Capstone Project: Infections

New Practice Approaches 

The modern practice of nursing had changed and evolved, with the changes made creating a cascade of more changes. Almost every area of nursing, including how nurses relate to their patients and colleagues, has evolved. Among the primary areas of change is the adoption of a holistic approach to nursing. Instead of aiming to combat ailment and get patients back to health, modern nurses take a case-based approach that incorporates all the needs of the patient (Dang & Dearholt, 2017). The holistic approach to care combines the physiological, psychological, emotional, and even spiritual needs of the patient. The modern nurse is a patient’s clinician, companion, and champion.

The second area of evolution in nursing involved the rise of evidence-based practice (EBC). EBC is a problem-solving approach where the nurse conscientiously uses the most effective practices when handling patients (Dang & Dearholt, 2017). The said practices need backing from the best available studies. Even well-established practices can change if there is evidence of ineffectiveness. This evidence is the applied with the values and preferences of the patient based on the expertise of the nurse. In this regard, the traditional approach where clinical treatment depended on the judgment of the clinician alone has changed. Indeed, patients can expressly decline treatment, and nurses are obliged to adhere to patient wishes.

A final component of new practice approaches is the changing of the role of nurses in the healthcare system. Traditionally, the nurse was a subordinate clinician whose primary training was taking care of patients under the guidance of a physician or other specialist. The training of nursing has evolved, leading to the advent of the Advanced Practice Registered Nurse (APRN), typically a highly trained and specialized clinician (Dang & Dearholt, 2017). Having highly trained nurses working under the traditional physician-dominated working environment has resulted in some conflict. Creating modalities for inter-professional cooperation is among the hallmarks of modern hospital administration.

Inter-professional Collaboration 

Inter-professional collaboration is a modern component of the modern working environment in the healthcare industry. The concept of inter-professional collaboration refers to different professionals in the healthcare system, considering each other’s opinions in the best interests of the patient (Kholed et al., 2017). These professionals include physicians, specialists, nurses, psychologists, and social workers, depending on patient requirements. These professionals then need to work with the patient and the patient’s loved ones.

Typically, inter-professional cooperation applies when the patient had inordinate clinical needs when the standard practice may not apply expressly. For example, a terminal patient may have some hope through experimental treatment, which, although having potential, can also adversely affect the patient’s quality of life. Under such circumstances, the best interest of the patient is not definitive. Different professionals allied to healthcare need to share their opinion on the subject and consider each other’s opinions over the same (Kholed et al., 2017). Further, these professionals also need to factor in the opinion of the patient and the family before arriving at a way forward.

Among the benefits of this concept is the improvement of patient outcomes as the different perspectives will create a better understanding of the situation. Secondly, inter-professional collaboration reduces proclivity for medical errors as the different professionals will check each other’s excesses. This concept also speeds up decision-making and saves resources as it brings the different professionals together instead of creating a decision-making chain (Kholed et al., 2017). Finally, this approach enables the incorporation of the opinion of the patient and the patient’s loved ones in the decision-making process.

Health Care Delivery and Clinical Systems 

Health care delivery and clinical systems are a manifestation of how the healthcare industry has evolved in the last few decades. This evolution stems from the development of a better understanding of healthcare, including preventative care. Further, clinical these systems have also developed due to an increased focus on money in modern healthcare (Green, 2018). Traditionally, patients would only seek clinical assistance when the need arose. Under the current regimen, patients, healthcare providers, and healthcare payers have developed long-term relationships.

Different types of healthcare delivery and clinical systems have developed over the years. First, there is the Exclusive Provider Organization (EPO), where payers and healthcare providers agree on the proviso of healthcare services to a group of people (Green, 2018). Members of the group can elect to seek clinical care from a different organization but only at their own cost. Secondly, there is the Health Maintenance Organization (HMO), where a single entity either provides all medical services to a group of patients or makes arrangements for such care to be provided by a third party. If the patient seeks care outside either the HMO or the HMO-recommended party, the single-payer is not responsible for the costs (Green, 2018). The third system is the Integrated Delivery System (IDS), where the payer, such as an insurance company, develops professional relationships with different service providers.

The IDS provides some freedom of choice for members as long as the selected service provider is on the payer's list. The fourth is the Preferred Provider Organization (PPO), which is a looser version of the IDS (Green, 2018). Under the PPO, the payer gets discounted rates from a collection of service providers. If the patient picks a provider not under the payer's PPO system, the patient pays for the cost difference. Finally, there is the Point-of-Service (POS) Plan, which is a combination of the PPO and HMO (Green, 2018). The patient gets to choose between a discounted rate under the PPO and almost no direct cost under the HMO.

