Emerging Health-Care Environment Essay
Read Chapter 13
You have to create an E-Poster on what you see as the future of nursing practice and the role of nursing in the emerging health-care environment. You need to predict the future based on present evidence.
The E-Poster needs to include the following:
2. Statement of the issue
3. Evidence supporting the issue
4. Prediction of the future role of the nurse Emerging Health-Care Environment Essay
6. References: minimum of three references from peer-reviewed nursing journals (encourage the use of international journals). Articles need to be within the last 3 years unless historical.
Writing Assignment #1/Emerging Issues in Health Care Management: Bioterrorism
Florida International University
September 25rd, 2016
HAS 3180. Dr. Michelle Kameka.
Inexplicable phenomenon occurs throughout our world in unprecedented times. Wars, famine and catastrophes are all things that have been experienced throughout time. One that hits close to home is bioterrorism. According to the Centers for Disease Control and Prevention (2007), Bioterrorism is the purposeful release of viruses, bacteria and other germs that can cause major illness and death in every living organism. These agents are usually enhanced in order to make them resistant to any form of medicine. In a bioterrorist attack, these agents can be spread through the air, through water, or through food. This form of despicable malice has shaken our nation multiple times. Means such as Anthrax, Botulism, Plague and Smallpox have left many dead in the massive amounts. In this nation, the recent Ebola virus has been an outbreak that some considered a bioterrorism event. Due to the many deaths and ill patients, there have been much skepticism on how this virus developed and the uncomforting facts that a cure cannot be made. With bioterrorism, we are left with many doubts and questions as health care workers and it is our duty to protect our patients and ourselves. No matter the circumstances, nurses, doctors, health care workers and the staff has a duty to prepare ourselves for…
This is a time of enormous investment in new health-care buildings. The UK plans to create upwards of a hundred hospitals and thousands of primary-care clinics and surgery centres. In the USA, more than $200 billion will be spent on new hospitals over the next decade. This wave of construction provides an opportunity to create better buildings by use of the emerging science of evidence-based design, in which the design process is guided by an empirical understanding of the eff ects of health-care physical environments on safety, effi ciency, and clinical outcomes.Emerging Health-Care Environment Essay The scientifi c foundation for evidence-based health-care design is already large and surprisingly strong. A joint project at Texas A&M University and the Georgia Institute of Technology in the USA identifi ed nearly 700 rigorous studies, most published in international medical journals, about how the architecture of acute-care hospitals aff ects health. A collaborative of more than 30 health-care organisations set up by the Center for Health Design has done several multi-year clinical and safety evaluations of specifi c design interventions and new buildings. Much credible evidence now shows that good design of a hospital’s physical environment promotes better clinical outcomes, increases safety, and reduces stress for both patients and staff . Research internationally has shown that hospital noise levels are far too high, with decibel intensities greatly exceeding guideline values such as those issued by WHO. Much of this noise, caused by, for example, bedrails being moved, overhead paging, trolleys, medical equipment, and staff shift changes, is unnecessarily loud. The problem is exacerbated by the prevalence of hard, sound-refl ecting fl oors and ceilings that cause sounds to reverberate, linger, and propagate over large areas into patients’ rooms and staff areas. Noise is a much greater problem in multi-bed than in single-patient rooms, owing to the additional disruptions caused by roommates. Noise has been associated with sleep loss and fragmentation, high blood pressure and heart rates, worse rates of recovery from myocardial infarction, and decreased oxygen saturation in infants in neonatal intensive care. For staff , noise is a stressful latent environmental condition that increases fatigue and job strain, and in some clinical situations heightens risk of error. Health-care building projects should therefore accord high priority to creating much quieter environments. Research shows that a quiet hospital is created mainly through appropriate design of the physical environment, not by modifying staff behaviour or organisational culture. Proven eff ective design measures for reducing noise include provision of single-bed rooms, elimination or insulation of noise sources (for example, replacement of overhead paging with a noiseless system), and installation of high-performance sound-absorbing ceiling tiles that diminish noise propagation. Carpeting in hallways and waiting areas further lessens propagation. In terms of safety, research strongly supports the conclusion that design of the physical environment is important for reducing infections spread by airborne and contact transmission; infection rates are lower when patients are in single rather than multi-bed rooms and air quality