Category: Health care

Health Promotion

Health Promotion
Health Promotion

Health Promotion

Task 2

Topic and significance

 This campaign focuses on elderly falls. World Health Organization (WHO) defines fall as “an event that results in a person coming to rest inadvertently on the ground, floor or lower level” (2013). Many older adults fall, making them succumbs to severe injuries, many of which make them lose the ability to be self-independent and cause financial strains. On an annual basis, approximately 30-40% of the people aged over sixty-five years experience a fall at least once a year (Nicklett & Taylor, 2014).

Similarly, about 50% of those in nursing homes have experienced a decline in the within the last one year. Falls are recognized as the leading cause of accidental deaths in this age group, and in the UK, it is the 7th principal death cause.  Studies indicate that 75% of the deaths among the elderly are associated with unintentional falls (Robertson & Gillespie, 2013).

Moreover, about 258,000 of the old people are admitted to hospitals annually as a result of hip fractures that result from falls (Rau et al., 2014). This hinders a high quality of life and causes immense medical costs. In 2013, direct medical expenses incurred from falls were as high as thirty billion (Robertson & Gillespie, 2013).

There is a projection that by 2020, over forty-four billion dollars will be dedicated towards these injuries (Robertson & Gillespie, 2013). These statistics make it apparent that falls among the elderly are a topic that needs to be campaigned on so that communities can take preventive measures. This would contribute to the lesser prevalence of the challenge.

Theories

Social learning theory

Social learning theory was developed by Albert Bandura (1977).  Bandura explains that people learn in social environments by observing others and then imitates the behavior of others.  In essence, this theory indicates that learning process is not just through reinforcement but also through influence from others (Cubas et al., 2015).  There are four principles of social learning theory that have been developed namely attention, retention, reproduction and motivation. Inattention principle, learning will not occur if people are not focused.

Therefore, to obtain attention, it is important to design the training materials for patient fall prevention intervention differently so as to reinforce targeted group perceptions (Aliakbari, Parvin, Heidari, & Haghani, 2015).  The targeted group includes nurses, elderly people representatives, unit nurse manager, registered nurses, nurse educators, orthopedic, physicians and community leaders.

The second principle is retention which states that people learn by internalizing the information stored in their memories. In this context, the training information will be designed in a manner that one can recall and respond appropriately (as taught). The third principle is reproduction which states that people actions are based on the information (behavior, knowledge or skills) previously learned (Aliakbari, Parvin, Heidari, & Haghani, 2015).

The training will be done in a way that it improves mental and physical rehearsal to ensure that the targeted populations reproduce the actions learned.  Motivation is the last principle of this theory which states that most people’s actions are motivated, especially when they observe other people getting rewarded after for their actions. This motivation will help the people to do the same act (Cubas et al., 2015). 

This theory works as a bridge between cognitive and behaviorist learning theories as it entails of motivation, memory, and attention. Therefore, when developing the campaign tool, one will focus on the novel as well as unique contexts that capture the targeted population attention in a manner that it stands out in their memory (Cubas et al., 2015). 

The designing of the campaign tool will be done in a way that helps the targeted population to develop this self- efficacy individually through constructive feedback and confidence building. This concept in social learning theory is referred to as social modeling, and has been shown to be an effective method of education (which is the campaigns tool focus) (Aliakbari, Parvin, Heidari, & Haghani, 2015).  

Stages of change model

            The stages of change model also known as Transtheoretical Model was developed by James Prochaska and Carlo Diclemente in the early 1980s (Prochaska, 2013).  According to this model, one should not assume that every person is ready for change because each individual has differing readiness to change.  Therefore, when designing the campaigning tool, it is important to identify the target group position in the change process to match intervention to the people’s readiness to change. It is a bio psychosocial, integrative model for conceptualizing the intentional behavior change’s process (Lee, Park, & Min, 2015).

 The stages of changes identified by this model included a) pre-contemplation, b) contemplation, c) preparation, d) action and e) maintenance. During the pre-contemplation, the target group is likely to be ignorant because they are not ready to adopt interventions foreseeable in the future (Prochaska, 2013).   In this context, the campaigning tool is designed in a way that it encourages a re-evaluation of the existing behavior, explains, and supports self- exploration.

The contemplation stage is where the person is totally not ready for the change.  The second stage is the consideration stage where people start becoming ambivalent to change. Therefore, the campaign tool is designed to ensure that it promotes the adoption of the suggested interventions (Lee, Park, & Min, 2015).

The third stage is the preparation stage which a stage where people are ready to change.  In the action stage, people make specific overt modifications in their lifestyles (Prochaska, 2013). The campaigning tool is designed to enhance self-efficacy especially when dealing with obstacles and to help guard the frustrations. The last stage of this model is the maintenance stage which mainly focuses on the ongoing changes. In this case, maintenance will be reinforced through follow-up support (Lee, Park, & Min, 2015).

The rationale of the health promotion campaign based on stages of change model

 This theory emphasizes on the role of other people during decision-making processes. The stages of change model apply in the elderly fall’s campaign. The first step was the presentation of negative impacts associated with old peoples’ falls. This is aimed at convincing the stakeholders about the urgency and need for change. Secondly, the theory helped one to expand people’s understanding of the social processes that influence the success of an implementation process (Prochaska, 2013).

 Based on this model, some resistance is expected because most of the stakeholders already had a particular lifestyle and therefore making the changes needed to prevent falls would be met with some reluctance. The target group would move through the various stages as they try to weigh whether to change or not (Karlsson et al., 2013).  The value of this approach is that it lays emphasis on professional communication where the caregiver’s providers can support one another.  As such, offering them accurate information would be essential in promoting the change (Prochaska, 2013).

Effectiveness of the approved health promotion activity

The health promotion activity was sufficient because it explored the facilitators and barriers of elderly falls to develop strategic, evidence-based support aids in the reduction of the old falls (Prochaska, 2013). The training campaign on elderly falls preventive measure was useful because it was cost friendly (that is no huge costs are required to implement them)  easy implementation process and it reached a large number of people at the same time (Balzer et al., 2012).

Own participation in the approved health promotion activity

The own primary involvement was through advocacy and mobilizing of the campaign to the stakeholders. The campaign took place at a community center hall for two days from 10.00Am to 3.00Pm.  The participation involved creating rapport with the interested parties involved (nurses, elderly people representatives, unit nurse manager, registered nurses, nurse educators, orthopedic, physicians and community leaders).

This was critical in ensuring that they were open and at ease to discuss the factors that were contributing to elderly falls.  This was vital as it made the target group and other involved stakeholders understand the importance of addressing the unique demands of older patients, which require patience as some of the seniors may have the hearing, language, and cognition problems. I also offered education on the strategic preventive measures against falls.

Whether the campaign was successful and had value and impact

The whole campaign was successful as detailed planning was done at every stage. The older adults and caregivers understood the reasons as to why falls had to be prevented. The campaign’s value and the impact were evident from the reduced prevalence of falls among the elderly, lesser hospitalizations, smaller costs dedicated towards falls, and an improved general wellbeing and health of the target group.

Strengths and weaknesses

The community members were able to learn a lot of insights about falls. The uptake of training on effective fall prevention measures was quite active; which increased awareness to the population that the aspect of fall is a healthcare concern (Gillespie et al., 2012). S

ome caregivers who previously did not have a caring attitude towards the elderly changed their attitudes and behavior after training, and most of the organizations were keen to implement some of the suggested change initiatives. However, a lot of time and resources had to be taken during the planning and implementation stages. This was quite strenuous. At the same time, reaching the seniors was a challenge due to their limited mobility.

Barriers and three recommendations on improving the campaign

The main obstacles were a lack of knowledge and motivation of healthcare providers, lack of change champions among the healthcare staff, language barriers, and lack of adequate resources. In future, the language barrier issues can be addressed by having a translator during any interaction with English non-speaking group. More efforts will be made so as to mobilize adequate resourced from stakeholders (Karlsson et al., 2013). This includes applying for funding from the government.

Lastly, leadership is an important aspect in implementing change in all organizations. The healthcare staff will be encouraged to attend leadership and management training so that they can understand better about their leadership roles and to offer a strong support and direction to the team members when implementing change. This will help the healthcare professionals to embrace their role as champions and facilitator in promoting and implementing change in their respective workstation (Karlsson et al., 2013).

Involvement in the campaign

The stakeholders involved in this campaign included; nurses, elderly people representatives, unit nurse manager, registered nurses, nurse educators, orthopedic, physicians and community leaders. Involving all the relevant stakeholders is very pivotal in promoting success.  This is because they shape the direction of change in the early stages (Prochaska, 2013).

Involving the stakeholders will also ensure that all the project’s resources are available and provide insight about the probable reaction to project’s outcome or the necessary adjustments that must be made so as to win the community’s support.  The benefits of all inclusive stakeholders involvement in this campaign is that it reduced distrust of the campaign’s outcome, increased commitment to the campaign processes and objectives and heightened the credibility of this campaign (Robertson &Gillespie, 2013).

