NHS FPX 4000 Assessment 4: Analyzing a Current Health Care Problem or Issue

NHS FPX 4000 Assessment 4: Analyzing a Current Health Care Problem or Issue

Sample Answer for NHS FPX 4000 Assessment 4: Analyzing a Current Health Care Problem or Issue Included After Question

Analyzing a Current Health Care Problem

Healthcare professionals such as nurses have the responsibility to ensure that they uphold the required levels of patient care to ensure patient safety, quality care, and efficient care. The implication is that nurses will, from day to day, encounter situations where they need to come up with an appropriate solution to protect patients and other professionals from experiencing harm. Central to the such solution is a careful analysis of the problem at hand to explore potential solutions and their possible impacts. The central focus of such attempts is to always promote a culture of safety in the care environment (Marx, 2019). Therefore, the purpose of this assignment is to explore a current problem or issue in healthcare, its potential solution, and associated ethical implications

A Sample Answer For the Assignment: NHS FPX 4000 Assessment 4: Analyzing a Current Health Care Problem or Issue

Title: NHS FPX 4000 Assessment 4: Analyzing a Current Health Care Problem or Issue

Description of the Health care Problem and The Possible Causes of the Problem

The identified problem is patient falls in the care settings. Patient falls can be described as an event that may lead to an individual resting inadvertently on the floor, ground, or some lower levels. Patient falls have been shown to result in substantial economic and physical burdens to the patients. For example, inpatient falls lead to decreased quality of life, increased mortality rates, and increased injury to patients, which may all lead to higher healthcare spending (LeLaurin et al.,2019). Inpatient falls also lead to litigation, higher medical care costs, and longer stays in the hospital. Even though the current evidence has shown that patient falls have been on the decline in the past years, the problem is still significant due to its devastating impacts, hence a need for a better solution.

Recent research shows that inpatient falls in hospitals still remain a major concern, and while the rates of falls vary widely, the fall rates range from three to eleven falls per one thousand bed days. Of all the patient falls, about one-quarter result in injuries that lead to soft tissue injuries and fractures. While patient falls can occur to any patient in the hospital care setting, it has been shown from previous reports show that the elderly are more prone to falls due to particular factors such as muscle weakness, polypharmacy, medication use, patient, anesthetics, comorbidities, and ill health. According to Heng et al.(2020), the negative impacts of patient falls mean that various strategies should be used to curb the problem, such as the use of education, both for the patients and the nursing staff. In addition, this source also indicates that other possible avenues that can be explored include implementing hospital policies and systems, assistive devices, environmental modifications, and medication management.

In a recent study, Najafpour et al.(2019) explored some of the factors which enhance the risks of patient falls. In a prospective study involving one hundred and eighty-five patients, various factors were found to lead to patient falls in hospital care settings. One of the factors that are associated with patient falls is the longer length of stay. Staying longer admitted in the hospitals means that the chances of falling while staying in the hospitals are enhanced. The other factor is using particular medications such as an angiotensin-converting enzyme, benzodiazepines, anticonvulsants, sedatives, and the use of chemotherapy medication. Other factors that may put patients at risk of falling while in the hospital include having cancer, urinary incontinence, use of manual transfer aid, the balance condition of a patient, and visual acuity.

 

Analysis of the Problem

            As earlier indicated, patient falls in the patient care setting lead to various negative impacts, which in the end, endanger patient safety and reduce the quality of life. The implication is that nurses need to be aware of the risks of patient falls, the associated danger, and the potential solutions to the problem; therefore, this section explores the problem in terms of the context of the problem, description of why the problem is important, and the groups of people impacted by the problem.

The Setting of the Problem

In the context of healthcare, patient falls are considered as those falls happening in the patient care environment. Therefore, the setting of the problem is at the admission wards. When patients are admitted, they have to stay in the hospital and use the hospital beds offered. However, depending on a patient’s condition, a patient may experience a fall while trying to turn on the bed, sit down from a sleeping position, or fall while coming out of the bed to go to the bathrooms or the toilets (Kim et al.,2019). Therefore such patients may need the assistance of nurses to accomplish such tasks. In some cases, patients may fall while walking in the hospital ward due to the nature of the floor, an obstacle on the way, or because of weakness. In some cases, patients may fall while in the bathrooms or toilets. Any fall occurring in any of the described situations is treated as patient falls in the hospital care setting. The problem of patient falls is important to me since it negatively impacts patients leading to adverse outcomes. However, various nursing interventions can be used to help reduce the chances of the problem occurring and reducing its impacts.

