Patient Care effect on Career and Education Decision
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Patient Care effect on Career and Education Decision
Discuss how the patient care you have provided has influenced your career and decision to continue your education
What is the meaning of patient care in medical terms? It begins by explaining what “patient” means and what medical practice is. Medical practice is the act of providing health services to those in need. There are different types of health services practiced. One is the medical diagnosis and another is the treatment or health service itself. In the medical field, the patient is one of the most important people involved.
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Patient satisfaction from Quality Improvement
Constant Quality improvement and patient contentment focuses on activities conducted within the healthcare institution to ensure that health care is patient-centered and good health is acknowledged as an integral part of the medical evaluation. Nursing leadership and management must put into consideration the quality and satisfaction of their patients and the health care as a whole.
Continuous Quality Improvement and Patient satisfaction are established as an efficient partnership between the medical practitioner, their patients and family. They ensure that patients are granted the standardized medical attention, their needs and want are respected and that they acquire the best support and direction in making a decision and practicing medical care. Every nurse leader and manager must consider directing their effort towards establishing quality care and patient satisfaction (McFadden, et al., 2014).
Nursing leaders and managers have different responsibilities and roles when it comes to ensuring continuous quality improvement and patient satisfaction. Subsequently, when focusing on continuous quality improvement this paper will concentrate on factors that ensure health care services are offered at a quality standard and the health environment is well established and cared for effectively. On the other hand, patient satisfaction is based on how patient receive quality service and care. It is structured to ensure that staff care and patient care are well established and maintained in any healthcare institution.
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In light of this continuous quality improvement and patient satisfaction, the essay will offer a comparison between nursing leaders and managers through supportive theories, rationale, principles, skills and roles.
Comparison between Health Manager and Nursing Leader
Dissimilarity
Nursing leaders and nursing managers have different roles, responsibility, and skills when it comes to ensuring continuous quality improvement and patient safety. Their distinction can be defined through how each corresponds to their department in ensuring quality health and patient care. While nursing leaders acquire their roles through their ability to lead, influence and motivate others to perform better, managers are appointed into their positions officially and hence play the role of overseeing activities and processes within the facility (Meehan, 2012).
In regard of Continuous Quality improvement and patient satisfaction, nursing leaders are likely to approach the matter of constant eminence development as well as patient satisfaction in distinct ways. One of the basic dissimilarities between nursing leaders and managers can be attributed to their roles. Nursing managers are responsible for direct patient care. They ensure that all the patients in a medical institution attain the medical attention and care they deserve by ensuring that all protocols are observed and that required resources are availed.
On the contrary, leaders play a motivational and individual development role, with an objective of encouraging others to perform their duties effectively. They keep vigilance on the issues and concerns of their patients to ensure that their safety and care is given priority. Through nursing leaders, staff can see quality improvement and patient satisfaction as a moral issue that will guarantee the happiness of patients and thus work towards achieving this objective. This is as opposed to managers who expect quality improvement and satisfaction through following set rules and expectations (Thompson, 2006).
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Nursing leaders play the role of streamlining the institution’s workforce as well as ensuring that the resources allocated are effectively used to achieve the organization’s objectives. This means that to ensure continuous quality improvement, nursing leaders would work towards ensuring that available resources are optimized to bring out maximum impact and enhance patient satisfaction (McFadden, et al, 2014).
Managers on the other hand would promote continuous quality improvement and satisfaction by promoting resource allocation and providing an appropriate working environment. They are in charge of medical staff and patient welfare at large in ensuring continuous quality improvement and patient satisfaction. Moreover, it is the duty of the manager to offer the nursing leader a viable platform through which they can conduct quality service to their patients. Thus, the manager plays an overall duty in ensuring health quality and patient care compared to a nursing leader whose primary focus is to their patient health and concern (Fleishman, 2002).
Manager skills ensure continuous quality improvement and patient safety through striking a balance coordinating resources, financial matters, and personnel in healthcare. Furthermore, the managers are responsible for ensuring goals and objective such as ensuring quality patient care are achieved. On the other hand, the nursing leader exhibits different responsibilities and skills in establishing continuous quality improvement and patient safety.
Nursing leaders must establish good communication and interpersonal relationships and expertise with their patient, staff, and other clients of the medical facilities. They are also responsible for empowering, motivating, inspiring and encouraging other towards achieving and establishing quality service and care.
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On the contrast, it can be established that managers envision the future for medical operation and create a path towards productivity and efficiency. The manager is in charge of growth and opportunities in healthcare to ensure new medical staffing are accounted and quality service in rendered throughout the season. However, nursing leaders are different as they do not have the power figure but can envisage socio-adaptive component that helps ensure a good relationship between the patients and the clinical staff. The nursing leader is task oriented and conducted their duty with the aim of offering their patients and clients a favorable environment.
Similarity
Despite their numerous dissimilarities, nursing leaders and managers share some equal responsibility and characteristics to establish continuous quality improvement and patient satisfaction. Both of them are responsible for ensuring job satisfaction for their clients. Managers can act as motivators and risk takers same applies to nursing leaders who take risk and chances to provide quality improvement and patient satisfactory (Thompson, 2006).
Additionally, managers, just like nursing leaders, are enforcing work unity and envision goals. They all strive towards cohesion at the health institution and encourage mutual tolerance in health care to boost quality and satisfactory service. Their duty is to maintain a conducive working environment comply with the various demand and obligation in ensuring continuous quality improvement and patient satisfactory is retained in the health care.
