Assignment: Framework for Praxis

Assignment: Framework for Praxis

Assignment: Framework for Praxis
Framework for Praxis
Type 2 diabetes mellitus is a chronic condition associated with several complications, including chronic kidney disease. Nurses are responsible for implementing evidence-based interventions that prevent risk development among the affected populations. Therefore, this essay examines the issue of chronic kidney disease, its significance, theoretic frameworks, philosophical influences, and a concept map that will guide the project.

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The Selected Phenomenon of Interest
The selected phenomenon of interest (POI) for the project is chronic kidney disease (CKD) among patients with type 2 diabetes mellitus. Patients with type 2 diabetes mellitus are increasingly predisposed to CKD as one of its complications. The adoption of interventions such as health education is effective in preventing the risk of patients developing CKD. Health education increases awareness levels among patients and promotes the adoption of healthy lifestyles and behaviors that minimize the risk of CKD and diabetes-related complications. The rates of CKD and other lifestyle diseases have been increasing significantly over the past years, placing immense pressure on the scarce nursing and health resources. Nurses play the role of promoting health of their populations by implementing interventions that reduce the disease burden. CKD affects the health and quality of life of the affected populations(Buse et al., 2019; Jitraknatee et al., 2020). Therefore, health education should be embraced to prevent CKD among patients with type 2 diabetes visiting the outpatient clinic.
Philosophical Influences
Analytical philosophy is my preferred philosophical viewpoint. Analytical philosophy focuses on the analysis of problems and concepts using logical analysis. The aim in this philosophical viewpoint is to understand the logical forms and or structures that influence a phenomenon (Morley, 2019; Williams, 2021). The philosophy influences my view of my POI. It strengthens the need for obtaining factual data about the influence of different factors such as lifestyle, ethnicity, age, and gender on the development of CKD. It also strengthens my focus on the need to determine the cause-effect relationship between CKD rates and health education among the populations at risk. The viewpoint also affects my view of my nursing specialty since I believe that nurses should make decisions based on evidence to enable tracking and evaluation of outcomes.
Ethical Framework
The utilitarian approach will guide the decision-making in the project. The utilitarian approach emphasizes the need to analyze the action in terms of its associated outcomes or consequences. The decision-makers should weigh the benefits and risks of an action to the stakeholders. The focus is to ensure the greatest good or benefit for the stakeholders while minimizing the potential of harm to them (Häyry, 2021; Helou et al., 2020). The utilitarian approach to decision-making reduces the difficulties experienced in addressing ethical dilemmas in nursing practice.
Ethical Principles
One of the ethical principles associated with the utilitarian approach is beneficence. Beneficence entails making decisions that do good to the affected stakeholders. The decisions made prioritize patient’s needs, values, and preferences. The other ethical principle is non-maleficence. Non-maleficence entails taking actions that do not cause any form of harm to the patients(Haddad & Geiger, 2023; Helou et al., 2020). Nurses should refrain from any action that would result in maltreatment and minimize harm in their role when treating and educating patients with type 2 diabetes mellitus.
Theoretical Influences
Hildegard Peplau’s theory of interpersonal relations is a grand nursing theory that relates to the framework and will guide my view of the POI. Peplau’s theory emphasized the importance of therapeutic nurse-patient relationship for the promotion of optimum patient and nursing outcomes. The theory will influence my view of the POI in that I have to explore effective interventions to enhance my relationship with patients (Pardede et al., 2020). I will also adopt systematic processes to enhance my relationship with the patients. The behavioral system model by Dorothy Johnson is a middle range nursing theory that relates to the framework and POI. According to Johnson’s theory, individuals comprise purposeful, patterned, and repetitive ways that form their behavioral system. The patterned, repetitive and purposeful ways influence health and health outcomes(Alligood, 2021). Family nurse practitioners can use health education to promote healthy, repetitive and purposeful behaviors among patients to minimize their risk of developing CKD.
CAS Related to POI
The CAS activity related to the POI is participative decision-making. Patients will be actively involved in making decisions to prevent their risks of developing CKD. The nurse will make decisions that align with values, beliefs, and preferences of their patients(Alligood, 2021). The decisions will also align with the available resources to optimize on outcomes and sustain behavioral change.
Concept Map

Conclusion
The selected POI is CKD among patients with type 2 diabetes mellitus. CKD is important to family nurse practitioners because of its burden on the profession, practice, and population. Analytic philosophy will guide the project. Utilitarian framework and its ethical principles will guide decision-making. Grand and middle range theories will guide the POI.

