[Link].

,XXV(1):9-18, 2007 RESEARCH

Application of a care model

in the Gynecology and Obstetrics service
from the Bolivarian University Clinic

Implementation of a nursing model in the

Gyneco-obstetrics service
of the Bolivarian University Clinic

GLORIAÁNGELJIMÉNEZ,
* MARTHALIGIAECHEVERRIURIBE,
** YAMILECASTROBETANCUR
***,

MONICAARBOLEDAALVARÁN
****NATALIAZAPATARIVERA
****,

ANACRISTINAARANGORAMÍREZ
**** NATALIA SÁNCHEZ SÁENZ,
*****

BLANCALILIANATOBÓNTOBÓN*****

Summary its degree of applicability in the clinical field, likewise,

a series of theory-practice integration experiences. It

Obstetrics and Gynecology Department of the University Clinic

project that aimed to apply in the hos-

Bolivarian (CUB) a model of care centered on the pa-

they chose the theoretical foundations of Virginia Henderson
to guide the care, because the group identified with its
philosophy and concepts, focused on the satisfaction of needs-
patient and nursing. It was developed in phases, under a method-
sides of the person, among other reasons. During the phase of
qualitative-quantitative methodology. Through a descriptive study,
operational design established the need to work on
made an initial diagnosis of professional care: case-
in accordance with the Nursing process; they were defined and operate
feeding, systematization, documentation, continuity, in-
individuality, integrality, closeness, interdisciplinarity, They categorized the most frequent nursing diagnoses.
coordination, differentiation, visibility and quality. It was concluded - by patient group and by needs; the re-
I know that there are areas of care that need to be addressed; respective clinical records and centered educational leaflets
on needs. During the implementation, the following activities were carried out
systematization, closeness, documentation, and visibility are
some of them. In the documentation phase, they were studied the defined processes. Currently, activities are being developed
the principles of various nursing theories for determining of monitoring and maintenance, focused on capacity-
education and research. The impact will be measured once it
consolidate the model. It is expected that this project will be an example-
Nurse, Master's in Management for Development.
Research Professor School of Nursing University plan to develop similar experiences in other services
[Link]@[Link] clinicals.
Nurse, Master in Public Health. Chief
Department of Nursing, Bolivarian University Clinic Keywords: nursing model, nursing diagnosis
[Link]@[Link] mercy, nursing care, needs.
Nurse, specialist in IPS management.
Coordinator of Hospitalization Maternal and Child Unit CUB.
mycbupb@[Link] Abstract
Head Nurses, Maternal and Child Unit (CUB).

UPB.
Undergraduate students of the Faculty of Nursing

Received:11-08-06 Approved: 15-06-07

A project whose goal was the implementation of a nursing
model focused on patient and nursing at the Uni Clinic
Bolivarian University’s (CUB) gyneco-obstetrics service.

