Introduction
Healthcare organization comprises of systems, which constantly interact depending on numerous forces. Systems theory posits that organizations comprise of systems and subsystems that determining organizational processes and activities. According to Meyer and O’Brien-Pallas (2010), “input, throughput, and output factors interact dynamically” and determine the performance of nurses and outcomes of nursing care (p. 2828). In this view, the application of systems theory in nursing unit such as critical care unit would enhance efficiency of input, throughput, and output processes of nursing. Therefore, this essay analyzes critical care unit using systems theory with a view of describing the problem and providing an appropriate intervention.
Description of Critical Care Unit
Critical care unit is a busy unit in a healthcare center because it deals with patients, who are in critical conditions and thus require intensive care. The inputs of the critical care unit are patients, critical care nurses, materials, equipment, and information. Patients form an important input of the critical care unit because they are the recipients of nursing care and determinants of outcomes. Critical care nurses offer input services of nursing care, and thus, they influence the recovery process of patients in the critical care environment. Materials such as medicines, gloves, reagents, chemicals, syringes, and other consumables are inputs of critical care unit. Since the critical care unit has special equipment like monitors, ventilators, feeding tubes, intravenous tubes, catheters, chest tubes, and pacemakers amongst others. Diagnostic information of patients comprises a significant input of the critical care unit for it forms the basis of medical history of patients, which influence medical intervention and nursing care.
Throughput is a component of a system that describes processes taking place in the system following the inputs. Meyer and O’Brien-Pallas (2010) argue that transformation and reorganization of inputs into internal energies of a system create throughput. In the critical care unit, nursing care processes and activities form throughput. The nature of nursing care processes and activities is dependent on inputs and the ability of the critical care system to transform and reorganize these inputs into effective energies that drive the system. The outputs of the critical care system are quality of healthcare services, safety of care, and patient outcomes. Manojlovich, Antonakos, and Ronis (2009) assert that the nature of communication among healthcare providers and quality of nursing care determine patient outcomes. Hence, patient outcome is an important output of the critical care unit.
The functioning of the critical care unit as a system requires cycles of events such as the improvement of nursing practices, the application of the updated nursing protocols, the use of modern equipments, the continued supply of materials and resources, and the accreditation of nurses and healthcare centers. Regarding the negative feedback, the critical care unit requires to undertake corrective measures in response to its functioning and patient outcomes. The rate of recovery among patients, the prevalence of nosocomial infections, safety of nursing care, and quality of nursing care are some of the negative feedback, which determine the adjustment of inputs.
Description of Problem
Poor quality of nursing care as depicted by high incidences of nosocomial infections and negative patient outcomes is a problem that is common in the critical care unit. The inputs such as critical care nurses, information, materials, and medical devices contributes to poor quality of nursing care and the occurrence of nosocomial infections. Incompliance with evidence-based practices makes nurses to offer a poor quality of nursing services, which give negative patient outcomes. According to Manojlovich, Antonakos, and Ronis (2009) faulty communication among healthcare providers causes adverse patient outcomes. Faulty communication affects delivery of accurate information in a timely manner for the benefit of patients. Insufficient supply of materials like medicines, gloves, reagents, chemicals, syringes, and other important consumables affect the delivery of nursing care effectively. Moreover, insufficient medical devices such as catheters, ventilators, syringes, and surgical blades increase the risk of nosocomial infections.
In the aspect of throughput, systems theory shows that problem exists in the critical care unit. Owing to incompliance with evidence-based practices, nursing practices and activities in the critical care unit are wanting. The processes and activities that entail the prevention of nosocomial infections are below the required standards, and thus, patients have a high risk of these infections. Additionally, the communication between healthcare providers, including critical care nurses is faulty in the critical care unit. As a consequence, patients receive disparate nursing care, which is detrimental to their health. Krein, Kowalski, Hofer, and Saint (2012) state that lack or insufficient supply of medical devices such as impregnated catheters and equipment to sterilizer surgical devices contribute to negative patient outcomes and the occurrence of nosocomial infections.