References
Alligood, M. R. (2021). Nursing Theorists and Their Work E-Book: Nursing Theorists and Their Work E-Book. Elsevier Health Sciences.
Buse, J. B., Wexler, D. J., Tsapas, A., Rossing, P., Mingrone, G., Mathieu, C., D’Alessio, D. A., & Davies, M. J. (2019). 2019 Update to: Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care, 43(2), 487–493. https://doi.org/10.2337/dci19-0066
Haddad, L. M., & Geiger, R. A. (2023). Nursing Ethical Considerations. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK526054/
Häyry, M. (2021). Just Better Utilitarianism. Cambridge Quarterly of Healthcare Ethics, 30(2), 343–367. https://doi.org/10.1017/S0963180120000882
Helou, S., Abou-Khalil, V., Yamamoto, G., & Kuroda, T. (2020). Utilitarian Redesign of Electronic Medical Record Systems. ヒューマンインタフェース学会論文誌, 22(4), 361–368. https://doi.org/10.11184/his.22.4_361
Jitraknatee, J., Ruengorn, C., & Nochaiwong, S. (2020). Prevalence and Risk Factors of Chronic Kidney Disease among Type 2 Diabetes Patients: A Cross-Sectional Study in Primary Care Practice. Scientific Reports, 10(1), Article 1. https://doi.org/10.1038/s41598-020-63443-4
Morley, J. (2019). Phenomenology in nursing studies: New perspectives – Commentary. International Journal of Nursing Studies, 93, 163–167. https://doi.org/10.1016/j.ijnurstu.2019.02.002
Pardede, J. A., Hamid, A. Y. S., & Putri, Y. S. E. (2020). Application of Social Skill Training using Hildegard Peplau Theory Approach to Reducing Symptoms and the Capability of Social Isolation Patients. Jurnal Keperawatan, 12(3), Article 3. https://doi.org/10.32583/keperawatan.v12i3.782
Williams, H. (2021). The meaning of “Phenomenology”: Qualitative and philosophical phenomenological research methods. The Qualitative Report, 26(2), 366–385.

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POI: Chronic kidney disease is just one of the many complications a type II diabetic can experience. Studies have shown medications are successful in preventing chronic kidney disease in diabetic individuals. Specifically, Sodium-glucose cotransporter 2 inhibitors have shown positive results in reducing the risk of kidney transplants, dialysis, and demise in type II diabetic patients. As an FNP, the role of education and prevention of CKD can greatly benefit adult patients in the outpatient setting.

POI

The approved POI is the implementation of education and prevention strategies for chronic kidney disease (CKD) in the outpatient setting. CKD is a chronic condition with increasing prevalence globally. CKD is associated with an immense disease burden and a decline in the quality of life for the patients and their significant others. Health education among the population concerning CKD, its causes, effects, and prevention is an effective health promotion tool (Elshahat et al., 2020). Therefore, the project proposes education and prevention for CKD among patients at risk and those affected visiting outpatient in the practice setting.

Significance of POI

CKD is significant to my nursing specialty role. Family nurse practitioners (FNP) play an important role in promoting the optimum health and outcomes of patients affected by and or at risk of CKD. They collaborate with other healthcare providers in providing evidence-based therapies that promote recovery and minimize symptoms. CKD and other renal problems have risen over the past decades, placing more pressure on scarce nursing resources. It also increases the workload among nurses and demands more resources in healthcare. Nurses adopt health promotion interventions such as health education and screening for early diagnosis and treatment of CKD (Hernandez, 2019). Therefore, implementing this project aligns with the nurses’ responsibility to promote optimum health and outcomes for their populations.

