NURS 6600: Capstone Synthesis Practicum Journal
NURS 6600 Practicum Experience Journal
Practicum Experience Journal Entries NURS 6600
Week 4
Introduction and purpose of the paper statement
Some patients are more vulnerable to multiple readmissions than others. Readmission do not only inconvenience the patient, but they put extra strain on existing medical facilities. As the ratio of health care workers to that of the population that they continue to become smaller coupled by increasing congesting facilities, it is crucial to ensure patients are not readmitted. This paper focuses on the issue of readmission and what has been done to prevent the problem.
Issue
During my Practicum Experience, I noted that discharged older adults with several medical challenges have a high chance of readmission into health care facilities. Due to their vulnerability to different diseases, chances of recurrent readmission are high.
Review of the Literature
Older adults suffering from multiple conditions have long been recognized as individuals with a high risk of readmission after treatment of an acute disease. One way medics deal with this issue is by referring them to home health care (HHC) (García-Pérez et al., 2011). These findings were echoed by Jones et al., (2017) which established that HCC referrals increased by about 65 per cent from 2001 to 2012. Recurrence of readmission among the aged with multiple diseases was also recorded in Vernon et al., (2019). This study recommended a follow –up service for the patients to continue monitoring their conditions while providing the necessary care.
How the Situation was Handled Consistent and Inconsistent with the Literature
During my Practicum Experience, the elderly with multiple conditions were advised to plan for home health care service. To start with, doctors recommended home health care service providers based on the patients home area. This practice was consistent with the recommendation of Jones et al. (2018). However, there was no follow up services, as suggested by Vernon et al. (2019). This lack of follow up may be due to inadequate medics.
Formulate a Plan based on Evidence-Based Approach
Handling patients with a high risk of readmission can be done differently by utilizing a new plan. First, more health care providers should be employed at the facility. Secondly, the management of the hospital should create a medical follow-up department. Next, communication between the department and in-patient department so that high patient files are forwarded for follow-up upon patient dismissal.
References
Vernon, D., Brown, J. E., Griffiths, E., Nevill, A. M., & Pinkney, M. (2019). Reducing readmission rates through a discharge follow-up service. Future healthcare journal, 6(2), 114–117. https://doi.org/10.7861/futurehosp.6-2-114
Jones, Christine D et al. “High-Value Home Health Care for Patients With Heart Failure: An Opportunity to Optimize Transitions From Hospital to Home.” Circulation. Cardiovascular quality and outcomes vol. 10,5 (2017): e003676. doi:10.1161/CIRCOUTCOMES.117.003676
García-Pérez, Lidia & Linertová, Renata & Lorenzo-Riera, A & Diaz, Vazquez & Duque-González, Beatriz & Sarría-Santamera, Antonio. (2011). Risk Factors for Hospital Readmissions in Elderly Patients: A Systematic Review. QJM : monthly journal of the Association of Physicians. 104. 639-51. 10.1093/qjmed/hcr070.
Week 5
Introduction and purpose of the paper statement
Accessing quality health care facilities for individuals living in rural areas can be challenging. When one has a chronic condition, for instance, they often need to see a health care specialist even after being discharged. This paper explores ways in which rural residents can still access medical care after the initial treatment.
Issue
People with chronic conditions often need continuous health care services. Travelling back to the city to see a specialized doctor whenever there is need may prove to be costly for rural dwellers. On the other hand, lack of access to health care services could have fatal consequences even for conditions that would easily be treated.
Review of the Literature
Several studies have examined barriers to quality health care services among rural residents. According to Brundisini et al., (2013), rurality significantly contributes to the vulnerability of individuals with a chronic illness due to such issues as distance and shortage of health workers. Similarly, Weisgrau et al., 1995 found that people in rural areas have always struggled to access quality health care. According to the survey, a good remedy for the challenge is to encourage the use of telemedicine. This technology allows patients to use available video conferencing equipment to access professional health services remotely. Health Quality Ontario (2013) asserts that one of the best ways to manage chronic illness for rural residents is home health care. Such care allows the patient to access quality services without travelling to urban areas which could be risky, costly and time-consuming.
How the Situation was Handled Consistent and Inconsistent with the Literature
During the Practicum Experience, patients from rural areas were advised to hire a home health care attendant whenever possible to avoid unnecessary travel back and forth. Unlike like recommendation from literature, there was no arrangement to utilize telemedicine facilities to offer extended services to the patients.
Formulate a Plan based on Evidence-Based Approach
With proper planning, patients with chronic illnesses can be put under home health care and monitored by a specialized physician remotely using telehealth facilities. These changes can be implemented in several steps. First, the hospital should install teleconferencing facilities. Secondly, physicians in this facility should be trained to use video communication equipment. Thirdly, the hospital should partner with home health providers to provide home health services and establish communication with physicians when the need arises.
References
Brundisini, F et al. “Chronic disease patients’ experiences with accessing health care in rural and remote areas: a systematic review and qualitative meta-synthesis.” Ontario health technology assessment series vol. 13,15 1-33. 1 Sep. 2013
Health Quality Ontario (2013). In-home care for optimizing chronic disease management in the community: an evidence-based analysis. Ontario health technology assessment series, 13(5), 1–65.
Weisgrau S. (1995). Issues in rural health: access, hospitals, and reform. Health care financing review, 17(1), 1–14.
Week 6
Introduction and purpose of the paper statement
Nursing is a mentally demanding career. As such, the application of knowledge and skills learnt in class is not always easy. Students in such practice are bound to lose confidence, leading to poor performance. In some cases, the support from the qualified staff is not enough to restore confidence in the student. This paper focuses on establishing ways in which extra support can be offered for nursing students.
Issue
Due to the complexity of nursing practice, students often lose confidence due to lack of adequate support. Nursing students, especially those new in the practice, often encounter challenges in balancing their social, financial and training needs. Consequently, they lose confidence in the course of practice and consequently register low performance.
Review of the Literature
Most nursing stakeholders agree on the need for support for nursing trainees. Whoever, there is no universal consensus on how much support is adequate. According to Shapiro (2016), nursing students required various types of support. These include financial, professional and peer support. While supporting this belief, Roberts (2008) argue that nursing students need extra support, especially from each other. This can be achieved by allowing them to work in groups to enable them to achieve the best learning experience. Similarly, Ravanipour (2015) established that support from peers is a useful source of motivation for students.
How the Situation was Handled Consistent and Inconsistent with the Literature
The issue of loss of confidence due to a lack of adequate support during the practicum experience was handled slightly different from recommendations from literature. While literature suggests facilitating different types of support for students, only professional support was provided. This approach left room for distressing challenges due to financial stress and lack of support from peers.
Formulate a Plan based on Evidence-Based Approach
Nursing institutions can provide additional support for practising clinicians using a multistep plan . First, the institution group students undertaking practice into various groups. Secondly, the institutions should create time for students to meet, interact and share experiences during the practice. Lastly, the health care facility should find and partner with philanthropists to provide additional financial support to students under practice.
References
Ravanipour, M., Bahreini, M., & Ravanipour, M. (2015). Exploring nursing students’ experience of peer learning in clinical practice. Journal of education and health promotion, 4, 46. https://doi.org/10.4103/2277-9531.157233
Roberts, Deborah. (2008). Learning in clinical practice: the importance of peers. Nursing Standard. 23. 35-41. 10.7748/ns.23.12.35.s55.
Shapiro, J., & Galowitz, P. (2016). Peer support for clinicians: a programmatic approach. Academic Medicine, 91(9), 1200-1204.