Reflection

Collectively, this theory was useful in developing the multifaceted interventions that targeted change, promoted caregivers behavior, and ultimately improved the outcome of the campaign. An evaluation would be made after some duration after the changes have been embraced as a way of ensuring that the right things are being done appropriately (Balzer et al., 2012).  Also, there are several elements identified after listening to other group’s presentation that we can adopt in the future. For instance, the use of pamphlets would have been effective as it would ensure that the information is widespread. Some groups used T-shirts to brand their campaign and to increase their coverage.

Conclusion

The campaign went well as the change model and theoretical frameworks used were correct for the topic. There are few aspects that many need to be refined according to our reviewer’s constructive criticism. However, participating in this activity was a good learning experience.

References

Aliakbari, F., Parvin, N., Heidari, M., & Haghani, F. (2015). Learning theories application in nursing education. Journal of Education and Health Promotion, 4, 2. http://doi.org/10.4103/2277-9531.151867

Balzer, K., Bremer, M., Schramm, S., Lühmann, D., &Raspe, H. (2012).Falls prevention for the elderly.GMS Health Technol Assess 8: Doc01.

Cubas, M. R., Costa, E. C. R. D., Malucelli, A., Nichiata, L. Y. I., & Enembreck, F. S. (2015). Components of social learning theory in a tool for teaching Nursing. Revista Brasileira de Enfermagem, 68(5), 906-912.

Gillespie, L. D., Robertson, M. C., Gillespie, W. J., Sherrington, C., Gates, S., et al. (2012).Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev.

Karlsson, M. K., Vonschewelov, T., Karlsson, C., Cöster, M., &Rosengen, B. E. (2013). Prevention of falls in the elderly: a review. Scand J Public Health 41: 442-454.

Lee, J. Y., Park, H. A., & Min, Y. H. (2015). Transtheoretical Model-based nursing intervention on lifestyle change: A review focused on intervention delivery methods. Asian nursing research, 9(2), 158-167.

Michael, Y. L., Lin, J. S., Whitlock, E. P., Gold, R., Fu, R. et al. (2010).Interventions to Prevent Falls in Older Adults: An Updated Systematic Review. Rockville (MD): Agency for Healthcare Research and Quality (US).

Robertson, M. C., &Gillespie, L. D. (2013). Fall prevention in community-dwelling older adults. JAMA 309: 1406-1407

Nicklett, E. J., & Taylor, R. J. (2014). Racial/ethnic predictors of falls among older adults: The Health and Retirement Study. Journal of Aging and Health, 26(6), 1060–1075. http://doi.org/10.1177/0898264314541698.

Rau, C.-S., Lin, T.-S., Wu, S.-C., Yang, J. C.-S., Hsu, S.-Y., Cho, T.-Y., & Hsieh, C.-H. (2014). Geriatric hospitalizations in fall-related injuries. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 22, 63. http://doi.org/10.1186/s13049-014-0063-1

Prochaska, J. O. (2013). Transtheoretical model of behavior change. In Encyclopedia of behavioral medicine (pp. 1997-2000). Springer New York.

Want help to write your Essay or Assignments? Click here

Resuscitation: Case Study

Resuscitation
Resuscitation

Resuscitation: Case Study

Part 1: Code Blue educational video from the Regina Qu’Appelle Health Region.

Time sequenceIssue notedcodecomments
0-22 seconds  Breach of Australian Resuscitation Council Guidelines:  BARCG- Guideline 2 priorities in an emergency        Finds Mr. Smith unresponsive. Fails to follow the Guide 2 BLS algorithm because she failed to assess danger, but she assessed the airway, as she is seen checking for the escape of air from the patients mouth or nose as recommended by guide 5.  Implications: Delay in resuscitation processes increases the risk of reduced cardiac output to the brain due to poor compressions.

 
Time 3.26Poor technical skills  PTS – BARCG Guide 6 & 8Chest compressions inadequate as recommended by Guide 6. The recommended chest compressions are 30 chest compressions followed by two breaths.
The chest compressions are slow than required by Guide 8. “A good CPR should deliver chest compressions over the lower half of the sternum at a depth of 5 cm” (ARC guide 8). Long pauses in CPR before shock delivery. Guide 6 discourages long pauses and distractions during a CPR Implications: Long pauses, distractions, slow and inadequate chest compressions lower the chance of  patient’s survival
Poor Non-Technical skills PNTS
Time 0.30Situation awarenessPNTS- SA The nurse did not press the emergency push button system to call for help immediately and instead used the overturn
Implications: Delayed response  by the code blue team
Time 0.30 secs Time 2.26 minutesDecision makingPNTS- DMDelay in full code response. The team arrived 2 minutes later after the call alert Implications: This led to delay important activities such as defibrillation. However, the rest of the decisions such as medication, hyperventilation and defibrillation activities went on well once the code blue captain arrived.
Time 3.36Task managementPNTS-TMCompressors for more than five cycles. One compressor was working for almost 5 minutes which is too long for a compressor. According to Guide 5, “the compressor roles approximately after 2 minutes or after five cycles of compressions and ventilations at a ratio of 30:2 so as to maintain the quality of compressions” (ARC guide 5).  However, other task management processes such as airway positioning, nasopharyngeal airway placement, bag-valve mask ventilation were correctly performed.
Time 5.28   Time 12.55CommunicationPNTS- comm  Occasionally fails to use the closed up communication which leads to miscommunications. For instance, at minute 12.55, the recorder had missed recording the endotracheal tube particulars due to poor communication strategy.
  The team used the SBAR technique to report the patient’s medical history to the code blue team leader. All the information was recorded including all the medication administered and other CPR outcomes such as cardiac rhythm before a shock was delivered. This is vital for future references.
 TeamworkPNTS-TeamNo introduction was done by the team members, but they delegated the resuscitation duties appropriately. The team consisted of a coordinator, compressor nurse, airway manager, nurse in charge of defibrillator, captain/leader and crash cart manager.
 LeadershipPNTS- LeadershipThe leader failed to evaluate the BLS on arrival. However, Mr. Sellinger (the code captain) performed his tasks effectively including identification of cardiac rhythm, initiation of ACLS protocol, and evaluation of the protocol reviewed the code blue documentation form and signed the code blue form after completing the code blue.

PART 2: Analysis of the issues covered

Code blue should be contacted immediately for all unresponsive patients. Calling for help and initiation for help should be done simultaneously.  One of the issues identified in this case study is delayed in the response of code blue code due to poor call out systems. The code team member should call out loudly for help through the facility-wide response system. In this technology, the nurse should have pressed the Blue code push button to ensure that the code blue team were notified accordingly (Bayramoglu et al., 2013).

As the nurse in charge waits for code blue team, he or she should initiate CPR (Clarke, Apesoa-Varano, & Barton, 2016). The code team are expected to introduce themselves as they arrive as well as and their roles statements such as “Am Mr. J. and will take document” or “I’ll take the airway” which helps in ensuring there is clear role differentiation. The service user physician should be contacted  immediately.

According to Price, Applegarth & Price (2012), the healthcare provider should first assess the patient dangers and risks before they start the air management. This was not done in the case study and violated the ARC guide four which states that the patient’s mouth should be opened and head slightly turned downwards to remove the airways (Australian Resuscitation Council, 2008).

 An ineffective cough indicates a severe obstruction. In this case, if the patient is responsive, the healthcare provider should give about five back blows, and if still, it is ineffective, they should give at least five chest thrusts (McInnes et al., 2012). This article states that for all unresponsive patients, the healthcare should send for help and start CPR immediately. Similarly, guideline 5 recommends that all patients who are breathing abnormally or are unresponsive require being resuscitated.

The first thing when assessing breathing, the rescuers should check for   movement around the chest (lower part) and abdomen (upper part). They should check for the exhalation through the patient’s oral cavity or nose, and feel the movement of air in the patient’s mouth or nose. The guide recommends a ratio of compressions to rescue breaths as 30:2 (Australian Resuscitation Council, 2008).

According to this article, the first nurse to respond should start saving the patient’s life by performing chest compressions immediately (100 compressions per minute). Although important, the nurse should not wait for backboard , they should start chest compressions as it can be put in place later when  the code team arrives. The switching the compressor roles in the case study is present but it took quite a long time than that recommended by ARC guide 6 which is approximately after 2 minutes.

To maintain the quality,  the ventilations ratio should be maintained at 30:2 (Castelao et al., 2013). This is supported by Guide 6 which recommends that interruptions to chest compressions should be minimized. The  best location to perform the compressions is the sternum- the lower half part of it. The healthcare provider’s heel is placed at the central part of the chest and put the other hand on top it. The recommended rates of compressions are 100 to 120 compressions per minute which are about two compressions per second.  

