King’s conceptual system helps in the comprehension of what it means to be human, as it is the central concept presented in its philosophical core. According to King, the general understanding of human behaviour has not evolved for the past six decades but has rather stayed the same ( Smith & Parker, 2015) . In King’s theory, the systems discussed aim at improving the nurse and patient’s relationship and consequently the quality of patient care. Although very few developments have been made on King’s theory, the proposition has been applied largely in nursing profession ( Smith & Parker, 2015). T he paper will discuss the three systems according to King and how they relate to the theory of goal attainment and also apply the theory to clinical practice. King’s conceptual system is efficient in cementing the nurse-patient relationship and setting reasonably achievable objectives which will aid in the provision of quality care.
An explanation of the 3 systems and the Examples of Each System
The three major interactive systems are personal, interpersonal, and social interactive systems. The first system; personal systems explain the individual perception of time, self, space and body image which influences the way one responds to events, people and objects surrounding him or her. When growing, one experiences changes in the body which in turn influence one's perception and how she or he views herself (Frey, Sieloff, & Norris, 2002). Personal systems give the concept of perception as awareness that a patient develops through experiences processed from his or her own life and this involves the physical appearance of patients, feelings, and thoughts about themselves (Adib-Hajbaghery & Tahmouresi, 2018). Individual thoughts and feelings about oneself play a more significant part in defining who the individual patients are. Body changes are reactions in the body, time changes are seen between one occurrence, and the patient saw the next event. Growth is interpreted to imply lifetime changes on body parts, emotions, behaviours that give one a sense of maturity. Space is the physical environment that the patient is in. Thus, one may conclude that personal systems have an essential role in the self-identification and perception of the patient.
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Interpersonal systems are defined by interactions between two people known as a dyad, a triad for three people and a group for many. Both verbal and nonverbal interactions between the patient and the nurse are crucial. The concepts in the interpersonal system consist of communication, and the interactions of the two parties that are the nurse and the patient (Smith & Parker, 2015). Interaction is understood by the behaviour of the nurse and patient towards each other while communication is where information is conveyed between the two either face to face or through a medium such as a call or writings (Frey, Sieloff, & Norris, 2002). Transaction and roles are understood by interactions of the patients and nurses, the goals they aim at achieving and their behaviours towards each other. Stress will disrupt all the above concepts and prevent effective interactions. Interpersonal systems are essential towards attaining the set goals although, are often disengaged by the occurrence of forms of stress.
Social systems are the third system that is defined by interactions between the nurse and other individuals who share the same characters, goals, and interests; the same applies to the patient. Relationships begin by people who share common values and interests in identifying themselves and eventually coming together to assist one another (Frey, Sieloff, & Norris, 2002). The determinants of social systems are power, social status, decision making, organization, and authority. The organization is a group of individuals in a company who perform various roles and authority is those in an organization who carries out transactional processes and validates events happening in an organization (Smith & Parker, 2015). Power is those influencing situations in an organization while social status is the position of an individual, responsibilities, and lifestyle in society. Decision making is hence more impactful when people agree. The social system identifies and determines the quality of the treatment that is provided to patients hence is an excellent asset in goal attainment.
Explain how the systems influence goal attainment
The three systems are essential in goal attainment by the patient, and the nurse since the process of delivering care involves rational thinking, interaction and acceptable conducts to get good outcomes. Personal and social systems are responsible for the quality of care that the patient receives. The interpersonal system is responsible for linking the two strangers who just met on the context of the nursing profession, and it will determine their relationship for the period they will interact. The systems influence goal attainment since nursing is a process, and all nurses need to create an understanding with the patient thus the systems as described above (Frey, Sieloff, & Norris, 2002).
Personal systems where communication is found are essential to verify the perception and translation of the goals set. The systems are at a proper position of determining patient to nurse relationships, then set care goals and work together towards achieving the goals set. Social systems aid to determine and authorize resources that the patient and nurse needs to achieve desired needs, patient education and overcome barriers (Smith & Parker, 2015). According to King’s, the three systems help to achieve the three-goal related issues that are, mutual trust, enhanced growth and development and lastly mutual goal setting and attainment.
