NR 500NP Week 5 Systems Theory and Practice Issues

Sample Answer

My experience as a RN is in the ED and ICU. The ED in itself can be considered as a complex adaptive system, because of the constantly changing dynamics and boundaries set by the staff as well as coordinating with the outside units and integrating the best plan of care for the patients. I have worked beside many great FNPs in the ED that assist doctors and lighten their patient load as well as make the turnover more efficient and smoother. Many of the patients that come through ED are not always as simple as just writing a prescription and seeing them on their way.

Many patients have adaptive challenges in place that can pose as barriers to the Nurse Practitioners and doctors. Lateef et al. (2022) stated that, “adaptive challenges, on the other hand, are less obvious and, thus, not so easy to identify”. “An example would be, attempting to change a negative behavior in a patient who presents with frequent giddiness and has not been taking his antihypertensive medication” (Lateef et al., 2022). Let’s also say this patient is a frequent flyer and continues to show up in the ED with noncompliance of taking meds causing hypertensive issues and is uninsured.

The first step in the care for this patient would be at the micro- level. The micro- level focuses on the subjective and objective data obtained from the NP and doctor to better help them make clinical decisions about this patient’s care such as treatment, goals of care, and or supportive services needed after discharge (Sawatzky et al., 2021). Sawatzky et al. (2021) mentions that at the meso-level, “healthcare managers and leaders of quality improvement, performance monitoring, and accreditation of different healthcare services and organizations” monitor data for better patient outcomes. This patient’s noncompliance and frequency of visits to ED, has now integrated the meso- level of care to intervene.

For example, at the meso-level the managers and the leaders of the ED will find ways of quality improvement and performance monitoring, as to why the frequency of visits are occurring. As a NP I could coordinate with these managers to find and try to resolve what can we do to better educate this patient or what services can we offer to help with the noncompliance and frequency of visits. Because of all of this the macro- level of the hospital is now affected in this patient’s care. Related to the patient being noninsured and the resources used to help this patient now affects the overall healthcare system and reimbursement of healthcare services that the hospital won’t receive because he is unfunded.

References

• Lateef, Kiat, K., Yunus, M., Rahman, M., Galwankar, S., Al Thani, H., & Agrawal, A. (2022). BRAVE A point of care adaptive leadership approach to providing patient-centric care in the emergency department. Journal of Emergencies, Trauma and Shock, 15(1), 47–52. https //doi.org/10.4103/jets.jets_138_21Links to an external site.
• Sawatzky, Kwon, J.-Y., Barclay, R., Chauhan, C., Frank, L., van den Hout, W. B., Nielsen, L. K., Nolte, S., & Sprangers, M. A. G. (2021). Implications of response shift for micro-, meso-, and macro-level healthcare decision-making using results of patient-reported outcome measures. Quality of Life Research, 30(12), 3343–3357. https //doi.org/10.1007/s11136-021-02766-9Links to an external site.