The guide also outlines on the quality of compressions ( which is identified as poor in the case study)  where it suggests that depth of compressions should be “at least 2 inches (5cm) with complete chest recoil after every compression” this helps the heart to re-fill completely by the next round of compressions. The number of interruptions should be minimized to ensure maintain the quantity and quality of compressions (Eroglu et al., 2014).

 According to the article, the patient should be given 2 ventilations for every 30 seconds of  oxygen-bag-mask device assisted ventilation. The oxygen level should be set to the flow meter 15 L/min, and where applicable, the reservoir should be fully open ensure that  the patient gets 100% oxygen for each breath. One strength observed in the study is the fact that bag-mask device is best done by two blue code team members where one open the airway to fasten the mask on whereas the second one squeezes the oxygen bag.

Also, the article states that defibrillation is very critical and that the use of placement hands-free defibrillation pads is a safer option than hands held defibrillation paddles (Girotra et al., 2012; Prince et al., 2014). The article states that the deployment of automated external defibrillators (AED) should be used as soon as possible as it reduces mortality and morbidity associated with cardiac arrest caused by either ventricular fibrillation or ventricular tachycardia (Australian Resuscitation Council, 2008).

The compressions should resume immediately after delivering shock even with a normal heart rhythm as it will not provide enough cardiac output that will ensure adequate perfusion. It is recommended that 2 minutes the cardiac rhythm should be assessed after 5 cycles of a CPR (Merchant et al., 2014). The use of vasopressors in cardiac arrest is recommended only when there are no high-quality CPR. It is important to be extra cautious when administering a drug. This is because miscommunication is a common issue which often leads in the administration of incorrect drug doses or medications.

This can be prevented by using “closed loop” method of communication (Segon et al., 2014; William et al., 2016). For instance, when a nurse receives an order to inject some medicine, they should repeat the information of drug prescribed out loud, inject it and then announce it again after administration (Price et al., 2012). This method was used in some instances, but in the instance that it was absent, the recorder was prone to miss out some key aspects; for example, in this code blue simulation, the recorder had missed recording the endotracheal tube measurements.

The article suggests that an effective code blue team should have leader who controls the all the procedures and efforts of resuscitation. They communicate with the staff involved and evaluate the cardiac rhythm of a patient. Mr. Sellinger is the team captain of the case study and was standing in a position such that he could effectively see all of the resuscitation procedures and efforts. If the organization allows, the family member can be allowed into the room. It is also important to ensure that the information is well recorded.

In the case study, the recorder is shown documenting all the resuscitation process. However, it is important to understand that documentation process is done according the healthcare facility’s policy (McEvoy et al., 2014; Sahin et al., 2016). The recorder should remind the code team when time for a specific task has elapsed and must record all the activities taking place including the medicines prescribed. The article also suggests that all clinical areas should grant quick access to equipment such as blood glucose, blood pressure, and equipment of pulse oximetry and other equipment so as to effectively manage a deteriorating patient (Clarke, Carolina Apesoa-Varano, & Barton, 2016).

Through this case study, it is evident code training programs using simulation is beneficial and has been recommended by various healthcare institution organizations since 1999. This training will help the learners to improve cardiac resuscitation outcomes as it offers an opportunity  for  regular hands-on practice within the hospitals.  This also helps the team to understand the various roles and responsibilities expected during a full code. Along with continuing education and mock codes, the team members become confident in their responsibilities (Gutwirth, Williams, Boyle, & Allen, 2012).

References

Australian Resuscitation Council. (2008). Standards for Resuscitation: Clinical Practice and Education. Retrieved from  http://www.resus.org.au/clinical_standards_for_resuscitation_march08.pdf

Bayramoglu, A., Cakir, Z. G., Akoz, A., Ozogul, B., Aslan, S., & Saritemur, M. (2013). Patient-Staff Safety Applications: The Evaluation of Blue Code Reports. The Eurasian Journal of Medicine, 45(3), 163–166. http://doi.org/10.5152/eajm.2013.34

Castelao, E. F., Russo, S. G., Riethmüller, M., & Boos, M. (2013). Effects of team coordination during cardiopulmonary resuscitation: A systematic review of the literature. Journal of critical care, 28(4), 504-521.

Clarke, S., Apesoa-Varano, E. C., & Barton, J. (2016). Code Blue: Methodology for a qualitative study of teamwork during simulated cardiac arrest. BMJ open, 6(1), e009259.

Eroglu, S. E., Onur, O., Urgan, O., Denizbasi, A., & Akoglu, H. (2014). Blue code: Is it a real emergency? World Journal of Emergency Medicine, 5(1), 20–23. http://doi.org/10.5847/wjem.j.issn.1920-8642.2014.01.003

 Girotra, S., Nallamothu, B. K., Spertus, J. A., Li, Y., Krumholz, H. M., & Chan, P. S. (2012). Trends in Survival after In-Hospital Cardiac Arrest. The New England Journal of Medicine, 367(20), 1912–1920. http://doi.org/10.1056/NEJMoa1109148

Gutwirth, H., Williams, B., Boyle, M., & Allen, T. (2012). CPR compression depth and rate about physical exertion in paramedic students. Journal of Paramedic Practice, 4(2).

McEvoy, M. D., Field, L. C., Moore, H. E., Smalley, J. C., Nietert, P. J., & Scarbrough, S. (2014). The Effect of Adherence to ACLS Protocols on Survival of Event in the Setting of In-Hospital Cardiac Arrest. Resuscitation, 85(1), 10.1016/j.resuscitation.2013.09.019. http://doi.org/10.1016/j.resuscitation.2013.09.019

Merchant, R. M., Berg, R. A., Yang, L., Becker, L. B., Groeneveld, P. W., & Chan, P. S. (2014). Hospital Variation in Survival After In‐hospital Cardiac Arrest. Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, 3(1), e000400. http://doi.org/10.1161/JAHA.113.000400

McInnes, A. D., Sutton, R. M., Nishisaki, A., Niles, D., Leffelman, J., Boyle, L., … Nadkarni, V. M. (2012). The ability of code leaders to recall CPR quality errors during the resuscitation of older children and adolescents. Resuscitation, 83(12), 1462–1466. http://doi.org/10.1016/j.resuscitation.2012.05.010

Price, J. W., Applegarth, O., Vu, M., & Price, J. R. (2012). Code Blue Emergencies: A Team Task Analysis and Educational Initiative. Canadian Medical Education Journal, 3(1), e4–e20.

Prince, C. R., Hines, E. J., Chyou, P.-H., & Heegeman, D. J. (2014). Finding the Key to a Better Code: Code Team Restructure to Improve Performance and Outcomes. Clinical Medicine & Research, 12(1-2), 47–57. http://doi.org/10.3121/cmr.2014.1201

Segon, A., Ahmad, S., Segon, Y., Kumar, V., Friedman, H., & Ali, M. (2014). Effect of a Rapid Response Team on Patient Outcomes in a Community-Based Teaching Hospital. Journal of Graduate Medical Education, 6(1), 61–64. http://doi.org/10.4300/JGME-D-13-00165.1

Sahin, K. E., Ozdinc, O. Z., Yoldas, S., Goktay, A., & Dorak, S. (2016). Code Blue evaluation in children’s hospital. World Journal of Emergency Medicine, 7(3), 208–212. http://doi.org/10.5847/wjem.j.1920-8642.2016.03.008

Williams, K.-L., Rideout, J., Pritchett-Kelly, S., McDonald, M., Mullins-Richards, P., & Dubrowski, A. (2016). Mock Code: A Code Blue Scenario Requested by and Developed for Registered Nurses. Cureus, 8(12), e938. http://doi.org/10.7759/cureus.938

Want help to write your Essay or Assignments? Click here

Healthcare Delivery: Case Study

Healthcare Delivery
Healthcare Delivery

The Impact of Electronic Health Record (EHR) Systems on Healthcare Delivery in Australian Hospitals

Abstract

Variations in healthcare needs of today’s population compel modern healthcare organizations to change the manner in which they deliver healthcare. A good number of contemporary healthcare organizations have taken advantage of advancements in information technologies, and they increasingly integrate electronic health record (EHR) systems into healthcare delivery.

The current study aims at finding the impact of electronic health record systems on healthcare delivery in Australian healthcare organizations. The study will utilize a theoretical research approach that involves a review of records of selected companies in order to obtain relevant data. Findings obtained from this study will be used to advise modern healthcare organizations on some of the reasons why they should either adopt or avoid implementation of electronic health record systems.

The Impact of Electronic Health Record (EHR) Systems on Healthcare Delivery in Australian Hospitals

1.0 INTRODUCTION

With the rapid rate of advancements in information communication technologies, contemporary healthcare organizations have integrated electronic health record system into healthcare delivery to match healthcare needs of the current population (Zeng, 2016). An electronic health record (EHR) system is a computerized version of a patient’s health data, including past medical history, laboratory reports, vital symptoms, demographics, medications, and progress notes, that can be shared among healthcare practitioners within a healthcare organization (Bowman, 2013).

