Levine conservation model...Nursesoutlook

levine conservation model

 INTRODUCTION

• Born in Chicago, raised with a sister and a brother with whom she shared a close loving relationship


• Also very fond of her father who was often ill and frequently hospitalized with GI problem. This was the reason of choosing nursing as a career.


• Also called as renaissance women-highly principled, remarkable and committed to patient’s quality of care.


• Died in 1996

ACHIEVEMENT

• Diploma in nursing:-Cook county SON, Chicago, 1944


• BSN:-University of Chicago,1949


• MSN:-Wayne state University, Detroit, 1962


• Publication:-An Introduction to Clinical Nursing, 1969,1973 & 1989


• Received honorary doctorate from Loyola University in 1992


• Clinical experience in OT technique and oncology nursing


• Director of nursing at Drexel home in Chicago


• Clinical instructor at Bryan memorial hospital in Lincoln, Nebraska


• Administrative supervisor at university of Chicago

CONSERVATIONAL MODEL

 Goal

• To promote adaptation and maintain wholeness using the principles of conservation.


• Model guides the nurse to focus on the influences and responses at the organismic level.


• Nurse accomplishes the goal of model through the conservation of energy, structure and personal and social integrity.

Two Important Concepts

Adaptation: An ongoing process of change in which patient maintains his integrity within the realities of environment and achieved through the "frugal, economic, contained and controlled use of environmental resources by individual in his or her best interest"



Wholeness

• Exist when the interaction or constant adaptations to the environment permits the assurance of integrity


• Promoted by use of conservation principle

Conservation: Is the product of adaptation and primary focus on "Keeping together "of the life systems or the wholeness of the individual

 Major concepts of conservation model

Person: A holistic being who constantly strives to preserve wholeness and integrity and a unique   individual in unity and integrity, feeling, believing, thinking and whole system of system

 Environment: Completes the wholeness of person. The individual has both an internal and external environment.

Internal environment

• Homeostasis: A state of energy sparing that also provide the necessary baselines for a multitude of synchronized physiological and psychological factors


• Homeorrhesis: A stabilized flow rather than a static state, emphasis the fluidity of change within a space-time continuum.

External Environment

• Perceptual: Aspect of the world that individual are able to intercept.


• Operational: Elements that may physically affects individuals but not perceived by them: radiation, micro-organism and pollution


• Conceptual: Part of person's environment including cultural patterns characterized by spiritual existence, ideas, values, beliefs and tradition.

 Health: Is a wholeness and successful adaptation. It is not merely healing of an afflicted part, it is return to daily activities, selfhood and the ability of the individual to pursue once more his or her own interest without constraints .

Disease: It is unregulated and undisciplined change and must be stopped or death will ensue

 Nursing:"Is a profession as well as an academic discipline, always practiced and studied in concert with all of the disciplines that together from the health sciences"

• The human interaction relying on communication ,rooted in the organic dependency of the individual human being in his relationships with other human beings


• Nursing involves engaging in "human interactions"

Person and environment: Levine’s conservation model discussed that the way in which it become congruent over time

1. Adaptation: The specific adaptive responses make conservation possible occur on many levels; molecular, physiologic, emotional, psychologic, and social. These responses are based on three factors:

 Historicity: Adaptations are grounded in history and await the challenges to which they   respond

 Specificity: Individual responses and their adaptive pattern varies on the base of specific genetic structure

Redundancy: Safe and fail options available to the individual to ensure continued adaptation

Organismic response: A change in behavior of an individual during an attempt to adapt to the environment and helps individual to protect and maintain their integrity. They are four types:

Flight or fight: An instantaneous response to real or imagined threat, most primitive response

 Inflammatory: Response intended to provide for structural integrity and the promotion of healing

Stress: Response developed over time and influenced by each stressful experience encountered by person

Perceptual: Involves gathering information from the environment and converting it in to a meaning experience

Four Conservational Principle:

These principles focus on conserving an individual's wholeness. Her framework includes:

Conservation of energy: Refers to balancing energy input and output to avoid excessive fatigue. It includes adequate rest, nutrition and exercise.

Example: Availability of adequate rest, Maintenance of adequate nutrition

Conservation of structural integrity: Refers to maintaining or restoring the structure of body preventing physical breakdown and promoting healing.

Example: Assist patient in ROM exercise, Maintenance of patient’s personal hygiene

Conservation of personal integrity: Recognizes the individual as one who strives for recognition, respect, self awareness, selfhood and self determination.

Example: Recognize and protect patient’s space needs

4. Conservation of social integrity: An individual is recognized as someone who resides with in a family, a community,a religious group, an ethnic group, a political system and a nation.

Example: Position patient in bed to foster social interaction with other patients, Promote patient’s use of news paper, magazines, radio. TV and Provide support and assistance to family.

 Nursing Process

• Assessment


• Trophicognosis


• Hypothesis


• Interventions


• Evaluation

• Collection of provocative facts through observation and interview of challenges to the internal and external environment using four conservation principles


• Nurses observes patient for organismic responses to illness, reads medical reports. talks to patient and family


• Assesses factors which challenges the individual

• Nursing diagnosis-gives provocative facts meaning


• A nursing care judgment arrived at through the use of the scientific process


• Judgment is made about patient’s needs for assistance

• Planning


• Nurse proposes hypothesis about the problems and the solutions which becomes the plan of care


• Goal is to maintain wholeness and promoting adaptation

• Testing the hypothesis


• Interventions are designed based on the conservation principles


• Mutually acceptable


• Goal is to maintain wholeness and promoting adaptation

• Observation of organismic response to interventions


• It is assesses whether hypothesis is supported or not supported


• If not supported, plan is revised, new hypothesis is proposed

Applications

1. Nursing research


2. Nursing education

• Principles of conservation have been used for data collection in various researches


• Conservational model was used by Hanson et al.in their study of incidence and prevalence of pressure ulcers in hospice patient

• Conservational model was used as guidelines for curriculum development


• It was used to develop nursing undergraduate program at Allentown college of St.Francis de sales, Pennsylvania.

3. Nursing administration

• Taylor described an assessment guide for data collection of neurological patients which forms basis for development of comprehensive nursing care plan and thus evaluate nursing care


• McCall developed an assessment tool for data collection on the basis of four conversational principles to identify nursing care needs of epileptic patients

4. Nursing practice

• Conservational model has been used for nursing practice in different settings


• Bayley discussed the care of a severely burned teenagers on the basis of four conservational principles and discussed patient’s perceptual, operational and conceptual environment