Write the short Paper in 2 pages, APA format.

Concept analysis describes objects thoughts, properties, and events, which is a basic component of nursing theory (Walker & Avant, 2011, p. 157). Walker and Avant (2011) provided an eight steps concept analysis model, introduced how to conduct concept analysis step by step, I will utilize these steps to analyze a concept (p. 160).

1. Select a concept: As Walker and Avant (2011) stated, this beginning step is the hardest because it's hard to choice one concept from several concepts that interested the writer, and they suggested to choose the concept related to reader's work (p. 160). From my experiences in utilization review/ case manager and intensive care unit (ICU), I often transfer patient out of ICU to the lower level of care such as med-surg unit or rehabilitation facility, interactions for I will be choosing transition care concept to analyze.

2. Determine the purposes of the analysis: Walker and Avant (2011) suggested the writer to ask think, " Why am I doing this analysis?" write the answer down and keep it in hand because this purpose will guide the writer throughout the entire study (p. 161). Appropriate planning of critically ill patients throughout their transition experience within and following discharge from the ICU is an important part of the nursing care process during critical illness. This concept analysis for transition care will context within ICU setting for perception from nursing, multidisciplinary term and patient's family, focusing on critically ill patients' impression and engagement for within and following discharge from the ICU.

3. Identify all uses of the concept: Walker and Avant (2011) suggested, "using dictionaries, thesauruses, colleagues, and available literature, identify as many uses of the concept"(p.161). I will be doing literature reviews, using CINAHL and PubMed databases, searching different terms, such as "Transition care", "Intensive care unit", "Critical care nursing", "communication"," Concept analysis".

4. Determine the defining attributes: This step is the "heart of concept analysis" and similar to " the criteria for making differential diagnoses in medicine."(Walker & Avant, 2011, p. 162). The word ‘transition' means to go across. Transition care in nursing terms can be defined as the movement patients make between health care practitioners and settings as their condition and care needs change during a chronic or acute illness (Smith, Ashok, Dy, Wines, &Teixeria-Poit, 2014, p. 46). According to Ludin, Arbon& Parker (2013), critically ill patients experience several transitions: 1. Role transition: from a normal person to a sick person (patient) 2. Situational transition: relocation, from the ICU to med-surg units (p. 189).

5. Identify a model case. Bob, a 72 year's old male admitted to a neurosurgical ICU after a cerebrovascular accident. The hospital Michael hospitalized at is a certified stroke center with a well-established stroke protocol for care transitions throughout entire hospitalization. The protocol includes early discharge planning upon patient's admission, medication reconciliation program through the continuum of care, and bedside nursing endorsement. Bob's condition improved and moved to a med-surg floor, ICU nurse transported him to the new room and introduced him to the receiving nurse, and then nurses were giving bedside report. Bob felt his not a stranger in this new environment, and he involved in his care, and everything been handled very well.

6. Identify a borderline case, contrary case, invented, and illegitimate case.
A borderline case: Patient transferred out of ICU to intermediate step-down unit, nurse orientated him of the room. Patient has deep brain stimulation implant which can enhance Parkinson medication regiment, which has been turned off during the CT scan in ICU and hasn't get turn on. His Parkinson's medications were restarted in the step-down unit. However, he felt his Parkinson medications unable to control his symptom.

Contrary case: Ron, A 38-year-old truck driver had cervical fractures and penetrating abdominal trauma from a car accident, he being tracheostomised for prolonged intubation that limited his communication and a skull halo for cervical injury which minimized his movement. After his conditions are improved, he had moved to an intermediate step-down unit for continue treatment for his bowel. Ron felt overwhelming, powerless, and helpless after transferred to here, and the room setting is different, no longer a glass door, that he used to wave to call for help, and he felt anxious when he need nurse suction his tracheostomy site but they unable to help him right away. Later on, Ron had transferred back to ICU due to pneumonia.

Invented case: The University of Pittsburgh Medical Center has a rapid-response team, consisting of a nurse administrator, a physician, a staff nurse, and a patient advocate who would convene immediately in response to a patient's or visitor's call (Smith et al., 2014, p. 52).

Illegitimate case: A mother buying her baby's first cup, a transition baby care cup.

7. Identify consequences and antecedents of the concept: Consequences of this concept include: promoted patient safety, improved patient satisfaction and clinical outcomes, archived high standards of nursing care. Antecedents of this concept include: Rehospitalizations make the significant quality of life and cost burden.

8. Define empirical referents of the concept (Walker & Avant, 2011)
Empirical referents can be determining by measuring the defining attributes (Walker & Avant, 2011, p. 168). Measuring the implementation of transitional of care by post- ICU patient satisfaction survey.
Concept analysis describes the process of stating, identifying and understanding the theory that outlines the science of nursing.

References:

•Ludin, S. M., Arbon, P., & Parker, S. (2013). Review: Patients' transition in the Intensive Care Units: Concept analysis. Intensive & Critical Care Nursing, 29187-192.doi:10.1016/j.iccn.2013.02.001

•Walker, L., Avant, K. (2011).Strategies for theory construction in nursing. (5th ed.). Norwalk, CT: Appleton, Lange.

•Smith, L.R., Ashok, M., Dy, S.M., Wines, R.C., &Teixeria-Poit, S. (2014). Care Transitions Framework. Contextual frameworks for research on the implementation of complex system interventions. (pp. 46-55). Retrieved from: http://www.ncbi.nlm.nih.gov/books/NBK196206/