Ethical Considerations in Health Care 

The issue of ethical considerations in healthcare has also gradually changed in some areas while still maintaining traditional components. Among the traditional considerations for healthcare is the issue of patient confidentiality (Chadwick & Gallagher, 2016). Ensuring that information about the patient remains confidential has become complicated due to the concept of healthcare information technology (HIT) and its components, such as interoperability (Lukaszewski, 2017). The sharing of data to improve healthcare as contrasted with the need to protect patient privacy is often the cause of ethical dilemmas.

The second vital ethical consideration in modern healthcare is the issue of medical errors and negligence. Traditionally, this issue involved taking measures to minimize or eliminate errors and avoid negligent activity. Currently, the issue has also extended to include honesty and transparency in the face of medical errors or professional negligence (Chadwick & Gallagher, 2016). Under modern laws, a singular incidence of medical error or negligence can create debilitating civil liabilities for hospitals. Clinicians and administrators may be tempted to cover up negligent action to avoid liability, which in itself is a breach of ethics.

A final significant area of ethical considerations involves patient autonomy, informed consent, and the concept of assisted suicide. Traditional practice rules assumed that the clinician knew what was best for the patient. This concept changed, and the acquisition of informed consent for all procedures involving the patient became mandatory (Chadwick & Gallagher, 2016). As the concept of informed consent advanced, the issue of patient autonomy was expanded to include components such as the right to decline treatment and do not resuscitate orders. In recent years, the ethical issue of patient autonomy has extended to the debate about assisted suicide.

The practice of Culturally Sensitive Care 

Among the hallmarks of the holistic approach to care is the issue of culturally sensitive care. Culturally sensitive care involves having cultural intelligence as a component of competence in clinical care (Rahimaghaee & Mozdbar, 2017). The process of providing physical care of a patient should not come at the cost of hurting the patient emotionally or psychologically due to a lack of cultural sensitivity. More importantly, some cultural minorities decline to seek treatment due to the fear of falling victim to cultural insensitivity in the workplace. Nurses and other clinicians are human beings who typically have their own cultural affiliation with strong views. Such views include sensitive issues such as those relating to gender and sexuality, LGBTQ, abortion, or religion (Rahimaghaee & Mozdbar, 2017). The opinions of these professions may create some biases or, in extreme cases, open hostility for people whose cultures do not align with those of the clinicians. For clarity, some cultural issues are complicated enough to create ethical dilemmas for clinicians. For example, some religions do not allow for blood transfusion, which may be a life and death issue for primary injury patients or those that need surgery. Nurses and other clinicians should avoid imposing their cultural beliefs on their patients, which amounts to a breach of ethics (Rahimaghaee & Mozdbar, 2017). However, in some extreme cases, such as the examples given above, reasonableness should be applied to the issue of culturally sensitive care on a case-by-case basis.

Preservation of Integrity of Human Dignity in the Care of All Patient 

Another vital component of holistic care is the preservation of the integrity of human dignity in the care of patients. Clinicians cannot guarantee that patients will get positive outcomes physiologically as fatalities and other adversities can happen despite the best possible intervention. However, human dignity should not be compromised. Indeed, during palliative care, clinicians are obliged to take measures to preserve the dignity of patients even when their deaths are imminent (Nyholm & koskinen, 2017). Preserving the patient’s dignity increases the propensity for patient satisfaction and patient self-esteem. Further, preserving the dignity of patients discourages the practice of declining to seek medical attention except as a last resort.

Among the ways of preserving the dignity of a patient is cultural intelligence, which ensures that the act or omissions of a clinician do not offend the patient (Nyholm & koskinen, 2017). Secondly, the clinician should always address the patient directly and avoid the practice of speaking about the patient in third-person when the patient is present. Pain management is another vital component of preserving the dignity of a patient, as extreme pain can lead to degrading behavior. Modern practice theory considers pain management as a fundamental right for all patients. Similarly, maintaining the hygiene of a patient is vital to the preservation of dignity, more so when the patient is no longer able to maintain personal hygiene (Nyholm & koskinen, 2017). Finally, effective communication is vital to patient dignity. In this context, effective communication involves giving the right information to the patient in an empathetic and caring manner.

Population Health Concerns 

Population health relates to the health outcomes of a group of people, including the prevalence of critical health issues. The concept of population health stems from the fact that the health needs of the members of the same community are interrelated (Powell et al., 2018). For example, a patient with cancer or a stroke may fail to get proper clinical care due to an untimely accident that stretches the resources of the local ER. Typically, population health concerns are the issues whose presence or prevalence poses a significant healthcare threat to the population. The high prevalence of a condition such as heart disease or diabetes is a population health concern due to the high cost of treatment (Powell et al., 2018). Similarly, the presence of only one case of a highly contagious disease is also a significant population health concern as the single case can spread and devastate the population.

According to the Centers for Disease Control and Prevention, alcohol-related harms are the critical population health concerns in the USA (CDC, 2020). Key among these harms is traffic accidents caused by drunk driving, which lead to high fatalities and injuries that drain healthcare resources. The high prevalence of cardiovascular disorders is also a significant population health concern due to its chronic nature and high cost of treatment. The abuse and overdosing of prescription drugs have also risen to become a primary health concern in America (CDC, 2020). The abuse of drugs not only leads to premature death and suffering but also complicates treatment regimens and pain management due to the fear of prescription drug abuse.

