Introduction
Various evidence-nursing theories are implemented in practice to define the nursing scope. King’s Conceptual System theory is one correlating to achieving set goals. Namely, the framework highlights that setting and achieving goals requires communication and a mutual objective between the nurse and the patient. Through interactions and communication, the care provider and the patient can find a common denominator regarding treatment objectives and put efforts toward obtaining the said goal. However, for the plans to coincide between those defined by the nurse and the patient, communication is critical. This will facilitate a better understanding of the factors that impact how the care receiver operates and what motivates them. In this paper, King’s Conceptual System Theory will be discussed from the perspective of its systems, its influence on goal attainment, employment in clinical quality circumstances, and additional theories to improve the quality of practice.
Conceptual Systems
King’s theory implies the presence of a set of systems that impact behavior. Namely, the framework developed by Imogene King is based on the influences of the personal, interpersonal, and social systems (Smith & Parker, 2020). The personal system comprises the notions of perception, self, development, body image, learning, time, personal space, and coping. Perception defines how the patient interprets the given information. Self, on the other hand, relates to the definition the patient uses to define themselves as individuals. Development is the action that leads to self-perception. Body image highlights one’s reaction to their physical appearance, and learning is linked to the conceptualization of a state. Time and space correlate with duration and a comfortable distance, respectively. Last but not least, coping is the strategy for dealing with stress.
The interpersonal system goes beyond the “self” and comprises interactions with other people. Namely, the term highlights how the person communicates with other individuals, interacts in a social situation, the role that the care provider takes during said interaction, potential stress following the communication, and the interactive process in which the person connects with the environment (Song & Kim, 2023). Furthermore, the social system exceeds personal perceptions and interactions with others. The term is applied to exemplify the larger group linked to the patient or the goal. Namely, it comprises workplaces as well as healthcare, religious, or educational systems and authorities. Thus, the theory implies that goal attainment relates to one’s personal system, for example, one’s perception of self, interpersonal – comprised of family members, and social – comprised of coworkers.
Goal Attainment
King’s theory highlights the relationship between the care provider and the patient concerning achieving objectives. Namely, the framework is built with the consideration of the interconnection between the nurse and the individual requiring assistance (Fronczek, 2021). Namely, the nurse participates in the patient’s assessment, diagnosis, and evaluation of whether the health goals will be attained based on the previous analysis. Specifically, goal attainment starts during the assessment when the nurse uses communicative skills to inquire and learn about the patient’s personal, interpersonal, and social systems. Furthermore, the theory implies that nursing diagnosing is the following step in which the healthcare provider determines the challenges that the patient is willing to solve. Last but not least, the evaluation is the stage in which it is determined which goals will be attained by the patient and to what extent. The theory implies that the nurse is focused on providing patient-centered care as the goals of each individual patient are different and require an individualistic approach.
Clinical Quality Problem
Various clinical quality problems can be identified as issues that negatively impact patient safety as well as the goals and values of the institution responsible for said patient. One of them is a high rate of occurrence of bed sores. Pressure ulcers are skin impairments that are linked to the patient’s limited mobility. However, through effective nursing diagnosis, which is one of the steps highlighted in King’s theory, injuries can be prevented (Wood et al., 2019). For example, the nurse communicates with the patient and determines that they lack physical activity, have had an injury that prevents them from being active, or have a sedentary lifestyle. As a result of said communication, the nurse can set a goal of presenting pressure ulcers both by monitoring the patient and providing care as well as by motivating the individual to be physically active if possible. Moreover, the goal correlates with the hospital’s objectives, as pressure ulcers are unsafe and lead to prolonged hospital stays (Wood et al., 2019). Thus, the goals of the nurse, which is to improve patient well-being, align with the goals of the patient who wants to avoid pain and correlate with the objective of the facility, which is to shorten hospital stays. As a result, it can be highlighted that King’s theory can, indeed, be applied when defining a clinical quality problem, such as a lack of safety mechanisms for pressure ulcer prevention and treatment.