9
 ADVANCES IN NURSING· VOL. XXV No. 1

model was developed phase by phase, under a quality and says how to observe and interpret the phenomena of inter-
quantitative methodology. An initial diagnosis of the professio- summary of the discipline (1).
Nursing care was done through a descriptive study: Bases, system
Developing nursing practice having
tization, documentation, continuity, individuality, integrality,
closeness, interdisciplinary, coordination, differentiation, visi- as a reference, a conceptual model provides a
bility and quality. We concluded that there are fields in caring disciplinary and professional orientation. This action allows
that require intervention; systematization, documentation and to integrate theory into practice, to move from the phase of
visibility among others. During the documentation phase, the construction of the theory to the phase of utilization of the
Principles of several theories of nursing were studied in order the same. This gives dynamism to the scientific cycle and makes
to determine the degree of applicability in the clinical field, as
that the disciplinary component of Nursing develops
well as a series of experiences of theoretical-practical integration
Virginia Henderson's theoretical fundamentals for guidance. meria.
ding care were chosen because the group identifies itself with On the other hand, the application of conceptual models
her philosophy and rules, focused on satisfying the person's The practice favors the research of diseases.
needs among other reasons. During the operational designing river, to the extent that it focuses on the study of
phase the need to work according to the Nursing process was phenomena of particular interest to the profession. The
established; the most frequent nursing diagnosis was defined
the model provides a framework that seeks to
and made operational per patient group and per set of needs;
the relevant clinical records and educational brochures were to know, describe, explain, understand and inter-
designed focused on needs. During the implementation phase, to deprive everything that has to do with care.
[Link],followupand In this way, theory is created and the field is strengthened.
maintenance activities focused on training and research are in disciplinary network (1).
the process of being developed. The impact will be measured Base the practice on a conceptual model
once the model is consolidated. We expect this project to be an
[Link]-
example to develop similar experiences in other clinical
services.
nursingprofessional,Iachievedgreatersatisfaction,self-
[Link]
nursing model, nursing diagnosis, nursing care
to the supportive action as it guides the practice of Nursing
obstetrics service.
aiming towards achievement of
own goals, already
INTRODUCTION be the independence
Nursing has achieved very significant theoretical achievements. as a person, your ca-
important during the last century, which has capacityforself-care
given the recognition as a discipline. Today it is accounted for of, the adaptation to its
with philosophies, conceptual models, theories of level process, among others.
medium, grand theories, among other theoretical developments
cos. Each of these conceptual elements struct-
turn the science of Nursing and in this way
become key references for the
profession.
From a theoretical point of view, a model with-
Conceptual is a set of organized concepts.
coherently and interrelated to each other that it
they serve as a frame of reference for the people who do
part of a specific discipline. It is composed of
a series of symbolic representations in the form of
structure that guides the problem-solving process
problems. It behaves as a reference to the extent that

10
 APPLICATION OF A CARE MODEL IN THE OBSTETRICAL-GYNECOLOGICAL SERVICE OF THE BOLIVARIAN UNIVERSITY CLINIC

Additionally,conceptualmodelsallowthestaff place the function oriented towards the direct care of the per-
ofnursing,toorganizeandunderstandwhatishappeninginthe dreams. For its part, this caregiving activity has been
practice,analyzethesituationsofthepatientsinapropermanner oriented to the concrete, to the execution of activities
criticism to make decisions, plan the care and specific, to biological assistance, to the use of technology-
proposethemostsuitableinterventions,definethere- guides, without adequate professional theoretical support. This
expectedresultsofthepatientregardingcare has not allowed to create and project a complete image
provided and evaluate its effectiveness (1). All of this has an im- of what Nursing is and has hindered its growth
positivepactinthequalityofpatientcare. as a professional discipline.
Given the magnitude of the advances achieved in the This situation shows the need to develop
field of care theory and the importance of its a nursing practice focused on the care of the
application in practice, a greater use would be expected people and that it is carried out with reference to
tion of the existing theory in different areas of rents the existing theory. To reach the planned objective.
care; however, this has not yet been achieved, since it is necessary for professionals to acquire
to a large extent, the science of Nursing has remained a solid conceptual base that allows for clarification of the
It is in theory and has not yet been integrated into practice. nature of the care they provide and guide everything the
Alberdi and collaborators (2) support this appreciation. nursing process. Various experiences develop-
by stating that nursing practitioners have reached in the national and international sphere have demonstrated
there is an important consensus regarding the definition trade that it is possible to put the theory into practice
generic care, according to theoretical approaches nursing, and moreover, it is important to do so since the
rich, but in the realm of practice, they are far from patients, professionals, and institutions benefit
achieve a real consensus on the meaning and the this (4), (5).
consequences of care or caring. They consider that The stated approaches highlight the importance of
the concept of care has been left in 'the conceptual' the importance of generating experiences in our environment that

which requires reconsideration since the contribution of Nursing- show the possibility of uniting theory and practice and the
Mería is unique, indispensable, and irreplaceable. benefits that this implies. In this context arose the
Similarly, the Colombian nurse Castri- This work aimed to choose a mo-
llón, C. (3) considers that in Latin America it is scarce the conceptual work and apply it in practice, based on a
work that has been done regarding the models concrete reflective and investigative project, adapted to
conceptual, particularly at the research level and specific context. The strategic link established
Add that in the research colloquia in Nursing- between the Faculty of Nursing of the University Pon-
Bolivarian University (UPB) and the Bolivian University Clinic
the topic has had little presence. This situation
has not allowed for the full benefit of the existing theoretical background variana (CUB) for this purpose, thus became the
possibility of innovating in this field and achieving benefits
attempt that has been systematized in the conceptual models
tangible benefits for both, in terms of disciplinary development
with the aim of guiding actions in the field of
linear, professional and institutional.
Nursing, to demonstrate their contribution to the team of
health and make known the nature of the service that pres-
to society. METHODOLOGY