The Affected Population

In-hospital patient falls can occur in patients in any age group in the hospital. Therefore, falls affect patients admitted to the hospital. However, one group of people which is heavily impacted or affected by patient falls is the geriatric population or the elderly. This population has certain characteristics which make them prone to patient falls. For example, they have relatively weaker bones which expose them to falls, such as falling while coming out of bed. They are also more likely to be using more medications, and the polypharmacy may take a toll on them, which exposes them to falls (Khalifa, 2019). Their comorbidities and general ill health are the other factors that expose them to more patient fall as compared to other groups or populations.

The Potential Solutions

            It is evident from the earlier discussion that in-hospital patient falls have adverse impacts on patients, especially the geriatric population, which is more prone to falls. Therefore, it is important to use effective solutions or strategies to help reduce the chances of falls. One of the potential solutions is using bed alarms. Alarms can play a key role in alerting nurses or healthcare professionals in case patients are about to fall (LeLaurin et al.,2019). The nurses can then act by going to bed and preventing such falls. The alarms are put on the beds to ensure that they sense if a high fall-risk patient changes position on the bed, suggesting movement. The sound of the alarm then prompts the nurses to move in and prevent the potential fall.

Another potential solution involves identifying at-risk patients. Some patients are more likely to experience falls as compared to others; as such, the nurses should be in a position to identify such patients and make extra plans to take care of them as appropriate.  In recent times, there has been the continued use of fall risk prediction tools to help identify patients who are more likely to experience falls. In addition, fall risk assessment can also be key in identifying such patients. It is also important to make the at-risk patients easily identifiable by clinicians so that prompt action can be taken to ensure that they are protected from falls (LeLaurin et al.,2019). Some of the falls are due to environmental factors such as the presence of obstacles and wet and slippery floors which can increase the chance of falls. Making the rounds, especially after every two hours, can also be important to find out what patients need to prevent them from having to frequently come out of bed without help. Therefore, such falls can be prevented or reduced by doing safety rounds. Such rounds can be key to identifying potential hazards and eliminating them.

Another potential approach or solution is the use of sitters, also referred to as specials or companions can also be used to prevent falls. The sitters offer one-on-one surveillance for individuals who have been labeled as at risk of patient falls. These sitters are key as they have been shown to reduce the chances of falls, even though the approach is relatively expensive. Patient education can also play a key role in preventing patient falls while in the hospital (LeLaurin et al.,2019). Patient education can be key as it helps patients to follow fall prevention instructions and other instructions, such as those to restrain them from moving out of bed without help. Such educational initiatives are more effective among patients in rehabilitation settings than those who are the acute care since they are more cognitively intact. Modifying the patient care environment is also important. Some of the environmental modifications which are key include lower beds, the use of visual cues, modifying floors using vinyl flooring, and modifying lighting.

Using singular approaches has in the past shown minimal improvement; therefore, the most current approaches involve the use of care bundles related to patient falls. These care bundles entail the use of multi-component interventions to help reduce falls in patient care settings. For example, a fall-care bundle may entail integrating all the strategies discussed already to improve the efficacy of the approach. Therefore, it is expected that a bundle care approach is more effective. There a fall-care bundle has been proposed herein as the most effective approach. One of the pros of the fall-care bundle is that it is likely to be more effective as compared to single approaches (LeLaurin et al.,2019). On the other hand, a fall-care bundle is relatively expensive as all the aspects of the single intervention approaches have to be brought on board. Ignoring the problem may have various consequences, such as increased rates of falls, higher healthcare spending due to further treatments resulting from fractures, and longer length of stay in the hospitals.

