Since the healthcare system is mainly represented by nurses in terms of the number of workers, the individuals who work as RNs and APRNs certainly are to be active participants in regulatory procedures. However, certain limitations create an environment in which nurses are not fully functional in policy review. Reviewing policies is essential before implementing them and causing a change within the system. Nurses are to review such concepts due to their expertise in ethical and professional care provision and access to patient feedback.
Opportunities
Nurses can participate in policy reviews based on various opportunities. According to researchers, nurses often ensure the patients receive ethical treatment (Barzegar Safari et al., 2020). Thus, nurses can be responsible for reviewing the ethical aspect of a proposed policy and assessing whether it promotes accessibility and equality. For example, an approach to address treatment regarding diabetes is not only to consider the type of care and medications a patient requires. Since diabetes implies the use of life-and-death medications, nurses can attest to the importance of lowering the cost and making insulin affordable.
Moreover, the care that nurses provide for patients with diabetes-related complications gives them an overview of the severity of skipping medications because individuals cannot afford them. Another opportunity to participate in policy review is providing feedback on the implementation aspects that may lack consideration of human subject protection. For example, the policy has to do with medical research. In this case, the policy-makers may have the interest of the general population as the main focus, which nurses value patient-centered care and respect privacy. Relevant literature highlights the importance of considering the desires of the research subjects (Williams & Anderson, 2018). Thus, nurses can ensure the research-related policies are based on privacy and the wishes of every topic under the research.
Overcoming Challenges
A challenge that may prevent nurses from participating in policy reviews is the lack of belief in the fact that they are contributing to a change. This is supported by researchers illustrating that nurses do not see a practical meaning in such activities (Barzegar Safari et al., 2020). This may be mitigated by demonstrating the impact nurses can have on policies. For example, a policy reviewed by ANA that has changed due to the implication on nurses during the review stage is to be illustrated as a collective effort in which RNs and APRNs applied their expertise. Another challenge that can be minimized is a lack of external support. For example, researchers mention a lack of feedback when it comes to practical involvement (Glasgow et al., 2003). This is to be addressed by encouraging nurses to participate by administrators and offering input on reviews that have led to the successful implementation of a policy.
Promoting Opportunities
Communicating opportunities to participate in policy reviews is the first step toward an improvement. For example, nurses are to be informed on the relevant research regarding the importance of being active in policy-making in the healthcare industry. This can be effective by building a research infrastructure addressing nursing in establishing systematic change (Shiramizu et al., 2016). Another option is for policy-makers to seek feedback from nurses. They are the primary care providers with access to the needed information on patients, treatments, and the possible need for change.
Conclusion
Nurse participation in policy-making and implementation is crucial, especially during the review stage. Since the profession implies the presence of expertise when it comes to caring provision and ethics, nurses can effectively participate in such reviews to determine the most efficient measures and solutions to existing problems. This will not only create an environment in which nurses directly influence the industry but also allows them to actively contribute to a better healthcare system overall.
The recent coronavirus outbreak and its high transmissibility identified significant issues in the system of measuring air and surface contamination, required to estimate worker exposure to virus particles. An article written by Cherrie et al. (2021), published in the journal Annals of Work Exposures and Health, presents a systematic review of methods used for the measurement of air and surface contamination.
Summary
The report starts with providing informational background on COVID-19 and SARS-CoV-2, where authors emphasize how the virus could be easily transmitted from patients to healthcare workers. The background explains the foundation of the research and its application and connection to actual problems in the healthcare system. The authors state that the article presents a summary of reports on air and surface contamination in workplaces where the virus was located. In addition, the article reviews the sampling and measurements data, makes assumptions about the quality of measurements, and provides recommendations that could be used in measurements and sampling methodology in the future.
The first significant finding from the article is that because there is no standardized procedure for quantifying the concentration of SARS-CoV-2 RNA in the air, the results were different among several reports. In terms of methods used for air sampling, the authors listed the use of gelatin filters, wet cyclone, impingers, dry filters, and water-based condensational samples (Cherrie et al., 2021). The authors also clarified that some reports used a combination of different sampling methods. On the other hand, the sampling methods for surface contamination were consistent through the majority of reports. According to Cherrie et al. (2021), in general, in the surface contamination sampling method, most of the reports followed recommendations provided by WHO. Thus, the articles findings suggest that due to the absence of recommendations from credible organizations for air sampling procedure, the results from the reports have different non-comparable data from the use of different measurement systems.
