PPT NIGHTINGALE THEORY AND IT’S APPLICATION final.pptx

Nightingale’s theory and it's application

1. LADY WITH THE LAMP FLORENCE NIGHTINGALE

2. NIGHTINGALE’S THEORY AND IT’S APPLICATION SUBMITTED TO: PRESENTED BY: Mrs. POONAM GUPTA MANISH KUMAR TUTOR M.Sc. NURSING RAK COLLEGE OF NURSING FIRST YEAR

3. OUTLINE OF THE PRESENTATION Introduction to the Nightingale’s theory. Biography of the Florence Nightingale. Evolution of the theory. Nightingale’s Assumptions. Nightingales’ theory on Environment. Paradigm on nightingale’s environment model. Application of Nightingales’ work in the nursing process. Nightingale’s model, the characteristics of theory Evaluation of theory and Application of nightingale’s theory in nursing practice and education. Strengths and limitations of nightingale’s theory. Review of literature.

4. INTRODUCTION Florence Nightingale (1820-1910), considered the founder of education and scientific nursing and widely known as “The Lady with the Lamp” wrote the first nursing notes that became the basis of nursing practice and research. Nightingale is considered the first nursing theorist . Environmental Theory, which incorporated the restoration of the usual h ealth status of the nurse’s clients into the delivery of healthcare-it is still practiced today.

5. BIOGRAPHY OF FLORENCE NIGHTINGALE 12 May 1820 - Birth of Florence Nightingale ( Pioneer of Modern nursing and Public health) 1851 - S he went to Kaiserswerth Germany , for her early nursing training . 1853 - S he became superintendent of the Hospital for invalid Gentlewomen in London. 1854 - Nightingale went to the front of the Crimean war at the request of her friend, Sir Sidney Herbert, secretary at war . She arrived in Scutari on 5 Nov 1854 accompanied by 38 nurses . T he mortality rate in the hospital dropped to 22% after 6 month. Nightingale achieved this drop by attending to the environment of the soldiers.

6. BIOGRAPHY OF FLORENCE NIGHTINGALE 1856 - After war on August 5 , she established a teaching institution for nurses at Thomas Hospital and at King’s College Hospital in London . Within a few years after its foundation, the Nightingale School began receiving requests from nurses to establish new schools at hospitals worldwide . For her efforts, Nightingale received numerous awards, including the order of Merit from King Edward VII, Germany’s Cros of Merit and France’s Secours aux Blesses Militaries. 1910 - She died in her sleep at the age of 90 on August 13 , in London .

7. EVOLUTION OF THEORY Many factors influenced the development of Nightingale's theory of nursing. Individual, societal, and professional values were all integral in the development of her work. She used her broad base of knowledge, her understanding of incidence and prevalence of disease, and her acute powers of observation to develop an approach to nursing as well as to the management and construction of hospitals. Nightingale's main focus was the control of the environment of Individuals and families, both healthy and ill.

8. A S S U M P T I O N S

9.   NIGHTINGALE’S THEORY ON ENVIRONMENT Nightingale’s theory focused on the environment. Environment includes surrounding matters that influence or modify a Course of development; the system must interest and adjust to its environment. Environment which is capable of preventing, suppressing or contributing to disease, accidents or death, in all the extended Conditions and influences affecting the life and developments of all organism.

10.   NIGHTINGALE’S THEORY ON ENVIRONMENT Nightingale viewed the manipulations of the physical environment as the major component of nursing care. She identified ventilation and warmth, light, noise, variety, bed and bedding, cleanliness of rooms and walls, and nutrition as major areas of the environment the nurse could control. When one or more aspects of the environment are out of balance, the clients must use increased energy to counter the Environmental Stress.

11. Health of houses Ventilation and warming Bed and bedding Cleanliness of Rooms and Walls Light and noise Personal Cleanliness Nutrition and Taking Food Chattering Hopes and Advices Social consideration Variety NIGHTINGALE’S CANONS

12. 1. Health of Houses She discussed the importance of the health of houses as being closely related to the presence of pure air, pure water, efficient Drainage, cleanliness and light. She also noted that the cleanliness outside the house affected the inside.

13. The aspect of the environment that concerned Nightingale most was providing proper ventilation to a patient. She urged the caregiver to consider the source of the air in the patient’s room, as she believed a steady supply of fresh air was the most important principle of nursing. Nightingale believed that the person who repeatedly breathed his or her own air would become sick or remain sick. 2. Ventilation and warming

14. Light, specially direct sunlight has purifying effect on the air of the room. Modern hospital b e constructed in such a way that day light is available for patients . She believed that patient should never be waked i ntentionally or accidentally during the sleep. She viewed unnecessary noise i rritating to the patient . So, nurses responsibility is to assess and stop this kind of noise. 3. Light and N oise

15. She b elieved that variety in environment was a c ritical a spects of affecting the patient’s recovery. She discussed the need for c hange in color and form, i ncluding bringing the patient brightly and colored flowers or plants. Nightingale also a dvocated reading, needlework, writing, and cleaning as activities to relieve the sick of boredom. Now , this is called Diversion Therapy . 4. Variety