In Colombia the situation is similar; the experience Type of study: the project was developed under a
as it indicates. What plan- is not well understood. qualitative-quantitative methodology. The quantitative component-
the nursing theories, moreover, they are few the narrative was descriptive in nature and helped to characterize,
institutions that have tried to guide the work pro- in the first phase of the study, nursing care
professional under a specific conceptual model. The la- would be provided in the chosen service. For its part, the com-
nursing graduates in health institutions have had qualitative speaker was based on the principles of the in-
an administrative emphasis and has remained in a second action-research-participation, among them, the

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 ADVANCES IN NURSING· VOL. XXV No. 1

permanent combination of reflection-action and the par- Stage 1. Setting. It was developed for the purpose of
protagonist participation of the subjects involved, in to promote in the clinic and the chosen service, the am-
in this case, the nursing professionals. In this way- favorable environment for the start and development of work.
A participatory diagnostic work was developed. Various meetings were held for informational purposes,
with, discussion, construction and validation that resulted in of motivation for change and training regarding
result a new care proposal to be to the research topic.
applied in the service. Stage 2. Diagnosis. Sought to identify the c-
Population-service: the Gine service was chosen. general characteristics of impartial professional care
obstetrics of the CUB for the development of the project. held in the service. To this end, a study was developed.
The following factors favored this choice: the descriptive, in order to make an initial diagnosis
recent opening of the service; the profile of the professional- which served as a basis for the election, implements-
nursing staff, especially the favorable disposition implementation and subsequent evaluation of the care model
talk about the change and interest in development of selected. Through surveys answered in
investigative processes; the type of patients that anonymous forms addressed to the nurses of the service-
they manage the service (mother and son), which can hi, medical professionals and other therapists of the
it can be easily divided into groups according to its diagnosis health team, nursing assistants and a group-
Tico; the characteristics of attention, as it has representative of patients, knowledge was explored
a high component of nursing care; and in lie and the perception they had about the
last term, the service conditions, among following aspects of professional care: visibility,
them, the high bed turn and the occupancy, which scientific foundation, legal and ethical bases, system-
they present caregivers with special challenges that they must nuancing, documentation, continuity, individuali-
to be properly attended to. dad, integrity, closeness, interdisciplinarity
Technique and instruments: the project is developed coordination, differentiation, and quality. The info-
rolled through the following stages: setting, The collected data underwent a quantitative analysis.
diagnosis, theoretical documentation, documentation Stage 3. Theoretical documentation. With the aim-
practice, theoretical design, practical-operational design, im- I had to identify the general guidelines of the mo-
implementation, monitoring-maintenance and mediation gifts and nursing theories that offer greater
tion of the impact. Each of them had its objective and possibility of application in the clinical field. It proceeds-
specific methodologies. The phases that were considered I am gathering bibliographic material related to the
information gathering using forms is- theme and then analyze the information based on the
structured to deliver it. specific interests. Of the different models or theories-
Analysis: the work combined quantitative analysis the following were studied: concept of person,
and qualitative of the information collected in corres- care, environment, and nursing that is worked on; elemen-
correspondence with the general methodology of the work and the specific theoretical guidelines that are based on the model or
emphasis of each of the stages. It was in this way that the results- theory, and applicability of the model or theory to practice.
Data obtained in the diagnostic stage had a Stage 4. Practical documentation. The stage
quantitative management, based on obtaining the fr- sought to analyze the main characteristics that have
absolute and relative frequencies of the studied variables I have other similar experiences in the national scope.
the. For its part, the information collected in the phases international. Various articles were studied that do-
theoretical and practical documentation was subjected to a they documented experiences on the application of the theory to
qualitative analysis. the practice. The following were identified and analyzed
The following stages are announced: characteristics of each experience: of the field or group
calls and expands on the methodology used in population where it was applied; theory or model that guides
each one of them: it was the work; strengths of the model or theory;