Both managers and nursing leaders are a representative of each group or unit they lead and hence act as role models. They are therefore expected to possess qualities that do not contradict their position and value. They should maintain a high standard of professionalism that is acceptable within their jurisdiction and adhere to different roles, responsibility, and accountability.
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Personal and Professional Philosophy of Nursing
The most appropriate personal and professional philosophy than can be considered in this case is accountability. Nursing is a calling and is held to high professional standards and obligations hence the need to show a high level of accountability (Meehan, 2012). Nevertheless, when dealing with a patient, nurses, and medical practitioners take their lives in their own hands, making them responsible for any outcome and consequences that their patients might face.
Hence, it is recommended for a nurse to exhibit a high standard of accountability. They should not be limited from performing their duties with utmost care and accountability based on self-esteem, belief or negativity.
Accountability is suitable for personal leadership skills as it helps to build self-responsibility, improve tolerance and acceptance. It also fosters competence, determination and goal orientation within an individual. Being accountable is also being responsible for others. This means one is able to take the risk for the sake of saving and helping others.
It is also suitable for personal leadership skills as it improves personal relationships, communication skills and fosters social engagement with other people. Accountability can therefore be perceived as effective in promoting personal and public relationships with other people in the healthcare institution.
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References
Fleishman, R. (2002). The RAF method for regulation, assessment, follow-up and continuous improvement of quality of care: Conceptual framework. International Journal of Health Care Quality Assurance, 15(6), 303-310. Retrieved from http://search.proquest.com/docview/229598851?accountid=45049
McFadden, K. L., Lee, J. Y., Gowen, Charles R., I.,II, & Sharp, B. M. (2014). Linking quality improvement practices to knowledge management capabilities. The Quality Management Journal, 21(1), 42-58. Retrieved from http://search.proquest.com/docview/1503666127?accountid=45049
Meehan, T. C. (2012). The Careful Nursing philosophy and professional practice model. Journal Of Clinical Nursing, 21(19/20), 2905-2916. doi:10.1111/j.1365-2702.2012.04214.x
Thompson, J. M. (2006). Nurse managers’ participation in management training and nursing staffs’ job satisfaction and retention (Order No. 3230066). Available from ABI/INFORM Complete. (304937671). Retrieved from http://search.proquest.com/docview/304937671?accountid=45049
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Nursing and patient care delivery methods
Introduction
The evolving practices in patient care delivery system indicate that the nursing profession need to transform in order to meet the healthcare’s demand. The nursing practice is expected to change in its approach to leadership and education so that it can deliver its functions effectively (Nursing’s Social Policy Statement, 2010). In this context, this paper aims at analysing how nursing practice is expected to change. The paper will also discuss the concepts of continuum of care, nurse-manage healthcare clinics (NMHCs) and accountable care organizations (ACO’s) (Perry & Hoffaman, 2010).
The transformations are associated with the Patient Protection and Affordable Care Act of 2010 (PPACA) changes which focuses on provisions that will intertwine cost efficient care with high quality of care. For a long time, the healthcare systems arrangements have been somewhat fragmented, lacking coordination and individual responsibility, which affected the quality of care. The integrated care delivery models aims at improving coordination and quality of healthcare services by allocating resources in the underserved areas.
The law attempts to restore the healthcare system by rewarding quality of services rather than the volume of services delivered. Consequently, the nurses are expected to become adjusted to the reorganized structure as they are the focal point of patient care. They play a huge role in the attainment of objectives for the emerging healthcare delivery methods (Quad Council of Public Health Nursing Organizations, 2011).
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The continuity of care concepts refers to the interaction between a patient and practitioner that goes beyond the clinical encounters. It is defined by two core aspects; a) the focus on individual (patient) context and their health demands, and b) continuity of care i.e. patients care over time- present and future. The restructuring of the USA healthcare system aims at ensuring continuity of care, which entails developing a discharge care plan that will enable smooth transition from acute care to home self-care (Quad Council of Public Health Nursing Organizations, 2011).
This will call for extremely trained nurse practitioners, who are equipped with great nursing skills, competencies and knowledge. Therefore, looking forward to the challenging but exciting roles, nurse educators must ensure that the basic value of nursing is reemphasised. This is a profession that delivers care based on scientific knowledge. They must work in partnership with other disciplines to efficiently meet the healthcare goals (Nursing’s Social Policy Statement, 2010).
Arguably, various factors have converged to transform the healthcare system. Consequently, this affects the responsibilities of a nurse practitioner. The changes in the healthcare system are radical and occurring more rapidly than it used to be in the past. Previously, health care facilities used to be the main avenue for nursing practice. Today, the role has reversed.
This is because patients are in the hospital for the shortest time possible. Only patients under critical conditions stay in the hospitals for the longest time. This calls for nurses who understand and value patient’s demands, and who have the capability to facilitate smooth transitions from healthcare settings to home (Quad Council of Public Health Nursing Organizations, 2011).
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Accountable care organizations (ACO’s) were implemented to ensure that the various healthcare organizations focus on delivering comprehensive care to the patients. It comprises of an association of healthcare providers who join together to ensure a collective accountability to ensure delivery of quality and cost effective care. The ACO has developed pre-defined quality performance indicators to ensure that quality standards of care are maintained.
