Many of you have experience in complex adaptive systems whether you realize it or not. Thinking about your future practice specialty area, identify a situation in which an issue or concern common to your future specialty would impact that system. (Note: This can be the same practice issue identified in Week 5.)
The majority of nurses and advanced practice nurses today are working in complex adaptive systems. As science and evidence-based practice have evolved, so have complex adaptive systems (CAS). Complex adaptive systems or complexity science in nursing is a non-linear, unpredictable model of behavior with many diverse components that are interconnected, all functioning together towards new and improved care models (D’Agata & McGrath, 2016). CAS’s are interactive systems, involving an array of disciplines. They have multiple components that often challenge the way things were always done towards a new and improved method of thinking and doing that is science based. Once CAS’s are embraced by the healthcare community, great stride towards a better functioning healthcare system can and will evolve.
As a future nurse educator, I see the need for greater understanding and involvement in complex adaptive systems. One issue that I would like to see further advanced is that of family centered care in the neonatal intensive care unit (NICU) environment. Clinical nurse educators have become increasingly valuable resources to nurses, other healthcare disciplines, patients, and their families. This advanced practice role can provide the necessary education and role modeling that can ultimately transition current models of care into improved future models of care. As I researched this discussion question, I found a clinical issue that I could identify with and one that I would like to see my future role as a nurse educator impact. Through exploration of interconnected relationships between the parent, nurse, and patient, the need for increased parental involvement in direct care is an identifiable need for promoting the neurodevelopment in the NICU patient (D’Agata & McGrath, 2016). Educating nurses to allow for supportive parental caregiving right from the start in NICU stays, offers a stronger potential for improved parent attachment to their infant and possibly impacting premature brain development (D’Agata & McGrath, 2016).
Premature infants are presenting to hospitals across our country with earlier gestations and more complicated medical needs than ever before. Their survival rates have greatly improved. However, the neurodevelopmental outcomes long after NICU stay is the clinical issue that needs to be addressed. There is rising evidence that poorer brain development caused by premature births lead to “cognitive, emotional, and behavioral deficits” (D’Agata & McGrath, 2016). Anxiety, attention deficits, autism, depression, cognitive deficits, and social difficulties have manifested in these individuals, long after NICU stay (D’Agata & McGrath, 2016). Family centered care is not a new concept in nursing, especially in the neonatal and pediatric settings. Incorporating the family into care, specifically the patient’s parents is one that is overall an accepted part of care but there is room for growth.
In the NICU setting where the patient is in a complex and fragile medical state, the bedside nurse is the primary caregiver and coordinator of care for the baby. In an essence, the nurse acts as the gateway between newborn and parents. Parents can often feel a lack of control or inadequacy in this type of situation. The neonate will likely experience factors that are abnormal early life experiences like stress, pain, and separation which can negatively affect the premature brain (D’Agata & McGrath, 2016). D’Agata & McGrath (2016) go on to describe research proving that chronic stress can alter the course for normal brain development. For example, a normal diaper change should not be a stressful event but accompanied by vital signs, heel sticks, repositioning, and bathing might be too much for a little one who has no reserve. Increased incorporation of parental participation in hands on care early in NICU stay has shown potential for improving short and long-term outcomes for the neonate (D’Agata & McGrath, 2016).
The pathway of letting go of some of the rigidity that occurs in NICU care and adapting to a less linear approach to family centered care would help foster the crucial emotional connection needed to be formed between parent and child. The nurse educator can intervene by sharing recommendations for parental involvement with the staff and en
Order this paper