Nursing care can vary from one hospital, community and from one country to the other. The model also varies but most depict the stages involved which are the assessment, planning, implementation as well as evaluation. The use of logic and systematic approach to care by way of application of models and theories as a guide is evolving as opposed to previous task oriented approach .Nursing models form the basis for nursing care and is both scientifically based and systematically structured (Fawcet 1995).Correct application of Nursing models gives direction as well as guides nurses while it shines light on their understanding of logic behind every step taken .It guides, lessen disagreement among nursing team and the advantage of this is that it brings about continuity of care received by patients(Pearson etal, 1996).According to Roper, Logan and Tierney model, eventhogh living activities are essential component, individual however executes the activities differently on a daily basis and ‘this individuality can be seen to be a product of the influence on the activities of all the other components and the complete interaction and association between them’ (Roper et al, 1996).To improve independence of living activities, the model makes use of the nursing process to structure logical stages for nursing care delivery.
This attempts to find out the importance and value of the model in nursing practice to the patient care(Angleton and Chamber,2000).The steps for evaluation of this models used by nurses was given in 1992 by Cormack and Reynolds. By this, a nurse is strengthened to utilize his or her informed judgment of the appropriateness of a particular model to his or her chosen nursing field. In Fraser’s word: “Roper, Lugar and Tierney’s activities of living are just the physical or better still physiological approach to patients’ assessment.” Newton opposed this by referencing 5 factors underlying and influencing activities of living .This affords nurses the opportunity to assess patients as a whole rather than concentrating on the ‘presenting signs and symptoms,’ incorporating all the 12 activities of living. For instance, in using the model to assess planning and implementing the care of an infant A in neonatal intensive care unit, the baby’s nurse has the tendency to be early engaged in baby’s ventilation, temperature and BP while overlooking the patient’s as well as his own psychological needs which are basic at that point in time. Some authors are of the opinion that the model places physical assessment over psychological assessment. It could however be debated that this is just a reflection on the model users and not the model itself.
Analyzing and understanding the model
It is a fact that difficulty often arises among nurses in comprehending the model and this subsequently leads to lack of use. On the contrary, Girot accused Roper, Logan and Tierney on the simplicity of the model which is responsible for its popularity. Roper, Logan and Tierney model has been popular in UK and Europe and it’s been included in American textbooks and even translated to 8 languages (Tierney, 1998), with emphasis being placed on its cultural and geographical convenience and manageability .Research could not however find out the validity of the model despite the fact that its use dated to 20 years ago .Similarly, the model lacks testing (Fraser, 1990).A good model ought to be reliable, valid and well tested according to Reynolds and Cormack. Assertion was made that the model has the potential to generate further research and question has been raised on the rationale behind testing and whether “models can and should be tested” (Tierney, 1998).
Nursing models gives bearing to nursing care .There is wide acceptance of the Roper Logan and Tierney model (1996) in both UK and US in which the patient is assessed on the basis of whether he can perform the 12 activities of living in relation to his or her level on the lifespan as well as his or her position on the scale of dependence/independence. The objectives of care plan are jointly agreed upon among patient, nurse and the family .In the long run, care evaluation is done to find out whether or not the objectives are achieved or need revision. The Roper, Logan and Tierney model gives reasonable, orderly and organized means of care delivery which allows for team participation with resulting primary care and its continuity with elimination of the 1960’s nursing style of task allocation (Roper etal, 1996)
Aggleton, P., Chalmers, H. (2000). Nursing Models and Nursing Practice. (2nd Ed). London: Macmillan.
Fawcett, J. (1995). Analysis and Evaluation of Conceptual Models of Nursing (3rd Ed). Philadelphia: F.A. Davis.
Roper, etal (1996).The Elements of Nursing: A model for nursing based on a model for living. (4th Ed). London: Churchill Livingstone.
Tierney, A.J. (1998). Nursing models: extant or extinct? Journal of Advanced Nursing 28: 1, 77-85.