The process of devising healthcare establishments requires substantial concentration due to the significance of ones surroundings while receiving medical assistance. Expertly designed spaces can positively affect building users well-being and enhance recovery (Gaminiesfahani et al., 2020). It is important to consider the usage of medical machines alongside the therapeutic environment to achieve good patient outcomes (Gaminiesfahani et al., 2020). The proposed birthing center (BC) will incorporate information technology (IT) equipment to assist specialists in providing adequate care while also including creative healing elements to help mothers and their children recover.
Technology, Equipment, and Design Elements
Technology and equipment planned to be employed in the BC involve contemporary devices that would sustain the operation of the facility. First, the BC will need computers, laptops, and other similar gadgets to maintain different procedures. Second, the center will use tools similar to electronic health records to monitor the health history of women and children in the establishment (Reddy et al., 2019). Third, the BC will install software that will assist in making better decisions and reducing potential errors (Reddy et al., 2019). Fourth, the facility will utilize such applications as Zoom to be able to conduct virtual prenatal and postpartum visits, which have become a necessity since the beginning of the COVID-19 pandemic (Davis-Floyd et al., 2020). The listed IT equipment and technology are intended to assist the BCs employees and service users in the long term by examining health history, aiding decision-making, and connecting specialists with patients.
The BC will incorporate design elements to create a healing environment. First, the center will organize a green recreation area where the mothers would be able to rest, thus contributing to their psycho-emotional, physical, and spiritual well-being (Chashchina et al., 2021). Second, the facility will set up several speakers to play certain melodies so that the children will be more comfortable since music has positive effects on newborns and infants (Gaminiesfahani et al., 2020). Third, the BC will prioritize installing bright natural lights, which can benefit people both psychologically and physiologically (Gaminiesfahani et al., 2020). Creative healing elements that the facility plans to utilize are meant to assist women and their children in relaxing.
Community-Based Sustainable Healthcare Facility
Furthermore, the BC will meet the needs of the local community by providing them with adequate care. On the one hand, the recent COVID-19 pandemic has made community birth a more appealing alternative for numerous pregnant individuals (Davis-Floyd et al., 2020). On the other hand, being able to give birth in a safe and sustainable environment can be considered an element of reproductive justice (Julian et al., 2020). Designing a community-based sustainable medical establishment will address the needs of the BCs local community by offering them an opportunity to childbirth in a comfortable setting.
Renovation
If the establishment under examination was a renovation, aspects that would have been done differently concern design improvements that would benefit employees and patients. For example, more windows would have been added to provide access to natural scenery and lighting, which both have positive influences on peoples well-being (Anwar et al., 2020; Gaminiesfahani et al., 2020). Moreover, each area, whether a waiting or inpatient room, would be painted in colors appealing to the human brain and the atmosphere of the given setting (Anwar et al., 2020). Finally, each space would be modernized in accordance with contemporary demands. For instance, translucent buffers would have been placed in visiting areas so that pregnant persons would be able to interact with their relatives but with a reduced risk of transmitting infections (Chashchina et al., 2021). Accordingly, there would not be major changes if the facility were a renovation, yet they would have been oriented toward improvement.
Successes and Challenges
The proposed facility design has presented both successes and challenges. The primary victories were developing a setting where mothers and their newborns would be relaxed during the initial days of childbirth while specialists would be able to work in a comfortable space. Nonetheless, the main difficulties were locating necessary details and finding solutions that would be attainable yet useful. Consequently, what would be done differently to address the identified challenges is starting the search for information earlier to have additional time and utilizing more specific keywords.
References
Anwar, S. R., Firmansyah, R., & Salayanti, S. (2020). Study of interior elements in women and childrens hospital on application of healing environment. Case Study: RSIA Graha Bunda. EProceedings of Art & Design, 7(2), 4375-4381.
Sickle cell anemia is a disorder of the blood that affects the synthesis of red blood cells.
Genetic changes in hemoglobin gene is the causes of sickle cell anemia (Sahoo, 2020).
The shape of red blood cells changes from the normal biconcave shape to the abnormal crescent moon shape.
The change in the shape of red blood cells affects their functions of transporting oxygen in the blood vessels.
Sickle-shaped red blood cells have a reduced capacity to carry oxygen and experience inflexible and sticky movement in the blood vessels (Yuruva et al., 2020).
As a genetic disorder, sickle cell anemia manifests at the age of six months and gets worse with age, resulting in reduced life expectancy to 40 to 60 years.
Treatments and management interventions improve the life span of individuals with sickle cell anemia.
Population Affected Sickle Cell Anemia
Across the world, sickle cell anemia is prevalent among babies, children and young adults in most countries.
The proportions babies with sickle cell anemia is similar in males (50%) and females (50%) since the mutation occurs in somatic genes.
The average age of diagnosis is 2 years for males and 4 years for females (Ceglie et al., 2019).
More males experience severe crisis (68%) than females (32%) due to hormonal differences.
The mean age of deaths of females (48 years) is higher than that of males (42 years) (Ceglie et al., 2019).
The mortality rates varies across the age as 68% (0-3 years), 39% (4-9 years), and 24% (10-14 years) (Centers for Disease Control and Prevention, 2020).
With poor treatment and management interventions, 50%-90% of children die before they attain the age of five (1-5 years).
Globally, about 300,000 cases of sickle cell anemia among babies occur with 80% of them being Africans (Cisneros & Thein, 2020).
In the United States, the healthcare system registers 100,000 cases of babies with sickle cell anemia, with major occurrences among African Americans (0.3%) followed by American Hispanics (0.006%), while Asians and Indians have minimal proportions of less than 0.001% (Centers for Disease Control and Prevention, 2020).
About 8% of African-American babies have sickle cell trait (Centers for Disease Control and Prevention, 2020).
In Africa, the prevalence of sickle cell trait among babies is between 10% and 45%, with the highest rates in Nigeria of the disease (2-3%).
The analysis of the distribution shows that sickle cell anemia is common in tropical regions, such as Middle East, sub-Saharan, and Asia, where malaria is endemic.
Projections indicate that migration would increase the prevalence of sickle cell anemia to about 14 million cases by 2050.
People who live in malaria endemic regions are susceptible to sickle cell anemia because homozygous trait do not have adaptive advantage.
Causes of Sickle Cell Anemia
A genetic change is the cause of sickle cell anemia among individuals. A single nucleotide substitution that changes the codon from GAG to GUG at the sixth position causes sickle cell anemia (Sahoo, 2020).
This form of substitution arises on the coding sequence of the beta-hemoglobin chain situated in the short arm of chromosome 11.
The resulting change in an amino acid is the substitution of glutamate in the acidic class, with valine in the aliphatic class (E6V).
The coded protein by the mutated gene polymerizes and triggers changes in red blood cell shape from a biconcave into a crescent conformation (Cisneros & Thein, 2020).
The inheritance of the mutant gene from parents follows the autosomal recessive pattern.
Signs and Symptoms of Sickle Cell Anemia
Signs and symptoms of sickle cell anemia become evident during childhood and present diverse acute and chronic problems, which vary from one person to another.
Sickle cell crisis characterized by acute anemia is one of the major signs and symptoms of sickle cell anemia.
A vaso-occlusive crisis occurs due to obstruction of capillaries, resulting in pain, necrosis, and ischemia (Meier et al., 2018).
Splenomegaly originates from the sequestration of red blood cells in the spleen and obstructed capillaries. Fever, chest pain, and pulmonary infiltrate contribute to acute chest syndrome (Sahoo, 2020).
Fatigue, high heart rate, and pallor stem from aplastic crisis and anemic conditions, which affects uptake and distribution of oxygen in tissues
Ultimately, a hemolytic crisis happens due to the affected synthesis of red blood cells.
Body Parts Affected by Sickle Cell Anemia
The primary part of the body affected by sickle cell anemia is the blood tissue, particularly the red blood cells.