is very good. Single rooms have advantages over multi-bed rooms in reducing airborne transmission through ventilation and the possibility of such air quality measures as fi ltration, air changes, creation of positive air pressure to protect an immunocompromised patient from airborne pathogens in adjacent spaces, or creation of negative room pressure to prevent a patient with an aerially spread infection from infecting others. Other evidence suggests that single rooms also help to decrease risk of infections spread by contact. Single rooms are easier than multi-bed rooms to clean thoroughly after a patient leaves, lessening the problem of contaminated environmental surfaces remaining as pathogen reservoirs that can spread infection through hand contact. Single rooms also enable separation or isolation of patients on admission, so that those with unrecognised infections can be identifi ed and assignment to multi-bed rooms with uninfected patients avoided. A major source of contact transmission of infection is unwashed staff hands, and low hand-washing rates among staff are well documented. Evidence suggests that hand-cleaning compliance is worse when sinks and dispensers of alcohol hand gel are positioned several paces away from staff work or movement paths, or behind doors or in other locations outside the visual fi elds of busy nurses and physicians. There are encouraging indications that installation of wash basins and gel dispensers close to staff work paths in visually prominent locations near the point of care leads to sustained increases in hand washing. Floor layouts can be designed to reduce staff fatigue and increase time for care. Conventional fl oor layouts for patient-care units generally provide corridors organised around a central nursing station, where medications and charts are located, and a central location for supplies. Nurses therefore spend much of their time walking up and down halls engaged in wasteful activity, such as fetching supplies, thereby increasing fatigue and shrinking the time available for observing patients and delivering direct care. By contrast, fl oor layouts with decentralised nurse charting or observation stations and supplies dispersed to be close to patients’ rooms cut staff time spent walking and fetching and greatly increase time for observation and care of patients.Emerging Health-Care Environment Essay
The Nursing profession is one of the essential professions in the health care framework. While diverse forces are changing the face of contemporary healthcare, the nursing practices and trends are changing, which are also imposing significant impact upon the current nursing practices. The role of emerging technology and its impact upon the current contemporary health care context is highlighted in every part of health care settings (Drewsbury & Ballard, 2014). Technology is changing the world rapidly and the change it is rapidly changing the healthcare settings including the nursing facilities. Several emerging technologies have changed the view of nursing practices by enhancing the efficiency of the practices and the potential of the nursing professionals. Through these emerging technologies, nursing professionals gain several advantages. In essay, the impact of the emerging technologies on nursing practices would be analyzed from socio-cultural, political, economic, ethico-legal and professional perspectives. If there were any kind of issues resulted as an effect of emerging technologies, these would also be critically evaluated in this essay.
The nursing profession has been evolved along with the emergence of new and innovative technologies in the health care settings. Thus, several studies has been highlighted the impact of emerging technologies on nursing care facilities. Several reasons or driving forces influenced more research on emerging technologies that can help nursing faculties to deal with the complex health care practices. However, the trend evolved with the enhanced complications in the health care settings, which in turn enhanced with the changed lifestyle and environment surrounding the human society (Huston, 2013). From all three global, national and local viewpoint, ‘outcome vs. episodic success’ is one of the cause of technology advancement in health care setting. Previously, the focus of the medical practice was based on episodic success, which were efficient for removing the health issues from the root. To improve the situation, the nursing services are focusing towards value-based reimbursement with long-term goal setting form making incremental improvements of the interventions. The new emerging technologies now help nurses and physicians to directly communicate with patients through medical devices and telehealth services and reducing the necessity of coming to clinic for symptoms-based health care (Institute of Medicine, 2010). Emerging Health-Care Environment Essay For several reasons, the emerging technologies are being incorporated into the nursing practices, which include reduction of medication errors, improvement of patient safety and security, enhancing the accessibility of health related information to the patients, reducing nursing burnout, providing evidence for care plan decision making, empowering patient’s involvement into care practice, monitoring workforce as well as enhancing the coordination throughout the health care settings (McGonigle et al., 2014).
