discussion reply 148

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Please reply to the following 4 post , 100 words one reference each

#1 Discussion 3 Stephanie Mortimer-Wallace

Reinforcing and Balancing Feedback are two types of feedback that are typically expressed in terms of a loop where the feedback is invested back into the system. This is considered the basic idea that every action triggers a reaction that triggers further actions. Reinforcing Feedback is that change in a system towards a positive or negative trend. Positively reinforcing feedback is what is typically desired, an example might be a manager commending a staff for a job well done, which if done well can have a positive trend which will result in a reaction. This practice is a good example because these actions when poorly done can have a negative trend. Balancing Feedback is that which maintains the system in a stable state. This can be a good or a bad thing depending on if there is a desired change to be done in the organization. An example might be a failed change program in an organization such as employees trying to maintain the status quo. This may be due to the attitudes and goals of the employees and a failure for the change program to target the correct causes (Kim, 2018).

According to Kim 2018, these two basic loops –reinforcing and balancing – can be seen as the two corresponding building blocks of two multifaceted common and profitable systems. These simple structures are combined to create a complex system that nursing managers are expected to manage. For example, in the manager-employee reinforcing loop, positive reinforcement from the manager is capable of producing good employee productivity, while negative reinforcement can produce poor employee productivity over time. Herein, the balancing loop comes into play so as to try and bring such situations to a desired state and keep them there. Therefore, it is my view that organizations can operate on both types of feedback, the goal is to ensure that there is a balancing loop.

Chaos in an organization can come about as a result of sudden change, whereas complexity is concerned with both the structure and the system and how interrelated they are. It is important for administrators to understand chaos and complexity in a health care setting as they are required to display a strong foundation of trust and respect to navigate change, deploy new solutions, and stay focus on organizational goals amidst chaos. Healthcare systems are interlinked with other equally complex systems in society. Personal values and cultures are a part of guiding complexities in healthcare and as an administrator, it is important to guide these complexities through principles and ongoing creativeness until they are complete. To understand complexity, administrators should develop a ‘system mindset’ that identifies changing between parts of the system and adapts to unexpected change (Greenhalgh & Papoutsi, (2018).


Greenhalgh, T., & Papoutsi, C. (2018). Studying complexity in health services research: desperately seeking an overdue paradigm shift. BMC medicine, 16(1), 95. https://doi.org/10.1186/s12916-018-1089-4

Kim, D. (2018) Reinforcing and Balancing Loops: Building Blocks of Dynamic Systems Retrieved from https://thesystemsthinker.com/reinforcing-and-balancing-loops-building-blocks-of-dynamic-systems/

#2 Tinesha Henry

Developing competent future clinical leaders is an essential duty for present day clinical leaders. However, in spite of the critical need for todays leaders to plan, train and prepare successive leaders their still seems to be a lag. As a result, wayward leaders who lead based on emotions are creating the perfect storm in an already strained healthcare system (Dyess, 2016). Reinforcement Feedback is essential to training and development additionally monitoring daily professional activities (Hardavella, 2017) Reinforcement feedback is a tool utilized in demonstrating guidelines and measures in place are actually working or perhaps redirection/re-evaluation is needed. Balancing feedback pertains to the substance or act which brings stability within an organization. In my opinion for health care organizations to successful thrive within an ever changing and evolving health care system it is essential to have reinforcement feedback and balancing feedback systems in place. Today healthcare system nationwide particularly within the united states critically require these systems now more than ever to prevent to the looming crash of a failing healthcare system. Healthcare organizations need reinforcement feedback as this assist in developing higher levels of performance in low performing areas within an organization.

Health care administrators should be prepared to function competently under chaos and complexity within healthcare. It concerns me that in present day nursing healthcare administrators and clinical nurse leaders are ill prepared and lead within an emotional state and bend policies and procedures to fit whatever emotional state they are feeling within the complex and chaotic environment. Experiencing the global Covid19 pandemic firsthand has shifted my view of leadership and administrators alike. Continuing education is great and essential for specific leadership roles however experience is the best teacher. If administrators are not prepared to manage within a complex and chaotic healthcare environment much like what we are experiencing now people will die unnecessarily.


