Concepts and theories guiding professional practice
Concepts and Theories
Objectives And Activities
Describe the importance of having a theory for professional nursing
Identify the scope and standards for nurse administrators as a
framework for practice.
Define the terms executive, manager, managing, management,
and nursing management.
roles for nurse managers and nurse executives.
Illustrate selected principles of nursing management.
Discuss general systems theory.
Discuss the use of nursing theory in managing a clinical practice.
Differentiate among concepts, principles, and theory.
1. Aim of health care.
2. Scope of practice.
3. Standards of practice for nurse
4. Management theory.
5. Nursing management theory.
6. Critical theory.
7. General systems theory.
8. Nursing management.
9. Management principles.
11.Nursing management roles.
16. Management levels.
17.Modalities of nursing.
A. Nurse Manager Behaviors:
1. Applies postmodern management theory to organizational operations.
2. Assesses the impact of ethnic, political, social, financial, economic, and ethical
3. Share ideas and conduct mutual problem solving.
4. Activities as certification and participation in professional organizations.
B. Nurse Executive Behaviors:
1. Examines the application of a nursing and management theory.
2. Works with the professional nursing staff to develop and test the pilot study.
3. Pursues continuing education, certification, professional development.
4. Seeks experiences to advance one’s skills and knowledge base including the art
and science of nursing.
Aims For Improvement In Health
1. Health care must be safe: “First, do no harm”.
2. Health care must be effective.
3. Health care should be patient centered.
4. Health care should be timely.
5. The health care system should be efficient, constantly seeking to
reduce the waste—and hence the cost.
6. Health care should be equitable. Race, ethnicity, gender, and
income should not prevent anyone in the world from receiving
Core Competencies Apply To All Health
1. Provide patient-centered care.
2. Work in interdisciplinary teams.
3. Use evidence-based practice.
4. Apply quality improvement.
5. Utilize informatics.
American Nurses Association (ANA) notes
work environments that support professional
1. Magnet hospital recognition.
2. Preceptorships and residencies.
3. Differentiated nursing practice.
4. Interdisciplinary collaboration.
Scope and Standards for Nurse Administrators
provides Framework to:
1) Nursing services management, philosophy, and practices.
2) Adherence to standards for improving the quality of patient care.
3) Leadership of the chief nurse executive and competence of
4) Attention to the cultural and ethnic diversity of patients, their
significant others, and the care.
5) Providers in the health care system.
The ANA outlines components of a professional nursing practice environment:
1. Manifests a philosophy of clinical care emphasizing quality, safety and continuity of
2. Recognizes contributions of nurses’ knowledge and expertise to clinical care quality.
3. Promotes executive level nursing leadership.
4. Empowers nurses’ participation in clinical decision making and organization of clinical
5. Maintains clinical advancement programs based on education, certification, and
6. Demonstrates professional development support for nurses.
7. Creates collaborative relationships among members of the health care provider team.
8. Uses technological advances in clinical care and information systems(in that
Scope And Standards For Nurse
Administrators: Framework For Practice
1) Core abilities necessary for nurses in administrative roles.
2) Management skills.
3) Team-based learning to advocate for patients and community.
4) Strategic management, policy development, financial
management, cost analysis, leadership, organizational
development and business planning.
5) Evidence-based management (effectiveness of care, cost of care,
and patient outcomes).
The Nurse Administrator
The nurse administrator has been described as a “registered nurse whose
primary responsibility is the management of health care delivery services and
who represents nursing service.”
Nurse administrators can be found in a wide variety of settings: hospitals, home
health care, community health services, residential care, and adult day care.
1. Level of nursing administrative practice.
2. Magnet recognition program and scope and standards for nurse
3. Qualifications of nurse administrators certification of nursing administration.
4. Certification of Nursing Administration.
1.Level of nursing administrative practice:
The ANA conceptually divides nursing administration practice
into two levels, nurse executive and nurse manager:
1) The nurse executive’s scope includes overall management of
nursing practice, nursing education and professional development,
nursing research, nursing administration, and nursing services.
