Collaborating with Patients and Families
Hello
colleagues, I hope that you are doing well. Collaboration with patients and
their families is essential to achieve optimal health outcomes. Hagedoorn et
al. (2021) note that such a partnership involves effective communication,
shared decision-making, and a tailored approach based on the specific needs and
preferences of the patient. One effective strategy is medication-specific
education. This involves equipping patients and their families with essential
information about the purpose, side effects, and appropriate use of
medications. Such educational interventions have been associated with improved
medication adherence and fewer medication-related errors, leading to better
health outcomes. Equally important is the application of cultural competence strategies.
We serve a diverse population in our nursing home, and understanding,
acknowledging, and respecting the cultural beliefs and values of our patients
is fundamental to effective care. Incorporating these cultural perspectives
into our care plans enhances patient engagement and satisfaction, thus leading
to improved health outcomes (Hasbrouck, 2021).
Change Management and Patient Experience
Change
management in our nursing homes should be approached with a strong emphasis on
its potential impact on the patient experience. According to Gandhi et al.
(2021), the patient experience, distinct from patient satisfaction, pertains to
patients' interactions with the healthcare system, including their care from
health plans, and from doctors, nurses, and staff in hospitals, physician
practices, and other healthcare facilities. Changes may involve adjustments in
care routines, the introduction of new services, or modifications to the
physical environment. However, we must be mindful of the potential consequences
of these changes on aspects of care that patients value highly such as respect
for their preferences, emotional support, and effective communication.
Therefore, any change management strategy should involve thorough planning,
inclusive of patients' input, to ensure that the implemented changes contribute
to high-quality, patient-centered care, without compromising aspects that could
negatively affect the patient experience.
Ethical Rationale for Coordinated Care Plans
In
developing coordinated care plans, ethical decision-making is paramount.
Ethical considerations guide us to provide care that is respectful of the
autonomy, values, and needs of our patients (Jakobsen et al., 2019). This
implies considering the potential benefits and risks of different care options
and engaging patients and their families in making informed decisions about
their care. Additionally, ethical decision-making necessitates recognizing the
inherent dignity of our patients and striving to promote their overall
well-being, while avoiding harm. An ethical approach in coordinated care could
also involve considerations about fair resource allocation, particularly in
circumstances where resources are scarce. It is important to acknowledge that
these ethical decisions are guided by professional nursing values, the
principles of biomedical ethics, and legal regulations (Magelssen &
Karlsen, 2022). Therefore, ongoing ethics education and reflective practices
are crucial to ensure the ethical integrity of our care coordination process.
Impact of Health Care Policy Provisions on Outcomes and Patient Experiences
Healthcare policies significantly shape the landscape of patient care and outcomes.
The HIPAA for instance ensures patient privacy and confidentiality thus
enhancing trust between patients and health care providers. However, it also
introduces complexities, particularly in achieving a balance between
information sharing for effective care coordination and respecting patient
privacy (Krzyzanowski & Manson, 2022). Moreover, Medicaid-managed long-term
services and supports have changed how nursing home care is financed and
delivered. This policy shift can influence the quality of care provided and,
consequently, patient experiences. Limited resources, for example, may result
in strained services and dissatisfaction among patients and their families
(Potter & Bowblis, 2021). Understanding these policy provisions and their
implications can guide us in optimizing our care practices and advocating for
policy improvements that enhance patient outcomes and experiences.
The Nurse's Role in Care Coordination and Continuum of Care
Nurses
are at the heart of care coordination and the continuum of care because we are
responsible for ensuring that the care provided to patients is consistent,
comprehensive, and patient-centered. Our role extends beyond delivering
clinical care. It includes advocating for patients, facilitating communication
among the care team, and educating patients and their families (Gandhi et al.,
2021). We also oversee care transitions, ensuring that patients receive the
necessary care as they move between different settings or levels of care. This
important role demands that we continually enhance our skills and knowledge to
deliver effective care coordination. Investing in our professional development
and capacity to navigate the complexities of patient care is not only
beneficial to our nursing practice but also crucial for improving patient
outcomes and experiences (Monroe, 2019).