In their research, the authors tried to compare results from reports on contamination data but determined that only a small amount of collected data could be used for making further suggestions. In particular, some surface samples identified 0% positive for SARS-CoV-2 RNA, and some identified 74% positive results, with a median of 6% (Cherrie et al., 2021). Additionally, some of the reports did not detect SARS-CoV-2 RNA on any surfaces, while others showed a tendency to show a high number of positive results in air samples (Cherrie et al., 2021). According to the authors, only part of the reports used concertation units for measurements, most suitable for comparison purposes (Cherrie et al., 2021). In analyzing the findings of inconsistencies in data, the authors suggested that most reports have a descriptive character and lack documentation and statistics on air and surface contamination.
In conclusion and discussion of research results, the article suggests that inconsistencies in data and sampling methods could be explained by limitations due to conditions of the pandemic and shortage of equipment. The article states that inconsistencies in data and measurements could not deny that workers exposure to high concentration of SARS-CoV-2 RNA in the air presents a risk for workers safety. According to the authors, contamination could be dangerous only in cases of high (37% and more) concentration as cultivation of virus requires a high concentration of SARS-CoV-2 RNA in the air (Cherrie et al., 2021). Thus, in low concentrations, the SARS-CoV-2 RNA is relatively harmless to people.
Critique
The research findings indicated a significant issue in the system of measuring air contamination with SARS-CoV-2 RNA. In the article, comparing the inconsistencies in air sampling methods with surface sampling showed how recommendations from credible organizations such as WHO could improve the accuracy of sampling results. The authors suggest that preparing for the next outbreak requires international coordination, which could be fulfilled by WHO. Although WHO previously addressed the recommendations for indoor air sampling and analysis methods, they mainly relate to exposure to chemical pollutants and do not fit SARS-CoV-2 RNA tests (WHO Europe, 2020). Thus, the article emphasizes the critical issue of addressing the need for the development of a standardized procedure of air contamination sampling and measurements. Moreover, the article provides evidence that due to inconsistencies in the data, the collective analysis of different reports lacks accuracy and could only provide depthless results.
The article also points that due to inconsistencies in data, there is no opportunity to provide an accurate value of SARS-CoV-2 RNA in the air that could be dangerous to people in cases of exposure. The authors use previous findings from Lednicky et al. suggesting that successful culture of the virus requires the RNA concentration higher than 38% (as cited in Cherrie et al., 2021, p. 12). Therefore, after comparing the statement with results from different reports, the article states that the contamination of workplace air with SARS-CoV-2 RNA in small concentrations is harmless to people.
The authors acknowledge the fact that their research and reports that the research is based on do not reflect several vital factors. In particular, the authors listed measurement contextual data as one of the factors that were missing in the reports. The factor includes additional information about the workers room sizes, ventilation systems, use of protective equipment etc. Without centralized sampling procedures and measurement system, the abovementioned factors could potentially add more depth to the existing research. According to the authors, in future development of the centralized processes the new protocols should be formatted with an opportunity to feature such important information. Moreover, the protocols should also provide additional data on workers health status, behavior, and remaining social context of workplace interactions.
In terms of the organizations perspective, I assume that engaging 3rd party organizations in cleaning and disinfecting services is a good intention to provide a safe workplace. Although, in some cases, the initiative could be misinterpreted as relieving oneself from responsibilities, spending additional resources to provide safety for the workers is better than ignoring the cleaning and disinfecting regimen. Moreover, cleaning and disinfecting should be an essential part of any functioning organization, and I think that even after the COVID-19 pandemic, the organizations should carry the cleaning and disinfecting regimen. A clean workplace environment could prevent transmission of other diseases and result in improvement of workers health status.
The fact that non-viable virus particles on surfaces could culture the virus emphasizes the need for further research and the development of standardized techniques and protocols that would improve the accuracy of currently available research. There could be more pandemics like COVID-19 in the future, so taking proactive actions now could benefit the efficiency of response to the following situations. New mutations of the COVID-19 virus characterized with a higher level of transmissibility present a significant threat for the population and workers.
Epidemics and outbreaks of various diseases regularly occur throughout the planet. States and health systems must deal with them in order to minimize the negative consequences. One of the tools of such a fight is the analysis of outbreaks of viruses and diseases by scientists, which helps to establish the root causes of the incident. It is necessary to analyze the measles outbreak in California in 2014, and consider how the process took place and how it was controlled.