Impact of POI on the US Healthcare System

CKD immensely affects the USA’s healthcare system. CKD is currently among the leading causes of death in the USA. CKD increases the need for treatments such as dialysis in the country’s healthcare system. About 360 people are initiated dialysis treatment every 24 hours in America because of kidney failure. The government’s spending on CKD for Medicare beneficiaries was $87.2 billion, and an additional $37.3 billion for end-stage renal disease (CDC, 2022). Increased cases of CKD also result in high demand for healthcare resources by patients. Health organizations experience challenges in meeting their competing needs (Elshahat et al., 2020). With the increasing rates, CKD acts as a stressor to healthcare systems, hence, the need for a responsive intervention to address it.

My Preferred Philosophical Viewpoint

Analytical philosophy is my preferred philosophical viewpoint. I value the use of numerical data to understand phenomena. I use logic to examine the relationship between exposure and outcomes. I am objective in my approach to the world. I rely on the senses of sight, smell, touch, hearing, and tasting, alongside critical and creative thinking to make decisions (Morley, 2019). The point of view minimizes the risk of barriers in my decisions.

Effect on Data for POI

My preferred philosophical viewpoint influences the data I will evaluate related to my POI. I will mainly rely on numerical data when investigating the POI. I will adopt statistical data to examine the cause-and-effect relationship between exposure to interventions such as education and prevention and CKD rates and outcomes (Morley, 2019). I will also rely on objective data from inspection, palpation, auscultation, percussion, and diagnostic investigations.

Value of Data Represented by Alternative Point of View

The alternative viewpoint to my philosophy is continental philosophy. The continental philosophy focuses on understanding phenomena from human experiences. It utilizes qualitative data. The focus is on data collection through qualitative methods before interpreting the experiences of others (Albinsson et al., 2019). Therefore, based on qualitative data, nurses understand the experiences and their meaning in society.

Advantages of Analytical and Continental Philosophical Views

Incorporating analytical and continental philosophical views into my advanced nursing practice is associated with considerable benefits. One of them is that it provides a balanced view of the POI. The methods combine qualitative and quantitative methods to enhance the accuracy of the data associated with the topic of interest. Combining philosophical views also eliminates bias in the analysis of issues. Incorporating both perspectives encourages critical and creative thinking in approaching problems, hence, decision-making accuracy (Morley, 2019). One also understands the importance of considering several alternatives in the decision-making process, minimizing bias.

Ways of Knowing

Ways of knowing exist in types that include empirical (science), esthetic (art), personal, and ethical (moral understanding of what is right and wrong). Empirical knowing entails the use of systematic research methods to learn about something. I will research different sources of evidence about education and CKD prevention to utilize empirical knowledge. Esthetics relies on one’s experiences and skills. I will use my personal and professional experiences with patients with CKD to develop plans for preventing and enhancing outcomes among CKD patients. Personal knowing requires interaction with others to learn more about them. I will develop therapeutic nurse-patient relationships and patient-centered plans to learn about CKD prevention and education strategies. Ethics rely on moral components of decision-making (Congreve, 2020). I will make decisions that protect and prioritize the rights and needs of the patients.

Conclusion

The approved POI is health education and prevention for CKD. The POI has significance to advanced practice nursing and healthcare systems. Analytical philosophy is my preferred philosophy. Analytical philosophy provides objective, numerical data. Advanced practice nurses should incorporate analytical and continental philosophies to explore their practice issues and provide patient care. I will incorporate the ways of knowing into investigating the POI issue.

References

Albinsson, G., Elmqvist, C., & Hörberg, U. (2019). Nursing students’ and lecturers’ experiences of learning at a university-based nursing student–run health clinic. Reflective Practice, 20(4), 423–436. https://doi.org/10.1080/14623943.2019.1638242

(2022, February 28). Chronic Kidney Disease Basics | Chronic Kidney Disease Initiative | CDC. https://www.cdc.gov/kidneydisease/basics.html

Congreve, W. (2020). The Way of the World: New Edition. Bloomsbury Publishing.

