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SAMPLE ANSWER
A health policy refers to the actions, decisions and plans undertaken for the achievement of specific goals in a given society. The set health policies will be helpful in the achievement of several things such as defining the vision for the future, the establishment of the points and targets for the short or long term basis (Blank & Burau, 2013). The health policies will outline the expected roles and priorities of different groups while also informs people and builds a consensus. On the other hand, public policies refer to the factors that influencing health that are not solely family or individual characteristics but are linked to the political system, economic system and the culture as a whole. The health policies will be classified based on factors such as systematic issues, organizational issues, instrumental issues and also the programmatic issues (Blank & Burau, 2013). The classification of the public policies will defer as they will depend on economic, cultural and political policies. The health policies will effectively dictate whom, when and what should be performed. The health policies will include licensure and the regulations of the care providers, arrangement for the payment of health services and insurances (Blank & Burau, 2013). The health policies will also include the mix of private services, public services, quality of services provided in a community and also the access and cost of the health services.
The government public policy is different as it will entail the policies written in other sectors rather than the health sector. These sectors include transportation and education statutes. However, the public policies usually modify the social health determinants. The government public policies’ intent is to ensure the positive health impact. The health policies change in accordance with the current health problems and also the advances in knowledge and technology (Reader, 2012). On the other hand, government public policies change in accordance to the evolvement of broad social goals over time. Public policies will be promulgated by the government entities or its representatives while the health policies will be mainly developed implemented by the health institutions and bodies.
The public health approaches will entail all the strategies that focus on the prevention of health problems and promote the delivery of care in a way that extends the safety and better care to the entire population rather than the selected individuals (Tulchinsky & Varavikova, 2014). The principles used in the public health approach provide a framework for continuing with the investigations to identify the causes and consequences of the challenges encountered in the health sector as well as coming up with the best policy interventions and advocacy. The major difference between the old and new public approach is that the recent approaches will entail the manner in which the health promotion discourse has adapted to the crucial doctrines of previous eras in the old approach to addressing the present public health threats. The old health approach was characterized by the capital intensive investments in health care services, facilities and the high cost of the healthcare. In the old public health approach, concerns were classified into five key areas such as creating the supportive environment in the health sector, development of personal skills, building public health policies and also orienting the health services (Tulchinsky & Varavikova, 2014). In the old public health approach, there was no clear philosophical definition of the contemporary public health. In this case, the need to facilitate effective monitoring of the public health functions for a more secure basis for advocacy of the funding in the public sector as not given priority.
In the old public approach, health was characterized to be global in nature. There were difficulties to develop the global public health framework due to the failure of implementation of the primary health care as global public health instrument (Tulchinsky & Varavikova,2014)t. Ensuring health conditions for all was not easy due to the promotion of the paradigm’s functionalist orientation. Some of the characteristics of the new public health approach include recognition of the social determinants with the aim of improving the health of populations. Empowerment of individuals is also key in the new approach where they people are given the opportunity to increase control over their health. In the old approach, development of personal skills to recognize their needs that impact their health was not given much consideration as in the new public health approach. In the new public health approach, community participation is an essential and a vital characteristic. The health promotions strategies are more centered on the communities. Contrary to the old approach, in the new approach, the programs and strategies for health promotions are adapted to the needs of the people who work together for a healthier environment (Rutten et al, 2011).
Power is the ability to achieve the desired results or outcome after the performance of the various tasks. The development or change of policies entails the process of coming up with more appropriate strategies aimed at improving the currently implemented protocols or procedures (Altman, 2013). The development of policies enhances the adoption of better strategies and protocols of running operation in the various organizations. In policy development and change, the concept of power is understood in a relational sense as the ability to effectively make decisions regarding the protocols and procedures proposed or under development before they are fully implemented. There are three phases of power when it comes to policy development and change (Altman, 2013). These dimensions include power as non-decision making tool, power as decision making and also power as a thought control. Power in decision making focuses on the ability of groups or individuals to influence the policy decisions during development and change. In this case, the groups and individuals will exert their influence on the various policy processes. They have the direct influence over the key decisions and mostly initiate the policy proposals for change or development (Altman, 2013).
Power as a non-decision making when it comes to policies will involve the practice and process of limiting the scope of decision making to safe issues by manipulating the dominant political institutions, community myths and also values (Francesca et al, 2011). Consequently, power will be and agenda setting that highlighting how the able groups will keep control over the agenda to ensure the threatening issues are below their radar screen during the development and change process. Power is also conceptualized as a thought control when it comes to policies development and change. Power as a thought control will be a function of the ability to exert influence on others by shaping their preferences about policies development and change (Francesca et al, 2011).
The control of the obesity cases has become one of the highest priorities for the practitioners in the public health sector of most countries. The adoption of the high risk and effective approaches will require the formulation of various policies (Tsai et al, 2014). The implementation of these policies will ensure the effective control of the obesity cases. The national health obesity health campaigns and also the community-based approaches have been identified as some of the best interventions to control obesity that has its health hazards (Rosen, 2015). The community-based approaches have also been tied to the health campaigns in making the initiatives a success. The major consideration is to ensure the compliance with the initiatives and the smooth running of operations of the health campaign. The creation of an oversight committee structure to be held accountable for the activities and strategies of the campaign is a vital policy consideration (Tsai et al, 2014). The policies formulated for the campaign strategies should consider having the community-based interventions that are designed to improve the physical activity and quality dietary levels (Rosen, 2015). The policies should consider having initiatives that increase the exposure to healthy foods at a subsidized price and also restrictions on the unhealthy foods to ensure that the campaign efficiently controls the cases of obesity. The policies should consider having pricing adjustments to the foods that help in controlling obesity such as energy dense nutrient foods.
It is important to identify any workflow that might interfere with the protocols and procedures proposed during the obesity health campaign (Tsai et al, 2014). Adopting of the government principles for healthcare during the planning of the campaigns is a crucial policy consideration. The provision of a standardized consent document to all the participant of the health campaign for consistency is another policy consideration during the obesity health campaign.
The development of the smoke-free environment policies is necessary as it ensures that customers, service users and also the employees are protected from exposure to the second-hand smoke (Hyland et al, 2012). The policies developed will also help in the restriction and control of the smoking acts. There are various factors that I would consider and include in the creation of the new policy. Education and creation of awareness about the need for stopping the smoking are a factor to consider during the creation of policies. The training and education will be helpful in creating awareness about the hazards of combining the materials used in work processes and the secondhand smoke (Hyland et al, 2014). Concise and simple information on how to quit smoking will be communicated. The enforcement and the consequences of compliance is another factor to be included in the policy created. The inclusion of the factor in the policy will make it clear that disciplinary measures would follow for any staff not complying with the policy (Schultz et al, 2011). Those not adhering to the agreed policy and not complying with the smoke laws will be subject to penalty. The consideration of the factor in the policy will enhance its enforcement.
Designing of an implementation plan and laying out the purpose of the policy is the third factor to include the creation of the policy. These actions will be included to communicate the support to be provided to the smokers during the campaign to develop effective smoke-free environment policies. Including the plan during the creation of the policy will prepare the supervisory and management staff. The plan will include the strategies to support those quitting smoking in ways such as providing medical coverage to them. Having consistent sources of funds to support the strategies focusing on safety regarding secondhand smoke will be the factor to consider (Schultz et al, 2011). Consideration of the factor will also ensure the provision of the visible and real opportunities for worker’s participation in the planning and implementation of the policies.
References
Altman, D. (2013). Power & Community. Routledge.
Blank, R. H., & Burau, V. (2013). Comparative health policy. Palgrave Macmillan.
Francesca, C., Ana, L. N., Jérôme, M., & Frits, T. (2011). OECD Health Policy Studies Help Wanted? Providing and Paying for Long-Term Care: Providing and Paying for Long-Term Care (Vol. 2011). OECD Publishing.
Hyland, A., Barnoya, J., & Corral, J. E. (2012). Smoke-free air policies: past, present and future. Tobacco control, 21(2), 154-161.
Reader, A. M. (2012). Health policy and systems research.
Rosen, G. (2015). A history of public health. JHU Press.
Rütten, A., Gelius, P., & Abu-Omar, K. (2011). Policy development and implementation in health promotion—from theory to practice: the ADEPT model. Health promotion international, 26(3), 322-329.
Schultz, A. S., Finegan, B., Nykiforuk, C. I., & Kvern, M. A. (2011). A qualitative investigation of smoke-free policies on hospital property. Canadian Medical Association Journal, 183(18), E1334-E1344.
Tsai, A. G., Boyle, T. F., Hill, J. O., Lindley, C., & Weiss, K. (2014). Changes in Obesity Awareness, Obesity Identification, and Self-Assessment of Health: Results from a Statewide Public Education Campaign. American Journal of Health Education, 45(6), 342-350.
Tulchinsky, T. H., & Varavikova, E. A. (2014). The new public health: an introduction for the 21st century. Academic Press.
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Final Project. A maximum eight (8) page final paper/report shall be turned in by each group spokespersons. Use of charts and tables are strongly encouraged in the appendix and not in the body of the paper/report. Please keep in mind a source (citation and reference) is required on each table/chart used. All sentences with quotes or numbers need citations with page numbers. Groups are free to use the text book as a source but should not rely on the text book exclusively. The text book is merely a good starting point for additional ideas and resources.
Topic: 1st Amendments provides freedom of religion. It forbids Congress from both promoting one religion over others and also restricting an individual’s religious practices. It is actually quite different in this case because “the courts have noticed that some beliefs may simply be too crazy to qualify for protection (Morrison E, p132).”
The textbook reference is below:
Morrison, E. (2014). Health care ethics: Critical issues for the 21st century (3rd ed.). Burlington, MA: Jones & Bartlett Learning.
Each paper shall include the following format. These 6 sections are required to be in the paper submitted or points will be deducted: (1) Title page (including Group#, member names and student ID’#s); (2) Introduction (introducing the chapter issue in globally then nationally); (3) Methods (what sources were used to secure the information used in the paper (i.e., Pub Med, Medline, etc., – do not use internet sites without advance authorization by faculty unless they are government, educational or organizations); (4) Results (this is where you state your findings on the chapter issue both pro and con); (5) Discussion (this is where you explain the ethical implications of your findings/results); (6) Conclusions & Recommendations (this is where your group can chose a position, advocate a middle ground, or deem more research is necessary at this time.
APA Style in-text citations are required in sections 2, 4 and 5 at a minimum!
Data and Sources. All data (facts and figures/statistics) shall be cited and referenced appropriately. References and in text citations shall use APA Style format. All writing shall be by the students. No cutting and pasting of text from any source is allowed. That constitutes plagiarism. For those students that need help with proper APA in text citation and references, please see the following link: http://owl.english.purdue.edu/owl/. Additional APA Style links and documents will be posted on the Class online site. Also, see www.refworks.com – this source is available free to FIU students and will assist you in formatting references properly in APA and other formats.
Grading Rubric: In order to receive full points the group final submission shall: (1) Contain the 6 required section titles with the appropriate substantive information in each section (2) make sure to cite and reference sources for sentence, statement, statistic and quote used in the paper (3) the narrative shall be in the students own words (4) the paper shall be clear and concise while making sure that each section content requirement has been fully addressed (5) Include proper APA Style in text citation(s) to the text book, articles and other sources used (6) include proper APA references for citations used – at the end of the paper.
SAMPLE ANSWER
Looking at the organizational perspective in the aspect of religion, healthcare organizations ought not to be biased by a certain religion in providing healthcare to patients. The religion a patient belongs to be should not be the factor upon which the quantity of health care to is delivered to him or she should be measured. In fact, all patients that belong to different religions ought to be provided with the same quality of health care without bias or any discrimination. An organization ought to follow the ethical code of conduct that dictates how the staff treats the patients thus acting in a professional way. Therefore, the organization has to act in a way that it accepts all patients regardless of how they relate religiously.
