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Unified Model of Patient Safety and Nursing Care


In the modern and complex healthcare systems, models serve as the basis of nursing practice to ensure the delivery of high-quality and accessible care that meets the needs and demands of the patient. Models are developed by nurses who use their experience and expertise to devise frameworks of care that improve the process of care in terms of quality, safety, or efficiency. This essay will identify a nursing care model utilized in a real-world setting and discuss other theories contributing to the discipline.

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Observation Exercise

During the observation exercise, an intensive-care unit was evaluated in an urban medical facility. The unit housed patients with severe traumas, some receiving end-of-life care due to the intensity of injuries that were not sustainable with life. In the high stress and depressing environment, it is difficult for nurses to focus on other aspects except for physical care. However, nurses were encouraged to engage in holistic care in accordance with Watson’s Human Caring Theory.

Nurses attempted to speak to patients and provide gentle encouragement even for those who were withdrawn or unconscious. Nurses sought to recognize each patient as a human being, treating them with dignity, respect, and tremendous care. This included attempting to connect with them, even if the prognosis was fatal. Often, nurses would go out of their way to ensure comfort for the patients and meeting any needs or demands they might have. Nurses attempted to connect with patients on personal and humanistic dimensions.

Model Details

The Human Caring Theory created by Jean Watson is one of the most universally accepted and adopted models of nursing care. It can be used in every aspect of the nursing discipline including education, medical practice, research, and management. Watson viewed nursing as a process of caregiving from one person to another. The purpose of nursing is focused on supporting the patient in achieving harmony with their mind, body, and soul. This would inherently increase the capacity of self-healing. Watson argued that the term “intervention” has a mechanical connotation, instead preferring “caring (healing) factors” (Tektaş & Çam, 2017, p. 441).

The model itself consists of the caring process, moments, occasions, healing modalities, and transpersonal caring relationships. Nursing care should go beyond a physician’s requirements, but provide a holistic, personalized approach to the patient. This can be done by adopting humanistic and altruistic values as well as belief in the other person. Furthermore, the model encourages a scientific problem-solving approach for decision-making and the use of teaching to help patients understand. Overall, the theory seeks to create comfort and serenity in the caring environment and encompass fundamental human physical, emotional, and spiritual needs (Tektaş & Çam, 2017).

In many cases, Watson’s theory of human caring becomes vital in practice when a patient is experiencing a traumatic event. Both scholarly resources selected present the use of the model in women experiencing distress caused by infertility or pregnancy loss, events that create significant psychological pressure. The model is effective at increasing self-efficacy and can be a helpful guide in the adjustment process.

Interventions based on the model help to reduce the impacts of negative outcomes in patients long-term (Arslan-Özkan, Okumus, & Buldukoglu, 2013). Nurses in their role and capacity as caregivers should understand the experiences and feelings that a patient, such as a woman after pregnancy, will encounter. The understanding and insight will allow providing a higher level of therapeutic and sensitive care to the patient, ensuring that a support system is in place to manage both physical and emotional conditions (Tektaş & Çam, 2017).

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Self-Efficacy Model

Self-efficacy is a concept that means an individual’s belief or confidence to achieve the desired outcome through personal behavior and actions to overcome a given situation. A fundamental model of self-efficacy was developed by Albert Bandura in the mid-1990s. An important aspect related to nursing is self-care self-efficacy, or the ability to perform self-care behaviors. Self-efficacy can inherently empower behaviors that lead to positive outcomes.

Therefore, the model suggests that the level of self-efficacy in a patient can be predictive of their behaviors that will influence health-related outcomes. In the context of self-care that would include aspects such as adherence to treatment, self-management, and lifestyle changes, all in order to control the disease. Bandura developed a social cognitive theory suggesting that cognitive mechanisms such as confidence and interaction with others influence self-efficacy, and in turn, self-care (Eller, Lev, Yuan, & Watkins, 2016).

In nursing, this theory is commonly used to design interventions that would increase self-efficacy and lead to better health behaviors. Interventions should be multi-focused with health education, skills practice, and verbal encouragement that would enhance self-efficacy in patients. Shorey, Chan, Chong, and He (2014) apply the concept to postnatal psychoeducational programs in order to increase maternal self-efficacy and social support. Mothers experiencing post-partum depression are noted to have significantly low levels of parental self-efficacy. The intervention utilized Bandura’s model to present social support in the form of positive verbal feedback on a mother’s performance. As a result, baseline self-efficacy levels increased, and this led to lower rates of postnatal depression in the long term.

Improving Patient Safety

A fundamental theory for patient safety commonly utilized in practice is known as Heinrich’s iceberg model. The premise of the model is that most evident and consequential safety concerns are visible, similar to that of an iceberg tip. However, following the metaphor, there is a myriad of other lesser visible safety concerns which may occur more frequently but are not commonly addressed.

Therefore, as a preventive heuristic, if measures are taken against lower-level events, then it is probable that safety outcomes of serious nature can be avoided as safety barriers will appear at a systemic level. The complexity of the healthcare system will inherently create unexpected scenarios as an organization consists of numerous layers that cannot all be predicted or protected. However, the iceberg model in combination with other patient safety initiatives can lead to harm reduction in the long term (Coiera, Collins, & Kuziemsky, 2013).


Watson’s Theory of Human Caring was identified in a practice setting as a driving force to the nursing profession and attitudes of creating a caring and healing environment. The relationship that is formed with the patient allows demonstrating competent care as well as support. As a result, a nurse can encourage patients to gain self-efficacy and independence, leading to positive health behaviors and motivation to improve one’s well-being. Meanwhile, the iceberg model serves as a mechanism to potentially prevent negative patient safety outcomes by taking action against small safety concerns and therefore avoiding large adverse events. This activity demonstrated that a multitude of theories could be utilized in combination while providing nursing care to ensure that the best outcomes and quality of care are achieved.


Arslan-Özkan, I., Okumuş, H., & Buldukoğlu, K. (2013). A randomized controlled trial of the effects of nursing care based on Watsons Theory of Human Caring on distress, self-efficacy and adjustment in infertile women. Journal of Advanced Nursing, 70(8), 1801-1812. Web.

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Coiera, E., Collins, S., & Kuziemsky, C. (2013). A unified model of patient safety (or “who froze my cheese?”). BMJ, 347, 1-4. Web.

Eller, L. S., Lev, E. L., Yuan, C., & Watkins, A. V. (2016). Describing self-care self-efficacy: Definition, measurement, outcomes, and implications. International Journal of Nursing Knowledge, 29(1), 38-48. Web.

Shorey, S., Chan, S. W., Chong, Y. S., & He, H. (2014). A randomized controlled trial of the effectiveness of a postnatal psychoeducation programme on self-efficacy, social support and postnatal depression among primiparas. Journal of Advanced Nursing, 71(6), 1260-1273. Web.

Tektaş, P., & Çam, O. (2017). The effects of nursing care based on Watson’s Theory of Human Caring on the mental health of pregnant women after a pregnancy loss. Archives of Psychiatric Nursing, 31(5), 440-446. Web.

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