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 APPLICATION OF A CARE MODEL IN THE GYNECOLOGY-OBSTETRICS SERVICE OF THE BOLIVARIAN UNIVERSITY CLINIC

instruments designed and used; the way in which they maintenance, for its part, focuses on activities
application and benefits obtained. of training and research about the theoretical model
Stage 5. Theoretical design. Specify the model chosen and of the nursing process. It seeks that the per-
theoretical framework that would guide the care was the objective of this personal finance everything corresponding to the needs
stage. After analyzing the results obtained in the of the person in thought and action.
previous stages, the model to follow was selected, to the Stage 9. Impact measurement. Stage proposed to
light of the following criteria: simplicity, applicability, future through which it is intended to measure the impact on-
ease of understanding and adaptability to the type of pa- canceled. Once the model is consolidated in the service,
clients and to the institutional characteristics. Of the mode- they will be evaluated through a qualitative-quantitative study
the chosen theory took up the guidelines those aspects that were intended to be improved with the apli-
general and specific more aligned with the thought of model's location, including autonomy, visibility-
group to be applied in practice. dad and professional satisfaction. The quality of care
Stage 6. Practical-operational design. It was carried out it must also have a higher rating, in sp
end of designing the operating model that leads- Such the aspects evaluated in the diagnostic phase. Thus
the chosen theoretical model was put into practice. It was studied same, the institutional indicators related to
previously what has been taken into account in other in- nursing care must have a modification
investigations or in other institutions in the design phase positive over time, among them: the opportunity, following
Well, to determine the importance and relevance of relevance, continuity and satisfaction of the
consider them in the present work. Then, it is designed- patients.
they adjusted and validated the necessary instruments
to make the model operational (clinical sheets and forms - RESULTS
educational molds). The design and standardization of the for-
In accordance with the applied methodology, the resul-
The materials were made by consensus of the group, based on the
They will show the conclusions in a detailed manner.
main needs of the mother and the newborn
neither the achievements obtained in each of the stages
the most relevant nursing diagnoses and the inter-
developed according to its nature.
necessary interventions at the time of admission, during
the hospitalization and at the time of discharge. For the defi-
definition of Nursing diagnoses was used the Setting
International Classification of the North American Nur- The development of the projected activities allowed for
Nursing Diagnosis Association (NANDA) from the year 2005 achievingtheobjectivesofmotivationandinformationproposes
2006. two. Through meetings with the groups, one
Stage 7. Implementation. It aimed to carry out theyidentifiedfeelingsforandagainsttheproject
to the practice the chosen model. Considered pre-actions [Link]-
motivation, training and adjustment to the conditions positive signs were considered that the research allowed
conditions of the clinic, especially regarding availability strengthentheroleofthenursingprofessionalintheinsti-
nursing professionals in service. tuition,totheextentthatitfocusesitsmanagementonaspectsof
Stage 8. Monitoring-maintenance. specific care based on the theory of
Theseactivitieshavebeenproposedonapermanentbasis. existing nursing. Additionally, it was assessed that the project
Theyobeytheinterestofmonitoringtheapplicationofthemodel outsideofNursingandthatthiswouldnotremainin
agreement with the established plan and seek to improve a greater do- thediagnosis,butratheradvancedtotheapplication.
staff reduction in all matters related to the MIS- On the other hand, initial feelings were detected.
The follow-up aims to identify of fear of change. For the staff, the gene project-
various difficulties, analyze them and make the adjustments would be a new way of working, with more activities and
pertaining to the processes and instruments developed. The a demand for more time; moreover, it was thought