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The Ethical Principles and Implementation

Implementing fall-bundle-based care to prevent falls would require various things. One of them is financial resources to purchase alarms and materials to modify the floor and the patient care environment. It may also need support from the organizational leaders. Even though the proposed solution can be implemented to help reduce falls, such implementation may need to consider various ethical principles. One of them is beneficence, where the solution must focus on promoting the patients’ well-being (Varkey et al.,2021). Another factor to consider is nonmaleficence which means that the solution must avoid harming or injuring patients. The patient’s privacy and confidentiality must also come into play. As part of the bundle, at-risk patients are identified, and their data is kept. The professionals should ensure that such data is not accessed by unauthorized individuals as that violates patient privacy and confidentiality.

NHS FPX 4000 Assessment 4: Analyzing a Current Health Care Problem or Issue Conclusion

            Patient safety is one of the major concerns in recent times as there are various aspects that expose patients to potential harm in the care environment. Therefore, it is important to identify such risks as patient falls and formulate appropriate ways of solving them. This write-up has explored patient falls as a patient safety problem in the care environment and discussed potential solutions to the problem.

NHS FPX 4000 Assessment 4: Analyzing a Current Health Care Problem or Issue

 

NHS FPX 4000 Assessment 4: Analyzing a Current Health Care Problem or Issue References

Heng, H., Jazayeri, D., Shaw, L., Kiegaldie, D., Hill, A. M., & Morris, M. E. (2020). Hospital falls prevention with patient education: a scoping review. BMC Geriatrics, 20(1), 1-12. https://doi.org/10.1186/s12877-020-01515-w

Khalifa, M. (2019). Improving Patient Safety by Reducing Falls in Hospitals Among the Elderly: A Review of Successful Strategies. ICIMTH, 340–343.

Kim, J., Kim, S., Park, J., & Lee, E. (2019). Multilevel factors influencing falls of patients in hospital: the impact of nurse staffing. Journal of Nursing Management, 27(5), 1011-1019. https://doi.org/10.1111/jonm.12765

LeLaurin, J. H., & Shorr, R. I. (2019). Preventing falls in hospitalized patients: state of the science. Clinics in Geriatric Medicine, 35(2), 273–283. https://doi.org/10.1016%2Fj.cger.2019.01.007

Marx, D. (2019). Patient safety and the just culture. Obstetrics and Gynecology Clinics, 46(2), 239–245. https://doi.org/10.1016/j.ogc.2019.01.003

Najafpour, Z., Godarzi, Z., Arab, M., & Yaseri, M. (2019). Risk factors for falls in hospital inpatients: a prospective nested case-control study. International Journal of Health Policy and Management, 8(5), 300. https://doi.org/10.15171%2Fijhpm.2019.11

Varkey, B. (2021). Principles of clinical ethics and their application to practice. Medical Principles and Practice, 30(1), 17–28. https://doi.org/10.1159/000509119

Write a 4-6 page analysis of a current problem or issue in health care, including a proposed solution and possible ethical implications.

Introduction

In your health care career, you will be confronted with many problems that demand a solution. By using research skills, you can learn what others are doing and saying about similar problems. Then, you can analyze the problem and the people and systems it affects. You can also examine potential solutions and their ramifications. This assessment allows you to practice this approach with a real-world problem.

Instructions

Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum, be sure to address each point. In addition, you are encouraged to review the performance-level descriptions for each criterion to see how your work will be assessed.

1. Describe the health care problem or issue you selected for use in Assessment 2 (from the Assessment Topic Areas media piece) and provide details about it.
   • Explore your chosen topic. For this, you should use the first four steps of the Socratic Problem-Solving Approach to aid your critical thinking. This approach was introduced in Assessment 2.
   • Identify possible causes for the problem or issue.
2. Use scholarly information to describe and explain the health care problem or issue and identify possible causes for it.
   • Identify at least three scholarly or academic peer-reviewed journal articles about the topic.
     • You may find the How Do I Find Peer-Reviewed Articles? library guide helpful in locating appropriate references.
     • You may use articles you found while working on Assessment 2 or you may search the Capella library for other articles.
     • You may find the applicable Undergraduate Library Research Guide helpful in your search.
   • Review the Think Critically About Source Quality to help you complete the following:
     • Assess the credibility of the information sources.
     • Assess the relevance of the information sources.
3. Analyze the health care problem or issue.
   • Describe the setting or context for the problem or issue.
   • Describe why the problem or issue is important to you.
   • Identify groups of people affected by the problem or issue.
   • Provide examples that support your analysis of the problem or issue.
4. Discuss potential solutions for the health care problem or issue.
   • Describe what would be required to implement a solution.
   • Describe potential consequences of ignoring the problem or issue.
   • Provide the pros and cons for one of the solutions you are proposing.
5. Explain the ethical principles (Beneficence, Nonmaleficence, Autonomy, and Justice) if potential solution was implemented.
   • Describe what would be necessary to implement the proposed solution.
   • Explain the ethical principles that need to be considered (Beneficence, Nonmaleficence, Autonomy, and Justice) if the potential solution was implemented.
   • Provide examples from the literature to support the points you are making.

Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:

• Assessment 4 Example [PDF].

Additional Requirements

Your assessment should also meet the following requirements:

• Length: 4–6 typed, double-spaced pages, not including the title page and reference page.
• Font and font size: Times New Roman, 12 point.
• APA tutorial: Use the APA Style Paper Tutorial [DOCX] for guidance.
• Written communication: Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
• Using outside sources: Integrate information from outside sources into academic writing by appropriately quoting, paraphrasing, and summarizing, following APA style.
• References: Integrate information from outside sources to include at least three scholarly or academic peer-reviewed journal articles and three in-text citations within the paper.
• APA format: Follow current APA guidelines for in-text citations of outside sources in the body of your paper and also on the reference page.

Organize your paper using the following structure and headings:

• Title page. A separate page.
• Introduction. A brief one-paragraph statement about the purpose of the paper.
• Elements of the problem/issue. Identify the elements of the problem or issue or question.
• Analysis. Analyze, define, and frame the problem or issue.
• Considering options. Consider solutions, responses, or answers.
• Solution. Choose a solution, response, or answer.
• Ethical implications. Ethical implications of implementing the solution.
• Implementation. Implementation of the potential solution.
• Conclusion. One paragraph.

Competencies Measured:

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

• Competency 1: Apply information literacy and library research skills to obtain scholarly information in the field of health care.
  • Use scholarly information to describe and explain a health care problem or issue and identify possible causes for it.
• Competency 2: Apply scholarly information through critical thinking to solve problems in the field of health care.
  • Analyze a health care problem or issue by describing the context, explaining why it is important and identifying populations affected by it.
  • Discuss potential solutions for a health care problem or issue and describe what would be required to implement a solution.
• Competency 3: Apply ethical principles and academic standards to the study of health care.
  • Explain the ethical principles (Beneficence, Nonmaleficence, Autonomy, and Justice) if potential solution was implemented
• Competency 4: Write for a specific audience, in appropriate tone and style, in accordance with Capella’s writing standards.
  • Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
  • Write following APA style for in-text citations, quotes, and references.

Limited access to healthcare is an issue of focus in this paper. Healthcare providers and other stakeholders in health actively focus on implementing policies that aim at eliminating the barriers to access to healthcare. All individuals have the right to access the care that they need for their optimum health and functioning. However, factors such as the high cost of healthcare, lack of medical insurance coverage, shortage of specialists, and geographical disadvantages have continued to worsen the challenges that most experience in accessing the healthcare they need. Therefore, this research paper analyzes the issue of limited access to healthcare, its causes, potential alternatives, and a solution that should be adopted to address it.

