Application of Nursing Theory
The theoretical basis of inquiring and understanding different nursing situations is the most pragmatic step to counter problems of negative personal attitudes that might derail the objective of attaining positive outcomes in patient care. As a result, the profession puts emphasis on the use of Benner-Model of Skill Acquisition to help nurses in executing their work in a professional and clinically ethical manner.
This paper examines the fundamental importance of applying Benner-Model of Skill Acquisition as a way to resolve Healthcare Associated Infections (HAIs) in advance clinical practice.
Summary of Benner-Model of Skill Acquisition
Benner’s Skill Acquisition Model in nursing delineates five skill acquisition stages: advanced beginner, novice, proficient, competent, as well as the expert (Pena, 2010). Benner’s work made use of the Dreyfus skill acquisition nursing model that was published in 1984 and incorporate five skill acquisition stages regarding education, administration, research, and practice. Nursing remains an exceptional profession that the practitioner’s experience is the most momentous aspect of professional growth along with knowledge development. The theory is Patricia Benner, novice to expert, besides the reflective practice concept together authenticate this thought. Benner used reflection in her nursing profession study so as to portray the sole knowledge and characteristics embedded in the nursing experience. Ideally, both the concept and the theory have been utilized to improve professional growth, knowledge development, and innovative transformations in the nursing line of work. Benner (1984) describes a novice as a beginner without situational experience that they are anticipated to carry out. For the novice nurse to build up skills, the nurse has to be devoted to new clinical circumstances. The next skill acquisition stage is the advanced beginner. The theorist defines it as a nurse “who is capable of demonstrating marginally acceptable recital, who have managed real states enough to note the persisting significant situational elements, which are termed features of the state” in the Dreyfus Model (Kelly, 2012). A competent nurse remains a nurse who has achieved 2-3 years of experience in the very similar profession or comparable everyday states (Johnson & Webber, 2010). Benner outlines that competence builds up when the nurse begins to plan or see his/her acts in terms of long-term goals. The proficient nurse observes circumstances as one rather than regarding characteristics. Consistent with Alligood (2014), perspective is not deliberate but reveals itself basing on recent events and experience. The expert nurse is the next stage in the skill acquisition model (Alligood, 2014). Following Johnson and Webber (2010), the expert nurse is the one that has a profound association and understanding of the circumstances. The expert nurse no longer depends on an analytic standard; as an alternative, the expert nurse has a spontaneous grasp of events, which is used to establish actions (Johnson & Webber, 2010).
Description of Issue and Literature Review
HAIs also referred to as hospital and nosocomial infections, affect patients in a hospital or other healthcare facility, as well as are not incubating or present during admission. On the other hand, they include infections attained by patients in the facility or hospital but emerging following discharge, and work-related infections among personnel. Most nations require surveillance systems for HAIs. Those, which do have systems frequently, deal with the complexity and need standardized diagnostic criteria for the infections. At the same time as this makes it had to meet reliable worldwide information on HAIs, stem from studies evidently point out that each year, many patients are affected by HAIs Globally. HAIs only more often than not get public attention when there are outbreaks. Even though often concealed from public consideration, the very real endemic, the constant problem remains one that no organization or state can allege to have solved, in spite of many efforts (Miller et al., 2011).
The prevention of HAIs is dependent on the nursing staffs. Their proper care and maintenance of central lines remain relevant to the prevention of this infection. They are obliged to ensure that there is suitable line flushing, management of tubing as well as needleless connectors, patient or family edification, sterile dressing alterations, precise data collection, among other measures. The nursing care model and the association between nurses and patients is directly impacted by nurse model in position as well as the application of Benner’s Skill Acquisition Model in nursing can provide organization and structure, offering a methodical, predictable practice (Sievert et al., 2013). This can incorporate the data anthology, progress notes, practice principles, nursing orders, and deliberate interventions that lead to a defined, efficient nursing practice (Miller et al., 2011). With regard to HAIs, this paper take into consideration the application of Benner’s Skill Acquisition nursing Model that can promote the support in the progress of methods to practice, which may bring about improved patient results (Sievert et al., 2013).
In American healthcare system according to Zimlichman et al. (2013), HAIs account for about $10 billion dollars in the healthcare system (Zimlichman et al., 2013). Even though these events are preventable, they are capable of leading to great injury to patients and related to high costs. The majority of the infection, which are those linked to bloodstream infections costs highest at 45,814 dollars per event, which is approximately 19 percent of the general problem. According to Center for Disease Control and Prevention (CDC), central line-associated blood stream infections (CLABSIs) the commonest nosocomial are a positive single blood organism’s culture rare to the skin or two positive cultures for organisms universally on the skin, at the time a client has a central line during infection or in the 48 hours prior to. The infection may fail to be linked to whichever other infections they have had rising or on hospitalization (Mauldin et al., 2010). Ideally, the adverse incidents remain a serious problem in healthcare affecting 5 percent of the entire admitted patients yearly in America (Zimlichman et al., 2013). ICUs (Intensive Care Units) and hemodialysis units are the departments that are considerably affected by CLABSIs. This lead to in lengthened hospitalization period and an increased death rate, 12-25% (Mauldin et al., 2010).
