Relevance of Nursing Theories and Health Quality Standards in Improving Patient Outcome

This essay discusses the relevance of nursing theories, health quality standards, and frameworks in improving patient outcomes. It focuses on a case study of a 40-year-old aboriginal female diagnosed with gestational diabetes. The essay highlights effective and ineffective care and the application of person-centered care, family-centered care, code of nursing ethics, National Safety and Quality Health Service Standards, and Erikson theory of 8 stages.

Running head: NURSING
Nursing
Name of the Student
Name of the University
Author Note

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The following essay is based on the concept that observance of the proper nursing
theories and health quality standards helps to improve the overall outcome of the patients. In
discussing the relevance of the nursing theories, health quality standards and framework, this
essay will focus on a specific case scenario. The case study selected for this essay centers on
a 40 year old aboriginal female Raelene Ward, mother of three children and is actively
working. The essay will mainly focus on the theories of person-centered care, family centered
care, code of nursing ethics of nurses and National Safety and Quality Health Service
Standards and Erikson theory of 8 stages. The essay will initiate with the identification of the
relevant nursing theories followed by examples of effective and ineffective care highlighted
in the case study. At the end, the essay will discuss the application of the “partnering with the
consumers” from the perspective of the case study.
The relevant theory, that can be applied in this case scenario is, code of ethics for
nurses. According to Nursing and the Midwifery Board of Australia (2013), it is the duty of
the nursing professionals to value informed decision making. However, the analysis of the
case study highlighted that while Raelene was detected with gestational diabetes; she was
directly injected prescribed for insulin. The concerned healthcare professionals did not
bothered to discuss the fatal effects of gestational diabetes. They did not even explain why
injection of insulin is important or took informed consent from Raelene. Faden, Beauchamp
and Kass (2014) highlighted that nurses are required to respect for the health care consumers
and at the same time are required to recognize their capacity for active and informed
participation in their own healthcare. This respect of dignity of the patient via the practice of
kindness and the proper recognition of the vulnerability and powerlessness of the people
helps to increase their overall participation in the care plan. This in turn helps to improve the
overall outcome of care. However, Alfano (2015) is of the opinion that when a person is

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bestowed with more than two options to choose from in their process of care, they become
rapidly overwhelmed are become perplexed to choose which option is best for them.
The patient care explained in the scenario contained in-effective care because it does
not follow the process of person-centered care plan. According to the case scenario, when
Raelene was diagnosed with gestational diabetes, the healthcare professionals directly opted
for the insulin administration in order to control the overall situation. The systematic review
and the meta-analysis conducted by Viana, Gross, and Azevedo (2014) highlighted that diet is
the cornerstone for the treatment of gestational diabetes mellitus (GDM). The randomized
control trial conducted by Tobias et al. (2012) revealed that adherence to healthy diet and
mild to moderate physical exercise at the times of gestational period can help to reduce the
impending risk of GDM at the time of child-birth. Thus providing person-centered care plan
in-case of Raelene via analyzing her weight and the health of the baby towards treating GDM
will help to promote intrinsically valuable outcomes.
Another ineffective care that is highlighted in the case-scenario is the lack of
involvement of the aboriginal healthcare professionals in the care plan and the involvement
of the family member in the care plan. Panaretto, Wenitong, Button and Ring (2014) stated
that involvement of the aboriginal workforce is an important aspect of designing a culturally
competent care for the Aboriginals or Torres Strait Islanders healthcare service users. The
study conducted by Uhl, Fisher, Docherty and Brandon (2013) revealed that involvement of
the family member helps to devise the care plan with a family centered care plan approach.
National Safety and Quality Health Service Standards (NSHSS) of Australia further support
this approach. According to NSHSS (2012), involvement of the family member (in case of
Raelene it would be her family member) would help to promote partnering with the
consumers.