Since red blood cells play a key role in the transportation of oxygen in the body, sickle cell anemia reduces the capacity and respiration rate in tissues (Sahoo, 2020).
Sickle cell anemia also affects the efficiency of the circulatory system due to the obstruction and slow flow of blood in the body by the abnormal cells.
Since ischemic stroke is one of the consequences of sickle cell anemia, it stems from obstructed supply of blood to the brain (Yuruva et al., 2020).
A restricted circulation of blood resists the lungs and causes pulmonary hypertension.
Liver and spleen are affected due to sequestration of red blood cells and hemolytic crisis in the metabolic processes.
What is Used to Diagnose Sickle Cell Anemia
Numerous methods are effective in the diagnosis of sickle cell anemia among individuals across ages.
A complete blood count checks the level of hemoglobin if lower than the normal level (Sahoo, 2020).
Moreover, this method also evaluates if reticulocytes are higher than normal threshold.
Sickle solubility test using sodium metabisulfite to differentiate hemoglobin S from A by the formation of a precipitate due to polymerization of sickle-shaped red blood cells (Meier et al., 2018).
High-performance liquid chromatography identifies different forms of hemoglobin, such as A, F, S, C, D, and E (Sahoo, 2020).
Hemoglobin electrophoresis and isoelectric focusing are two methods commonly used to diagnose sickle cell anemia (Sahoo 2).
Genetic screening to establish the existence of mutation in the hemoglobin gene is done on a fetus, baby, or adult (Yuruva et al., 2020).
How Diagnosis is Made
The procedure of diagnosis varies according to the sample used and the age of individuals.
For unborn babies, genetic screening is effective in the diagnosis of sickle cell anemia because it identifies mutations (Meier et al., 2018).
A doctor removes a sample of amniotic fluid from a pregnant woman and uses it in genetic screening.
The procedure entails the isolation of genomic DNA, amplification of the hemoglobin gene, and sequencing to identify substitution at the sixth codon position (Sahoo, 2020).
In adults, a sample of blood is subjected to high-performance liquid chromatography.
High-performance liquid chromatography differentiates different forms of hemoglobin in red blood cells (Sahoo, 2020).
The analysis of chromatogram peaks would reveal the type of hemoglobin in blood.
Red blood cells with sickle cell anemia would show a chromatogram peak of hemoglobin S.
Treatment for Sickle Cell Anemia
Chemotherapy is one of the effective treatments of sickle cell anemia.
Some medications are folic acid to boost hemoglobin level, analgesics to relieve pain, penicillin to prevent pneumonia, and malaria prophylaxis to reduce susceptibility (Provenzano et al., 2018).
Patients with chronic symptoms require administration of hydroxyurea to stimulate fetal hemoglobin and prevent vaso-occlusive crisis (Sahoo, 2020).
Blood transfusion is necessary to increase hemoglobin level in severe anemia, prevent stroke, and alleviate acute chest syndrome (Provenzano et al., 2018).
Gene therapy using CRISPR-Cas9, gamma-globin gene transfer, lentivirus short hairpin RNA, lentiglobin bb305, and bone marrow transplant are effective in the modification of hemoglobin genotypes to correct the target mutation (Cisneros & Thein, 2020).
Interesting Facts: Prognosis
The efficacy of treatment varies from one person to another and according to treatment and management interventions.
Approximately 90% of people with sickle cell anemia attain the age of 20 years (Meier et al., 2018).
Moreover, over 50% of patients survive beyond 50 years when provided with appropriate treatment (Provenzano et al., 2018).
The expected life span of people with sickle cell anemia is between 40 and 60 years (Yaruva et al., 2020).
However, advancements in treatments, such as gene editing and bone marrow transplantation, offer a promising cure for sickle cell anemia.
Historic Importance of Sickle Cell Anemia
The history of sickle cell anemia dates back to 1910 when doctors discovered it in the United States and Africa and abbreviated it as SCD.
Ernest Edwards Irons observed red blood cells and become the first person to describe them as having sickle-shaped cells (Yuruva et al., 2020).
In 1952, doctors in India discovered it among people who lived in the Deccan plateau (Yuruva et al., 2020).
In the late 21st century, the prevalence of sickle cell anemia was high among African Americans with a mortality rate of 1.5%.
Sickle cell anemia was prevalent in tropical regions, namely, the Mediterranean region, sub-Saharan Africa, the Middle Eastern region, and India, where malaria was endemic due to adaptive advantages (Cisneros & Thein, 2020).
Meier, E. M., Abraham, A., & Fasano, R. M. (2018). Sickle cell disease and hematopoietic stem cell transplantation. Springer.
Provenzano, R., Lerma, E. V., & Szczech, L. (2018). Management of anemia: A comprehensive guide for clinicians. Springer.
Sahoo, S. R. (2020). Sickle cell anemia: A brief synopsis. Journal of Genetic Syndromes and Gene Therapy, 11(2), 1-2. Web.
Yeruva, S., Varalakshmi, M. S., Gowtham, B. P., Chandana, Y. H., & Prasad, P. E. (2020). Sickle cell disease: A comprehensive study and usage of technology for diagnosis. International Blood Research and Reviews, 11(2), 6-14. Web.
Management entails the processes and practices that enable an organization to attain its goals efficiently and effectively. It is focused on the day-to-day nursing operations, such as staffing, performance, budgeting, and resource allocation. Alban-Metcalfe and Alimo-Metcalfe (2018) state that effective nursing management provides leadership and direction to guarantee high-quality patient care. Various theories define management practice by enabling managers to understand organizational behaviors complexities better, identify critical factors influencing organizational performance, and develop strategies to improve organizational effectiveness. This paper covers a reflection on the human relations management theory. It is based on individual development goals aligned to the NHSs nine dimensions of leadership behavior. The objectives define the action plans to enable safe and effective nursing care management, which is pertinent to the mental health nursing practice.
Management Theories and Relevance to Mental Health Nursing
Management practice has attracted the development of theories prescribed to help managers make effective decisions. The theories provide a framework for understanding and analyzing the varied aspects of management, including the behavior of managers, employees, and organizations. According to Blstakova and Palencarova (2021), human relations management theory focuses on effective communication, collaboration, and teamwork in achieving organizational goals and objectives. The approach recognizes the importance of human resources in an organization and suggests that managing people effectively is crucial for organizational success ( Yuin et al., 2021). In the context of mental health nursing, human relations management theory supports the need for nurses to be dealt with as impeccable healthcare team members (Apen et al., 2021). Belrhiti et al. (2018) state that a nursing manager ought to recognize and appreciate the teams contributions and push for positive relations between nurses, patients, and other healthcare professionals for improved quality of care. The approach helps to encourage collaboration across professional boundaries, especially in complex mental health cases that may require a team involving psychiatrists, social workers, and occupational therapists.
Management Developmental Needs and Internal and External Drivers
In the United Kingdom, healthcare services are managed under the National Health Service (NHS). In 2013, the NHS developed the NHS Healthcare Leadership Model (HLM) that guides healthcare leaders in practice ( Davidson et al., 2020). The model creates a vision for leadership, which mirrors the best in care and compassion, one of the values proposed by the NHS. The HLM advocates for healthcare managers to prioritize the needs of patients and staff, seek feedback, collaborate with others, manage resources efficiently, delegate responsibilities, and embrace innovation (Patient Safety Learning, 2019). These leadership principles set the stage for driving positive change and improving the quality of healthcare services. It also empowers managers to organize their actions in handling external and internal factors influencing service delivery ( Matsumoto, 2019). The fundamental external forces that leadership must ponder include changes in regulations, technological innovations and improvements, or competitive forces. In contrast, internal factors include leadership and management style, organizational culture, and employee engagement.