16. She viewed bedding as an important part of environment. She believed that the bed should be placed in the lightest part of the room so that patient could see out of a window. It is important for nurses to keep bedding clean, neat and dry and to position the patient for maximum comfort. 5. Bed and B edding

17. She stated that dirty carpets and walls containing large quantities of organic matter provide ready source of infection, just as dirty sheets and beds did. Nightingale indicated that “the greatest part of nursing consists in preserving cleanliness. She pointed out that even the best ventilation cannot freshen a room that is not first of all clean. 6. Cleanliness of Rooms and Walls

18. The need for cleanliness is extended to the patient,nurse and environment. S he viewed the function of the skin is important, believing that many diseases or disorders breaks through skin. She believed that unwashed skin poison the patient and noted that bathing and drying the skin provided great relief to the patient. 7. Personal cleanliness

19. She noted their individual desire for different foods at different times of the day and the frequent small services maybe more beneficial to the patient then a large breakfast or dinner. She also urged that the right food be brought at right time and be taken away eaten at right time. 8. Nutrition and Taking Food

20. She considered that false hope was depressing to patients and caused them to worry and become fatigued. Nightingale encouraged the nurse to heed what is being said by visitors, believing that sick persons should hear good news as that would assist them in becoming healthier. 9. Chattering Hopes and Advices

21. She supported the importance of looking beyond the persons to the social environments in which he or she lived. She was a role model for political activities by nurses. She believed that the nurse and hospital related to be well managed, i.e. organized, clean and with appropriate supplies show client and environment in balance and expending unnecessary energy being stressed by environment. 10. Social consideration

22.   PARADIGM ON NIGHTINGALE’S ENVIRONMENT MODEL NURSING According to Nightingale, nursing is, to put the patient on the best condition for nature to act upon him. She stated that the nursing “ought to signify the proper use of fresh air, light, warmth, cleanliness, quick and proper selections and administration of diet, all at the least expense of vital power to the patient. HUMAN BEING Human being is not defined by Nightingale, but they are defined on relationship to their environment and the impact of the Environment upon them.

23. PARADIGM ON NIGHTINGALE’S ENVIRONMENT MODEL HEALTH It is also not specifically defined. She stated “we know nothing of health, the positive of which pathology in the negative, except from observation and experience. She believed nature alone cures. She believed the nursing should provide care to the healthy as well as the ill and discussed health promotions as an activity in which nurses should engage. ENVIRONMENT The physical environment is stressed by nightingale in her writings. Her writings reflect the community health model in which all that surrounds human beings is considered in r elation to their state of health. She synthesized immediate knowledge of disease with the existing sanitary conditions in the Environment.

24. NORMAL (NURSE,OBSERVER, PRACTIONER) MANIPULATION OF ENVIRONMENT

25. NIGHTINGALE’S MODEL & THE CHARACTERIST I C S OF THEORY

26. NIGHTINGALE’S MODEL & THE CHARACTERIST I C S OF THEORY

27. NIGHTINGALE AND NURSING PROCESS 1. A SSESSMENT In this stage, Nightingale advocated two essential behaviors by the nurses. The first is to ask the client what is needed or wanted, i.e. ask many questions to know the actual status of the client. The second area of assessment she advocated was the use of observation. She used precise observations concerning all aspects of the client’s physical health and environment. First one is subjective data and second is objective data that are used to present nursing process.

28. NIGHTINGALE AND NURSING PROCESS 2. N URSING DIAGNOSIS Nursing diagnosis are based on an analysis of the conclusion gained from the information to the assessment. Nightingale believed that data should be used as the basis for drawing any conclusion. Nursing diagnosis reflects the importance of the environment to the health and well-being of the client.

29. NIGHTINGALE AND NURSING PROCESS 3. P LANNING It includes identifying the nursing actions needed to keep clients comfortable, dry and in the best state for nature to work on Planning focused on modifying the environment to enhance the client’s ability to respond to the disease process.

30. NIGHTINGALE AND NURSING PROCESS 4. I MPLEMENTATION Implementation takes place on the environment that affects out client and involves taking action to modify that environment. All factors of the environment should be considered, including noise, air, odors , beddings, cleanliness, and light-all the factors that place clients in the best positions for the nature to work upon them.

31. NIGHTINGALE AND NURSING PROCESS 5. E VALUATION Evaluation is based on the effects of the changes in the environment on the client’s ability to regain their health at the least expense of energy. Observation is primary method of data collection based to evaluate the client’s response to the intervention.

32. EVALUATION OF THEORY 1. Nightingale’s Theory Contains Three Major Relationships Environment to patient, nurse to environment, and nurse to patient. She viewed environment as the main factor acting on the patient to produce an illness state and regarded disease as “the reactions of kindly nature against the conditions in which we have placed ourselves.”

33. EVALUATION OF THEORY 2. Nightingale’s Theory Attempts to Provide General Guidelines for all Nurses in all Times Although Many of her specific direction are no longer applicable general concepts such as relationship between nurse patient and environment are still pertinent. Generality is criterion met by Nightingale’s theory.

