Evidenced Based Practice And Applied Nursing Research

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EVIDENCED BASED PRACTICE AND APPLIED NURSING RESEARCH

EvidencedBased Practice And Applied Nursing Research

UniversityAffiliation

Table of Contents

Table of Contents 2

Summary 3

Problem statement 3

PICO question 3

Significance of the problem 3

The current practice related to the problem 4

Impact of the problem 4

PICO TABLE 5

The use of indicator to measure the outcome change 5

Search strategy 6

Keywords used during the search: 6

Research evidence sources 6

Non-research evidence sources 6

Evidence Matrix 7

Study population selection 10

Measurement of the problem 10

Analysis of the recommended practice change 10

Evaluation of the process of implementing the recommendation 11

Roles of the stakeholders 11

Reference: 14

EvidencedBased Practice And Applied Nursing Research

SummaryProblemstatement

Theprovision of poor quality, unaffordable and inaccessibility to thehealth care services in the United States hospitals has significantlygrown over the past years. In Michigan community, Kent county in theUnited States for instance accessibility to healthcare has been ahuge problem thus limiting the county from achieving the its goalsfor 2020. Various interpretations and investigations of health caresystems and services within the country have provided unfavorableresults on the costs, quality, use, delivery, accessibility,financing, outcomes, and even the organization of the health caresystems and services. The results of these parameters have beenreally bad hence poor and inaccessibility to the health care services(Starr,2016).

PICOquestion

Whyhas the healthcare service in Michigan, Kent County beenunaffordable, of poor quality and inaccessible to most members of thecounty? What is the significance of the problem?

Significanceof the problem

Theproblem is very important in ensuring that all the stakeholders inthe healthcare sector in Kent county including the insurers,government officials, consumers, providers etc. take responsibilityto improve the services offered to the patients in the hospitals.Access to better health care is a right of all the citizens of theUnited States, therefore, it is very important for all thestakeholders to do their part in making sure that affordable,accessibility and high-quality health care systems and services areprovided to everyone in the country. Assuring the people of Michiganand Kent County an affordable healthcare is the most essential goalof reforming the health sector. The families from the county cannever be secure as long as they are facing financial challenges whenthey are sick. The society can also never lead a productive and ahealthy life when they cannot afford to be treated. Provision of areform that will provide a good quality, affordable and accessibilityto healthcare services would therefore be very crucial for Americanpeople.

Thecurrent practice related to the problem

Healthpolicies within the country have hugely contributed to the provisionof poor quality and unaffordable health care services in the UnitedStates hospitals. For instance, recent changes in Medicaid coverageand Medicare, inconsistencies in the utilization and access to thecare, new innovations and advances in the private insurance of healthservices and continued increase in the number of citizens withouthealth insurance have largely contributed to the poor quality andunaffordable health care systems and services in the countyespecially in Michigan community (Starr,2016).

Impactof the problem

Theprovision of poor quality, inaccessibility, and unaffordable healthcare services in the Kent county hospitals has had a huge effect onthe citizens of the county. To understand the negative effect theproblem has had on the patients, it is important to look into thesatisfaction of the patients with the services offered to them, thelife quality, and the health status of the patients. The abovefactors are found to be very poor to most of the patients thusbringing us to the conclusion that the health services are poor(Kohn,Corriganet al., 2013).

PICO TABLE

P (problem/patient)

Poor, inaccessibility and unaffordable healthcare services

I (indicator/intervention)

Having good policies in the healthcare sector to achieve 2020 goals

C (comparison)

Poor and bad policies within the healthcare sector

O (outcome)

Affordable, accessibility high-quality healthcare services

The use of indicator to measure the outcome change

Havinggood policies in the healthcare sector will be very crucial ineliminating the problem of poor quality, inaccessibility tohealthcare, and unaffordable healthcare services within the county.Good policies like expanding the coverage, holding all the insurancecompanies responsible, lowering the costs of healthcare services,guaranteeing more choice of healthcare hospitals and finallyimproving the general quality of the services will all be verycrucial in measuring the outcome change. The above policies willfully eliminate the problem thus helping the county to achieve thehealthcare goal of 2020 (James,2015).