13
 Advances in Nursing· VOL. XXV No. 1

that the characteristics of the service would hinder the im- Nursing and confronting it with the paradigm concepts
implementation of it. It was important to explain that mathematics that guide the profession in order to verify if
putting a model into practice implies a change, but there is a related thought in this regard (6).
this had to adapt to the institutional conditions and Thefollowingaresomeoftheassumptions
of the service, such as: bed turn, type of patients, theoretical frameworks related to the act of caregiving that are chosen
number of nurses/patients, occupancy percentage These constitute general approaches apply-
nal, functions assigned to the professional, among others. twooncare,guidelinesfornursingpractice,
duetotheirapplicability,regardlessofthemodel
Diagnosis ortheoreticalthatworksonthem(1),(7),(8),(9).
The patient must be evaluated and cared for as a
The quantitative results obtained in this stage,
be bios psychosocial (Virginia Henderson).
they allowed to conclude that there are characteristics of the cui-
The nurse needs to know individuality
professional data – or specific aspects related
of each patient to personalize care, plan
with these - which appear stronger and others weaker
Carlo, implement it and evaluate its results (Roper,
In the first group is the ethical foundation
Logan, Tierney).
of care (86.54%) and its coordination
It is important to value verbal behaviors and
(76.92%). In the second, there are characteristics.
non-verbal cues of the patient (Ida Orlando).
like the documentation of care (36.00%), the sys-
It is important to value everything related to
the nuance of the same (46.15%), the proximity (55.77%) and
the processes of human development, as well as the conditions-
the integrity (61.53%). Regarding the visibility pro-
actions and events that occur during the life cycle (Do-
It was found that 25.94% of the patient group
wrote Orem).
you were not aware of the professional at the time
The nursing intervention is more effective under
from the survey.
conditions for open communication, as they are necessary
The development of this initial descriptive study evidences
patient data can be perceived more accurately
denounced the need to have a nurse-patient relationship
(Ida Orlando)
of greater significance, focused on care,
It is important for the nurse to verify with the
that contributes to achieving the stated objectives for
patient if your observations are correct (Virginia
each patient, and at the same time, allows to strengthen the image of
Henderson); obtain the patient's confirmation with
nursing professional in the memory of each one of
[Link]
regarding their perceptions, thoughts, and feelings
tos (Ida Orlando); analyze and validate continuously with the
What this work proposes to achieve it
patient's interpretation of their needs
raised.
Ida Orlando
Nurse and patient always work to
Theoreticaldocumentation achieving a goal (Virginia Henderson).
The study of the following theories allowed the group The client-human-patient-user possesses
reflect on the concepts of the metaparadigm of an active role in negotiating the objectives of cui-
Nursing (human being, care, health, environment and in- nursing gift (Ida Orlando).
nursing), and identify the most relevant theoretical assumptions. The nurse and the patient must work on in
They are: Virginia Henderson, I attach the care plan (Virginia Henderson).
Dorotea Orem, Sor Callista Roy, Betty Neuman, Evelyn The foundations of the nurse-patient relationship go-
Adam, Nancy Roper, Winifred Logan and Alison Tierney, they are dependent on the patient's condition (Virginia Henderson).
Ida Jean Orlando, Ramona Mercer, Dorothy Yohnson and The close relationship that the nurse has with
Imogene King (1). It was considered important to clarify des- the patient can be therapeutic in itself (Virginia
from the outset, the very philosophical position regarding Henderson).