The HLM contains nine dimensions of leadership that aim to build capacity to enable people to meet future challenges. Kline (2019) states that the dimensions enhance individual and organizational learning by acting as role models for personal development. Therefore, the nine dimensions encompass the development needs to guide my selection of the goals. Each dimension is measured using a four-part scale: essential proficient strong exemplary. I desire to attain the exemplary level for all the dimensions to become a better manager in mental health nursing.
Application of Management Development Goals and Critical Evaluation of Progress
Goal 1: Shared Purpose
Every nurse manager should be able to develop insight and apply the elements of the HLM model. As a mental health nursing practitioner, the model provides a powerful challenge for an aspiring manager. It forms the basis as I consider what to do and the upshot in the team, organization, and patients. Fennell, K. L. (2021) argues that collaboration and teamwork are integral in meeting the shared purpose and value of working together for patients, as proposed by the NHS. In mental health nursing, I realized that I have a strength in collaboration and pushing for the common goal of improved health outcomes in the local communities. Since collaboration is a significant value, I felt the need to ensure I continually develop my capacity to work with others.
My desire to choose shared purpose as one of my development goals is also centered on inspiring a team to work towards a joint objective or objectives. Drawing upon my reflection when working on a patient, I realized that the fundamental issue for the leader could help the team identify shared purposes. Even though I have the strength to hold to principles and values under pressure, in becoming a competent manager, I aim to have the courage to face and deal with challenges for the benefit of the service. According to Monkhouse et al. (2018), development can be facilitated by engaging in a few strategies, such as having a team ideology of care that each team member should support. The shared purpose can be further supported by developing mission and vision statements and having frequent multidisciplinary team discussions ( Thusini & Mingay, 2019; Xiao et al., 2022). The goal further underscores a fundamental quality of being a competent leader, which entails setting an example in leading the team on proper ways of acting toward each other and the patients.
Goal 2: Evaluating Information
Evaluating information is an integral component of mental health nursing. It facilitates accurate diagnosis, treatment planning, risk assessment, communication, and evaluation of progress. Therefore, information empowers nurses to make informed decisions and provide effective patient care (Sipe & Testa, 2020). It is also aligned with the NHS value of improving the lives of patients and communities by providing the best possible care and promoting health and well-being ( Streeton et al., 2021). I appreciate that technology has made information freely available and can be accessed easily from multiple sources. I chose this dimension as part of my development goals because I have had a weakness in leveraging information to critically evaluate the latest research and evidence-based practices to provide the best possible care.
Information has become part of humanitys everyday existence and is even more at the workplace. However, I noted that information could be a best friend and worst enemy while attending to my duties. I came to appreciate the need for information when working on a patient whose mental health had been affected by engaging in substance abuse. Cook (2018) states that information should be correctly received, processed, and understood, a decision made and an action taken. I desire to make information highly beneficial in informing the appropriate action for a patient after it has been appropriately evaluated. In such a way, it will facilitate thinking in an informed way on formulating proposals for improvement. It will be able to safely and effectively lead and manage the nursing care of a group of people (Sze et al., 2021). I will also enhance my integrity and competency in prioritizing the needs of patients and focusing on delivering high-quality care.
Goal 3: Inclusive Leadership
Inclusive leadership is a critical quality any competent manager must expose. Malila et al. (2018) state that inclusive leadership involves engaging diverse viewpoints to drive high-quality care. I remember the day we were asked to give our views on a new technology that needed to be introduced to enhance service delivery. I realized that partners could collectively move through an iterative process, from identifying an issue and developing an action plan to addressing the issue. The process enables nurses to collaborate in executing the needed action and evaluating the response (Neal-Boylan & Miller, 2020; Nikpour et al., 2022). Therefore, I desired to develop my approach to inclusive leadership to collaborate in implementing care that has meaningful social and health impacts. This emerged as I participated in a community initiative that provided a distinctive opening to see the benefit of building trust. Inclusive leadership provides a unique understanding of the communitys health needs that should be determined and raised to promote health equity.
Conclusion
Nursing management entails the day-to-day actions that must be undertaken to drive an organization. The human relations theory emphasizes the need for the manager to collaborate and work with teams for enhanced quality of care. The NHS developed the HLM model to help nursing managers to have a vision for excellence. It proposes nine dimensions, out of which three informed my development goals. Having a shared purpose encourages working together in teams, including different healthcare professionals. Evaluating information is a goal I desire to meet to ensure the information available is best applied to deliver safe and efficient care. Finally, inclusive leadership works best in promoting the health needs of a community and brings practical touch to mental health nursing.
Apen, L. V., Rosenblum, R., Solvason, N., & Chan, G. K. (2021). Nursing academic leadership. Nursing Education Perspectives, Publish Ahead of Print. Web.
Sze, G. W., Yuin, Y. S., Durganaudu, H., Pillai, N., Yap, C. G., & Jahan, N. K. (2021). Narrative review of leadership development programs among medical professionals. OALib, 08(06), 112. Web.
Yuin, Y. S., Sze, G. W., Durganaudu, H., Pillai, N., Yap, C. G., & Jahan, N. K. (2021). Review of leadership enhancement strategies in healthcare settings. OALib, 08(06), 114. Web.
The supervisor at Leahi Hospital is a highly educated and experienced social worker with a Master of Social Work degree from the University of Hawaii. She received a Bachelor of Arts in Psychology from the same university in 2010. She has over ten years of professional experience in healthcare, non-profit organizations, and government institutions. The supervisor understands the complex challenges patients and families encounter in healthcare settings. She has worked as a social worker at Leahi Hospital since 2014, as a case manager for a non-profit, and as a social worker for the State of Hawaii.
Discussion
The supervisors primary job title as a social worker at Leahi Hospital is Clinical Social Worker. In her job, she delivers various services to patients and their families, such as psychological assessments, counseling, and referrals to other resources. She collaborates extensively with interdisciplinary teams to design treatment programs and advocate for her patients needs. Some of her primary tasks as a Clinical Social Worker at Leahi Hospital include performing biopsychosocial examinations of patients, assessing their needs, and devising and implementing treatment programs. She also provides patients with individual and group counseling, information, and assistance to their families. The supervisor is responsible for providing appropriate referrals to community resources and coordinating discharge plans to ensure patients return to their homes or other care settings smoothly.
In addition, the supervisor provides crisis intervention and aids in the resolution of patient and family issues. She collaborates closely with doctors, nurses, and other healthcare professionals to ensure patients receive excellent treatment and meet their needs and rights. She is in charge of thoroughly assessing patients psychosocial needs, including identifying any social, economic, or cultural hurdles to their health results. The supervisor also assists patients in locating community support networks and resources such as housing assistance, financial assistance, and transportation options.
Conclusion
The supervisor is a social worker at Leahi Hospital who is dedicated to improving the lives of patients and their families. Because of her extensive training and expertise and her commitment to patient-centered care, she is a vital healthcare team member. Therefore, the supervisor is a highly certified social worker with substantial hospital experience. At Leahi Hospital, she provides various services to patients and their families, including assessments, counseling, referrals, and advocacy.
This experiment aimed to find out how drinking more water each day affected my energy levels, general health, and bathroom habits. I drank eight 8-ounce glasses of water daily for three days, and information about their daily water intake, energy levels, and bathroom habits was gathered. The subject experienced bloating and an increased desire to use the restroom due to the increased water intake, but the results also showed that the individual felt more alert and active. According to the evidence, increased water consumption may increase energy levels but also have unfavorable side effects. In conclusion, consuming the necessary amount of water daily may help people feel healthier and more in tune with their bodies. Nevertheless, people should be mindful of potential negative consequences, such as bloating and increased urination.
Introduction
The Healthier You experiment aimed to see how my body reacts to adjusting ones water intake to live a healthier lifestyle. Adequate hydration is necessary for overall health and well-being, but it is also important to understand how the body reacts to changes in water intake. According to previous research, enough hydration is required to maintain a healthy metabolism, manage body temperature, and promote digestion (Healthdirect, 2021). Water overdoses, on the other hand, might result in bloating and excessive urination. The Healthier You experiment aims to contribute to this knowledge by providing first-hand knowledge and information on how the body reacts to drinking more water.
