In the contemporary medical world, patient outcomes bear much significance. That is the case because patients’ outcomes are often reflective of the quality of healthcare provided by hospitals and are essential for the measurement of the efficacy of interventions instituted. Despite such importance, a definitive description of all the aspects constituting this concept is particularly lacking in the nursing field. As such, a concept analysis is of utmost significance if the situation is to change. In essence, this paper aims to achieve this by identifying a peer-reviewed article that analyzes the concept of patient outcomes to its practical details. Moreover, at the heart of this discussion is an illustration of how the concept is applicable in a clinical practice situation. By so doing, further understanding of patient outcomes as a concept is inevitable.
Method for Analysis
Central to the concept analysis method adopted in the article reviewed is the Walker and Avant’s framework of concept analysis. McEwen and Wills, (2014) are of the opinion that the Walker and Avant’s model of concept analysis entail 8 crucial steps that are necessary for the unfolding of the various aspects of nursing concepts.
Steps of Analysis and Results
Selection of the Concept
Primarily, the first step of the concept analysis process as explained by Walker and Avant is the selection of the concept. A principle requirement for the selection of the concept is that it should be interesting to the researcher. Additionally, the selected concepts ought to be bearing more than one description from various sources making them vague (McEwen, & Wills, 2014).
As for the reviewed study, the concept of interest is patient outcomes. The researcher arrived on this concept given the lack of a comprehensive description of the various facets the patient outcomes (Liu, Avant, Aungsuroch, Zhang, & Jiang, 2014).
Purpose of the Concept Analysis
Walker and Avant’s second step of the concept analysis framework entails stating the aim of the in-depth review. The purpose of the concept analysis, in this case, was the clarification and enhancement of deeper comprehension of the establishment of the concept of patient outcomes (Liu, Avant, Aungsuroch, Zhang, & Jiang, 2014).
Uses of the Concept
As explained by Walker and Avant, the third step entails establishing all possible definitions and uses of the concept of interest by the searching it in several resources. Such resources include but not limited to dictionaries, thesaurus, colleagues and literature (Walker, 2014). In the chosen article, the researchers were able to find definitions of patient outcomes in the dictionaries as well as the literature. A befitting example of a definition of patient outcomes commonly used is the consequences seen in patients after health care interventions. Another determined definition for the patient outcomes from literature was any change that occurs after seeking medical care (Liu, Avant, Aungsuroch, Zhang, & Jiang, 2014).
The study also highlights various uses of patient outcomes that are worth noting. A case in point in medicine, patient outcomes have been a foundation for the evaluation of health care since time immemorial. Another use of patient outcomes is the establishment of the quality of healthcare services provided in hospitals. Lastly, in nursing, the use of patient outcomes is predominantly for the measurement of the quality of nursing care provided (Liu, Avant, Aungsuroch, Zhang, & Jiang, 2014).
Identification of the defining attributes/characteristics is the next step as envisioned by Walker and Avant. In their description of defining attributes, Walker and Avant termed them as characteristics that one repeatedly observes in literature when scrutinizing a particular concept. Liu, Avant, Aungsuroch, Zhang, and Jiang, (2014) highlight three defining characteristics for patient outcomes. They include patient functional status, patient safety, and patient satisfaction. Functional status as a patient outcome is necessary for the determination of the level of performance after an intervention. On the other hand, patient safety as an outcome indicator targets to reduce instances of patient harm following an intervention. Finally, patient satisfaction as an outcome is measurable through individual reports of contentment with the care on provision (Liu, Avant, Aungsuroch, Zhang, & Jiang, 2014).
Characteristic of the concept analysis process is the identification of a model case that depicts the real life application of the concept and its critical attributes. According to Walker, (2014), this marks the fifth step of the concept analysis process.
The chosen article brings to light a case in which a male patient aged 56 years with fatigue angina receives treatment following admission to a hospital. After receiving nursing care and treatment for two weeks, the patient got clearance for discharge from the hospital. Before the discharge, however, the nurses evaluate the patient’s health status, self-care abilities, and wellbeing. Moreover, after release, the nurses followed up the patient to assess the satisfaction level. The results of the assessment both before and after discharge depicted that the patient had high content with the nursing management provided as well as he was able to carry out the self-care activities (Liu, Avant, Aungsuroch, Zhang, & Jiang, 2014).