14
 APPLICATION OF A CARE MODEL IN THE OBSTETRIC-GYNECOLOGY SERVICE OF THE BOLIVARIAN UNIVERSITY CLINIC

The nurse uses interpersonal relationships Theoreticaldesign

read as a basis (Go Orlando). Based on the results and conclusions obtained
A nurse-patient situation occurs when they saw in the documentation phase proceeded to choose
there is a contact between a patient and a nurse, the theoretical model to follow. The selection favored
in which both perceive, feel, and act in a way that is in- Virginia Henderson and her theory of basic needs
mediata (Ida Orlando) case, for the following reasons (1), (7):
The effectiveness of nursing care is seen de- • Group affinity with its philosophy and its concep-
finished by the climate of empathy, warmth, respect mu- theoretical tools, focused on human needs.
your, care and acceptance (Evelyn Adam). The theoretical concepts are easy to understand.
The nurse works in coordination with others. both for professionals and for assistants of
health professionals, all members of the team Nursing.
they work together to carry out the program
It is easy to apply in the chosen service.
complete with care (Virginia Henderson).
• Their concepts have had durability in the
time.
Practicaldocumentation
It has a high adaptability to groups of patients.
The study of different experiences of application of the
different, in this case, that of childbirth mothers
theory to practice allowed us to draw these conclusions
normal or cesarean, that of newborns and that of the ma-
that constitute important guidelines for the
high-risk obstetric dress.
monitoring of the current study (1), (4), (5), (8), (10)
• The experience can easily be replicated.
(11), (12), (13), (14):
CIA in other services of the institution.
• The approaches of Dorothea Orem and Virginia
The studied practical experiences show
Henderson guides many of the study experiences.
that their proposals have been put into practice with
this indicates that they have a good applicability to the
success in other hospitals. Some of them are the Hospi-
clinic.
Queen Sofía of Spain (14) and the National Institute of
The application of models to practice requires
a creative adaptation that takes into account the characteristics
Cardiology 'Ignacio Chávez' of Mexico (4).
characteristics of the institutional context. From the chosen theoretical model, it was resumed,
previously, the concepts of the metaparadigm, as well as
The application of the models to practice is focused on
the general and specific guidelines of the theory of
largely in the nursing process as
Virginia Henderson, more aligned with the thinking of the group-
tool. The process includes assessment, identifies-
identification of the problems (diagnosis), establishment of
to be applied in practice (1), (7). A continuous-
some of them are raised:
goals, intervention, and evaluation.
It is common to observe that the evaluation of needs...
Assumptions:
universities are complemented by nursing diagnoses
North American Nursing Diagnosis Every person (mother or newborn) is a whole
Association (NANDA). complex that has basic needs.
The assessment of patients is developed with Everyone wishes and strives to be independent.
based on the theoretical perspective. The existence of a for- pending.
pre-established method helps in this process because uni- When a need is not satisfied, the per-
facing criteria. Sona loses independence.
The nursing documentation system
must be structured based on the chosen theory. Beliefsandvalues:
It is common to find care plans that are Integralness, individuality, communication, planning-
standardized and at the same time individualized. action, teamwork, autonomy.

15
 Advances in Nursing· VOL. XXV No. 1

Elements: • Definition and standardization of processes: input-

of the patient, care planning, follow-up,
• Objectives: to maintain, improve, or recover the in-
patient discharge.
dependency of the mother and the newborn in relation
with the satisfaction of basic needs.
Beneficiary: person who requires care of Implementation
nursing in a specific health situation: mother and Carrying out what is established constituted the stage
newborn. more significant of the project. The nurses who par-
theyre-
• Role: to supplement and/or complement the mother and the participated, directly executed the process; moreover,
one born in the performance of activities that contri- they became multipliers with the rest of the teachers
they buy to satisfy needs. service professionals; reported what happened each day to
Source of difficulty: obstacles or limitations regarding; they received concerns and sought solutions
personal or environmental factors that change at a moment to the same ones.

given the capability of the mother and the newborn to sa- The main obstacles during the implementation phase
satisfy their basic needs. implementation were:
Intervention: actions developed by the teacher The available time of professionals to de-
professional interventions aimed at supplementing, helping, or accompanying the patient to develop the different planned activities.
in the satisfaction of their needs. The high administrative and operational burden of its

Consequences: the satisfaction of needs work.