The National Health Care Workforce commission (NHCWC) facilitates the analysis of the workforce to ensure that only qualified and determined people are permitted to practice. The processes of this commission are steered by nurse educators in conjunction with policy makers with the aim of identifying ways to improve delivery of care. This includes deploying resources in rural areas (Perry & Hoffaman, 2010).
NMHC’s are primary healthcare services at community levels. It is under the leadership of the APN and is very important especially, with the new changed in the healthcare system that aims at providing medical cover to over 30 million people in rural areas. NMHC’s models are well established with the aim of providing health education, disease prevention and health promotion in the underserved areas (Quad Council of Public Health Nursing Organizations, 2011).
Currently, there are 200 NMHCs in 37 states. They currently attend about 2 million patients every year. Most of them are uninsured. If the healthcare systems are restructured, it will facilitate the NMHC’s to operate at its full capacity. If the healthcare reforms are made, the changes are expected to focus more on preventive care in the community. The advancement of technology will improve delivery services. Therefore, nurse practitioners will be expected to be knowledgeable and competent on preventive health and in healthcare technological advancement (Nursing’s Social Policy Statement, 2010).
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Evidently, the restructuring of the healthcare systems will shape the nursing practice. This implies that nurse educators should ensure that nurse student skills, abilities theoretical, practical and technological knowledge are improved. Additionally, the students must be equipped with leadership skills as they are intricate part of these healthcare changes.
This approach will ensure that the new professionals are adequately equipped with skills that will enable them to manage sensitive and ethical dilemmas in a healthcare that have uniform regulated systems. This will help in ensuring that the patient healthcare receives effective care and at a cost effective (Perry & Hoffaman, 2010).
Nurses feedback summaries:
Feedback 1: Stephany is a RN with four years’ experience. She believes that nursing practice is a vocation. It requires one to be enthusiastic to deliver effective care. The practice is dynamic, which requires one to continue researching to learning and understand the futuristic technological advancements that are emerging in this profession. She supports NMHC’s programme arguing that it will help reach many vulnerable population, and simultaneously offer new opportunities which will enable the nurses to cultivate their competencies.
Feedback 2:
Alfred has a 10 years’ experience in nursing profession. He has worked as an APN in both the traditional and current healthcare systems. His commitment to delivering effective care has made him become a nurse educator. He says that nursing practice is a sensitive field and only strong willed survive. He supports the concept of continuum of care arguing it is the only way one is assured that the patient healing is holistic.
He says that during teaching, he ensures that the students understand the benefits of establishing a good interaction with their clients. He says that technological advancement has improved the delivery of care as it helped reduce medical errors. The interoperability in healthcare practice has ensured that nurses can learn evidenced based practice. He states that he happy and confident that nurses are ready to face the future emerging trends in healthcare.
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Feedback 3:
Aria is a passionate RN, who has worked in this field for the last five years. She began her nursing career as clinical assistant nurse and has consistently worked hard. The issue of Accountable Care Organization (ACO’s) is thrilling and has helped improve delivery of care in other healthcare institutions. She says that she has analysed the ACO’s concepts and its intentions. She says that the model supports growth in healthcare system. She also supports NHMC’s arguing that their approaches of preventive care us strategic in ensuring that the community health is protected.
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Therefore, it is evident that nursing professionals act as the controllers of new healthcare system. This healthcare industry comprises of wide range of professionals with diverse knowledge and capabilities. Due to these increased changes in the healthcare industry, the nurses are ultimately responsible for the patient’s outcome. Therefore, the nurses are expected to be very knowledgeable in discussions of the proposed reforms.
The nursing professionals must participate in these policy making meetings. This evolution of collaborative approach is beneficial as it has enabled policy makers to address patient issues foreseen. This facilitates the uniformly regulated healthcare systems to ensure that patients are well taken care of through the implementation of the care plans identified (Quad Council of Public Health Nursing Organizations, 2011).
References
Nursing’s Social Policy Statement (2010). The Essence of the Profession. 2010 Ed., 3rd ed. Silver Spring, Md.: American Nurses Association, 2010. Print.
Quad Council of Public Health Nursing Organizations. (2011). Core competencies for public health nurses. Washington, DC: Quad Council of Public Health Nursing Organizations
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Continuous Quality improvement and patient satisfaction
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Continuous Quality improvement and patient satisfaction
Constant Quality improvement and patient contentment focuses on activities conducted within the healthcare institution to ensure that health care is patient-centered and good health is acknowledged as an integral part of the medical evaluation. Nursing leadership and management must put into consideration the quality and satisfaction of their patients and the health care as a whole.
Continuous Quality Improvement and Patient satisfaction are established as an efficient partnership between the medical practitioner, their patients and family. They ensure that patients are granted the standardized medical attention, their needs and want are respected and that they acquire the best support and direction in making a decision and practicing medical care. Every nurse leader and manager must consider directing their effort towards establishing quality care and patient satisfaction (McFadden, et al., 2014).
Nursing leaders and managers have different responsibilities and roles when it comes to ensuring continuous quality improvement and patient satisfaction. Subsequently, when focusing on continuous quality improvement this paper will concentrate on factors that ensure health care services are offered at a quality standard and the health environment is well established and cared for effectively. On the other hand, patient satisfaction is based on how patient receive quality service and care. It is structured to ensure that staff care and patient care are well established and maintained in any healthcare institution.
