Week 5 respond to faculty

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Chamberlain College of Nursing *

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NR500NP

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Health Science

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Dec 6, 2023

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docx

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2

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Week 5 respond to faculty According to the lesson in week 5, complex adaptive systems are learning organizations that aren’t stagnant, but rather considers healthcare as a dynamic process. A complex adaptive system welcomes the many changes that occur within the organization, a characteristic necessary for the success of healthcare and healthcare related organizations. Organization systems have three levels: micro-, meso-, and macrosystems. The highest level is the macrosystem which signifies the community or organization. At the community level, leaders in the macrosystem level can be government entities, regulatory agencies, and professional organizations. For the organizational level, leaders are made up of the chief executive officer, president, chief financial officer, and chief operations officer. The middle level is the mesosystem, which exemplifies an organization and major divisions within the healthcare organization. This level is managed by nurse managers and directors. Lastly, the microsystem level embodies a department within an organization. In relation to the healthcare organization, patient care units consisting of patients, families, and patient care teams a brought together in a collaborative approach to provide care. This level is where direct services are managed. Anticipating my future practice area, an issue or concern that may arise would be dealing with types of interprofessional practice or nurse to physician relationship in a complex adaptive system. Although my current hospital and clinic are very much collaborative and use an integrative and interprofessional practice between nurses and all other healthcare professionals, I did experience a hospital in which healthcare providers modelled parallel practice. For instance, changes in primary care practices prove that conversation between system and organizational members is significant in the success of interventions to improve healthcare delivery ( Complex adaptive systems Identify Innovate Demonstrate Encourage , 2010). Relative to parallel practice, each provider or consult at this hospital worked independently and did not collaborate with each provider in the delivery of patient care. I found this method to not work well as it separated each provider and there would be miscommunication and overlap of orders. Additionally, nurses were becoming middlemen in relaying messages from one physician, let’s say internal medicine to another specialist, cardiologist. As a result, there were strains in the healthcare system and overall, in the microsystem level where we are providing direct services to patients and patient families. To address this issue, we can develop effective strategies for improvement, breaking the culture at this hospital. Meetings and/or huddles with providers that would involve all aspects of the team to unite and discuss the patient’s plan of care. Furthermore, there was a high turnover rate for nurse managers in this telemetry unit. If we were to incorporate and implement these strategies for improvement, the mesosystem level involving the nurse managers and directors would also have positive outcomes, hopefully maintaining the retention of staff. Introducing interprofessional collaboration to resolve this issue can tackle problem areas of miscommunication. Similarly, the work environment would be more open-minded, there would be shared decision making and mutual regard for all healthcare professionals.
Alma, Great example and an issue that can create not only possible complications or negative patient outcomes but also general confusion for both patients and providers as well. Unfortunately, the trend away from primary and towards specialized care introduces an increased risk for communication breakdown in other areas as well as patients also have numerous providers they are following with in the outpatient setting. I believe that in parallel practice, the role of nurse is significantly important as a messenger among physicians, specialists, and patients. From my experience, lack of communication between physicians and specialists caused great confusion to not only patients but also me as a nurse. There were often duplicated or missing orders, missed diagnosis, unnecessary tests, and premature discharge. These led to failure in continuity care and patients’ safety. At that time, I realized that it is very important to collaborate and communicate with each other among healthcare providers. A nurse plays a key role between them in order to have the best outcome in patient care. Communication is very important component in healthcare systems. Lack of communication among healthcare providers negatively results in patient’s outcome. Miscommunication between physician and nurse often caused duplicated tests, failed in the shared goalhigh quality, cost-effective medical care.
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