altered in the mother and the newborn and the man- The characteristics of the service, especially the
entertainment for those who are not. high bed turnover, and therefore, a number of high cases per day
considerable.
The existence at night of a number more li-
Practical-operationaldesign
half of the nursing staff to cover the service
The development of this phase resulted in the following of gynecology and obstetrics (surgery and hospitalization).
your products: The integration with the auxiliary staff in certain
Classification of service patients into three processes.
large groups: patients with normal delivery or cesarean section, The involvement of nurses from other services
high-risk obstetric patients and newborns. to the new job.
Selection of nursing diagnoses that The main obstacle had to do with time.
they occur more frequently in the service. that it was carried out the different processes and the
List of diagnoses by patient group registration of the same, in a service that is characterized
clients and for needs. due to the high bed turn. This warranted changes, among them
simplify clinical records, delegate activities in-
Operationalization of each of the diagnoses
operational nurses, optimize the rounds of
as chosen: diagnosis, manifestations, factors
nursing and the medical round, among others.
related, interventions, and outcomes.
It is concluded that during the implementation phase
Preparation of instruments-clinical sheets for
they are definitive: everyone's commitment, flexibility
orient and document the valuation in the income, the ela-
for change and the creative solutions that arise to
preparation of the care plan, the follow-up during the
difficulties that arise.
hospitalization and the evaluation/education to carry out
in the outflow.
Monitoring/Maintenance
• Creation of educational brochures for guidance
the care of the mother and the newborn, according to The monitoring was carried out in parallel with the implementation.
needs. and it is believed that it should continue over time, since

16
 APPLICATION OF A CARE MODEL IN THE OBSTETRICAL GYNECOLOGY SERVICE OF THE BOLIVARIAN UNIVERSITY CLINIC

it is important to determine on a 'day-to-day' basis how things are going The nursing care is based on the history-
developing nursing processes, and see if they clinical ria. There is a space in history for the
are adjusted to the established model. The follow-up must be professional.
video to make the necessary adjustments and show new- It has been made explicit in the Development Plan
you will find ways to perform the work. the clinic aims to extend and adapt the model to the
The maintenance of the model, for its part, is fun- other services.
foundations in continuous training and research.
The development of this type of activities must strengthen CONCLUSIONSANDRECOMMENDATIONS
the thought and action of all the staff around
The development of the present research experience
from the needs of the patient, according to the li-
allowed to draw the following conclusions:
theoretical framework of Virginia Henderson, likewise,
In Nursing, it is necessary to unite theory to
strengthen the thinking and action of professionals
practice. Any effort made in this direction
the issues in the nursing process.
will promote their disciplinary and professional development and helps
will change the current situation.
Measurementofimpact
There are fields of professional care that di-
According to what is presented in the methodology chapter you can modify it if you want to have a more forceful role
This stage will take place once it has been consolidated. Dental in hospital services focused on
given the new established processes. For this, it patients. The closeness, the visibility, the systematization
a study similar to the one developed in the phase of and the documentation are some of them.
diagnosis. The application of a care model to the practice
Itwillbeanalyzedwhethertheprofessionalsstrengthenedthebond. tica based on existing Nursing theory requires the
theory-practice;iftheystrengthenedtheknowledgeaboutthe creative adaptation of it to the specific context.
discipline; if this new way of working provides them Guide the practice under a care model
greater visibility, autonomy, personal satisfaction requires changes in being, thinking, and in
professionalmeaning;iftheworkunderamodelimprovesthe task of professionals. These changes must be
quality of care in the service; and ultimately, if to warm up properly if you want the process to
TherehavebeencurriculumimprovementsintheNursingprogram. carry out without major setbacks. The active participation
meritderivedfromthisexperience. it goes to the people directly responsible in all
As of the date of the publication of this article, the required phases favor change.
nursing professionals from the service have detected The term of needs is very specific to
the following advantages derived from working under a mo- Nursing. Their work surrounding them can
specific care work. They are: mark the difference between Nursing and Medicine, and of
There is a greater foundation for the practice this way, give greater autonomy and meaning to
based on the existing theory in Nursing. professional.
The relationship of the profession has been strengthened. The nursing process in all its stages,
nurse-patient: more personalized care greatly complements the work oriented by
yes, greater knowledge of the patients, better needs. It is a tool that systematizes the
daily tracking of the same. thought and practice of the professional.
The nurse is observed to be closer to the pa- The current experience and other similar ones that are
patient during admission and discharge. they have given in other contexts, they point out that it is impor-

Needs and complications are detected that aunt carry out the process in stages. Some of
they used to go unnoticed in a more they are: setting, initial diagnosis, docu-
opportune. feeding, operational design, implementation, follow-up
Teamwork has been strengthened. maintenance and upkeep.

17
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• The design of proprietary records focused on theHENDERSON, [Link] nature of Nursing.

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