According to Gao, Sorwar, and Croll (2013), Australian healthcare industry began to consider electronic health record systems in 2000. Since then, many hospitals in the country have made an effort to develop and implement electronic health record systems. As opposed to the traditional paper records system, it is anticipated that electronic health record systems will enhance the quality of care, minimize medical errors, improve patient satisfaction, and reduce healthcare costs in Australian healthcare organizations (Gao, Sorwar, and Croll, 2013).

This proposal will direct a study on the impact of electronic health record systems on healthcare delivery in Australian hospitals. It provides a detailed analysis of existing body of literature on the study topic. Additionally, the paper outlines the procedures and processes that will be followed to gather data to answer the research question. It also highlights the relevance of the study approach as well as the implications of study findings.

1.1 Problem Identification

Traditionally, hospitals used to rely on paper records to keep important medical information of patients. Although clinicians used well-organized templates to document their patient’s health data, retrieving this information was sometimes difficult due to illegible handwriting. Furthermore, the handwritten information could not be shared among healthcare providers through computer systems.

Paper records were also easy to destroy, thereby resulting in loss of patient’s data. Advancements in information technology systems allow contemporary healthcare organizations to store patients’ medical data electronically to allow easy sharing and analysis. The number of hospitals which are implementing electronic health record systems is on the rise in today’s society due to the anticipated benefits of this new technological advancement.

In order to help Australian hospitals to evaluate the financial feasibility of implementing electronic health record systems, it is important to investigate and reveal the nature of impact that an electronic health record system has on healthcare delivery.

1.2 Significance of the Problem

An electronic health record system makes it much easier to track and retrieve patient data as compared to paper reviews. Availability of these systems in hospitals makes patient information available to authorized healthcare practitioners who may need it within the organization. For this reason, healthcare organizations that use electronic health record systems are highly likely to have a form of healthcare delivery that is different from those organizations that use paper records (Bowman, 2013).

1.3 Research Question

Have electronic health record systems improved healthcare delivery in Australian Hospitals?

1.4 Hypotheses

Alternate Hypothesis (H1): Electronic health record systems have improved healthcare delivery in Australian hospitals

Null Hypothesis (HO): Electronic health record systems have not improved healthcare delivery in Australian hospitals

1.5 Variables

Independent variable; an electronic health record system

Dependent variables; health care quality, medical errors, and patient safety

2.0 LITERATURE REVIEW

A number of studies have been performed with the aim of finding out the benefits of electronic health record systems as far as their influence on clinical outcomes is concerned. The main clinical outcomes that have been the center of focus in a large percentage of these studies are patient safety, healthcare quality, and medical errors (Menachemi and Collum, 2011). Healthcare quality is achieved when the healthcare provider delivers the right type of care, in the right manner, at the right time, and to the right patient, with the aim of having the best results possible.

In order to maximize patient safety, healthcare providers must avoid injuries for their clients and ensure that services offered are able to generate the intended help (Gao, Sorwar and Croll, 2013). As Gao, Sorwar and Croll (2013) explain, medical errors are minimized during care delivery when data is entered accurately and when there is clarity of medical records. According to Menachemi and Collum (2011), electronic health record systems generally minimize medical errors, improve health care quality, and enhance patient safety.

In a survey conducted across Australian health organizations in 2015, Australian Digital Health Agency revealed that electronic health records have got numerous benefits for healthcare providers which translate into improved healthcare delivery for patients. According to the Australian Digital Health Agency (2015), electronic health record systems enable healthcare providers to spend more time with their patients as they do not have to waste time looking for clinical information.

This gives patients an opportunity to share their important health information with health care providers thereby contributing to improved health care quality. Furthermore, healthcare providers in Australian health organizations which have implemented electronic health record systems are able to closely monitor their patients’ progress, including those with chronic health problems, while at the same time offering them necessary medical support. This helps patients to have a comprehensive understanding of their health problems (Australian Digital Health Agency, 2015).

Australia is one of the industrialized countries which support the integration of electronic health record systems into healthcare delivery. The version of electronic health record system which majorly operates in Australia is the Personality Controlled Electronic Health Record (PCEHR) system (Gao, Sorwar and Croll, 2013). The Australian public has demonstrated support for PCEHR system due to a number of benefits they have experienced since its adoption.

For instance, with PCEHR systems, patients can now have immediate access to their health information, easily track their prescriptions and medications, as well as make necessary changes to their health records. Basically, PCEHR system has helped Australian healthcare organizations to keep accurate patients’ health records, deliver the right care at the right time, and to maximize patient safety (Gao, Sorwar and Croll, 2013).

Several researchers agree that electronic medical systems are associated with reductions in medical errors in healthcare organizations because they improve the accuracy with which patients’ health data is maintained (Menachemi and Collum, 2011). In a study conducted by Bates, Leap, and Cullen (1998), an electronic health record system reduces medical errors in healthcare settings by approximately 50 percent.

In a similar study, Bowman (2013) found out that computerization of patients’ health data results into an error rate reduction of approximately 10 percent. These findings indicate that clarity and accuracy of medical records are greatly enhanced with the use of electronic health record systems in healthcare organizations.

Although electronic health record systems generate numerous benefits, healthcare organizations serious negative consequences by adopting the technology due to inappropriate design choice and careless use (Bowman, 2013). For instance, poor design choice of an electronic health record system will increase medical errors instead of reducing them. Additionally, poor use of the system may interfere with the integrity of data thereby endangering patient safety and decreasing the quality of care (Zeng, 2016).

In most instances, these are unintended consequences which may make an organization to face lawsuits and pay huge legal fines. As health information technology becomes increasingly involved in the delivery of care, healthcare organizations must be prepared to manage HIT-related risks which may damage their reputations if no appropriate actions are taken. The most appropriate ways through which such risks can be avoided are; choosing appropriate electronic health record system design, and ensuring proper use of the system (Sitting and Singh, 2011).

3.0 METHODOLOGY

The study will involve a detailed analysis of the impact of electronic health record systems on healthcare delivery in Australian hospitals. The first step of the study approach will involve selecting Australian health organizations which have already adopted electronic health record system. A list of this category of hospitals will be obtained from the Australian Public Health Database. Top 30 largest hospitals which have adopted the EHR systems will be used in the study.

The Chief Executive Officers of the selected organizations will be contacted via email in order to obtain an appointment to visit their organizations. The chosen healthcare organizations will be visited physically in order to obtain consent from them and to request usage of their health records for purposes of the study. During the visit, the Chief Executive Officers will be informed about the purpose of the study, the study objectives, how research findings will be used, benefits of taking part in the study, as well as the risks involved. Only those organizations that will agree with the provided terms will be used in the study.

Under the permission of Chief Executive Officers, health records and annual reports of the selected organizations will be reviewed. Changes in a number of factors will be recorded from when the selected companies used paper-based records to the period following adoption of the electronic health record systems.

Specific items which will be extracted from the health records include changes in; patients’ waiting time, the manner in which care is delivered, clarity of medical records, the accuracy of patients’ data, recovery period, readmission rates, and death rates. Similar data will be collected across all healthcare organizations which will have agreed to take part in the study. The collected data will be analyzed using Statistical Packages for Social Sciences (SPSS) software.

4.0 DISCUSSION
4.1 Relevance of the study approach

The proposed methodology is highly appropriate for this study because it will help in gathering data that will best answer the research question. A list of Australian healthcare organizations which have adopted electronic health record systems is found in country’s Public Health Database. The rationale behind selecting top 30 largest organizations in the list is the large volume of relevant data that these organizations can provide.

In addition, it is important to obtain consent from the Chief Executive Officers of the selected organizations due to high privacy concerns associated with the release of important health records. The Chief Executive Officers of the chosen health care organizations must be convinced that their health records will be used solely for purposes of research before they can allow anybody to access them.

The effectiveness of healthcare delivery in hospitals are best measured in terms of major clinical variables namely; quality of care, medical errors, and patient safety (Gao, Sorwar and Croll, 2013). The type of data collected during health records’ review can easily tell the degree of health care quality, medical errors, and patient safety in the selected hospitals. For instance, data related to changes in patients’ waiting time and the manner in which care is delivered will help the researcher to understand the quality of care in the selected organizations.

Data related to changes in clarity of medical records and accuracy of patients’ data will tell more about medical errors, while data related to changes in the recovery period, readmission rates, and death rates will inform the researcher more about patient safety in the selected hospitals. By analyzing the collected data using SPSS software, the researcher will be able to see the impact of electronic health record systems on healthcare delivery in Australian hospitals. This research approach will help the researcher to easily answer the research question.

4.2 Limitations of Methodology

            The main limitation of the methodology is reviewing health records of only 30 hospitals. By limiting the data collection process to only top 30 hospitals which have already adopted electronic health record systems, the researcher may leave out other small hospitals which might have successfully adopted HER systems, and which may have better information than the organizations used.

