florence nigtgale

1. Presented by Arackathazhath, M.X,. George, J,. Siby, T,.
Smith, S,. Stephen, M,. And Varghese, R,.

2. Dorothea Orem
 One of the America’s foremost nursing theorist.
 Started in early 1930’s with AD in nursing.
 Education journey ends up in 1976 with a Honorary
Doctorate of Science.
 In 1976, first publication of her nursing theory.
 In 2001 last edition of her revised theory was published.

3. Orem’s Theory of Self Care
Deficit.
 Is the central focus of Orem’s General Theory of Nursing.
 It specifies when nursing is needed.
 It describes and explains how people can be helped
through nursing.
 Results when a self care agency (patient) can’t meet
his/her self care need or administer self care.
 One of the most widely used models in nursing today.

4. Four Metaparadigm Concepts
as per Orem’s Theory.
 Orem’s self care is defined as the practice of activities by
individuals that they personally begin and execute their on
behalf in maintaining their life, health and well being.
Orem's self care model of nursing is implemented within
the nursing metaparadigm concepts of
person, environment, health and nursing. This theory is a
person centered and as a person centered theory it is
highly compatible with the practice of nursing.

5. Four metaparadigm
 Human Being:
 An individual beneath the care of a nurse.
 Health:
 A state characterized by soundness or wholeness of
developed human structures and of bodily and mental
functioning.(Orem, 1995,p.101)

6. Four Metaparadigm concepts
 Environment:
 Internal and external condition in which human being
lives.
 Nursing:
 It helps provides self care needs when patients are
unable to do themselves.

7. Ways to Improve Nursing
practice Based on Orem’s
Theory.
 Nursing Care Plan: Nursing care plan includes
assessment, nursing diagnosis, nursing
intervention, expected outcomes and evaluation. Self care
aspect of Orem’s theory applies to the assessment and
evaluation of the nursing process. Orem emphasizes how
once own self care is important for maintaining health and
well being. For example, maintaining our health through
diet, exercises, meditation and annual physical checkup.

8. Ways to Improve Nursing
Practice Based on Orem’s Self
Care Deficit Theory.
 Theory based nursing can improve nursing practice:
 Delivery of patient care based on theoretical principles can
promote successful outcome.
 The Orem’s theory is compatible with the traditional
medical model, has been widely used in practice and
education and recently has been the basis of
education.(Hood, L.J. 2010).
 Orem’s nursing theory has been used to guide acute and
chronic care nursing departments, for utilization review
programs, and in undergraduate and graduate nursing
programs.(Hood,L.J.(2010)

9. Ways to Improve Nursing
Practice Based on Orem’s
Theory.
 Helping-Trusting, Human care relationship.
 Orem’s theory can be achieved by acting and doing for
others, guiding and supporting, by providing and
promoting personnel development in relation to meet the
future demands. For instance, nurse provides
instructions,guidence and discuss the care plan with the
patient and family when they get admitted to the hospital.
Nurse’s supportive protective attitude, and effective
communication skills aids the patient and the family to
trust on him/her.

10. Case Study.
 Mr. Wilson, 68 years old male patient, newly admitted to the hospital with the
diagnosis of heart failure/pulmonary edema. He is 5 feet 8 inches tall and weighs
162 pounds. Initial assessment/history data reveals that he was unable to meet his
self care needs, he was experiencing shortness of breath, so that he cannot do the
daily activities. Mr. Wilson has been experiencing fatigue, which leads to the
difficulty to maintaining a balance between activity and rest.
 Mr. Wilson's care plan includes, the self care deficit due to impaired gas
exchange, decreased cardiac output, fluid volume excess, fear and fatigue related to
disease process . Nursing system measures include oxygen, elevate the head of the
bed, bed rest, monitor rate and quality of respirations, monitor ABG/Pulse oximetry,
 Digoxin to improve cardiac output, lasix and potassium replacement, foley
catheterization to monitor intake/output.
 Morphine for dyspnea and discomfort. Assist with personal activities as tolerated
and needed. Provide frequent rest periods between nursing care procedures, quiet
and restful environment.

11. Conclusion
 Orem’s theory provides a comprehensive base to nursing
practice, function, self care needs and nursing system
based on research. Orem’s theory’s application can be
further extended to the areas of nursing
curricula, education, administration and research.
 Her self care approach is contemporary with the concepts
of health promotion and maintenance.
 A patient progress from an inability situation or limited
ability to the goal of self care .

12. References.
 Chinn, P. L., & Kramer, M. K. (2004). Integrated knowledge development
in nursing(6th ed.). St. Louis: Mosby.
 Foster, P. C. & Bennett, A. M.(2002). Self care deficit nursing theory.
 Hood, L. J. (2010). Leddy & Peppers Conceptual Bases of Professional
Nursing(7th ed.). Philadelphia: Lippincott Williams & Wilkins.
 Nursing Theories: the Base for Professional Nursing Practice, Julia, B. G.
 Orem, D. E. (1980). Nursing: Concepts of Practice(2nd ed.). New York:
McGraw-Hill.
 Orem, D. E.(1985).Nursing: Concepts of Practice(3rd ed.). P 180. New York:
McGraw-Hill.
 Orem, D. E. (1990). A Nursing Practice Theory in Three Parts, nursing
theories in practice(pp 47-60). New York: National League for Nursing.