It is important to understand how middle-range theory can help you in your everyday environment as a nurse. In the previous assignment, you identified a practical problem that emerged from the evidence in the extant literature or professional practice. In this assignment, you will explore and apply middle-range theory to solve the specific problem that you identified in the previous assignment.


Consider the problem that you described in the previous assignment and the instructor feedback about that assignment.

Write a paper (1,000 to 1,500 words) that describes how middle-range theory can be applied to the identified problem. The paper should include the following:

  1. A brief summary of the problem.
  2. A description of a middle-range theory that could be applied to the problem. Is this middle-range theory appropriate to your identified problem?
  3. A brief discussion of the middle-range theory’s origins.
  4. A discussion of how the middle-range theory has been previously applied.
  5. A discussion of the application of the middle-range theory to the identified problem. How would your practice change by incorporating this theory?

Prepare this assignment according to guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

APA format, 3 references, 

the below paper is my previous paper in which this paper needs to be based off of


Diane Boll

Grand Canyon University: NUR 502












Title of paper

                                                            Problem description

The nurses working in psychiatric units experience various problems. In this case, these problems impact significantly on the quality of care given by such professionals. One of the problems[jw2]  faced in the psychiatric workplace setting is patient violence that influences and affects the outcome of nursing management (Arnetz et al, 2015). These cases mostly happen in the acute psychiatric settings. The patient violence against the nursing professionals in their work areas remains a global problem and happens particularly in the mental health care facilities. In this case, the violence results from the nature of the patients’ conditions that results in harm to the self and others. This problem is prevalent to nurses, becauseit is the nurses who take care of the patients and exposed for long hours to the patients (Arnetz et al, 2015). Nurse professionals are the first and the primary health care providers in psychiatric facilities, which places them at high risk to the violence The violence varies from physical to non-physical violence. Research was conducted indicating that about 20% of patients admitted to the psychiatric facilities possess violent behaviors in a variety of ways Need citation here especially with the percent mentioned.  The violent behaviors may be associated with various triggers that the only the nurses who have known the patients for a long time can understand (Arnetz et al, 2015[jw3] ).

                                Literature supported rationale for significance of the problem

According to Richter and Whittington (2006), patient violence significantly affects both the health professionals and the quality of health that the patients  receive. The results of these violent behaviors translate to longer hospital stays and readmissions. It also results in  work related stress, blame, fear, post-traumatic events, and feelings of abuse and insult. The patient violence against the health professional has a great significance and can be used to help manage the problem and prevent its future occurrence (Richter & Whittington, 2006).

A study conducted by Richter and Whittington (2006), offers a significant administration[jw4] , nursing education, practice development, and policy making. More training and proper practice development are associated with helping to handle  the violent patients. In this case, the training and proper practice offer the nurses and other health professionals to understand the triggers and the signs of violence that psychiatric patients may display for the anticipation of care[jw5] . Policy making was found to be of great significance in psychiatric nursing. Overburdening of health facilities, overcrowding, and climates of cynicism how come?  were found to be great causes of violence in such patients. The De-escalation techniques dealing with fewer skills of physical restraints and focus more on competent and skilled interactions respecting the patient perspectives (Richter & Whittington, 2006[jw6] ).

Violence rarely erupts or happens without any warning, the staff need or require optimal training of pre-planned care criteria of when to set various limits because patients remain optimal in any intervention (Phillips, 2016). Detecting and monitoring early warnings and signs helps in allowing for early detection and intervention while the frustration level of the frustration is still low. This remains an empirical evidence because recidivist clients show warning signs prior to performing acts of violence in the psychiatric wards (Phillips, 2016). The violence prevention benefits largely from comprehensive accurate and proper monitoring of patients and violence precipitators (Phillips, 2016[jw7] ).

In conclusion, the current research plays an essential role in various aspects of violence prevention in the psychiatric facilities. In this case, literature has indicated that preventing the violence against staff can be reduced through proper administration[jw8] , comprehensive training for triggers and warning signs detection, practice development and proper policy making remain the pillars of reducing and managing the patient violence of all types in the psychiatric facilities[jw9] .


Arnetz, J. E., Hamblin, L., Essenmacher, L., Upfal, M. J., Ager, J., & Luborsky, M. (2015). Understanding patient‐to‐worker violence in hospitals: a qualitative analysis of documented incident reports. Journal of advanced nursing, 71(2), 338-348.

Phillips, J. P. (2016). Workplace violence against health care workers in the United States. New England journal of medicine, 374(17), 1661-1669.

Richter, D., & Whittington, R. (2006). Violence in mental health settings: Causes, consequences, management. New York: Springer.

Excellent job Diane. This is a wonderful topic that you have chosen. Very interesting and informative. I am looking forward to the final paper. When you write the final paper, make sure the reference page is separate from the rest of the paper. Also, make sure paragraphs are at least 3 sentences long. Write the sentences clearer so they are easier to understand. Add the title to the beginning of the paper. Overall, you have a great beginning to your final paper. Nicely done. Thanks. Dr. Wright

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 [jw1]Should not all be in caps.

 [jw2]Paper should not be justified

 [jw3]Very interesting topic. Great description of the problem. Well done.

 [jw4]This needs more clarification to what it means.

 [jw5]This is really good to demonstrate the significance of the problem in health care. The problems can get out of hand and needs to be managed appropriately. We would not want our health care workers to be assaulted nor other patients.

 [jw6]Expand on this in the final paper, explain it more clearly. However, this is very relevant to the topic of this paper. Some great reasons in this paragraph to discuss the importance of this topic.

 [jw7]Good job. This is interesting. Some great interventions. Just try to clean up the sentences to make the clearer and easier to understand.

 [jw8]Not quite sure what this means. Does this mean administration personnel?

 [jw9]Good ending. In final paper, make sure that paragraphs have at least 3 sentences.