Exploring Middle Rage Theories and Framing Practice Issue

My practice issue relates to “surgical and medication errors” in nursing settings. I am a
medical-surgical nurse working in an orthopedic-neurology surgical unit but previously worked
in other critical departments, including the Progressive Care Unit (PCU) and Intensive Care Unit
(ICU). Throughout my practice, I have realized that surgical and medical errors are the primary
causes of stress, discomfort, delayed hospital release, ballooning hospital bills, and sometimes
death among patients. Evidence suggests that surgical and medical errors usually lead to low
quality of life of patients post-operatively (Bari, Khan, & Rathore, 2016). Therefore, in my
following projects, I intend to look for better solutions to reduce medication errors and improve
patient safety and quality of care. This will subsequently improve patient satisfaction, reduce the
time spent in the hospital, and lower the overall cost of care. The intention is to address some of
the primary causes and risks associated with medication errors. Studies have shown that
incompetence, inadequate preoperative planning, improper work process, poor communication,
fatigue, alcohol and drug abuse, and neglect contribute to medication errors.
Therefore, I intend to use several theoretical perspectives to explore the causes and
potential solutions to medical errors in nursing settings. These theories will also provide a
philosophical and academic background as to why patients should be protected from
unscrupulous, unethical, and incompetent nurses (Rodgers, 2018). For example, Kolcaba’s
Theory of Comfort best explains why nurses and other medical professionals should reduce
medication errors – to provide patients the satisfaction of the primary human requirements of
transcendence, ease, or relief stemming from stressful health care situations. An example of such
a stressful healthcare situation is surgery. Kolcaba suggested that nurses should identify these

WEEK 2 DISCUSSION 3
stressful situations and implement solutions/interventions that address the needs of patients and
alleviate pain/suffering (Peterson & Bredow, 2020).
The Synergy Model for Patient Care presents one of the most practical and evidence-
based practice (EBP) solutions to medication errors. The American Association of Critical-Care
Nurses developed the theory in the 1990s to provide nurses with core competencies to respond to
specific patient characteristics/needs. The nursing competencies represent the experience, skills,
and knowledge that nurses should integrate into nursing care. They include response to diversity,
caring practices, moral agency and advocacy, systems thinking, collaboration, facilitation of
learning, clinical inquiry, and clinical judgment (Rodgers, 2018). The Model also defines three
outcome levels associated with the system, the nurse and the patient. System outcomes include
resource utilization, costs, and recidivism. Nurse outcomes entail the absence or presence of
complications, physiologic changes, and the level at which care goals are attained. Finally,
patient outcomes involve quality of life, comfort, satisfaction, trust, and behavioral change.
These patient outcomes reflect the very consequences post-operative patients desire after
undergoing surgical operations or any other treatment under the watch and care of nurses and
physicians (Peterson & Bredow, 2020). Therefore, the Synergy Model is designed to synergize
nurse competencies and patient characteristics to improve and optimize patient outcomes.

WEEK 2 DISCUSSION 4

References

Bari, A., Khan, R. A., & Rathore, A. W. (2016). Medical errors; causes, consequence, emotional
response, and resulting behavioral change. Pakistan Journal of Medical Sciences, 32(3),
523-528.
Peterson, S. J., & Bredow, T. S. (2020). Middle range theories: Application to nursing research
and practice. Wolters Kluwer.
Rogers, B. L. (2018). The evolution of nursing science. In J. B Butts & K. L. Rich (Eds.),
Philosophies and theories for advanced nursing practice (p. 21). Jones & Bartlett.