AVANT AND WALKER MODEL

Avant and Walker Model

Abstract

The concept of invulnerability is explored from the perspective of nursing, medicine, psychology, sociology, public health, and education. Walker and Avant's structure for concept investigation will be used. Definitions of the concept are presented along with related terms. Antecedents, attributes, and consequences of the concept are discussed in detail. Model, borderline, related, and contrary cases are presented to provide a rich representation of the concept. Empirical referents and implications for nursing are presented.

Avant and Walker Model

Introduction

Nurses are exposed to a host of infectious diseases including, hepatitis B and C, human immunodeficiency virus, meningococcal meningitis and tuberculosis to name a few. US Department of Labor's Occupational Safety and Health Administration and the US Center of Disease control recommend universal precautions for all nurses who work in patient care settings. These precautions include, but are not limited to the use of gloves, gowns, protective eyewear, and needle protective-devices when there is a potential exposure to blood or body fluids. However, not all nurses practice universal precautions consistently to protect themselves from these infectious diseases. The US Centers for Disease Control and Prevention estimate that there are 380,000 exposure incidents annually from needlestick injuries (Swallow, 2006). In effort to prevent needlestick injuries, various interventions have been initiated to help make nurses safer. Some of these include universal precautions, education, changes in needle practices (e.g., not recapping needles), hepatitis B vaccination, and the engineering inventions of needle-protective devices (Trim, 2004). There are over 1,000 US patents on devices for needlestick safety (McConnell, 2000). Needlestick wounds remain emotionally and financially very costly. Therefore, in the year 2010, with all the available interventions, it is unacceptable that nurses are still subject to needlestick injuries. The unforeseen variable, invulnerability, emerged as this scribe reviewed the literature on needlestick injuries. Clarke, Rockett, Sloane, and Aiken (2002) addressed compliance with safety apparatuss. The study included, 2287 medical-surgical nurses from 22 hospitals nationwide. Clarke et al. (2002), found that 57% of the nurses surveyed reported being “somewhat” but not “very” worried about acquiring bloodborne diseases from a needlestick injury. Sixty- two per hundred reported that they considered about the risk less than one time a month. Invulnerability was a variable this scribe felt required exploration.

Aim of Analysis

Walker and Avant's (2005) framework for concept analysis will be used to examine and ultimately define the concept of invulnerability. This analysis will add to the body of nursing knowledge that currently lacks a clear understanding of this concept. The aims of this analysis include (a) identity all possible uses of the concept, (b) identify all antecedents, (c) identify all defining attributes and synthesize definition, (d) identify consequences, (e) construct model, borderline, related, and contrary cases, and (f) identify empirical referents. Implications for nursing will also be addressed.

Identify Uses of Concept

Initially, the literature was reviewed using the term invulnerable. This author discovered that many of the results led to literature that addressed the concept of vulnerable or vulnerability. It was quickly discovered that invulnerably was not the opposite of ...