Approximate Duration of the Incubation Period
One of the main criteria for studying the epidemic is the incubation period of the disease. For more objective information, it is necessary to use a graph that clearly demonstrates the statistical data on measles. It is known that the first visit to the hospital was made on January 5, 2015, where the measles infection was confirmed. At the same time, the infected person visited Disney theme park in mid-December 2014, which is similar to the testimony of other infected people who later went to the hospital (Centola, 2020). Based on this information, it can be argued that the approximate incubation period of the disease was half a month, or 19 days. However, a more accurate conclusion would be 14 days, since the disease was felt earlier, but was not interpreted as measles (Centola, 2020). In the calculation of such data, the source of the epidemic was also taken into account, which is the only.
Type of Source
The most likely conclusion about the epidemic is its general type, since we are talking about the Disney park. According to the data on the epidemic of 2014 and the history of those infected, they all visited the same places in the form of a theme park in almost the same period. Of course, then the epidemic grew due to the fact that people returned to their places of residence, which spread the measles outside of California. However, such people should be considered carriers, but not sources, which means that it is impossible to argue about a mixed or punctate type (Tulchinsky, 2018). It is worth emphasizing that no specific species or other sources of the disease were identified in the park, only a commonplace. It should be borne in mind that the park is a large area with a large number of people, animals and insects, but the first or zero patient has not been identified (Centola, 2020). Based on all of the above, the epidemic is in the nature of a common source.
Peak of Occur
The next important criterion is the peak of the measles outbreak in the state. According to the schedule, it falls on the first half of January 2015, more precisely on January 2nd. This is explained by the fact that since the patients visited the Disney theme park on the same dates, their incubation period was the same (Centola, 2020). Consequently, after about two weeks, the largest number of cases of measles was detected. The situation was aggravated by the lack of preventive measures, such as a vaccine.
End of Outbreak
It is important to emphasize that the outbreak did not end on its own, but thanks to the help of the state and the healthcare system. First of all, this park was closed to eliminate potential sources of the disease, as well as to analyze the general environment. This allowed to prevent subsequent infections, and stop the number of infected at about the same level (Tulchinsky, 2018). The next intervention was to vaccinate citizens in risk states, which also slowed down the spread of the disease (Tulchinsky, 2018). Finally, the infected were in quarantine under the supervision of doctors, which contributed to their recovery and lack of contact with society (Tulchinsky, 2018). Thus, it was these actions of the health care system that helped stop the development of the epidemic.
References
Centola, D. (2020). How behavior spreads. The science of complex contagions. Princeton University Press.
Tulchinsky, T. H. (2018). Case studies in public health. Elsevier Science.
Herbal weight-loss aids are sold for self-medication and are often used under the delusion that their natural origin ensures their safety. They are not required to conduct any benefit and risk evaluation before marketing (Yousaf et al., 2019). Nevertheless, possible risks of using herbal extracts are becoming more and more frequent in the literature. Some herbs are documented as the leading causes of herb-induced liver injury (HILI), with a potentially lethal clinical course and unexpected herb-drug interactions.
Garcinia cambogia (GC) extract and associated products are some of the most widespread supplements marketed for weight loss. In 2009, the U.S. Food and Drug Administration administered a recall of Hydroxycut products with GC due to its indirect connection to liver failure in several case reports (McCarthy et al., 2020). Although GC was asserted as the assumed cause of the hepatotoxic effects, it has never been banned because of a lack of explicit evidence. Most cases of hepatotoxicity associated with GC have come from mixed supplements or formulaic variations, making defining the causal component of supplement-induced hepatoxicity difficult.
Nevertheless, McCarthy et al. (2020) present a case of a 54-year-old woman coming to her local clinic with acute liver failure that required transplantation after ingesting GC for two months. Her initial complaints included jaundice, malaise, as well as dark urine. The findings were consistent with HILI secondary to GC, given the temporal correlation with the GC ingestion and the absence of other potential causes on serology and clinical history. Additionally, the histopathological traits were consistent with the biopsy results in published GC liver toxicity case reports.
Consequently, despite many consumers considering herbal supplements safe, the concern should be raised to increase public awareness regarding the lack of adequate regulation of supplements. Moreover, healthcare professionals should ask patients with unexplained deranged liver function or acute liver failure about food supplements for accurate diagnosis and clinical management. GC is not the only herbal supplement with possible exacerbations; thus, the matter should be monitored and adequately addressed.