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In light of this continuous quality improvement and patient satisfaction, the essay will offer a comparison between nursing leaders and managers through supportive theories, rationale, principles, skills and roles.
Comparison between Health Manager and Nursing Leader
Dissimilarity
Nursing leaders and nursing managers have different roles, responsibility, and skills when it comes to ensuring continuous quality improvement and patient safety. Their distinction can be defined through how each corresponds to their department in ensuring quality health and patient care. While nursing leaders acquire their roles through their ability to lead, influence and motivate others to perform better, managers are appointed into their positions officially and hence play the role of overseeing activities and processes within the facility (Meehan, 2012).
In regard of Continuous Quality improvement and patient satisfaction, nursing leaders are likely to approach the matter of constant eminence development as well as patient satisfaction in distinct ways. One of the basic dissimilarities between nursing leaders and managers can be attributed to their roles. Nursing managers are responsible for direct patient care. They ensure that all the patients in a medical institution attain the medical attention and care they deserve by ensuring that all protocols are observed and that required resources are availed.
On the contrary, leaders play a motivational and individual development role, with an objective of encouraging others to perform their duties effectively. They keep vigilance on the issues and concerns of their patients to ensure that their safety and care is given priority. Through nursing leaders, staff can see quality improvement and patient satisfaction as a moral issue that will guarantee the happiness of patients and thus work towards achieving this objective. This is as opposed to managers who expect quality improvement and satisfaction through following set rules and expectations (Thompson, 2006).
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Nursing leaders play the role of streamlining the institution’s workforce as well as ensuring that the resources allocated are effectively used to achieve the organization’s objectives. This means that to ensure continuous quality improvement, nursing leaders would work towards ensuring that available resources are optimized to bring out maximum impact and enhance patient satisfaction (McFadden, et al, 2014).
Managers on the other hand would promote continuous quality improvement and satisfaction by promoting resource allocation and providing an appropriate working environment. They are in charge of medical staff and patient welfare at large in ensuring continuous quality improvement and patient satisfaction. Moreover, it is the duty of the manager to offer the nursing leader a viable platform through which they can conduct quality service to their patients. Thus, the manager plays an overall duty in ensuring health quality and patient care compared to a nursing leader whose primary focus is to their patient health and concern (Fleishman, 2002).
Manager skills ensure continuous quality improvement and patient safety through striking a balance coordinating resources, financial matters, and personnel in healthcare. Furthermore, the managers are responsible for ensuring goals and objective such as ensuring quality patient care are achieved. On the other hand, the nursing leader exhibits different responsibilities and skills in establishing continuous quality improvement and patient safety.
Nursing leaders must establish good communication and interpersonal relationships and expertise with their patient, staff, and other clients of the medical facilities. They are also responsible for empowering, motivating, inspiring and encouraging other towards achieving and establishing quality service and care.
Want help to write your Essay or Assignments? Click here
On the contrast, it can be established that managers envision the future for medical operation and create a path towards productivity and efficiency. The manager is in charge of growth and opportunities in healthcare to ensure new medical staffing are accounted and quality service in rendered throughout the season. However, nursing leaders are different as they do not have the power figure but can envisage socio-adaptive component that helps ensure a good relationship between the patients and the clinical staff. The nursing leader is task oriented and conducted their duty with the aim of offering their patients and clients a favorable environment.
Similarity
Despite their numerous dissimilarities, nursing leaders and managers share some equal responsibility and characteristics to establish continuous quality improvement and patient satisfaction. Both of them are responsible for ensuring job satisfaction for their clients. Managers can act as motivators and risk takers same applies to nursing leaders who take risk and chances to provide quality improvement and patient satisfactory (Thompson, 2006).
Additionally, managers, just like nursing leaders, are enforcing work unity and envision goals. They all strive towards cohesion at the health institution and encourage mutual tolerance in health care to boost quality and satisfactory service. Their duty is to maintain a conducive working environment comply with the various demand and obligation in ensuring continuous quality improvement and patient satisfactory is retained in the health care.
Both managers and nursing leaders are a representative of each group or unit they lead and hence act as role models. They are therefore expected to possess qualities that do not contradict their position and value. They should maintain a high standard of professionalism that is acceptable within their jurisdiction and adhere to different roles, responsibility, and accountability.
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Personal and Professional Philosophy of Nursing
The most appropriate personal and professional philosophy than can be considered in this case is accountability. Nursing is a calling and is held to high professional standards and obligations hence the need to show a high level of accountability (Meehan, 2012). Nevertheless, when dealing with a patient, nurses, and medical practitioners take their lives in their own hands, making them responsible for any outcome and consequences that their patients might face.
Hence, it is recommended for a nurse to exhibit a high standard of accountability. They should not be limited from performing their duties with utmost care and accountability based on self-esteem, belief or negativity.
Accountability is suitable for personal leadership skills as it helps to build self-responsibility, improve tolerance and acceptance. It also fosters competence, determination and goal orientation within an individual. Being accountable is also being responsible for others. This means one is able to take the risk for the sake of saving and helping others.
It is also suitable for personal leadership skills as it improves personal relationships, communication skills and fosters social engagement with other people. Accountability can therefore be perceived as effective in promoting personal and public relationships with other people in the healthcare institution.