Practice Quality Improvement Initiative
Within the personal clinical practice, King’s theory can, indeed, be applied to improve specific quality improvement initiatives. Specifically, it appears that the goal attainment framework can be employed during the provision of discharge instructions. According to researchers, patients who have not been provided with enough information that they can retain and adhere to in regard to their conditions and prevention measures encounter more negative health outcomes (DeSai et al., 2021). The framework allows for the determination of the patient’s influences and, as a result, the goals that are more likely to be achieved. Thus, in care, the individual is to increase physical activity, and the nurse can determine in which ways said objective could be approached. Under the circumstances that the patient is, for example, a member of a church group, the nurse can provide instructions on the benefits of volunteering while walking or joining an activity with fellow church members. A patient who is more likely to be isolated may follow online exercises and workouts depending on the condition that is to be prevented or addressed. Similarly, a patient with body image issues may be motivated by physical activity linked to weight loss, which would similarly lead to goal attainment. On the other hand, discharge instructions may be provided to a spouse or caretaker in case the patient is more likely to be motivated by people close to them. This highlights that the theory aligns with patient-centered care as it accounts for individual cases and motivations that differ from person to person. A nurse would, therefore, be aware of the best possible measures that can be applied when preparing the patient for discharge.
Quality Committee Employment of King’s Theory
The quality committee is responsible for monitoring both organizational processes and outcomes. One of the elements that are linked to the quality of care is patient-centered care (Oldland et al., 2020). Namely, the committee ensures that each patient is being approached based on personal wishes, cultural preferences, and needs. As highlighted prior, King’s goal attainment theory is, indeed, one of the approaches correlating with the principles of patient-centered care as it emphasizes the importance of communication (Park, 2021). The quality committee may exercise an assessment by seeking feedback on communication with nurses. For example, the circumstances that can be examined are whether the health goal was achieved. Since the facility’s goals are to ensure patient safety, be financially efficient, and establish regulatory measures that generate success, patient goal attainment aligns with all of the aforementioned values. Thus, the quality committee can align the outcomes with King’s Conceptual Model simply by determining whether the patient’s targets were reached as a result of treatment.
Additional Theory
A variety of additional nursing theories can be applied to improve the quality of practice initiatives. Namely, the initiative mentioned previously, which is improved discharge instruction provision, can be addressed through Orem’s Self-Care Deficit Theory. The framework highlights that in order for a patient’s recovery to be successful, the patients themselves are to participate in it and have a level of independence over their efforts toward improved well-being (Smith & Parker, 2020). Thus, a patient who is able to perform certain tasks, such as hygiene or mobility actions, does not require the assistance of a nurse and would likely succeed without the involvement of care providers in each step of the recovery.
Conclusion
King’s Conceptual System Theory is the nursing theory in which the patient’s goals are exemplified based on the systems influencing them. Namely, each individual is bound to personal, interpersonal, and social circumstances that can either maximize or minimize health goal attainment. The goal of the nurse, on the other hand, is patient well-being, and it can be achieved by communicating and understanding the elements that lead to behavioral changes in said individual. The model can be applied to improve the quality of care as well as practice initiatives as it correlates with the value of patient-centered care and considers the differences between people’s needs and preferences. A framework that likewise can be applied to quality improvement is Orem’s Self-Care Deficit Theory which emphasizes the importance of patient participation in care.
References
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Fronczek, A. E. (2021). Ushering in a new era for King’s conceptual system and theory of goal attainment. Nursing Science Quarterly, 35(1), 89–91. Web.
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Smith, M. C., & Parker, M. E. (2020). Nursing theories and nursing practice (5th ed.). F.A. Davis.
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Wood, J., Brown, B., Bartley, A., Margarida Batista Custódio Cavaco, A., Roberts, A. P., Santon, K., & Cook, S. (2019). Reducing pressure ulcers across multiple care settings using a collaborative approach. BMJ Open Quality, 8(3). Web.