34. EVALUATION OF THEORY 3. Concepts and Relationships within Nightingale’s Theory Concepts and relationships within Nightingale’s theory are frequently stated implicitly and are presented as established truths rather than as tentative, testable statements. Little or no provision Is made for empirical examination. Indeed, Nightingale Suggested that the practice of Nursing should be built on individual observation rather than systematic research when the advised. “let experience, not theory, decide upon this as upon all other things”.

35. EVALUATION OF THEORY 4. Nightingale’s Writings, to an Extraordinary Degree Nightingale’s writings, to an extraordinary degree, direct the nurse to action on behalf of her patient and herself. These directives encompass the areas of practice, research and education. most specific are her principles attempted to shape nursing practice. Her encouragement of a measure of independence and precision previously unknown in nursing may still guide and motivate us today as nursing continues to evolve.

36. EVALUATION OF THEORY 5. Nightingale’s View of Humanity. Nightingale’s view of humanity was consistent with her theories of nursing. She believed in creative, universal humanity with the potential and ability for growth and change. Deeply religious, she viewed nursing as a means of doing the will of her God. Although the lack of patient involvement in health seems to be a gap in Nightingale’s views, it may be accounted for by the historical period in which she lived and wrote.

37. APPLICATIONS OF NIGHTANGALE’S THEORY IN PRACTICE Patients are to be put in the best condition for nature to act on them; it is the responsibility of nurses to reduce noise, to relieve patients’ anxieties, and to help them sleep” As per most of the nursing theories, environmental adaptation remains the basis of holistic nursing care. IN EDUCATION Nightingale’s nursing education emphasized the need to blend a mixture of theoretical and clinical experiences. Schools of nursing were established on her model throughout the world. They emphasized the moral qualities of nursing and introduced humanitarian, patient- centered values that are still relevant today .

38. STRENGTHS OF NIGHTINGALE’S THEORY Nightingale’s theory is logical in nature. Her writings are simple, easy to understand. It increases the general body of knowledge. It can be used by the practitioner as guide to improve their practice.

39. LIMITATIONS OF NIGHTINGALE’S THEORY 1. Professional Distance The close patient-nurse relationship that Nightingale theory stresses helps create a nurturing, emotionally supportive environment, but it also risks violating the boundaries of professional distance that health professionals are expected to maintain. The kind of devotional care the theory encourages can be considered unprofessional or even emotionally counterproductive to both patient and nurse. Emotional bonds that become too intimate can make it difficult for a nurse to perform her job objectively while causing the patient to become overly attached.

40. LIMITATIONS OF NIGHTINGALE’S THEORY 2. Patient Incapacitation Nightingale’s theory conceives of the patient as a central agent in his own healing. This may be effective in some cases, but is limited in cases in which the patient is incapacitated or otherwise incapable of working toward his own healing. Some patients may be physically in capable of engaging to the degree that theory advocates, while others may be psychologically incapable, or may be overwhelmed by the pressure of taking such an active role.

41. LIMITATIONS OF NIGHTINGALE’S THEORY 3. Emphasis on Environmental Measures The theory’s emphasis on environmental measures, clean air and water, drainage, light and warmth, may be effective to an extent but is inherently limited. Healthy environmental conditions can only go far in treating disease and illness. It says little about the application of medical technology, which was rudimentary but nonetheless existent in Nightingale’s time: She emphasized subservience to doctors. She focused more on physical factors than on psychological needs of patient.

42. REVIEW OF LITERATURE Health in environment: reduce surgical site infections by applying Florence nightingale's environmental theory AUTHOR : Anna Rana. J Pak Med Assoc. 2021 Feb. Surgical site infection is one of the most common causes of readmission in hospitals and it also leads to an overall increased burden. This can be decreased by applying basic concepts of Nightingale (1860) "Environmental Theory" while giving care to the patients. Keeping in view Nightingale's environmental theory, this paper aims to discuss the case of a patient suffering from a surgical site infection. It will help readers to understand the environmental factors which affect the patients' health and provide a way to promote healing and fast recovery by modifying their environment.

43.   CONCLUSION OF THEORY The Environmental Theory of Nursing is a patient-care theory. it focuses in the alteration of the patient's environment in order to affect change in his or her health. Caring for the patient is of more importance rather than the nursing process, the relationship between patient and nurse, or the individual nurse .

44. BIBLIOGRAPHY 1. Parker E. Marilyn, Nursing theories and nursing practice, Florence nightingale’s legacy of caring and its applications, Jaypee brothers medical publishers (P) Ltd, Second edition, Page no. 39-54. 2. Brar kaur Navdeep and rawat H C, Textbook of advanced nursing practice, Nursing theories, The health sciences publisher, First edition, 2015, page no. 562-570. 3. A redesign of Florence Nightingale's Rose Chart created by Jeffrey A. Shaffer | DataPlusScience.com 4. https://assignology.com/conceptual-model-in-nursing-analysis-florence-nightingales-theory/ 5 . https://www.scielo.br/j/rgenf/a/FCtdhW9CT3k47gJS9KTSXkk

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