Clinical Knowledge, Is Essential Within

¶ … clinical knowledge, is essential within the paradigm of nursing. It is a foundation upon which one builds a toolbox of materials, designed not to treat every situation in a similar manner, but to have a means and template from which to help make decisions for the patient. It is a given that the modern nurse will have a far greater exposure to new medical methods, pharmaceutical interactions, and techniques than many nurses of the past. In fact, "the use of clinical judgment in the provision of care to enable people to improve, maintain, or recover health, to cope with health problems, and to achieve the best possible quality of life, whatever their disease or disability, until death" is one of the definitions of modern nursing (Royal College of Nursing, 2003). In fact, with such a vast amount of clinical information needed, combined with the stress of a busy hospital, and the various insurance and legalities to be considered, many contemporary nurse managers find that it is helpful for the modern nurse to utilize a "medical checklist" to improve patient care (Hales, 2008).

General Systems Theory - One theory, the General Systems Theory was proposed by Karl Ludwig von Bertalalanffy, an Austrian Biologist. This theory is an interdisciplinary practice that describes systems that have numerous spokes, or interacting components. The origins of the theory came from Bertalanffy's view that the basic laws of thermodynamics (i.e. temperature, energy and entropy) work better for closed systems. Open systems, like living things, show different patterns and tendencies.

GST and Healthcare Delivery- GST tells us to think in a whole system fashion. Thus, for the healthcare profession, GST takes a more holistic approach to healing and the body than looking at individual organs, disease, or symptoms. In other words, GST thinking would look at nutrition, lifestyle, psychological factors, genetic factors, and the environment when dealing with patient concerns. It would ask that we look at the human body as a complex organism that operates as a whole, in synergy, with a number of issues that make up the way the body works. For instance, treating Type-II diabetes without looking at diet and exercise only treats symptoms; not the root cause. This changes the medical paradigm drastically and requires a more multidisciplinary approach to healthcare.

GST and Current Nursing Practice- Contemporary nursing requires much more than clinical theory. We have seen example after example of theoretical processes that have improved the profession yet the crisis in health care and nursing continues. Often at the crux of the matter is the nurse's responsibility to their employer, to the fiscal needs of the clinic or hospital, or even the constraints that modern medicine has placed on them also form a very real conundrum within the paradigm of philosophical ethics. This question is, as well, one of balance -- balancing the human need with the need to stay solvent. Often at the crux of the matter is the nurse's responsibility to their employer, to the fiscal needs of the clinic or hospital, or even the constraints that modern medicine has placed on them also form a very real conundrum within the paradigm of philosophical ethics. This question is, as well, one of balance -- balancing the human need with the need to stay solvent. The holistic continuum that truly defines the new model -- the new model focuses on interaction, focuses on holism, and focuses less on simply the cause of disease, but ways to improve the quality of life to prevent disease. In fact, building a truly holistic approach to nursing theory, practice, pedagogy and implementation can change the critical juncture of nursing to fit more of the 21st century needs of combining various healthcare models.

Diffusion of Innovation Theory -- This theory, expressed by sociologist Everett Rogers, seeks to explain how and why new ideas and technology spread through culture. The theory holds that diffusion is a process in which innovation is communicated through certain levels or channels over time and mitigated by whether the decision is made freely and who makes the decision.

DIT and Healthcare delivery - Modern healthcare is quite complex, as are the relationships between various stakeholders within the system -- patients, family, specialists, staff, administration, medical personnel, regulatory bodies, insurance, public and private health personnel and even the political sphere. DIT heals measure the breadth and number of organizational units affected, the amount of communication across organizational lines, and the manner in which individual groups interact proactively. Innovation theory in health organizations often induces two cycles: 1) poorly performing organizations that respond with rule bound behaviors and indeed perpetuates poor performance and; 2) beneficent responses in which better performing organizations have autonomy which reinforces their stronger performance (Lundblad, 2003). For organizations to remain competitive, they must adopt the more proactive stance from DIT and find ways to both streamline and self-critique.

DIT and Current Nursing Practice -- Because of the complex nature of nursing practice, combined with new expectations for many nurses (e.g. stronger and more robust clinical roles, more teaching and interaction requirements, larger patient loads, etc.); there are more and more technical demands upon nurses. At times, the increased pressure from so much information, new technical specifications, and increased loads can be mitigated by using the essential concepts of DIT strategies to apply innovation and adaptation processes. The underlying assumption, of course, is that the DIT model assumes change is promoted through ideas or information introduced by people with whom one can identify. This is critical within the nursing paradigm -- the carative models of Watson and Peplau for instance, show that emulation and modeling can be most effective among a group of people within an organization over time -- and how to speed this process up to its maximum efficacy (Sunderman and Johnson, 2008)..

ANNOTATED BIBLIOGRAPHY

Lundblad, J. (2003). A Review and Critique of Rogers' Diffusion of Innovation Theory

As it Applies to Organizations. Organization Development Journal. 21 (4):

50-9.

Scholarly material that focuses on a demonstration on why innovation is important in organizational development for a number of fields, including health care. The four primary elements of Rogers' theory are described (innovation, communication, time and social system) with an emphasis on how the theory applies within and most especially across organizations.

Sunderman, C. And Johnson, C. (2008, August 4). Complexity Theory Versus

Organizational Theory Guiding Electronic Nursing Documentation System