Want help to write your Essay or Assignments? Click here
References
Fleishman, R. (2002). The RAF method for regulation, assessment, follow-up and continuous improvement of quality of care: Conceptual framework. International Journal of Health Care Quality Assurance, 15(6), 303-310. Retrieved from http://search.proquest.com/docview/229598851?accountid=45049
McFadden, K. L., Lee, J. Y., Gowen, Charles R., I.,II, & Sharp, B. M. (2014). Linking quality improvement practices to knowledge management capabilities. The Quality Management Journal, 21(1), 42-58. Retrieved from http://search.proquest.com/docview/1503666127?accountid=45049
Meehan, T. C. (2012). The Careful Nursing philosophy and professional practice model. Journal Of Clinical Nursing, 21(19/20), 2905-2916. doi:10.1111/j.1365-2702.2012.04214.x
Thompson, J. M. (2006). Nurse managers’ participation in management training and nursing staffs’ job satisfaction and retention (Order No. 3230066). Available from ABI/INFORM Complete. (304937671). Retrieved from http://search.proquest.com/docview/304937671?accountid=45049
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Chronic care model
The chronic care model refers to an organizational approach through which people suffering from chronic diseases can receive care in the primary care settings. It is population-based. Moreover, it creates supportive, evidence-based, and practical interactions between the activated, informed patient and proactive, and prepared practice team.
This model identifies some vital healthcare system elements which promote care for chronic diseases that is high-quality. Within the elements, there are particular change concepts, which are used by the team to guide the improvement efforts. The care redesign processes applied agree to the change concepts.
In the same way, the aim of the patient-centered medical home is ensuring that the patients receive better care (Varkey, 2010). The model focuses more on patient needs. Some of the aspects through which care access can be improved include increased communication between the patients and providers through telephone and email, and extending the office hours. The elements of the chronic care model increase care coordination as each contributes in its own way.
One of the goals of the patient-centered medical home is also increasing care coordination. Moreover, the latter model aims to enhance the overall quality and reduce costs simultaneously (The Commonwealth Fund, 2009).
The patient-centered medical home model has a keen focus on the whole person, and different healthcare professionals participate in the care provision. There aspects are not focused on the chronic care model where attention is solely on the chronic disease. Similar to the chronic care model, the patient-centered medical home model integrated all health care aspects for overall health improvement. A unique characteristic of the patient-centered medical homes is that patients seek care from personal physicians who lead care teams within the medical practice (National Business Coalition on Health & National Health Leadership Council, 2010).
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Elements that are most significant for achieving safety and quality goals
The patient-centered medical home model
This model also has some elements that promote achievement of its set goals. These are physician-led practice, whole-person orientation, coordinated and integrated care, access, and focus on safety and quality. These elements have to interact for the care being provided to be relevant. Same as the chronic care model, evidence-based medicine is given a lot of emphasis as it helps improve the patient outcomes. Moreover, the care team has to offer comprehensive care that is both coordinated and integrated (Institute for Healthcare Improvement, n.d.).
Chronic care model
This model identifies the cardinal elements that every healthcare system should have for high-quality care for chronic diseases to be realized. The elements are as follows; clinical information systems, decision support, delivery system design, self-management support, health system, and community. Under each element, there are evidence-based change concepts and in combination, they foster interactions that are productive and meaningful between informed patients that are very active in their health and well-being and providers with expertise and resources.
Based on this model, these elements should all interact for chronic diseases to be managed and prevented effectively. In essence, the factors in the community that contribute to chronic diseases should be addressed and measures taken to promote safer communities (Varkey, 2010). In addition, patients should engage in self-care and management; healthcare delivery should be safe, personalized, and high-quality; the best decisions should be made for better care provision; and the clinical side should also be effective.
As such, chronic diseases can be prevented and managed appropriately. All the elements of this model are important for safety and quality goals. Each of them has a cardinal contribution, and ignoring any would result to inefficiencies.
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Structuring the models to achieve the best medical outcomes for individual patients at the lowest cost to society
In relation to the chronic care model, the organizations being created should be committed to offering high quality and safe care. Basically, the business plan of the health system should reflect a dedication to applying the model across the organization. Moreover, the clinical leaders should ever be dedicated and visible members whose roles performance should be perfect. Again, the community resources should be mobilized so that the patients’ needs can be met. As a result, the chronically ill patients can be kept active, involved, and supported.
Moreover, it is necessary that the patients are prepared and empowered to as to participate in their healthcare. The delivery system design should assure self-management support and effective, efficient care. Birenbaum (2011) indicated that the decision support should promote care that agrees to patient preferences and scientific data. In relation to the clinical information systems, data should be organized to promote effective and efficient care (Varkey, 2010).
For the patient-centered medical home model to be effective, the team of providers have to cooperate. In addition, there has to be payment reform and health information technology. Considering that medical homes might be virtual or physical network of services and providers, there has to be health information technology that can facilitate information sharing and communication among providers. In addition, the providers receive financial incentives that enables them focus on quality as opposed to volume.
References
Birenbaum, A. (2011). Remaking chronic care in the age of health care reform: Changes for lower cost, higher quality treatment. Santa Barbara, Calif: Praeger.
National Business Coalition on Health, & National Health Leadership Council. (2010). Patient-centered medical home: Has the time come? : National Health Leadership Council, Portland, ME, June 22-24, 2010. Washington, D.C: National Business Coalition on Health.
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The patient-centered medical home model
The chronic care model refers to an organizational approach through which people suffering from chronic diseases can receive care in the primary care settings. It is population-based. Moreover, it creates supportive, evidence-based, and practical interactions between the activated, informed patient and proactive, and prepared practice team.
