Nursing Discussion Responses

Nursing Discussion Responses: Please respond to each of the 4 discussions listed below. Each should be 1/2 page in response with 1 source per response. Responses should add to / reflect on the discussion.  HPF Discussion 1n in response to Tori Lynn  This week for the discussion I want to discuss the lack of performance related to mental health and mental health care coverage and how it is affecting our patients and our healthcare employees. There has been a stigma around mental health for years. These patients feel like they are drowning within themselves, there are mental hurdles that they can’t cross themselves, which causes sincere anxiety, depression, PTSD, OCD, etc. Then we tack on the inability to get coverage to speak to a psychiatrist to provide help and guidance.

I personally know 3 nurses in my department alone who have had to seek out psychiatrists for help, and who accept our hospital insurance, but it only covers the initial consultation. The remaining sessions are $175/hr. This is insane! Most people cannot afford this or don’t have insurance at all and have to pay out of pocket for the entirety. This typically leads to self-healing; alcohol abuse, substance abuse, domestic abuse, etc. Many times I have seen patients come in as a Baker Act who have tried committing suicide with pill overdose because they couldn’t afford the help they need. It is sad to see so many patients and employees suffering during this pandemic. Patients being quarantined are trying to commit suicide, and the nurses providing care are seeing so much death that they are losing their mental strength. Meanwhile, the institute for healthcare improvement is trying to implement the triple aim initiative to improve the US healthcare system. The triple aim initiative involves improving the patient’s care and satisfaction, improving the population’s health, but also cutting healthcare cost per capita (IHI, 2019).  My two suggestions for improving mental health care coverage are;

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1) Have regular behavior health screenings as part of the yearly physical; 

2) build mental health services within the community to promote self-care, that is covered with health insurance or free to the general public. Part of improving mental health is noticing the signs and symptoms. This can be determined during a yearly physical with a focus on behavior. This way it is included in the physical, and that patient can get help if need be. The mental health services will promote how to notice the signs and symptoms, what triggers these episodes, how to promote self-care, and how to find help. These suggestions will help to promote patient satisfaction, the population’s health, and healthcare per capita.  IHI. (2019). The IHI Triple Aim | IHI – Institute for Healthcare Improvement. Institute of Healthcare Improvement. http://www.ihi.org/Engage/Initiatives/TripleAim/Pages/default.aspx#:%7E:text=It%20is%20IHI’s%20belief%20that,capita%20cost%20of%20health%20care (Links to an external site.).   HPF Discussion 2 in response to Christy C. I currently am not working in the health care setting, however, a performance issue in the U.S. healthcare system would be the lack of access individuals have to health care. As discussed throughout this course thus far most of us if not all of us have mentioned the lack of organization and access the U.S. health care system delivers. For example, insurance may not cover medications that would be more beneficial than currently prescribed medications a patient is receiving for their condition. Or maybe they do not have insurance in general and cannot afford the medication needed for treatment.

The U.S. health care system is complex, but there need to be adjustments to improve patient outcomes and reduce the per capita cost of health care. The economy also hurts patients who need care and receive it but are unable to pay for their medical bills. The Institute for Healthcare Improvement (IHI) has developed a framework for developing quality health programs across institutions, states, and even other countries (Galen College of Nursing, n.d.-a). The framework is called the triple aim, which consists of 3 “pillars”: improving patient experience, improving the health of populations, and reducing the per capita cost of health care (Galen College of Nursing, n.d.-a).

Two ways performance could be improved upon in the U.S. health system would be prioritizing quality and safety. Communicating to all employees not only nurses and health care providers, but to admitting clerks and housekeeping staff the importance of their job description. This is because everyone who works in the health care setting has a duty that influences the patient experiences and outcomes. For example, housekeeping staff are important in influencing patient experience because without them it would be hard to control infections if the halls, restrooms, and patient rooms are dirty (Galen College of Nursing, n.d.-b). The second way performance could be improved would be finding a health care system that benefits patients, the entire population, and its economy.

References Galen College of Nursing. (n.d.-a). Health system performance [PowerPoint slides].

https://files.galencollege.edu/media/bsn/NUR410/unit_5/unit_5_2/NUR410_unit_5_2.pdf Galen College of Nursing. (n.d.-b). Quality of health care- part 1 [PowerPoint slides].

https://files.galencollege.edu/media/bsn/NUR410/unit_5/unit_5_3/NUR410_unit_5_3.pdf     EBR discussion 1 in response to Sarah F The article found is called A qualitative study exploring patient motivations for screening for lung cancer.     

According to Brown (2018), qualitative and quantitative research are important for a more well-rounded view of what is going on. The method used for this study according to Roth et al. (2018) was semi-structured qualitative interviews of people that have on low-dose computed tomography of the chest for lung cancer screening for heavy smokers. The advantages of qualitative research are to get opinions about low-dose computed tomography lung screenings. The question was why these patients seek this test out. The disadvantages to this is this type of test is not testing numerical calculations. It will not tell them how many people seek preventive screenings that are heavy smokers. This research done for qualitative lung cancer screening research could give insight on how healthcare providers can reach out to patients that fit the criteria to catch lung cancer before advancing.

References Brown, S. J. (2018). Evidence-Based Nursing The Research-Practice Connection (4th ed.).  (Ed.). Burlington, MA: Jones & Bartlett Learning. Roth, J. A., Carter-Harris, L., Brandzel, S., Busit, D. S., & Wernil, K. J. Qualitative study exploring patient motivations for screening for lung cancer. Public Library of Science, 1-11. https://doi.org/10.1371/journal.pone.0196758  EBR discussion 2 in response to Trista T Review the data provided for appraisal of quantitative research where you will compare and contrast studies to draw conclusions (click here for the data). After reviewing the data presented in the table, answer the following questions:

1.     What two patterns in the study can you identify? (Consider the sample and its size, study methods and whether it was appropriate to test the data, similarities/differences in the findings, and statistical significance or p value). Two patterns that I was able to identify within the study and subsequent evidence table was both the sample size/characteristics of the participants as well as the length of the studies that were conducted. All participants we at least 60 years old and all three studies compiled data from six months in order to report specific findings.

2.     What are the two strengths or limitations of the data? One limitation to the supplied data is within the prospective cohort study conducted by Marrero, Fortinsky, Kuchel, and Robison (2017) the method used was the completion of a survey in which the accuracy of collected data hinges directly upon the ability of the participants to be subjective versus objective, tangible data provided within the other two study samples. Another limitation to the data is that all three study designs explored were different (i.e. randomized clinical trial, prospective cohort study, and a longitudinal cohort study) thus resulting in a wider variety of feedback based solely on the type of study conducted in each situation.

3.     What is one practice recommendation that you could make based on your analysis of the studies? One practice recommendation that I could make based on my own analysis of the provided studies would be to further reduce potential variables that may result in inaccurate findings by limiting information to the objective instead of reported or subjective data.

In order to make this possible, I would only allow incidents to be reported directly by medical staff or falls that have been documented in a patient’s medical chart to be allowed into the study for consideration to result in more conclusive findings. Reference: Sample Quantitative Evidence Table [Lecture File]. Retrieved from              file:///C:/Users/trist/Downloads/NSG%204000%20Quant%20Evidence%20Table_%20Jan%202020%20Term-1%20(2).pdf

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