References
McCarthy, R. E., Bowen, D. G., Strasser, S. I., & McKenzie, C. (2020). The dangers of herbal weight loss supplements: A case report of drug-induced liver injury secondary to Garcinia Cambogia ingestion and literature review. Pathology, 53(4), 545-547.
Yousaf, M. N., Chaudhary, F. S., Hodanazari, S. M., & Sittambalam, C. D. (2019). Hepatotoxicity associated with Garcinia cambogia: A case report. World Journal of Hepatology, 11(11), 735.
Participants in human subject studies frequently express concern about the physical, psychological, social, economic, health, and privacy risks brought by the methods and procedures of the research. For instance, subjects often worry about privacy, personal dignity, costs, damage to employability, guilt, health, and other negative consequences that may diminish their opportunities or well-being. Biomedical research is one sensitive field where concerns over who should bear the cost of harm resulting directly from the research are frequent (White, 2020). Participants have also expressed concerns over people authorized to access their data or how researchers will conceal their identity.
The informed consent process can alleviate the concerns because it demonstrates respect for participants and transparency. A consent form is written in a language understood by subjects to eliminate the possibility of coercion or undue influence (Manti & Licari, 2018). Therefore, the information provided to participants during the process allows them to make informed decisions and gain confidence in the research.
The informed consent document is an effective educational tool and a contract. It is based on ethically sound approach, including information on the research risks, to protect the subjects (White, 2020). However, mistrust or unconsciousness about the participants culture and social and economic well-being could trigger a negative response to a researcher. Researchers who appear unfriendly, not hospitable, time poorly, or lack the skills to approach participants properly can also create doubt or concerns over the research. Therefore, researchers should learn about their subjects cultural aspects, welfare, lifestyle, and opinion to determine the best approach.
Assuring participants that their personal information will be protected is a fundamental way to make them believe their rights are protected. It includes making the process transparent by revealing the research benefits, risks, uses of their data, and the freedom to withdraw consent and seek clarification whenever an issue arises (White, 2020). Observing ethical principles during the research also helps assure the subjects their dignity and rights are protected.
The use of information technology in medicine is not new, but in developing countries, it is still at the implementation stage. Lack of specific and professional training programs, as a highlighted weakness, and shortage of human resources and untrained staff, as an external threat factor, have common roots (Arshad et al., 2017). The causes of these problems lie in the general health care system, from education to highly qualified specialists. In challenging crises, the authorities are moving to attract young students to medical universities, as was the case during the pandemic (Torda, 2020). Information technologies provide many opportunities not only for the direct operational activities of doctors but also for educational processes that precede qualifying workfor example, improving specific skills through remote courses or the ability to manually work with an integrated knowledge system, having relevant competencies on the market.
This problem, however, is also observed in developed countries. The U.S. has also been experiencing a long-term shortage of staff, which worsened during the pandemic, even though the countrys healthcare costs are the highest in the world (Zhang et al., 2020). Differences with Pakistan are manifested in the levels of application of information technology, again due to the enormous difference in costs. Nevertheless, implementing promising solutions in the field of education should not be limited only to technological resources; it requires infrastructural intervention from the leadership and even the state. Given that these factors are also included in the weaknesses in Pakistan, they have a long way to go to level the risks of such threats. The United States, in turn, has more opportunities to solve them, but the larger scale creates problems of a different kind, for example, burnout or financial provision of the budget.
References
Arshad, A., Noordin, M. F., & Othman, R. (2017). A synthesis on swot analysis of public sector healthcare knowledge management information systems in Pakistan. Management, 8(8), 130-6.
Torda, A. (2020). How COVID19 has pushed us into a medical education revolution. Internal Medicine Journal, 50(9), 1150-1153. Web.
In the context of the contemporary evidence-based healthcare system, adherence to a healthy lifestyle has become one of the pivotal factors contributing to well-being and longevity. The shift from treatment-based to preventative care allows for minimizing health care costs, losses of human lives, and contributing to the well-being of the population. In this regard, the prevention of the most commonly observed severe disease is rational and obligatory due to the long-term benefits for individuals and healthcare systems. Indeed, one of such prevalent healthcare crises is kidney failure which impacts the lives of multiple people across the globe. The patients suffering from kidney disease include both adults and children, which validates the implementation of specific preventative measures for both these age groups. This proposal emphasizes the problem of kidney failure risks deriving from unhealthy lifestyles to justify the urgent need for healthcare workers and educators to implement educational interventions to tackle the identified problem.
