Theoretical and Ethical Framework Paper

Purpose: Integrate nursing science with knowledge from ethical, psychosocial, biophysical, philosophical, analytical, and social sciences to form the basis of clinically effective advanced nursing practice. The student will discuss the meta-paradigm of nursing, grand and middle-range nursing theories, complexity science, and ethical principles and framework appropriate to the identified phenomenon of interest and pertinent to advanced nursing practice specialty
Skills: The purpose of this assignment is to allow you to practice the following skills that are essential to your success in this course as well as your academic and professional practice.

Evaluating and explaining abstract disciplinary theories.

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Applying learned knowledge to a phenomenon of interest.

Critically examining individual elements or deconstructing issues related to ethical, theoretical, and analytical sciences.

Critiquing and evaluating philosophical and theoretical concepts and ideas.

Knowledge: This assignment will also help you to become familiar with the following important content knowledge:

Relationship of the nursing meta-paradigm to nursing theory.

Impact of selected nursing theories on the identified phenomenon of interest within an advanced nursing practice specialty.

Differences in grand nursing theory and middle-range theory as applied to the selected phenomenon of interest.

Examine complexity theory and complex adaptive systems on the identified phenomenon of interest within the advanced nursing specialty.

Apply graduate-level scholarship.

Tasks:

Review required and recommended resources.

Conduct a literature search and review of the literature to support ideas and concepts.

Identify a grand nursing theory and middle-range theory that are aligned and relevant to the selected phenomenon of interest.

Appraise the impact of selected theories on advanced nursing practice.

Discuss complexity theory specific to the identified phenomenon of interest.

Develop a scholarly paper that adheres to the requirements outlined in the rubric.

Demonstrate graduate-level scholarship as outlined in the rubric.

POI

EMERGENCY DEPARTMENT BOARDING OF CRITICAL CARE PATIENTS

Grand Nursing Theory Keynote

Nursing’s Meta-paradigm

The term “paradigm” is defined as the development of knowledge in a specific field or discipline. In 1984, Dr. Jacqueline Fawcett evaluated existing nursing theories and identified four concepts common to the individual paradigms within each theory: Patient-Environment-Health-Nursing. Placing the nursing theories within one context enhanced the potential for the development of nursing knowledge. Dr. Fawcett’s work is commonly referred to as the “Meta-paradigm” of nursing (Fawcett, 1984). Nursing knowledge and knowledge development focuses on the “whole” and is directed at defining and understanding the inter-relationships among the four core concepts identified above (Smith & Liehr, 2014).

Nursing Theory
Nursing theories are constructed as a framework of knowledge that is applied in a pattern to guide and facilitate thought.
Grand Nursing Theory

Among the core beliefs of nursing is the idea that nursing should be founded on the best empirical evidence, incorporate the beliefs of patients and families, and be guided by disciplinary theory (Pipe, 2013).

Beginning in the 1950’s multiple theories of nursing were developed; some scholars believe the first nursing theory was postulated by Florence Nightingale when she published her “Notes on Nursing” in 1860. As we discussed in an earlier Unit, concepts are the building blocks of theory.

A theory that defines the relationship between two or more concepts; conceptual models of nursing are typically called “Grand nursing theories”. Grand theories are quite abstract and usually do not provide specific instruction for nursing actions (Kenney, 2013).

While there are a number of grand nursing theories, a few will be briefly discussed here.

Grand Nursing Theory Paradigms: Nursing as a professional discipline evolves and transforms with scientific discoveries, technological advances, and in response to changes in the health care delivery system. Nursing theory has evolved as new paradigms arise, although the theoretical foundations may remain unchanged.

1. Integrative/Interactive Paradigm: View of the patient as an individual that interacts and is integrated with the environment that impacts health as a larger system (Smith & Parker, 2015).

Dorothy Johnson’s Behavioral System Model

Dorothy Orem’s Self-care Deficit Nursing Theory

Imogene King’s Theory of Goal Attainment

Sister Callista Roy’s Adaptation Model

Betty Neuman’s Systems Model

2. Unitary/Transformative Paradigm: View of the patient as a human being that is part of the environment; with the human being and environment changing together through a mutual pattern (Smith & Parker, 2015).

