Theory guided practice in nursing
Received Date: Oct 30, 2017 / Accepted Date: Dec 11, 2017 / Published Date: Jan 07, 2018
Citation: Saleh US. Theory guided practice in nursing. J Nurs Res Pract. 2018;2(1):18.
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Practice research, and theory are the cornerstones of the nursing profession. The relationship of these three cornerstones are reciprocal and cyclical. Clinical practice generates research questions and knowledge for theory. Research guides our practice and build knowledge through theory development. Theory guides research and improve practice. In this editorial, I will describe the relationship among the three cornerstones of nursing— Practice, research, and theory—and discuss the theory-practice gap as an impediment to theory-based practice.
Effective nursing practice requires the application of knowledge, skills, caring, and art to care for patients in an effective, efficient, and considerate way. An important part of the knowledge used in making nursing clinical decisions is produced by research findings. Ideally, all patient care decisions should be based on research-evidence. Research findings are used to develop a protocol and the protocol is followed in daily nursing practice.
In any discipline, science is the result of the relationship between the process of inquiry (research) and the product of knowledge (theory). In addition to guiding nursing practice, the purpose of research is to build knowledge in a discipline through the generation of theory and or testing theory. The relationship between research and theory is reciprocal where research generate more knowledge and theory. Theory is integral to the research process where it is important to use theory as a framework to provide perspective and guidance to the research study. Theory can also be used to guide the research process by generating and testing phenomena of interest.
The primary purpose of theory in the profession of nursing is to improve practice by positively influence the health and quality of life of patients. The relationship between theory and practice is reciprocal. Practice is the basis for the development of nursing theory whereas nursing theory must be validated in practice.
Despite the development, evolution, and study of nursing theory in the past a few decades, the “gap” between theory and practice is a common perception among nurses. Practicing nurses rarely use the language of nursing theory unless mandated to do so by accrediting bodies. There are several factors that contribute to the theory-practice gap. Theory development has been viewed as the domain of nurse educators and scholars rather than the concerns of practicing nurses. Nursing theory and practice have been viewed as two different and separate nursing activities. Nursing theories contain concepts and construct that must be explained before applying them to practice. Finally, practice often develop without theory, and knowing theory is not a guarantee for good practice.
There have been several calls to relate theory, practice, and research. However, the profession triangle remains fragmented and unrecognized. To promote the nursing profession’s ability to meet the societal obligations, there need to be an ongoing reciprocal and cyclical relationship among theory, practice, and research. This will help close the perceived “gap” between theory and practice and promote the theory guided practice.
Nursing leaders must work toward keeping the reciprocal and cyclical relationship among theory, practice, and research by bridging the “gap” between theory and practice. These can be done by continued interaction between nursing researchers/scholars and practicing nurses. Second, we need to increase undergraduate and graduate student nurses’ exposure to theoretical principles. As well, we need to stress theoretical concepts, constructs, and principles following the completion of formal education. We need to provide nursing theorists/scholars and researchers the opportunity for clinical involvement to minimize the disparity between the world of nursing theorists and scholars and the world of practicing nurses. Finally, we need to address current healthcare and nursing issues from theoretical perspectives.
Theory guided practice, in the form of practice theory, is the future of nursing. Practice theories are narrow, circumscribed theories proposed for a specific type of practice. As we progress into the 21st century, nurse scholars, scientists, researchers, and practitioners must place theory-guided practice at the core of nursing. To provide effective, efficient, and holistic care, nurses must rely on sound theoretical principles to develop and implement the plan of care.