Orlando's theory is a interrelate concepts. Many various theorist have describe different classification of this theory. It is a Middle Range Nursing Theory However all have shown it is an interactive type of theory

1. Orlando's Nursing Process Theory

2. By the end of this presentation, you’ll be able to
Discuss the nursing process theory.
 Describe the major concepts nursing
according to Orlando.
 Define the assumptions of Orlando’s theory.
 Discuss the propositions of Orlando’s theory.
Explain Orlando’s theory as a framework for
nursing practice.
Explain The nursing process and Orlando’s
theory.

3. Discuss the nursing process theory
• Inculeds:Theory Description ,Critical
Reflection, And theory Evaluation of the
nursing process theory of Ida Jean Orlando.

4. INTRODUCTION
• Orlando's theory is a interrelate concepts. Many
various theorist have describe different
classification of this theory. It is a Middle Range
Nursing Theory However all have shown it is an
interactive type of theory.
• We are going to describe this theory analysis
mostly related to Chinn and Kramer’s(2011)
• This theory is a cyclic process as we can
reevaluate and repeat with the new access to
achieve the target goals.

6. HISTORY AND BACKGROUND
About the theorist
• Jean Orlando - born in 1926.
• wrote about the nursing process in1950
• Nursing diploma - New York Medical College
• BSc in public health nursing - St. John's University,
New York.
• MA in mental health nursing - Columbia University,
New York.

7. About the theorist con…
• Associate Professor at Yale School of Nursing and Director of
the Graduate Program in Mental Health Psychiatric Nursing.
• Project investigator of a National Institute of Mental Health
grant entitled: Integration of Mental Health Concepts in a
Basic Nursing Curriculum.
• published in her 1961 book, The Dynamic Nurse-Patient
Relationship and revised 1972 book: The Discipline and
Teaching of Nursing Processes
• A board member of Harvard Community Health Plan.
• Orlando her good works ended on November 28, 2007 when
she died

8. Formulation of this theory
• Orlando's theory was developed in the late
1950s from2000 observation between nurse
and patient interaction. Despite her efforts,
she was only able to categorize the records as
"good" or "bad" nursing.
• From these observations she formulated the
deliberative nursing process theory.

9. THE DOMAINS OF THE THEORY
THE MAIN DOMAIN
-Nurse
-Patient
-Health
-Environment

10. SUB DOMAINS CONCEPTS
• Nursing
• Process of care in an immediate experience
• Goal of nursing
• Health
• Environment
• Human being
• Nursing client
• Nursing problem
• Nursing process
• Direct and indirect immediate nursing therapeutic actions
• Automatic functions

11. Major concept and definitions
This is a middle range theory and having 5 major concepts
01. Function of professional nursing(organizing principle) -
- Find out and meeting the patients immediate needs for
help.
-The responses of the nurse as responsive to individually
who suffer or anticipate sense of helpless.
-Direct assistance by empirically or interactively .
-Avoiding, Reliving, Diminishing or curing the sufferings
and the helpless.

12. Major concept…
02.Presenting behavior -- Problematic situation
• Problem client behavior Automatic
internal response of the nurse- Nursing action
03.Immediate reaction- Internal response
• Perceives through five sense – Thought
stimulations and feelings – Immediate acts for
needs by the automatically thoughts and
feelings

13. Major concept…
04. Nursing process and discipline– investigations
THE PROCESS STEPS (ADPIE)
A-Assessment
D- Diagnosis
P – Planning
I – Implementing
E - Evaluation

14. Nursing process

15. Nursing process and discipline con…..
• Any observation shared and explored with the patient is
immediately useful in ascertaining and meeting his/her
need or finding out that he/she is not in need at that
time
• The nurse does not assume that any aspect of her
reaction to the patient is correct, helpful or
appropriate until she checks the validity of it in
exploration with the patient
• The nurse initiates a process of exploration to ascertain
how the patient is affected by what she says or does .
• When the nurse does not explore with the patient her
reaction it seems reasonably certain that clear
communication between them stop.

16. Major concept…
05.Improve resolution
I. Evaluation – it was help the nurse to
communicate and fulfill the clients needs.
II. Repeat the procedure of learning – it is a
cyclic process and might be evaluate the out
come

17. DEFINITIONS
This theory has defined as follows
 Distress: Experiences of the patient
 Nursing role: Discover and meet the patients
immediate
 Nursing action : Directly and Indirectly
providing patient’s immediate needs.
 Out come : It is a change in the patient’s
behavior shown by the indicators.

