The nursing framework plays a critical role in the implementation of programs to support and improve patient care. They are based on metaparadigm concepts, which are the building blocks that inform the application of the nursing model in practice. They also comprise the critical issues in the profession to find practical solutions to problems. Person, nursing, health, and environment are the four nursing concepts that stimulate nursing theory and related programs. When developing programs to achieve the Joint Commission national patient safety goals, care providers should identify and explain the concepts as well as their relationship in practice. One example of a program is to improve handwashing compliance as a way of preventing hospital-acquired infections. Although other essential elements in the development of program outcomes are critical, such as identification of the nature of a project, the initial step should be the identification and definition of the metaparadigm concepts, including health, nursing, person, and the environment.
Concepts Development
The concepts selected in the framework include nursing, health, environment, and person. The four aspects are the foundation for theory and frameworks used in nursing institutions and health care in general. The concept of “health” relates to the overall wellbeing and wellness of an individual. It refers to other ideas such as the harmony of mind, soul, and spirit, self-healing, holistic healing, and conciseness-transcendence among other aspects (Nikfarid, Hekmat, Vedad, & Rajabi, 2018). It is the synthesis of illness and wellbeing as perceived by the patient across the lifespan.
The “person” is the recipient of care in the health framework. The human being is conceptualized as an open energy field that has exceptional life experience. For example, the “person” is the part that experiences disease. The individual is also a holistic being that interacts with the other metaparadigms in the care process (Bender, 2018). The “person” as a concept is the valued being, worthy of respect, which should be nurtured and understood.
The concept of “environment” covers the various factors that affect the person (patient). They are the internal and external factors that affect the health of an individual (Nikfarid, Hekmat, Vedad, & Rajabi, 2018). It is the geography and landscape of human experiences that affect their life and quality of life. The factors include other people, social and cultural backgrounds, economic and political aspects, historical and developmental processes, and environmental forces that influence their health.
The concept of “nursing” relates to the actual provision of care in the health care setting. It is an academic as well as a practice profession that affects the person through the care process. It is the science and art of holistic health that is directed by human freedom values, responsibility and choice, and accountability for the wellbeing of others (Bender, 2018). Nurses implement therapeutic experiences using their clinical knowledge and expertise.
Discussion of Relationship Between Concepts
Nursing entails the concept of a person (patient) from the perspective of the nurse-patient relationship. The association plays a vital role in the outcome of interventions implemented to help people (individuals and communities) to overcome health challenges, such as hospital-acquired infections (Nikfarid, Hekmat, Vedad, & Rajabi, 2018). Effective healthcare depends on therapeutic encounters between care providers and their patients. It also depends on the nature of communication and interactions between the two concepts.
Furthermore, nursing professionals in the field are responsible for the restoration of health and the wellness of clients in a therapeutic environment. Nurses interact with patients to implement the necessary therapeutic interventions aimed at improving this metaparadigm. Therefore, nurses should be adequately trained and proficient to provide necessary treatment to restore health.
The environment relates to the person in the care provision framework because it determines the setting for the process. The environment has significant implications on the health of a person. Depending on its nature, people can be either healthy or unhealthy. Therefore, nurses should control the environment by making it safe for patients to support the healing process (Nikfarid, Hekmat, Vedad, & Rajabi, 2018). They should provide a setup that supports the health and wellbeing of patients.
Nursing relates to the environment because of the role played by health care providers who offer an effective setting for medical interventions to support healing. Nurses have a significant role in placing the “person” in a suitable environment to enhance the natural reparative process. They should ensure that the care setting is supportive of the treatment and healing process. Optimizing the health in a care setting for the patient is critical in nursing.
Development of Program Outcomes
The program is to promote hand hygiene compliance to reduce and control hospital-acquired infections. The Joint Commission national patient safety goal that it relates to is infection prevention. The high prevalence of hospital-acquired infections requires effective and adequate interventions to save the life of a person (patient) and reduce the cost of care due to extended hospital stays to treat infections (VanAmringe, 2014). By the end of the program, nurses should understand about hand hygiene and when to act, such as before and after contact with patients, before and after dressing, as well as before and after conducting any invasive procedure. They will learn the handwashing guidelines published by the CDC to develop proper hand washing practices in the hospital (Huang, Stewardson, & Grayson, 2014). They will be taught how to use antimicrobial soap or a waterless antiseptic agent to ensure that their hands are disinfected before they interact with patients.
Various outcomes will be measured to establish the effectiveness of the program. After the program, nurses should enhance their level of compliance with hand hygiene practices. For example, they should regularly wash their hands with the required products. Nurses should also demonstrate an adequate understanding of the relationships between hand hygiene and infection prevention (VanAmringe, 2014). They should identify the patients who require particular attention, such as the critically ill and those requiring invasive procedures. The program aims at teaching nurses about the metaparadigm concepts and the way they relate to each other and the profession. Nurses will work collaboratively to develop the target knowledge and improve patient care through infection prevention.
Conclusion
Metaparadigm concepts are the basis for nursing frameworks used in health care institutions. They include nursing, health, environment, and person. Furthermore, these aspects connect to each and the way they affect the care process. The proposed program to support hand hygiene compliance to prevent hospital-acquired infections uses the four-metaparadigm concepts to achieve the objective. Hence, nurses will implement the initiative within the nursing profession. It is aimed at improving the health of persons (admitted patients) within the clinical environment. It is among the programs that will achieve the Joint Commission national patient safety goals.
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