Martha Rogers Science of Unitary Human Beings

Rosemarie Rizzo Parse’s Humanbecoming Paradigm

Marget Newman’s Theory of Health as Expanding Consciousness

3. Care or Caring Paradigm: View of care and caring as central to the discipline of nursing (Smith & Parker, 2015).

Madeleine Leininger’s Theory of Culture Care Diversity and Universality

Jean Watson’s Theory of Caring

Anne Boykin and Savina Schoenhofer’s Theory of Nursing as Caring

References

Fawcett, J. (1984). The meta-paradigm of nursing: Current status and future refinements. Image: Journal of Nursing Scholarship. 16, 84-87. Retrieved from: http://www.nursingsociety.org/Publication

Griffin, M.T.Q., & Landers, M.G. (2014). Extant nursing models and theories: Grand and middle range theories in nursing. In J. Fitzpatrick & G. McCarthy (Eds.). Theories guiding nursing research and practice. (pp 15-31). New York: Springer.

Moran K., Burson, R., & Conrad, D. (2017). The doctor of nursing practice scholarly project. Burlington, MA: Jones & Bartlett Learning.

Smith, M.J., & Liehr, P.R. (2018). (4th ed). Middle range theory for nursing. New York: Springer.

Smith, M. C., & Parker, M. E. (2015). Nursing theories and nursing practice (2nd ed.). Philadelphia, PA: FA Davis Company.

Middle Range Nursing Theory Keynote
Middle Range Nursing Theories

In contrast to Grand Nursing Theories, middle-range theories are focused, and therefore apply more descriptive and predictive models to a phenomenon of interest. Each middle range theory seeks to address a particular experience and typically focuses on only one of the nursing meta-paradigm concepts. Many times, middle-range theories have evolved from a grand theory of nursing or have resulted from nursing research (Chism, 2013; Tracy, & O’Grady, 2019; Smith & Liehr, 2018).

Examples of Middle-range Theories include (Smith & Parker, 2015):

Katharine Kolcaba’s Comfort Theory

Pamela Reed’s Theory of Self-Transcendence

Patricia Liehr and Mary Jane Smith’s Story Theory

The Community Nursing Practice Model

Rozzano Locsin’s Technological Competency as Caring in Nursing

Marilyn Anne Ray’s Theory of Bureaucratic Caring

Troutman-Jordan’s Theory of Successful Aging

Barrett’s Theory of Power as Knowing Participation in Change

Marlaine Smith’s Theory of Unitary Caring

Kristen Swanson’s Theory of Caring

It is very important that the middle range theory you select works well with the Grand Nursing theory you have chosen. You want these two theories to work together to give you a fuller understanding of the patient situation, environment, or problem you are encountering.

References:

Chism, L.A. (2013). The Doctor of Nursing Practice: A guidebook for role development and professional issues. Burlington, MA: Jones & Bartlett.

Tracy, M.F., & O’Grady, E. T. (2019). (6th ed). Advance practice nursing: An integrative approach. St. Louis, MO: Elsevier.

Smith, M.J., & Liehr, P.R. (2018). (4th ed). Middle range theory for nursing. New York: Springer.

Smith, M. C., & Parker, M. E. (2015). Nursing theories and nursing practice (2nd ed.). Philadelphia, PA: FA Davis Company.

Complexity Science Keynote
Complexity Science
Complexity science is not a single theory but rather an emerging interdisciplinary paradigm.

Complexity science incorporates elements of multiple fields of study including chaos theory and non-linear mathematics.

While this sounds complicated (and it is!), the basic tenet of Complexity Science is that “the whole is more than the sum of its parts” which is also the basic tenet of nursing.

Complexity science is being applied to multiple areas of study including Organizational and Systems Analysis, Healthcare Systems, even medical research (Butts & Rich, 2018).

The identification of Complex Adaptive systems is an offshoot of complexity science.

Examples of complex adaptive systems consist of such things as a school of fish, a flock of birds, and the human body.

In 2001, the Institute of Medicine (IOM) referred to health care facilities in this context (IOM, 2001).

All complex adaptive systems are composed of individual parts or “agents” who are connected to one another is some way, but who act independently and unpredictable at times.