On the other side, the individuals tend to be in fact the most affected when it comes to conducting themselves in an ethical way. When a patient comes is treated in some medical condition. The nurse or doctor ought to do so without including their religious thought to the treatment Process. This can severely affect the treatment process and lead to the patient not receiving the type of quality care that they ought to have received. The 1st amendment has given people the freedom of religion. In that context, an individual ought not to be judged in a negative way regarding the kind of religion one chooses to follow. Therefore, this should not be a factor that should affect the way that professionals who provide care delivers healthcare
There has been quite a debate on the degree to which religion affects the quality of health care provided to some patients. It considered illegal to treat a patient an inappropriate way due to their choice of religion. It is also considered unethical to the same to the patient. Therefore, it is quite unprofessional to let your religious views or perception about a certain religion affect the quality of work outputted by a certain individual. Health care professionals are therefore guided by the ethical code in conduct to aid them on deciding when or when not their beliefs have any effect on their choices, especially in their work environment.
Most of the time, individuals tend to attach their knowledge of wrong or right to their religion. In this context, most religions have different fundamentals that guide individuals to choose what is wrong and what is right. Therefore, in nursing practice, there are some practices that are considered wrong according to the basis of an individual’s religion. Once a situation like this occurs, the quality of care offered by the health care professional will be biased in a certain direction. Therefore, the individual ought to disregard his or her religious views when the life or health of the patient is at stake. If the nurse opts to let his or her, views come in the way of her professional work. He or she might not act in an ethical manner and thus act unprofessionally. Therefore, the nurse is subject to legal action once the quality of care is undermined due to some bias that comes from the religious aspect of life.
Conclusion
In a nutshell, religion is a very delicate matter. In essence, religion is significant in almost all aspects of the organizational conduct and ethical code of conduct. Its significance is in the way it can affect how people react, think and make decisions regarding certain matters in life. Hence, religion can be considered to be very crucial to the behavior of human beings. In fact, it is very crucial to all human beings, and it is what brings order to the world. Without religion, there would be no order in the world. Hence, religion should be respected. This includes the diversity of it and how it relates to each situation in the real world.
References
Cockerham, W. C. (2014). Medical sociology. John Wiley & Sons, Ltd.
Davis, G. S. (2012). Believing and acting: the pragmatic turn in comparative religion and ethics. Oxford University Press.
Finkelman, A., & Kenner, C. (2014). Professional nursing concepts. Jones & Bartlett Publishers.
Koenig, H., King, D., & Carson, V. B. (2012). Handbook of religion and health. Oxford university press.
Morrison, E. E. (2015). Ethics in health administration. Jones & Bartlett Publishers.
Schweiker, W. (2013). Religion and Global Ethics. The International Encyclopedia of Ethics.
Shi, L., & Singh, D. A. (2014). Delivering health care in America. Jones & Bartlett Learning.
Thornton, P. H., Ocasio, W., & Lounsbury, M. (2012). The institutional logics perspective. John Wiley & Sons, Inc..
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1. Introduce your chosen Health care policy issue(ACCESS TO HEALTH CARE FOR MINORITIES IN BROWARD COUNTY, FL), the current status, and an overview of your plan for a legislative visit.
2. Articulate key strategies involved in your plan, message, and recommendations under each of the Planning Your Visit Ungraded Worksheet 2 sections using headings in your paper. – SEE BELOW ON SPECIFIC REQUIREMENTS
3. Provide an analysis of empirical evidence supporting your approach strategies including plan, message, and follow-up.
4. Provide specific examples of the impact and/or importance of a successful visit/presentation to nursing.
5. Provide concluding statements summarizing the content.
6. Paper will be five (5) pages, excluding title and reference pages, and in APA format 6th edition.
PREPARING THE PAPER
Following completion of Planning Your Visit Ungraded Worksheet 2, develop a plan for visiting your policymaker, including the message, and the recommendation(s) you will deliver. Include a minimum of five (5) classic references or current references (published FROM 2011 to now) that support your plan, the message, and recommendations.
Specific Requirements
1. Review what has been done in the past by others regarding your chosen healthcare policy issue. What was the result of their actions related to this policy issue? Why is this issue important to nursing?
2. Who are the federal, state, and local policymakers involved in your chosen policy issue? How can you contact your policymaker? Be sure you single out a policymaker whom you know is interested in your issue.
3. What will be the plan for your presentation to the policymaker? When, where, and how?
4. What is the message you want to give to your selected policymaker/legislator? Can you present a compelling ‘story’? Can you convey your passion and experience with the policy issue? Can you present basic research data in an easy-to-understand and interesting way? What are you asking? What are you recommending? Please review the examples of a policy brief in your text or on the American Nurses Association website. What are your expectations of the policymaker and for your visit/presentation in general?
5. How do you plan to convey your message? What considerations must you have in place with respect to time constraints, availability of policymaker, and contingency plans?
6. Can you include a presentation using PowerPoint, flip chart, or overheads in some way (email or mail ahead of the call)? Include the actual presentation slides (max of 5 slides) in your final course presentation due week 7 (total 15 slides). What information (i.e. handouts) will you leave with the policymaker?
Guidelines for Policymaker/Legislative Visits
7. Most nurses are uncomfortable approaching policymakers, regardless of how prepared they are and how knowledgeable or passionate they are about their policy issue. Nurses tend to grossly underestimate their power and don’t initially understand that policymakers are receptive and anxious to have their input.
8. After you have selected your healthcare policy issue and have thoroughly researched it, develop a message or proposal that is clear and succinct. Be sure that you know the appropriate policymaker and the staff that you approach for your issue. Most students in this course will select a local-level policymaker such as a member of their city council or their local school board.
SAMPLE ANSWER
Health care policy issue
The health care policy issue of concern is poor access to healthcare in Broward County, Florida. Some of the barriers to healthcare as indicated by past community assessment conducted includes poor healthcare literacy, poverty and lack of medical cover (Varughes, 2013). This indicated that there is the need to simplify the healthcare systems, especially the navigation systems to ensure that everyone can obtain care (Varughes, 2013). The 2010 U.S. Census Bureau studies indicated that 24% of the Broward County residents lacked medical cover. The county reported the highest rate of uninsured children below the age of 18, and among the elderly above the age of 65 years (Silverman, 2013).
Broward County is reported to be the second most populated in the State and has the highest record in diversity. It has high percentage of minorities. Approximately, 14.3% of Broward population are aged (above 65 years). The county is also significantly affected by unemployment, with employment rate increasing to 8.1% by 2012 as compared to 4.5% in 2001. This indicated economic crisis (Varughes, 2013). In fact, statistic estimates that 15% of the Broward residents live below poverty levels. Approximately, 15.6% of youths below 18 years are reported to live below the Federal Poverty Level (FPL). About 24.8% of the families are below the poverty line. This indicates an increase in number if people relying on public assistance (Silverman, 2013).
For this reason, accessing healthcare has become a challenge, putting the county at risk of communicable and non-communicable diseases. For instance, cardiovascular disorders were rated as the key reason behind the increased mortality for people above 75 years and above (Varughes, 2013). Cancer is also another challenge affecting the minorities and the leading cause of mortality. The non-communicable diseases that are reported to be high among the minorities include diabetes, hypertension and congestive heart failure. The mortality rates for unintentional injuries have also increased, especially unintentional falls among the elderly. The public health efforts include the capacity to develop age appropriate resources for minority, disabled people and ensure that all of these resources are culturally competent. This will help in promoting healthcare through increased health literacy (Silverman, 2013).
Empirical evidence Presentation
Stakeholders: The stakeholders that will be involved includes the health care managers in all healthcare facilities at the Broward county, Key staff of the local department of health as well as the administration of agency of health care as well as the state and the local advisory panels. These stakeholders will give the appropriate input into the policy revisions as well as developments (Varughes, 2013). Other stakeholders that will be involved include partners from various private sectors and government agencies to enhance effective policy development. These includes the Department of Business and professional regulation in Broward county and the emergency management in the Broward county, whose responsibilities will be to coordinate all the healthcare policies related to access of healthcare among the minorities (Silverman, 2013).
Location: The Selected special public health figures/ stakeholders will meet on December 5th, at 1600hrs. The location for the meeting will be held at the BHMC auditoriums. The mode of information to be transferred will be informed of PowerPoint presentations. The meeting is expected to take one hour, 10 minutes of introducing the key stakeholders, 30 minutes of talk, and fifteen minutes to answer questions that may arise during the meeting. Additionally, each of the members will be receive an email that contains all the relevant information about the policy (Silverman, 2013).
Policy statement issue: Increase access to healthcare among the minorities.
As indicated, the main barriers to healthcare facilities are lack of medical insurance, low health literacy and poverty. The federally qualified healthcare facilities in Broward County include the family health centres, memorial healthcare system and the Broward health (Rand, 2014). There in increased detachment between these major healthcare facilities with the minorities in the region (who are the most vulnerable people in the communities). This calls for culturally competent strategies to increase healthcare awareness and provide linkages between the healthcare facilities and these underprivileged people in Broward County (Datar & Chung, 2015).
Gaps identified/ current status: According to community health status assessment in Broward County, only 80.3% of the people have medical insurance. This is way below the state rate, which is 83%. Majority of the people without health insurance are from the minorities (Varughes, 2013).
Table 1.1 Lack of medical cover
Additionally, the number of healthcare resources that are available is inadequate to cater for the health demands in the county. For instance, the ratio of physicians who are licensed in the county per 100,000 populations is below the expected state rate, making the county become federally designated among the regions with shortage of the healthcare professionals (Healthy People 2020, 2012).
Table 1.2 Rates of licensed physicians
Despite the numerous intervention put in place by the previous governance, healthcare access is still an enormous public health concern among the minorities. This calls for development of community health plans that will address this challenge amicably, to produce a long term solution to this public menance (Healthy People 2020, 2012).
Health policy overview
Key strategies and policy implication
The aim of the Florida department of Health in the Broward County (FDOHBC) is to promote, protect as well as improve the health of the people, especially the minorities residing in Florida via integrated local and state efforts (Varughes, 2013). This involves engagement of the community through Mobilizing for Action through Planning and Partnerships (MAPP). These approaches are strategic and have been widely adopted by communities to improve and facilitated improvement of community health and well-being (Silverman, 2013).
As indicated previously, there is increased detachment between the minorities and the major healthcare providers in the Broward community (Walter, Evans, and Atherwood, 2015). This calls for a rapid strategy to improve the navigational systems to ensure that the minorities can access healthcare at affordable prices. The community healthcare programmes must be integrated to increase healthcare awareness in the communities. The first priority is to increase the proportion of the Broward county minority’s medical coverage by 5% annually (Varughes, 2013). This is through increased assistance in completion of federally sponsored medical coverage such as Medicaid, Kidcare and Indigent care programs. Additionally, culturally competent materials, and resources that are age appropriate will be provided to the residents to simplify the medical cover application systems. These include referrals and enrolment of eligible residents in these federal managed medical cover systems (Varughes, 2013).
The second priority is implementation of three strategies that will remove the health barriers as well as improve the linkage between the minorities and the healthcare plan. This strategy will begin through performing a community based assessment to identify the community barriers. This will aid in identification of linkages in care. Strategies will be developed to eradicate and also to strengthen the linkages. The strategies developed must be culturally competent. The strategies will be evaluated and refined (Silverman, 2013).
Conclusion and Recommendations
Due to the increased diverse population in Broward county, the community health demands of the region is increasingly becoming more complex. This is attributable to fluctuations in economy that affect the county negatively, increasing unemployment rates and poverty levels. The recommended steps for this healthcare includes a) developing an action plan to identify and plan for the priorities; b) incorporation and implementation of the identified strategies, c) presentation of findings to the stakeholders and the communities, d) develop a tool to track the improvements to the community and e) establish a system to refine the established strategies.
References
Datar, A., & Chung, P. (2015). Changes in Socioeconomic, Racial/Ethnic, and Sex Disparities in Childhood Obesity at School Entry in the United States. JAMA Pediatrics.169:10 doi:10.1001/jamapediatrics.2015
Walter, R., Evans, A. and Atherwood, S. (2015). Addressing the Affordable Housing Crisis for Vulnerable Renters: Insights From Broward County on an Affordable Housing Acquisition Tool. Housing Policy Debate, 1:27 DOI: 10.1080/10511482.2014.
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Maternal morbidity and mortality is a national health problem. Preventing complications of pregnancy is included in the 2020 National Health Goals. The purpose of this written assignment is to describe how evidenced based findings can improve patient outcomes related to obstetrical care.
