CHAPTER 2- REVIEW OF RELATED LITERATURE

Nursing, as an integral part of the health care system, encompasses the promotion of health, the prevention of illness, and care of the physically ill, mentally ill, and disabled people of all ages, in all health care and other community settings. Within this broad spectrum of health care, the phenomena of particular concern to nurses are individual family and group responses to actual or potential health problems. These human responses range broadly from health restoring reactions to an individual episode of illness to the development of policy in promoting the long-term health of a population. (1
Nursing is one of the youngest professions but one of the oldest arts. Its hallmark is caring more than curing Henderson's Basic Needs Model offers 14 components in providing nursing care !hich is holistically focused. "#$

!irginia "enderson is famous because of her theory in nursing #hich states that the uni$ue function of a nurse is to assist an individual to perform certain activities for his recovery or for the individual to die peacefully. %ooner or later that individual can perform certain duties #ithout the aid of nurses. (&
Henderson believed that the nurse should have the kno!ledge to practice individuali%ed and humane care by being a problem&solver. 'dditionally she vie!ed the patient's independence as an important criterion for health. (hese beliefs are !hat fostered Henderson's identification of 14 components of basic nursing care. (hese components are closely paralleled to Maslo!'s hierarchy of human needs. "4$

When the individual can perform all his daily functions by himself, he is no# considered independent and no longer re$uired the aid of a nurse.

"enderson believed in the importance of nursing research in improving nursing practice. %he also #or'ed and developed an inde( of nursing. )n addition, she believed that reading current nursing research and nursing literatures #ill help improve the practices of nurses.

*oreover, !irginia "enderson+s Theory of Nursing has enumerated 1, functions of nursing care. Nurses need to help the patient in performing these functions- .at and drin' ade$uately, having healthy foods #ill help a patient improve faster, drin'ing /-10 glasses of #ater if not contraindicated #ill also improve a patient+s condition, breathe normally, deep

breathing e(ercises help alleviate pain in a person, nurses need to guide patients in breathing normally, this is one vital function of a nurse, help a person move, help a patient undress and dress clean clothes, #or' in such a #ay to achieve a sense of accomplishment, maintain normal body temperature by modifying environment and ad1usting clothing, eliminate body #aste, 'eep the body clean and groomed, communicate, help the patient in e(pressing emotions, needs, and fears, play, participate in various forms of recreation, #orship, avoid dangers in the environment and avoid hurting other, learn, satisfy, and discover.

)n the Nature of Nursing: A Definition and Its Implications for Practice, Research, and Education, "enderson (1233 identified 1, basic needs upon #hich nursing care is based. %he identified the follo#ing three levels of nurse-patient relationships in #hich the nurse acts as the follo#ing- 1. 4 substitute for the patient, 5. 4 helper for the patient, &. 4 partner #ith the patient.

%he supported empathetic understanding and stated that the nurse must get inside the s'inof each of her patients in order to 'no# #hat he needs ("enderson, 123,, p.3& . 4lthough she believed that the functions of nurses and physicians overlap, "enderson asserted that the nurse #or's in interdependence #ith other health professionals and #ith the patient, and used #edges of a pie graph to represent their relative contributions. The si6es of pieces vary, depending upon the patient+s needs, but the goal is for the patient to represent the ma1ority of the pie as he or she gains independence. Nurses, as the principal care giver in any health care system, directly and profoundly affect the lives of patients and are critical to the $uality of care patients receive. "o#ever, patient acuity and shorter lengths of stay, the nursing shortage, changing technology, e(pansion of public community health services, and higher patient e(pectations have produced a greater demand for care, mounted financial pressure, and limited resources. Today+s nurses practice in a constrained environment that tests the core of their contribution to $uality (National 7uality 8orum, 5009 :oth the public and physicians ran' nurse understaffing of the hospital as one of the most serious threats to patient safety ( :lendon et al. 5005 . T#o-thirds of the hospital bedside nurses concur that there are not enough nurses in their hospitals to provide high $uality care, and close to half score in the high- burnout range on standardi6ed tests. 4lmost one in four nurses intends to leave his or her 1ob in the hospital #ithin a year (4i'en et al. 5001 . Quality of Nursin Car! 7uality li'e beauty is in the eye of the beholder. The #orld is ubi$uitos in health care, but does it mean the same to providers, patients, health plan leaders and payers; ()nstitute of *edicine, 5005 .

The <% )nstitute of *edicine defines $uality- the degree to #hich health services for individuals and populations increases the li'elihood of desired health outcomes and consistent #ith current professional 'no#ledge. What this really means is the each individual consumer should receive the best possible health care available every time services are needed. "ealth care providers should provide care that meets the needs of each individual patient including the use of appropriate advances in medical technology. "ealth care should also be non discriminatory, providing the same $uality of service regardless of race, ethnicity, age, se( or health status ()=* 5005 . )n measuring $uality of care nurses are accountable for their o#n acts, as #ell as for the conse$uences of such acts, they cannot claim immunity for legitimate challenges or criticism leveled at their #or'. They are accountable for the $uality of care they provide their patients. They must have some #ay to assure themselves that the care they provide is effective. They are even responsible for events that could occur but for #hich they have not ade$uately anticipated and for not having made plans sufficiently to assure the delivery of safe and appropriate care to patients. These include providing ade$uate information to determine #hether the agency+s established standards are met and the e(tent to #hich adherence to these standards assure $uality care. 4ccording to :auman (122/ , $uality does not 1ust happen it is a result of learning and changing. :y analy6ing patient outcomes the nurse creates a feedbac' system, conducive to learning and effecting change to develop a high $uality of patient care.