Abstract：
Background: Millions of injuries and deaths occur yearly from preventable errors, despite interventions applied at the point of care. Although evidence suggests that system-level factors are responsible for hospital system health and patient safety, research has largely not accounted for hospital complexity. Prior to the authors\' research regarding the communication of system-level events that influence hospital system health and patient safety, no nursing-specific communication theories that accounted for hospital complexity were identified. However, theory-guided research holds the potential to boost scientific knowledge through the provision of a robust foundational understanding of phenomena. Purpose: The purpose of this article is to discuss the concept derivation used to create a middle-range theory for the guidance of research involving system-level communication in complex healthcare environments as it relates to hospital system health and patient safety. Methods: Concept derivation as described by Walker and Avant (2018) was conducted using parent concepts from the Effective Nurse-to-Nurse Communication Framework, Symbolic Interactionism, Information Theory, Gerbner\'s Communication Model, and Complexity Theory. Results: Authentication of the derived Effective System-to-System Communication Theory (ESSCT) was confirmed through identification of coherent relationships between the concepts and conceptual statements, alignment with the nursing metaparadigm, and peer review by a subject matter expert from the nursing discipline. Additionally, research revealed an overall congruency between the research findings and the ESSCT\'s theoretical statements. Implications: The current healthcare climate necessitates that research involving communication be optimized by a germane theoretical underpinning that accounts for hospital complexity. The authors contend that the use of the derived theory may assist such endeavors.
摘要：
背景：每年有数百万人受伤和死亡是由可预防的错误造成的，尽管在护理点应用了干预措施。尽管有证据表明系统级因素是医院系统健康和患者安全的原因，研究在很大程度上没有考虑到医院的复杂性。在作者研究影响医院系统健康和患者安全的系统级事件的沟通之前，没有发现与医院复杂性相关的护理传播理论.然而,理论指导的研究具有通过提供对现象的强大基础理解来提高科学知识的潜力。目的：本文的目的是讨论用于创建中程理论的概念推导，以指导涉及复杂医疗保健环境中系统级通信的研究，因为它涉及医院系统健康和患者安全。方法：Walker和Avant（2018）描述的概念推导是使用有效的护士与护士沟通框架中的父母概念进行的，象征性互动主义，信息论,Gerbner的沟通模型，复杂性理论。结果：通过识别概念和概念陈述之间的连贯关系，确认了派生的有效系统到系统通信理论（ESSCT）的认证。与护理元数据库保持一致，并由护理学科的主题专家进行同行评审。此外,研究揭示了研究结果与ESSCT的理论陈述之间的总体一致性。含义：当前的医疗保健环境需要通过考虑医院复杂性的相关理论基础来优化涉及交流的研究。作者认为，使用派生理论可能有助于这种努力。