Tanya Kim, 36, G4 P4, was in labor for 36 hours when she had a cesarean birth for a failed induction of labor. She delivered a 9 pound 8 ounce male infant. Tanya’s labor was induced with oxytocin at 41 weeks gestation and continuous epidural was placed during active labor. The epidural was discontinued after delivery. She has iron deficiency anemia but otherwise an unremarkable medical history. She has no known allergies. Her obstetrical history includes 1 spontaneous abortion 6 years ago, vaginal delivery of twins 4 years ago, one singleton vaginal delivery 2 years ago and the cesarean birth today. Tanya plans to breastfeed her infant.
Two hours post-delivery the RN assesses the following:
Vital signs: BP 90/62, pulse 88, Respirations 22, temperature 98.6°F
Skin color: pink
Fundus: boggy, firms with fundal massage, midline and at umbilicus.
Lochia: Heavy rubra with nickel-sized clots
Pain: Uterine cramping rates pain 4 out of 10 on verbal pain scale
Intravenous fluids: 3000 mL Lactated Ringers with 20 units of Pitocin in each bag.
Urinary output: 200 mL since delivery (urinary catheter in place)
Patient comments: “I’m really tired. I have been up for the last two nights.”
One hour later the patient puts her light on and makes the following comment:
“I’m really bleeding a lot!” The RN comes in the room and notes increased vaginal bleeding. The patient is pale, diaphoretic, and the uterine fundus is boggy. The fundus does not firm with massage.
Using APA format, write a 2-3 page paper (excludes cover and reference page) that addresses the following:
1.Identify at least one (1) risk factor from the patient’s obstetrical history associated with the primary problem. Describe why this piece of obstetrical history places the patient at risk for the identified problem.
2.Early identification of emergencies in the obstetric setting is essential to save lives. Four (4) approaches are identified in the literature that can be utilized to positively impact patient outcomes: simulations, drills, protocols, vital sign alerts. Select one of these approaches and address the following: ?
Discuss two (2) benefits and two (2) limitations of the selected approach.
Describe two (2) ways by which this approach will improve patient outcomes in the perinatal setting.
A minimum of two (2) current professional references must be provided. Only one (1) textbook that is no more than one (1) edition old may be used.
Current references include professional publications that reflect nursing care provided within the United States. Current nursing professional references must be current (five [5] years or less). Reliable internet sources such as those offered by government agencies, academic institutions or nationally recognized professional organizations may also be used. Examples of unacceptable internet sources include but are not limited to: Wikipedia, medicinenet.com, allnurses.com, and any nursing blog site.
Compose your work using a word processor (or other software as appropriate) and save it frequently to your computer. Use a 12 font size, double space your work and use APA format for citations, references, and overall format. Information on how to use the Excelsior College Library to help you research and write your paper is available through the Library Help for AD Nursing Courses page. Assistance with APA format, grammar, and avoiding plagiarism is available for free through the Excelsior College Online Writing Lab (OWL). Be sure to check your work and correct any spelling or grammatical errors before you submit your assignment
FYI: Current text books being used for this course and materials are:
Textbooks (Chapter numbers and titles may differ in subsequent editions of a given textbook. If your edition is different, use the Table of Contents in the textbook to locate the appropriate chapters to read):
Hinkle, J., & Cheever, K. (2013). Brunner and Suddarth’s textbook of medical-surgical nursing (13th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
Kee, J., Hayes, E., & McCuistion, L. (2015). Pharmacology: A nursing process approach (8th ed.). Philadelphia, PA: Elsevier.
Nursing Diagnosis Guidebook – A pocket-size nursing diagnosis guidebook of your choice that is no more than one edition old, that includes NANDA International-approved nursing diagnoses, definitions, defining characteristics, and possible nursing Interventions.
Pillitteri, A. (2014). Maternal & child health nursing: Care of the childbearing and childrearing family (7th ed.). Philadelphia: Lippincott, Williams and Wilkins.
FYI Paper rubic.
NUR209 M6A3: Improving Obstetric Patient Outcomes Paper Rubric
The Case Study assignment addresses the following Student Learning Program Outcomes (SLPOs) and Course Outcomes.
Student Learning Program Outcomes (SLPO) Course Outcomes (CLO)
SLPO #2 (Nursing Judgment): Apply the nursing process to make nursing judgments, substantiated with evidence to provide safe, quality patient care across the lifespan.
2. Apply the nursing process when making nursing judgments to provide safe, quality,
nursing care for families and patients with perinatal and reproductive health care needs.
SLPO #6 (Spirit of Inquiry): Use interpreted published research and information
technology to improve the quality of care for patients.
6. Incorporate evidence-based findings and interpreted research into the provision of safe, quality nursing care for patients with perinatal and reproductive health care needs.
The following criteria are used to grade your two (2) to three (3) page (excluding the cover page and reference page) Case Study Assignment, which accounts for 10% of your final course grade.
Performance levels for each criterion include the following:
Unacceptable indicates that the student’s attempt at the assignment is poor in quality and fails to meet minimum “adequate” criteria.
Adequate indicates a student has met minimal requirements.
Good indicates all expectations of the assignment were met in a comprehensive manner.
Exceptional indicates that expectations of the assignment were exceeded, whereby a student went above and beyond the assignment as written.
Exceptional performance is considered rare.
Expectations described under each performance level define the minimum performance that must be demonstrated to earn the minimum points at that level.
**Plagiarism is not acceptable. Evidence of plagiarism will result in a zero (0) grade for the assignment and may also result in academic discipline.**
SAMPLE ANSWER
Improving Obstetric Patient Outcomes Paper
Labour complications are the leading cause of long term disabilities, mortalities and morbidity for both the mother and the babies. One of the approaches is to assess the patient obstetrical history to identify if the pregnancy is a high risk or not. Certain maternal risks factors are associated with risk factors and are identified by assess the outcomes of previous pregnancies. In this context, the patient had suffered from spontaneous abortion during her first pregnancy. Additionally, the patient had undergone other pregnancies (multiple delieveries), and this could have had an impact with her delivery. This is the main factor that could be associated with the prolonged labour and increased bleeding post-delivery. The excessive may result due to the opened blood vessels during the caesarean delivery (Pillitteri, 2014). This is because a pregnant uterus has the most blood supplies as compared to any other body organ. Therefore, the walls of the uterus are cut wide open to access the baby. Although most of the women have the ability to tolerate the blood loss without presenting any health complications, in some few people, some complications could arise. This is severe especially in patients who have difficult in clotting; making it difficult to stop bleeding even with minor cut or even shears. Research indicates that postpartum haemorrhage is common and affects about 6% of the women undergoing caesarean delivery(Kee, Hayes, & McCuistion, 2015).
To save the lives of both the child and the mother, it is important to identify emergencies in the obstetric settings early enough. This is because emergencies can lead to the permanent disabilities or even death of the mother, the infant or both. The main approaches identified by the evidence based practice that can be utilized includes, drills, protocols, simulation and vital sign alerts. In this case study, the best approach that should be used is the protocols. The most strategic approach in this case is use of protocols. Protocols refer to set of rules and procedures that must be followed based on the conventions that have been proven to work in such incidences (Kee, Hayes, & McCuistion, 2015).
The main advantage is that it helps the healthcare provider make the most ethical decision as required by the organization and their professional standards (Kee, Hayes, & McCuistion, 2015). Secondly, because the information in the protocols are written according to the evidence based research, it provides the most effective remedy to patients irrespective of where or who delivers the care i.e. makes quality care the standard. The main challenge is the possibility of err in healthcare protocols, because the judgement value made by guideline could be the wrong choice for this particular patient. Secondly, effective use of protocols is determined by the nurse experience and clinical opinions, and thus, for an inexperienced nurse can pick the most inferior options due to misconceptions or misrepresented community norms (Hinkle & Cheever, 2013).
In this context, the protocol of postpartum assessment includes the assessment of patient’s vital signs, the assessment of breasts, bladder, fundus, perineum, lochia, legs as well as any other incision in the body. The patient pain must be assessed including the location, the type of pain, quality and degree of severity. If necessary, pain medications can be administered to reduce the irritation as well as the swelling. From the assessment records, the postpartum condition of the patient was normal. However after one hour, the patient calls for help, as she feels that she are bleeding a lot (Pillitteri, 2014).
The nurse assessment notices the vaginal bleeding, the patient if diaphoretic, pale and her fundus is boggy even with a firm massage. This is an indicator of postpartum haemorrhage, which could be due to uterine atony and trauma. Postpartum haemorrhages are grouped as emergency complications, and must be treated by a qualified physician. According to the protocols, the patient should be administered oxytocin IV or IM. If the intravenous oxytocin is unavailable, or the bleeding still continuous, then the following medication should be used, including the intravenous ergometrine, prostaglandin (sublingual misoprostol, 800 µg) or combination of oxytocin-ergometrine is strongly recommended. With effective treatment as indicated by the protocol, 90% of the patients make recovery few weeks. In some cases, blood transfusion can be administered to patients who have lost a lot of blood. Other supplements such as iron supplements, vitamins and nutritious dietary could facilitate improve the patient strength and increase patients’ blood supply. The approach will reduce the bleeding rate and improve the patients’ quality of life (Kee, Hayes, & McCuistion, 2015). The protocol also helps in the identification of the risk factors associated with postpartum haemorrhage including history of post-partum, prolonged labour, fetal macrosomia, multiple deliveries. However, it can also occur in patients not presenting the risk factors. The healthcare plan must be identified and designed before delivery. This coupled with assessment of vital signs can improve the patient’s delivery process and help in the detection of both slow and steady bleeding (Kee, Hayes, & McCuistion, 2015).
References
Hinkle, J., & Cheever, K. (2013). Brunner and Suddarth’s textbook of medical-surgical nursing (13th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
Kee, J., Hayes, E., & McCuistion, L. (2015). Pharmacology: A nursing process approach (8th ed.). Philadelphia, PA: Elsevier.
Pillitteri, A. (2014). Maternal & child health nursing: Care of the childbearing and childrearing family (7th ed.). Philadelphia: Lippincott, Williams and Wilkins.
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You must identify 4 pieces of artwork and present this as part of your e-portfolio Exhibition report. This must be a visual
and informative research piece containing at least 2000 words 10 a4 pages.
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context, form, process, and mood.
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For each painting have 5 separate paragraphs. (content, context, form, process, and mood) answering all the questions from
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Communicating in Health and Social Care Institutions
Communicating in Health and Social Care Institutions
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SAMPLE ANSWER
Communicating in Health and Social Care Institutions
Communication forms the basis of interactions and coordination in health care. Health care professionals have to communicate with their patients, among themselves, as well as with the hospital management. On their part, hospitals have to communicate with their staff and patients and also interact with the external environment. The efficiency of running health care institutions is dependent on the effectiveness of communication systems. Usually, service delivery is unsatisfactory if proper communication fails to take place. Patients may not understand instructions, clinicians may misinterpret directions, and hospitals may lose important information. Basically, communication in health and social care organizations involves concepts such as communication channels, policies, agents, services, devices, and message type, interaction mode, and security protocol. Each of these concepts is mostly determined by the organizational structure in specific institutions. When the communication system is faulty, organizations experience inconveniences and hardships in their practice. So as to avoid such inconveniencies, facilities must explore technologically advanced tools, optimize interactions and discussions among professionals and interdisciplinary personnel, and avoid risks associated with poor communication. On their part, health and social care practitioners should possess particular skills to have efficient communications with their patients. This paper gives an in-depth look into the application of communication skills in clinical and social care by health professionals. Later, the paper discusses factors that influence the application of such skills in the two settings. Lastly, it discusses ways in which health and social care institutions apply technology in their communication systems for enhanced efficiency.
1.0 Use of Communication Skills in Health and Social Care Institutions
Communication skills that clinicians and social care practitioners apply during their practice influence the ability of patients to understand, follow, and adhere to recommendations and instructions. For instance, studies indicate that patients are better placed to manage chronic ailments and administer preventive self-care when clinicians deliver information effectively (Institute of Healthcare Communication, 2011). Practitioners use communication skills in different ways when ensuring that they communicate effectively with patients.