Elements of the Problem or Issue

Despite being a developed country, some of the populations in America still experience limited access to healthcare. For example, the existing statistics show that patients suffering chronic illnesses such as mental illnesses experience considerable challenges in accessing the care that they need due to factors such as stigmatization, ignorance, and prejudice. Geography is another factor that plays a crucial role in limiting healthcare access. According to Matin et al., (2021), residing in rural settings act as a barrier to access to the needed healthcare for the population. The participants in the study by Martin et al., (2021) reported that they incur significant transportation cost in accessing the healthcare facilities based on their geographical locations. In the study by Malik-Soni et al., (2022), factors that include physician shortage, stigma, high cost and shortage of services, limited insurance, and communication difficulties with physicians limited access to care for patients with autism spectrum disorder. Unforeseen events such as the recent changes due to covid19 pandemic also limit healthcare access for the population. For example, Jeste et al., (2020) found in their research that covid19 restrictions led to a loss of at least some healthcare services for patients with intellectual and developmental disorder. The effect was seen from 74% of the patients losing access to at least one therapy or educational service. Policy changes made in the country also act as a source of barriers to access to healthcare in America. For instance, most of the policy initiatives adopted policies in healthcare continue to limit the access of immigrants in the USA to healthcare (Buchmueller & Levy, 2020). A small proportion of noncitizen immigrants in the state have Medicaid, which worsens healthcare access for most of them.

Healthcare cost in the United States of America is also among the highest of all the developed nations globally. Accordingly, the USA spends the highest amount of per capita on person’s healthcare as compared to other countries such as Canada and the United Kingdom. The high cost of healthcare is a disadvantage to the majority who are in low socioeconomic group. Compounded by factors such as the lack of medical insurance coverage and residing in rural areas, the population experience considerable challenges in accessing the high quality care that they need (Lee & Porell, 2020).

America is also a multiethnic country. Factors such as race and ethnic backgrounds influence access to healthcare services. Often, individuals from ethnic minority backgrounds experience disproportionate barriers in accessing the healthcare that they need. The recently experienced challenges during Covid19 revealed that the pandemic disproportionately affected some ethnic and racial minority groups. The impact was attributed to the high uninsurance rate among African Americans (12%) and Hispanics (19%) as compared to whites (8%) (Tai et al., 2021). According to Thakur et al., (2020), structural and social circumstances place racial and ethnic minority groups at risk of diseases and worse outcomes due to limited access to healthcare. For example, African Americans and Latino Americans, which form part of the ethnic minority groups experience barriers such as lack of insurance, unemployment, and low income, which limit access to quality healthcare they desire for their health and wellbeing (Petersen et al., 2019).

Analysis

Nurses must be aware of the factors that contribute to limited access to healthcare for the American population. The awareness stimulates them and other healthcare providers to advocate the adoption of policies that increase the universal access to healthcare for all. Nurses also explore the incorporation of novel technologies such as telemedicine, telehealth, and mhealth into the adopted solutions to address limited access to healthcare for the population (Jeste et al., 2020). Studies have demonstrated that technologies such as telemedicine and telehealth increase the access to healthcare for the vulnerable populations and those residing in rural areas since they can interact with their practitioners virtually (Haynes et al., 2021). The consideration of these options will likely to increase healthcare access for all.

Context of Limited Access to Healthcare

Limited access to healthcare refers to the disproportionate utilization of healthcare services by the population because of factors that may be beyond their control. The vulnerable populations that include people with disabilities such as those intellectual and development disabilities, autism spectrum disorders, and women with disabilities (Huot et al., 2019; Jeste et al., 2020; Malik-Soni et al., 2022). Racial and ethnic minority groups also suffer from limited access to healthcare because of social and structural factors such as lack of health insurance, unemployment, and low income (Thakur et al., 2020). In addition, the socioeconomically disadvantages, individuals with chronic health conditions, women, children, and the elderly experience disproportionate limited access to specialty care, especially in the medically underserved rural and urban areas (Cyr et al., 2019).

Limited access to healthcare is attributed to multilevel factors. At the foundational level, geography plays a crucial role in limiting access to healthcare. Accordingly, patients residing in rural areas experience unique challenges such as the lack of physician care and high transportation costs in seeking the care they need in urban areas. According to Cyr et al., (2019), one-fifth of the USA’s population resides in rural areas and being served by one-tenth of the clinicians practicing in these areas. In addition, most of the rural dwellers are likely to be older, veterans, uninsured, or less likely to have higher education, which limits their access to healthcare (Cyr et al., 2019).

At the individual level, factors such as poverty, low income, unemployment, lack of medical insurance coverage, ignorance, and negative experiences with healthcare services influence access to and utilization of healthcare services. At the healthcare system level, variance in healthcare costs, negative patient experiences with healthcare services and providers, staff shortage, and fragmentation of healthcare services hinder the population’s access to the healthcare they need. At the policy level, constant changes in healthcare policies such as the enhancements of the Affordable Care Act lowers the types of healthcare services that the population can access (Buchmueller & Levy, 2020). Consequently, these factors contribute to the worsening challenges in access to healthcare for the vulnerable in the country.

