Identify a practice or organization issue of importance to you. Then, you select two middle-range theories and apply them to address the practice or organization issue.
Reflect on your nursing practice to identify issues of particular interest or concern to you and/or your organization.
Select one practice or organization issue on which to focus for this Discussion.
Review the Learning Resources for this week, focusing on specific middle-range theories that may apply to the practice or organization issue that you selected.
Select two middle-range theories that you believe are relevant and valuable in addressing the practice or organization issue you selected.
Post the following:
Identify the practice or organization issue you selected. Explain why you chose it.
Describe the two middle-range theories that you selected. Explain why you chose them.
Explain how you would apply each middle-range theory to the practice or organization issue. Be specific and provide examples.
Sample Answer
Practice Issue: Alarm Fatigue in the ICU
The practice issue I have selected is Alarm Fatigue in the Intensive Care Unit (ICU).
I chose this issue because it is a critical safety and quality problem directly impacting patient outcomes and staff burnout. The constant, non-critical noise from monitors in the ICU leads nurses to become desensitized (fatigued) to alarms. This can result in delayed responses, disabled alarms, or even missed true patient emergencies, posing a significant risk of patient harm. It represents a systemic failure that is both clinical and organizational.
Selected Middle-Range Theories
I have selected two middle-range theories that offer complementary frameworks for analyzing and solving the problem of alarm fatigue: Mishel's Uncertainty in Illness Theory (MUIT) and Orem's Self-Care Deficit Theory (SCDT).
1. Mishel's Uncertainty in Illness Theory (MUIT)
Description: MUIT focuses on the cognitive state experienced when a person cannot adequately structure or make meaning of an event, often due to a lack of clear, consistent information. Uncertainty is characterized by ambiguity, complexity, lack of information, and unpredictability.
Why Chosen: While often applied to patients, the theory is highly relevant to the nursing staff's cognitive environment. Alarm fatigue creates a state of uncertainty and cognitive overload for the nurse. The constant exposure to alarms, most of which are false or non-actionable, creates uncertainty about which alarm is real and requires immediate action, leading to the maladaptive coping mechanism of fatigue and desensitization.