Poor quality of healthcare services, reduced safety of care, and increase the prevalence of nosocomial infections are some of the outputs of the critical care unit, which show that there are problems in the system. These outputs emanate from the issues in input and throughput processes of the critical care system. Poor quality of health care services indicates that nurses do not comply with standard nursing practices and/or some materials and equipment are lacking. Reduced safety of patients implies that the throughput processes are not effective addressing health issues of patients. The prevalence of nosocomial infections shows that the conditions of the critical care environment and nursing practices are unhygienic (Kelly, Kutney-Lee, Lake, & Aiken, 2012). Although these negative patient outcomes provide appropriate negative feedback, lack of materials, equipment, and resources, as cycle of events, limits the critical care unit from taking appropriate feedback response.
Proposed Solution
Desired Outcome
The desired outcome is to improve positive patient outcomes in the critical care unit. To achieve the desired outcome, the critical care nurses need to apply evidence-based approaches in the treatment of patients. Evidenced-based nursing practices are central in the treatment of patients and prevention of nosocomial infections.
Goals and Objectives
- To promote communication among healthcare providers, specifically nurses and physicians in the critical care unit.
- To improve nursing practices are applicable in the treatment of patients in the critical care unit.
- To incorporate evidence-based practices in the prevention of nosocomial infections in the critical care environment.
- To apply negative feedbacks effectively in making adjustments that increases efficiency of the critical care system.
- To ensure that there is enough supply of materials and resources so that the critical care system to function effectively.
Policies and Procedures
The critical care unit needs to enhance communication among healthcare providers by adopting information technology policies and procedures. The adoption of protocols, which promote communication, storage, and retrieval of information, would enhance accuracy data and timely retrieval of information. The application of evidence-based practices is necessary to enhance effectiveness of procedures that critical care nurses apply in the treatment of diseases and prevention of nosocomial infections. Since inputs determine outcomes of nursing care, the critical care should develop feedback mechanism and respond to patient outcomes appropriately. For example, the supply of materials and resources should be in tandem with the demands of the critical care unit.
Relevant Professional Standards
Standards of professional practice that are applicable in the critical care unit are quality care, competency, collegiality, and collaboration (American Association of Critical-Care Nurses, 2014). Quality of care is an integral professional standard that critical care nurses need to improve patient outcomes. Professional competency is important because it enables nurses to apply evidence-based practices in their routine practices and activities. Collegiality and collaboration are two related standards, which require critical care nurses to cooperate with other healthcare providers and family members in the provision of quality healthcare to patients.
Mission, values, Culture, and Climate
Improvement of patient outcome in the critical care environment is in line with the mission Spotsylvania Regional Medical Center, which aims to provide quality of care, improve human life, and serve the community. Moreover, the improvement of patient outcome in the critical care environment is in tandem with the vision of the medical center that aims to be the best place to receive healthcare, practice medicine, work, and act as an asset of the community. Given that patient outcome is a key output in the critical care system, the improvement of patient outcome would transform the culture and climate of Spotsylvania Regional Medical Center to focus on the needs of patients. From the mission, vision, and philosophy, it is evident that the medical center puts patients at the center of focus.
Conclusion
The application of systems theory in the analysis of critical care unit has revealed healthcare problems. These problems emanate from inputs, outputs, and throughput processes in the critical care unit. The common problems are poor quality of care, increased nosocomial infections, and reduced safety of patients. The desired solution to these problems is the improvement of patient outcomes using input, throughput, and negative feedback processes. The improvement of patient outcome is in line with the mission and vision of Spotsylvania Regional Medical Center. Therefore, the improvement of patient outcome would transform the culture and climate of the medical center, according to its mission, vision, and philosophy.
References
American Association of Critical-Care Nurses. (2014). Standards for Acute and Critical Care Nursing Practice. Web.
Kelly, D., Kutney-Lee, A., Lake, E., & Aiken, L. (2012). The critical care work environment and nurse reported healthcare-associated infections. American Journal of Critical Care, 22(6), 482-489. Web.
Krein, S., Kowalski, C., Hofer, T., & Saint, S. (2012). Preventing hospital-acquired infections: A national survey of practices reported by the U.S. hospitals in 2005 and 2009.Journal of General Internal Medicine, 27(7):773-779. Web.
Manojlovich, M., Antonakos, C., & Ronis, D. (2009). Intensive care units, communication between nurses and physicians.American Journal of Critical Care, 18(1), 21-30. Web.
Meyer R.M. & O’Brien-Pallas L.L. (2010). Nursing services delivery theory: An open system approach.Journal of Advanced Nursing, 66(12), 2828-2838. Web.