This model identifies some vital healthcare system elements which promote care for chronic diseases that is high-quality. Within the elements, there are particular change concepts, which are used by the team to guide the improvement efforts. The care redesign processes applied agree to the change concepts.
In the same way, the aim of the patient-centered medical home is ensuring that the patients receive better care (Varkey, 2010). The model focuses more on patient needs. Some of the aspects through which care access can be improved include increased communication between the patients and providers through telephone and email, and extending the office hours. The elements of the chronic care model increase care coordination as each contributes in its own way.
One of the goals of the patient-centered medical home is also increasing care coordination. Moreover, the latter model aims to enhance the overall quality and reduce costs simultaneously (The Commonwealth Fund, 2009).
The patient-centered medical home model has a keen focus on the whole person, and different healthcare professionals participate in the care provision. There aspects are not focused on the chronic care model where attention is solely on the chronic disease. Similar to the chronic care model, the patient-centered medical home model integrated all health care aspects for overall health improvement. A unique characteristic of the patient-centered medical homes is that patients seek care from personal physicians who lead care teams within the medical practice (National Business Coalition on Health & National Health Leadership Council, 2010).
Want help to write your Essay or Assignments? Click here
Elements that are most significant for achieving safety and quality goals
The patient-centered medical home model
This model also has some elements that promote achievement of its set goals. These are physician-led practice, whole-person orientation, coordinated and integrated care, access, and focus on safety and quality. These elements have to interact for the care being provided to be relevant. Same as the chronic care model, evidence-based medicine is given a lot of emphasis as it helps improve the patient outcomes. Moreover, the care team has to offer comprehensive care that is both coordinated and integrated (Institute for Healthcare Improvement, n.d.).
Chronic care model
This model identifies the cardinal elements that every healthcare system should have for high-quality care for chronic diseases to be realized. The elements are as follows; clinical information systems, decision support, delivery system design, self-management support, health system, and community. Under each element, there are evidence-based change concepts and in combination, they foster interactions that are productive and meaningful between informed patients that are very active in their health and well-being and providers with expertise and resources.
Based on this model, these elements should all interact for chronic diseases to be managed and prevented effectively. In essence, the factors in the community that contribute to chronic diseases should be addressed and measures taken to promote safer communities (Varkey, 2010). In addition, patients should engage in self-care and management; healthcare delivery should be safe, personalized, and high-quality; the best decisions should be made for better care provision; and the clinical side should also be effective.
As such, chronic diseases can be prevented and managed appropriately. All the elements of this model are important for safety and quality goals. Each of them has a cardinal contribution, and ignoring any would result to inefficiencies.
Want help to write your Essay or Assignments? Click here
Structuring the models to achieve the best medical outcomes for individual patients at the lowest cost to society
In relation to the chronic care model, the organizations being created should be committed to offering high quality and safe care. Basically, the business plan of the health system should reflect a dedication to applying the model across the organization. Moreover, the clinical leaders should ever be dedicated and visible members whose roles performance should be perfect. Again, the community resources should be mobilized so that the patients’ needs can be met. As a result, the chronically ill patients can be kept active, involved, and supported.
Moreover, it is necessary that the patients are prepared and empowered to as to participate in their healthcare. The delivery system design should assure self-management support and effective, efficient care. Birenbaum (2011) indicated that the decision support should promote care that agrees to patient preferences and scientific data. In relation to the clinical information systems, data should be organized to promote effective and efficient care (Varkey, 2010).
For the patient-centered medical home model to be effective, the team of providers have to cooperate. In addition, there has to be payment reform and health information technology. Considering that medical homes might be virtual or physical network of services and providers, there has to be health information technology that can facilitate information sharing and communication among providers. In addition, the providers receive financial incentives that enables them focus on quality as opposed to volume.
References
Birenbaum, A. (2011). Remaking chronic care in the age of health care reform: Changes for lower cost, higher quality treatment. Santa Barbara, Calif: Praeger.
National Business Coalition on Health, & National Health Leadership Council. (2010). Patient-centered medical home: Has the time come? : National Health Leadership Council, Portland, ME, June 22-24, 2010. Washington, D.C: National Business Coalition on Health.
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Pressure Ulcer
Immaculate Mart Home has an occupancy rate of 99% with 293 patients occupying its total of 296 beds. The facility is a non-profit home and is not part of a multiple nursing home ownership. It has a below average RN per resident per day of approximately 43 minutes compared to that of the state of Pennsylvania of 55 minutes.
It has a Long Term Pressure Ulcer Percentage (LTPUP) of 2.4% and a short term pressure percentage (STPUP) of 2.1%. In September 24th 2015, PA was awarded a rating of 5 out 5 by the CMS of the Dept. Health for Human Services. This rating means that the nursing home is way above average based on quality measures, staffing, and health inspections.
Chapel Manner Nursing Home has a 95% occupancy rate with 229 patients using its total of 240 beds. It is part of a multiple nursing home ownership and it is a for profit organization. Its RN Hours/Resident/ Day is 57 minutes with an average of 2.29 minutes of Physical Therapy Staff. It has a LTPUP of 2.3% and a STPUP of 1.4%. It received a 2 out 5 overall rating. A score that implies that the facility is rated below average based on staffing, quality measures, and health inspections.
