Applying Theory to a Practice Problem
For nurses to be competent in their practice, they are required to embrace effective communication skills. It is the ability to communicate and connect with patients and other healthcare professionals that help nurses to build strong relationships, avoid mistakes in their practice as well as maintain high level of care given to patients. Communication failures in healthcare have been classified as a major problem as it determines the care given to patients. Communication is the cause of nearly 66percent of the medical errors experienced in healthcare. According to research done, there is a strong correlation between the communication skills of healthcare providers and the capacity of a patient to follow medical recommendations as well as adopting preventive health behaviors. The ability of a nurse to explain to the patient, listen and empathize determines the outcome of the interaction between the nurse and the patient.
Healthcare communication depends largely on core communication skills which allow healthcare professionals to connect with patients. A study in the year 2013 proved that more than 440,000 people die each year due to preventable medical errors that arise due to poor communications. Medical errors account for a third of all death cases reported in the United States, and among these deaths, 80percebt are due to miscommunication between health professionals and patients. Communication is among the leading causes of sentinel events or patient safety-related events. Increased rate of deaths due to communication errors make communication failure in healthcare a greater problem that requires a solution with immediate effect. Increase in nursing communication can reduce medical errors and lead to positive patient outcomes; thus, communication failures in healthcare should be addressed to minimize the rates of deaths.
The potential middle-range theory that should be applied in this case is Peplau’s interpersonal relations theory which focuses on the relationship between nurses and patients including the therapeutic process taking place between them. The theory recognizes the importance of patients’ experiences due to nursing care is given. In this case, patients’ experiences are assumed to be the perceptions of the patients towards the care given by the nurses where they can take them as the only best source of healthcare information. In this theory, nursing is taken as an interpersonal, therapeutic process which takes place when educated nurses initiate therapeutic relationships with patients and other people in need of their services. To have strong relationships, communication is important as it enhances collaboration between patients and nurses for effective care.
Peplau’s interpersonal relations theory includes for stages of a relationship that help nurses and patients achieve a common goal. The orientation phase is the first one which involves nurse engaging the patient in treatment and allows the patient to ask questions regarding the care given. The process is interactive where the patient asks questions, and the nurse responds to the question. The second phase is the identification phase where the nurse and the patient work together to identify the issue. Thus, the patient becomes an active participant of the treatment. The third phase is the exploitation phase where the patient exploits all the services offered by the nurse to achieve better treatment. Resolution phase occurs when the patient no longer requires nurse help because all the needs were met from their effective communication.
Description of the Borrowed Theory
The borrowed theory that could apply to this problem is the Andragogy theory of learning. This theory gives details of how adults learn differently when compared to children. It is a theory of adult learning that tries to reveal how adults are more self-directed, always ready to learn and have internal motivation. The theory believes that since adults are self-directed, they are allowed to have a say in the process if their learning. The theory also believes that adults should understand why they need the learning; they have to learn experientially and should be involved in learning with value. The approach to learning used by adults, in this case, is problem-solving where a problem is presented, and the adults are involved in deciding the solution to the problem. The theory is appropriate to the identified problem of communication failures in healthcare because the failed communication is as a result of poor patient-nurse interactions. Making the patients understand the importance of care makes them more involved and are motivated to work towards improved care. For instance, when the theory is employed in nursing practice, patients are assumed to be adults who are self-directed hence can be allowed to make contributions towards their treatment which improves the quality and safety of care given.
Brief History of Andragogy Theory of Learning
Andragogy as uses in the theory was used to refer to the methods and principles that are used in adult education. The word means leading man, and it was initially used by a German educator Alexander Kapp in the year 1833. It was developed to a theory of adult education by a man known as Eugen Rosenstock-Huessy. Its use was first made by educator Malcolm Knowles who assembled ideas about the theory of education at the end of 2nd World War. Knowles was based in the United States, and he was an adult educator since 1950s. He came up with several theories to assist adult learners who he referred to them as neglected species among them being the Andragogy theory of learning. Knowles in his theory recognized that adults could not just act as passive receptors of other people expertise as children do. To make them understand the use of information given to them, they were expected to have a different level of engagement during the interaction which could yield in a better solution to the prevailing problem. The theory came up as a result of the desire to understand why men require explanations of specific concepts they are involved in and why their participation in any interaction is necessary.
Application of Andragogy Theory of Learning
Andragogy Theory of Learning has been applied in many education centers where including health education and personal computer training among other places that involve adults. When Knowles developed the theory, he was unsatisfied with the adult education and how educators viewed the adults. In personal computer training, the theory acknowledges the need to explain reasons certain computer related things are taught. The instructions used are task-oriented where tasks to be performed by the adults are at the high usage. The instructions used are based on a wide range of different backgrounds which allow learners to employ experience from different origins. The instructions used in adult learning should help them discover things and have knowledge without depending on information from other people. Adults in any education learning are only offered guidance when they seem to make mistakes but not when they are contributing their ideas.