Search strategy

Varioussearches within the structured database library were done to help inthe identification of the peer-reviewed books and articles, which arerelated to the quality of healthcare services in the United States.

Keywordsused during the search:

Quality,healthcare services, affordability, cost, accessibility, delivery.

Typesof articles available for consideration

Researchevidence sources

Differentstudies reporting on the measurements of the accessibility andquality of the healthcare services in Kent county were used asevidenced based sources. The studies included different concepts,hypotheses, and theories. The research used reviews, observationalstudies, and even experimental studies to give the results. The tworesearch articles used were:

AnellA, Willis M. (2014) International comparison of health care systemsusing resource proviles. BullWorld Health Organ.

JamesB. (2015) Quality improvement opportunities in health care—makingit easy to do it right. JManag Care Pharm.

Non-researchevidence sources

Theresearch used materials from the world health organization. Theresearch also used sources that were revised or developed within thepast five years. On the reflection of the health care servicesquality, publications from the year 2013 were used since the searchstrategy had set the search limit. It allowed only papers that werewithin the last five years to be used. Examples of non-researcharticles used were:

KohnLT, Corrigan JM, Donaldson MS, editors. (2013) Areport of the Committee on Quality of Health Care in America,Institute of Medicine. Washington,DC: National Academy Press.

StarrP. (2016) Thesocial transformation of American medicine: the rise of a sovereignprofession and the making of a vast industry. NewYork: Basic Books.

Evidence Matrix

Authors

Name of the Journal/WGU library

Publication year

Research Design

Simple size

Measurement of the outcome variables

Level (I–III)

Quality (A, B, C)

Results or the conclusions suggested by the authors

Anell A and Willis M.

International comparison of health care systems using resource proviles.

2014

Purpose: 4 databases from 2011-2014

N=12

HMR

I

A

Healthcare services in the United States is better than most countries

McDonald K, Romano P, Geppert J, Rockville, MD.

Agency for Healthcare Research and Quality Measures of patient safety based on hospital administrative data

2014

Purpose: CR databases searched.

N=8

CR

II

B

The quality of the healthcare is not that perfect.

James B.

Quality improvement opportunities in health care—making it easy to do it right.

2015

Purpose: 3 databases

N=7

RRT

II

B

With good policies, the quality of healthcare services can actually grow.

Kohn LT, Corrigan JM, Donaldson MS, editors.

A report of the Committee on Quality of Health Care in America, Institute of Medicine.

2013

Purpose: 9 databases

N=5

HMR

I

A

The quality of healthcare can highly increase if good policies are used in the health sector.

Starr P.

The social transformation of American medicine: the rise of a sovereign profession and the making of a vast industry.

2016

Purpose: 2 databases

N=6

RRT

III

C

American medicine sector will improve highly with the use of good policies.

Study population selection

Inconsideration of the basic elements of epidemiology study, theresearch selected Kent County Michigan community for the study. Theresearch studied various hospitals within the community andidentified the issue of poor inaccessibility and unaffordablehealthcare can be solved in the county as a serious problem in thecounty.

Measurement of the problem

Theproblem of poor quality, inaccessibility to healthcare, andunaffordable healthcare services was found to be serious in theMichigan community. Most members of the community could not accessthe healthcare services due to various factors. The problem has beena hindrance to the major 2020 goals of the county. Solving thisproblem is thus a crucial issue for both the state and Nationalgovernment of the United States.

Analysis of the recommended practice change

Theproblem of poor inaccessibility and unaffordable healthcare can besolved in the county. American healthcare systems have always beenvery inconsistent and require a huge improvement. The cost ofhealthcare services should be reduced significantly to ensure thateven the middle and lower class Americans are accessed to thehealthcare services (James,2015).