2) Nurse managers are responsible to a nurse executive and have
more defined areas of nursing service. A nurse manager performs
these management functions to deliver health care to patients.
Nurse managers or administrators work at all levels to put into
practice the concepts, principles, and theories of nursing
2. Magnet recognition program and scope
and standards for nurse administrators:
This program’s purpose is to recognize health care organizations
that have demonstrated the very best in nursing care and
professional nursing practice. Such programs have been
recognized for having the best practices in nursing, and they also
serve retain quality employees. A key objective of the program is
to promote positive patient outcomes.
“Magnet designation helps consumers locate health care
organizations that have a proven level of nursing care.”
3.Qualifications of nurse administrators
certification of nursing administration:
In the nurse manager’s role, preparation should be a minimum of a
bachelor’s degree with a major in nursing. A master’s degree with a focus
in nursing is recommended along with nationally recognized certification in
nursing administration with an appropriate specialty. “The experience
backgrounds of professional nurses who serve as nurse administrators must
include clinical and administrative practice, which enables these
registered nurses to consistently fulfill the responsibilities inherent in their
respective administrative roles.”
4.Certification of Nursing Administration
Both certification examinations include the following
domains: organization and structure, economics, human
resources, ethics, and legal and regulatory issues.
The domain of organization and structure accounts for
the highest percentage of questions for the advanced
For the nurse manager level, the domain of human
resources ranks highest.
Mary Parker Follett is credited with being the “mother of modern
Taylor, Fayol, and Weber have had considerable influence on
modern management and are called the “fathers of modern
management.” Scientific management (efficiency) provided
information on standards, time/motion studies, task analysis, job
simplification, and productivity incentives.
Modern management theory evolved from the work of
Henri Fayol, who identified the activities or functions of the
administrator as planning, organizing, coordinating, and
The principles of management described by
1) Division of work.
4) Unity of command.
5) Unity of direction.
8) Scalar chain (line of authority).
11) Stability or tenure of personnel.
13) Subordination of individual
interests to the general interests.
Five essential management practices in nurses’
work environment and health care
These five practices have not been consistently applied, adding further
evidence to their importance in today’s health care environment:
1) Balancing the tension between efficiency and effectiveness.
2) Creating and sustaining trust. Trust and honest, open communication are
critical to successful organizational change.
3) Actively managing the process of change. This management practice is
related to human resource management.
4) Involving workers in work design and workflow decision making.
Additionally, nurses’ autonomy and control over practice are positively
related to trust in management.
5) Creating a learning organization.
Critical theory aims to do the following:
1. Critique the ideology of scientism, the institutionalized form of
reasoning that accepts the idea that the meaning of knowledge is
defined by what the sciences do and thus can be adequately
explicated through analysis of scientific procedures
2. Develop an organizational science capable of changing
organizational processes. These aims are compatible with a theory of
nursing management. Nurses use science to legitimize the practice
of clinical nursing and nursing management.
levels of a general systems theory
Kenneth Boulding describes nine levels of a general systems theory:
1. A static structure: the framework.
2. A moving level of necessary predetermined motions.
3. A control mechanism.
4. An open system or self-maintaining structure.
5. The genetic–societal level.
6. The “animal” level: designing or purposeful behavior, and self-awareness.
7. The “human” level: The nurse manager can process the knowledge and
skills of management to produce specific results.
8. The level of social organization.
9. Transcendental systems.
Nursing Theories in Professional Practice
Each result of nursing research adds tested facts to nursing theory that
can be learned by nursing students and active practitioners.
1. Watson’s Theory of Caring.
2. Orem’s theory of self-care.
3. Roy’s adaptation level theory to nursing intervention.
4. Margaret Newman’s theory of health as expanding consciousness.
5. Johnson’s Theory: Johnson incorporated the nursing process (assessment,
diagnosis planning, intervention, and evaluation)
6. Peplau’s theory defines nursing as a “significant, therapeutic, interpersonal