The systems theory as applied in nursing care settings views the settings as consisting of an energic input-output systems (Meyer, 2010). It has a support system that ensures continuous supply of inputs for sustainability. The inputs are processed through interactions of individuals in order to produce outputs. In this paper, systems theory is explained in relation to a cardiac unit in a hospital. The description includes the components of a systems theory. A problem in the system is identified, and a solution for it devised using the open systems model.

In regard to the general system theory, a department or a unit in a hospital is a sub-system, or a small system of the larger system. The cardiac unit of a hospital is a sub-system of the big system. Being a subsystem, it has all the features of the larger system (Meyer &O’Brian-Pallas, 2010). Thus, the cardiac unit has the inputs, the throughput, the outputs, the cycles and the negative feedback. There are many inputs in the cardiac sub-system of a hospital. These are the nurses, the cardiac drugs, the equipment like cardiac beds, vital-signs monitors, electrocardiographic machines and trolleys and the building. Also, in this category are the cardiac patients, knowledge of the nurses, ethics of the nurses, skills of the nurses, finances, information about patients and the beliefs of the nurses. The throughputs in the cardiac department are the nursing services like giving cardiac medications to patients, counselling, bathing patients and monitoring the progress of a patient. The outputs in the cardiac unit include the number of cardiac patients seen in a given time, the resolutions made by the nurses, the problems of the cardiac patients, outcomes of client health care goals, peaceful death and improvement of care (Marquis & Huston, 2009). The cycles in the cardiac unit include the revenue generated through the provision of nursing care and the achievement of the accreditation criteria (Meyer&O’Brian-Pallas, 2010). In the cardiac unit, the negative feedback factors include the outcomes of care in the unit, for example, the quality of care, the efficiency with which care is delivered, and the manner in which resources are utilized.

The problem identified is a high patient to nurse ratio, 8:1, in the cardiac units. In relation to the systems model, it is clear that a system is made up of components and that a defect in one component of the system is likely to affect the other components (Marquis & Huston, 2009). In this case, the problem is with the inputs component of the system. The nurses and the patient’s parts of the input component of the system are affected. The nurses are very few compared to the number of patients in the unit. This is likely to affect the throughput in that; the delivery of nursing care is compromised. Some procedures like turning and bathing patients are not be performed as required. This has a significant effect on the outputs. For example, there has been poor realization of client goals. Improvement of care may never be realized. In terms of outputs, also, the number of patients who would receive quality care remains low. Cycles are also affected. Because of the inability of the unit to provide quality care, the levels of revenue are have reduced. Since the components of the system are inter-connected (Meyer&O’Brian-Pallas, 2010), negative feedback presents in terms of low quality care, decreased efficiency, and poor utilization of resources, due to understaffing.

The open systems model can be applied to solve this problem (Meyer&O’Brian-Pallas, 2010). In this case, the desired outcomes would be quality care, increased efficiency, and the realization of client goals the following goals would be set: to renew the inputs by retaining and hiring more nurses, to decrease the patient-nurse ratios; to intensify the workload of nurses in order to increase volumes, increasing the working hours of nurses to increase efficiency and to mobilize nurses into realizing client’s goals.

For the formulated goals and procedures to work, they have to be translated into policies and procedures. The department’s policy concerning staffing levels would be a patient to nurse ratio of 3:1. For this to be achieved, nurses will be retained at their retirement age. The department would also hire more nurses to meet the target. In regard to efficiency, the policy adopted would be to ensure that all procedures are done for patients. This will be achieved by making sure there are enough nurses in the unit at any given time. In addition, the policy will require that nurses attend to patients with standardized set goals, which they have to achieve.

In regard to professional standards, the policy will be followed strictly, and reviewed whenever necessary to conform to the professional standards of care. The U.S Department of Health and Human Services (2014) outlines the nurse patient ratios of the State of California as ranging from 1:1 in the operating rooms, to 1:6 in the mental units. However, policy varies from state to state, and it may also vary as per the hospital. The set ratio in the cardiac unit in this case conforms to the international standards. For acute cardiac patients, the team leader can allocate them more nurses and consider fewer nurses for stable patients.

The mission of the hospital is “To provide Christ-like healing to the community through education, treatment and health services. The vision is to “To be the comprehensive medical system”. Relating this to the open systems model, it is clear that a defect in one component of the system affects the others (Meyer&O’Brian-Pallas, 2010). Correcting the problem also affects the whole system. When the patient-nurse ratio is decreased, quality of care is improved. This will eventually lead to the realization of client goals and desired outcomes. The community will be satisfied with the system, and it will work effectively.

References

Marquis, L.B., &Huston, J. C. (2009). Leadership roles and management functions in nursing: Theory and application. New York, NY: Lippincott Williams & Williams.

Meyer, M. R., & O’Brian-Pallas, L. (2010). Nursing services delivery theory: An open system approach. Journal of Advanced Nursing, 68(12), 2828-2838.

U.S Department of Health and Human Services. (2014).State-mandated nurse staffing levels alleviate workloads, leading to lower patient mortality and higher nurse satisfaction. Retrieved online from nnovations.ahrq.gov/content.aspx?id=3708