Problem Identification
Kidney failure is one of the most acute and dangerous diseases faced by humanity today. Its prevalence in all countries of the world is characterized by a wide range of populations of different ages, gender, and background. Such a scope of disease prevalence implies its frequent diagnosis and the lack of adequate preventative measures in place. Indeed, the statistical data on kidney failure demonstrates that kidney disease is a public health crisis affecting 37 million people in the U.S., 10,000 of whom are children ( National Kidney Foundation launches online educational program for children, 2021, para. 2). Moreover, the disturbing statistics of this disease prevalence apply not only to the United States of America but also to the overall global community. Indeed, there were 2.618 million people that received renal replacement therapy in 2010, 2.050 million received dialyzes, and the remaining patients received renal transplant (Lv & Zhang, 2019, p. 5). Thus, the scope of the negative outcomes and prevalence of kidney failure demonstrates the urgency of the problem of limited preventative measures.
The burden of the complicated and costly treatment and the threatening outcomes of the disease signifies its severe nature due to the impairment of the renal system, which is one of the vital body systems for survival. Indeed, the epidemiology of kidney failure is characterized by high disability, comorbidity, and mortality rates (Luyckx et al., 2018). Furthermore, due to the diagnosis of kidney failure in both children and adults, it is essential to ensure that the disease is not only treated but also prevented in a timely and efficient manner. In addition, research demonstrates that mere alteration of lifestyle choices and the development of healthy lifestyle habits can minimize the risks of kidney failure (Luyckx et al., 2018; National Kidney Foundation launches online educational program for children, 2021). Therefore, the problem of the lack of preventative measures should be tackled immediately.
The Necessity to Solve the Identified Problem
The identified problem of diminished effectiveness and insufficiency of prevention of kidney failure in children demonstrates the necessity for finding a solution capable of bridging the gap in kidney prevention. Several considerations inform the necessity for the proposed solutions implementation. In particular, the high costs of kidney disease treatment and the scarcity of resources for kidney transplantation due to kidney failure impose a significant burden on healthcare systems. Furthermore, the high mortality rate from kidney failure urges healthcare practitioners, decision-makers, and educators to act proactively. Indeed, statistical research demonstrates that in 2015, 1.2 million people died from kidney failure, an increase of 32% since 2005 (Luyckx et al., 2018, p. 416). Thus, the severe nature of the disease and its tragic outcomes for a large proportion of the population necessitate the implementation of problem-solving practices.
Moreover, the scope of disease spread and impact should be a motivating factor for the decision-makers to implement preventative strategies to tackle the issue of the burden of kidney failure. Indeed, since a large proportion of kidney disease patients are children, it is particularly important to introduce effective preventative measures to minimize the exposure of people to the risks leading to kidney failure ( National Kidney Foundation launches online educational program for children, 2021). Furthermore, the effectiveness of educational efforts as a means of disease prevention implies the availability of resources for the extensive implementation of an educational program for children (Azadi et al., 2021). Similarly, evidence based on recent research studies suggests that the alteration of lifestyle minimizes the risks for kidney disease development (Huang et al., 2019; National Kidney Foundation launches online educational program for Children, 2021). In such a manner, these validations serve as a solid basis for implementing educational lifestyle habits for children as an effective and cost-efficient preventative measure.
Proposed Actions to Alleviate the Problem
The actions proposed for the implementation within the educational program launching will be based on the combination of conventional and digitalized teaching methods. The actions will tackle the development of simple lifestyle habits for children, as well as cultivate their mindful perception of their healthy choices as a contribution to their well-being and longevity. Overall, the lifestyle habits that impact the reduction of risks for kidney failure informed by research will be developed in the participants of the program. The following actions will be initiated:
Engagement of non-profit organizations, health care units, and volunteers for enrolment of participants in the program;
Dissemination of the program goals among schools;
Training of professionals on adequate teaching methods;
Development of childrens habits of regular drinking of quality water ( National Kidney Foundation launches online educational program for children, 2021);
Launching of lectures and discussions about the harms of cigarette smoking in the context of kidney failure (Peng et al., 2019);
Training for a healthy choice of food and maintenance of healthy dieting;
Physical training through in-person classes, media popularization of physical activity, and dissemination of mobile applications for physical activity tracking (Huang et al., 2019);
Lectures and discussions on kidney functions, their healthy state, the development of kidney disease, and the importance of healthy lifestyles for disease prevention.