The other limitation of the methodology is over-reliance on secondary data which is available in company records and annual reports. Conducting actual research would produce more accurate data because the validity of information available in company records might be questionable.

4.3 How the study findings may lead to further research

            The proposed study focuses on how clinical factors may be impacted by the adoption of an electronic health record system. For instance, in the study, the researcher intends to evaluate how electronic health record system will impact health care quality, medical errors, and patient safety in Australian hospitals. Findings obtained from this study can guide further research on the impact of electric health record systems on organizational factors such as healthcare cost.

5.0 CONCLUSION

            The number of Australian hospitals which are adopting electronic health record systems is on the rise. Australian healthcare organizations which are implementing electronic health record systems anticipate that the new technology will help them to improve the quality of care, minimize medical errors, improve patient satisfaction, and reduce healthcare costs.

Prior to spending a lot of money in the implementation of electronic health record systems, Australian healthcare organizations should be aware of the financial feasibility of implementing those systems. Making a decision of whether the approach is financially possible requires a comprehensive knowledge of the nature of impact that EHR systems will have on the quality of care, medical errors, and patient safety.

The proposed study intends to investigate whether electronic health records systems have improved healthcare delivery in Australian hospitals, by focusing on three variable; quality of care, medical errors, and patient safety. A comprehensive analysis of available literature has been conducted to show previous studies on the topic.

In addition, a methodology that will help to answer the research question has been identified. Findings obtained from this study will be used to advise modern healthcare organizations on some of the reasons why they should either adopt or avoid implementation of electronic health record systems.

References

Australian Digital Health Agency. (2015). Retrieved May 19, 2017, from https://www.digitalhealth.gov.au/get-started-with-digital-health/benefits

Bates, D., Leap, L. & Cullen, D. (1998). Effect of computerized physician order entry and a team intervention on prevention of serious medication errors. JAMA, 280(15):1311-1316.

Bowman, S. (2013). Impact of electronic health record systems on information integrity: Quality and safety implications. Perspectives in Health Information Management, 10(Fall):1c.

Gao, J. X., Sorwar, G. & Croll, P. (2013). Implementation of E-health record systems in Australia. The International Journal Technology Management Review, 3(2):92-104.

Menachemi, N. & Collum, T. H. (2011). Benefits and drawbacks of electronic health record systems. Risk Management and Healthcare Quality, 4: 47-55. Doi:10.2147/RMHP.S12985

Sitting, D. F. & Singh, H. (2011). Defining health information technology-related errors. Archives of Internal Medicine, 171:1281.

Zeng, X. (2016). The impacts of electronic health record implementation on the health care workforce. North Carolina Medical Journal, 77(2):112-114. Doi:10.18043/ncm.77.2.112

Want help to write your Essay or Assignments? Click here

Health Care Accreditation

Health Care Accreditation
Health Care Accreditation

Health Care Accreditation

Accreditation

 Mayo Clinic, Wisconsin receives accreditation from Wisconsin Accreditation Organization for Hospitals and The Joint Commission. Before offering accreditation, The Joint Commission evaluates health care organizations for compliance with the set standards. Wisconsin Accreditation Organization for Hospitals evaluates health care organizations at an interval of three years.

Accrediting is mandatory for Mayo Clinic, Wisconsin because the organization cannot be allowed to provide medical services to patients if it is not accredited. The main purpose of accrediting, therefore, is to validate if the Clinic meets quality standards documented by the two accrediting bodies. Accreditation supports Mayo Clinic to make improvements on its systems to meet the set quality standards (Mayo Clinic Health System, 2016).

            Accrediting of Mayo Clinic by Wisconsin Accreditation Organization for Hospitals and The Joint Commission is important to heath care because it results in improved care across all departments of the organization. Additionally, accreditation helps patients to receive the highest and best quality health care.

Furthermore, accrediting influences Mayo Clinic, Wisconsin to engage in socially responsible behaviors thereby promoting the safety of the community. Again, since Accreditation encourages Mayo Clinic to maximize quality in all its health care delivery processes, it has contributed significantly to the clinic’s expansion and growth (Alkhenizan and Shaw, 2011).

The accrediting requirements for Mayo Clinic include safe and high-quality patient care, effective communication with stakeholders, high level of coordination and planning to promote mitigation of risks, facility safety, and effective leadership. Mayo Clinic, Wisconsin requires highly performing technology systems and competent employees to maintain accreditation. If the organization loses accreditation, it will lose clients due to reduced quality of care and compromised patient safety. Failure to make improvements on its systems will result in closure (Mayo Clinic Health System, 2016).

Mayo Clinic should be accredited to offer medical services related to prevention, treatment, and control of infections. The organization requires licensure in the following areas; perinatal care, disease-specific care, palliative care, medication compounding, and health care staffing (Mayo Clinic Health System, 2016).

Licensure

            Mayo Clinic has been licensed to provide Acute Stroke Management and Diabetes Management services which fall under disease-specific care. These two licensures are mandatory because, without them, the clinic will not be authorized to offer acute stroke management and diabetes management services. The purpose of the licensures is to confirm that Mayo Clinic meets the standards required for an organization to offer acute stroke management and diabetes management services (Mayo Clinic Health System, 2016).

The licensures are important to Mayo Clinic because they help it to implement strategies that are aimed at improving the quality of care for acute stroke and diabetes management. Furthermore, the licensures contribute to the provision of the highest and best quality health care for patients (Alkhenizan and Shaw, 2011).

Moreover, they are essential to heath care in the sense that, it results in improved health care across all departments of the organization. Additionally, the licensures help Mayo Clinic, Wisconsin to become a socially responsible organization by influencing it to engage in activities that promote safety of the community (Rooney and Ostenberg, 1999)

 The licensure requirements for Mayo Clinic about the provision of acute stroke and diabetes management services include care delivery, admission, discharge and referrals, a continuum of care, and emergency management. Mayo Clinic, Wisconsin needs three significant resources to maintain these licensures, and they include competent and enough medical practitioners, highly performing technological systems, and a safe facility (Mayo Clinic Health System, 2016).

Suppose the Clinic loses the licensure, it will no longer be authorized to provide acute stroke and diabetes management services. While the loss of accreditation will prevent Mayo Clinic from serving as a health care organization in Wisconsin, loss of licensure will only prevent the organization from providing care services related to acute stroke management and diabetes management (Rooney and Ostenberg, 1999).

References

Alkhenizan, A. & Shaw, C. (2011) Impact of accreditation on the quality of healthcare services: A systematic review of the literature. Annals of Saudi Medicine, 31(4): 407-416. doi:10.4103/0256-4947.83204.

Mayo Clinic Health System (2016). Accreditation. Retrieved from mayoclinichealthsystem.org

Rooney, A. & Ostenberg, P. (1999). Licensure, accreditation, and certification: Approaches to health services quality. Wisconsin: Bethesda

Want help to write your Essay or Assignments? Click here

Evolving Nursing Practice and Patient Care Delivery Models

Evolving Nursing Practice
Evolving Nursing Practice
Evolving Nursing Practice and Patient Care Delivery Models

“This presentation will begin by welcoming remarks that are extended to everyone who is present in this session. The topic that will be explored in this presentation is, ‘The anticipated growth and changes in nursing practice over the coming years.”If you take your time to compare the health care delivery in traditional health care organizations with the one used in contemporary organizations, you will learn that modern approaches to care are better than the ones that were used in the past.

It is also important to recognize that the mode of care delivery in future will be far much better than it is today. Rapid health care reforms are currently taking place to enable nurses to provide care that meets the needs of the ever-changing population. As nurses, we must be conversant with the changes and growth that are expected to take place in nursing practice in the near future for us to be in a position to contribute positively to the reorganization of the United States’ health care delivery system (Salmond and Echevarria, 2017).

            For instance, it is anticipated that the number of nurses who will be required to deliver care in acute care hospitals will decrease while the number of those nurses who will be required to serve in the community will increase. Furthermore, it is expected that future health care organizations will reward nurses based on the quality of care they deliver, a system known as Accountable Care Organizations (Song, 2014).

In order to effectively meet the health care needs of the future community, nurses will be required to posses the right knowledge and skills to enable them to deliver quality care in accountable care organizations. Nurses are required to prepare adequately to deliver care both in hospital-based and community-based settings. The best way through which nurses can prepare for the future is by obtaining the highest level of academic qualifications from relevant academic institutions which have been accredited to provide nursing education in the United States. This way, they will adequately be equipped to deliver quality care that matches the trends and issues in United States healthcare system (Shortell, Colla, and Ramsay, 2017).

            Today’s society needs clinical advice on how it can effectively manage new infections that have a negative impact on health. As Kovner and Walani (2010) point out, the increasing need for health education among the current and future populations greatly influences the creation of nurse-managed clinics in the community. Advanced practice nurses will be assigned clinical roles in nurse-managed clinics from where they will be required to educate community members on how they can effectively manage infections which are affecting their health.