Using a healthcare facility for an example of a complex adaptive system, the facility itself may be thought of as the “whole”, the “agents” would include the various departments such as Nursing, Environmental Services, Social Work, the Business office, etc.

Breaking this down even further, within the Nursing department, each individual nursing unit would be an “agent”, and so on down to the level of the individual nurse, unit secretary, or nursing assistant.

A hallmark of complex adaptive systems is that oftentimes, small changes can have large effects throughout the system; actions taken by one “agent” often have profound effects on others within the system (Butts & Rich, 2018).

References:

Butts, J.B. & Rich, K. L. (2018). Philosophies and theories for advanced nursing practice. (3rd ed). Burlington, MA: Jones & Bartlett.

Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, D.C.: National Academy Press.

Ethical Framework Keynote
Overview

Ethics is a philosophy based on beliefs of what is considered morally acceptable and morally unacceptable. Therefore, it is considered a moral philosophy.

Ancient Greek philosophers such as Socrates, Plato, and Aristotle applied a philosophical inquiry to behavior for rational clarification and justification of beliefs.

The term ‘bioethics’ is derived from ancient Greek with ‘bios’ meaning ‘life’, and ‘ethikos’ meaning ‘ethics’. Today, bioethics is a systematic study of moral dimensions in healthcare.

We begin our discussion about Ethical frameworks by considering the relationship between ethics and morality.

There is no philosophically significant difference in ‘ethics’ and ‘morality’, and the terms are often used interchangeably in the literature (Johnstone, 2015). ‘Ethics’ is derived from the ancient Greek term ‘ethikos’, which was ‘pertaining to custom or habit’; and ‘morality’ which is derived from the ancient Greek term ‘moralitas’ also pertains to ‘custom or habit’.

Ethics is considered to be a body of knowledge that tries to make sense of what is “right” and what is “wrong”.

An ethical system or framework is based on ethical principles, such as autonomy, nonmaleficence, beneficence, and justice (Beauchamp & Childress, 2013).

Moral rules guide ethical behavior and are more focused than ethical principles. Examples of moral rules would be ‘do not lie’, ‘do not kill’, and so forth (Johnstone, 2015).

Going back to our earlier discussion on Ways of Knowing, Carper (1978) states that the ethical component of knowing focuses on what “ought” to be done.

The development of ethical knowledge comes from who we are and what we believe; knowledge development is generated when we ask “Is this right?” or “Is this the responsible way to deal with this situation?” (Chinn & Kramer, 2015).

Ethical knowledge can take many forms: rules, statements of duties, the development of “rights” such as the Patient’s Bill of Rights, theories, and laws. Many professional organizations, such as the American Nurses Association (ANA) have developed a code of ethics; this too is a type of ethical knowledge development (Chinn & Kramer, 2015).

A link to the ANA Code of Ethics is supplied to you in the required readings and resources section of this Unit. Please take the time to read over this code.

Moral Disagreement

Moral courage is the courage to act based on moral beliefs in the face of fear (Savel & Munroe, 2015), and a moral community of nurses sharing ethical commitments creates a bond that may strengthen moral courage (Wocial, 2018).

Moral conflicts may arise when choosing between two or more actions, in which neither is fully acceptable (Johnstone, 2015)

Moral distress is an internal conflict that arises when an individual knows what is right, but is prevented from taking the right action (Johnstone, 2015).

A moral dilemma is an internal conflict that arises when there is no action that is fully or wholly acceptable (Johnstone, 2015).

Core Ethical Principles

Core ethical principles were included in the Belmont Report, now known as the Common Rule that governs the ethical guidelines for research that utilizes human participation (National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, 1979). Beauchamp and Childress (2013) have expounded on this report as the principles relate to nursing practice:

Autonomy- this principle holds that each person has worth in their own right, each person should have the unrestricted freedom to make choices for themselves; this principle is at the core of the informed consent procedure.

Non-maleficence- requires the avoidance of harm. Patients have the right to expect that the health care provided to them won’t do them further harm. An easy clinical situation to apply this principle to is hand washing. Again, every healthcare professional knows hand washing is the most effective way to limit the spread of hospital-acquired infections. Does everyone who comes into contact with the patients in your facility comply with the handwashing policy every time? Do you?