The theory has also been applied in adult learning and patient education. When designing the patients’ education, lessons are derived from this theory which helps patients to understand the learning, retain it and act accordingly in making the right preventive health decisions. The theory allows the educator to put patients in control of their education and help them decide which education is helpful to them. It also provides a collaborative and supportive experience which gives patients the confidence to check on their health progress. The theory has also been employed in transformative learning which is a type of learning that recognizes the importance of change, and that change is inevitable in every learner life. With such knowledge, the use of the theory in transformative learning allows both the educator and the patient to collaborate so that the changes can be addressed collaboratively.
Andragogy Theory of Learning has also been applied in criminal justice programs where the principles are used in the teaching of the criminal justice programs. The theory was used after the realization that teachers control the teaching together with the learning process which in the end led to the reduced participation of the learners. Also, the learners were taught in a consistent manner that was inflexible and this affected learners’ competencies and denied them relevant skills for a criminal justice professional. The use of andragogy theory allowed the creation of a conducive learning atmosphere that encouraged collaboration of learners and educators. The theory allowed students to formulate objectives that were later used in their learning and this promoted their participation and self-directed learning approach. Therefore, in most adult education systems, educators employ the theory as a way to promote better learning of the learners due to their involvement.
Application of Andragogy Theory to Communication Failures in Healthcare
Effective communication in healthcare determines the quality of care given to the patient. The interaction between the patients and the healthcare practitioners’ guides determines the outcome of the treatment given. Andragogy theory recommends that adults understand the significance of action so that they can play a part in the learning. When the theory is applied in the healthcare sector, patients are treated as adults, and their interaction with the nurses is enhanced. Nursing is assumed to be an art or a concept that is mostly practical. The theory focus on human beings or rather patients and not the treatment, nurse or doctor where the needs of the patient are the center of the healing process. Thus, patients take part in their treatment where they understand the reasons for the treatment and take part in deciding the best treatment for their conditions. Assuming patients to be adults and giving them a role in participating in the treatment by giving existing knowledge and life experiences allow nurse and other medical practitioners to reduce medical errors arising from communication failures.
The theory has previously been used in the treatment of patients with chronic illness. Patients require a different treatment approach because they are mature and have the need to know, are responsible for their own decisions, have previous experiences that can help the practitioner to understand better treatment, are ready to learn and the motivation can drive them to a better outcome of care. This can be achieved through communication between the patient and the practitioners which allow the practitioners to value the contribution of patients to their treatment. Involving patients in their treatment enhance the relationship and the environment created by the nurse practitioners motivate them to participate in their care. Increased participation enhances patients responsible for their care where they even seek advice from their practitioners through communication. Also, their readiness to learn during their interaction with the practitioners can minimize the problem of communication because an interactive session is creased where the patient can ask questions and the practitioner give feedback regarding the questions asked.
Nursing practice can change if this theory is incorporated in giving care. Nursing is believed to be an art that requires the application of the best communication skills to enable the nursing practitioner to capture all the needs of a patient. It is the ability to communicate and connect with patients and other healthcare professionals that help nurses to build strong relationships, avoid mistakes in their practice as well as maintain a high level of care given to patients. The use of Andragogy theory in the nursing practice will increase collaboration of patients and nurses which can result in a positive treatment outcome. Nurse professional have close contact with patients during care, and the use of this Andragogy theory will encourage calls for increased participation of patients in their treatment where they will be allowed to make necessary decisions regarding their care. The theory assumes patients are adults who can make competent decisions regarding care given and their desire to learn to encourage an atmosphere where the nurse and the patient can define the problem and develop solutions together based on nurse expertise and patient experience. Thus, a high level of care will be achieved if nurses use andragogy theory in their practice.
Integrating the Theories
Application of Both Peplau’s Interpersonal relations theory and andragogy theory can be the solution to communication failure in healthcare. Peplau’s interpersonal relation theory recognizes the importance of a good relationship between the nurse and patients. Andragogy theory believes that since adults are self-directed, they are allowed to have a say in the process of their treatment. To promote a good relationship between healthcare providers and patients, communication skills are required for healthcare practitioners as they will guide them on how to relate with patients to enhance their experiences. With enhanced experience, patients will demonstrate their willingness to communicate and become fully engaged in their treatment which will lead to positive treatment outcomes. Engagement of patients in their treatment can change their perception of the care given where their experiences can be incorporated into the care for effective treatment outcome. With the two theories in place, the problem of communication failure in healthcare will no longer exist because a workable atmosphere is created and patients are allowed to be self-directed where they assume good health to be their responsibility. Thus, the problem of medical errors can be eliminated when both patient and care providers come up with a treatment strategy suitable for both.