Apolicy that protects the patients can also be used to ensure thatMichigan people are not harmed or hurt by the services that aresupposed to help them. A research by Anell and Willis (2014) reportedthat between 45000 and 100000 patients die in the hospitals everyyear due to errors made by the people who provide healthcareservices. Medical errors are common in most of the hospitals inAmerica and the government should prioritize on the ways ofpreventing such occurrences.

Also,the healthcare services should benefit every citizen of Americaequally. A report by Starr reported that the current system hasfailed to accomplish one of the main goals of ensuring that theservices provided in the healthcare sector benefit every Americancitizen. The report said that there are pervasive differences withinthe healthcare sector by ethnic and racial minorities. The ethnic andracial minorities receive poor health care quality compared to otherpopulation (Starr,2016).

Evaluation of the process of implementing the recommendation

Tosolve these problems of poor quality, inaccessibility and expensivehealthcare services in the healthcare sector, both the stategovernments of Kent County and national government will need to havea strategic policy, which examines the interactions between thepatients and the healthcare providers. For instance, a strategicpolicy describing the communication between doctors can ensure thatall the patients are satisfied with the services (Kohn,Corriganet al., 2013).

Rolesof the stakeholders

Thekey stakeholders of health sector including the state government, thenational government, the hospital management, the health providers(nurses and doctors) must perform their roles to ensure that theproblem of poor quality, inaccessibility, and expensive healthcareservices in the healthcare sector is completely solved.

Onthe medical errors made by healthcare providers, the governmentshould ensure that all the doctors and nurses graduating from theschools have got enough skills and ability to avoid such errors. Thiswill significantly reduce the number of individuals who die every daydue to the errors made by medical providers. Healthcare stakeholderslike the government, the healthcare providers (nurses and doctors)and the management of the hospitals should always make sure thatbetter healthcare services are offered to all the patients withoutany discriminations.

Thegovernment must also make sure that the health insurance does notdiscriminate against any sick person. Since the premium prices of theinsurance will have a huge effect on the affordability of the healthservices, the government should then ensure that the premium pricesof the insurance are reduced. Affordability of healthcare servicesdoes not only depend on the family and individual premiumcontributions, but it also depends on the obligation cost sharing andseveral deductibles. It is therefore very crucial for the hospitalmanagement and the government to reduce all the deductibles andobligation cost sharing to ensure that the healthcare services areaffordable to everyone within the county.

Implementingthe policies within the sector can, however, experience some barrierslike insufficient equipment used in the diagnosis and treating of thepatients and delaying of the services. Sometimes the services areprovided too late that they find when the patients are not able torespond to them well. To help solve these barriers, the governmentand other stakeholders can help in providing enough and betterequipment, which will help in diagnosis and treatment of thepatients. The health providers like the nurses and doctors can alsoensure that the services are provided in time to prevent any delay ofthe services (Kohn,Corriganet al., 2013). All the problems within the healthcare sector can onlybe solved when good policies are put in place. The policies will actas the indicator to measure all the results gotten from therecommendation.

Reference:

AnellA, Willis M. (2014) International comparison of health care systemsusing resource proviles. BullWorld Health Organ.

JamesB. (2015) Quality improvement opportunities in health care—makingit easy to do it right. JManag Care Pharm.

KohnLT, Corrigan JM, Donaldson MS, editors. (2013) Areport of the Committee on Quality of Health Care in America,Institute of Medicine. Washington,DC: National Academy Press.

McDonaldK, Romano P, Geppert J, Rockville, MD. (2014) Agency for HealthcareResearch and Quality Measures of patient safety based on hospitaladministrative data—the patient safety indicators (Prepared by theUniversity of California San Francisco-Stanford Evidence-basedPractice Center under Contract No 290-97-0013).

StarrP. (2016) Thesocial transformation of American medicine: the rise of a sovereignprofession and the making of a vast industry. NewYork: Basic Books.

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