Beneficence- this principle holds that each action undertaken should be done for the benefit of others. It is oftentimes linked with non-maleficence. A classic example of this type of ethical decision would be to consider the process of allowing natural death to occur versus the act of euthanasia.

Justice- this principle states that all care should be distributed in an equitable and fair manner. Any care that violates this principle (think lack of access to specialty care in rural or underserved populations) can be a potential ethical issue for the APN to address in some way.

Overview of theoretical perspectives and frameworks that inform ethical practice:

Ethical frameworks serve to inform, or guide practice, and as such, may be divided into three (3) broad categories;

Consequentialist framework (consequentialism) is concerned with the future effect, or ethical consequences of an action.

Duty framework is concerned with the duties and obligations in a situation, and ethical conduct is doing what is right.

Virtue framework is concerned with positive or negative character traits that may motivate an action.

This section is not intended to be a full discussion of the perspective and frameworks; rather, it is intended to provide you with a basic description as a starting point.

Virtue Ethics- focuses on the mind and character and the type of person you want to be rather than on specific actions.

Five focal virtues of healthcare workers have been described as compassion, discernment, trustworthiness, integrity, and conscientiousness (Beauchamp & Childress, 2013).

Natural Law Theory- based on Judeo-Christian ethics and principles. This work is most often attribute to St. Thomas Aquinas and defines rules of basic human behavior.

Deontology- this theory focuses primarily on the concept of duty and rules. The nature of the act (good or bad) is judged on the act itself, not the outcome. (the end does not justify the means)

Ethical Principlism- places emphasis on rules and duties; this type of framework includes the principles of autonomy and beneficence discussed. It is recognized as a foundation for Bioethics and such documents as the Patient’s Bill of Rights.

Moral Rights Theory – a ‘rights’ view of ethics that is included in professional codes of ethics and bills of patient rights.

Utilitarianism- all actions are judged by their utility. In other words, what worked the “best” and did the least amount of harm?

Casuistry- each situation is examined separately when evaluating ethical decisions, past “cases” similar to the one currently being considered are evaluated for history, precedent, etc.

Narrative ethics- focuses on inter-life narratives (stories) and how they impact with other inter-life stories. You would consider the person’s “background” before making an ethical judgment on their actions. (Butts & Rich, 2018)

Finally, we will consider the core ethical competencies for Advanced Practice Nursing as outlined by Tracy and O’Grady (2019). As a future APN, you are required to master the following skills relating to ethics:

Knowledge Development: the APN should explore and discuss core ethical theories and principles and apply them to clinical situations.

Knowledge Application: the APN should apply the acquired knowledge to their personal area of specialty practice through their actions and the delivery of advanced nursing care.

Creating an ethical environment: the APN is expected to serve as a role model for others through their own ethical behavior. The APN should also take an active mentoring role to foster ethical knowledge development.

References

American Nurses Association [ANA]. (2015). Code of ethics for nursing with interpretive statements. Silver Spring, MD.

Beauchamp, T. & Childress, J. (2013). Principles of biomedical ethics. (7th ed). New York: Oxford University Press.

Butts, J.B., & Rich, K.L. (2018) Nursing ethics: Across the continuum and into practice. (2nd Ed.). Sudbury, MA: Jones and Bartlett.

Carper, B.A. (1978). Fundamental patterns of knowing in nursing. Advances in Nursing Science. 1(1): 13- 24. Retrieved from: http://journals.lww.com/advancesinnursingscience/

Chism, L.A. (2013) The Doctor of Nursing Practice: A guidebook for role development and professional issues. Burlington, MA: Jones and Bartlett.

Johnstone, M. J. (2015). Bioethics: a nursing perspective. Elsevier, Australia: Elsevier Health Sciences.

Savel, R. H., & Munro, C. L. (2015). Moral distress, moral courage. American Journal of Critical Care. doi: http://dx.doi.org/10.4037/ajcc2015738 (Links to an external site.)

Tracy, M.F., & O’Grady, E.T. (2019) Advanced practice nursing: An integrative approach. (6th ed). St. Louis, MO: Elsevier.

National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. (1979). Ethical principles and guidelines for the protection of human subjects of research. Retrieved from: http://www.hhs.gov/ohrp/humansubjects/guidance/belmont.htm (Links to an external site.)

