1. Shanda Richer RN, BSN, CEN Christina Jilek RN
Neuman’s System Model
Shanda Richer RN, BSN, CEN
Christina Jilek RN

2. Origin of Systems Model
Used to teach nursing students.
The goal of the model was to provide a “wholistic”or holistic overview:
physiological
psychological
socio-cultural
and developmental aspects of human beings.
(Neuman, 2008)
Betty Neuman was a nursing school professor at UCLA. She wanted a way to reach out to her nursing students and teach them to look at patients as “wholistic “ beings. “Neuman's model was influenced by a variety of sources, but most particularly:
The philosophy of writers such as deChardin, Gestalt theory, Hans Selye's General Adaptation Syndrome & General Systems Theory” (Heyman & Heyman, 2000).

3. What is the Neuman Systems Model
Views the person as a layered, multidimensional whole that is in constant dynamic interaction with the environment (Heyman & Heyman, 2000).
Main goal is to protect the core
How?
Levels of defense
Stress reactions
Feedback
Prevention
The layers represent the defense of protecting the core being. Key concepts are stress reactions and systemic feedback loops. How does the client reacts to stress? Lines of defense and resistance (Neuman, 1995). Feedback is used to adjust the lines of defense and resistance protect the core . Feedback is also provided with interaction with the environment. This interaction is constant. The goal is balance.
Nursing interventions are the key to prevention according to the Systems Model(Neuman, 1995)

4. Research NSM(Neuman System Model) Research Institute
Purpose of the Research Institute is to formulate and test NSM.
Past research
Eileen Gigliotti published a research article in 1999 based on the Neuman Systems Model( Gigliotti ,1996).
In 2001 over 200 research studies involved Neuman's Systems Model
In an effort to get the Neuman model alive, Betty Neuman has created an institute devoted to testing and applying the Neuman systems model. Each year fellowships/grants etc. are awarded to those who apply. This ensures the systems model will be tested and adapted as needed.

5. Research Continued
2001: Wellness and Stressors that Interfere with the Beduin Woman’s Pursuit of Wellness for Self and Family
2001: Cultural Research: Application of the Neuman Systems Model
2001: A Nursing Intervention Designed to Increase Resilience in Homeless Abused Women
2003: Stanhope and Lancaster researched stress due to job loss and the poor economy (Stanhope & Lancaster, 2003)
The NSM Institute provides an overview of the research conducted. Here are some examples of clinical research and application of practice with the Neuman Systems Model as of 2001.
2001 J. Fawcett conducted a review of 200 published research studies using Betty Neuman's System Theory. Majority were concentrated on prevention and education

6. How is it applied to nursing?
NURSING PROCESS BASED ON SYSTEM MODEL
Assessment:
Nursing diagnosis
Outcome identification and planning
Implementation
Evaluation
Assessment: obtain data to determine state of wellness/ examine pt. stressors
Nursing diagnosis: must reflect the pt. as a whole
Outcome identification and planning: work with the pt. to move beyond the present.
Implementation: nursing actions are “wholistic” in nature. Goals are established : immediate, short and long term
Evaluation: occur to ensure change has occurred. – If it is not met the goals are reformed
All of the above are in our nursing care plans

7. continued Neuman Systems Model used in: All areas of nursing including
Public health
Family nursing
Health Policy
Nursing education (assessment, Nursing Dx, goals, outcomes)
Psychiatric nursing
Research
Neuman's theory is based on physiological, psychological socio-cultural, and developmental aspects of human beings. (Neuman, 2008). Because of its generalizability it can be applied to all types of nursing.

8. Neuman and my current nursing practice
Guides the SJHS (South Jersey Healthcare).
Chosen by unit based nursing councils
Most consistent with SJHS culture
Is reflected in our assessments
Supports SJHS mission and vision
Where I work, Betty Neuman is the nursing theorist we guide our practice by.
There are inter disciplinary councils throughout the health system which work collaboratively to provide the best clinical outcomes based on evidence based practice.
Recently one of Directors was at a conference and described to her how we incorporate her theory into our every day practice. So she decided to come and see for herself. She attended our research day and I got the opportunity to sit 1 on 1 and discuss her theory. This is me and Betty Neuman 2009.

9. continued
Initial assessment used as guide to formulate nursing diagnosis
Plan of care developed with identified needs
Interventions are formulated as a inter- disciplinary group (holistic)
Goals are set and outcomes evaluated daily
Patients position on continuum of wellness based on evaluation outcomes and adjusted accordingly
SJHS assists families, patients and the community to maintain maximum levels of wellness. SJHS participates in community wellness programs with our clinics, stroke education, Women’s health fairs, & cardiovascular seminars to name a few. SJHS emphasizes the needs of our patients:
Physical/physiologic, psychological, socio-cultural, developmental and spiritual. We accomplish this through working as a team to meet all our patients and their families needs.

10. References
Neuman, B. (2008). Neuman Systems Model. Retrieved from Neuman Systems Model:
Neuman, B. (1995). The Neuman Systems Model (3rd edition). Norwalk, CT: Appleton & Lange.
Gigliotti, E. (1996). Use of Neuman's lines of defense and resistance in nursing research: conceptual and empirical considerations. Nursing Science Quarterly, 10(3),
Current Nursing. (2010, January 16). Betty Neuman's System Model. Retrieved March 23, 2010,
from Current Nursing: Open Access Nursing Research and Review Articles: