Application of Concepts from Caring Science in Watson’s theory (Answered)

Caring behaviors in nursing can contribute to improved patient outcomes and satisfaction of care received during hospitalization. Without caring, nursing actions toward the promotion of health and alleviation of suffering may be meaningless leading to poor outcomes like dissatisfaction (Pajnkihar et al., 2017). One way to ensure that caring is central to the patient’s experience is the application of Watson’s theory of human caring to guide nursing practice. Nurses should understand that caring is the core concept of the profession and it involves caring for and caring about clients and families. While ensuring this theory is applied in nursing, nurses should utilize artistic and scientific knowledge to inform their decisions during care delivery. This discussion utilizes Watson’s theory to address challenges in nursing care that impact patient outcomes.

Nursing Practice Outcome

Communication in healthcare is an important aspect of care that influences relationships between providers and patient outcomes (Tiwary et al., 2019). Supported by evidence, ineffective communication among healthcare workers is one of the leading causes of medical errors and patient harm. Communication breakdown can happen due to various reasons including healthcare provider burnout, lack of proper communication guidelines, or personal issues between providers. According to the Joint Commission, more than 80% of serious medical errors involve poor communication between providers, especially during patient handoffs (Fucik, 2018). Similarly, research establishes that approximately 70% of sentinel events happen due to communication breakdown between healthcare workers (Fucik, 2018). This practice outcome affects the care given to patients causing undesirable events like prolonged hospitalization, increased cost of healthcare, and decreased patient satisfaction.

The growing body of literature on safety and prevention of errors reveals that poor communication results in medical errors. All patients come to seek care at the hospital hoping to receive good medical care and while the majority receive good care, sometimes outcomes may be impacted by poor medical care. For nurses, communication is central to the delivery and continuity of care (Freel & Fleharty, 2021). Because no doctor or nurse can stay in the hospital around the clock, shift handoffs are used to communicate care. As a result, patients end up being seen by different nurses and physicians alongside other professionals like nursing assistants. The handoff process can involve different scenarios including nurse-to-nurse communication, patient-doctor communication, physician-nurse communication, or communication between physician teams. The greatest risk during handoff is failure to effectively communicate crucial information like medications, tests, or basic data like patients’ demographics (Freel & Fleharty, 2021). Poor communication of this information leads to the omission of essential aspects of care or administration of wrong medication or tests leading to adverse events.

Better communication is of great importance to the field of nursing because it reduces patient injury and medical errors. During communication, nurses should learn to use good language and employ effective communication skills to ensure the recipient gets all crucial information. Traditionally, educational institutions focused on teaching technical expertise forgetting the crucial aspect of communication. As a result, more errors were observed despite staff having the appropriate technical expertise to perform their duties (Tiwary et al., 2019). Today, the shift to value-based care and the need to improve quality has made communication a central focus for improving patient outcomes. It has been estimated that 27% of medical malpractice is a result of communication failure with most hospitals incurring extra costs due to errors in communication (Tiwary et al., 2019). Poor communication can result in negative outcomes of patient care like decreased adherence to medication, patient dissatisfaction, and inefficiencies in the use of resources. To demonstrate a caring attitude and concern for patient safety, nurses need to address the issue of communication, especially during shift handoffs.

Concept in Watson’s Theory 

Nursing theories provide a systematic way of offering care and help to generate knowledge for future nursing. Jean Watson’s theory of caring is among the widely used theories that guide nursing care delivery. Watson contends that caring regenerates life energies and potentiates the capabilities of patients and providers (Kandula, 2019). Caring safeguards humanity and it unveils the true thoughts, feelings, and attitudes of providers. The caring attitude is beneficial to both patients and nurses because it is only through caring for themselves that healthcare providers can be able to care for patients. According to Watson, caring is what defines nursing and humans cannot be treated as objects (Gunawan et al., 2022). The concept of caring revolves around the development of interpersonal relationships with patients and healing is quickly achieved when caring prevails. The structure for the science of caring is built upon ten carative factors that guide nurses in making professional and personal decisions.

The concept in Watson’s theory that matches the outcome of medication errors and safety events due to poor communication is the creative use of self and all ways of knowing as part of the caring process. Watson’s theory emphasizes that nurses should be creative in making decisions and understand their consequences for patients (Gunawan et al., 2022). Nurses should demonstrate the use of scientific problem-solving methods for decision-making. The increased need for quality in healthcare also means that healthcare providers should utilize problem-solving approaches that are scientific. According to Watson’s theory, the scientific method is most preferred because it allows for control and prediction and that it permits self-correction (Kandula, 2019). The challenge of communication is a problem that is proven to cause adverse outcomes in healthcare. Evidence from research indicates that ineffective communication leads to poor patient satisfaction, medication errors, and impairs care delivery processes. Utilizing Watson’s theory can help nurses to solve problems like ineffective communication to improve patient outcomes.

Practice Implementation

Inadequate hand-off communication is a major challenge in healthcare organizations that leads to adverse events (Fucik, 2019). Handoffs can happen during shift change or passing information about patients from one department to another making effective communication crucial. Recent reports indicate that inadequate communication during handoffs has resulted in increased adverse events including wrong side surgery and delays in treatment. The Joint Commission 2017 report indicated that ineffective handoff resulted in over 30% of malpractice claims and $1.7 billion in malpractice costs (Fucik, 2019). To address the problem of communication, standardizing critical content to be communicated is the most recommended approach. Standardized communication tools provide nurses and other healthcare providers with the most important data to be communicated. Educating nurses about the use of standardized communication tools is the practice I will recommend to solve communication issues in the organization.

Nursing handoff is a communication activity with a high risk of information omission or loss that results in undesirable patient outcomes. Standardization of the communication process and the content of handoff communication is supported by literature to improve healthcare outcomes (Tiwary et al., 2019). Although handoff elements are defined by practice culture, a clear and consistent process can help nurses and other providers to ensure crucial patient information is communicated. For example, nursing shift handoffs on the bedside should involve SBAR (situation, background, assessment, recommendation) communication about the patient, assessment of pain, safety checks, current medications, and any necessary test performed or tests to be ordered (Rhudy et al., 2022). Depending on the organizational culture, important things like head-to-toe exam and discharge information can be included in the handoff reports.

Implementing new practices in healthcare is not an easy task given the need to create awareness and assimilate processes into the organizational culture. For several years, the Joint Commission and other agencies have cited transitions as an area of concern and proposed the use of standardized handoffs (Freel & Fleharty, 2021). However, standardization of handoffs without educating providers leaves a gap in the implementation of the new practice. Nurses should be educated about the use of standardized handoffs and the utilization of effective communication tools like SBAR. Additionally, today’s healthcare system utilizes technologies like electronic health records (EHRs) that are used for documentation of the patient’s data. Comprehensive education on standardized electronic handoff tools is necessary to address communication breakdown in the organization.

Concept in Watson’s Theory

The concept in Watson’s theory that includes the recommended practice is engaging in teaching-learning experiences within the concept of the caring relationship. Watson’s theory explains that the caring nurse must focus on the learning process as much as the teaching process (Kandula, 2019). Nursing education emphasizes holistic, individualized, and patient-centered care that should be based on evidence. Watson’s theory recognizes the importance of engaging in genuine teaching-learning experiences to enable holistic approaches to patient care delivery (Pajnkihar, 2017). Through education and learning, nurses will understand how patients benefit from effective communication. Learning about standardized handoffs will enable nurses and other healthcare professionals to understand the role of good communication in reducing costs and minimizing errors that cause harm to patients.

The two caring concepts emphasized in this discussion are creative use of self through scientific-problem solving and promotion of interpersonal teaching-learning. These carative factors allow nurses to demonstrate care by applying scientific research like evidence-based practices. The challenge of communication in healthcare has been widely researched and observed to cause adverse outcomes to patients. To measure the concept of creative use of self, the implemented changes should improve communication during shift handoffs. The organization should see a marked improvement in the way information is relayed and the desire for nurses to address their personal challenges that impair communication. The second concept deals with the teaching-learning experience and can be measured through the implementation of standardized communication tools in the organization. For example, the use of standardized bedside shift handoff should result in reduced medication errors and improved patient satisfaction.

References

Freel, J., & Fleharty, B. (2021). Standardizing handoff communication: An electronic tool helps ensure care continuity and reduces miscommunication. American Nurse Journal, 16(3), 30-34. https://www.myamericannurse.com/standardizing-handoff-communication/

Fucik, S. (2019). Standardized bedside handoff: One organization’s journey. Journal of Pediatric Nursing, 44, 133. https://doi.org/10.1016/j.pedn.2018.11.002

Kandula, U.R. (2019). Watson human caring theory. JNPE, 5(1), 28-31. https://www.researchgate.net/profile/Usha-Kandula-2/publication/338621474_Watson_Human_Caring_Theory/links/5e1fe34392851cafc3873916/Watson-Human-Caring-Theory.pdf

Pajnkihar, M., Štiglic, G., & Vrbnjak, D. (2017). The concept of Watson’s carative factors in nursing and their (dis)harmony with patient satisfaction. PeerJ, 5, e2940. https://doi.org/10.7717/peerj.2940

Rhudy, L. M., Johnson, M. R., Krecke, C. A., Keigley, D. S., Kraft, S. J., Maxson, P. M., … & Warfield, K. T. (2022). Standardized change-of-shift handoff: Nurses’ perspectives and implications for evidence-based practice. American Journal of Critical Care, 31(3), 181-188. https://doi.org/10.4037/ajcc2022629

Tiwary, A., Rimal, A., Paudyal, B., Sigdel, K. R., & Basnyat, B. (2019). Poor communication by health care professionals may lead to life-threatening complications: Examples from two case reports. Wellcome Open Research, 4, (7), 1-4. https://doi.org/10.12688/wellcomeopenres.15042.1

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