Wocial, L. D. (2018). In search of a moral community. Online Journal of Issues in Nursing, 23(1), 7-7. doi:10.3912/OJIN.Vol23No01Man02

Zaccagnini, M.E., & White, K.W. (2011). The doctor of nursing practice essentials: A new model for advanced practice nursing. Sudbury, MA: Jones and Bartlett.

The following articles provide you with peer-reviewed articles to further enhance your understanding of the theoretical content presented in this Module. Articles that do not have a copyright restriction are included below, and all other articles may be retrieved through the Biomedical Library. Please note that these articles are provided as an example and are not intended to be an all-inclusive listing of peer-reviewed articles available on the topic of Nursing theory.

Grand Nursing Theory Resources

Bender, M. (2018). Re‐conceptualizing the nursing metaparadigm: Articulating the philosophical ontology of the nursing discipline that orients inquiry and practice. Nursing Inquiry, 25(3), e12243. doi:https://doi.org/10.1111/nin.12243

Clarke, P. N., Barone, S. H., Hanna, D., & Senesac, P. M. (2011). Roy’s adaptation model. Nursing Science Quarterly, 24(4), 337-344. doi:10.1177/0894318411419223

Fawcett, J. (1984). The metaparadigm of nursing: Present status and future refinements. Journal of Nursing Scholarship, 16(3), 84-87. Direct link to the article: Fawcett-1984-Metaparadigm of Nursing_Journal_of_Nursing_Scholarship.pdf

Fawcett, J. (2003). Orem’s self-care deficit nursing theory: actual and potential sources for evidence-based practice. Self-Care, Dependent-Care & Nursing, 11(1), 11-16. Orem’s self-care deficit nursing theory_actual and potential uses for EBP.pdf

Henderson, V. (1978, 2006). The concept of nursing. Journal of Advanced Nursing, 3(2), 113-130. doi: https://doi.org/10.1111/j.1365-2648.2006.03660.x

Leininger, M. M. (1988). Leininger’s theory of nursing: Cultural care diversity and universality. Nursing Science Quarterly, 1(4), 152-160. Retrieved from http://libguides.southalabama.edu/c.php?g=314770&p=2565779Links to an external site.

Neuman, B. M. (1990). Health as a continuum based on the Neuman systems model. Nursing Science Quarterly, 3(3), 129-135. doi:10.1177/089431849000300308

Rogers, M. E. (1994). The science of unitary human beings: current perspectives. Nursing Science Quarterly, 7(1), 33-35. doi:https://doi-org.libproxy.usouthal.edu/10.1177/089431849400700111. Retrieved from http://libguides.southalabama.edu/c.php?g=314770&p=2565781Links to an external site.

Middle Range Nursing Theory Resources

The importance of Middle Range nursing theory to clinical practice is emphasized in the linked article by J. Fawcett below. The remaining articles are samples of middle-range theory articles that are found in the peer-reviewed literature. Again, these articles are only a sample of what is available and should not be construed as being a “complete” listing. Your Smith and Liehr textbook provides additional middle-range theories and many more are available to you.

Fawcett, J. (2005). Middle range nursing theories are necessary for the advancement of the discipline. Aquichan, 5(1), 32-43. Retrieved from http://www.scielo.org.co/pdf/aqui/v5n1/v5n1a04.pdf. (Links to an external site.)Fawcett: Middle Range Nursing Theory and clinical practice

Kolcaba, K. Y. (1994). A theory of holistic comfort for nursing. Journal of Advanced Nursing, 19(6), 1178-1184. Kolcaba’s Theory of Comfort

Pender, N. J. (1975). A conceptual model for preventive health behavior. Nursing Outlook, 23, 385-390. Pender’s Health Promotion Theory

Complexity Science Resources

The three articles provided below discuss how complexity science is being used in health care today and how complexity science is related to grand theory. All three articles are excellent resources and a great reference source for this scholarly paper.

