Ideally, King’s system theory is based on the assumption that humans are the focus of nursing and the goal of nursing is to interact with the human beings environment to promote, maintain, and restore health. More specifically, the perception of the nursing professionals and the client plays an integral part in the interaction process. Patients and their families have a right to know specific details about their health and accept or reject the type of healthcare administered to them. Consequently, healthcare professionals must share information with the patients and their families to enable them to make informed decisions. Consistently, more than three decades ago, King’s identified the problem and prospect of knowledge development in the area of nursing (Smith & Parker, 2015). Among the problems identified, the absence of a professional nursing language, a theoretical nursing phenomena, and lack of a concept development were some of the major problems affecting the development and utilization of knowledge within the nursing profession. In particular, according to King’s rationale, the concept development is a never-ending process within the movement of nursing science. The nursing phenomenon was based on Howland systems model and Howland and McDowell conceptual framework. Through the combination of the levels of interaction in these works, Kings was able to come up with an approach to structure nursing knowledge and identify the comprehensive concepts for her conceptual system. The theory of goal attainment was developed in 1981 and is used to describe the dynamic, interpersonal relationship that a patient grows and develops to achieve various goals in their life. The theory views individuals as personal systems, two or more individuals as interpersonal systems, and organized boundary systems as social systems.
Theory of Goal Attainment Systems
According to King’s conceptual system theory, there are three interacting systems in the theory of goal attainment, which include a social system, interpersonal systems, and personal systems (Fitzpatrick & Kazer, 2012). More elaborate, social systems are comprehensive interacting systems that consist of a group of individuals that make up the society. Examples of social systems include educational, religious, and healthcare systems. Within this particular system, authority, decision-making, power, and status are the concepts that guide the system understanding. Interpersonal systems are formed through human interaction between two or three individuals to form a small or large group. A large number of interacting individuals implies the complexity of the interactions. Communication, interaction, role, stress, and transaction concepts are required in order to understand the interpersonal system. The other system is the personal system, which represents an individual. An example of a personal system can be a patient or a nurse. The system uses the concepts of self, growth, and development, perception, space, and time.
Influence of Systems on Goal Attainment
The goal of nursing care is to promote, maintain, and help regain individual health. Concepts are essential to the understanding of nursing theories. King developed the general systems framework, which refers to the three interacting systems and the goal attainment, which pertains to the significance of the concepts of the systems. Ideally, among the three systems, the interpersonal system conceptual framework has the greatest influence on goal attainment. Practically, while personal and social systems affect the quality of care delivered, the theory of goal attainment is attained in the interpersonal system. In this specific conceptual framework, two or more people usually come together in a health care facility to seek help to attain or maintain a state of health that allows functioning in roles.
Using King’s theory to define a Clinical Quality Problem
Quality care is the degree to which health services delivered to increase the likelihood of desired health outcomes and are consistent with up-to-date professional knowledge. Ideally, indicators of quality care are based on standards of care given. By definition, clinical quality involves the interdisciplinary process that is designed to improve the standards of the delivery of care to maintain, restore, or improve the health outcomes of an individual or the society. Usually, these indicators of clinical quality are supported by evidence-based standards to standards derived from academic literature. Clinical quality problems are likely to arise when these standards are compromised. In the theory of goal attainment, the patient is placed at the center with the nurse supporting and facilitating care, and health maintenance. Applying the goal attainment theory to clinical quality means that desired health outcomes and patient satisfaction must be achieved for the clinical quality process to be complete. The theory application can also be used to assess the impact of patient participation on health outcomes. Virtually, the clinical interaction between nurses and patients to establish mutual goals and the disturbances inadvertently leads to the patient being more active in the delivery of care. The implication of this is that the higher the patient interacts with the healthcare professionals, the better the goal achievement.
Applying King’s Conceptual Theory to Potential Practice Quality Improvement Initiative within clinical practice
Amy just had a knee arthroscopy surgery to correct a problem in the knee joint. In this experience with Amy who is now a postoperative patient, King’s theory was applied to assess the patient understanding of the risk factors of the surgery and her understanding of a postoperative patient. As a nurse, I identified that the patient was not fully aware of the procedure; including how long it takes to recover from arthroscopic knee surgery, what she can or cannot do during the recovery period, and how soon she can walk after the surgery. Thus, consistent with the King’s theory of goal attainment, I set to educate the patient on procedure and what she can or cannot do. Next, we agreed on the right exercises for the patient and educated her on the frequency and importance of doing these exercises.
Aligning Outcomes with King’s Conceptual System Theory
Within the health systems, a quality committee is responsible for the definition, prioritization, overseeing, and monitoring of the clinical performance, assessment of improvement activities including patient and environmental safety. In essence, the primary duties of a quality committee include analyzing performance data, monitoring performance, recommending improvement efforts for delivery of quality care within the organization. In order to assess quality outcomes, quality committees must come up with performance indicators in order to measure the effective of the health care systems. Goal-attainment scaling can be used to measure the effectiveness of the performance indicators to assess clinical quality outcomes.
Nursing theory that aligns with improved quality of practice initiative
Nursing theory refers to a group of interconnected notions that are used to explain or predict the area of inquiry. The theories provide a focus and direction along which the results in a defined practice find an anchor. Consistently, apart from King’s conceptual system theory of goal attainment, Jean Watson’s theory of Human Caring also aligns with improved quality of practice initiatives. Virtually, Jean Watson’s theory of human caring views nursing as a caring science that is deeply supported by moral and ethical contexts. The theory views nursing and healing as work that is beyond conventional thinking. Caring is an integral part of nursing and plays a critically significant role in the delivery of quality care. According to Pajnkihar, Štiglic, and Vrbnjak (2017) caring for nurses have the potential to contribute to patient satisfaction and well-being of the patients. In fact, as Pajnkihar et al. elaborate, the absence of care is likely to pose a major threat to the quality of care delivered.
Virtually, in today’s healthcare sector, major efforts have been launched to ensure more patient-centered care delivery. The shift focuses on care delivery that meets the patient needs and achieves the desired health outcomes that are consistent with the current professional knowledge. King’s theory provides a desirable approach to provide better care that focuses on the patient’s individual health goals. Researching King’s theory reveals the practicality and application of the theory in nearly every area of patient-nurse interaction. The theory shifts focus from the simple process of gathering information to truly listening to the needs of the patients, which can be directly or indirectly. Adopting a goal-oriented approach within the clinical setting ensures appropriate and effective healthcare decisions, assessment of outcomes, and measurement of success. The approach also allows nurses to align patient needs and align treatment towards the common goal of improving or restoring the health of the patient.
Fitzpatrick, J. J., & Kazer, M. W. (2012). Encyclopedia of nursing research. New York: Springer Pub.
Pajnkihar, M., Štiglic, G., & Vrbnjak, D. (2017). The concept of Watson’s carative factors in nursing and their (dis)harmony with patient satisfaction: Elektronski vir. PeerJ(5), 1-16.
Smith, M. C., & Parker, M. E. (2015). Nursing theories & nursing practice. Philadelphia, PA : F.A. Davis Company.
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