Since more jobs will be available in nurse-managed clinics in the community, nurses must be prepared enough to work as community nurses and to teach clients on how they can prevent and manage infections (Kovner and Walani, 2010).

            We should also recognize that the rates of deaths that are associated with chronic infections are on the rise in today’s society. It is anticipated that incidences of chronic infections such as cancer and diabetes will continue to rise in the near future due to the anticipated changes in lifestyle and because very few people are adequately informed of how they can effectively manage their health problems outside the hospital setting (Suter, Oelke and Armitage, 2009).

Therefore, advanced practice nurses will be expected to possess the right knowledge and skills to provide a continuum of care to patients who need clinical guidance after they will have been discharged from the hospital. In this manner, nurses will play a big role in reducing deaths that occur from ineffectively managed chronic infections (Haggerty, Reid and McKendry, 2003).

            It is anticipated that the future community will be in need of more personalized care than the current society. As Scribner and Kehoe (2017) explain, it is expected that patient-centered medical homes will be used more than hospitals in the next few years. From these medical homes, nurses will be deployed to offer constant personalized care as well as medical consultations to the community. For this reason, nurses will only be able to retain their job positions if they are competent enough to work in patient-centered medical homes and in hospital settings (Reynolds, Klink and Davis, 2015).

Based on the anticipated growth and changes in nursing practice over the coming years, I urge all of you to seek for training on how to deliver quality care in areas related to Accountable care organizations, nurse-managed clinics, continuum of care, and patient-centered medical homes in order to prepare adequately to fit in the job market in future. Thank you.”            

Nurse One supports the idea that nursing practice is expected to change and grow in the next few years, and that nurses are required to prepare adequately to deliver health care that will meet the needs of the future generation. According to Nurse One, the rate of deaths that occur as a result of chronic infections is on the rise in today’s society. It is reported everywhere in the media that the number of people who die of cancer, diabetes, and high blood pressure continue to increase each day as a result of poor health management practices.

The main reason why the number of deaths associated with chronic infections continues to rise is due to lack of knowledge on how these conditions can be managed once a patient leaves the hospital. For instance, some patients may suffer severe health consequence associated with either drug side effects or non-adherence to drugs.  In order to reduce deaths that are associated with chronic health problems from affecting the community in future, nurses will be expected to be competent enough to deliver continuum care to clients in the community.

Additionally, the number of nurses who will be expected to provide health care services in nurse-managed homes will be greater than that required to serve in hospitals. In Nurse One’s opinions, nursing practice is expected to grow and change in the next few years and only competent nurses will be able to find jobs.

Nurse One supports the idea that nursing practice is expected to change and grow in the next few years, and that nurses are required to prepare adequately to deliver health care that will meet the needs of the future generation. According to Nurse One, the rate of deaths that occur as a result of chronic infections is on the rise in today’s society. It is reported everywhere in the media that the number of people who die of cancer, diabetes, and high blood pressure continue to increase each day as a result of poor health management practices.

The main reason why the number of deaths associated with chronic infections continues to rise is due to lack of knowledge on how these conditions can be managed once a patient leaves the hospital. For instance, some patients may suffer severe health consequence associated with either drug side effects or non-adherence to drugs.  In order to reduce deaths that are associated with chronic health problems from affecting the community in future, nurses will be expected to be competent enough to deliver continuum care to clients in the community.

Additionally, the number of nurses who will be expected to provide health care services in nurse-managed homes will be greater than that required to serve in hospitals. In Nurse One’s opinions, nursing practice is expected to grow and change in the next few years and only competent nurses will be able to find jobs. The views of this nurse are consistent with ideas presented by Haggerty Reid and McKendry (2003) and by Suter, Oelke, and Armitage (2009) concerning the need for nurses to be prepared to deliver continuum care in the community over the coming years.

 References

Haggerty, J. L., Reid, R. & McKendry, R. (2003). Continuity of care: A multidisciplinary review. The British Medical Journal, 327(7425): 1219-1221.

Kovner, C. & Walani, S. (2010). Nurse-managed health centers. Nursing Research Network: Robert Wood Johnson Foundation.

Reynolds, P., Klink, K. & Davis, M. (2015). The patient-centered medical home: Preparation of the workforce, more questions than answers. Journal of General Internal Medicine, 30(7): 1013-1017.

Salmond, S. & Echevarria, M. (2017). Health care transformation and changing roles for nursing. Orthopedic Nursing, 36(1): 12-25.

Scribner, M. N. & Kehoe, K. (2017). Establishing successful patient-centered medical homes in rural Hawaii: Three strategies to consider. Hawaii Journal of Medicine & Public Health, 76(3): 18-23.

Shortell, S., Colla, C. & Ramsay, P. (2017). Accountable care organizations: The national landscape. Journal of Health Politics, Policy, and Law, 40 (4): 647-668.

Song, Z. (2014). Accountable care organizations in the US health care system. Journal of Clinical Outcomes Management: JCOM, 21(8):364-371.

Suter, E., Oelke, N. & Armitage, G. (2009). Key principles for successful health systems integration. Healthcare Quarterly, 13(1): 16-23.

Want help to write your Essay or Assignments? Click here.

Nursing Practice Reflection Paper

Nursing Practice
Nursing Practice

Nursing Practice Reflection Paper

Part 1

Since the Future of Nursing recommendations was released by the Institute of Medicine (IOM), nurses have worked hard to ensure that they fit into each one of them. For instance, nurses strive to obtain the right academic qualifications from institutions of higher learning to enable them to perform their roles effectively (Reinhard and Hassmiller, 2015). Personally, I see myself fitting into recommendation 4, recommendation 5, and recommendation 6 documented by the Institute of Medicine.

The IOM recommends that nursing practice in the United States can be transformed by increasing the number of nurses who graduate with baccalaureate degrees to 80 percent by the year 2020. According to the IOM, relevant accrediting bodies should work in collaboration with academic nurse leaders, employers, as well as public and private funders to ensure that student nurses obtain the right academic qualifications that can enable them to deliver quality care to diverse populations.

This means that the number of student nurses who are enrolled in baccalaureate degrees should increase for the fourth IOM recommendation to be implemented successfully (The Institute of Medicine, 2010). Since I am preparing to graduate with a Bachelor of Science in Nursing (BSN) degree in a few years to come, I am confident that I perfectly fit into the IOM Future of Nursing recommendation four.

I will effectively apply the knowledge and skills that I will acquire from my baccalaureate degree to deliver quality healthcare to diverse populations. In this manner, I believe that I will form part of nurses who graduate with baccalaureate degrees by the year 2020 as I continue to deliver care that is intended to improve nursing practice in the United States.

The IOM also gives a recommendation that the number of nurses who possess doctorate degrees should double by 2020 for nursing practice in the United States to be improved. Under recommendation five, the IOM directs academic nurses to collaborate with both public and private funders as well as with accrediting bodies to increase the number of student nurses who are enrolled into and who graduate with doctorate degrees (AnneMarie, 2016; & The Institute of Medicine, 2010).

Since I am planning to be enrolled in a Master’s program once I complete my undergraduate degree, and into a doctorate degree program thereafter, I believe that I will fit into the IOM Future of Nursing recommendation five. From the doctorate degree program, I will acquire advanced nursing knowledge that I will apply to carry out nursing research for an improved nursing practice. I, therefore, believe that I will form part of nurses who possess doctorate qualifications by 2020.

The IOM recommends that nursing institutions should engage in long-term learning for nursing practice in the United States to be improved. Under recommendation six, healthcare organizations, accrediting bodies, and educators are required to join hands in ensuring that student nurses, as well as graduate nurses, engage in prolonged learning with the aim of acquiring competencies that will enable them to deliver quality care to patients from different backgrounds (The Institute of Medicine, 2010; & AnneMarie, 2016).

Personally, I undertake numerous training that is related to nursing care even as I strive to achieve higher academic qualifications. For this reason, I have been able to obtain relevant knowledge and skills that I intend to apply in delivering quality care to patients in future. Since I currently engage in lifelong learning, I perfectly see myself fitting into the IOM Future of Nursing recommendation six.

Part 2

Increasing my level of education will positively affect how I compete in the current job market. According to McHugh and Lake (2011), today’s health care organizations are keen to hire nurses who possess relevant clinical nursing expertise because this is critical to health care quality. For this reason, only nurses who possess relevant nursing knowledge and skills can effectively compete in the current job market.

Individual nurse education has been identified as one of the factors that help to increase clinical nursing expertise (McHugh and Lake, 2011). In this regard, nurses who obtain high levels of education are believed to be in a better position to compete in the job market than those who do not.  By increasing my level of education, I believe that I will possess the right clinical expertise that will enable me to compete favorably in the current job market.