Hardavella, G (2017) How to give and receive feedback effectively. Breathe (Sheff) Vol 13(4) pp 327-333- doi: 10.1183/20734735.009917

Dyess, S (2016) Growing Nurse Leaders: Their Perspective on Nursing Leadership and Today’s Practice Environment. OJIN. Vol 21

#3 Dscussion 4 Stephanie Mortimer-Wallace

One innovative strategy that can be utilized to promote access to nursing informatics is through the integration and utilization of trained nursing informaticist. Data collection is the means of supporting informatics and can be utilized in demonstrating how lucrative certain protocols, practices and procedures have been. The inclusion of a trained nurse informaticist will reinforce measurements and the ability to analyze data from various areas of the healthcare organization which will focus on supporting better patient outcomes as well as supporting the nursing practice (Nibbelink et al., 2019). Trained nurse informaticist have the ability to reorganize parts of the process that requires tweaking as a result of nursing input and make the activities nurses perform simpler, while improving patient care. These professionals work on driving efficiency and enhancing best practices throughout the entire healthcare system.

Master’s Essential V emphasizes Informatics and healthcare technologies (AACN, 2011). Utilizing patient data to improve patient care and communication technologies to deliver such care improves on the knowledge of nurses. As technology expands it is imperative that master’s prepared nurses be equip with the data and skills necessary to coordinate and deliver care across multiple settings, analyze patient outcomes but, a precursor to this is an attitude of sincerity in doing what is best for the patient. Utilizing research and clinical evidence are highly recommended in making informed decisions in clinical practice and this can be achieved through analyzing collected data (AACN, 2011).


American Association of Colleges of Nursing (AACN), (2011, March 21). The essentials of master’s education in nursing Retrieved from http://www.aacn.nche.edu/education-resources/MasterEssentials11.pdf

Nibbelink, C. W., Young, J. R., Carrington, J. M., & Brewer, B. B. (2018). Informatics Solutions for Application of Decision-Making Skills. Critical care nursing clinics of North America, 30(2), 237–246. https://doi.org/10.1016/j.cnc.2018.02.006

#4 Shannon Del Orbe-Been

Nursing informatics plays a major role within healthcare to communicate information used to improve healthcare accessibility. As nurses, its important to ensure are patients are well informed and agree to all treatment plans. Patients can make educated decisions about their care and need to have access to their personal health information. One innovative used in nursing informatic for making sensitive health care data readily available for patient access through online use (Cummins, 2014). Patient portals are a valuable tool for providing this access. However, these tools are useless if they do not contain the necessary information. Informatics professionals can play a role in shaping patient portals and ensuring that they are integrated with other systems, such as EHRs, to maximize their value in patient engagement.

As nurses, we must ensure accuracy when documenting patient history, assessments, and any important information significant to their care. For patients, documentation ensures the delivery of safe, consistent, quality healthcare. Documentation is often the sole point of communication between nurses of changing shifts. This means that if no verbal conversation has taken place, the documented notes must be read by the incoming nurse to understand where in the care cycle the patient stands. In the case that a documentation error, or lack of documentation altogether, leads to a medical error that threatens a patient’s life, the charting (or lack thereof) protects the patient. Therefore, as healthcare providers it’s to manage and maintain personal patient healthcare information and teach them how to access and use the hospital patient portal.


Innovations in Nursing Informatics | AMIA. (n.d.). Retrieved May 21, 2020, from https://www.amia.org/news-and-publications/amia-news/innovations-nursing-informatics

Cummins, M. R. (2014). Nursing Informatics and Learning Health System. CIN: Computers, Informatics, Nursing, 32(10), 471-474. doi:10.1097/cin.0000000000000109

Williams, S. J. (2016). Improving Healthcare Systems. Improving Healthcare Operations, 15-27. doi:10.1007/978-3-319-46913-3_2

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