N 491 Conceptual System Theory Discussion Paper

King’s Conceptual System Theory

Nursing theories attempt to systematize the nursing practice and knowledge required in the profession. These theories focus on the attainment of the four meta-paradigms of nursing and the interaction between nurses, patients, and their care environment. The conceptual system theory that lays the foundation for the goal attainment theory by Imogene King is an essential model that demonstrates the need for nurses to understand theories as concepts, definitions, and approaches aimed at helping them provide quality care to patients (Fawcett, 2018). The purpose of this paper is to discuss King’s conceptual system theory and its facets, from its systems to its application in nursing practice to improve the quality of care.

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King’s Conceptual System Theory

Conceptual frameworks address the general and abstract concepts of phenomena and postulations that delineate them. These frameworks have practical values as they guide to research and practice in different fields. According to Butts and Rich (2018), conceptual frameworks enable nurses to attain unique perspectives concerning the metaparadigm concept and offer a path for the development of concrete theories. Imogene King developed a conceptual system that is used in nursing.

The conceptual system by King scrutinizes the interactions and interrelationships between human beings and their environment that determine the physical and social conditions for their functioning. The conceptual system advances that human beings are interacting with open systems in their external and internal environments. King’s conceptual system assumes that human beings are the focus of nursing whose goal is to promote, maintain, and restore health, and care for the sick or the injured and even the dying. King’s conceptual system ascertains that nurses deal with human beings, families, and communities and make transactions in diverse environments with health as the primary goal. Therefore, nurses require knowledge and skills to observe and interpret behaviors and intervene through the behavioral realm to help individuals and groups cope with health, illness, and crisis. King’s model asserts that these concepts are interrelated and can be used across systems as they are important in offering applicable knowledge to practice (Adib-Hajbaghery & Tahmouresi, 2018). The theory advances that there are three systems; personal, interpersonal, and social that allow nurses to offer care with a view of attaining the set goals.

Three Systems of the Conceptual Model

The King’s conceptual system identifies three critical parts of care that include personal, interpersonal, and social systems with their associated concepts. The concept of personal system advances that individuals comprise personal systems and each individual is an open, complete, and distinct system that constantly interacts with the environment (Butts & Rich, 2018). The concepts of the personal system include perception, self, growth, and development as well as body image, space, and time. The self-concept means that each one is a system on their own like the patient, the physician, and the nurse as well as the chaplain and the physical therapist (Fawcett, 2018). The implication is that the personal system embodies an individual who interacts and reacts to stimuli from others and the environment, and their influence on their functioning.

King advances that an interpersonal system happens between individuals and groups of people like healthcare providers. The interpersonal system has concepts like communication, interaction, transaction, role, and stress. Accordingly, interaction is a process of perception and communication between the individual and the environment and between the person and individuals represented by both verbal and nonverbal behaviors that are goal-focused (Butts & Rich, 2018). The transaction entails the interaction between persons like the nurse and patient to attain set goals while communication is the exchange of information. The role entails a set of behaviors expected of the individual occupying a position in a social system while rules define the obligations and rights of the position. The interaction between nurses and patients in the nursing setting is an example of the interpersonal system based on the conceptual model.

The social system entails wider interactions that happen within and between groups where boundaries, social roles, behaviors, and practices exist. These groups have common aspects like interests and goals as well as values. The concepts in the social system include organization, power and status, authority, and making decisions. Groups exist in nursing practice and healthcare environments like religious formations, healthcare organizations, regulatory agencies, schools, and families as well as communities.

Influence of the Systems on Goal Attainment

The systems in the conceptual model have a significant influence on how nurses attain patient care and delivery goals in practice. King developed the goal attainment theory as a nursing theory based on the interactions and influence of the three systems. The goal attainment theory asserts that nursing is a process based on actions, reactions, and interactions whereby nurses and clients share information concerning their perception of the nursing situation. Imogene King introduced the goal attainment theory in the 1960s and the model’s focus entailed how nurses can achieve set care goals in their clinical practice and settings (Butts & Rich, 2018). The theory asserts that nurses and patients share information through effective communication, set goals collaboratively, and take necessary actions to attain the set goals.

The three interacting systems impact the attainment of goals, especially the personal and interpersonal systems as nurses must communicate with patients to share their desires and need to enhance health outcomes. The goal attainment theory leverages concepts from personal and interpersonal ideas that include interactions, communication and transactions, self and role as well as time and space. Imperatively, personal and social systems impact the quality of care as patients, nurses and other healthcare providers must share information concerning the situation at hand and how to deal with it with a focus on attaining set goals.

King’s Theory in Defining a Clinical Quality Issue

Quality is a critical aspect of care provision and entails setting standards of excellence in healthcare for patients to attain better outcomes. King’s theory can assist define clinical quality issues through the personal system where patients’ level of satisfaction entails their ratings of a facility. The individual can rate the facility using public rating systems like the Hospital Consumer Assessment of Healthcare Providers and Systems. This tool entails results from surveys on healthcare facilities and organizations based on how patients rate their experiences and their opinions of the level of quality or excellent care.