Facilitating Drug-Specific Educational Interventions
Medication
education is a fundamental aspect of patient care, especially for elderly
patients who often have multiple medications. By providing drug-specific
educational interventions, we can empower patients and their families to
actively participate in their care. This includes providing clear instructions
on how and when to take medications, explaining potential side effects, and
discussing the importance of medication adherence. It's also essential to
consider the patient's health literacy level and to use patient-friendly
language to ensure understanding. By doing so, Hasbrouck (2021) explains that
it is possible to enhance medication compliance, minimize the risk of
medication errors, and improve overall health outcomes. Additionally, by
fostering open communication, we can address any concerns or questions patients
and their families may have about medications, which can lead to increased
trust and satisfaction with the care provided.
Promoting Cultural Competence in Care Provision
In
the diverse environment of nursing homes, cultural competence is an essential
tool in our arsenal as care providers. This includes acknowledging and
respecting the cultural beliefs, values, and practices of our patients, and
integrating these into care plans as appropriate. By providing training and
resources on cultural competence, we can promote an understanding of various
cultural perspectives, and effectively communicate and provide care that is
sensitive to cultural differences (Hasbrouck, 2021). Culturally sensitive care
not only upholds the dignity and autonomy of our patients but also fosters
trust, improves patient satisfaction, and leads to better health outcomes.
The Importance of Ethical Decision-Making in Care Coordination
Ethical
decision-making forms the backbone of care coordination. According to Magelssen
and Karlsen (2022), ethical decision-making encompasses a range of
considerations, such as evaluating potential risks and benefits of our actions,
upholding patient autonomy, and enhancing patient well-being. Ethics education
plays a vital role in strengthening our ability to navigate these complexities
and make decisions that are in the best interest of our patients (Monroe,
2019). An ethical approach allows us to deliver care that aligns with
professional values while resonating with patients' values and needs.
Navigating Health Care Policies to Improve Patient Outcomes
Healthcare policies shape the quality of care and patient outcomes in nursing homes. Understanding and effectively navigating these policies are key elements in optimizing our care provision (Potter & Bowblis, 2021). By staying informed about relevant policies, we can ensure that our practice aligns with current standards and regulations. Moreover, it is our responsibility to advocate for policy changes that enhance the quality of care and ultimately improve patient outcomes and experiences.
Expanding the Role of Nurses in Care Coordination
The role of nurses in care coordination extends far beyond basic patient care. We are instrumental in managing comprehensive care plans, collaborating with interdisciplinary teams, and ensuring smooth transitions between different care settings (Gandhi et al., 2021). By investing in our knowledge and skills in care coordination, we can actively contribute to improved patient outcomes, increased patient satisfaction, and more efficient care delivery in our nursing homes. Continuous professional development enables us to navigate the ever-evolving healthcare landscape and reinforces our commitment to delivering high-quality, patient-centered care.
References
Gandhi, A., Yu, H.,
& Grabowski, D. C. (2021). High nursing staff turnover in nursing homes
offers important quality information. Health Affairs, 40(3),
384–391. https://doi.org/10.1377/hlthaff.2020.00957
Hasbrouck, L. (2021).
Healthy People 2030: An improved framework. Health Education &
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Hagedoorn, E. I., Paans,
W., van der Schans, C., Jaarsma, T., Luttik, M. L., & Keers, J. (2021).
Family caregivers’ perceived level of collaboration with hospital nurses: a
cross-sectional study. Journal of Nursing Management, 29(5),
1064–1072. https://doi.org/10.1111/jonm.13244
Jakobsen, R., Sellevold,
G. S., Egede-Nissen, V., & Sørlie, V. (2019). Ethics and quality care in
nursing homes: Relatives’ experiences. Nursing Ethics, 26(3),
767–777. https://doi.org/10.1177/0969733017727151
Krzyzanowski, B., &
Manson, S. M. (2022). Twenty years of the Health Insurance Portability and
Accountability Act safe harbor provision: Unsolved challenges and ways forward. JMIR
Medical Informatics, 10(8), e37756–e37756. https://doi.org/10.2196/37756
Magelssen, M., &
Karlsen, H. (2022). Clinical ethics committees in nursing homes: what good can
they do? Analysis of a single case consultation. Nursing Ethics, 29(1),
94–103. https://doi.org/10.1177/09697330211003269
Monroe, H. A. (2019).
Nurses’ professional values: Influences of experience and ethics
education. Journal of Clinical Nursing, 28(9-10),
2009–2019. https://doi.org/10.1111/jocn.14806
Potter, A. J., & Bowblis, J. R. (2021). Nursing home care under Medicaid managed long‐term services and supports. Health Services Research, 56(6), 1179–1189. https://doi.org/10.1111/1475-6773.13701
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