Theory selection and application to proposed solutions

PICO

Nursing theory informs nursing practice, and especially evidence-based practice. Theory offers a framework for decision-making and policy. Neuman's systems model provides the perfect theoretical framework with which to conduct my research and inform best practices. My PICO question is as follows: "For hospitalized patients who are susceptible to catheter associated Urinary Tract infection (CAUTI), if nurses and other assistive personnel develop an action plan with a systematic team approach of evidence-based infection control practices, compared to current practices, could it reduce or eliminate incidences of CAUTI?"

Developed by Betty Neuman, Neuman's systems model has a variety of applications in the workplace. Although it is a broad mid-range theory, Neuman's systems model also has specific applications for daily nursing practice. According to Neuman (2011), the systems model "provides a unifying focus for approaching a wide range of international health concerns." One of these concerns regards the correct use of catheters in hospitalized patients. Therefore, Neuman's systems model is an appropriate framework for researching my PICO question and providing suggestions for future research and practice.

One of the reasons why Neuman's systems model is especially applicable to my PICO question is that an open systems framework takes into account the multiple variables at play in catheterization. Environmental variables (both inside and outside of the institutional environment) are important considerations when researching best practices aimed at preventing CAUTI. Understanding other variables impacting the system, such as stress and miscommunication, can also prevent infections. Hospital procedures and administrative variables must also be taken into account, in order to reduce CAUTI incidences.

Another reason why Neuman's systems model is particularly important for my PICO question is that catheterization is itself a systematic procedure involving tools and techniques specific and unique to its clinical usage. The particular modes of preventing CAUTI and other infections do have some overlap with other areas (hand washing for example). However, there are system-specific issues that can and must be addressed if nurses are to develop sensible plans of action for prevention in their respective institutions. Viewing catheterization as a system helps nursing staff and administration conceptualize strategic plans of action and practive interventions These interventions are not necessarily medical in nature. Sometimes they involve attending to the communication and humanitarian needs of the patient. Other times the interventions may involve changing the structure of the nursing team, or the relationship of supervisor to staff. It is my goal to research the implications for team building as a systematic factor in preventing CAUTI.

The preliminary research I have unearthed show an underlying pattern that conforms to Neuman's systems model. Research is culled from a wide variety of sources and data sets are international. Both qualitative and quantitative research reveals that catheterization can be viewed from the perspective of systems theory. Systems theory works to support my proposed solution, which is the development of a systematic action plan involving a team-based approach to personnel management. Without a systems theory approach, management and other human resources might not be taken into account when developing a solution to the problem.

I will incorporate Neuman's systems theory into my project by highlighting the various systems that interact: including systems unique to each patient (culture, family background, and psychological variables). There will also be variables related to geography and public policy in any given area. Then, variables that are confined to the individual hospital setting are taken into account because they inform practice too. Especially when it comes to a personnel-focused solution, hospital policies, organizational culture, and organizational behavior issues need to be looked at from a critical perspective. Furthermore, I will incorporate systems theory into my project by showing which medical variables are important to the prevention and treatment of CAUTI.