Material and Method
Materials
64 oz water bottle
Notebook and pen for recording observations
Bathroom scale
Measuring tape
Water bottle
Measuring cup
Methods
I increased my daily water intake to eight eight-ounce glasses over three days.
I recorded my views and thoughts throughout the day in a notebook.
I measured my water intake precisely by using a measuring cup.
The time and volume of water consumed and any physical responses to the increased water consumption were noted in the notebook along with other raw data and observations.
Calculations were done to establish the total amount of water drunk each day.
The entire amount of water consumed over three days was represented on a graph.
Lab Notes
Day 1
Drank eight glasses of water throughout the day, totaling 64 oz.
Felt more alert and energetic.
I noticed some bloating and had to use the bathroom more frequently.
Urination time increased slightly but still within a reasonable range.
Day 2
Drank eight glasses of water throughout the day, totaling 64 oz.
Felt less bloated than yesterday.
I still needed to use the bathroom more frequently.
Urination time increased slightly again, but still within a reasonable range.
Day 3
Drank eight glasses of water throughout the day, totaling 64 oz.
Felt fully adjusted to the increased water intake.
No longer experienced bloating or excessive bathroom use.
Urination time remained slightly higher than normal but still within a reasonable range.
Observations
I consistently drank eight 8-ounce glasses of water daily, making them feel more awake and active. Yet they also felt slightly bloated and needed to go to the bathroom more frequently. Each day, the amount of time required to urinate grew slightly longer, but overall, it was still within acceptable limits. According to the statistics, drinking more water may cause short-term weight loss and a reduction in waist circumference.
Results
According to the experiments final findings, I consistently drank eight 8-ounce glasses of water daily for three days. Each day, 64 ounces of water were drunk in total. I increased water intake made them feel more alert and energetic, but they also felt bloated and had to go to the bathroom more frequently. Each day, the amount of time spent urinating increased somewhat, although it was still within acceptable limits.
Therefore, a line graph displayed the daily water intake during the trial. The graph is labeled with the number of 8-ounce glasses of water consumed daily on the y-axis and the experiments days (Days 1, 2, and 3) on the x-axis. Each data point is marked with the number of glasses of water the person drank that day. The graph displays a flat line at 64 oz for every day, demonstrating that the participant regularly drank the recommended volume of water daily.
Table 1: The number of 8 oz glasses of water consumed by the participant each day of the experiment
Day
Number of 8 oz Glasses of Water Consumed
1
8
2
8
2
8
Figure 1: Graph Showing Consistent Daily Water Intake Across the Experiment
Discussion
The Healthier You experiment aimed to ascertain how drinking more water would affect my body over three days. The emphasis was on healthily altering lifestyles and watching how my body responded (Centers for Disease Control and Prevention, 2022). The modification was to raise daily water consumption to eight 8-ounce glasses, a usual hydration recommendation. During the three days, I kept track of my progress, recording the time and amount of water I drank, how I felt, and any changes to my energy levels, digestion, and bathroom routines. The information revealed that I regularly drank the advised amount of water daily and felt more energized and aware. However, I felt bloated and wanted to use the restroom more frequently.
The experiment results are consistent with prior research on the benefits of drinking water for general health and well-being. Enough hydration is required for the body to function optimally. These functions include aiding digestion, maintaining a healthy metabolism, and regulating body temperature. But, as I experienced, drinking too much water too quickly might produce bloating and frequent urination (Healthdirect, 2021). It is critical to remember to keep track of your water intake throughout the day and to avoid drinking too much at once. The experiment lasted three days, which may not have been enough to analyze the long-term effects of increased water intake adequately. The participants individual physiology and lifestyle traits could have influenced the results. In the future, it may be good to extend the experiment and include more volunteers to account for individual differences to enhance the results.
This experiment serves as a reminder that small, healthy lifestyle adjustments can greatly influence our overall health and well-being. Individuals need to listen to their bodies and watch how they react to these changes to ensure they make positive, long-term choices. Increased water consumption, such as greater energy and improved cognitive performance, can benefit the body. Nonetheless, managing water consumption and avoiding overconsumption is critical, which can have significant health repercussions. The experiment revealed that increasing water intake to eight glasses of eight oz per day improved participants alertness and energy levels. However, there were some negative effects, such as bloating and increased urine frequency. Generally, the experiment shows proper hydration is important for general health and well-being.
The United Arab Emirates is a fast-evolving country with outstanding resources and opportunities for becoming one of the leading nations at the international level. The health of the nation is viewed as one of the main priorities as it ensures the improved well-being of all citizens and their ability to contribute to the emergency development of the state. Emergency medical services (EMS) are viewed as an essential component of the healthcare sector vital for responding to critical situations and providing care to patients in need.
The UAE Brief Overview
The United Arab Emirates (UAE) is a country situated in the Southeast of the Arabian Peninsula. The state emerged in December 1971 as the federation of the six emirates: Abu Dhabi, Sharjah, Dubai, Ajman, Umm Al-Quwain, and Fujairah (About the UAE, 2022). In 1972 the seventh emirate, Ras AL Khaimah, joined the union, and the UAE became the federation of the seven emirates (About the UAE, 2022). Today, it is one of the most potent nations of the Gulf region, influencing its development, policy, and economy. The UAE has the second-largest economy in the Middle East, with a GDP of around $427.9 billion (About the UAE, 2022). It means the state can invest in new projects and support their development.
Prehospital care in the country is given much attention, but emergency medicine is nowadays in the developing phase. Nowadays, the UAEs healthcare sector lacks uniform medical control or treatment protocols, systems management, training, education, and quality assurance policies (Sasser, Gibbs and Blackwell, 2009). This means that care providers might be limited in their attempts to assist patients. The UAE Ministry of Health (MOH) focuses on improving the infrastructure and the overall health delivery system to meet the growing populations needs (Sasser, Gibbs and Blackwell, 2009). Moreover, medical education is also supported as the country has only three medical schools preparing demanded specialists (Fares et al., 2014). In such a way, prehospital care is still developing under the influence of the governments efforts to improve the nations health.
EMS Organizations
Emergency medicine in the UAE is represented by two public organizations, the National Ambulance and the Dubai Corporation for Ambulance Services (DCAS). However, emergency medicine was not viewed as a distinct specialty within the UAE, which resulted in the absence of formal training for residents, problematic certifications, and trauma systems (Fares et al., 2014). In 2012, a group of emergency physicians created the Emirates Society of Emergency Medicine (ESEM), focusing on developing high standards of this practice and connecting all emergency medicine providers across the UAE (Fares et al., 2014). It promoted the standardization of approaches and increased attention to paramedic training as a part of a new environment. Thus, the National Ambulance and DCAS operate within this network and play a critical role in delivering this sort of care to all patients within the UAE and meeting their needs.
DCAS emerged in Dubai in 1977 as a specialized government agency. It is focused on providing multiple ambulance and emergency services to all representatives of the Dubai community (History of DCAS, 2022). It performs a wide variety of functions, such as planning the delivery of ambulance services to citizens, private training, treating patients, and assisting them in recovery. In general, the agency outlines 11 primary tasks that should be performed, making DCAS a vital part of UAE emergency medicine (History of DCAS, 2022). However, because of the peculiarities of its functioning, DCAS mainly covers the area of Dubai, offering transport services for patients and facilities operating within and outside the Emirate (History of DCAS, 2022). It is characterized by the stable development and increased attention to preparing specialists and developing infrastructure, making DCAS an important part of the UAE healthcare system.