In essence, this model case demonstrates the successful attainment of the defining characteristics of the patient outcomes concept. That is the case given that the patient’s functional status was intact after nurse established the wellbeing status and the self-care ability of the patient. Moreover, patient satisfaction was also evident after the patient affirmed contentment with the management. Lastly, the patient did not experience the development of decubitus ulcers, medical errors, infections and falls during hospitalizations, which are all suggestive of maintenance of patient safety (Liu, Avant, Aungsuroch, Zhang, & Jiang, 2014).
Related and Contrary Cases
The sixth step of the concept analysis entails an examination of additional cases showing either utilization or non-use of the concept. Related, invented, borderline, contrary and illegitimate cases are the focus of scrutiny during this step (McEwen, & Wills, 2014). On this account, however, the article unfortunately never considered such instances.
Antecedents and Consequences
According to Walker and Avant, the seventh step focuses on identification of antecedents and consequences. Antecedents refer to circumstances leading to the occurrence of the concept whereas consequences are the events or ramifications immediately after the inception of a concept (Walker, 2014).
The antecedents evident in the study included individual patient attributes and health challenges, the organizational structures of health care and health interventions provided to the sick (Liu, Avant, Aungsuroch, Zhang, & Jiang, 2014).
On the other hand, the consequences of patient outcomes manifest in the literature comprised highly cost-effective care, better quality of care and more refined heath care policy-making (Liu, Avant, Aungsuroch, Zhang, & Jiang, 2014).
Define Empirical Referents
Last but not the least, Walker and Avant conclude their concept analysis model by connecting the defining attributes with their empirical referents in the real world. Empirical referents are vital as they offer the evidence of the existence of the concept in nursing. Besides, they provide parameters that one can use to measure the concept, which is not possible with defining attributes because of their abstract nature (McEwen, & Wills, 2014).
Similarly, in this step, the article brings to the fore the empirical referent that one can also use to measure the existence of the patient outcomes concept. A case in point of an empirical referent for patient functional status is the individual’s ability to eat, dress and use the toilet. As for the definitive attribute of patient safety, one can look for the existence of pressure ulcers, medical errors, and infections. Finally, empirical referents of patient satisfaction may include nurses preserving the privacy of patient as required and nurses helping the patients to cope with their illness (Liu, Avant, Aungsuroch, Zhang, & Jiang, 2014).
Application of Concept in Clinical Practice Situation
The concept of patient outcomes is applicable in many clinical practice situations that are worth noting. A case in point the patient outcomes are applicable when evaluating the effectiveness of a nursing care plan instituted for a patient. Such is the case given that as a requirement for formulating a nursing care plan, a nurse needs to identify outcome criteria that will assist in the evaluation of its effectiveness (Lewis, Dirksen, Heitkemper, Bucher, & Harding, 2014). As such, for every nursing care plan formulated the concept can be used to identify if the care given is effective.
In closure, this paper aimed at reviewing an article that demonstrates the process of concept analysis. Indeed, it has achieved this purpose as it has given a full account of a study devoted to analyzing the concept of patient outcomes. From the discussion, it is clear that this concept of patient outcomes constitute various aspects, namely, patient’s functional status, safety, and satisfaction. Nurses can draw lessons from this analysis in this paper on where they need to focus their efforts when addressing this concept. In the absence of such, however, it will result in omissions important aspects of the concept of patient outcomes, whose effects are harsh to bear. As such, going into the future, caution to consider these issues is of the essence if prevention of these effects is to become a reality.
Lewis, S. M., Dirksen, S. R., Heitkemper, M. M., Bucher, L., &Harding, M. (2014). Medical-surgical nursing: Assessment and management of clinical problems.St. Louis, Missouri: Elsevier/Mosby
Liu, Y., Avant, K., Aungsuroch, Y., Zhang, X., & Jiang, P. (2014). Patient outcomes in the field of nursing: A concept analysis. International Journal Of Nursing Sciences, 1(1), 69-74. http://dx.doi.org/10.1016/j.ijnss.2014.02.006
McEwen, M., & Wills, E. M. (2014). Theoretical basis for nursing.Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins
Walker, L. O. (2014). Strategies for theory construction in nursing. Pearson.