Justification of the Proposed Solutions and Rationale
Adherence to educational programs as a means of disease prevention has been deemed to be an effective tool in a healthcare setting. Indeed, according to the findings of the research study conducted by Azadi et al. (2021), the implementation of educational practices with individuals through training and information helps minimize the risks of disease development. Indeed, the scholars claim that a persons decision and motivation to adopt a healthy behavior depends on three categories: personal perception, moderating behaviors, and the likelihood of doing that behavior (Azadi et al., 2021, p. 1), since educational programs in general and those introduced early in the life of an individual help shape personal perception and behavioral patterns concerning health and healthy lifestyles. Moreover, educational practices allow for improving the chances for life-long well-being, timely detection, and effective management of diseases. Such evidence on the effectiveness and sustainable application of educational programs for health promotion and disease prevention justify the introduced program for children to minimize their exposure to risks for developing kidney failure.
Moreover, since multiple modifying lifestyle factors might be altered to avoid the development of the disease, it is essential to disseminate the practices for eliminating such factors. According to research, they include cigarette smoking, physical inactivity, obesity, and an unhealthy diet (Peng et al., 2019). Indeed, since modifiable lifestyle risk factors account for 24% of the excess risk of kidney disease, their addressing might help reduce the risks and prevent the disease (Peng et al., 2019, para. 1). Thus, lifestyle alteration is an accessible, simple, and sustainable measure capable of preventing such a severe disease as kidney failure.
Conclusion
In summation, the proposal for the educational program for children aimed at teaching them habits for a healthy lifestyle to prevent kidney failure has been introduced and supported by evidence. The outlined rationale for the proposed solution in the form of a preventative educational program and the urgency of the issue justifies the proposed actions. Overall, the implementation of the suggested program has its benefits due to the cost-efficiency, sustainability, long-term positive outcomes, and accessibility for a large population of prospective participants. Thus, the implementation of the proposed solution is highly recommended for the decision-makers due to its effective impact on the solution to the burden of kidney failure in both adults and children.
References
Azadi, N. A., Ziapour, A., Lebni, J. Y., Irandoost, S. F., Abbas, J., & Chaboksavar, F. (2021). The effect of education based on the health belief model on promoting preventive behaviors of hypertensive disease in staff of the Iran University of Medical Sciences. Archives of Public Health, 79(1), 1-8.
Huang, P. P., Shu, D. H., Su, Z., Luo, S. N., Xu, F. F., & Lin, F. (2019). Association between lifestyle, gender and risk for developing end-stage renal failure in IgA nephropathy: A case-control study within 10 years. Renal Failure, 41(1), 914-920.
Luyckx, V. A., Tonelli, M., & Stanifer, J. W. (2018). The global burden of kidney disease and the sustainable development goals. Bulletin of the World Health Organization, 96(6), 414-422.
Peng, S., Shen, F., Wen, A., Wang, L., Fan, Y., Liu, X., & Liu, H. (2019). Detecting lifestyle risk factors for chronic kidney disease with comorbidities: Association rule mining analysis of web-based survey data. Journal of Medical Internet Research, 21(12), e14204.
The problem of prevention and management is significant among people with prediabetes, especially in underserved populations. The identified practice problem is the increased risk of adult African Americans developing type 2 diabetes following the diagnosis of prediabetes (Cunningham et al., 2018). As many people do not know how to change their lifestyles after being diagnosed with prediabetes, timely education, and support are essential for preventing the development of diabetes, a much more severe condition.
Discussion
The proposed intervention is the diabetes self-management education and support (DSMES) program designed to teach and provide resources for future changes to ones life (Powers et al., 2020). According to Cunningham et al. (2018), DSMES-based solutions lead to decreased hemoglobin A1c levels the identified practice problem. Furthermore, this intervention may improve participants quality of life.
DSMES tools are flexible and numerous, based on the specific needs of the practicum site. However, all standards, curriculum requirements, program elements, and other information is available in the public domain (Cunningham et al., 2018). Teachings for DSMES workshops and meetings are based on dealing with diabetes and its symptoms, which is also accessible in literature and evidence-based practice. Thus, no specific authorization is necessary for implementing this intervention and measuring its effectiveness.