Cost is another significant cause. It has been seen in global perspectives that a number of people, from the remote areas, cannot access the expensive medical care, however, the new technologies are making the nursing care more accessible to the care users, by cutting cost. It has been reported by Miliard (2012) that United States have steadily risen the health care cost to about $3 trillion a year, which led to the creation of Affordable Care Act and telemedicine parity laws. It has been seen that clinical telemedicine is the only way of enhanced access to health care services with lower cost, thereby improving the sole outcomes. The emergency of information technology also drove the enhancement in technology development for improving medical and nursing care. As a reflection of an uncertain economy, available financing has shifted short-term, return-focused investors, to mid-capital and large-capital medical technology companies with a long-term interest in the healthcare future (Oren, Shaffer & Guglielmo, 2013). These established companies plan to stay in the medical technology business instead of current market condition and thus require innovation for progressing in their industry. Additionally, with the enhancement of research from innovators in different scientific disciplines and related understanding, a range of novel medical technologies evolved. The medical technology manufacturers attempt to create paradigm-shifting products, but end up with small improvements of existing technologies (Williams et al., 2012). However, continuous up gradation of existing technologies and advancement showed consistent value to the health care users, which also drove the technology advancement in health care. These are the causes of emerging technologies in medical field, which are implemented in nursing care.Emerging Health-Care Environment Essay
Electronic health records have been developed as a result of emerging technology in nursing practice and it is related to one of the essential part in nursing, patient documentation. Therefore, the impact of electronic health record upon nursing practices would be discussed here with the help of different perspectives. The electronic health record is referred to the system that records patient’s data in digital form, which can be made with records from many sources including clinics, hospitals and other providers (HIMSS Position Statement 2011). This technology has both economic and social benefits. This is a user-friendly technique. It is accessible 24 X 7 days a week, thereby promoting better coordination between the patients and care providers as well as within the care providers. It also includes built-in safeguards for assuring patient’s confidentiality and security, regarding their personal information.
It has been seen that the technology helps to improve the connection between the care providers as well as the patients, which can be classified as the social impact of the issue on the nursing practice. On the other hand, very soon after the implementation of HER, the management of patient records in the clinics began to improve radically (Gastaldi et al., 2012). Nowadays, the clinicians are able to track and access patient’s records, as a result, the implementation of this technology reduced its transcription expenses dramatically along with the staffing requirement related to chart pulling, fitting and maintenance. The financial benefit has also gained by elimination of chart building for new patients, eliminating the requirement of chart storage space and the elimination of increased revenues through improved E/M coding. From the professional perspective, it has been seen that with the use of HER, the nursing staffs are able to reduce their professional mistakes and improved the quality of care provided by them (Shih et al., 2012).Emerging Health-Care Environment Essay
In care settings, elimination of the misinterpretation also helps to improve the nurse-patient relationship, which is the key element of holistic nursing care. Additionally, the teamwork is also improved with the use of EHR. It has been revealed that this technology help to reduce the miscommunication within the health care professionals, by keeping all the patient’s data in a digital form. In the case of organizational perspectives, by reducing the misinterpretation of medication, patient’s data, and enhancing the communication efficiency within the professionals of multidisciplinary team, the EHR technology helps improve the quality of healthcare service provided by the organization, thereby enhancing patient’s satisfaction and corporate image of the organization (Jensen, Jensen & Brunak, 2012).
In spite of facilitating several innovations in reforming health care, many legal, ethical and financial issues has been raise regarding the EHRs. The legal framework relies upon the standards and lags behind the implementation of “technologies like EHRs”, offer very few guidance for navigating the conversion from paper-based work to “electronic health records” (Beard et al., 2012). In spite of the fact that the technology addresses longstanding issues regarding misinterpreted of missing medical information, there is no standard for addressing the level to which professionals will be accountable for monitoring the data in a “community-based integrated HER” containing data from several resources (Hsu et al., 2012). On the other hand, EHR tend to enhance the legal responsibilities and accountability of the clinical nurses. Thirdly, the EHR system introduced new liabilities regarding the documentation related issues. Usually, EHRs include progress report templates, where the recent test results are incorporated automatically, thereby enhancing the professional liabilities (Middleton et al., 2013). Additionally, issues regarding quality, usability and reliability of the available EHRs enhanced the complexity of legal ramifications. For example, clause in many HER contacts hinders a clinician’s ability of reporting HER-related issues.Emerging Health-Care Environment Essay