Elshahat, S., Cockwell, P., Maxwell, A. P., Griffin, M., O’Brien, T., & O’Neill, C. (2020). The impact of chronic kidney disease on developed countries from a health economics perspective: A systematic scoping review. PLoS ONE, 15(3). https://doi.org/10.1371/journal.pone.0230512

Hernandez, J. (2019). Chronic Kidney Disease: The Need to Increase Nurse Practitioner Awareness. Electronic Theses and Dissertations. https://digitalcommons.acu.edu/etd/171

Morley, J. (2019). Phenomenology in nursing studies: New perspectives – Commentary. International Journal of Nursing Studies, 93, 163–167. https://doi.org/10.1016/j.ijnurstu.2019.02.002

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Ethical Underpinnings

Family nurse practitioners (FNPs) often encounter moral issues while providing care for many patients. The problem, as mentioned earlier, may arise due to a patient’s discomfort during the medical intervention, a patient’s refusal to undergo therapy due to their cultural or personal beliefs, or circumstances where patients and their families are required to make decisions regarding the continuation or cessation of treatment based on the patient’s health status (Goldman et al., 2020). In specific circumstances, nurses must conform to the prescribed Code of Ethics for Nurses while also delivering superior healthcare services (Giubilini, 2020). The rejection of medicine and immunizations by patients and their families is an example of an ethical dilemma I may encounter while working as an FNP. Although it is a parent’s choice whether or not to vaccinate their child, medical practitioners must inform them of the potential health hazards. Providers must respect limits while also providing them with factual information.

It is critical to keep in mind that vaccination is not merely a personal medical choice in the ethical issue mentioned above. Additionally, it is a social issue that affects the justice of society and its constituents. Several conceptions of social morality or justice theories may support this choice. The simplest way to base it is to refer to a theory of justice that emphasizes well-being, such as the social justice theory of Powers and Faden (Fernández-Basanta et al., 2021). This theory holds that a fair society ensures that every member achieves a certain amount of well-being. The social context in which children may achieve minimum levels of welfare must be created by society, and it must also be vigilant for any systematic causes or effects that can cause individuals or groups to fall below these standards.

As advanced nurse practitioners, we must understand that vaccination should be seen as a benevolent act. According to Rus and Groselj (2021), the obligation of the state to protect herd immunity as a collective good provides a rationale for implementing compulsory vaccination laws in instances where individuals fail to fulfill their responsibility to contribute to herd immunity. The significance of upholding patients’ or parents’ autonomy is amplified in the context of compulsory interventions, as vaccinations are distinctive in their benefits to the body and associated risks (Helps et al., 2019). The ethical dilemma of balancing herd immunity and parental autonomy necessitates a nuanced compromise that is contingent upon the cultural and societal values of each individual.

References

Fernández-Basanta, S., Lagoa-Millarengo, M., & Movilla-Fernández, M.-J. (2021). Encountering Parents Who Are Hesitant or Reluctant to Vaccinate Their Children: A Meta-Ethnography. International Journal of Environmental Research and Public Health, 18(14), 7584. https://doi.org/10.3390/ijerph18147584Links to an external site.

Giubilini, A. (2020). Vaccination Ethics. British Medical Bulletin, 137(1). https://doi.org/10.1093/bmb/ldaa036Links to an external site.

Goldman, R. D., Yan, T. D., Seiler, M., Parra Cotanda, C., Brown, J. C., Klein, E. J., Hoeffe, J., Gelernter, R., Hall, J. E., Davis, A. L., Griffiths, M. A., Mater, A., Manzano, S., Gualco, G., Shimizu, N., Hurt, T. L., Ahmed, S., Hansen, M., Sheridan, D., & Ali, S. (2020). Caregiver willingness to vaccinate their children against COVID-19: Cross-sectional survey. Vaccine, 38(48), 7668–7673. https://doi.org/10.1016/j.vaccine.2020.09.084

Helps, C., Leask, J., Barclay, L., & Carter, S. (2019). Understanding non-vaccinating parents’ views to inform and improve clinical encounters: a qualitative study in an Australian community. BMJ Open, 9(5), e026299. https://doi.org/10.1136/bmjopen-2018-026299Links to an external site.

Rus, M., & Groselj, U. (2021). Ethics of Vaccination in Childhood—A Framework Based on the Four Principles of Biomedical Ethics. Vaccines, 9(2), 113. https://doi.org/10.3390/vaccines9020113Links to an external site.