1. Shumetria Cleveland Tara Zander
Dorothea Orem
Shumetria Cleveland
Tara Zander

2. Orem’s Self-Care Theory
Introduction
Orem’s Self-Care Theory
Improve the quality of nursing and the foundation in order to better teach self care to both independent and dependent patients and families.

3. Philosophy Standard for Nursing Patient Self-Care Standard
Knowledgeable in self-care
Therapeutic in approach
Patient Self-Care Standard
Independent
Desire to do self-care
Ability to do self-care
Dependent
Ability to learn self-care

4. Origin Dorothea Orem Started nursing in 1939
1945 Master Degree Catholic University of America
Concepts 1st Published in 1959
Orem continue to improve and evolved the theory
Published Nursing: Concepts of Practice in 1971
Sixth edition published in 2001

5. Background Orem’s Self Care Model
Orem developed three interrelated theories
Theory of Self Care
Theory of Self-care Deficit
Theory of Nursing System
Orem uses the nursing process to determine self care deficits.
Assessment
Care plan
Implementation
Evaluation

6. Theory of Self Care
Focuses on the patients ability to provide basic care for self
How does the patient care for themselves as a human being
Is their environment appropriate for their health conditions
What nursing resources does the patient have to assist them
Patient is able to ADL’s to maintain a healthy life and well- being

7. Theory of Self Care Deficit
Limitations in effective self care due to illness, injury or disease.
Nursing intervention is needed.

8. Theory of Nursing In patients with self care deficit:
nursing interventions will be followed
to promote self care needs.

9. Global Concepts Meet condition for self- care
Human and Environmental
Health and Nursing
Meet condition for self- care
Meets developmental needs
Understand and consider environmental factors that hinder patient self-care
Maintains integrity
Exceeds capabilities
Design a plan
Implement the plan
Follow the plan

10. Evaluation of nursing model
Philosophy of self-care is unique to nursing
Focus on Global Concepts
Model usage in OB and OR
Concept is specific
Concept has lead to other theories
Model is used in:
Nursing schools
Hospitals

11. Resources
Editor. (2012). Low status, dirty work', in whose opinion? Current Nursing. Retrieve from icit_theory.html

12. Case Study: John, 32 year old male
Presented in emergency department with rapid respirations and pale skin.
Oxygen via nasal cannula at 2 liters and IV infusion of 0.9% sodium chloride via 20 gauge peripheral venous access device was started.
Vital signs were 98.6 F (37 C) orally; heart rate 126, respirations 24, and blood pressure 99/70 lying and 78/60 sitting, skin turgor is poor.
Paramedics who transported him to the emergency department stated that his finger stick blood glucose level was 400mg/dl in route.
John stated that he was playing football and began to feel sick. One hour later at home he began vomiting and felt confused, so his girlfriend called 911.
The girlfriend said that recently John had been experiencing increased hunger, weight loss, frequent urination and fatigue.
Based on John’s clinical status and history he was diagnosed with acute hyperglycemia and diabetic ketoacidosis (DKA) cause by undiagnosed type I diabetes.
John was admitted to the medical surgical unit.

13. What self-care measures does the nurse need to teach?

14. Answer: The nurse should provide the patient with information about insulin, how to use a glucometer, how to give injection based on a sliding scale, the sign and symptoms of hyper and hypoglycemia.
The nurse should have the patient to draw up his insulin and give himself the injection.
The patient should also be taught the safe place to give subcutaneous injections and to remember to rotate the injections. Inform the patient that he needs regular evaluations by an endocrinologist, ophthalmologist and primary care provider for diabetes complications.
It is important for the patient to have his HBG A1c check quarterly and inform the patient to consider wearing a medical alert bracelet.
Consult the nutritionist to see the patient for new onset of diabetes. On discharge refer the patient to the diabetes clinic for additional teaching.

15. References
Taber’s Cyclopedia Medical Dictionary, 21st edition, Dorothea Orem’s Self- Care Framework,
Orem, D.E, Taylor, S. G., (2011) Reflection on Nursing Practice Science: The Nature, the Structure and the Foundation of Nursing Sciences, Nursing Science Quarterly,
Doi: /
Chitty, K.K & Black, B.P. (2011), Professional nursing: Concepts and Challenges (6th ed.) Maryland Heights, MO: Saunders