1.1 Application of Communication Theories to Health and Social Care
The theory of communication as a multi-way process applies perfectly to the health care se up. The theory divides communication into two major concepts, verbal and non-verbal communication (Chaaban & Sezgin, 2015, Pg. 190). The theory describes the verbal part as the words, sentences, and phrases that communicators use. On the hand, the non-verbal part includes four elements. The four are the standing, kinesics, paralinguistic, and prosodic elements (Corcoran, 2013, Pg. 8). The prosodic part includes the rhythm and intonation used in communication. In health and social care, for instance, the speed of communication alters the extent to which message recipients comprehend communications. This concept is particularly important when clinicians interact with patients. I will illustrate this with my personal experience at Gracefield Hospital. I once used to be fast in directing patients until a time when I had directed one of my patients to the laboratory only for him to head directly to the pharmacy. He queued in the pharmacy section and when I spotted him, I asked him whether he had gone to the laboratory. I learnt from his reply that he did not get my directions, and since the pharmacy is the most obvious destination for patients who have seen their physicians, he just assumed that I had directed him to the place. Upon my reflection, I realized that I was too fast and the patient was not that quick in grasping my directions. This was a practical experience of inefficiencies caused by poor communication skills as warned in the aspect of prosodic element of the theory of multi-way communication. My poor skills had resulted in a waste of time for the client. The other non-verbal cues in the theory of multi-way communication are kinesics, standing, and paralinguistic features which refer to body language, appearance, and use of expressions such as “ahhh” respectively. It is common to find patients and staff members describe how attractive or unattractive other people are in their communication on the basis of these non-verbal features. On their part, verbal expressions as described in the theory of multi-way communication refer to the message itself. For example, if clinicians keep using phrases rather than exact words that they mean, patients may find it hard to get the message. The other relevant model in social and health care communication is the theory of self-disclosure. The model explains interpersonal communication in health care delivery systems (Bylund, Peterson, & Cameron, 2012, Pg. 263). The theory centers on the level of interactions that health practitioners enjoy with their clients. For this model, unlike in the multi-way theory, communication is mainly perceived from the perspective of the patient. When clinicians earn the trust of their clients, they may need to respond by expressing certain features in their communications. For instance, they may need to express emotional attachment to their clients. They would do so by the choice of words that they use. From a personal experience, I express affection to patients who disclose their private life to me and by so doing, I earn more trust from patients and the move enhances my efficiency in attending patients. So as to improve my communication skills, I should emphasize on the elements in the multi-way communication as well as the ones in the Theory of Self-Disclosure.
1.2 Using Communication Skills in Health and Social Care
Clinicians’ ability to apply communications skills to practice has numerous benefits. Actually, communication is a determinant of the quality of services that professionals offer to their patients. Personally, I boost the quality of my services by conducting open-ended enquiries, reflective listening, and developing emotional connections when necessary. In so doing, I am able to address the specific or unique needs that each patient would present. Generally, application of effective communication skills enhances the accuracy of services such as diagnoses and treatment. It also enhances patient medication-adherence and safety and promotes patient and family satisfaction. Additionally, the practice minimizes chances of malpractice, and it enables health and social care practitioners to address the needs of their patients effectively hence increasing the quality of their services and so their demand. However, so as to have optimal communication outcomes in health care, practitioners need setting the pace from the beginning. Therefore, they should not just focus in areas such as the directions they give to their patients during treatment, but also on the information that patients offer to them during diagnoses. It is for this reason that they should consider a variety of theories when conducting the overall care process. Actually, the basis of health and service care is interviewing patients during diagnosis. If clinicians apply skills that would enable them to conduct interviews efficiently, they would collect all the essential information. Personally, I prioritize on collecting all the necessary information by exploiting skills that stabilize patients such as being able to minimize interruptions. I also promote medication adherence by ensuring that patients understand what they are supposed to do. When purposing to promote patient satisfaction, clinicians should employ skills that convince their clients that they are handling their problems with the necessary weight. For instance, they could let their patients know that the entire patient care team is involved and it is dedicated to address their specific demands. Also, clinicians should show that they understand the history of their clients so as to convince them that their services are satisfactory. Clinicians should also use communication to avoid risks and malpractices. Huntington and Kuhn noted that improper communication strategies are a major cause of risks and malpractices (cited in Institute of Healthcare Communication, 2011).
1.3 Methods of Dealing with Inappropriate Interpersonal Communication in Health and Social Care Facilities
Usually, communication in health care involves multiple parties and it could be termed as interpersonal. For Gracefield Hospital, clinicians such as nurses, doctors, pharmacists, therapists, dieticians, and others would need to interact effectively for them to handle the needs of their wide range of patients efficiently. However, there may be instances when such communication could be disrupted. Application of interpersonal communication theories would be a crucial approach in overcoming such challenges. For communication between practitioners, interpersonal communication strategies would include dialogues and the use of interactive channels such as office phones and computers. Gracefield Hospital enhances dialogues by adopting interactive communication systems. Failures of communication between health and social care providers and their clients are also risky in patient care processes. At Gracefield Hospital, some of these hardships are commonly generated by language barriers, differences in education levels, disparities associated with culture and social practices, as well personal matters such as privacy, and time constraints. In most cases, hospitals and social care institutions should address particular challenges when designing their communication systems. For instance, they would employ interpreters where instances of language barrier are likely to hinder communication. So as to overcome barriers of communication associated with differences in education, practitioners should use simple language and explain concepts in simplified manners. It would also be important for facilities to encourage their employees to extend culturally-sensitive care so as to avoid misunderstandings between them and their patients. Also, institutions should ensure that practitioners adhere to ethics of care such as those expecting them to maintain confidentiality and privacy when entrusted with patient information. It would also be important for hospitals to have enough facilities and personnel so as to maximize the instructions of patients and care providers. Usually, shortage of resources and inadequacy of healthcare staff pressure practitioners to hasten their care creating time constraints (Chertoff, 2015, Pg. 2). Provision of adequate resources would facilitate interpersonal communications and raise the overall quality of services.
1.4 Use of Strategies that Support Users of Health and Social Care Services with Specific Communication Needs
Patients present different communication needs to health and social care providers. It is important for clinicians to address the needs of specific people so as to ensure that they accurately get their messages for optimal patient treatment and satisfaction outcomes (Ha & Longnecker, 2010, Pg. 38). Specific needs could range from physical, emotional, and psychological disabilities as well as economic, social, and geographical considerations. For instance, healthcare facilities would require having sign language experts so as to address the communication needs of the deaf. For the blind, practitioners should consider extending services such as helping patients use assistive devices and guiding them to different facilities within the institutions. Such practices would facilitate care delivery by enhancing the effectiveness of communication. For people with learning and language disabilities, institutions should consider approaches such as using images, non-verbal cues, translators, or family members. For the case of Gracefield Hospital, translators are indispensible considering that the institution serves people from backgrounds of all manners. Economic, social, and cultural backgrounds are also crucial when addressing patients’ communication needs. Personally, I ensure that my communication strategies are efficient by offering patients an opportunity to choose their preferred interaction strategies during follow ups. I also ensure that I only use gestures that I am sure that they would not be misinterpreted in different cultures.
2.1 How Values and Cultural Factors Influence Communication in Health and Social Care setups
Usually, culture makes people adopt certain values and beliefs that may influence communication. It is a critical requirement by ethical guidelines that practitioners offer culturally-sensitive care to patients by respecting their beliefs and cultural dignity (Zahedi, Sanjari, Aala, Peymani, Aramesh, Parsapour, & Dastgerdi, 2013, Pg. 1). In the case of Gracefield Hospital, for instance, clinicians occasionally deal with people who insist on particular practices concerning their health. For instance, there are cultures that would restrict men from offering or communicating gynecological care to women. Gynecology patients from such cultures may decline to communicate with male practitioners, and the overall care process would be impaired. Whether such beliefs are reasonable or not, it is beyond health care professionals to overlook the preferences of their patients. Instead of initiating cultural conflict, Gracefield Hospital encourages practitioners to explore possible alternatives to maximize patient satisfaction. From my experience of cultural disparities that patient present and my knowledge on communication skills, I encourage patients at Gracefield Hospital to express any concerns that they may have. I also educate them on the importance of avoiding beliefs that could limit their access to health services.
2.2 Impact of Legislation, Codes, and Charters on Communication in Health and Social Care Setup
Health care services and professional practice is subject to legislative regulations. Clinicians and social care workers must adhere to laws, guidelines, codes, charters, and standards that are structured so as to discourage malpractices. In healthcare, each discipline has specific regulations developed by their respective boards, unions, and other regulatory agencies. They include codes of ethical conduct, standards of practice, codes of professional conduct, and of course the national constitution. Gracefield Hospital adheres to the UK regulatory requirements including parliamentary acts. For instance, the Hospital relies on Data Protection Act which was developed by the legislature in 1998 when operating its communication systems. The act requires that organizations only use patient information for the primary purpose which their owners are notified about, and therefore, it is a critical pillar in preventing malpractices and conflicts in hospitals and social care facilities (Gov.UK, 2015a). Since health care providers collect much personal information from their clients, they should handle it responsibly to avoid exposing what would be contrary to the expectations of their clients. Personally when undertaking my day-to-day duties in the wards of Gracefield Hospital, I come across patients who warn me against disclosing certain information to other people. So as to come up with an acceptable decision, I usually refer to professional codes, principles, policies, and guidelines. Generally, laws and regulations promote patient confidentiality. Health and social care practitioners are always expected to take caution when handling patient information. Additionally, the law requires that clinicians inform their clients how specifically they intend to use their information (Gov.UK, 2015). In my newly entrusted responsibility, I would inform my fellow care providers about specific laws governing communication matters in health care. Again, I would suggest measures that would promote patient knowledge about their rights in managing their information. Through such measures, I would also inform patients that Gracefield Hospital is sensitive to their confidentiality and privacy, and at the same time, the facility is obliged to inform them accordingly.
2.3 Effectiveness of Organizational Systems and Policies in Promoting Good Practice in Communication
Organizational systems are critical determinants of the manner in which health and social care professionals handle communication matters (Kodjo, 2009, Pg. 58). There are certain practices that organizations would encourage or discourage, and by so doing, they influence the nature of communication behaviors that prevails. For instance, if organizations tolerate practices such as ignoring privacy and confidentiality concerns raised by patients, then practitioners would increasingly engage in the habit (Entwistle, Carter, Cribb, & McCaffery, 2010, Pg. 742). Eventually, such communication systems would have impaired rather than facilitated patient-clinician interactions. The current reputable image of Gracefield Hospital could be attributed to factors such as having an excellent communication system. The system allows the management to see to it that clinicians adhere to policies and codes of practice throughout their interactions with patients. It is however important to note that the system at Gracefield hospital does not frustrate care providers. Actually, the communication system is designed in a way that it protects patients, and at the same time, it crates enough room for clinicians to extend high-quality services. Generally, social and health care practitioners are expected to be conversant with laws, policies, and regulations governing communication for their institutions to prosper. Failure of practitioners to observe such laws is a common source of legal conflicts and institutions end up having their image tarnished. Institutions that would be aiming at advancing to more recognizable heights would not afford legal conflicts emanating from improper handling of patient communication. Instead, they would prioritize on perfection, conduct thorough spot-checking, and monitor their communication approaches to evade conflicts with their clients. Gracefield Hospital looks forward to being upgraded to a foundation, and therefore, its staff should practice in a way that would avoid situations that would compromise its integrity and reputation.
