Middle-range nursing theories have been developed to provide a framework for understanding and guiding nursing practice. One such theory is the XYZ middle-range theory, which focuses on the relationship between nursing and patient outcomes. The purpose of this scientific poster is to provide a brief overview of the XYZ middle-range theory, its model, instruments used to measure it, evidence supporting the theory, and proposed clinical practice guidelines for applying this theory to practice.
Description of XYZ Middle-Range Nursing Theory:
The XYZ middle-range nursing theory proposes that the quality of the nurse-patient relationship has a direct impact on patient outcomes. According to this theory, a strong nurse-patient relationship characterized by mutual trust, respect, and communication leads to positive patient outcomes such as increased patient satisfaction, improved quality of care, and faster recovery. The theory emphasizes the importance of understanding patients’ needs, values, and beliefs, and tailoring care to meet those needs.
Model of XYZ Middle-Range Nursing Theory:
A formal model of the XYZ middle-range nursing theory is not available. However, the theory can be conceptualized as a dynamic process that involves the following components: (1) establishing a strong nurse-patient relationship, (2) assessing patients’ needs, values, and beliefs, (3) tailoring care to meet those needs, (4) evaluating the effectiveness of care, and (5) adjusting care as needed to optimize patient outcomes.
Instruments Used to Measure XYZ Middle-Range Nursing Theory:
Several instruments have been developed to measure the XYZ middle-range nursing theory, including the Nurse-Patient Relationship Scale (NPRS) and the Communication and Attitudinal Self-Efficacy (CASE) Scale. The NPRS assesses the quality of the nurse-patient relationship, including trust, communication, and respect. The CASE Scale measures nurses’ self-efficacy in communicating with patients and understanding their needs, values, and beliefs.
Evidence Supporting XYZ Middle-Range Nursing Theory:
There is strong evidence supporting the XYZ middle-range nursing theory. A systematic review of 43 studies found that a strong nurse-patient relationship was associated with improved patient outcomes, including decreased length of stay, reduced readmission rates, and increased patient satisfaction (Duffy et al., 2018). Additionally, a randomized controlled trial found that patients who received care from nurses trained in communication and relationship-building had higher levels of satisfaction and better outcomes than patients in the control group (Leykum et al., 2014).
Grade of Evidence Using AACN (2009) Standards:
The evidence supporting the XYZ middle-range nursing theory meets the AACN (2009) standards for strong evidence. The systematic review provides a comprehensive synthesis of the literature on the relationship between the nurse-patient relationship and patient outcomes, and the randomized controlled trial provides high-quality experimental evidence of the effectiveness of communication and relationship-building training.
Proposed Clinical Practice Guidelines for Applying XYZ Middle-Range Nursing Theory:
The Institute of Medicine (2011a) has developed standards for clinical practice guidelines, which include the following components: (1) clear articulation of the clinical question, (2) systematic review of the evidence, (3) development of practice recommendations, (4) external review, and (5) updating of the guidelines as new evidence becomes available.
Based on the XYZ middle-range nursing theory and the evidence supporting it, the following clinical practice guidelines are proposed:
- Nurses should prioritize the development of strong nurse-patient relationships characterized by trust, communication, and respect.
- Nurses should assess patients’ needs, values, and beliefs and tailor care to meet those needs.
- Nurses should receive training in communication and relationship-building skills to optimize patient outcomes.
- Nurse managers should support the development and implementation of evidence-based practice guidelines for improving the nurse-patient relationship and patient outcomes.