Fair View Care Center is a for profit nursing home that accepts Medicaid. It has a capacity of 36 beds. Its RN Hours/Resident/Day is averaged at 44 minutes and that of physical therapy staff is less than one minute. Moreover, it has 0.0% of its long staying patients as well as short staying patients with pressure ulcers.
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Baptist Health Care Center: This is a non-profit nursing home that has a total of 140 beds, all fully sprinkled with 138 beds occupied. It has an occupancy rate of 99%. It accepts both Medicaid and Medicare and it is not located within a hospital. It has a LTPUP of 2.8% and a STPUP of 1.6%
Its reported physical therapy hours are 0.03 per day and the total nurse staffing hours per patient daily is 4.47. In addition, it has a quality rating of 3 and a RN staffing rating of 4.
Some of the risk factors that predispose an individual to developing pressure ulcers include immobility, inactivity, smoking, poor nutrition, use of corticosteroids, and urinary or fecal incontinence.
Some of the strategies that can be used to prevent pressure ulcers include frequent weight shifting, using cushions or specialized mattresses that relieve pressure, protect and clean affected skin, maintaining a balanced diet, and proper health standards such as avoidance of smoking (Coleman et al., 2013).
Awareness can be increased by first laying out facts to the nursing home staff about the consequences of pressure ulcers, how they develop, and how easily they can be prevented. For instance, the staff should be aware that in 2013, the condition caused a totally of 29, 000 deaths up from 14, 000 in 1990 (Lachenbruch et al., 2016). This therefore, begs the nursing staff to implement urgent interventions against pressure ulcers.
Lachenbruch, C., Ribble, D., Emmons, K., & VanGilder, C. (2016). Pressure Ulcer Risk in the Incontinent Patient: Analysis of Incontinence and Hospital-Acquired Pressure Ulcers from the International Pressure Ulcer Prevalence (TM) Survey. Journal of Wound Ostomy & Continence Nursing.
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Reducing nursing alarm fatigue
Introduction
In the healthcare setting, clinical alarm fatigue management failure is often as a result of nursing mistakes relating to complexity of the system. Telemetry technicians as well as nurses are occasionally affected by clinical alarm fatigue which hinders their capability to respond to the clinical alerts in the monitors (Sowan et al, 2015). Often, these practitioners are inundated with a significant number of visual and audio alerts which makes them ignore or fail to see the pertinent clinical alarm.
According to a qualitative research done by Dressler et al (2014), fatigue alarms rate from about 187 alarms per day in a single bed, 88.8% of which are false positives. This high rate has been a nuisance and a distraction in the healthcare setting as they can lead to increased number of mistakes in patient care. They are also a cause of panic and stress to patients who may be trying to rest as well as recover from illnesses and surgeries. Therefore reducing nursing alarm fatigue is much needed in the healthcare setting.
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Problem statement
The rate at which false alarm fatigue go off has remained to be a huge problem for telemetry technicians and nurses in charge of monitoring alarm signals in the telemetry room. These nurses and technicians are faced by a barrage of alarms and alerts during their shifts which makes them ignore the alerts at times. As a result, these practitioners may ignore a true positive alarm that needs immediate action leading to detrimental safety complications on the patient (Sowan et al, 2016).
Purpose of this study
The main aim for this study is to investigate whether healthcare organizations can minimize the amount of fatigue alerts in the telemetry rooms by applying the Plan Do Study Act (PDSA) method. Failure to respond to true actionable alarms has led to serious patient injuries and even deaths in the healthcare setting (Christensen, Dodds, Sauer, & Watts, 2018).
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Significance of the study
This research is important because it informs the healthcare practitioners on how to minimize the severity of non-actionable alerts that nurses and other clinicians face during their shifts. Reducing the number of false positive alarms will create an environment that can improve the practitioner’s awareness of the alarms thus decreasing alarm fatigue (Cho, Kim, Lee, & Cho, 2016)
Research Questions (PICO)
How does an organization’s infrastructure, culture, technology, and practices influence a strong alarm management plan?
How can the elimination of false alarms such as premature ventricular contraction (PVC) and low amplitude GCG complexes lower the number of non-actionable alerts in the telemetry room?
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This qualitative research investigates how the healthcare system can minimize the number of alerts that cause fatigue among nurses as well as telemetry technicians to enhance patient safety. This paper uses peer reviewed papers from credible sources retrieved from databases such as PubMed, CINAHL, MEDLINE/EBSCO, Proquest, and HEALTH SOURCE/NURSING/ACADEMIC EBSCO.
The key terms that were used in this research includes clinical alarms, alarm fatigue, and physiologic monitor alarms. The timeline for this research was publications that dated from 2012 to 2019. The inclusion criteria for this research study included qualitative and quantitative studies that discussed how to reduce false positives in the telemetry room. A total of 46 research articles were reviewed though only 10 were used as the rest were duplicates or did not include detailed information.
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Reducing nursing alarm fatigue
Results
Srinivasa et al. (2017) and De Vaux et al. (2017) carried out quality improvement projects using the PDSA methodology in an effort of minimizing the severity of false alarms that nurses and technicians are exposed to in a single shift by revisiting the alarm alert typology. While De Vaux et al. (2017) used direct observations based on the alarm codes to develop concepts, Srinivasa et al. (2017) captured data using electronic software tools to capture data.