Conclusion
The chosen point of evaluation is the change in hemoglobin A1c levels of the participants before and after the intervention. Therefore, it is not required to use a specific evaluating tool, and only statistical software will be required for completing calculations pertaining to the projects reliability and the results significance. Similarly, the demographic data collected during the project will also not be checked by any specific tool it will only serve as a basis for further statistical analysis. It can be concluded that all information is in the public domain, and authorization for using these data and tools is not required.
Chief nursing officers (CNO) and nurse managers are obligated to allot the necessary funds to provide high-quality care. One of the biggest obstacles for acute care nurses in providing high-quality treatment is staffing (Fowler & Comeaux, 2017). Essentially, it might be challenging to perform nurse staffing obligations, particularly when allocating and dispersing caregivers. The idea of patient acuity is frequently used to calculate staffing ratios. Acuity-based staffing manages the number of nurses on a shift while considering the demands of the patients, such as those who require intensive or minimal care, as opposed to the sheer number of clients (Fowler & Comeaux, 2017). CNOs who choose the acuity-based method now have access to specialized computer gear and software because of current technological advances. CNOs may optimize savings, support improved clinical outcomes, and increase staff satisfaction by factoring acuity into recruitment.
Cost Issues in the Development, Implementation, and Monitoring of Acuity-Based Staffing
The management of essential nurse resources and provision of value-based healthcare is made possible by the acuity-based staffing matrix. However, adopting technology that supports or facilitates such a staffing strategy is expensive. Thus, to generate excellent financial returns, maintain a stable and engaged nursing workforce, and achieve quality patient outcomes, a CNO must continuously manage nurse staffing costs and practice to stay competitive. By focusing on quality outcomes connected to reimbursement and significantly lowering medical errors, the creative and smart staffing model must be sensitive to the changing reimbursement structure of the present healthcare business. Overall, the CNO will keep an eye on all cost concerns to ensure a profitable return on investment while creating, implementing, and monitoring the acuity-based staffing matrix.
Controlling labor expenses and reimbursement concerns are the top two challenges for CNOs in the healthcare industry. The easiest method to achieve these goals is introducing an acuity-based staffing tool when reimbursement shifts to a value-based payment system (Long, 2020). Essentially, this guarantees good patient outcomes while simultaneously ensuring the best possible labor cost savings. Currently, it is even more crucial to alter present personnel methods due to legislative changes like the Affordable Care Act (ACA).
Recruitment and Retention Initiatives for and Costs of Acuity-Based Staffing
The acuity-based staffing matrix makes it accessible, accurate and consistent to plan and manage personnel based on various factors crucial to nursing. A strong nursing workforce dedicated to raising nursing and patient satisfaction scores and avoiding more expensive labor is necessary to recruit and keep. The hospital will put into place a strong nurse residency program for recent nursing graduates in addition to the conventional means of recruitment. The new hires will receive mentoring and support to help them advance their knowledge and experience before being given a merit-based job offer. The same applies to adopting best practices to keep seasoned nurses and optimize their contribution.
The ultimate objective of the CNO and financing officer is to reduce expenses while preserving the quality of healthcare in light of changes in reimbursement caused by the ACA and rising healthcare prices. According to Long (2020), hospital labor is the most expensive component; therefore, reducing the number of nurses on duty is the most straightforward approach to lowering costs. Although this appears positive in terms of the numbers, it ultimately impacts patient outcomes. Negative results happen when there is insufficient staff to offer patients high-quality care. Generally, these undesirable results indicate the caliber of nursing care provided and may influence various aspects of patients lives.
Novel Nursing Leadership Philosophies
Democratic and continuous involvement are the new nursing leadership philosophies that can advance acuity-based staffing. Enhancing nurses autonomy and control over practice fosters a positive workplace atmosphere that enables nurses to provide high-quality, safe patient service and reduces turnover. CNO must promote an environment at work that encourages engagement and involvement. Nursing burnout is often accompanied by a decline in caregivers motivation, which shows itself as emotional tiredness, a loss of enthusiasm, and feelings of dissatisfaction and may lower work efficacy (Mudallal et al., 2017). The developed staffing matrix will aim to lessen workload and personnel scarcity per the democratic or participatory leadership philosophy that is being used. With this change, leaders can plan patient care rounds so that nurses can be present and contribute to facilitating decision-making. Additionally, it will try to specify expectations related to independent practice. Generally, the concept should encourage employees to self-reflect and foster a welcoming setting that promotes ongoing learning.
