Application of concept Analysis to Clinical Practice - Essay Example

?Application of concept Analysis to Clinical Practice Teamwork is considered a major facilitator for effective communication in various clinical settings. However, the meaning and nature of teamwork requires an in-depth research for effective translation of the concept into practice. As healthcare systems are regarded as organizations, teamwork helps to create more adaptive and productive working environments facilitating positive and cost-effective outcomes. Healthcare institutions throughout the world advocate the need for development of effective healthcare teams. Many researchers have even warned that lack of teamwork amongst healthcare individuals can lead to unsafe patient care practices. Better communication and understanding among healthcare professionals may reduce medication errors and effect patient outcomes positively. The lack of conceptual clarity with regards to actual representation of the concept is one of the major hindrances in clinical practice. In their concept analysis study of teamwork, Xyrichis & Ream (2008) have presented a universally acceptable definition of teamwork. As there was no universal definition published in previous literature, the purpose of their teamwork concept analysis was to bring clarity in meaning and understanding of the term by exploring the current and future implementation of teamwork concept in nursing practice. They attempted to investigate the various ways in which teamwork affects healthcare environments and patient outcomes. Steps of the Process McEwen & Wills (2002) suggest that concept analysis is a process that explores and differentiates a particular concept from other meanings and understandings to further the research and increase communication. Although there exist a number of different approaches, authors used the most common Walker and Avant’s (2005) method for analysis of teamwork concept. This method comprises eight steps arranged in a systematic manner enhancing clarity. It also helps focusing on the key processes involved eliminating the chances of deviation. They also chose this method due to its successful implementation in several concept analyses as evident in previously published literature. However, some analysts also argue the limitations and completeness of this method as a concept may imply number of meanings in different contexts and it is important for clarification of concept to be explored according to its unique context. As the understanding of teamwork concept was merely addressed in healthcare theories, the authors compared their findings with theories from organizational theory literature. In first two steps of the process, the concept of team work was identified and purpose of the analysis was established. The study aimed at providing useful definition for the concept within healthcare, which also has implications for future research. Along from nursing, other literature was also searched to prevent biasness of opinion. Various databases including, Medline, CINAHL, Web of Science and Cambridge Scientific Abstracts were searched for terms ‘team working’, ‘teamwork’, ‘team’ and ‘team working’ to screen titles. Existing definitions for the concept were also deeply researched from literature published in the last few decades. In the next step, the uses of the concept were identified. It is critical to note here that though the concept should be examined across different disciplines, but complete explorations can sometimes also render the results impractical. For instance, in human resource management, teamwork increases the expertise and skills of the employees. Learning capabilities are nourished and enhanced through team work in educational settings. In healthcare, team work reduces medical errors to a greater extent improving patient outcomes. Multiple definitions for ‘Team’ and ‘Work’ were both combined and separately sought and analyzed from various English as well as medical dictionaries for better understanding of the combined term. Some attributes of teamwork were also determined in the next step. As some analysts suggest that for real characterization of the concept, it is more appropriate to determine fewer concepts to avoid repetition. Test for necessity and test of sufficiency were applied for further screening of teamwork’s defining attributes. The involvement of team members in teamwork became evident through this step of the process. Once the defining attributes were successfully determined, concepts related to the teamwork concept were analyzed. For instance, collaboration is related to teamwork sharing various aspects. Researchers found that these two different concepts were often used interchangeably in clinical practice and thus it was quite hard to distinguish them. As Walker and Avant (2005) suggested, “the model case should be a pure case of the concept, a paradigmatic example, or a pure exemplar. Basically, a model case is one that we are absolutely sure is an instance of the concept”, a model case must reflect the previously determined defining attributes. The authors have demonstrated a good example of model case that includes all the attributes. Their example shows clear collaboration among team members leading to a shared decision making. Along with the model case, the adopted method suggest additional cases such as borderline, related, contrary, invented and legitimate cases. However, authors in this concept analysis have only offered the related case and the contrary case. The related case is though quite similar to the model case but contains no defining attributes. There is a complete lack of mutual decision making and interdependent collaboration as opinion of all team members has not been sought. In the contrary case, no collaborative or team work efforts have been demonstrated making it a totally non-model case. Antecedents are events prior to and consequences are events after the occurrence of the concept. Antecedents and consequences of the process were identified and summarized in form of graphical illustration. Finally, empirical referents were determined for the defining attributes. According to Walker and Avant (2005), “empirical referents are classes or categories of actual phenomena that by their existence or presence demonstrate the occurrence of the concept itself”. Thus, measurement of the concept in the real world is done through empirical referents. This demonstrated positive attributes including job satisfaction and quality nursing care. Results The authors, Xyriches and Ream, came up with a definition at the end which that states, “A dynamic process involving two or more health professionals with complementary backgrounds and skills, sharing common health goals and exercising concerted physical and mental effort in assessing, planning, or evaluating patient care. This is accomplished through interdependent collaboration, open communication and shared decision-making. This in turn generates value-added patient, organizational and staff outcomes.” They proposed team members as having backbone importance for effective and errorless communication in clinical practice. This definition laid a step stone from which further research can be carried out. Conclusion In the concept analysis, it was clear from literature search that despite the wide use of term in healthcare practices, the meaning and understanding of team work was missing. The collaboration concept was used interchangeably with teamwork to fill the room of conceptual understanding. Undoubtedly, the proposed definition was a milestone achieved in terms of its usefulness, helpfulness and relevance in the clinical practice. The antecedents, attributes and consequences explored and presented in this analysis can be efficiently used for evaluating current practice of the concept in healthcare settings. As this analysis provides the basic and true understanding for future research, the nature and meaning of the term would probably further in-depth exploration across diverse settings and contexts. References McEwen, M., & Willis, E. M. (2010). Theoretical basis for nursing (3rd ed.). Philadelphia: Lippincott Williams & Wilkins Walker, L. O., & Avant, K. C., (2005). The strategies for theory construction in nursing (4th ed.). Upper Saddle River, New Jersey: Pearson Prentice Hall. Xyrichis, A., & REAM, E. (2008) Teamwork: a concept analysis. Journal of Advanced Nursing. 61(2), 232–241 Read More