Theory of Self-Care Deficit - Essay Example

This research proposal is guided by the theory of self-care deficit which proposes that sometimes patients or their families have a bigger need for self-care than they can satisfy. As a result, a self-care deficit develops, which is offered by a nurse.  The nursing system, in this case, is wholly compensatory where a nurse will carry out all care for the adults in the ICU (Fitzpatrick & Kazer, 2012). Self-care deficit theory has eight general propositions that suggest:

• The self-care potential is determined by socio-cultural background, developmental state, age, and experiences.
• Self-care deficits should be maintained at equilibrium between self-care capabilities and self-care demands.
• Individuals have the ability to provide their self-care to fulfill health-deviation, universal and growth self-care requisites.
• Nurses participate in choosing reliable and valid procedures, actions or technologies to fulfill self-care needs.
• A nurse is responsible to evaluate the capabilities of patients to perform their self-care needs as well as their possibility of not being able to meet them.
• Parts of therapeutic self-care are supportive-educative, wholly compensatory and partly compensatory.
• Self-care needs are determined by health, age, resources and developmental stage.
• Therapeutic self-care consist of activities by patients, caregivers, and nurses that control self-care abilities and satisfy self-care needs (Masters, 2014).

The proposition borrowed from the theory of self-care deficit is that nurses participate in choosing reliable and valid procedures, actions or technologies to fulfill self-care needs. In this research proposal, therefore, attentive oral hygiene is a significant part of VAP prevention approach; though there is a difference in the real practice for particular application technique, products utilized, and timing prevent development of VAP. The participants will be ICU adults receiving mechanical ventilation who are in need of regular oral care hygiene. The problem is that there are no definite recommendations in the guidelines about a specific solution to be utilized and the frequency of oral care. A research in an ICU suggest that performing oral care thrice a day with routine tooth brushing minimized the rate of pathogenic bacteria colonization in the oral cavity that resulted in a remarkable reduction in the prevalence of VAP (Ebbing, 2010).  In recent studies, use of 2% chlorhexidine solution as the oral care hygiene technique in ventilated patients indicated a lower rate in oropharyngeal colonization with gram-negative bacilli and therefore, a reduction in the development of VAP (Ebbing, 2010).

The research topic is ‘what is the most efficient intervention to reduce ventilator-associated pneumonia in adult ICU patients; use of antiseptic agent (chlorhexidine) or performing oral care (using toothbrushes or toothpaste)?’ The tooth brushing technique will involve the use of a soft toothbrush to clean the patient’s teeth to reduce plaque. Also, the patient’s gums and tongue will be brushed to stimulate the tissues (Urden, 2014). The use of antiseptic agent chlorhexidine will be performed after a duration of 6 hours, which is a recommendation for patients undergoing mechanical ventilation. In such a case, the patient’s teeth should be cleaned before using chlorhexidine to minimize staining. However, chlorhexidine can be made less active by toothpaste if used within a period of thirty minutes to two hours.

Where the two methods may be incorporated, the correct regime would be to perform tooth brushing two times a day and apply chlorhexidine agent four times daily. A note of precaution when using chlorhexidine is to make sure the patient does not react to the substance (Damani, 2012).