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One of the reference towards the effective care in relation to the chosen case scenario
include appointed of a dietician working as a diabetes educator who helped Raelene in
monitoring her blood glucose level. Haas et al. (2012) argued that having a trained yet
professional diabetes educator helps in the self-management of diabetes mellitus. A diabetes
educator helps to provide proper diabetes education to the patient. This helps to increase
patient’s knowledge about the overall process of disease progress and the underlying
consequences of the disease and its side effects. This in turn helps to increase the patient’s
awareness about the disease and thereby helping to achieve quality outcome. However, the
analysis of the case study revealed that the diabetes educator was appointed initially and not
throughout the course of the treatment and this hampered the overall process of GDM
management.
The theory and framework that can improve patient experience include NSHSS and
Erikson theory of 8 stages (stage 7: 40 to 50 years). According to the NSHSS of Australia
(2012), leaders of health care organizations are required to implement proper systems in order
to support the concept of partnering with patients and their direct carers. This helps to
improve the safety and quality of care. The evidence highlighted by Australian Commission
on Safety and Quality in Healthcare (2012) revealed that partnering with patients and their
carers helps to reduce the mortality rate, decreased chances of unwanted hospital admissions,
decreased rate of hospital readmission and improved adherence to the treatment regime. The
case study showed that it was Raelene, who helped herself in injecting insulin throughput the
tenure of gestational diabetes. While procuring the care plan, the discussion of the provision
of care was not discussed comprehensively with the patient. Moreover, after the birth of her
third child, Raelene’s diabetes went normal but sudden death of her sister shattered her
mental and physical health. Raelene was unable to manage her medication intake and her
diet. Furthermore, she is actively working in order to support her family with three children

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and this hampered her health-related quality of life. Thus, involvement of a family member in
the care plan in case of Raelene might have helped to increase the overall observance of
medication management and thereby helping to improve her health-related quality of life
(Gaugler, Potter & Pruinelli, 2014). It is the duty of the healthcare professional to establish
governance structures in order to facilitate proper partnership with the consumers and the
carers. The evidence also suggest that the healthcare professionals must facilitate access to
relevant training for the consumers and their carers in order to improve decision making
about the safety and quality initiatives ((Gaugler, Potter & Pruinelli, 2014).
Stage 7 of Erikson theory is generativity and stagnation. Contributing something
meaningful at this stage of life gives a sense of accomplishment. Contribution in Raelene will
be providing quality input in her care plan (Svetina, 2014).
Thus from the above discussion, it can be concluded that effective management of
GDM in case of Raelene can be done via effective application of the person-centred care
plan, Erikson theory and proper application of the family centred care plan. Application of
the family centred care plan in turn will help to increase the provision for “partnering with the
consumers”. This in turn will help to promote proper medication management and
improvement in the health-related quality of life. The analysis of the case study also
highlighted that proper education about the disease helps in proper observance of the
treatment planning. In case of Aboriginals and Torres Strait Islander like Raelene,
involvement of Aboriginal healthcare professional in the care plan would further help to
improve the overall quality of care.

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References
Alfano, M. (2015). Placebo effects and informed consent. The American Journal of
Bioethics, 15(10), 3-12. https://doi.org/10.1080/15265161.2015.1074302
Australian Commission on Safety and Quality in Healthcare. (2012). National Safety and
Quality Health Service Standards (NSHSS) of Australia. Access date: 19th September
2018. Retrieved from:
https://www.safetyandquality.gov.au/wp-content/uploads/2011/09/NSQHS-
Standards-Sept-2012.pdf
Entwistle, V. A., & Watt, I. S. (2013). Treating patients as persons: a capabilities approach to
support delivery of person-centered care. The American Journal of Bioethics, 13(8),
29-39. https://doi.org/10.1080/15265161.2013.802060
Faden, R. R., Beauchamp, T. L., & Kass, N. E. (2014). Informed consent, comparative
effectiveness, and learning health care. N Engl J Med, 370(8), 766-768. Retrieved
from:
http://www.cmtpnet.org/docs/resources/20140220_nejm_CER_Consent_Kass.pdf
Gaugler, J. E., Potter, T., & Pruinelli, L. (2014). Partnering with caregivers. Clinics in
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Haas, L., Maryniuk, M., Beck, J., Cox, C. E., Duker, P., Edwards, L., ... & McLaughlin, S.
(2012). National standards for diabetes self-management education and support. The
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Nursing and Midwifery Board of Australia. (2013). Code of Ethics. Access date: 19th
September 2018. Retrieved from:
https://www.nursingmidwiferyboard.gov.au/search.aspx?q=code+of+ethics
Panaretto, K. S., Wenitong, M., Button, S., & Ring, I. T. (2014). Aboriginal community
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Tobias, D. K., Zhang, C., Chavarro, J., Bowers, K., Rich-Edwards, J., Rosner, B., ... & Hu, F.
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Obstetric, Gynecologic & Neonatal Nursing, 42(1), 121-131.
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Viana, L. V., Gross, J. L., & Azevedo, M. J. (2014). Dietary intervention in patients with
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