The Staffing Strategy in Recruiting Licensed Versus Non-Licensed Personnel
The chosen staffing strategy will improve patient outcomes by matching nurses skills and staffing levels to patient acuity. Essentially, the hospital will compare its staffing approachs success or efficacy to that of other facilities. However, more certified nurses should be employed to support the acuity-based staffing paradigm and standardize and improve quality, cost, and safety. Additionally, a sizable number of non-licensed people will be engaged to ensure that the total responsibilities are evenly distributed among the nurses, enhance patient flow, prevent medical errors, and reduce work-related stress. While managing the nurse labor crisis and ensuring satisfaction, the staffing technique that favors a mix of licensed and non-licensed people would significantly cut operational expenditures like overtime and other unforeseen charges.
The Variables that Need Tracking in Implementing the Plan
Monitoring various factors, including nurses experience, patient safety, insight, and patient census, is necessary while implementing the plan. As a result, data must be consolidated to provide information to the leadership and personnel (Long, 2020). The strategy aims to give caregivers the power to alter their working environment and successfully manage the stress caused by the practice setting. Staff attrition is one of the other variables since the plans successful implementation demands a dedicated and reliable workforce. According to Long (2020), the most efficient method for estimating the required number of registered nurses per shift is based on the annual acuity mix and necessary nursing hours to reduce unneeded workload and turnover. Monitoring organizational collaboration, nursing engagement, and financial management are required to ensure that the budgeted cost to implement the plan is not exceeded.
The Anticipated Positive and Negative Patterns in Implementing Acuity-Based Staffing
A staffing matrix based on patient acuity is essential to ensure financial viability, better patient outcomes, and a consistent nurse workforce. Additionally, the model can dramatically improve nursing judgment and expertise while guaranteeing accurate and safe staffing. A technologically integrated strategic nurse staffing plan enables a new level of collaboration between nursing and finance, resulting in effective cost control, patient safety, and value-based patient care. The hospitals ability to manage nursing staff and care quality will increase its ability to compete in the market and maintain its financial viability. In contrast, the framework will probably encounter strong opposition from some employees, which could thwart its deployment or efficacy. Resistance will be reduced through training and incorporating the staff in all phases of the creation, execution, and evaluation of the plan. Finally, given the required resources and time, the matrix will be expensive to execute, but close monitoring guarantees that expenditure stays within the designated budget.
In brief, CNOs should investigate the advantages of acuity-based staffing. Adjusting the workforce following changes in healthcare spending and reimbursement is the greatest strategy to maximize savings while guaranteeing good results. The effects of nurses on optimal services might be either favorable or unfavorable. Caregivers cannot offer their clients the most outstanding care while they are overworked. Therefore, implementing this adjustment may mark a revolution that will enhance both patient outcomes and nurse satisfaction.
References
Fowler, D., & Comeaux, Y. (2017). The legislative role in nurse staffing ratios. MedSurg Nursing, 26(2), 12. Web.
Long, N. (2020). Acuity-based staffing: Improving patient outcomes and staff satisfaction. MSN Capstone Projects, 1-15. Web.
The project explores a preventive solution for developing diabetes from prediabetes in a specific population. The main types of data collected during the investigation are demographic information about the participants and their hemoglobin A1c levels before and after the intervention. Thus, people who are considered participants in the project are adult African Americans who have received a diagnosis of prediabetes and have agreed to take part in the project.
Individuals participating in the program can benefit from the suggested intervention, but they also may encounter some risks related to data gathering. First, the basis of this PICOT is a practice change that improves patients knowledge of diabetes prevention. Furthermore, individuals can gain insight into their health and lifestyle and access helpful apps and other digital resources for tracking their vitals and habits. Therefore, increased awareness about their health, nutrition, and potential ways to prevent diabetes from developing is the main advantage of participating in the project. If the proposed change in practice is successful, the participants may see improvements in their physical health and lower the risk of diabetes. However, as the assignment requires data collection and analysis, participating in the project puts patient data at risk of a privacy breach.
The nurse leading the project will follow certain steps to protect participant data and ensure their privacy and confidentiality. Data collection will be limited to ensure that only the necessary information is gathered using private spaces (Holland & Linvill, 2019). Any potentially identifying data will be available only to the assignment author, and it will be depersonalized for future use during the investigation (Wu et al., 2019). To protect the participants right to privacy and affirm their consent, all individuals taking part in the project will be asked to sign a written consent form (Wu et al., 2019). They will be informed about their ability to withdraw their consent at any project stage. Overall, all information will be used only for this project and stored safely to protect the participants identities.