Advances in Nursing Science

From the Editor No abstract available

Reducing 30-Day Readmissions Through Nursing Science: An Application of Transitions Theory With Best Practice Guidelines The Transition Management Model was developed by and for nurse care coordinators at an Independent Health Network to reduce Medicare and Medicaid 30-day readmission rates. Preimplementation assessment revealed the need for a nursing science framework to effectively reduce 30-day readmissions. The model was developed through thoughtful integration of transitions theory with best practice guidelines set forth by Project BOOST. Initial results of the Transition Management Model produced a decline in readmission rates by 11%. The Transition Management Model initiative can serve as an exemplar for the integration of transitions theory to best practice guidelines to effectively reduce 30-day readmissions.

Claiming the Narrative Wave With Story Theory Over the past few decades, there has been a narrative wave that has advanced and subsided but consistently moved toward acceptance in health care circles. Despite the importance of narrative to nursing practice and research, the discipline has been slow to claim the narrative wave as its own. The purpose of this article is to claim the narrative wave for the discipline of nursing with story theory–guided research and practice and to describe dimensions of the narrative movement in health-related literature. Practical application of story theory is described for both nursing practice and nursing research.

Development of a Theory of Wisdom-in-Action for Clinical Nursing Nurses published dialogues on wisdom; yet, a conceptual model is unavailable. We present the development process for a theory of wisdom-in-action for clinical nursing developed in 3 phases: (1) a deductively derived model using derivation and synthesis; (2) inductively, a constructivist grounded theory captured the experience of wisdom in nursing practice; and (3) the 2 theories were synthesized into a nascent theory. The theory describes 2 antecedent dimensions, person-related and setting-related factors, and 2 types of wisdom, general and personal. The theory provides a framework for translating wisdom in nursing practice, depicting both the science and art of nursing.

Proposing Standards for Teaching Authentic Nursing Knowledge This article's purpose is to propose ideas about developing teaching standards for each of 4 learner levels that lead to 4 types of nursing practice. The learner levels and types of practice are undergraduate/basic practice, graduate/enhanced practice, doctor of nursing practice/translational practice, and research doctorate/knowledge development practice. Each learner level requires different content and different teaching strategies. Thus, teaching at each level requires different teaching standards. This article is written in separate parts. Each section develops necessary ideas to support a set of recommended teaching standards needed to teach authentic nursing theoretical thinking at each level of nursing education.

Keeping the Nurse in the Nurse Practitioner: Returning to Our Disciplinary Roots of Knowing in Nursing Nurse practitioners are a vital and growing body of primary healthcare providers. The ever-changing advancements in science and technology and the increasing complexities in health care delivery are significant factors culminating in the expanding role of nurse practitioner-led care. Nurse educators are striving to develop nurse practitioner curricula to keep pace with the increasingly sophisticated knowledge and competencies nurse practitioners must possess to render safe quality care as independent primary health care providers. However, nursing theory is losing its place as a formative foundation in nurse practitioner curricula. Multiple factors such as content-laden, competency-based, medically focused education have caused a diminishing presence of nursing theory, shrinking the philosophical basis for nursing in nurse practitioner education. The loss of the central unifying focus of the discipline and discipline-specific knowledge (nursology) risks losing the very identity that forms the basis and relevance for nurse practitioner practice. Moreover, the loss of the nurse in the nurse practitioner unmoors nurse practitioner practice from its theoretical and scientific basis, losing discipline-specific attributes that lead to higher levels of patient satisfaction and improved patient outcomes. Keeping the nurse in the nurse practitioner is a moral imperative in nurses' ethical and social contract with society. This article discusses relevant literature and offers recommendations to keep the nurse in the nurse practitioner.

Embodying Caring Science as Islamic Philosophy of Care: Implications for Nursing Practice Despite the diversity and complexity of nursing theories, including those embedded with a philosophy of caring, few if any have aligned their assumptions with an Islamic philosophy of caring. To do so would call into question the compatibility of such caring for some Muslim scholars. The purpose of this article is to understand how and why an Islamic philosophy of care can be taken up through an application of Watson's caring science. In doing so, a broader understanding of caring is provided for nurses and other health care providers who work with Muslim communities in the context of care provision.

Toward a System Theory of Stress, Resilience, and Reintegration Military to civilian reintegration is a complex, multidimensional phenomenon warranting holistic perspectives. Complex phenomena require theory to understand and interpret relationships among concepts. Despite the need for theory-driven research, recent nursing reports often lack a theoretical structure. We extracted relevant concepts from the Neuman's Systems Model (stressors, environment, and person) and the Transactional Model of Stress and Coping (primary and secondary appraisal, coping, and adaptation) to form a Conceptual-Theoretical-Empirical model. Exemplar empirical instruments are presented, along with their conceptual and theoretical dimensions. An integrated System Theory of Stress, Resilience, and Reintegration is presented with its utility demonstrated through a research application.

Epistemic Injustice: A Philosophical Analysis of Women's Reproductive Health Care in a Somali-American Community Epistemology is the study of the grounds of knowledge. We illustrate through case studies how epistemic injustice is manifested in the delivery of reproductive health care services for women from Somalia, even though it may not be intended or recognized as injustice. Testimonial injustice occurs when women are not believed or are discredited in their aim to receive care. Hermeneutic injustice occurs when a significant area of one's social experience is obscured from understanding owing to flaws in group knowledge resources for understanding. For example, women from Somalia may not receive full disclosure about the diagnostic or treatment services that are recommended in the reproductive health care setting. We explore how the many intersections in a person's identity can give rise to epistemic injustice and we suggest more expansive ways of evaluating the validity of diverse epistemologies in patient-centered care. Structural competency is recommended as a way nurses and other health care providers can mitigate the social determinants of health, which contribute to epistemic injustice.

Traditional Masculinity: A Review of Toxicity Rooted in Social Norms and Gender Socialization The toxicity of traditional masculinity has become a heated topic of mainstream media debate since the American Psychological Association's release of psychological treatment guidelines for men and boys. To recognize how traditional masculinity is toxic, there needs to be greater understanding of the social norms and gender socialization behind traditional masculinity. Gender-based social norms and gender socialization have had dire consequences on how men behave, act in relationships, and care for their health. There is a need to reform the perception of masculinity in the contemporary social climate.