• Users Online: 89
  • Print this page
  • Email this page

 Table of Contents  
Year : 2020  |  Volume : 7  |  Issue : 4  |  Page : 288

Application of chaos theory in the patient's safety

1 Ph.D in Nursing,Iranian Research Center on Healthy Aging, Sabzevar University of Medical Sciences, Sabzevar, Iran
2 Nursing Research Center, Golestan University of Medical Sciences, Gorgan, Iran

Date of Web Publication15-Oct-2020

Correspondence Address:
Dr. Leila Mahasti Jouybari
Nursing Research Center, Golestan University of Medical Sciences, Gorgan
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/JNMS.JNMS_34_19

Rights and Permissions

How to cite this article:
Jesmi AA, Leila Mahasti Jouybari, Sanagoo A. Application of chaos theory in the patient's safety. J Nurs Midwifery Sci 2020;7:288

How to cite this URL:
Jesmi AA, Leila Mahasti Jouybari, Sanagoo A. Application of chaos theory in the patient's safety. J Nurs Midwifery Sci [serial online] 2020 [cited 2021 Jan 25];7:288. Available from: https://www.jnmsjournal.org/text.asp?2020/7/4/288/298235

Dear Editor,

The chaos theory was first used by meteorologists Edward Lorenz and introduced as a science.[1] This theory has four main attributes; the most important is the butterfly effect. In a dynamic and nonlinear system, a small change can lead to dramatic effects. This theory can lead to new thinking in the field of health.[1],[2] It has been used successfully in various medical disciplines, for instance, neuroscience. However, nursing has not succeeded in applying this theory to its own system.[1] The first theoretician who pointed it out in the nursing theory is Martha Rogers.[3] The nursing mission is providing health, care, treatment, and rehabilitation services at the highest standard for the maintenance, preservation, and promotion of community health.[4] For instance, since patients in intensive care units may have critical condition, nurses should be aware that even insignificant behaviors can dramatically affect the patient's health. The following examples are provided to describe the issue:

  1. The lack of attention of the nurse in controlling the light of the laryngoscope or the pressure of the oxygen cylinder can delay the intubation process, followed by hypoxia, consequent cardiac arrhythmia, or brain damage.[5]
  2. Failure to adhere to aseptic procedures during the intubation leads to pneumonia and septicemia, respectively.[5]
  3. The presence of additional lights at night in the patient's unit or inappropriate ventilator setting and cardiac monitoring alarms can cause sleep disruption and finally delirium in patients.[6]

Therefore, nurses, especially those working in intensive care units, should be aware of the butterfly effect and apply it in their professional affairs. Supervisors of educational hospitals ought to also pay special attention to this subject.

Conflicts of interest

There are no conflicts of interest.

Authors' contribution

Jesmi AA developed the idea, Jouybari LM and Sanago A verified and supervised the findings of this work.

Financial support and sponsorship



The author thanked the Iranian Research Center on Healthy Aging, Sabzevar University of Medical Sciences, Sabzevar, Iran.

  References Top

Kumar A, Hegde BM. Chaos theory: Impact on and applications in medicine. Nitte University Journal of Health Science 2012;2:93-9.  Back to cited text no. 1
Hilborn RC. Sea gulls, butterflies, and grasshoppers: A brief history of the butterfly effect in nonlinear dynamics. Am J Phys 2004;72:425-7.  Back to cited text no. 2
Papathanasiou I, Sklavou M, Kourkouta L. Holistic nursing care: Theories and perspectives. Am J Nurs Sci 2013;2:1-5.  Back to cited text no. 3
Esperat MC, Hanson-Turton T, Richardson M, Tyree Debisette A, Rupinta C. Nurse-managed health centers: Safety-net care through advanced nursing practice. J Am Acad Nurse Pract 2012;24:24-31.  Back to cited text no. 4
Shiri H. Nikravan Mofrad M. Principles of Intensive Care in CCU, ICU, Dialysis. Tehran: Nordanesh publication; 2014. p. 265.  Back to cited text no. 5
Devlin JW, Skrobik Y, Gélinas C, Needham DM, Slooter AJC, Pandharipande PP, et al. Clinical practice guidelines for the prevention and management of pain, agitation/Sedation, delirium, immobility, and sleep disruption in adult patients in the ICU. Crit Care Med 2018;46:e825-e873.  Back to cited text no. 6


Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

  In this article

 Article Access Statistics
    PDF Downloaded39    
    Comments [Add]    

Recommend this journal