2.4 Ways of Improving Communication in Health and Social Care Settings
There are different approaches that organizations could take in bettering their communication strategies (Ha & Longnecker, 2010, Pg. 41). Interestingly, communication is one of them. The approach entails equipping practitioners with professional communication skills through training, capacity building, educational seminars, and so on. For international hospitals, the management should encourage the staff to learn common languages such as English, Spanish, French, Chinese, Germany, Indian, Russian, and others depending on the regions from which they fetch most of their customers. Having basic skills in multiple languages would not only make professionals and their institutions operate efficiently, but it would also attract people in the sense that they would feel a psychological sense of belonging. Likewise, disabled persons such as the deaf would feel secure if they visit institutions where their type of communication is appreciated. In cases where institutions may not necessarily train their practitioners to learn skills such as sign language, an effective alternative would definitely be employing interpreters for such purposes. Gracefield Hospital, so to illustrate, has a specific subdivision in the communication department concerned with translating information presented in languages other than English. As such, the Hospital would rarely delay services to patients regardless of its customers’ origin. Other important approach that health and social care institutions should consider when focusing on improving communication strategies between care providers and patients include encouraging basic practices such as listening and paying attention to the meaning of the information that patients disclose. Practitioners should possess rich listening skills for them to interact effectively with their clients. On the same line, institutions should discourage distractions such as making personal calls in the middle of interviewing patients. From a different angle, organizations should better their communication systems by ensuring that their staff members are conversant with different cultures. For instance, they should know that cultures vary on their perception of certain gestures, paralinguistic features, speaking tone, as well as certain lines of interrogations such as those that could sound as prying into one’s personal life. Having such knowledge on communication would place them at a position where they can deliver care effectively. Also, hospitals should update their staff members on information concerning policy changes from the legislative, boards, and union perspectives. Such updates are necessary to ensure that clinicians and social health care providers adjust their communication strategies so that they adhere to regulations.
1 Accessing and Using Standard ICT Software Packages in Supporting Practice in Health and Social Care Setups
Perron et al. defined ICT as modern tools employed in patient care to store, convey, or manipulate data (Perron, Taylor, Glass, & Margerum-Leys, 2010, Pg. 67). The tools influence the careers of social health care workers just as they influence those of clinicians. Practitioners require adapting to the technological environment by expressing competencies in using these tools. There are both technical skills as well as abilities such as being well-placed to collaborate with other health care professionals. In some cases, practitioners in England learn the use of ICT tools through online databases such as Social Care Online (Scie, 2008). At Gracefield Hospital, one of the facilities that employ ICT is the Common Assessment Framework (CAF). The technique is ICT-enabled, more so from the perspectives of case assessment recording and data sharing. The basis of CAF is technologically-assisted reporting systems (Holmes, 2014). Usually, the technique enables the involved professionals to assess the needs of minor patients with efficiency (Hampshire County Council, 2012). The administration of the tool includes having a lead practitioner and a team of health care professionals (Department for Education and Skills, 2015). Professionals share information through online portals. It should be noted that the involved team members may not necessarily be in the hospital practice, but they could be in social care as well. In the UK, there are specific guidelines, policies, and performance management information that direct the use of CAF. Generally, for hospitals and social care institutions to fully employ CAF, they need having reliable infrastructure with a competent IT system, efficient information support systems, and also equip their personnel with the requisite skills.
3.2 Benefits of Using ICT in Health and Social Care to Service Users, Health Practitioners, and Institutions
The application of ICT in healthcare has numerous benefits. The technology enhances the speed, reliability, standardization, and overall efficiency of care delivery. Healthcare professionals can monitor their patients remotely and handle complications with their requisite urgency. Electronic health records (EHR) are of special significance when considering the benefits of ICT instruments in health care. The devices facilitate care delivery by allowing practitioners to instantly access all patient history necessary for diagnosis and treatment. Additionally, these devices allow clinicians to consult each other and seek clarifications when necessary. Usually, it is only authorized persons who access patient information through EHR systems. This is enabled by having the system requiring login information which is only available to healthcare personnel (Fernandez-Aleman, Senor, Lozoya, & Toval, 2013, Pg. 541). Therefore, unless clinicians act irregularly, patient information is held intact by the use of the technologically developed systems. EHR devices also promote patient safety by minimizing chances of errors. The systems overcome the challenges of inaccuracies associated with unclear representation of data. Also important to consider is the property of the devices enabling the consolidation of various types of patient information including physical diagnoses, laboratory results, pharmacy records, financial records, insurance services and others. When such information is consolidated, clinicians find it easier to come up with decisions. On their part, health and social care organizations find it economical to use EHR systems as opposed to the traditional paperwork practices. Institutions do not have to keep collections of as many papers as they used to do prior to advances in ICT. ICT overcomes the challenge of losing information by misplacing papers or by having books get damaged and also saves space for institutions. Hospitals are able to maintain orderliness and their management gets improved. For the case of Gracefield, EHR devices have promoted general practices by allowing clinicians to instantly access patient information such as blood pressure, breathing rate, past medication history, temperature, and other crucial tests. Such information would have taken time to access had there not been the technological instruments.
3.3 Impact of Legal Considerations Concerning the Use of ICT on Health and Social Care Systems
The application of ICT in health care is regulated by several legal policies. Such policies are instituted so as to control malpractices and safeguard the general wellness of patients. In the UK, the law requires practitioners to use ICT meaningfully (Adler-Milstein, Ronchi, Cohen, Winn, & Jha, 2014, Pg. 112). For instance, it is unexpected of clinicians to use patient information to establish personal or business links with them. Again, practitioners are not expected to compromise patient confidentiality and safety by placing information in places where unnecessary parties may find access. The law in Britain does not tolerate malpractices associated with ICT. Indeed, there is an established Act addressing misuse of computers. The Computer Misuse Act was developed in 1990 and it defines inappropriate uses of ICT as a prosecutable crime. The Act points out actions such as hacking of information, unauthorized access to information, deliberate moves to alter data among other practices as unconstitutional (Gov.UK, 2015b). While the law does not limit the application of ICT in service provision, it is tough on those who seize the opportunity to cause harm. The law explains penalties imposed on culprits of ICT crime, and the punitive measures include custody and fines (“Penalties”, 2015). Definitely, the British law protects patients and therefore impacts positively on health and social care. Without the law, there would be cases of malicious exposure of patient information on public sites such as social media. Usually, non-adherence to the law leads to poor patient outcomes, unmet patient expectations, high chances of legal conflicts, and a bad reputation for institutions. Gracefield Hospital prioritizes on responsible use of patient information and practitioners who would use ICT irresponsibly would face severe punishments. The hospital’s emphasis on appropriate use of ICT has contributed to its desirable reputation.
Conclusion
Communication is an important tool in running health and social care facilities. It is the basis of interactions and coordination in health and social care. Health care providers should apply vital communication skills for them to deliver services effectively. The theory of multi-way communication and that of self-disclosure are essential when addressing communication issues in healthcare. There are various ways through which institutions can better their communication systems. They include training their personnel, and employing professional translators. Being in the heart of London, Gracefield Hospital stands a chance to serve people of varied backgrounds, and translators are indispensible for efficiency running of the institutions. By enhancing its communication system, the hospital will maintain its high profile, earn more credit, and be upgraded to a foundation. However, the hospital would face risks of having its image tarnished if its staff members fail to observe the law and ethics of practice. Non-adherence to the law, regulations, and policies would attract legal technicalities, and the integrity of the hospital would be compromised.
References
Adler-Milstein, J., Ronchi, E., Cohen, G. R., Winn, L. A. P., & Jha, A. K. (2014). Benchmarking health IT among OECD countries: better data for better policy. Journal of the American Medical Informatics Association : JAMIA, 21(1), 111–116.
Bylund, C. L., Peterson, E. B., & Cameron, K. A. (2012). A practitioner’s guide to interpersonal communication theory: An overview and exploration of selected theories. Patient Education and Counseling, 87(3), 261–267.
Chaaban, A. & Sezgin, A. (2015). Multi-way communications: an information theoretic perspective. Foundations and Trends in Communications and Information Theory, 12(3), 185-371.
Chertoff, J. (2015). The evolving physician-patient relationship: equal partnership, more responsibility. Insight Medical Publishing Group, 23(1), 1-3.
Corcoran, N. (2013). Communicating health: strategies for health promotion. London: SAGE.
Entwistle, V. A., Carter, S. M., Cribb, A., & McCaffery, K. (2010). Supporting Patient Autonomy: The Importance of Clinician-patient Relationships. Journal of General Internal Medicine, 25(7), 741–745. http://doi.org/10.1007/s11606-010-1292-2
Fernandez-Aleman, J., Senor, I., Lozoya, P., & Toval, A. (2013). Security and privacy in electronic health records: A systematic literature review. Journal of Biomedical Informatics, 46(3), 541-562.
Holmes, L. (2014). The Common Assessment Framework: the impact of the lead professional on families and professionals as part of a continuum of care in England. John Wiley & Sons, 2014. Doi: 10.1111/cfs.12174.
Perron, B. E., Taylor, H. O., Glass, J. E., & Margerum-Leys, J. (2010). Information and Communication Technologies in social work. Advances in Social Work, 11(2), 67–81.
Zahedi, F., Sanjari, M., Aala, M., Peymani, M., Aramesh, K., Parsapour, A., … Dastgerdi, M. V. (2013). The Code of Ethics for Nurses. Iranian Journal of Public Health, 42(1), 1–8.
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Policy Priority Issue of Access to Health Care Order Instructions:
Policy Priority Issue of Access to Health Care
PURPOSE
The purpose of this assignment is to: a) identify and reflect upon key concepts related to your planning a policymaker call b) provide empirical evidence to support new insights gained regarding your policy issue and the policymaking process, and c) present ideas in a clear, succinct, and scholarly manner.
REQUIREMENTS
Assignment Criteria for Presentation:
1. Provide an introduction to your policy-priority issue. ****Access to health care will be the health care policy issue for this assignment******
2. Articulate key points under each of the Formulating a Healthcare Policy Ungraded Worksheet #1 sections, using the headings in your paper.
3. Provide a critique of empirical evidence that supports your chosen policy issue and analysis.
4. Demonstrate the importance and impact of the chosen policy issue to nursing.
5. Provide concluding statements summarizing the content.
6. The paper will be a minimum of 4 pages and a maximum of five pages in length, in APA format 6th edition, excluding the title and reference page.
PREPARING THE PAPER
After completing Formulating a Health Care Policy Ungraded Worksheet #1, address all areas on the worksheet in the body of a scholarly paper. Include a minimum of five (5) classic or current references published within the past 5 years.
Guidelines
Specific Requirements
1. Describe a public-health policy issue with which you have personal and/or professional experience, and about which you are interested, familiar, and passionate. Why is this issue of particular interest/importance to you and to the profession of nursing? Examples of policy issues include
****Access to health care will be the health care policy issue for this assignment******
2. What is the specific problem, including background, surrounding this issue? Is there a need for a new law or campaign related to this issue? Is there a need for change to an existing law? Is there need for a change in regulatory issues? What specific supportive evidence do you have for this issue, including evidence and references? You will need to include this in your message/ask/recommendation(s).
3. Review thoughts regarding your chosen healthcare policy issue. It is important to analyze your issue thoroughly. Be sure you address the following with evidence and research:
• Context
• Goals/options
• Evaluation of options
• Recommended solutions
4. How can you find out the current status of this issue? Is there a website (professional organization such as the American Nurses Association or local, state, or federal government) that provides status updates or alerts? Please describe.
5. What level(s) of government does your issue involve (local, state, federal)? What level of government is your immediate target? Please describe.
Policy Priority Issue of Access to Health Care Sample Answer
Policy Priority Issue: Access to Health Care
This paper addresses access to health care as the policy issue of concern. For people to enjoy high-quality care, they must have the necessary resources to reach it. Such resources include healthcare facilities, drugs, healthcare professionals, and insurance covers among others. The measure to which people have such resources, as well as their ability to use them, is what care accessibility entails. When care is accessible, it means that there is an adequate supply of services, an opportunity to use it and that people could use it at the time they need it. The issue of care accessibility is crucial for a nurse as well as the nursing profession. It is the focus of a nurse and the nursing profession to ensure that patients get the services they require. This means that nurses must have the resources necessary for practice for them to serve their patients. If such resources are unavailable, inadequate, unaffordable, or limited to particular groups, then patients would not access quality nursing services.