DCAS was initially part of the police and ensured the provision of necessary services to all citizens in need. However, the further evolution of the state, its fundamental institutions, and the healthcare sector outlined the need for creating an independent agency with a similar scope of tasks (History of DCAS, 2022). For this reason, DCAS became an independent government entity with the medical dispatch operated by the Police Department of Dubai. Specialists are represented by trained medical technicians, paramedics, and qualified staff (History of DCAS, 2022). For this reason, DCAS remains successful in assisting citizens in coping with difficult cases and situations.
The National Ambulance is the second largest organization responsible for providing emergency care in the UAE. The organization was established in 2010 to ensure all citizens have access to high-quality prehospital services and benefit from improved well-being (About us, 2021). The National Ambulance woks both in the government and private sectors and functions regarding the international standards using innovative technology and implementing the recent advances of evidence-based practices into real life (About us, 2021). The agency is supported by an advanced fleet of vehicles, which allows it to respond to all emergency calls and work in close coordination with other healthcare agencies (About us, 2021). Correctly realizing the importance of this organization, the government devotes much attention to financing and innovating this service to ensure its stable work and growth.
Altogether, both these organizations perform the important function of providing clients with emergency care. They are available to citizens of the UAE who are in need or who experience severe health problems (About us, 2021). DCAS and the National Ambulance can be contacted by calling 999 or 998 in case of an emergency (About us, 2021). At the same time, people can also ask for a hospital-to-hospital transfer, transfer to home, make an appointment or ask for a consultation or help (About us, 2021). The given two establishments also evolve regarding the network established by ESEM and the incentives for improving the healthcare sector and care delivery.
Costs and Insurance
The UAE also has a specific approach to insurance and treatment costs. Following the existing regulations, health care is offered free of charge to all UAE nationals, including emergency cases (Sasser, Gibbs and Blackwell, 2009). It means that all public hospitals in the country treat all cases without any additional payment, except for some emergencies (Fares et al., 2014). As for the private hospitals, they require upfront payment to work with clients (Fares et al., 2014). However, expatriates cannot benefit from the free services as the government does not subsidize this aspect, and they are expected to pay for treatment (Sasser, Gibbs and Blackwell, 2009). At the same time, there are incentives and proposals to initiate an insurance program for both nationals and expatriates to guarantee they can acquire all needed services (Sasser, Gibbs and Blackwell, 2009). In such a way, the existing system is specific and continues to evolve.
Emiratization
The UAE also conducts the Emiratization policy focusing on increasing the role of nationals in various spheres. For healthcare, it means that the government encourages the UAE citizens to work in this field and contribute to the sectors development. It is one of the long-standing priorities as it will guarantee a sufficient supply of specialists coming from the state and needed to meet the growing demand (SEHA, 2022). The major barriers include the lengthy academic years of study, the nature of work after graduation, and the high responsibility (SEHA, 2022). However, as part of Emiratization policy, the government creates new infrastructure objects, learning facilities and focuses on making the position of health workers more attractive for individuals (SEHA, 2022). It results in a stable growth in the number of UAE nationals working in the sphere.
The Emiratis position in the healthcare and in the emergency sector is specific. Due to the focus on creating the developed infrastructure and engaging nationals in the work of these facilities, all Emiratis work at the level of paramedics, advanced paramedics, and other trained and skilled specialists (Fares et al., 2014). It can be viewed as the result of the governmental policy aimed at preparing medics who can contribute to the development of the sector and guarantee its stable growth (Fares et al., 2014). Additionally, they are motivated to take part in the training or programs focused on improving skills and preparedness levels among staff (SEHA, 2022). In such a way, Emiratis play an important role in the functioning of the UAE healthcare sector and emergency sphere.
People from other nationalities are also represented in the UAE emergency facilities. However, they play other roles and have different responsibilities. In accordance with the recent statistics, expatriates such as Indians, the Philippines, Egyptians, and Jordanians mainly work as emergency medical technicians and also contribute to the development of the sector (Sasser, Gibbs and Blackwell, 2009). Most of them were qualified outside the UAE, in their own countries as a nurse or EMT specialists (Fares et al., 2014). For this reason, they do not occupy positions of advanced paramedics and work in teams headed by UAE nationals (SEHA, 2022). This system provides much space for citizens to engage in the work of the sphere and make a career.
Vehicles
Finally, the emergency sphere has a sufficient supply of vehicles needed to perform its central functions. About 80% of the ambulances are fully equipped and characterized as ALS/Type 3 vehicles (Fares et al., 2014). The agencies also use fast responder units, motorcycles, intensive care units, helicopters, and bus-based mobile hospitals for serious accidents involving numerous victims (Fares et al., 2014). Ambulance vehicles are driven by specially trained ambulance drivers at DCAS, while the National Ambulance also has the demanded supply of specialists (Fares et al., 2014). The government ensures the existing facilities have the needed number of cars to transport patients.
Conclusion
Altogether, the emergency service in the UAE is in the development stage. It benefits from the governmental attempts to create a potent healthcare sector and improve the nations health. For this reason, the are numerous attempts to involve more nationals in the work of the emergency teams. The free provision of services to nationals and the plans to create insurance programs for expatriates also influence the work of the sector and its future. The establishment of new standards of practice, new methods, and procedures creates the basis for future improvement.
Sasser, S., Gibbs, M. and Blackwell, T. (2009) Prehospital emergency care in Abu Dhabi, United Arab Emirates, Prehospital Emergency Care, 8(1), pp. 51-57.
In this presentation, the topic of diagnostic errors will be overviewed. Diagnostic errors have an extremely negative impact on medical practice and the wellness of patients. As such, the topic is worth discussing in detail. The existence and quality of clinical judgement in regards to diagnostic errors will be overlooked first, then advancing to the question of policy. At the same time, this presentation will also touch upon the ways in which diagnostic errors impact quality improvement. Lastly, the interaction between workplace communication and diagnostics will also be touched upon.
Overview of the Issue
Diagnostic errors, which can alternatively be called a misdiagnosis, are a problem where medical professionals access the symptoms of a patient and make an incorrect diagnosis. In this case, a condition that actually affects the patient can end up neglected, impacting their health and wellbeing. Similarly, diagnostic errors can occur when the doctor interprets symptoms incorrectly. The process of diagnosing a health condition is complex, and errors can be made on all levels of the assessment. In some cases, errors can be made because of poor management, communication, or insufficient preparedness. The prevention and correction of diagnostic errors therefore becomes the primary goal of medical professionals, where the overall wellness and health of patients depends on their work competence.
Impact on Clinical Judgment
Clinical judgment can be identified as a process of deduction and analysis that helps medical professionals make correct decisions. Such skills are used by doctors and nurses even without their explicit intention, as a tool to understand and diagnose symptoms of their patient. Clinical judgment affects the types of symptoms a medical professional considers to be important, which classification they use, and the final decision they come to in the end. In the end, the diagnostic process largely depends not on the facts of a patients condition, but a physicians interpretation of these facts (Kliegman et al., 2017).
Common disorders and diseases are much more frequently diagnosed than rare ones, which can contribute to the problem of making incorrect diagnoses (Kliegman et al., 2017). Medical statistics, presentation of diseases and previous work experiences of a person all contribute to their professional accessment. Additionally, some common afflictions can present in unexpected ways, making the process of identification more difficult. Both clinical judgment and diagnostic errors are interconnected issues. Poor clinical judgment can lead to incorrect assumptions about a patient condition, while a misdiagnosis can contribute to false clinical assumptions. Therefore, it is crucial that medical professionals utilize their best clinical judgment in the process of analysis.
Current Health Initiatives
Diagnostic errors are an inevitable and unfortunate part of the healthcare delivery process. With the progression of the medical profession, the amount of medical errors reduces, but completely eliminating them out of the procedure is beyond the scope of the current health systems (Kliegman et al., 2017). Due to the need to involve human logic and reasoning in the medical appraisal process, there are no concrete ways of getting rid of mistakes. Human errors persistently exists as a facet of healthcare delivery. However, there are particular methods for reducing the impact of human error or its chances of occurrence. Medical researchers note that systematic improvement is the only way to ensure that the amount of errors is minimized.