Geary, C. R., & Schumacher, K. L. (2012). Care transitions: Integrating transition theory and complexity science concepts. Advances in Nursing Science, 35(3), 236-248. doi:10.1097/ANS.0b013e31826260a5

Florczak, K., Poradzisz, M., & Hampson, S. (2012). Nursing in a complex world: A case for grand theory. Nursing Science Quarterly, 25(4), 307-312. doi: 10.1177/0894318412457069

Plsek, P. E., & Greenhalgh, T. (2001). The challenge of complexity in health care. BMJ, 323(7313), 625-628. doi:10.1136/bmj.323.7313.625

Ethics/Bioethics Recommended Resources:

The ANA updated the Code of Ethics for Nurses with Interpretative Statements, or “The Code” in 2015, and the year was designated the “Year of Ethics”. A link to the ANA website Code of Ethics and other information is provided for you here. ANA Code of Ethics

Beauchamp, T. L. (2003). Methods and principles in biomedical ethics. Journal of Medical Ethics, 29(5), 269-274. Retrieved from https://jme-bmj-com.libproxy.usouthal.edu/content/29/5/269 (Links to an external site.)

Cobb, W. M. (1973). The Tuskegee syphilis study (0027-9684). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/PMC2609060/ (Links to an external site.)

Fowler, M. D. (2016). Nursing’s Code of Ethics, Social Ethics, and Social Policy. Hastings Center Report, 46, S9-S12. doi:10.1002/hast.624 Hastings Center Report: Nursing’s Code of Ethics

Savel, R. H., & Munro, C. L. (2015). Moral distress, moral courage. American Journal of Critical Care. doi:doi: http://dx.doi.org/10.4037/ajcc2015738Links to an external site.

Criteria Ratings Pts
This criterion is linked to a Learning Outcome Introduction & Thesis Statement
1. Introduce the theoretical and ethical basis of advanced nursing practice in one paragraph.

2. Conclude the introductory paragraph with a direct thesis statement that informs the reader of your purpose, or primary objective of the paper.

1.0 to >0.8 pts
Met
The information fully addresses the required content. Thesis statement was well developed.

0.8 to >0.0 pts
Not Met
Minimal or partial information that does not fully address the required element; either an introduction or thesis statement may not be included

0.0 pts
Missing
Student did not address.

1.0 pts

This criterion is linked to a Learning Outcome Nursing Metaparadigm Relationship to POI
1. Identify your chosen POI topic and include a brief summary of current evidence related to the POI

2. Briefly describe the Nursing Metaparadigm and its origin

2. Discuss how each of the four (4) components of the meta-paradigm relate to your specific POI.

3. Support this discussion with at least two (2) current peer-reviewed references in addition to any textbooks, and cite/reference the primary source.

6.0 to >4.0 pts
Met or Exceeds Criteria
The information fully addresses the required elements and demonstrates an understanding of the meta-paradigm of nursing and how it relates to specific POI. Content is well supported with peer-reviewed references.

4.0 to >2.0 pts
Met Minimum Criteria
The information was basic and addressed the majority of the required elements in some manner. Content may not be well supported by peer-reviewed literature.

2.0 to >0.0 pts
Did not Meet Criteria
The information did not address the required content. Content may not be well supported by peer-reviewed literature.

0.0 pts
Missing
Student did not address.

6.0 pts

This criterion is linked to a Learning Outcome Theory
1. Grand Nursing Theory
a. Select a Grand Nursing theory and discuss the inter-related concepts.
b. Discuss your POI within the framework of the Grand Nursing theory selected

2. Middle Range Theory
a. Select a middle-range theory and discuss the inter-related concepts identified
b. Discuss how your middle-range theory “fits” with your grand nursing theory
c. Discuss your POI within the context provided by the middle-range theory

3. Complexity Theory
a. Briefly describe complexity science and complex adaptive systems
b. Discuss your POI within the framework of complexity science; and identify the focus, i.e. organizational, physiologic, or environmental
c. Identify a specific Complex Adaptive System within your POI and discuss the principles of complexity science that impact this system and your POI

4. Support this discussion with at least six (6) peer-reviewed references in addition to any textbooks, and cite/reference the primary source.

10.0 to >6.5 pts
Met or Exceeds Criteria
The information fully addresses the required elements and demonstrates an understanding of theories and how each relates to a specific POI. Content is well supported with peer-reviewed references and primary sources are used.

6.5 to >3.5 pts
Met Minimum Criteria
The information was basic and addressed the majority of the required content in some manner. Content may not be well supported by peer-reviewed literature. Primary sources may or may not have been used.