18. MAJOR DIMENTIONS
NURSING
IMEDIATE
ACTIONS
DISTRESS
NURSING
PROCESS
STEP BY
STEP
OUT COME
AND
PATIENT’S
INDICATION
NURSING
RESPONSE

19. Concept relationship with the
Structure
• The theory is describe the step by step process
to achieve the goal as a frame work for
nursing practice there are 5 interrelated
concepts .
• The structure of five step by step process to
applying nursing intervention individually and
is the only theory for direct nurse – patient
intervention

20. RELATIONSHIP…
It is a theoretical frame work having two aspects
(THE DIANAMIC NURSE – PATIENT RELATIONSHIP)
01. Action process – person to person -
Perception
Thoughts
Feelings
02.Action process – Person to person
In at functions

21. MAJOR ASSUMPTIONS
• When a patient cannot cope with their needs
without help they become distressed with
feelings at helpless.
• Patients are unique and individual in their
response.
• Nursing officers mothering and nurturing of
their patients as a child.
• Nursing deals with people, health, and the
environment.

22. ASSUMPTIONS CON…
Basic acceptance truth
• Patient need help in communicating needs, they are
uncomfortable and ambivalent about dependency needs
• Human beings are able to be secretive or explicit about their
needs, perceptions, thoughts and feelings
• The nurse – patient situation is dynamic, actions and
reactions are influenced by both nurse and patient
• Human beings attach meanings to situations and actions that
are not apparent to others
• Nurses are concerned with needs that patients cannot meet
on their own.

23. ASSUMPTIONS CON …
Current indications for this truth
• using in the daily care activities
• By using get good efficient out come
• can be increase and refine the research
knowledge
• Make advance in education curriculum.
• It couldn't delimit at all.

24. CLARITY OF THIS THEORY
It having a congruent triangle process and
interactive.
NEEDS
OUTPUTS
NURSING
PROCESS
CONTAIN 5 STEPS

25. CLARITY…
• Semantic clarity – can be extend and improve according
to the changing context and growing advances of the life
span and he technologies.
• Semantic consistency – It is truly acceptable.
• Structural clarity – fixed basic concepts and having a
systematic frame work constantly.
• Structural consistency – theory shows only of the patient
needs individually, but now a days we are seems the
health care as the human as a whole and doing the
integral nursing so the consistency should be change
according to the context at the present and growing the
needs from the individual to the global level.

26. SIMPLICITY,GENERABILITY AND THE
ACCESSSIBLE OF THIS THEORY
SIMPLICITY
• Having the countable number of concepts which are
understandable and the continuously practicable.
• So this theory can be called simple
GENERALABILITY
• This is very general because up to now we are
practicing these concepts as possible as in all nursing
interventions and in all roles of nursing such in the
management, education and research also .
• In the evidence base practice also has infiltrated these
concepts.

27. Cont…
How accessible
• Now we are going to demonstrate in a simple
way that how much accessible this theory in our
nursing practice by using the main steps of this
theory in nursing process.
• Assessment – how?
• Diagnosis – how?
• Planning – how?
• Implementation– how?
• Evaluation – how?

28. CONGRUENT THE THEORY GOAL AND THE
PRACTICAL GOAL
Theory goal :
• Identification of the nature of the patient with distress and
• Immediate needs providing
The practical goal :
• Identifying the immediate and the potential need of the person as a
whole .
• Giving the primordial, primary prevention, secondary prevention,
Tertiary prevention and the rehabilitation level health care.
• Prevent the disease, promote the health, and the restore the health
from the unique individual to the global level.
• So there is a vast different between the goals of comparing the
practice but there is no so different between the theory goal
comparing .
• We are doing the holistic approach.

29. SUFFICIENT TO BE USED AS A BASIS IN PRATICAL
APPLICATION IN THE DAY TO DAY NURSING PRACTISE
• Earlier using this basic process concept directly
with the empirical evidence data
• Now a days also we using this concept as a
basically and extend our ways of approach
according to the growing scientific technology
world and needs of health care of the human
beings.
• So this theory is a applicable and sufficient to be
used with more evidence based practice and
more updated knowledge and it can be depict as
a congruent theory with the new generations.

30. STRENTHS AND WEAKNESSESS
STRENGTHS
• It has a concrete concepts using with the individuals
and treated actively and constantly input into their
own care
• Prevents inaccurate diagnosis , ineffective plans
because the nurse has constantly explore her reactions
with a patient.
• Assertion of nursing’s independence as a profession
and her belief that this independence based on a
sound theoretical framework.
• Guide the nurse to evaluate her care in terms of
objectively observable patient outcomes.

31. Cont…..
WEAKNESS
• Using the empirical evidence, thoughts, and feelings
only for assess the patient needs with the distress.
There is no any clear evidence for using any
instruments.
• Individual nurses perceive the patient needs in
different manner and outcome may differ.
• This study fails to focus on the ICU patients that are
unable to verbalize their discomforts.
• Orlando’s work focuses on short term care, particularly
aware and conscious individuals and on the virtual
absence of reference group or family members .