Role of Technology in Improving Health Care Outcomes 

Among the most significant factors in modern healthcare is technology. Due to advancements in healthcare technology, life expectancy has risen steadily, human suffering has reduced, and patient outcomes have improved. A vital component of technology in healthcare is Health Information technology (HIT), which has become an essential requirement in modern healthcare (Lukaszewski, 2017). Legally, hospitals are obliged to invest in HIT and maintain up to date records for their patients. Through the concept of interoperability, different players in the healthcare industry are able to share patient-data, leading to efficiency in service delivery. HIT has also reduced the propensity for medical errors due to the ease of re-checking and cross-referencing.

Technology has also prayed a substantial role in therapeutic care. Pharmaceutical companies rely on modern technology for the development and manufacture of modern drugs. Similarly, advanced gadgets have eased the process of diagnosing and treating a variety of ailments (Vafea et al., 2020). Indeed, through advanced and specialized machines such as extracorporeal membrane oxygenation (ECMO), clinicians are able to preserve human life to allow the body to heal or buy time for advanced treatment such as organ transfer. Similarly, technology such as dialysis has enabled hundreds of Americans or survive kidney failure.

Finally, information technology and portable equipment have led to advancements in ambulatory care, thus reducing congestion in hospitals and saving on costs (Vafea et al., 2020). Patients can now purchase and install life-saving machines in their homes, then use telemedicine to connect with clinicians for instructions on how to use them when the need arises.

Health Policy 

Health policy is a vital component of public or population health and refers to the decisions, plans, and actions that bear on the health of a society. The most vital component of healthcare policy currently is legislation (Blank et al., 2017). Modern governments have a stranglehold on healthcare by enacting criminal and civil laws relating to the industry. Among the significant laws relating to healthcare in America relate to access to medication through the United States Food and Drug Administration. Due to this regulation, the cost of medication is exponentially higher in the USA than in other developed nations (Blank et al., 2017). There is also legislation relating to the training of clinicians, including doctors and nurses, and the running of hospitals.

Among the issues that affect healthcare policy in the USA is the lack of coordination between states regarding healthcare policy in the absence of applicable federal laws. For example, laws relating to the hiring and duties of nurses vary from state to state, which creates confusion in the running of hospitals. Another vital component of healthcare policy is regulation through government and peer-regulatory bodies. Within this category are organizations such as the Center for Medicare and Medicaid and the CDC (Blank et al., 2017). The regulation of insurance companies and other payers of healthcare services is a crucial component of health policy in America.

Leadership and Economic Models 

Among the common motifs in modern nursing is the issue of scarcity. Most hospitals have fewer nurses, drugs, or facilities than they need. Leadership is a vital component of ensuring that available resources are utilized effectively to assist as many patients as possible and to the largest extent possible. According to Jones & Yoder (2010), one of the main economic models for ensuring the best sharing of resources is the economic theory. In nursing, economic theory refers to the evaluation of all available options to ensure that in the final decision, anticipated benefits are greater than the opportunity cost. However, regarding the care of patients, the use if purely economic concepts such as opportunity cost can be problematic as human life is in the balance. Ethical dilemmas will arise when the determination between who lives or dies comes down to convenience and efficacy in the sharing of resources. According to Jones & Yoder (2010), the solution to this impasse is leadership. Proper leadership will enable the striking of a balance between the data garnered through economic models and the humane treatment of patients. Human dignity demands that patients should not be reduced to numbers and figures in economic considerations. However, the economic theory, tempered with effective leadership, is an invaluable nursing tool due to the scarcity of resources.

Health Disparities 

Health disparities are both a social problem and a healthcare system issue. As a social problem, health disparities refer to the propensity for a segment of the population to be more susceptible to a specific ailment or health issue (Baciu et al., 2017). For example, teenage mothers are more susceptible to complications during birth than older mothers. Similarly, children in poor inner-city communities are more susceptible to ailments relating to poor nutrition than children from wealthy suburban families. Health disparities can also arise due to limitations in the healthcare system (Baciu et al., 2017). Among the vagaries created by the scarcity of healthcare, resources are the problem of health disparities. Among the victims of the scarcity of healthcare, resources are economically challenged. First, tens of millions of Americans lack healthcare insurance. Further, a large number of the insured have co-pay systems that create the risk of getting massive medical bills and the potential for bankruptcy (Green, 2018). Finally, there is no formal law on paid medical leave; hence some people will fail to seek medical attention to avoid losing wages. Finally, some cultural or ethnic majorities will avoid seeking medical attention due to the fear of discrimination. The combined factors of medical disparities outlined above create healthcare inequalities in society.

References

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