There are four major theories that are often deployed during nursing research. These are the Middle Range theory, Meta theory, Grand theory and the Practice theory. However, for this research the Middle Range theory will be used. This theory has been found to be instrumental in helping students and nurses to come up with sound research. The goal of this theory is to provide empirical information from theoretical concepts. Notably, the theory provides guidance and direction for the topic under study. In this case, the most relevant theory under the Middle Range theories will be the Deliberative Nursing theory.
The Deliberative Nursing Theory
The Middle Range, Deliberative Nursing theory was born by Ida J. Orlando in 1961 to describe the function and the outcomes of a professional nursing (Peterson & Bredow, 2013). This theory has little variables and scope. Nevertheless, it is specific, applicable and testable from a research perspective (Peterson & Bredow, 2013). According to Peterson & Bredow (2013), this theory is comprehensive and focused. It is limited to its concepts and provides a reproducible hypothesis. This theory has been used extensively as a framework for vast research.
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Relevance of the Theory in this Research
This theory has been used extensively as a framework for vast research. For instance, it has been applied in most qualitative and quantitative theoretical analysis. In relation to my topic of study, this theory has been used in studies that involve blood pressure and pulse rates, and levels of stress. Blood transfusion, for instance, has been found to cause complications such as pulmonary edema a condition that is often known as Transfusion Associated Circulatory Overload (TACO). Gajic et al., (2006) noted that this condition resulted when extravascular lung water accumulates because of an imbalance between filtration and reabsorption of cellular fluid. The Deliberative Nursing process is important in this study because it is a patient focused theory. Based on this theory, there is the need to focus on the effects that a nurse’s activities have on a patient. The research will focus on two main areas while garnering its data, namely, patients need help and a nurse’s action outcome.
Patient’s Need of Help
Notably, a patient demonstrates various behaviors to demonstrate that they are in need of help (Peterson & Bredow, 2013). In this research, for instance, the issue of blood transfusion is because of the vast cases of anemia that are reported in hospitals. Patients may gasp or rather appear to be suffocating thus it will be the nurse to judge and establish what specifically the need of the patient is, and advocate for an immediate solution. As part of the treatment plan, medics often opt for Red Blood Cells (RBCs) transfusions to such patients. The aim of such transfusions is to improve the delivery of oxygen to limit tissue hypoxia and cellular damage.
Failure to respond to patients’ behaviors that reflect pain and distress have been established to be the main cause of death that is encountered to victims of TACO. Notably, 11% of patients who undergo blood transfusions stand a chance of contracting TACO (Taylor, 2008). Mortality rates of between 5-15% have also been reported (Gajic et al., 2006). These incidents might be due to the failure of nurses to understand the meanings of the behavior of the patient. From the Deliberative Nursing Procedures, the association between nursing ability to assess patients’ distress or rather the pain is determined by the nurse-patient relationship (Peterson & Bredow, 2013). These relationships will be essential to attend to the needs of the patient before the situation worsens further (Peterson & Bredow, 2013).
Patients Outcome
Apparently, the outcome is defined by how a patient responds to an action that was taken by a nurse (Peterson & Bredow, 2013). The outcome can be positive or negative depending on how a nurse interpreted the signs from the patient. Thus, a nurse needs to critically examine both the verbal and non-verbal communications from the patient in order to establish the effects of their actions on them. TACO, for instance, is characterized by acute respiratory distress, elevated blood pressure, pulmonary edema or tachycardia occurring six hours after blood transfusion has been completed (Taylor, 2008). The patient will also present clinical symptoms and signs like cyanosis, tachypnea as well as dyspnoea (Taylor, 2008). At this point, a nurse will be in a good position to detect that the patient has developed TACO. Apparently, patients’ behaviors have meanings. This theory is thus important in establishing the outcome of certain actions (such as Blood Transfusion), and how the nursing care can be improved to mitigate their side effects. It acts as a platform for establishing a nurse’s action – patients’ outcome relationship.
The theory also is giving options for my research, such as the need to develop instruments that can be essential to help nurses on how to read and interpret a patient’s behavior. Kluwere (2015) also supports by adding that patients who are under a blood transfusion process need to be closely monitored. The Middle range Deliberative Nursing Program thus, provides a platform that will lead to the professionalization of nurses in their role. This information will be crucial in establishing how the nurses respond to their patients and how service delivery can be improved within the hospital setting. In conclusion, the Deliberative Nursing Procedures provide a process that would lead to the development of ideas or rather theories that will help in mitigating the challenges that are faced during the blood transfusion process.
References
Gajic, O., Gropper, M. A., & Hubmayr, R. D. (2006). Pulmonary edema after transfusion. How to differentiate transfusion-associated circulatory overload from transfusion-related acute lung injury. Critical Care Medicine, 34 (5), S109-S112.
Kluwer W. (2015). Responding to pulmonary-related blood transfusion reactions . New York: Lippincott Williams & Wilkins, CE Group .
Peterson S. J. & Bredow T. S. (2013). Middle Range Theories: Application to Research . New York: Lippincott, Williams & Wilkins.
Taylor C. (2008). Transfusion Associated Circulatory Overload (TACO). Retrieved from http://www.shotuk.org/wp-content/uploads/2010/03/BBTS-2008-Dr-Taylor-TACO.pdf