Healthcare organizations and practices can leverage these outcomes to develop quality improvement interventions when they identify areas that need quality interventions to enhance patient satisfaction and experience (Fronczek & Messmer, 2021). Through these surveys, healthcare organizations can identify quality problems. The survey contains questions on a host of issues like the level of communication and interactions between providers and patients, cleanliness and quietness of the hospital environment, and the level of interdisciplinary collaborations among the different providers.

Application of the Theory to Possible Practice Quality Improvement Initiative in Clinical Practice

My clinical practice environment is the emergency department which requires critical communication with the patient and their family based on the level of acuity that patients present. Nurses working in the emergency department leverage effective communication and interactions between them and patients to help improve quality. The possible practice quality improvement initiative in the emergency department is effective communication and interactions among the different stakeholders, especially the patient and the nurse. Communication helps nurses build rapport once a patient presents in the department, especially when they require care due to the severity of their health issue. This could include an attack among individuals with sickle-cell anemia, the need for control of blood sugar levels for diabetic patients, and asthmatic attacks that require fast medication and management.

The three systems of King’s conceptual model offer a platform for better communication and interactions with patients and other providers to attain the set goals of stabilizing such patients and proceeding to the next level of treatment provision (Butts & Rich, 2018). The application of the theory will determine the need for better communication and the tools that can be deployed, from technologies like telehealth to communication models like SBAR; situation, background, assessment, and recommendations.

Aligning Outcomes with King’s Conceptual System Theory

Quality improvement committees in healthcare settings focus on enhancing patient outcomes through interventions focused on better care delivery. Imperatively, the committee can align the outcomes using the interpersonal system of the theory. The transaction process measures outcomes and sets goals for quality improvement that the committee wishes to achieve (Fawcett, 2018). Further, the use of case conferences where the patients and designates are present can assist in the development and communication of goals in the care plan and delivery.

Additional Theory aligning with an Improve Quality of Practice Initiative

The theory of interpersonal relations by Hildegard Peplau details the interactions between nurses and patients as core to the nursing practice. The theory emphasizes that the nurse-patient relationship is a give-and-take based on the four components of the person, the environment, health, and nursing (Forchuk, 2021). Consequently, it aligns with the need to improve the quality of practice in the emergency department as nurses must forge mutually beneficial relationships and interactions with their patients. The implication is that Peplau and King all value the delivery of high-quality care based on the interactions between nurses and patients. The two theories emphasize the goal-based process of delivering nursing care. They also value nurses’ education and possession of vast medical and health knowledge to improve patient care and better outcomes. Advanced educated nurses perceive quality as a critical aspect of better patient outcomes.

Conclusion

Nurses and the nursing practice and profession continue to use the theories developed by theorists like Imogene King and Hildegard Peplau because of their relevance in guiding the care process. King’s conceptual system and the goal attainment theory are essential in patient care management because of the key concepts that they advance for nurses and patients. Nurses and patients will attain quality care provision and outcomes through the deliberate decision to use King’s conceptual system theory and other relevant models.

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: 10.4103/2322-1488.235636

Butts, J.B., & Rich, K.L. (2018). Philosophies and Theories for Advanced Nursing Practice (3rd

            ed.). Burlington, MA: Jones & Bartlett Learning.

Fawcett, J. (2018). Applying Conceptual Models of Nursing: Quality Improvement, Research,

            and Practice. New York, NY: Springer Publishing Company.

Fronczek, A. E., & Messmer, P. R. (2021). Imogene M. King: Conceptual System and Theory of

            Goal Attainment. Nursing Theorists and Their Work, E-Book, 213.

Forchuk, C. (2021). Overview of Peplau’s Theory. In From Therapeutic Relationships to

            Transitional Care (pp. 3-15). Routledge.

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Assignment Description:
King’s Conceptual System Theory

Write a 1250-1500 word APA paper addressing each of the following points. Be sure to completely answer all the questions for each bullet point. Separate each section in your paper with a clear heading that allows your professor to know which bullet you are addressing in that section of your paper. Support your ideas with at least two (2) outside sources and the textbook using citations in your essay. Make sure to cite using the APA writing style for the essay. The cover page and reference page in correct APA do not count towards the minimum word amount. Review the rubric criteria for this assignment.

Discuss and explain King’s Conceptual System Theory.
First explain the 3 systems and provide examples of each system
Explain how the systems influence goal attainment
How could King’s theory help define a clinical quality problem?
Apply this theory to a potential practice quality improvement initiative within your clinical practice.
How could a quality committee align outcomes with King’s Conceptual System Theory?
What additional nursing theory from our readings could also align with an improved quality of practice initiative?

The following specifications are required for this assignment:
Length: 1250 – 1500 words; answers must thoroughly address the questions in a clear, concise manner.
Structure: Include a title page and reference page in APA style. These do not count towards the minimum word count for this assignment.
References: Use the appropriate APA style in-text citations and references for all resources utilized to answer the questions. Include at least two (2) scholarly sources and the textbook to support your claims.
Format: Save your assignment as a Microsoft Word document (.doc or .docx).