that are specific in the way they address the theoretical foundations of nursing. They are the source of the conceptual underpinnings of nursing practice as it is known. They seek to explain the reasons behind the occurrence of phenomena in practice, as well as the reasons why interventions are carried out the way they are. Many nursing mid-range theories were formulated in the 20^th century by nurse theorists. There are many examples of these theories that can be used to solve current practice problems. Usefulness of a Nursing Mid-Range Theory in Solving a Practice

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The way these theories help in solving clinical practice problems is that they form the conceptual framework that informs the rationale behind the interventions used for the clinical practice problem. Examples of nursing mid-range theories are the Self-Care Deficit Theory by Dorothea Elizabeth Orem, the Transcultural Nursing Theory by Madeleine Leininger, and the Environmental Theory by none other than Florence Nightingale. This paper is about the clinical problems in geriatric nursing such as the inability to carry out activities of daily living (ADLs) because of neurodegenerative disorders (such as Alzheimer’s disease); and the risk of accidental patient falls. It is also about how the mid-range Theory of Successful Ageing by Meredith Flood (Troutman-Jordan & Staples, 2014; Lange & Grossman, n.d.) can be used to inform interventions aimed at solving these geriatric practice problems.Usefulness of a Nursing Mid-Range Theory in Solving a Practice Problem.

A Summary of the Problem

Geriatric nursing has its unique challenges that are not common to other specialties of nursing. The reason for this is that the patient population in this specialty is defined by old age, frailty, reduced cognitive abilities, disability, and chronic medical conditions. Those who are considered as belonging to this population focus are patients aged 65 years and above.Usefulness of a Nursing Mid-Range Theory in Solving a Practice Problem. These are the patients who are at a very high risk of suffering accidental patient falls (Mileski et al., 2019; AHRQ, 2018). This is because of the disability, frailty, and lack of sound judgement due to deterioration in cognitive abilities. The patients in this geriatric population focus also show problems with the ability to take care of themselves. Specifically, they are often unable to take care of their activities of daily living or ADLS such as bathing, feeding, walking, and emptying the bowels. They thus always require assistance with these activities. These two practice problems of (i) risk of fall, and (ii) inability to take care of ADLs are just two that have been chosen to represent the problems in geriatric nursing. These are the problems that may benefit from interventions theoretically underpinned by the mid-range nursing theory of Successful Ageing by Flood. Usefulness of a Nursing Mid-Range Theory in Solving a Practice Problem.

A Description of the Mid-Range Theory Applicable to the Geriatric Nursing Problems Stated Above

The mid-range nursing theory chosen as the most suitable to help solve the two geriatric nursing problems presented above is the Theory of Successful Ageing first proposed by Meredith Flood (Troutman-Jordan & Staples, 2014; Lange & Grossman, n.d.). Usefulness of a Nursing Mid-Range Theory in Solving a Practice Problem.This theory holds that successful ageing is dependent on the way an individual old person perceives their life. For instance, if a person believes that they are ageing as they would have wanted, then this will feed into their ageing process both psychologically and physically. As a result, they will age successfully with the person showing contentment. However, if an old person perceives that they are not ageing well, then indeed they will not age successfully. In essence, this theory is anchored on spirituality and belief. It is about getting what one desires with regard to ageing through spiritual belief.Usefulness of a Nursing Mid-Range Theory in Solving a Practice Problem.

The theory states that adaptation to the ageing process is key to its success. For an old person to have succeeded in the ageing process, they must have been able to cope with the process. Then there are the personal choices made during one’s lifetime. Usefulness of a Nursing Mid-Range Theory in Solving a Practice Problem.The Theory of Successful Ageing holds that these choices also have an important bearing on the success of the ageing process. Because of all these metaparadigms of the theory, the author of this paper believes that it is appropriate in solving the practice problem associated with geriatric nursing. Understanding the perceptions and the choices of the older patient will help the nurse in strategising on appropriate interventions in the nursing care plan. This will be done after making appropriate informed nursing diagnoses underpinned by the conceptual framework of the theory. For instance, an older patient who has not been able to cope with the changes of the ageing process and who perceives themselves as a failure will experience depression and despair. One of the nursing diagnoses informed by the theory would therefore be ‘Risk of infection due to negligence of personal hygiene as a result of despair and depression.’Usefulness of a Nursing Mid-Range Theory in Solving a Practice Problem.

The Origins and Previous Application of the Mid-Range Theory

Meredith Troutman Flood is a nursing scholar who was the originator of the Theory of Successful Ageing. She holds a PhD and is also a board certified clinical nurse specialist. The theory was the culmination of many years of study and teaching that allowed her to make observations and draw conclusions from a scientific interpretation of these observations. Usefulness of a Nursing Mid-Range Theory in Solving a Practice Problem.Previously, this theory has been applied in the healthcare setting by nurses to help bring about desired patient outcomes in older patients. For instance, Flood et al. (2009) state that nurses in a geriatric unit can help an older patient holistically by asking them to list the things that would make them happy or having a feeling of successful ageing. This is in the event that the nurses are informed by this theory to recognize that the patient is experiencing hopelessness after perceiving that their ageing process has not been a success. In essence, what the study by Flood et al. (2009) indicates is that there have been many occasions in the past in which the application of the Theory of Successful Ageing has informed nursing interventions.Usefulness of a Nursing Mid-Range Theory in Solving a Practice Problem.

Application of the Mid-Range Theory to the Problem

To recap on the problems needing attention in geriatric nursing and which need to be solved by this theory, the following can be stated:

3. That older patients in the population focus of geriatric nursing are susceptible to accidental falls that may be contributed to by their state of mind. In the United States, between 3.3 and 11.5 patient falls per 1,000 patient days are reported annually. This causes billions of dollars in hospitalization costs borne by providers as the Centers for Medicare and Medicaid Services no longer reimburse for care given to fall victims (AHRQ, 2018, Bouldin et al., 2013).Usefulness of a Nursing Mid-Range Theory in Solving a Practice Problem.
4. That because of the frailty of the older patients and neurodegenerative conditions, their cognitive abilities are deteriorated and they have to be reminded and assisted to undertake their ADLs.Usefulness of a Nursing Mid-Range Theory in Solving a Practice Problem.

Using the Theory of Successful Ageing, geriatric nurses can assess whether the patient perceives their ageing as successful or not. They can then make a determination if their perception of their ageing process has a bearing on their likelihood of absentmindedness and falling. As for ADLs, this theory can be instrumental in determining if the patient feels despair and/ or depression and hence likely to forget to bath or eat as a consequence of their state of mind.Usefulness of a Nursing Mid-Range Theory in Solving a Practice Problem.

Conclusion

The Theory of Successful Ageing is a mid-range nursing theory fronted by Meredith Troutman Flood. It is a theory applicable to geriatric nursing as it can theoretically underpin many of the interventions used in that specialty. Examples of the problems that this theory can help to solve in geriatric nursing are the risk of falls and the inability to carry out ADLs. This paper has discussed this mid-range theory and how it can be applied to solve these geriatric nursing issues. Usefulness of a Nursing Mid-Range Theory in Solving a Practice Problem.