Professional Documents
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SUMMARY
Using Abdellah’s concepts of health, nursing problems, and problem solving, the theoretical statement of
nursing that can be derived is the use of the problem solving approach with key nursing problems
related to health needs of people.
From this framework, 21 nursing problems were developed
CONCLUSIONS
Abdellah’s theory provides a basis for determining and organizing nursing care. The problems also
provide a basis for organizing appropriate nursing strategies.
It is anticipated that by solving the nursing problems, the client would be moved toward health. The
nurse’s philosophical frame of reference would determine whether this theory and the 21 nursing
problems could be implemented in practice.
AN illustration of the implementation of Abdellah’s framework in Ryan’s care
Consider a case of Ryan who experienced severe crushing chest pain ‘shortness of breath, tachycardia and
profuse diaphoresis
Stage of illness is basic to care
Selected Abdellah nursing problem
To maintain good hygiene and personal comfort
Classification and approach
Overt problem of pain; Direct and indirect method
Selected Nursing Interventions
administer oxygen
elevate headrest
reposition client
administer prescribed analgesic
remain with client
Criterion measure- Amount of pain
CONCEPT OF PROGRESSIVE PATIENT CARE
PPC is defined as better patient care through the organization of hospital facilities, services and staff
around the changing medical and nursing needs of the patient
PPC is tailoring of hospital services to meet patients needs
PPC is caring for the right patient in the right bed with the right services at the right time
PPC is systematic classification of patients based on their medical needs
Elements of PPC
1. Intensive care
Critically and seriously ill patients requiring highly skilled nursing care, close and frequent if not
constant, nursing observation are assigned to the ICU. One patient in an ICU requires at least
three nurses to observe him in 24 hrs
2. Intermediate care
Patients assigned to this unit are both the moderately ill and those for whom the treatment can
only be palliative
3. Self care
Ambulatory patients who are convalescencing or require diagnosis or therapy may be cared for
in this unit
4. Long term care unit
This unit will provide services to certain patients now cared for in the general hospital, in
nursing homes, or in their own homes and who would benefit by care in a hospital
environment to achieve its maximum potential
5. Home care
This programme makes it possible to extend needed services to the patient after he leaves the
hospital and returns to his home in the community
Benefits of PPC
PATIENT
better attention
better adjustment
minimized problems
life saving care
constant medical and nursing care
PHYSICIAN
assuring best nursing care
drugs and equipments at hand
orders carried out effectively
better clinical an team service
HOSPITAL
effective and efficient use of staff
improved public image
NURSING PERSONNEL
individual skills can be used
more time with patient
helping pt. and family to solve problems
job satisfaction
in-service education
COMMUNITY
continuity with hospital services
minimize the need of hospitalization
Implications of PPC for nursing education
Many nurse educators feel that the PPC hospital where all five phases of care are available can provide
clinical experience in which the nurse can learn to solve basic nursing problems in meeting patients’
needs.
The three month assignment of professional nurses may no longer be realistic in such a setting.
Organization of hospital and community services based on patients needs
In the intensive care unit, the critically ill patients are concentrated regardless of diagnosis.
These patients are under the constant audio-visual observation of the nurse, with life saving techniques
and equipment immediately available
In the intermediate care unit are concentrated patients requiring a moderate amount of nursing care, not of
an emergency nature, who are ambulatory for short periods, and who are beginning to participate in he
planning of their own care
The self-care unit provides for patients who are physically self-sufficient and require diagnostic and
convalescent care in hotel-type accommodations. This unit serves as a link between the hospital and the
home.
In the long-term care unit are concentrated patients requiring prolonged care. The grouping of such
patients will permit staffing patterns that are less costly
Home care, the fifth element of progressive patient care, extends hospital services into the home to assist
the physician in the care of his patients
USEFULNESS
The patient centered approach was constructed to be useful to nursing practice, with impetus for it
being nursing education.
Abdellah’s publications on nursing education began with her dissertation; her interest in education for
nurses continues into the present.
Cont…
Abdellah has also published on nursing, nursing research, and public policy related to nursing in several
international publications. She has been a strong advocate for improving nursing practice through
nursing research