Populations Affected by Limited Access to Healthcare

The unemployed, poor, and individuals from ethnic minority groups are most vulnerable to limited access to healthcare. Individuals from ethnic minority backgrounds often have increased predisposition to health problems such as diabetes, hypertension, and depression among other issues. They also experience significant challenges in accessing healthcare they need because of lack of medical insurance coverage, unemployment, and low wages (Petersen et al., 2019). The other group of people likely to experience limited access to healthcare include the elderly rural dwellers, with low income, educational levels, and veterans, who have challenges in accessing specialized care they need. Children, those with disability, women, and elderly in medically deprived urban and rural areas are also highly likely to experience limited access to healthcare (Cyr et al., 2019).

Considering the Options

One of the solutions that can be considered to address the issue of limited access to healthcare due to geographical residence is adopting new policies that support care delivery models that rely on team-based care and nonphysician providers (Germack et al., 2019). A study conducted by Germack et al., (2019) showed that most of the rural hospitals in the USA are unable to address the needs of their populations because of physician shortages. As a result, they are at the verge of closure should the problem persist. However, an effective solution proposed by the researchers is the adoption of non-physician providers and team-based care to address the issue. This includes the hiring of more nurse practitioners to fill the physician shortage, hence, assuring the rural residents access to high quality care they desire. Besides, delivery models such as rural clinics and medical homes that rely on team-based care could augment the physician workforce, hence, increased access to the medically underserved rural and urban dwellers (Germack et al., 2019). The challenge associated with this solution is that it may take time for its implementation since it requires a change in the existing healthcare policies.

Limited access to healthcare can be addressed by embracing technologies such as telehealth and telemedicine to expand healthcare coverage for the vulnerable. Telehealth and telemedicine allow healthcare providers and their patients to interact irrespective of their geographical locations. Healthcare providers can assess, monitor, and evaluate the effectiveness of the adopted interventions for optimum care outcomes. Issues associated with health technologies that may affect their adoption include data breaches leading to the loss of confidentiality and privacy (Haynes et al., 2021). The challenge of not addressing the issue of limited access to healthcare is that it would worsen disproportionate rates of poor health outcomes among the vulnerable populations.

Solution

Limited access to healthcare, especially due to residing in medically underserved regions is a crucial public health problem. However, the consideration of team-based model of care and use of non-physician healthcare providers is a sound solution to the problem. For example, nurse practitioners have been trained to deliver care like that of the physicians. Policy changes that recognize the need for hiring more nurse practitioners would help address the physician shortage, hence, increasing the population’s access to specialized care in undeserved regions. In addition,  delivery models such as rural clinics and medical homes that rely on team-based care could augment the physician workforce, hence, increased access to the medically underserved rural and urban dwellers (Germack et al., 2019).

Implementation

The consideration of policy reforms that incorporate team-based model of care and use of nonphysician providers is an effective solution to the problem of limited access to healthcare. Its implementation requires interventions such as lobbying for policy change, hiring more of nonphysician staff, and redesigning the existing model of care delivery to increase team-based approaches in the care process. The ethical principles that should be considered include justice. The adopted policy should ensure that all the populations have universal access to high quality, safe, and efficient care. The population should also not be discriminated in accessing the care they need based on their backgrounds. The principle of beneficence and non-maleficence should also be considered by ensuring that the target population is not predisposed to any unintended harm from the proposed policy reforms (Haynes et al., 2021). The use of non-physician providers should not lower the quality, safety, and efficiency of care that patients receive. It should also not subject them to any unintended harm in the disease management process.

Conclusion

Limited access to healthcare is an issue that should be addressed in America. Factors such as cost of healthcare, residing in rural settings, and lack of medical insurance coverage contribute to the issue. An effective solution to address it would be policy reforms to increase the use of non-physician providers and team-based approach to care. Nurses should consider ethical principles in implementing the solution.