Increasing my level of education will greatly change my role in the future of nursing. As Black, Balneaves, Garossino, Puyat, and Qian (2015) explain, future nurses are expected to engage in nursing research in order to generate data that can be used to promote evidence-based practice. Knowledge of how nursing research should be conducted is best acquired through nursing education.

This is because instructors normally teach nurses on how they can use evidence obtained from research to inform evidence-based practice. In addition, through nursing education, nurses are able to learn the best approaches to research that will generate important information that can be used to improve health care delivery (Ketefian and Redman, 2015). Therefore, increasing my level of education will enable me to perform both nursing practice roles as well as research roles.

References

AnneMarie, P. (2016). The future of nursing: Leading change, advancing health…how are we doing? Nursing Critical Care, 11(3):4.

Black, A. T., Balneaves, L. G. Garossino, C., Puyat, J. H. & Qian, H. (2015). Promoting evidence-based practice through a research training program for point-of-care clinicians. The Journal of Nursing Administration, 45(1): 14-20.

Ketefian, S. & Redman, R. W. (2015). A critical examination of the developments in nursing doctoral education in the United States. Revista Latino-American de Enfermagem, 23(3): 363-371.

McHugh, M. D. & Lake, E. (2011). Understanding clinical expertise: Nurse Education, experience, and the hospital context. Research in Nursing & Health, 33(4): 276-287.

Reinhard, S. & Hassmiller, S. (2015). The future of nursing: Transforming health care. The AARP International Journal, retrieved from https://www.journal.aarpinternational.org/

The Institute of Medicine. (2010). The future of nursing: Leading change, advancing health. Washington, DC: The National Academies Press.

Want help to write your Essay or Assignments? Click here.

Disparities in Health Outcomes Between India and China

Disparities in Health Outcomes Between India and China
Disparities in Health Outcomes Between India and China

Disparities in Health Outcomes Between India and China

Disparities in Health Outcomes Between India and China

Introduction

            There are significant health disparities between India and China as well as within their populations. At the end of World War I, health outcomes of both China and India were almost comparable. However, the health system of China improved more tremendously than that of India roughly thirty years after the war. The health progress in India thirty years ago is surprisingly better than that of China despite the fact that India is still one of the countries of the world whose economy is highly impacted by the problem of food insecurity (Yip and Mahal, 2008). Ideally, India and China have had varied experiences in health outcomes in the last 50 years

Variations in Health Outcomes between China and India

            In the last 50 years, China and India have experienced significant differences in life expectancy rates as well as in rates of parasitic and infectious diseases. The most important measure of life expectancy is infant mortality, while the measure of infectious disease burden is adjustments in life years among the population (Bardhan, 2008). Since the early 1970s, India has been experiencing lower life expectancy, as evidenced by higher infant mortality rates, than China (Kanjilal, Mazumdar, Mukherjee and Rahman, 2010).

By the year 2000, the rate of deaths among children aged five years and below was 46 percent in India and only 8 percent in China. These are deaths that resulted from children who are born if they are underweight (Bardhan, 2008). According to Yip and Mahal (2008), the burden of infectious diseases in India is higher than that of China. Considering these variations, the health care systems of both India and China can only perform effectively if appropriate actions are taken to improve health outcomes about life expectancy and burden of parasitic and infectious diseases.

Reasons Behind the Health Outcome Disparities Between India and China

            The two leading causes of health outcome disparities between India and China are variations in health literacy and implementation of public health policies. According to Yip and Mahal (2008), India has been experiencing low life expectancy over the years because of limited health literacy among its population. Yip and Mahal (2008) further assert that the health literacy level in India at the moment is far much lower than it was in China more than ten years ago.

Due to limited health literacy among Indian population, families cannot implement basic health promotion strategies such as proper nutrition and home hygiene practices. The overall impact is an increased burden of infectious diseases coupled with high infant mortality rates in the country (Ma and Neeraj, 2008).

            Furthermore, the Chinese government is more committed than the Indian government at funding public health projects that are aimed at improving health outcomes of its population. Over the past fifty years, life expectancy in China has been increasing rapidly from approximately 39 percent to about 68 percent (Tang, Meng, Chen, Bekedam, Evana, and Whitehead, 2008). This has occurred due to the effort made by the Chinese government to support the implementation of public health policies.

The most recognizable initiative that was widely supported by the government is the Health China 2020, which was meant to address the problem of social inequality in health care and to improve the Chinese health care (Tang et al., 2008).  Conversely, India is suffering from inadequate public health support accompanied by significant disparities in the country’s health care system.

Consequently, poor implementation of public health policies in India is attributed to the higher mortality rates and burden of infectious diseases in India than in China (Mukherjee, Haddad and Narayana, 2011). Despite these differences, health outcomes of both India and China are greatly impacted by social and health care disparities in the two countries (Balarajan, Selvaraj, and Subramanian, 2011; & World Health Organization, 2005).

Comparison of Health Outcomes in Kerala and India

            Kerala state is located in India towards the southern regions of the country.  Surprisingly, the health outcomes of Kerala state are better than those of other parts of India, and this is evidenced by variations in both health and social indicators. As Mukherjee, Haddad and Narayana, (2011) explain, Kerala has experienced high life expectancy rates as well as reduced burden of infectious diseases in the last half century. Kerala became a “model India State” because of exhibiting a demographic health pattern that matches those of developed countries like the United States.

The main reasons for improved health outcomes in Kerala are educational equality, increased access to primary health care, and effective implementation of public health policies (Mukherjee, Haddad and Narayana, 2011). Educational equality in Kerala state contributes to an increase in health care literacy among the state’s population.

Furthermore, effective implementation of public health policies in the region has greatly improved the quality of care offered by health care organizations, and this translates into high life expectancy rates and reduced burden of infectious diseases (Mukherjee, Haddad and Narayana, 2011).

Conclusion

India and China are among countries of the world that are currently experiencing almost similar rates of economic growth. However, the two nations have experienced different health outcomes in the last fifty years. The main reasons behind variations in health outcomes between China and India are differences in health literacy levels and implementation of health care policy between the two countries. Although Kerala is a state in India, its health outcomes differ considerably from the rest of India.

References

Balarajan, Y., Selvaraj, S. & Subramanian, S. V. (2011). Health care and equity in India. Lancet, 377(9764): 505-515.

Bardhan, P. (2008). The state of health services in China and India in a larger context. Health Affairs, Retrieved from https://pdfs.semanticscholar.org/f9bd/1636dfa085748821241535eda868b8db4e2c.pdf

Kanjilal, B., Mazumdar, P., Mukherjee, M. & Rahman, M. (2010). Nutritional status of children in India: Household socio-economic condition as the contextual determinant. International Journal for Equity in Health, 9(1): 19-31.

Ma, S. & Neeraj, S. (2008). A comparison of the health systems in China and India. Santa Monice, CA: RAND Corporation.

Mukherjee, S., Haddad, S. & Narayana, D. (2011). Social class related inequalities in household health expenditure and economic burden: Evidence from Kerala, South India. International Journal for Equity in Health, 10(1):1-13.

Tang, S., Meng, Q., Chen, L., Bekedam, H., Evana, T. & Whitehead, M. (2008). Tackling the challenges to health equity in China. Lancet, 372(9648): 1493-1501.

World Health Organization. (2005). China: Health, poverty, and economic development. Retrieved from http://www.who.int/macrohealth/action/CMH_China.pdf

Yip, W. & Mahal, A. (2008). The health care systems of China and India: Performance and future challenges. Health Affairs, 27(4): 921-932.

Want help to write your Essay or Assignments? Click here.

Health care cost: Burden to low income earners

health care cost
health care cost

Financial Management

Health care cost

Patient care financial problem is one of the reasons why today’s populations are unable to receive high quality care that they need to achieve improved health outcomes. The problem of huge health care cost is a big burden to low income earners who always lack adequate finances to purchase drugs and to pay for hospital bills (Kelley, McGarry, Georges, and Skinner, 2015). It becomes even worse for patients who are suffering from chronic health conditions such as diabetes and cancer.

According to Kelley et al., (2015), dementia is one of the chronic diseases that are attracting large social costs for patients in the United State. For this reason, being a fatal health condition, many dementia patients in the United States are dying due to patient care financial problem. Patient care financial problem has an impact on federal and national budgets. Nurses play a very big role in ensuring that patient care financial problems are integrated into the national and federal budgets by analyzing information that may be required for budget development (Luga & McGuire, 2014)

Health care cost: Heath insurance

Lack of health care insurance and high costs of prescription drugs are the most common patient care financial problems in today’s society. According to Saksena, Hsu and Evans (2014), health care coverage helps to protect patients from financial risks, and lack of it becomes a big burden for many populations. In addition, paying for health care through out-of-pocket payments prevents many people around the world from accessing care.

Although lack of health care insurance is a financial problem for patients, it is always associated with both non-financial and financial health-related impacts to public health. For instance, limited access to quality health care as a result of lack of health care coverage, results into negative health outcomes for the population. This is a good example of a non-financial impact associated with lack of health insurance (Luga & McGuire, 2014).