The Existing Problem in Access to Health Care
Access to health care in the US is an area of concern with studies revealing disparities to the use of services along with different markers. Mandal reported that a significant portion of the American population cannot enjoy quality health services owing to factors such as lack of health insurance, financial resources, and health care professionals. The observer also noted obstacles to the access of health services such as structural, age, legal, and language barriers as well as irregularities of care sources as determinants causing limited care accessibility in the country (2014).So as to address these factors, there may be a need to campaign for the adoption of certain changes in the current policies. The prioritized issues in such campaigns would purpose to increase and measure care accessibility. Health care promotion agencies have recommended approaches that would increase care accessibility and its measurement so that it is appropriate, safe, effective, and inclusive of preventive strategies (HealthyPeople.gov., 2014). The institutions have also advocated that such measures address the diverse requirements of populations as well as the safety of palliative, emergency, and long-term forms of care (HealthyPeople.gov, 2014). The Affordable Care Act of the US is worth mentioning matters concerning care accessibility. Researchers and statisticians noted that since the institution of the ACA, there had been an increase in the number of insured persons and people’s visits to healthcare professionals, though it did not necessarily impact on the degree to which the population specialized at particular health care institutions (Martinez, Ward, & Adams, 2015). However, despite its huge achievements, ACA would require changes so that it addresses other factors affecting care accessibility other than affordability. Critiques have noted that while the act emphasizes on affordability, it does not necessarily promote accessibility in that it fails to ensure that users enjoy quality care. Critiques have argued that the Act has been associated with poorer services as patients flock in healthcare institutions. They point out that there has been increased waiting times as the Act only increases the number of patients reaching hospitals with minimal consideration for the available healthcare professionals as well as medical facilities (Anderson, 2014).From such a perspective, it is evident that ACA needs significant modifications so that its users can access high-quality medical services.
Critique of Empirical Evidence
Fiscella (2011) investigated America’s progress in the provision of health services and noted that for the recent decades, the country has not fully addressed health care disparities that limit people’s access to care (Pg. 78). However, the researcher noted that the ongoing reforms may have significant impact on health services accessibility and equity of care. The researcher noted that through extensive insurance covers, the reforms might cause remarkable improvements on accessibility of care. Fiscella pointed out that people’s access to care varied with their ethnicity, economic status, and social status (2011, Pg. 78).There are other research works supporting observation that significant disparities exist and that they are accelerated by social factors such as homelessness (Hwang, Ueng, Chiu, Kiss, Tolomiczenko, Cowan, Redelmeier, 2010). Further research shows that such disparities root from county levels. In the year 2006, for example, research indicated that Massachusetts outdid New England in the reduction of health care access disparities (Zhu, Brawarsky, Lipsitz, Huskamp, & Haas, 2010, Pg. 1356). According to Zhu et al., the provision of equitable care would require more specific interventions than general reforms (2010, pg. 1356). In addition, measures of improving care accessibility among the American population should address not only the availability of services, but also its quality. It is also recommendable that the measures focus on vulnerable groups such as the aged and homeless, as they would most likely have difficulties reaching quality services (Hwang et al., 2010).
The Importance of Care Accessibility to Nursing
Nursing is a primary discipline in calling for healthcare reforms (Hassmiller, 2010).Nurses play important roles in serving patients and they would have knowledge concerning factors that influence care accessibility among their clients as well as measures that would help overcome them. The professionals also play directly in influencing the quality, equitability, availability, and timeliness of care that patients get. From a different perspective, nurses offer services such as prevention of diseases, managing patients with chronic ailments, and offering humanitarian care such as that of compassion and comfort. This shows that the professionals play a wide variety of roles in serving patients. As such, their involvement in reforms that seek to improve care accessibility would be necessary.
Agencies that Give Updates on Care Accessibility
Centers for Disease Control and Prevention is an example of agencies that give updates on care accessibility among different populations in the US (Martinez, Ward, & Adams, 2015). The agency gives descriptions of measures such as people’s access to personal doctors, their interaction with nurses, exploitation of medical, dental, and pharmacy services among other determinants. Healthy People 2020 is also a proactive agency in monitoring accessibility of health care among US populations. The initiative has described the expectations of health care stakeholders concerning people’s ability to exploit and enjoy quality medical services (HealthyPeople.gov, 2014). In most cases, the issue of care accessibility affects healthcare from the national level. Policies that have most influence on care accessibility such as the ACA are federal institutions. Overcoming the disparities seen in the health system would require the modification of such federal institutions. However, evidence has indicated that there are significant disparities among counties and states, and therefore, it is important to first address the disparities at these lower levels before focusing on the larger national setup (Zhu et al., 2010). As such, this assignment addresses care accessibility with emphasis on the local level.
Policy Priority Issue of Access to Health Care Conclusion
There are significant hindrances to care accessibility in the United States. The disparities are more evident along the lines of social status, ethnicity, financial abilities, as well as culture. Though most of the influential policies of access to health care are designed at the federal level, studies show that the implementation of such policies at the local and state levels accounts significantly to the occurrence of the inaccessibility disparities. It would be important to modify the existing policies so that they address factors such as the quality of care and ease to use it in addition to focusing on its availability. The nursing profession should play centrally in such reforms.
Policy Priority Issue of Access to Health Care References
Anderson, A. (2014). The impact of the affordable care act on health care workforce.The Heritage Foundation.Retrieved from http://www.heritage.org/research/reports/2014/03/the-impact-of-the-affordable-care-act-on-the-health-care-workforce
Fiscella, K. (2011). Health Care Reform and Equity: Promise, Pitfalls, and Prescriptions. Annals of Family Medicine, 9(1), 78–84. http://doi.org/10.1370/afm.1213
Hassmiller, S. (2010).Nursing’s role in health care reforms.American Nurse Today, 5(9).
Healthy People.gov.(2014). Access to health services.Us Department of Health and Human Services.Retrieved from http://www.healthypeople.gov/2020/topics-objectives/topic/Access-to-Health-Services
Hwang, S. W., Ueng, J. J. M., Chiu, S., Kiss, A., Tolomiczenko, G., Cowan, L., …Redelmeier, D. A. (2010). Universal health insurance and health care access for homeless persons. American Journal of Public Health, 100(8), 1454–1461. http://doi.org/10.2105/AJPH.2009.182022
Kottke, T. E., &Isham, G. J. (2010).Measuring health care access and quality to improve health in populations.Preventing Chronic Disease, 7(4), 73.
Mandal, A. (2014, August 6). Disparities in access to health care. Retrieved from http://www.news-medical.net/health/Disparities-in-Access-to-Health-Care.aspx
Martinez, M. E., Ward, B. W., &Adams, P. F. (2015).Health care access and utilization among adults aged 18–64, by race and Hispanic origin: United States, 2013 and 2014. Hyattsville, MD: National Center for Health Statistics.
Zhu, J., Brawarsky, P., Lipsitz, S., Huskamp, H., & Haas, J. S. (2010).Massachusetts health reform and disparities in coverage, access and health status.Journal of General Internal Medicine, 25(12), 1356–1362. http://doi.org/10.1007/s11606-010-1482-y
use book for reference health and health behaviour 130.please read every question instructions because they are different for every question and choose one model and answer all the questions by taking that model.do not use different model for other questions.i will attach files of questions along with instructions.regards
SAMPLE ANSWER
Health behavior refers to an individual’s personal beliefs as well as activities carried out concerning their health and wellbeing to attain, promote and maintain better health lifestyles. Such health activities involve; not smoking or drinking excess alcohol, doing regular exercises to enhance physical fitness and eating well among others. Risky health behaviors will, therefore, refer to activities that negatively influence an individual’s health lifestyles. I have chosen drinking of alcohol in pregnancy as risk behavior those impacts on the health of the Australian citizens.
Women who happen to take alcohol during their pregnancy incur negative health effects probably to their babies as well as to themselves. Excessive drinking of alcohol at pregnancy period causes miscarriages and premature birth. Alcohol is a toxic substance that will rapidly enter the baby via the placenta into the bloodstream(McCarthy et al,2013).Too much of alcohol can even increase the risks of a new baby to be stillborn.
Heavy drinking of alcohol may tremendously damage the baby’s nervous system. The baby will start developing fetal alcohol spectrum disorders (FASD) having various problems like slow learning or social defects and birth defects. FASD will, therefore, refer to a term that describes the range of impacts that occurs to an individual exposed to alcohol in the uterus. Such impacts will involve mental, physical, behavioral and learning defects for a lifetime(McCarthy et al,2013). Babies born with fetal alcohol syndrome will tend to have facial defects, being small, learning difficulties, poor muscle development, and behavioral problems. It also causes delivery of babies with low birth weights which greatly affects the baby’s chances of survival and to have better health. From national strategy household survey, 1 in 16 lives born babies had less than weighed less than 2500 grams at birth .generally children born to alcoholic mothers tends to have damaged brains, birth defects, poor and slow growth, low intelligence quotient, language, and speech deficit as well as social and behavioral problems(McCarthy et al,2013).
From the various behavioral models, I chose the health belief model (HBM) as a behavioral change model of which I apply as not drinking alcohol during pregnancy. The health belief model will, therefore, refer to a theory that aims in predicting whether an individual can choose to involve in a health activity in order to lower or prevent chances of getting a disease or premature death (Chimied et al 2013). The model comprises of two types of beliefs that influence individuals to take necessary preventive actions; beliefs related to readiness to take actions as well as beliefs related to modifying agents that enable or inhibit an action. .the variables that are used in measuring the readiness to undertake any action is perceived susceptibility to the illness for example FASD disorders affecting babies as a result of alcohol consumption .another component of the model is the benefits, for instance, the perceived impotence of avoiding alcohol during pregnancy to the newly born babies. The barriers e.g the perceived costs and also constraints when women are taking the action of abstinence of alcohol during their pregnancy period. The theory advocates that the individual variables contribute in predicting their health behaviors. The model can be applied to potentially unhealthy behavior specifically drinking alcohol at pregnancy period. This can be achieved by examining the attitudes and beliefs that are related to taking of alcohol at pregnancy using variables; it can be predicted that fetal alcohol spectrum disorders could be avoided(susceptibility) hence discouraging the consumption of alcohol at pregnancy periods.
There are two Australian strategies of changing the risk behavior of taking alcohol during pregnancy. The health promotion champagne and the enactment of policies that covers the use of alcohol in Australia. The first strategy that is the development and implementation of policies that governs the use of alcohol .the government of Australia has laid down policies and guidelines to control the consumption of alcohol effectively. The national health and research council has developed guidelines policies that effectively targets to control women who consume alcohol during pregnancy period to reduce the health risk associated with. The strategy is specifically laid down to control the maternal alcohol consumption rates critically during the pregnancy and breastfeeding (Keith et al, 2014).
The policy recommends that any woman who are pregnant or are planning to become pregnant should significantly refrain from alcoholic drinks through their pregnancy period. Women who have taken any alcohol should be reassured while being given the advice to abstain from any further alcoholic drinks. The policies targeting alcoholic use in pregnancy has been established because of the concerns that are around alcohol usage when breastfeeding and during pregnancy period. The policy came into action in the year 2009.The actions of the strategy involve setting up of strict measures that will compel the women that initially used alcohol to change their behavior and to adopt healthy behaviors through the implementation of such alcoholic laws and also the reinforcement of women who are abstaining(Keith et al,2014). The strategy is complying with the Ottawa chatter of health promotion by advocating to move into the arena of public health policy and to advocate for clear political commitment to health .according to my rationale, the strategy is of great significance and leads to the attainment of the healthy lifestyle.
The second strategy is the role of Australian media as a strategy in championing the campaign for educating and informing the community. The strategy aims at increasing the awareness of alcohol use and promotion of healthy attitude and enhancement of healthy uses of alcohol.The national alcohol campaign was officially launched in the year 2000 and mainly targets the pregnant women or young teenagers who usually encounters early pregnancies(Hildebrand et al,2013). The media strategically creates awareness to the public on the unhealthy effects of consumption of alcohol.It tries to advocate the public to change their attitudes towards consumption of alcohol at pregnancy period through media.
.the strategy utilizes social media such as the use of brochures, magazines, newspapers and internet sites .the national campaign strategy critically tries to change the attitudes, belief and behaviors of the target group. It also facilitates the target group to change into health behavior such as health drinking of alcohol. The strategy tries to change the attitudes of drinking alcohol during pregnancy period hence aiding in resolving the related health problems(Hildebrand et al ,2013). The strategy is complying with the Ottawa chatter for health promotion through mass education on a significance of health behaviors. My rationale towards the strategy is that media will play an effective role in mobilizing the Australian citizens to change into healthy behaviors especially to women at pregnancy period.