HAIs are a major cause of complications across the care range and can be passed on between diverse healthcare facilities. However, latest studies propose that implementation of present prevention measures can lead to about a 70% decrease in specific HAIs. Similarly, latest modeling data puts forward that considerable reductions in resistant bacteria, for instance, MRSA, can be attained via similar activities between healthcare amenities in a particular area. The financial advantage of employing these prevention measures is anticipated to be 25 to 31.5 billion dollars in therapeutic cost savings. HAIs risk factors are capable of being categorized into three universal types: medical processes and antibiotic utilization, factors of an organization, and patient presentations. The healthcare providers’ behaviors and their contacts with the healthcare system as well impact on the HAIs rate. Researchers have revealed that appropriate edification and teaching of healthcare employees raises compliance with and implementation of preeminent practices (for instance hand hygiene, infection control, safety culture attention, and antibiotic stewardship) to avoid HAIs (Zimlichman et al., 2013). Examples of most excellent practices by a healthcare provider take account of thorough introduction, maintenance, as well as punctual removal of catheters and the cautious antibiotics use. Another case in point of a best practice is patients’ decolonization with an evidence-based technique to lessen MRSA transmission in healthcare facilities (Miller et al., 2011).
Application of Benner Skill Acquisition Nursing Theory to HAIs
As said earlier, Banner’s Skill Acquisition Model in nursing delineates five levels of acquiring skills. She employed the 1994 Dreyfus model that involved five levels of acquisition of skill regarding education, administration, research, and practice. Banner regards excellence in the provision of care attained via as evolutionary course developed from the experiential learning along with transmission into practical skills. Her emphasis is on the significance of rewarding and retaining healthcare personnel for their knowledge (Johnson & Webber, 2010).
Benner’s theory has been employed in the nursing field in making innovative transformations in the way knowledge is acquired as well as developed, the continuance of education’s basis and double as a foundation for the way nurses build and perk up skills with regard to acquisition of experience (Johnson & Webber, 2010). Benner’s model remains significant to our issue of HAIs by education application. The needs of nurses of learning and performance can be acknowledged and categorized basing on her five skill acquisition stages. This procedure can serve to recognize experts who could serve in an education and mentoring position to those personnel who are still in beginner phase (Johnson & Webber, 2010).
Staff education should remain a continuous process. This should incorporate the provision of safe, efficient care for central lines; staffs have to be skillful in the tubing; dressings; needless connectors; as well as have appropriate medication methods of infusions; blood culture and withdrawals; and line flushing. Acquisition of this knowledge and skills is entailing. However, learning these skills will assist the clinician becoming one, which “knows that and how” (Johnson & Webber, 2010).
Conclusion
In summary, the education curve that is linked to novel healthcare practices remains strenuous, if not threatening. Therefore, it is very important that novice nurses be incorporated into the strictness of expert accountability via long-drawn-out orientation phase. To make sure that HAIs are efficiently managed suitable programs for integrative learning as well as the promotion of salience in novice nurses remains significant. Furthermore, a work environment should be created that authorizes graduate nurses to offer most favorable standards of healthcare. At the time of the development of enhanced clinical reasoning, at the same time as the graduate nurse develops from novice to expert, the employment of perception maps may aid in the incorporation of novel knowledge and consequential learning.
References
Alligood, M. R. (2014). Nursing theorists and their work. St. Louis, Missouri : Elsevier
Johnson, B. M., & Webber, P. B. (2010). An introduction to theory and reasoning in nursing. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
Kelly, P. (2012). Nursing leadership & management. Clifton Park, NY: Cengage Learning.
Mauldin, P. D., Salgado, C. D., Hansen, I. S., Durup, D. T., & Bosso, J. A. (2010). Attributable hospital cost and length of stay associated with health care-associated infections caused by antibiotic-resistant gram-negative bacteria. Antimicrobial agents and chemotherapy, 54(1), 109-115.
Miller, B. A., Chen, L. F., Sexton, D. J., & Anderson, D. J. (2011). Comparison of the burdens of hospital-onset, healthcare facility-associated Clostridium difficile infection and of healthcare-associated infection due to methicillin-resistant Staphylococcus aureus in community hospitals. Infection Control & Hospital Epidemiology, 32(04), 387-390.
Peña, A. (2010). The Dreyfus model of clinical problem-solving skills acquisition: a critical perspective. Medical Education Online, 15.
Sievert, D. M., Ricks, P., Edwards, J. R., Schneider, A., Patel, J., Srinivasan, A., … & Fridkin, S. (2013). Antimicrobial-resistant pathogens associated with healthcare-associated infections summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2009–2010. Infection Control & Hospital Epidemiology, 34(01), 1-14.
Zimlichman, E., Henderson, D., Tamir, O., Franz, C., Song, P., Yamin, C. K., … & Bates, D. W. (2013). Health care–associated infections: a meta-analysis of costs and financial impact on the US health care system. JAMA internal medicine, 173(22), 2039-2046.
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