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2). By being an art, nurses are substantially encouraged to be practically creative and resourceful in delivering services that are efficient and effective. At the same time, it is a science for nursing practice should be anchored on theoretical and conceptual bodies of clinical knowledge in ensuring that every action promotes safety and enhancement of patients’ health. The patients’ overall well-being should be at the central of nursing. In line with this, nurses need to relate professional knowledge into clinical practice, through theoretical and conceptual frameworks bridges, dynamically linking care between health personnel and care recipients, in consideration with environmental factors.
The body of knowledge in nursing had been divided into several categories to distinguish bulks of nursing concepts constructed. Fawcett (1995 as cited in Timmins, 2005) identified hierarchical structure in nursing knowledge, where different levels are interconnected in clinical fields: “(1) metaparadigm (2) philosophy (3) theory (4) conceptual models.” Metaparadigms are quite broad in context, which translate clinical values indicated in constructed philosophies, while theories are more specific in experiential nursing fields.
Fawcett (1994 as cited in Masters, 2005) added that conceptual models, being the last, pertain to sets of nursing abstracts and propositions that are meaningfully integrated for valid reference in nursing disciplines. One of the fundamental bases in modern nursing profession is the theory created by Florence Nightingale. Her philosophical concepts are simple in construct, though, it primarily stabilized how nurses act in deference to patient interaction. In her environmental model for nurses, Nightingale proposed that elements observed in environment can have a significant impact on patients’ health conditions (Butts & Rich, 2010).
The model substantially linked three important entities together: the patient, nurses, and their environment. Her meta paradigm in Figure 1 (please see Appendix A), showed these three factors that may influence outcomes in health, where emphasis can be made on the nature present in the environment that can be manipulated, such as conditions in light and temperature, nutritional intake, hygienic provisions, and emotional support as essential in providing dynamic nursing services (Masters, 2005).
At this point, health promotion and disease prevention seemed at the heart of Nightingale’s environmental model, as largely observed in current priorities in modern day nursing practice. On the basis of Nightingale’s philosophical proposition, her conceptions on how to deliver nursing services may be too broad in specific nursing fields, but clinical areas can benefit from environmental modification emphasis in her mode. As affirmed by Alligood and Marriner-Tomey (2006), nursing models bridge the gap between professional knowledge and practices, as its communicative quality translates knowledge base into clinical actions.
In application, the said metaparadigm can be generated in preventing hospital-acquired bacterial transmission in urinary tract infection (UTI). According to several reports, hospital-acquired (nosocomial) infections compose almost 40% of cases, where majority (80%) had been contracted during “indwelling urethral catheter use” (Nicolle, 2007, p. 251). The alarming rate of infection transmission from health care providers to care recipients
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