Overall, there are a number of possible improvements to the healthcare delivery process that can contribute to less erroneous diagnoses. Firstly, the involvement of multiple healthcare professionals can serve as a safety net in case of mistakes (Graber et al., 2002). Another doctor offering a second opinion can be used as an insurance mechanic or a method of protecting patient health. Furthermore, the use of new technology in decision making, and the inclusion of proper support systems can also be especially effective (Graber et al., 2002). With the ability of current tech to identify symptoms of common afflictions and offer information, the procedure of making a prognosis becomes more streamlined and controlled. Furthermore, involvement of medical specialists and good medical professionals in the clinical appraisal process can be effective in reducing chances of error.
What Interferes with Quality Improvement
The process of quality improvement involves understanding the core causes of diagnostic errors and introducing systematic changes to provide better healthcare. However, there are some issues regarding the implementation of change and introduction of quality improvement in the medical sphere. First of all, resistance to change is an important component of quality improvement. Medical professionals currently working in the field have a particular set of skills, competencies and knowledge.
The need to adapt and change the process of healthcare delivery can be difficult for doctors and nurses working. Additionally, insufficient funding and staffing in a medical setting can pose problems in the quality improvement procedure. Furthermore, healthcare delivery is a field that develops in a continuous fashion, signifying a need to progressively improve health practices.
There are also other problems regarding in introducing quality improvement in the face of diagnostic errors. First, the diagnosis process itself requires a collection of competencies and skills that make it difficult to both regulate and improve in a systematic fashion. The lack of awareness regarding misdiagnosis in a medical setting often impedes care improvements. When the medical workers are unable to fully understand the scope of the issue or its impact on a population, the response and subsequent quality improvement might suffer as a result. The lack of professional accountability in terms of making an incorrect prognosis also contributes to the process.
Communication Problems
Communication between parts of the healthcare delivery process remains one of the most important parts of medical care, where patient-doctor and interpofessional interactions form a basis for successful practice. The lack of interaction between nurses and doctors often leads to patients condition being wrongly accessed, which then escalates into an improper diagnostic decision. Poor communication between the patient and their physician can lead to some symptoms being overlooked or disregarded, which in turn often contributes to an incorrect diagnosis. Listening to the patients and taking in their feedback is a tool most commonly needed to avoid incorrect diagnoses. Furthermore, the lack of proper communication between medical professionals makes noticing or bringing attention to diagnostic errors difficult.
Conclusion
Overall, diagnostic errors are one of the most dangerous and impactful mistakes a medical professional can make. Doctors and nurses have a professional and personal responsibility to avoid mistakes, meaning that the introduction of systematic change is needed. Improving staffing, funding, education for nurses, as well as securing the decision making process behind additional checks are all valid methods to combat medical error. The need to prevent misdiagnosis spreads over all aspects of healthcare delivery, including staff communication, treatment, patient care and paperwork.
References
Kliegman, R. M., Bordini, B. J., Basel, D., & Nocton, J. J. (2017). How doctors think. Pediatric Clinics of North America, 64(1), 115. Web.
Even mild muscle weakness can cause children discomfort and reduce their quality of life. Such a severe genetic disorder as Duchenne muscular dystrophy (DMD) leads to tremendous consequences for the muscular system and affects children very early in their development. Understanding the causes and implications of DMD for young children is imperative not only for raising awareness of the problem and recommending solutions for the management of the condition. The purpose of this paper is to provide an in-depth exploration of DMD, including its background and symptomology, genetic significance, diagnostic process and management, as well as prognosis.
Introduction
Duchenne muscular dystrophy (DMD) is a genetic condition that is characterized by the continuous deterioration and weakness of muscle associated with changes in the composition of a protein called dystrophin, which maintains the functioning of muscle cells. The disorder is rare and affects males predominantly, with women being diagnosed with it only in exceptional cases. DMD causes the muscles in the body to become less resistant to physical impact and get damaged over time. Thus, the purpose of the paper is to explore Duchenne muscular dystrophy in great detail, including its causes, demographic data, signs and symptoms, the overall effect on the body, discuss the diagnostic process and prognosis for the disease.
Background and Symptoms
Duchennes dystrophy develops as a result of a genetic mutation that does not allow the body to produce dystrophin, a protein needed to build muscles. Without the availability of enough dystrophin in the body, muscle cells weaken and become damaged. Children diagnosed with the disease at the early stages of life experience significant issues with walking and breathing, which decreases the quality of their lives (Birnkrant et al., 2018). Eventually, the muscles responsible for breathing stop working, which causes death. DMD is an irreversible, progressive disease that currently has no cure that could have alleviated the burden of the disease.
The estimated global prevalence of DMD is 4.78 per 100,000 males (Walter & Reilich, 2017). The implications of the condition also include a yearly disease burden of more than $130 million, without including costs for respiratory management, extra direct costs per one patient, as well as additional medical aids (Walter & Reilich, 2017). According to the official website dedicated to DMD, the average age of diagnosis is 5 years, while it takes 2.5 tears between the initial symptoms and diagnosis ( Duchenne muscular dystrophy: The basics, 2019).
Being one of the most severe genetic diseases that affect children globally, DMD causes more than 90% of individuals being confined to a wheelchair by age 15 ( Duchenne muscular dystrophy: The basics, 2019). The burden of the disease is severe, with DMD being diagnosed in 1 among 3,500 to 5,000 males around the world ( Duchenne muscular dystrophy: The basics, 2019). The statistics on the disease show that it has an adverse effect on the young male population.
The principal symptom of DMD is muscle weakness, which can begin in patients as early as at ages 2-3 (Birnkrant et al., 2018). The proximal muscles get affected first due to the fact that they are the closest to bodys core. The distal limb muscles get affected later because they are close to the bodys extremities (Birnkrant et al., 2018). Furthermore, it is notable that lower external muscles usually show DMD symptoms prior to the upper ones. In affected children, there are noticeable difficulties walking, running, and jumping, which decreases the quality of movement. Other symptoms of the disease include calves enlargement, waddle in the gait, as well as lumbar lordosis (Birnkrant et al., 2018).
The latter is a DMD sign implying an inward spine curve. Due to the difficulties associated with muscle strength, the affected children develop issues with the heart and respiratory muscles. The progressive weakness in the body, coupled with scoliosis, can lead to the development of impaired pulmonary function that causes acute respiratory failure.
When exploring the possible symptoms of DMD in their children, parents should understand that muscle deterioration may not be as painful as it is. This is because muscular dystrophy does not have a direct effect on the nerves, with touch and other senses being normal. This is also true for the functions of the bladder and the bowel. Furthermore, it is essential to note the development of learning disabilities among children with DMD.
While serious cognitive disabilities are rare, dystrophin abnormalities in the brain can have minor effects on both cognition and behavior ( Duchenne muscular dystrophy: The basics, 2019). Learning problems can occur with focusing attention, memory and verbal learning, as well as emotional interactions. Children with learning disabilities who have DMD are usually evaluated by developmental or pediatric neuropsychologists who provide referrals to special education departments. Therefore, the manifestations of DMD can vary from developmental to physical impairments, which points to the need for managing the complications from the point of a multi-dimensional approach.
Genetic Issues
The underlying genetic defect that causes the conditions development occurs in the dystrophin gene with an X-linked trait. This means that there is a mutation, an error, in one of the bodys genes that causes the DMD diagnosis. The dystrophin gene contains 79 exons, which are connected to create instructions intended for forming dystrophin protein, which is needed for muscle development ( Genetic testing: A Duchenne fingerprint, 2019).
Within DMD, there may be three forms of genetic mutations. The first type of mutation is concerned with large deletions, with one and more exons missing from the dystrophin gene. The second type is concerned with large duplications, which means that one or more exons create copies of one another within the dystrophin gene. The third type refers to other changes in the gene, with small alterations taking place and ranging from deletions to changes in a single letter in a gene makeup.