In addition to the above issues regarding HER, the increased portability and accessibility of patient’s data through EHR lift the ethical issues up regarding the ownership of protected information as well as the responsibility of clinicians about preventing and informing patients regarding the chances of privacy breaches. The digital patient’s health information breaches raise complex legal and ethical issues related to the suitability of current methods for addressing them. Thus, the institutions nowadays use audit logs as the evidence for accusing a person who is accessing the EHRs deliberately without authorization (Hammoud et al., 2012). In contrast, in paper-based documentation, privacy breaches are impossible to detect. It has also been revealed that the HER and state HIEs implementation in the health care framework is generating data resignng, which will further contribute in the rationalization of the health care delivery and payment mechanism; all of which are leading to ethical dilemma. Several ethical dilemmas surrounding privacy and control of electronic information are not resolved yet. For instance, with the increase of organizations participating in HIEs, issues related to reliability and uniquely recognizing the individual patients and the requirement of maintaining the patient privacy as well as data integrity will be enhanced (Huston, 2013). This legal issue imposes a significant barrier to adopt and use EHR and HIE, as current probabilistic patient’s data matching algorithms, in 5 to 10% cases, fail to match patient data correctly.Emerging Health-Care Environment Essay
In spite of reducing the cost, there are some financial dilemmas regarding EHRs and HIEs. One key unresolved financial issue is “who should pay for the implementation and the use of EHRs and HIEs”. Additionally, using EHR is reducing the productivity of individual caregiver or a nurse upto 10 % (Huston, 2012).It has been also revealed that, the professionals are significantly concerned about the cost and resources required for implementing and maintaining EHRs in the institutions, which has been estimated to be approximately $40 000 to $50 000. Another issue is raised regarding the retention of records for longer period. However, paper-based charts can be kept in simple lockers, but the security of digital records through EHRs is difficult and expensive. It is unanswered that who will pay for the longer storage and maintenance of data, after the liable professional retires. Finally, reduction of health care cost is overdue; however, many people are concerned about the downstream effects of health care cost reduction through EHRs and HIEs (Yen & Bakken, 2012).Emerging Health-Care Environment Essay
Electronic health records are shaping the way of managing health information, but the application of the technology is difficult, where the social and cultural issue should be addressed. Retaining the privacy and confidentiality through appropriate security is a critical challenge of adopting HER. The social issues include the person’s security and safety issues. A perfectly secure EHR is the one, which would not allow anyone to access the integrated data in the system. Thus, a balance between the access and security must be struck. However, the “correct” balance is not a scientific or technical issue, rather, it is a political and social issue and the answer of this “correct balance” relies on the values of participants, which varies widely (Huston, 2012). Whwreas, some people are trustworthy and use the medical records in a valid and ethical ways. However, some people are breaching the confidentiality and concerned about resisting such record-keeping.Emerging Health-Care Environment Essay
Therefore, it can be said that, the EHR is one of the significant issue resulted from the nursing trend “emerging technology” and it has significantly affected the nursing practice positively. However, the issues raised from the adoption and use of EHR has been evaluated here, which needed to be resolved soon, for improving the outcomes related to the user-friendly technology HER (Beard et al., 2012). To reduce the legal issues regarding the privacy breach and related cases, while dealing with HER and HIEs and improving the accuracy of matching patient’s data from disparate resources, the establishment of a nation-wide, health care related unique patient identifier (UPI) has been proposed. In 1998, the Federal regulations and public protested regarding infringement on the human right to privacy thwarted development of the UPI mandated in 1996 Health Insurance Portability and Accountability Act, which is known as HIPAA (Hammoud et al., 2012). A new and health national debate involving the key stakeholders is needed for addressing the ethical, legal and financial issues of an UPI along with the exploration of alternative solutions. These essential ethical, legal and financial issues should be addressed for achieving higher quality, lower-cost health care by widespread EHR use. A set of conversations should be started, culminating in the national forum or in global perspective, where lawyers, economists, informatics, policymakers, ethicists, clinicians and other stakeholders related to this issue, would participate. In these conversations, the goal should be set for recognizing and prioritizing solutions of these above mentioned key legal, economic, ethical and other social issues.Emerging Health-Care Environment Essay
The issues regarding privacy, security and confidentiality have grabbed the attention of government regulators. In 2002, the “health insurance portability and accountability act (HIPAA)” has been implemented for restricting the inappropriate flow of medical information without affecting the medical care (Middleton et al., 2013). However, more effective interventions regarding technological, educational and policy related issues are required to be addressed by the HIPAA regulations. Overall nursing practice can be improved, resolving these disputes, thereby making the EHRs more accessible and reliable to be adopted and implemented in nursing care practice.
In conclusion, it can be said that technology has a significant contribution in enhancing the quality of nursing care through the reduction of errors and misinterpretations of health care facilities. The Future of Nursing report highlights that “Health information technology will fundamentally change the ways in which registered nurses plan, deliver, document, and review clinical care”. The emerging technology is a significant trend in nursing, which is continuously evolving with research advancement. Here, one of prevalent technology Her has been critically reviewed as a significant result of emerging technology in nursing. With its huge positive impact upon nursing practices, the issues rose with this technology and its impact upon nursing has also been reviewed. More tough regulations and more focus on the ethical and legal perspectives are required for getting results that are more effective.Emerging Health-Care Environment Essay Emerging Health-Care Environment Essay
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