With regard to financial-related impact, an increase in disease burden among populations is of great financial impact to the public health sector, which must allocate additional funds to clear disease from the society (Saksena, Hsu and Evans, 2014).

The other financial problem that is related to patient care is high costs of prescription drugs. Many patients and their families really have to struggle in order to meet health care costs, especially medication costs. According to Walkom, Loxton, and Robertson, (2013) in a study conducted with the aim of assessing the impact of high medication costs on patients’ ability to adhere to prescription drugs, it has been discovered that 27 percent of participants from Australia and 36 percent of subjects from the United States tend to skip their drug doses because they are unable to purchase drugs which are charged at extremely high prices.

In addition, the need to purchase prescription drugs through out-of-pocket payments is one of the contributing factors to poor health among populations in today’s society (Luga & McGuire, 2014).

Lack of insurance as well as high costs of prescription drugs have an impact on federal and national budgets. This is because the government has to integrate health care costs into its budget to help low income earners to access care and to achieve improved health outcomes (Saksena, Hsu and Evans, 2014). According to Saksena, Hsu and Evans (2014), the number of uninsured citizens is on the rise in the United States because many people are reluctant to join available Medicare and Medicaid programs following increased uncertainties that continue to surround their use.

If the current trend persists, the federal government will be compelled to integrate patients’ health care costs into its budget in order to increase the percentage of United States citizens who receive quality care. As Kelley et al., (2015) explain, there is great need for the federal government to increase budget that it allocates for helping the society to manage chronic illnesses, considering the fact that chronic health conditions become more severe among the uninsured patients than among patients with health care coverage.

Similarly, high costs of prescription drugs have an impact on federal and national budget because the government has to increase its spending on these drugs to promote positive health among its population, especially the low income earners (Luga & McGuire, 2014).  

Nurses play a very crucial role in solving patient care financial problems because they are charged with the responsibility of analyzing public health information that is needed for budget development. The federal government depends on information collected by nurses regarding health care costs to make a decision on the most appropriate funds that should be allocated for patient care (Salmond and Echevarria, 2017).

In order to ensure that the right information is used for budget development, nurses must be sure to collect accurate and specific information as this will help the government to distinguish between funds that are allocated for health care coverage from those that are designated for prescription drugs. The staff nurse plays the role of collecting data directly from the community and presents it to the nurse manager.

The nurse manager analyzes the presented information and evaluates its relevance before passing it to the chief nurse. The chief nurse analyzes the information and forwards it to the agencies responsible for budget development, stating the reasons why it should be included in the budget (Salmond and Echevarria, 2017).

References

Kelley, A. S., McGarry, K., Georges, R. & Skinner, J. S. (2015). The burden of health care costs for patients with dementia in the last 5 years of life. Annals of International Medicine, 163(10): 729-736. doi: 10.7326/M15-0381.

Luga, A. O. & McGuire, M. J. (2014). Adherence and health care costs. Risk Management and Healthcare Policy, 7: 35-44. doi:  10.2147/RMHP.S19801

Salmond, S. W. & Echevarria, M. (2017). Healthcare transformation and changing roles for nursing. Orthopedic Nursing, 36(1): 12-25.  doi:  10.1097/NOR.0000000000000308

Saksena, P., Hsu, J. & Evans, D. B. (2014). Financial risk protection and universal health coverage: Evidence and measurement challenges. PLoS Med, 11(9): e1001701. https://doi.org/10.1371/journal.pmed.1001701

Walkom, E., J., Loxton, D. & Robertson, J. (2013). Costs of medicine and health care: A concern for Australian women across the ages. BMC Health Services Research, 13: 484. doi:  10.1186/1472-6963-13-484

Want help to write your Essay or Assignments? Click here.

Financial Management: Health Care Workers Compensation

Financial Management: Health Care Workers Compensation
Financial Management: Health Care Workers Compensation

Financial Management

Overview of the Financial Issue

While a reduction in compensation of health care workers may be influenced by organizational constraints, health care organizations may at times be compelled to trim workers’ wages and salaries due to poor financial management (Bai, Gu, Chen, Xiao, Liu, and Tang, 2017). The most recently reported financial management issue is a reduction in nurses’ compensation from 300 to 250 United States per month due to improper allocation of funds, which resulted in purchase of equipment that is not urgently needed by the organization. 

RacKol Health Care organization specializes in delivering cancer care to the community. The company has been experiencing a rapid rise in nurse turnover rates over the past two months. This has resulted in an increase in patient mortality rate from an average of 3 people week to 10 people every week. It is anticipated that the number of nurses who are leaving the organization is on the rise due to the recent reduction in their salaries that is majorly attributed to poor financial management (Dong, 2015).

To determine the actual cause of the financial issue, the Chief Finance Officer and the Senior Accountant have been interviewed, and they have been asked to share their opinions concerning a possibility of mismanagement of funds in the organization. The Chief Finance Officer is charged with the responsibility of preparing financial plans for the organization and for keeping records of those plans.

The Senior Accountant is responsible for compiling accounts information of the organization by checking whether there is a balance between assets and liabilities (Johns, 2013). According to the Chief Finance Officer and the Senior Accountant, the recent reduction in nurses’ compensation is solely attributed to improper allocation of funds during budgeting that made the organization to purchase cancer care equipment for pediatrics. The two interviewees have explained that the organization has tried to address the current issue for the past one month.

Finanacial Management: Measures that have Been Taken to Address the Issue

Officials in the finance department have taken two measures to address the financial management issue that is currently faced by RacKol Health Care. One of the measures is a move to align organizational plans with available funds without compromising the performance of health care workers. Initially, the health care organization did not take any actions to evaluate whether it has available funds to help it accomplish future financial plans.

Since they faced the challenge of compensating nurses, the Chief Finance Officer in collaboration with the Senior Accountant has begun to align future financial plans of the organization with available funds at any given time, as this helps the organization to only allocate funds to useful projects (Dong, 2015). The other measure that is currently implemented by the organization to prevent improper allocation of funds is involvement of departmental heads in financial decision-making.

Before the current financial issue, officials in the finance department did not involve heads of other departments in making financial decisions. As supported by Walsh (2016), involving departmental heads in financial decision-making facilitates proper allocation of funds because it prevents the purchase of equipment that is not urgently needed by the organization.

Future Steps that Have Been Planned to Address the Issue

RacKol Health Care is highly committed to ensuring that the current financial issue does not repeat itself in future. For this reason, officials in the finance department have documented a plan of how they will improve financial management in the organization over the coming months. For instance, they have a plan to hire an Information Technology professional with competent knowledge of data analytics.

The organization anticipates that with an expert in data analytics, it will be able to understand the specific financial needs of various departments and allocate funds based on the urgency of these requirements. In this manner, it will be able to avoid using funds to make purchases that are not urgently needed by the organization (Walsh, 2016).

Moreover, RacKol Health Care is planning to create a feedback loop that will allow free reporting between executives and the management. With a properly implemented feedback loop, executives on the finance department will be able to understand and strive to address concerns of various departments as far as quick financial allocation is concerned (Dong, 2015).

Potential Blocks in Resolving the Issue

 The Chief Finance Officer and senior accountant, however, foresee some problems that may prevent the organization from successfully addressing the financial issue that it is currently facing. One of the problems is the lack of motivation by departmental heads, which may make them to be reluctant to take part in financial decision-making and the creation of the feedback loop.

Moreover, these officials feel that heads of various departments in the organization may lack sufficient training on important issues related to financial management (Bai et al., 2017). Again, managers may lack knowledge and skills to apply in financial management due to unavailability of sufficient financial, managerial tools for use as a reference.

To mitigate these challenges, RacKol Health Care should train all heads of department on basic issues related to financial management. This will enable them to utilize the acquired knowledge and skills to prevent the occurrence of similar financial issues in future (Bai et al., 2017). Personal perception on the current financial issue is similar to the perception of those who are working on finances in the organization.

References

Bai, Y., Gu, C., Chen, Q., Xiao, J., Liu, D. & Tang, S. (2017). The challenges that head nurses confront on financial management today: A qualitative study. International Journal of Nursing Sciences, 4(2): 122-127. https://doi.org/10.1016/j.ijnss.2017.03.007

Dong, G. N. (2015). Performing well in financial management and quality of care: Evidence from hospital process measures for treatment of cardiovascular disease. BMC Health Services Research, 15: 45. doi:  10.1186/s12913-015-0690-x

Johns, M. (2013). Breaking the glass ceiling: Structural, cultural, and organizational barriers preventing women from achieving senior and executive positions. Perspectives in Health Information Management, 10(Winter): 1e.

Walsh, K. (2016). Managing a budget in healthcare professional education. Annals of Medical & Health Sciences Research, 6(2): 71-73. doi:  10.4103/2141-9248.181841

Want help to write your Essay or Assignments? Click here.