As seen in the diagram below, large deletions of one or more exons in the gene (Figure 1). Similar to a puzzle, the missing pieces in the gene prevent the remaining exons from properly fitting together. This causes errors in the instructions for making dystrophin, with the body not being able to produce the necessary amount of dystrophin protein.
Figure 1. Types of genetic mutations ( Genetic testing: A Duchenne fingerprint, 2019).
Understanding the importance of genetic mutations as related to DMD is essential because scholars have recorded more than 1,800 different changes in peoples diagnoses with either Duchenne or Becker types of muscular dystrophy. Knowing the kind of mutation that has occurred in a child is a fundamental step for considering the types of management (Bendixen & Houtrow, 2017). In order to determine the kind of genetic change, doctors prescribe a genetic test that provides further information on disease management. Moreover, children can be subjected to clinical trials that are currently being conducted to develop innovative treatments.
Different methods of genetic testing can be used for getting a full picture of a childs mutation. For instance, complete gene sequencing can help to reveal small modifications in a gene. It is also important to note that since Duchenne is a genetic disorder, it can be inherited from one family member to another. The characteristic of DMD as an X-linked disease means that mutations are only found in the X chromosome ( Genetic testing: A Duchenne fingerprint, 2019).
Therefore, in cases when women have Duchenne-causing mutations in their chromosomes, they are considered carriers of the disease. Carriers will most likely have no symptoms of DMD but will be capable of passing the gene along to a child; although, there is no certainty that the mutation will be transferred. The chance of having a boy from Duchenne from a carrier mother is 25%, with the same likelihood of 25% applied to having a carrier girl ( Genetic testing: A Duchenne fingerprint, 2019).
This means that there is a 50% chance that a mother-carrier will have a baby with no mutation at all. In case when Duchenne is under suspicion, genetic testing is recommended, including carrier testing, in order to provide valuable information for making further decisions on treatment. Besides, the expertise of a genetic counselor can be highly helpful for explaining what genetic results on Duchenne can mean for families.
Diagnostic Process, Medical Management, and Prognosis
As mentioned in the previous sections, Duchenne muscular dystrophy is a rare inherited disease of the neuromuscular system that has no known cure at this time. DMD is usually suspected in mostly boys who display abnormal gait patterns and complications with physical activity, such as running or climbing stairs. Despite the fact that the current diagnostic process is straightforward, supported with more than 3 decades of research, there is still no solution to overcoming the healthcare challenge (Bendixen & Houtrow, 2017).
Furthermore, the American Academy of Pediatrics (2015) underlines the importance of addressing the concerns of parents about childrens development as soon as possible, especially in cases of more progressive and pronounced motor delays. Getting a formal DMD diagnosis is imperative for understanding a specific genetic mutation and determining an appropriate care path.
When a family pediatrician is concerned with the possibility of a DMD diagnosis in a child, a recommendation and referral for testing are made. An expert in neuromuscular management or a pediatric neurologist will further work to identify the causes of the symptoms and prescribe appropriate genetic and non-genetic testing.
Thus, the typical steps in identifying the disease include observing the signs and symptoms, conducting blood tests for determining enzyme levels (including CK test), genetic testing, and muscle biopsy when needed (Bendixen & Houtrow, 2017). A CK test will measure the bloods concentration of creatine kinase, which would signify damage in muscle cells (Bendixen & Houtrow, 2017). The high levels of the enzyme in the blood will point to a muscle problem, but not confirm Duchenne as a final diagnosis as the testing is usually the first step.
Genetic testing is prescribed when an elevated level of CK is found, which means that Duchenne is suspected. This test will analyze the genetic makeup of an individual to determine a change in the dystrophin gene (Bendixen & Houtrow, 2017). When such a modification is identified, further decisions on management are made. A muscle biopsy may be prescribed when there is not enough certainty provided by a genetic test. While most patients do not require the biopsy, it is used for gathering more information.
Since there is no treatment for overcoming muscular dystrophy completely, some preventative and management efforts are taken to reduce the burden of disease. Treatment options predominantly range from medications to surgical procedures that help patients live with DMD and manage the conditions symptoms. Doctors can prescribe heart medications and corticosteroids, as well as the Food and Drug Administration approved a drug called Eteplirsen (Exondys 51) (Bendixen & Houtrow, 2017). Despite being approved and safe for use, the drug has not shown significant evidence of effectiveness. While it may not cure DMD, it has the potential of improving muscle strength through acting on specific gene variants.
Corticosteroids are sometimes necessary for strengthening the muscle mass and delaying the development of certain types of dystrophy in children. The adverse effects of using corticosteroids over prolonged time periods include weight gain and weakened bone integrity, which increases the risk of fracture. Medications for the heart, such as angiotensin-converting enzyme (ACE) inhibitors and beta blockers, are usually prescribed when muscular dystrophy causes damage to the heart (Bourke et al., 2018). Overall, despite being prescribed to patients with DMD, medications cannot guarantee long-term maintenance of relative well-being.
Therapy and assistive devices are used as additional methods for managing life with DMD. Children diagnosed with the condition may do range-of-motion and stretching exercises to maintain high levels of mobility and flexibility of muscles as the disease causes limbs to be drawn forward and maintain in such a position (Magee, Zachazewski, Quillen, & Manske, 2015). Low-impact aerobic exercises that range from swimming to walking can help patients maintain the general health and mobility of children. Although, any activities should be verified with a doctor first since they can also be damaging. Braces and mobility aids are supplementary tools that maintain mobility independence and muscle stretchiness (Magee et at., 2015).
Breathing assistance is implemented when childrens respiratory muscles weaken. Severe cases of muscular dystrophy may call for the use of a ventilator that would force the air to travel to and from the lungs. It is also important to note that Duchenne may call for a surgery that would improve spiral curvature that limits breathing.
At this time, the prognosis for patients diagnosed with DMD does not include recovery. The adverse impact on childrens health causes a significant deterioration in life quality, leading to the need to monitor vitals continuously. For example, parents should always be aware of respiratory infection risks in more severe stages of muscular dystrophy in their children. Proper nutrition is also necessary to help prevent obesity, dehydration, and bowel movement issues. Seeking support from communities to help families cope with DMD contributes to the increased chances of living with the condition (Magee et at., 2015).
Therefore, psychological assistance is as valuable as physical management of the disease when it comes to complex genetic limitations such as Duchenne muscular dystrophy. Since DMD causes individuals with the condition to die the latest in their early twenties, extensive research is necessary to develop treatments that would be effective in overcoming the disease.
Concluding Remarks
Duchenne muscular dystrophy presents a significant challenge for the health care industry because of its severe impact on the well-being and development of children. Since DMD has no cure at the present time, it requires significant control on the part of childrens families and healthcare providers. While the combination of mild exercising and prescription medication can help patients deal with the disorder, the absence of effective interventions and treatment calls for further research and clinical trials.
References
American Academy of Pediatrics. (2015). Pediatric clinical practice guidelines & policies: A compendium of evidence-based research for pediatric practice. Elk Grove Village, IL: AAP.
Bendixen, R. M., & Houtrow, A. (2017). Parental reflections on the diagnostic process for Duchenne muscular dystrophy: A qualitative study. Journal of Pediatric Health care: Official Publication of National Association of Pediatric Nurse Associates & Practitioners, 31(3), 285-292.
Birnkrant, D. J., Bushby, K., Bann, C. M., Apkon, S. D., Blackwell, A., Brumbaugh, D., & DMD Care Considerations Working Group (2018). Diagnosis and management of Duchenne muscular dystrophy, part 1: Diagnosis, and neuromuscular, rehabilitation, endocrine, and gastrointestinal and nutritional management. The Lancet. Neurology, 17(3), 251-267.
