Concept Analysis of Systems Thinking in the Context of Interprofessional Practice and Improved Patient Outcomes.

AIM: The purpose of this study was to explore the definition and application of systems thinking (ST) in interprofessional practice and improved patient outcomes. BACKGROUND: Nurse educators need a universal definition of ST to implement in curricula to foster quality and safety while enhancing outcomes for nursing students. METHOD: The QSEN RN-BSN Task Force used the hybrid model of concept analysis to identify the process of fostering ST in clinical and didactic learning experiences and how ST changed over time from the perspective of educators. RESULTS: The definition of ST in the context of interprofessional practice and outcomes was "a dynamic, analytical process that looks at complex patterns, relationships, and connections within elements and structures, resulting in the ability to recognize the whole picture." CONCLUSION: The concept of ST in the context of interprofessional practice and improved patient outcomes may be integrated within nursing curricula.

A nursing residency program: A window into clinical judgement and clinical decision making.

The purpose of this descriptive, qualitative research study was to explore a nursing residency students' perception of clinical decision making and clinical judgment as evidenced through reflective journaling. Seven Registered Nurses completed a one year Baccalaureate Degree, while concurrently participating in a nursing residency. Reflective Journals focusing on clinical incidences during the residency were analyzed using the Tanner's Model of Clinical Judgement (2006). The residency experiences were noted as temporal in nature; with three phases evident; Beginning Residency, Thresholds in Nursing Residency and Homecoming in Nursing Residency. Eight themes were identified throughout the three phases. A nursing residency is an exceptional transformative pedagogical methodology for skill/knowledge acquisition allowing for a deeper engagement in enhanced confidence, self-analysis and progression to professional socialization. In addition, reflective journaling is a viable method for the self-analysis of clinical decision making through the experience of a nursing residency.

Promoting civility in nursing practice using systems thinking: Evidence-based teaching strategies for nurse educators.

There is a critical need for nurse educators to promote civility in nursing practice using systems thinking to promote quality and safety and improve patient outcomes by preventing undue patient harm. In this article, evidence is synthesized in order that readers can recognize, respond and manage workplace incivility. Systems thinking is introduced as a best practice solution for advancing a civil workplace culture. The author-created Systems Awareness Model, adapted for civility awareness, guides nurse educators with evidence-based strategies for teaching nurses the essential skills to promoting a civility culture within health systems. The strategies can be used by nurse educators in practice to interface workplace application. Proposed examples of evaluation methods are aligned with the teaching strategies. The purpose of this article is to provide nurse educators in practice with evidence-based teaching strategies and evaluation methods to address incivility in health care using a systems thinking perspective.

Using Systems Thinking to Implement the QSEN Informatics Competency.

There is an urgent need to improve the use and usability of the electronic health record (EHR) in health care to prevent undue patient harm. Professional development educators can use systems thinking and the QSEN competency, Informatics, to educate nurses about such things as nurse-sensitive indicators in preventing medical errors. This article presents teaching tips in using systems thinking to champion communication technologies that support error prevention (betterment). [J Contin Educ Nurs. 2019;50(9):392-397.].

Systems Thinking for Transitions of Care: Reliability Testing for a Standardized Rubric.

PURPOSE: The purpose of this study was to develop a standardized rubric for systems thinking across transitions of care for clinical nurse specialists. DESIGN: The design was a mixed-methods study using the Systems Awareness Model as a framework for bridging theory to practice. METHODS: Content validity was determined using a content validity index. Reliability was established using statistical analysis with Cronbach's α and intraclass correlation coefficient. Usability of the rubric was established using content analysis from focus group discussions about their experiences in using the rubric. RESULTS: Content validity was established with a content validity ratio of 1.0. Statistical analysis showed a high interrater reliability (α = 0.99), and sections of the rubric showed a strong degree of reliability with α's ranging from 0.88 to 1.00. Content analysis revealed several overall themes for usability of the rubric: clarity, objectivity, and detail. The area for improvement included adding more detail in the scholarly writing section. CONCLUSION: The research team recommends using the rubric to reflect application of systems thinking across transitions of care.

A Concept Analysis of Systems Thinking.

PURPOSE: This concept analysis, written by the National Quality and Safety Education for Nurses (QSEN) RN-BSN Task Force, defines systems thinking in relation to healthcare delivery. METHODS: A review of the literature was conducted using five databases with the keywords "systems thinking" as well as "nursing education," "nursing curriculum," "online," "capstone," "practicum," "RN-BSN/RN to BSN," "healthcare organizations," "hospitals," and "clinical agencies." Only articles that focused on systems thinking in health care were used. The authors identified defining attributes, antecedents, consequences, and empirical referents of systems thinking. FINDINGS: Systems thinking was defined as a process applied to individuals, teams, and organizations to impact cause and effect where solutions to complex problems are accomplished through collaborative effort according to personal ability with respect to improving components and the greater whole. Four primary attributes characterized systems thinking: dynamic system, holistic perspective, pattern identification, and transformation. CONCLUSION: Using the platform provided in this concept analysis, interprofessional practice has the ability to embrace planned efforts to improve critically needed quality and safety initiatives across patients' lifespans and all healthcare settings.