APPLICATION OF DOROTHEA OREM’S SELF-CARE DEFICIT NURSING THEORY IN THE COMPREHENSIVE NURSING MANAGEMENT OF A CRITICALLY ILL PATIENT WITH ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS)

Abstract

Background: Integrating nursing theories into critical care practice is essential for organizing structured, empathetic, and evidence-based clinical management. Purpose: This case study examines the practical implementation of Dorothea Orem’s Self-Care Deficit Nursing Theory in caring for a sedated, mechanically ventilated patient diagnosed with Acute Respiratory Distress Syndrome (ARDS) in an Intensive Care Unit (ICU). Methods: Orem’s conceptual framework—specifically the notions of Self-Care Agency, Therapeutic Self-Care Demand, Self-Care Deficit, and the Wholly Compensatory Nursing System—was used to structure bedside assessment, nursing interventions, and outcome evaluation. Results: Due to critical illness and therapeutic sedation, the patient experienced total self-care deficits along with early Stage 1 pressure injuries over vulnerable bony prominences. Applying a Wholly Compensatory System—incorporating planned two-hourly repositioning, dynamic air mattress therapy, enteral feeding, invasive catheter maintenance, and close monitoring—halted skin breakdown and preserved physiological stability. Conclusion: Orem’s nursing model offers an effective clinical pathway for addressing absolute patient dependency in ARDS, supporting holistic recovery while minimizing secondary hospital-acquired complications.