The two research studies investigated the PVC alarms and asserted that these alarms go off when physiologic monitor peaks irregularities in cardiac rhythms. During the beginning of physiological monitoring, most healthcare practitioners treated PVCs using various interventions or medications. However, recent research shows that cardiac irregularities are basically benign and are not treated.
Nonetheless, even after this discovery the PVCs alarms were not removed from the physiologic monitoring system. These two researchers concluded that PVC alarms should be removed from the physiologic monitoring system to reduce alarm fatigue among the practitioners.
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In their research, Walsh-Irwin and Jurgens (2015) also investigated how the healthcare system can reduce false alarms by adopting better cultures and patient care systems. These researchers carried a research that involved monitoring physiologic alarms before interventions and after the application of certain physiologic monitor leads following improved skin preparation.
Walsh-Irwin and Jurgens (2015) analyzed the collected data before and after the skin care intervention in an effort of determining whether the number of alarms reduced or accelerated. The statistical data that was collected in this research showed that proper skin preparation results to a reduced number of false positive alarms. The healthcare system should therefore adopt cultures that ensure proper skin preparation in patients to reduce the number of false alarms in the telemetry room.
Paine et al. (2016) also carried out a quasi-experimental research to investigate how healthcare organizations can reduce the number of false positive alarms among patients. This research examined topics such as the relationship between nurse response time and alarms exposure, non-actionable and actionable alarm propositions, and important interventions that help in the reduction of false alarms frequency.
This research established that the actionable alarms raged between <1% and 36% across many healthcare organizations in the United States. This research also found that there is a considerable correlation between alert exposures and the time that nurses take to respond to the alarm.
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In another experiment, Pelter, Fidler, and Hu (2016) investigated the probable impacts of a low-amplitude QRA complexes on asystole alarms that are false positives. Low-amplitude QRS complexes occur when limb complexes lead to less than 5-10 millimeters in the precordial leads. This qualitative study involved 82 patients who were observed in a period of 31 days.
The research suggested that there was no significant statistical data to having a false positive asystole alarm when a 12-lead ECG measured QRS complexes that were low amplitude. This experiment demonstrated that the low amplitude QRS complex alarm can be eliminate from the physiologic monitor.
Discussion
The themes that are evident in the above research studies provide insight to the healthcare’s struggles to apply PSDA methods that can manage alarm alerts. The studies establish that most alarms are not actionable and are a source of disruption and fatigue among nurse and therefore there should be active efforts to minimize the number of false positive alarms because they result to alarm desensitization and important alerts can be ignored as a result (Model for Improvement, 2018).
The research studies also establish that modifying alarms to ensure that only actionable physiological changes are recorded is a good of reducing alarm fatigue. Pelter, Fidler, and Hu (2016) clearly show that interventions are also a safe way of reducing the number of non-actionable alarms.
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Conclusion
In essence, alarm fatigue is a huge problem that puts patients in grave danger and a practitioner can ignore an actionable alarm thinking that it is a false positive. As such, adopting a PSDA methodology to reduce the number of false alarms will enhance the opportunities for practitioners to respond to the actionable alarms as well as reduce alarm fatigue. The healthcare organizations should create an environment that provides meaningful information to telemetry room monitors.
Reducing nursing alarm fatigue
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References
Cho, O. M., Kim, H., Lee, Y. W., & Cho, I. (2016). Clinical alarms in intensive care units: Perceived obstacles of alarm management and alarm fatigue in nurses. Healthcare informatics research, 22(1), 46-53.
De Vaux, L., Cooper, D., Knudson, K., Gasperini, M., Rodgerson, K., & Funk, M. (2017). Reduction of nonactionable alarms in medical intensive care. Biomedical Instrumentation & Technology, 51(s2), 58-61.
Dressler, R., Dryer, M. M., Coletti, C., Mahoney, D., & Doorey, A. J. (2014). Altering overuse of cardiac telemetry in non–intensive care unit settings by hardwiring the use of American Heart Association guidelines. JAMA internal medicine, 174(11), 1852-1854.
Paine, C. W., Goel, V. V., Ely, E., Stave, C. D., Stemler, S., Zander, M., & Bonafide, C. P. (2016). Systematic review of physiologic monitor alarm characteristics and pragmatic interventions to reduce alarm frequency. Journal of Hospital Medicine, 11(2), 136-144.
Pelter, M. M., Fidler, R., & Hu, X. (2016). Research: Association of low-amplitude QRSs with false-positive asystole alarms. Biomedical Instrumentation & Technology, 50(5), 329- 335. Srinivasa, E., Mankoo, J., & Kerr, C. (2017). An evidence‐based approach to reducing cardiac telemetry alarm fatigue. Worldviews on Evidence‐Based Nursing, 14(4), 265-273.
Walsh-Irwin, C., & Jurgens, C. Y. (2015). Proper skin preparation and electrode placement decreases alarms on a telemetry unit. Dimensions of Critical Care Nursing, 34(3), 134- 139.
Sowan, A. K., Tarriela, A. F., Gomez, T. M., Reed, C. C., & Rapp, K. M. (2015). Nurses’ perceptions and practices toward clinical alarms in a transplant cardiac intensive care unit: Exploring key issues leading to alarm fatigue. JMIR human factors, 2(1), e3.
Walsh-Irwin, C., & Jurgens, C. Y. (2015). Proper skin preparation and electrode placement decreases alarms on a telemetry unit. Dimensions of Critical Care Nursing, 34(3), 134- 139.
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