Definition of a Clinical Quality Problem by King
King's theory helps define a clinical quality problem in solving three types of problems. They include physician, nursing and discharging related challenges which determine the quality of the clinical pathway. Communication is the primary critical facilitating factor in a healthcare organization. Clinical pathways involve the process of medics interacting with their patients and following up on the patients’ progress towards the healing and recovery. Effective communication and interaction will help the nurse and patients set goals and achieve (Adib-Hajbaghery&Tahmouresi, 2018). King's reflection on the science of nursing enables critical thinking which helps to discover actions to be taken when making quality clinical pathways. In summary, King’s theory helps to define a quality clinical problem by, reducing a patient’s length of stay, increasing understanding and increasing satisfaction of the patient and the caregiver (Smith & Parker, 2015). Additionally, the cost of hospitalization is reduced, clinical quality improved with fewer complications and attaining a practice that has evidence.
Apply this theory to a potential practice quality improvement initiative within your clinical practice
The theory can be applied to the various clinical systems in improving practices such as health education, patient appraisal, and assessment, health screening, and prevention of trauma. For instance, when giving health education the nurse is required to set objectives that ensure the patient understands the information provided (Adib-Hajbaghery&Tahmouresi, 2018). Health education requires the three systems suggested by King whose comprehension will help improve patient knowledge and relationship. Perfect interaction and communication are required to conduct the education process and give a follow up on the patient after educating him. The goal attainment theory will ensure the process of health education is smooth and of high quality (Smith & Parker, 2015). The clinical systems will establish various communication barriers and work on them. Those providing education will have to establish good relationships with the patients to make following up more accessible after the patient has been discharged and if he or she understood the teachings.
Aligning a Quality Committee Outcomes with King’s Conceptual System Theory
Members of the quality committee can align outcomes with King’s concept systems by meeting regularly to agree on procedures to be taken towards effective patient care. All proposals must be tabled for discussion, and the members will decide on the best pathway to be taken towards achieving the desired patient service (Adib-Hajbaghery&Tahmouresi, 2018). Information must be shared with every committee member and assessment on previous pathways done to see which one achieved the goals perfectly. Also, modification of procedures should be done with all the members, and an interactive session with patients will also be useful to help them understand if they are on the right track of meeting patients’ needs.
An Additional Nursing Theory that Aligns with an Improved Quality of Practice Initiative
The Martha Rogers theory also helps improve the quality of nursing care. She defined health as an expression of the life process. Martha’s theory explains that nurses should focus on pain management and patient rehabilitation. Frey, Sieloff, & Norris (2002), also discuss how nurses should aid the patient's process of change and assist the patient in achieving better health. One should look at the patient’s environment when giving treatment which helps patients have a smooth recovery. The theory concurs with King’s theory where they both aim at increasing the quality and efficiency of patient care awarded.
Nurses should embrace King’s theory and relate it to other theories to achieve their goals in hospitals. Patient’s care and interaction is an essential factor for enhancing treatment. With the relevant authorities and systems, the patient may be developed by relating to nursing theories. King’s concept of goal attainment is thus sufficient in ensuring that objectives set by both nurses and patients are achieved within the set time and also strengthening the professional relationship between the two individuals. King’s system consists of three sub systems namely; the personal, Interpersonal, and Social systems. The previously mentioned systems help nurses to properly plan for their career goals as well as patients who intended. Additionally, King’s theory provides a clear definition of the clinical quality problem as challenges that determine the state of the clinical pathway. Therefore, it is advisable for nurses to apply the concepts proposed by King’s system of goal attainment to improve the quality of the practice.
References
Adib-Hajbaghery, M., &Tahmouresi, M. (2018). Nurse–Patient Relationship Based on the Imogene King's Theory of Goal Attainment. Nursing and Midwifery Studies , 7 (3), 141. doi:10.4103/nms.nms_10_17
Frey, M., Sieloff, C., & Norris, D. (2002). King's Conceptual System and Theory of Goal Attainment: Past, Present, and Future. Nursing Science Quarterly , 15 (2), 107-112.doi:10.1177/08943180222108895
Smith, M. C., & Parker, M. E. (2015). Nursing Theories and Nursing Practice (4th ed.). Philadelphia: F. A. Davis Company.