32. Research evidence to support theory
• A cross sectional study on nursing process implementation and
associated factors among nurses working in selected hospitals of
Central and Northwest zones, Tigray Region, Ethiopia
According to this study
- Seventy (35%) of participants have implemented nursing process.
Different factors showed significant association.
- Nurses who worked in a stressful atmosphere of the workplace were
99% less likely to implement the nursing process than nurses who
worked at a very good atmosphere.
- The nurses with an educational level of BSc. Degree were 6.972
times more likely to implement the nursing process than those who
were diploma qualified.
- Nurses with no consistent material supply to use the nursing process
were 95.1% less likely to implement the nursing process than
nurses with consistent material supply.
.

33. Research evidence to support theory
con….
• Orlando’s Nursing Process Theory the Effects
of an Ambulatory Collaborative Practice
Model on Process and Outcome of Care for
Bipolar Disorder by Shea, N., McBride, L., &
Bauer, C., Gavin, M. (1997). Journal of the
American Psychiatric Nurses Association, 3,
Retrieved April 11, 2009.

34. Research evidence to support theory
con..
After applying Orlando’s Nursing Process
Theory to patient care, the following results
were discovered:
• Increased patient satisfaction
• Decreased hospital length of stay
• Less emergency services required
• Higher patient retention
• Increased intensity of medication treatment
• Decreased use of costly mental health services

35. Research evidence to support theory
con..
Application of Nursing Process and Its Affecting Factors among Nurses
Working in Mekelle Zone Hospitals, Northern Ethiopia (Received 4
September 2013; Accepted 18 November 2013; Published 6 February
2014)
• The majority (90%) of the study participants were poorly knowledgeable
about the nursing process.
• Almost all of study participants had positive attitude towards the nursing
process. This seems that nurses’ attitude towards the nursing process is
not a factor affecting the application of nursing process.
• From the sociodemographic characteristics, only educational status has
direct statistically significant relationship with the knowledge of nurses on
nursing process.
• Participants reported that factors such as shortage of resources, lack of
knowledge, high patient nurse ratio/work load, and lack of training and
motivating factors such as salary affected the application of the nursing
process

36. Conclusion
• Orlando’s nursing theory stresses the reciprocal relationship
between patient and nurse. What the nurse and the patient say and
do affects them both.
• Orlando views the professional function of nursing as finding out
and meeting the patient’s immediate need for help.
• She was one of the first nursing leaders to identify and emphasize
the elements of the nursing process and the critical importance of
the patient’s participation in the nursing process.
• Orlando’s theory focuses on how to produce improvement in the
patient’s behavior. Evidence of relieving the patient’s distress is
seen as positive changes in the patient’s observable behavior.
Orlando may have facilitated the development of nurses as logical
thinkers.
• The Deliberative Nursing Process helps nurses achieve more
successful patient outcomes such as fall reduction. Orlando’s theory
remains a most effective practice theory that is especially helpful to
new nurses as they begin their practice.

37. Summary
Get clear picture of nursing process theory.
 Understand the major concepts nursing
according to Orlando.
Can define the assumptions of Orlando’s
theory.
 Understand of Orlando’s theory as a
framework for nursing practice.
Simply explain The nursing process and
Orlando’s theory.

38. References
1. Fisseha Hagos,1 Fessehaye Alemseged,2 Fikadu Balcha,2 Semar
Berhe3 and Alemseged Aregay3 A cross sectional study on nursing process
implementation and associated factors among nurses working in selected hospitals
of Central and Northwest zones, Tigray Region, Ethiopia BMC Nursing volume 16,
Article number: 54 (2017)
2. Zeray Barai, Fiseha Girmay, Kalayou Kidanu, and Hadgu Gerensea Application of
Nursing Process and Its Affecting Factors among Nurses Working in Mekelle Zone
Hospitals, Northern Ethiopia (Received 4 September 2013; Accepted 18 November
2013; Published 6 February 2014)
3.Potter, M.L., & Bockenhauer, B.J. (2000). Implementing Orlando's Nursing Theory: a
pilot study. Journal of Psychosocial Nursing and Mental Health Services. 38(3), 14-
21.
4. Shea, N., McBride, L., & Bauer, C., Gavin, M. (1997). The Effects of an Ambulatory
Collaborative Practice Model on Process and Outcome of Care for Bipolar
Disorder. Journal of the American Psychiatric Nurses Association, 3, Retrieved April
11, 2009, from http://jap.sagepub.com/cgi/content/abstract/3/2/49
5.http://currentnursing.com/nursing-theory/Orlando-nursing-process.html

39. Take home Message

40. Thank you for listening