References
Hildebrand, J., Maycock, B., Howat, P., Burns, S., Allsop, S., Dhaliwal, S., & Lobo, R. (2013). Investigation of alcohol-related social norms among youth aged 14–17 years in Perth, Western Australia: protocol for a respondent-driven sampling study. BMJ open, 3(10), e003870.
Keith, M. R., & Moore, M. (2014). Public Health Association of Australia (NT Branch) submission to Northern Territory Select Committee on Action to Prevent Foetal Alcohol Spectrum Disorder.
McCarthy, F. P., O’Keeffe, L. M., Khashan, A. S., North, R. A., Poston, L., McCowan, L. M., … & Kenny, L. C. (2013). Association between maternal alcohol consumption in early pregnancy and pregnancy outcomes. Obstetrics & Gynecology, 122(4), 830-837.
Schmied, V., Johnson, M., Naidoo, N., Austin, M. P., Matthey, S., Kemp, L., … & Yeo, A. (2013). Maternal mental health in Australia and New Zealand: A review of longitudinal studies. Women and Birth, 26(3), 167-178.
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This assessment aims to apply the principles of effective leadership and change theory to a change or performance improvement strategy which is professionally relevant to the learner. The assessment needs to consider the implications for workforce development and the ways in which organizational culture may enhance or hinder the capacity to achieve sustainable change outcomes. It is asked to consider the role of the leader in developing workplaces which are able to meet the demands for change.
This is a formal academic essay where it is required to demonstrate a capacity to critically discuss either a change management process or performance improvement strategy. (**Remarks: use Hong Kong health care practice)
Essay topics:
Performance improvement
Choose one area that requires performance improvement within an area of health care practice (clinical- e.g. a skill or clinical process, managerial – e.g. leadership issue or team building, or education- e.g. related program to a particular performance/ activity you would like to see improved.)
Analyze & critically discuss the following key points:
The area of an organizational performance that is of concern and how it relates to the organization’s strategic goals and objectives.
The steps required to implement a process for improving this aspect of organizational performance
The approach best suited to improving performance in this instance.
The type of performance indicators or measures selected.
Strategies for motivating and engaging stakeholder in ongoing performance improvement.
Thanks!
SAMPLE ANSWER
Performance improvement plans or action plans help give struggling employees get the opportunity to succeed and at the same time make them accountable for their past performance. The poor performance of clinicians is not smooth on the presence of it. Various reasons can be brought forward on the reasons for poor performance. This can be whether the clinician received the appropriate training and their knowledge of the expectations of the job. Any unforeseen roadblocks for future achievements also facilitate performance improvement plans (Bonow, et al., 2012).
It is, therefore, critical for the departments of a healthcare practice to give room for an open dialog and feedback directly from employees. This helps in the determination of the extent to which employees are provided with the sufficient resources and tools necessary for their success. Performance improvement can be used to address the failures that are arising to issues related to performance and behavior. The outcome of the performance improvement plan can be improved the performance of the health workers in Hong Kong. Also, training gaps and recognition of skills of employees can be evaluated. Employment related issues that may result can lead to the demotion of individual employees, transfer of some and demotion of underperforming employees.
In Hong Kong health care practice, an employee who does not perform well to meet expectations can be corrected by their supervisors. The performance improvement plan can be used to replace the disciplinary processes. This helps correct workplace behaviors that affect productivity given that any action taken earlier is better compared to waiting for the result. The presence of employee relations staff help in consultation and providing any technical assistance to health supervisors and other clinical employees and services. Training can also be supplied in the course of the performance improvement plan (Ferrer, et al., 2014).
Area of organizational Improvement
People who practice medicine have a high potential in assisting patients to stop smoking. Deficits have been found concerning the amount and type of training these people receive when undertaking smoking cessation counseling whereby they little consider the training. This area ought to be improved in health care facilities so as to improve the levels of service delivery in health systems. Trials should be conducted to examine the relativity of effective Quality improvement. The difference in educational programs of Departments of health care of Hong Kong in teaching smoking cessation skills help in achieving this noble course of improving performance.
Quality improvement works as a systems and processes. To make improvements, the health care and clinical departments need to have a clear understanding of their systems and delivery of services. Quality improvement takes into account the relationship between the resources of the organization and the activities carried out will help achieve improved health care quality. The service delivery in health is typically straightforward, and an example in a dental clinic and on the other hand, a large managed care hospital requires complex systems (Eijkenaar, et al., 2013).
The senior trained medical students and practitioners should demonstrate their efforts in improving the performance through their intervention to reduce smoking. The educational purposes of medical students should expose them to smoking cessation and the efforts to help smoking patients. Specific training should be provided in order to increase the rate of success of the nursing students. Traditional methods will not be effective and embracing teachings of that are appropriate in nature in all levels of education will help the students achieve this noble course.
Focus on patients: This is another area of measuring quality improvement and the level to which smoking cessation is effectively done. Patient’s needs ought to be met in health care, and the society and beneficiaries of the clinical area can be that there should be systems that affect the level of access by patients. Patients do not expect to queue for long due to slow systems. Patients also expect to receive care from the clinics that are based on evidence. The health practitioners can be trained so that they are well conversant with the type of treatment that they provide as per the DOME clinical skills. Evidences on successful cessation can be used. (Hamric, et al., 2013).
Patients also should expect safety at the premises and, therefore, need to assure them of safety by ensuring that medical practitioners observe security in their areas of service. Safety can be both physical and provision of quality medicines. Support for the engagement of patients in the treatment process is critical because patients can be able to express their problems directly. Care is communicated and coordinated with other parts or departments of the health care system. Another measure could be to ensure cultural competence in the assessment of the literacy levels of patients and to ensure that care is linguistically appropriate to ensure client satisfaction.
Focus on being part of the team: Quality improvement is a team process, and thus, knowledge and skills are brought together. Differences in thoughts of individuals are combined to obtain lasting solutions, and this approach is most useful when the process of quality improvement is complicated, and not even one person has the clinical skills or issue at hand. Also, it is useful when the process involves more than one discipline or work area and thus leading to the creation of creativity so as to establish a lasting solution (Nicolay, et al., 2012).
Let us say an organization wishes to reduce smoking cessation by reducing the patient wait time in the health care, the efforts presented by a team will help the health care facility achieve a lasting solution to these problems. All individuals should contribute to the team to ensure proper analysis as per the DOME clinical skills. Members bring in different perspectives on an issue and on how to sustain the improvements. Quality improvement and the participation of the teams highly depend on the availability of infrastructure. These can be team leadership and procedures plus the policies of undertaking each activity (Hermann, et al., 2014).
Focus on use of data: The major activity in quality improvement of services in Healthcare is data because it mainly describes how well the existing systems to reduce smoking are working. It is also an indication of the outcomes of applying a new change and is useful when noting a success in performance. The use of data helps in separating what is happening actually from what people think. For example, the level of attendance of patients to the available number of clinical officers. Data is useful in setting up a baseline whereby performance at that baseline is acceptable and deemed fit. Scoring low at the first episode can be accepted with an anticipated improvement in subsequent results. It also helps in the reduction of solutions not useful from being placed be the supervisors.
Procedural changes can easily be monitored, and this helps make sure that the resulting improvements can be sustained. The clinicians and nurse should be able to cope with the improvements in helping smoking patients and give an indication if the changes affected have shown any improvement in their service delivery. Performance can easily be compared to all the departments, and, therefore, patients and staff satisfaction surveys can easily be conducted (Witter, et al., 2012). Quality improvement will help achieve improved health of patients and efficiency in managerial and clinical processes. It also helps avoid costs that are associated with failure of processes and errors thus leading to a balance of quality in Hong Kong health care services (Unützer, et al., 2012).
Steps to implement the process
The first step is to document the performance issues. The issue being a quality improvement in health care, it is good to develop a format or use existing ones to ensure that consistency of values is observed. This helps protect the clinical heads if any legal claims are made in expectations. The performance plan will include information about the staff. These are their skills and training received to handle patients. Also, the dates should be expected and any performance gap should be indicated. Expected performance is described and compared with the actual performance and the plan of action designed by the team stated clearly.
The second step is to develop an action plan in the process of quality improvement. The quality of service provision is desired to be improved to match the DOME clinical skills and thus need to create a plan that suits those standards. An action plan can be established by the supervisors and request an expression of interests from employees to ensure that everyone agrees to it. Collaborative engagement makes it easy to solve issues and thus, creating database requires employee participation (Murray, et al., 2013). Some of the nursing and clinical tools can be included while others can be excluded depending on the mutual decisions. The consequences of not meeting the objectives are also set.
The third step is reviewing the performance plan in the organization. Quality improvement in the clinical case engages the top management and the supervisors. The director of a department should seek guidance from the senior manager or directors of health on matters documentation of the performance plan. This will help ensure that all the parties to the quality improvement project adhere to the requirements of the program and hence instill disciplinary activities to lazy clinical workers. It should be specific, attainable and relevant (Jha, et al., 2012).
The fourth step is meeting with the employees and, if possible, the other stakeholders including patients. A program might be in the process of its quality improvement, but the patients feel that lack sufficient knowledge of how to use the service. Here, the action plan can be modified to include specifications and proposals from the stakeholders. The nurses and clinical officers can then sign the personal improvement plan forms.
The fifth stage involves making follow ups. Both the employees and the supervisors should be holding meetings on designed basis to evaluate the level of improvement of the quality of service. The meeting should include discussions concerning the objectives and any matters arising are documented. The employees are expected to ask questions and go further to seek guidance on a particular step, for example, the introduction of online medicine payment and the establishment of booking systems. The nurses and clinicians are motivated towards producing the best in quality improvement (Santiago, et al., 2014).
The last step is concluding the process whereby non-performing employees who do not follow the quality improvement plan will experience poor performance. This is because the new system is taking over slowly. This can be a high time for him or her to request for reassignment to other departments of the clinic such as social work or can choose to be transferred. When the goals have been reached, the quality improvement plan can be done periodic reviews to ensure its flexibility in service provision and health care practices.
Approaches to Performance Improvement
Not all quality improvement strategies are successful although health care facilities seek to improve performance. The first approach is through the system view. The best acceptable approach in quality improvement should be taken using Systems Thinking techniques that help in the identification of activities that are reducing the ability of the clinical skills from being achieved. Operations analysis can be used to ensure the maximum improvement of quality all through the performance improvement phases. This will enable focus on development that brings change to the health care departments (Toussaint, et al., 2013, January).
People involvement is an approach because any quality improvement’s success depends on the efforts of people at all the improvement levels. All the employees including the social workers and nurses plus clinical officers should be at the front line and involved in the decision-making process. Most of the failed quality improvements as per DOME clinical skills is as a result of ignorance. The lead supervisors should include other employees in the decisions to undertake quality improvement. This results in failed efforts of the management. Engaged workers will feel the ownership of the quality improvement process and thus enabling them to become owners of the project (Haas, et al., 2013).
Another approach to ensuring quality in health care is improved is to focus on the process involved. Focusing on the process is the best approach compared to building up blames due to lapses. Maybe some of the health workers and clinicians do not come to their jobs on a daily basis which is an indicator of failed implementations. The new process will help promote the operations and patient attendance and achieving the quality improvement goals. The improvements in quality require that people within the health care change their behavior and focus on the process to suit the new quality improvement plans for the clinics.
The purpose of the quality improvement should be evaluated and defined. Here, it is to improve service delivery to the patients while reducing the queuing of these patients. The process involves all the levels of management in Hong Kong health care, and thus, definition of the existing system and the available staff plus patients is important. The value of service offered by the clinic is critical and customer satisfaction should be measured. In a clinical case, the primary customers are patients and therefore there is a need to ensure that the level of services offered to them is satisfactory (DeRenzi, et al., 2012, March).
The value stream is important in the determination of the entity’s value creation to the patients through the existing Value Stream Analysis set aside by the quality improvement team. At a strategic level, the firm is analyzed and compared to the tactical level of individual departments in the clinical case. People performing value stream such as nurses should be included, and this carries a short period.