Bourke, J. P., Watson, G., Muntoni, F., Spinty, S., Roper, H., Guglieri, M., & DMD Heart Protection study group (2018). Randomized placebo-controlled trial of combination ACE inhibitor and beta-blocker therapy to prevent cardiomyopathy in children with Duchenne muscular dystrophy? (DMD Heart Protection Study): A protocol study. BMJ Open, 8(12), e022572.
Magee, D., Zachazewski, J., Quillen, W., & Manske, R. (2016). Pathology and intervention in musculoskeletal rehabilitation. Maryland Heights, MO: Elsevier.
Walter, M. C., & Reilich, P. (2017). Recent developments in Duchenne muscular dystrophy: facts and numbers. Journal of Cachexia, Sarcopenia and Muscle, 8(5), 681-685.
The Capacity Management Information System (CMIS) enables healthcare companies to manage resource allocation and capacity utilization. Healthcare businesses may more efficiently manage resources by using real-time data on patient flow and bed occupancy rates provided by CMIS. The CMIS might additionally assist healthcare organizations in forecasting their capacity requirements in the future and planning appropriately, which can enhance their overall effectiveness and patient outcomes. Therefore, it is important for healthcare organizations to carefully evaluate their needs and invest in a CMIS that aligns with their goals and objectives since this system significantly improves operational efficiency.
The adoption of healthcare information systems is heavily influenced by the Agency for Healthcare Research and Quality (AHRQ). Its goal is to make health care for all Americans better in terms of quality, safety, efficiency, and effectiveness (AHRQ Digital Healthcare Research, 2014). The high implementation and maintenance costs of healthcare information systems are one of the central concerns. AHRQ has identified this matter as an issue and has created solutions to address it. In order to alleviate such a concern, open-source software can be used to lower the cost of deployment and maintenance (AHRQ, 2022). The possibility of data breaches and security vulnerabilities is another significant concern in the purchase of healthcare information systems. To adress this concern, an alternative, such as the Health Information Security and Privacy Collaboration Toolkit, can be applied (AHRQ, 2022). The project offers instructions for creating and putting into effect security and privacy policies and procedures.
Healthcare businesses made a vital decision when they decided to purchase the Capacity Management Information System (CMIS), which greatly improved the value of their information systems. The software development lifecycle (SDLC) is a methodology for making decisions that describes the phases of developing or purchasing software (Glaser et al., 2022). Using SDLC concepts for CMIS acquisition guarantees that the system is user-friendly, dependable, and secure, and satisfies the needs of the healthcare business (Glaser et al., 2022). The healthcare organization recognizes the need for a CMIS during the planning stage, and a feasibility analysis is done to see if the purchase is financially feasible. The organization specifies the CMIS requirements and evaluates the choices during the analysis stage (Glaser et al., 2022). A comprehensive acquisition strategy is created during the design stage, and the CMIS is configured, deployed, and tested during the implementation stage (Glaser et al., 2022). The CMIS is thereafter monitored, updated, and enhanced regularly during the maintenance stage.
An instrument for evaluating a systems usability is the System Usability Scale (SUS). It gauges how satisfied and how well the user feels the system works. The CMIS is user-friendly and fits the needs of the healthcare organization if it receives a high SUS score. The success of the CMIS purchase depends in large part on the user experience. User experience is vital since if it is favorable, the healthcare organization will reap the rewards. The project life cycle, which consists of the four crucial elements of initiation, planning, execution, and closure, is another aspect that merits analysis. The healthcare organization decides the projects scope and the necessity for the CMIS at the initiation phase (Hasman & Househ, 2022). The organization creates a thorough project plan, complete with timeframes, finances, and resources, during the planning phase (Hasman & Househ, 2022). The CMIS is really put into use during the execution stage, the project is assessed, and the healthcare organization decides whether the CMIS acquisition was successful during the closure stage.
Consequently, the value was added through the acquisition of the CMIS healthcare information system. In general, healthcare firms might gain a lot from the procurement of CMIS. By ensuring that the organization has the resources required to deliver high-quality care, it may enhance patient outcomes and user experience. Other ways that CMIS may boost operational effectiveness include resource allocation optimization, waste reduction, and improved scheduling (Balgrosky, 2019). The acquisition of CMIS can have a major economic impact since it can lower the expenses associated with manual operations and boost revenue by speeding up patient throughput.
The effectiveness of the CMIS implementation or acquisition can be greatly impacted by its quality. A high-quality purchase guarantees that the CMIS is user-friendly, dependable, and secure and satisfies the demands of the healthcare business. A poor acquisition can result in system outages, project failure, and financial loss. This might occur as a result of the CMISs inability to handle the volume of users, which could cause sluggish response times or even crashes (Balgrosky, 2019). Furthermore, it can be challenging to use and need extensive training, which would reduce staff members productivity. Moreover, a badly developed or bought CMIS could not be secure, putting confidential patient information at risk (Balgrosky, 2019). Therefore, to secure the success of the healthcare organization and the safety of its patients, it is imperative to invest in a high-quality CMIS acquisition and implementation.
Hence, as CMIS greatly increases operational efficiency, it is crucial for healthcare organizations to thoroughly assess their needs and invest in a CMIS that is in line with their aims and objectives. The implementation of SDLC principles guarantees that the CMIS is dependable, secure, and user-friendly and that it satisfies the requirements of the healthcare business. The success of the CMIS acquisition depends heavily on the System Usability Scale and user experience. The project life cycle offers a structure for effective CMIS acquisition, and CMIS acquisition can have large positive economic effects. Ultimately, a successful CMIS purchase depends on high-quality implementation and acquisition.
Accountable Care Organizations (ACO) were introduced to supervise and assist Medicare and Medicaid programs. More than 900 ACO have established 1300 contracts with private and public hospitals across the country since 2010 to manage payments of Medicare patients (Kaufman et al., 2018). This model holds healthcare organizations accountable for the cost and quality of care by creating a system of value-based payment, meaning that hospitals are paid for the outcome, not per service (Kaufman et al., 2018). Furthermore, ACO contract components include financial accountability, quality measurement, and population health data sharing, resulting in improved care and cost reduction (Kaufman et al., 2018, p. 257). For example, the nominal savings were $700 per fiscal year per cancer patient (Kaufman et al., 2018). However, there was no significant cost reduction for surgical procedures with the ACO model (Nathan et al., 2019). It appears that the benefit of this program is not evident for all specialties yet. Still, I believe that the principle of value payment is fair for patients because it ensures that high-quality care is provided to maximize favorable outcomes.
Reliance Healthcare is an example of a successful ACO that partnered with emergency departments (ED) in Michigan to coordinate care for Medicare patients. This organization consists of three groups: clinicians, an information technology (IT) team, and managers (Centers for Medicare and Medicaid Services [CMMS], 2020). The primary goal of Reliance Healthcare in this partnership with EDs was to minimize healthcare costs by preventing unnecessary hospitalizations through an organized work of reliance nurses, managers, and IT departments (CMMS, 2020). The recent report stated that this program could prevent, on average, two avoidable admissions per day from 2014 to 2020, leading to significant cost reduction of care (CMMS, 2020). I think that Reliance Healthcare should continue working with healthcare providers, and forming more contracts because unnecessary hospitalization is a big issue in our hospitals; thus, an ACO control can prevent needless expenditures.
References
Centers for Medicare and Medicaid Services. (2020). Reliance Healthcares emergency department care coordination program. Web.
Kaufman, B. G., Spivack, B. S., Stearns, S. C., Song, P. H., & OBrien, E. C. (2018). Impact of accountable care organizations on utilization, care, and outcomes: A systematic review. Medical Care Research and Review, 76(3), 255-290. Web.
Nathan, H., Thumma, J. R., Ryan, A. M., & Dimick, J. B. (2019). Early impact of Medicare accountable care organizations on inpatient surgical spending. Annals of Surgery, 269(2), 191196. Web.