3.5 to >0.0 pts
Did not Meet Criteria
The information did not address the required content. Content may not be well supported by peer-reviewed literature.

0.0 pts
Missing
Student did not address.

10.0 pts

This criterion is linked to a Learning Outcome Ethical Framework and Principles
1. Identify and discuss an overall ethical framework that will direct your advanced nursing practice.

2. Describe at least two (2) ethical principles upheld in your chosen ethical framework.

3. Explain why the specific framework was chosen and its relevance to your advanced nursing practice.

4. Support this discussion with at least four (4) peer-reviewed references

9.0 to >6.0 pts
Met or Exceeds Criteria
The information fully addresses the required elements and demonstrates an understanding of the POI within the ethical framework. Content is supported with peer-reviewed references.

6.0 to >3.0 pts
Met Minimum Criteria
The information was basic and addressed the majority of the required elements in some manner. Content may not be well supported by peer-reviewed literature.

3.0 to >0.0 pts
Did not Meet Criteria
The information did not address the required elements. Content may not be well supported by peer-reviewed literature.

0.0 pts
Missing
Student did not address.

9.0 pts

This criterion is linked to a Learning Outcome Conclusion
1. Summarize the major points of the paper in one paragraph.

2. No new information or references should be included in this section.

1.0 to >0.8 pts
Met
The information fully summarizes the major points in the paper, without including any new information or references.

0.8 to >0.0 pts
Not Met
The information did not adequately summarize the major points in the paper. New information or references may have been introduced.

0.0 pts
Missing
Student did not address.

1.0 pts

This criterion is linked to a Learning Outcome Scholarship
Demonstrate Graduate Level Scholarship

1. Formal, scholarly writing style with no first-person language.

2. Writing should be clear and concise, and free of grammatical and spelling errors

3. Organize work by headings

4. Writing should be free of APA 7th errors, including citations and references.

5. Full paper (except reference page, appendices, and attachments) submitted to Turnitin, with minimal similarity.

6. College of Nursing approved format for the title page.

7. A minimum of 12 peer-reviewed references (excluding textbooks).

8. Paper not to exceed 10 pages (excluding title page, reference page, and any appendices).

9. Follow all assignment instructions.

10. Additional deductions may apply for late submissions, plagiarism, or lack of scholarship and professionalism.

3.0 to >2.4 pts
Met or Exceeds Criteria
Demonstrates graduate-level scholarship with one (1) to two (2) errors (the error type may have been repeated multiple times). Faculty discretion will apply.

2.4 to >2.1 pts
Met Minimum Criteria
Demonstrates minimal graduate-level scholarship with three (3) types of errors (the error type may have been repeated multiple times). Faculty discretion will apply.

2.1 to >0.0 pts
Did not Meet Criteria
Does not demonstrate graduate-level scholarship with four (4) types of error (the error type may have been repeated multiple times). Faculty discretion will apply.

0.0 pts
Missing
Graduate-level scholarship missing, with five (5) or more types of errors (the error type may have been repeated multiple times). Faculty discretion will apply.

3.0 pts

Total Points: 30.0

National Council of State Boards of Nursing. (2014). A nurse’s guide to professional boundaries. Retrieved from https://www.ncsbn.org/ProfessionalBoundaries_Complete.pdf

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Our Services

No need to work on your paper at night. Sleep tight, we will cover your back. We offer all kinds of writing services.

Essays

Essay Writing Service

No matter what kind of academic paper you need and how urgent you need it, you are welcome to choose your academic level and the type of your paper at an affordable price. We take care of all your paper needs and give a 24/7 customer care support system.

Admissions

Admission Essays & Business Writing Help

An admission essay is an essay or other written statement by a candidate, often a potential student enrolling in a college, university, or graduate school. You can be rest assurred that through our service we will write the best admission essay for you.

Reviews

Editing Support

Our academic writers and editors make the necessary changes to your paper so that it is polished. We also format your document by correctly quoting the sources and creating reference lists in the formats APA, Harvard, MLA, Chicago / Turabian.

Reviews

Revision Support

If you think your paper could be improved, you can request a review. In this case, your paper will be checked by the writer or assigned to an editor. You can use this option as many times as you see fit. This is free because we want you to be completely satisfied with the service offered.