An improvement plan will be produced by the value stream whereby actions are categorized according to the ability of undertaking. Others can just be done while others will follow the rapid improvement events. The achievement of these goals should include involvement in the process of implementing the quality improvement to people. It values the current ways of job performance while reducing the discrepancies in the process of improving the quality of health care services. The last approach base is to sustain the improvements in the quality of services. Key metrics plus the loops for controlling quality improvement are planned with an aim of ensuring that health workers adapt to the new changes in the system (Källander, et al., 2013).
Performance Indicators
Monitoring the quality improvement is facilitated by the indicators, and they help to create the basis for improving the quality of health care practice and the modified system. The indicators need to be designed and defined so as to enable its implementation in agreement with medical practices. A rate based index will use the data concerning the events unfolding and their occurrence at the same frequency. These are the rates and proportions with which the quality improvement project has satisfied the patients in the hospital. The trends over the years will indicate the speed with which the performance improvement has been active (Kern, et al., 2014).
The sentinel indicators will help in identifying the individual events such as patient waiting time and its improvements. This helps in triggering further alterations to the performance improvement plan of quality. It will show the poor performance as a comparison to the past clinical skills performance. Process indicators will show the actual performances and what has been done while giving and receiving care by patients and clinicians. It helps indicate what the clinicians attended to the patients and the quality it was done. The care that health care provider’s accord to patients and the limits of the stipulated period all through the process according to dome clinical skills are included (Unützer, et al., 2014).
Structural indicators such as health system characteristics and quality improved will affect the quality of the improved system to meet the needs of healthcare of patients. It will help in describing the amount of resources used by the quality improvement system of the organization in delivering the services and programs. These systems are directly related to the health care performance improvement system and are affected by the number of the staff dispatched to the new system. Resources concerning money, the beds in the health care and the supplies plus the wards or buildings for in-patients are analyzed (Jha, et al., 2012). This will help in judging the quality of care provision under conducive to the quality of health provision in Hong Kong.
Outcome indicators assist in showing the health states and events that follow the quality improvement program in the health care system. This includes the possible effects of the new system on both patients and the health workers. It captures the potential impact of the policy on the health improvement and performance of patients. The worst outcome of the quality improvement is death. This results from untimely or naive implementation. Another outcome is the possibility of disease outbreak and its symptoms and abnormalities. Discomfort can result from the quality improvement process, and these may include nausea and dyspnea. Disability is another possible outcome, and it can present itself in the form of impaired recreation. The patients can also be dissatisfied with the quality of service and can lead to persistent complaints.
Adjusting to these indicators can involve the factors that are contributing to the survival of patients in the clinical process and the outcomes of the health quality improvement. The results of the quality improvement can be adjusted in comparison to other factors not within the health care system through quality assessment and other factors or components that are about quality health care. Demographic factors of the patients such as age and sex are considered. The lifestyle of the patients and psychosocial factors plus compliance to the prescribed medication can affect the quality of outcome. The severity of the illness and its comorbidity should be considered in the outcome evaluation (Groves, et al., 2013). The quality of treatment and the competence plus technical equipment available and the evidence-based treatment can affect quality. Adherence to using the clinical guidance available and cooperation from the top medical stakeholders is essential.
Strategies for Motivating and Engaging Stakeholders
Despite the advances in the quality improvement through healthcare in performance improvement, there is a failure in reliability from the customers as a result of health care. The systematic increase in health workers’ complexity and hard work does not guarantee efficiency in health care provision. Fixing these problems require transformations in systems to a team-based services aimed at satisfying the customers.
Engagement in the shared purpose of the quality improvement in clinical skills involves leaders’ shift of conversation to achieving the articulated visions and improved patient care. The need for sacrifice should be embraced because the performance improvement process can reduce autonomy and income levels of physicians. Leaders should encourage health workers to change the mentality of maintaining the status quo to advanced medical services (Friedberg, et al.,2014). The needs of the patients need to be prioritized, and doctors cannot be shielded from this.
Consensus needs to be built to allow the views that are varied to be articulated. An appeal to self-interest is essential given that physicians need to be motivated through financial incentives. The measures of performance should be realistic and non-biased o reinforce engagement of the health workers. The compensation can be pledged depending on the quality of improvements per individual. The successful health workers can be communicated to through earning them respect from their duties. Role play is appreciated through the positive feedback from the top management as no employee yearns to lose respect from colleagues.
The tradition of the health care and clinical practice of the physicians should be valued as a member of the health care system. They are given motivation so that they can adhere to the standards and traditions of the organization. Dome clinical skills tradition has been followed by doctors, and they are required to wear hosiery for female physicians and neckties for male medical practitioners (Reeves, et al., 2013). The patients can be engaged by the provision of training on the ease of access to certain technological improvements. Mass education can be carried out and the patients given sessions to express their levels of satisfaction. With this, the entire process of quality improvement in performance improvement of health care can be achieved.
References
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Hi pleaseclick on link above . And log in with my username and u r required to read each module and assessment task Given at the end and write on it in relation my specialty area which was preoperative. And u need to cite whatever u write with peer reviewed articles or references . Make sure u read all the modules before u start writing assignment .
It’s 1000 words altogether (3 modules )
SAMPLE ANSWER
Module 1: legal responsibility in preoperative care
Personnel in the preoperative settings have numerous responsibilities in relation to the legal and ethical responsibilities. This is because their duty of delivering care is deep seated core within the nursing principles and code of conduct. In this context, the documentation of nursing care is a legal responsibility during preoperative care. This is the only proof they can use in their defense that they are not negligent (Litwack, 2010). The documentation process must meet the established practice of documentation. The records must indicates patients preoperative assessment, care provided by the surgical team, the outcomes and evaluation plan conducted as they are used to indicate the procedures that should be used in primary care settings. One of the most important documentation processes in preoperative care is the informed consent (Lim et al., 2010).
The main element of quality care in preoperative department is the issue of informed consent. The general legal principle of preoperative care is that the healthcare provider must obtain a valid informed consent from their patient, before any treatment intervention is put in place. This principle is put in place to ensure that the patient enjoys the right to their health, and to decide what health care practice that takes place in their body. This right is entitled to every patient including the children, but the laws have specific rules that should be followed for these minors, or patient under critical care (Litwack, 2010).
Additionally, patient have right to confidentiality, unless they have allowed their health condition be shared in the consent form. This implies that the patient have a legal right that must be obeyed by the healthcare providers in the preoperative care, if the patient refuses presence of visitors during this phase. The healthcare providers have a legal responsibility of informing all the patient’s visitors and the contractors that the preoperative environment is a very confidential department, and that it is only chaperoned by the staff members assigned in these departments only. If the visitors are present for any reasons, it must be recorded in the theatre record for referencing purposes (Tilse and Wilson, 2013).
Module 2: Dilemma of providing patient information to carers
Patient privacy is important as it upholds patient’s dignity, which is a core nurse principle and fundamental aspect of care. The physicians are often face challenges as patients health deteriorates, especially when they have to deliver relevant information that can be used at home care. More often, doctors face criticism from family relatives and carers for not giving patients adequate information. This is because it is the physician legal obligation to respect and to protect patient information. Traditionally, patient privacy philosophy argues that patient identify the person who can be informed about their health condition, and including if the information can be shared with the friends or the family (Gold et al., 2009).
This theoretical model, which focuses on patient centered care, is not always the clinical reality. The legal obligations demands that such information should be provided is there is explicit permission. This can create huge debate if a relative who have been at the center of delivering care of patient is denied the patient information. On the contrary, if the patient condition does not permit them to make decisions for themselves due to severe illness or dementia, then the family or carer can be integrated in the decision making process. These two scenarios indicate divergent positions in the communication between the patient’s carers and the physicians. This indicates that the culture of patient centered care in some cases can create tensions in healthcare (Atkinson & Coia, 2012).
In reality, the family members and carers are always concerned about the patient health. This is especially important during transition of care from acute settings to homes. In this context, the patients discharged from the hospital are weak and will rely on caregiver for their daily activity. Research indicates that providing patient information to carer is beneficial because it reduces carer anxiety, improve competency, and improve the coping strategies that will facilitate the decision-making processes. These findings have been supported by one studies conducted in cancer patients. From this perspective, then it is true that the carers work is often unrecognized, and often overlooked due to the way the medical ethics and law protects the patient’s information. These individualistic ethics dominating the healthcare practice could be hindering quality care (Gold et al., 2009).
Therefore, it is important to empower the carer with clear and effective communication about the essentials as they undertake the quasi-nurse role. This is because the patient carer knows the patient best. The carer is the constant support in patient’s life, and over time, the patient builds trust. Research indicates that the carer are encouraged and feel appreciated when integrated in decision making processes, as they become aware of the patients physical and psychological demands than when denied access to patient information (Atkinson & Coia, 2012).
Module 3: Reflection
Patient perspective about illness, disease, dying and death is best explained by the Spoon theory developed by Christine Miserandino. According to her, illness especially those diagnosed with chronic illness such as systemic lupus makes the patient have limited expendable energy. This is because even a small activity makes a patient loose a spoon (energy), which is very difficult to retrieve back. Her perspective about systemic lupus and all chronic illnesses are that patients are weak to even to undertake simple daily activities such as taking birth, walking and feeding. This is similar to the daily incidences that we deal with at the perioperative care. Most of the perioperative patients lack the exact words to explain the way they feel or their worries. This narration has helped me in understands the needs, the struggles and the services needed by the patients, especially those under preoperative care (Wagner et al., 2010).
From this narration, I have learnt that the most affected individuals during illness, dying and death are friends and the close relatives. From the narration, it is evident that healthy people are usually distressed and have unimaginable fear about illness, especially in chronic illness such as lupus. For instance, the narration indicates that the patient friend got confused and may felt helpless during the treatment regimes. However, as indicated in Maggie’s case study of hope in recovery, it is important for the family to understand, and to find ways they can meaningfully participate in their patient’s recovery, and to understand that their acceptance positively impact the response of their loved ones. The family have crucial role especially in hospital settings. They must a way to advocate for quality care for the loved ones (Atkinson & Coia, 2012).
As indicated in Maggie’s story of hope in recovery case study and Christine’s story of the twelve spoons, the healthcare role in managing patients goes beyond offering quality care alone. I have learnt that the healthcare providers have additional role to care giving which includes educators, advocates, and counselors. The healthcare staffs have the responsibility of helping the patients to understand the disease they are suffering from, and to ensure they understand and accept the management of their condition. This activity is important as it builds the gap between the healthcare providers and the patient. Additionally, it offers emotional support that will help the patient cope with the illnesses (Bennet et al., 2010).
References
Atkinson,J.M., & Coia, D.A. (2012). Responsibility to carers — an ethical dilemma. Psychiatric Bulletin 11/1989; 13(11):602-604. DOI: 10.1192/pb.13.11.602
Bennet, A., Coleman, E., Parry, C., Bodenheimer, T., and Chen, E. (2010). Health Coaching for Patients With Chronic Illness. Fam Pract Manag. 2010 Sep-Oct;17(5):24-29.
Gold, M., Philip, J., McIver, S., & Komesaroff, P. A. (2009). Between a rock and a hard place: exploring the conflict between respecting the privacy of patients and informing their carers. Internal Medicine Journal, 39(9), 582-587. doi:10.1111/j.1445-5994.2009.02020.x
Litwack, K. (2009). Clinical coach for effective perioperative nursing care. F.A. Davis Company. Philadelphia
Lim, J., Bogossian, F., & Ahern, K. (2010). Stress and coping in Australian nurses: a systematic review. International Nursing Review, 57(1), 22-31. doi:10.1111/j.1466-7657.2009.00765.x
Tilse, C., & Wilson, J. (2013). Recognising and responding to financial abuse in residential aged care. The Journal of Adult Protection, 15(3), 141-152. doi:http://dx.doi.org/10.1108/JAP-11-2012-0025
Wagner, G., Lorenz, K.A., Riopelle, D., Steckart, M.J., Rosenfeld, K. (2010). Provider Communication and Patient Understanding of Life-Limiting Illness and Their Relationship to Patient Communication of Treatment Preferences. Journal of pain and symptom management ; 39(3):527-34. DOI: 10.1016/j.jpainsymman.2009.07.012
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