Comprehensive Needs Assessment Assignment Help
Next, analyze your issue/event through the lens of the natural and applied sciences by exploring the following questions:
• How does this issue/event provide a social commentary through the natural and applied sciences?
• In what ways can science help resolve or enhance your issue/event?
****Next, analyze your issue/event through the lens of the social sciences, and address the following:
• How does this issue/event interact with the social sciences lens and impact social issues?
• In what ways does the social science lens help articulate a deeper understanding of the social issue(s) that inform your issue/event?
**********Note: You are completing two separate analyses: one from the natural and applied sciences and one from the social sciences. You must submit two papers in a single Word document.
Be sure to use evidence from research to support your analysis. Refer to course resources, the IDS 402 Research LibGuide (https://libguides.snhu.edu/ids402), and any other pertinent resources to support your responses. Relevant current news sources may be used with instructor approval.
Final Project Part One. Specifically, the following critical elements must be addressed:
I. Lens Analysis: In this section of your assignment, you will analyze your issue/event through two of the four general education lenses.
A. Analyze your issue/event through the lens of the natural and applied sciences for determining its impact on various institutions. Utilize evidence from research to support your analysis.
B. Analyze your issue/event through the lens of the social sciences for determining its impact on various institutions. Utilize evidence from research to support your analysis.
Comprehensive Needs Assessment
Learner’s Name
University
Introduction to Care Coordination
Instructor Name
Date
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Comprehensive Needs Assessment
A comprehensive health needs assessment of patients enables health care providers to systematically use their resources to disperse care efficiently. In this paper, a comprehensive needs assessment of a simulated patient is discussed to highlight the importance of comprehensive needs assessments in identifying and reducing gaps in patient care and implementing effective care coordination. This paper discusses the various dimensions of a patient’s needs and the strategies to extract relevant patient information to understand these needs to establish the significance of a health needs assessment. This paper also presents effective evidence-based practices in care coordination and the importance of a multidisciplinary approach to patient care for improving health care outcomes.
Current Gaps in Mr. Decker’s Care
Mr. Decker is a 79-year-old diabetic patient readmitted to one of Vila Health’s hospitals. Initially admitted with a badly infected toe, Mr. Decker’s inability to adhere to medical instructions after discharge has resulted in him being readmitted with sepsis. Mr. Decker’s readmission can be attributed to the following gaps in care:
• Lack of an interdisciplinary approach to care: The inability of the health care provider to ensure that factors such as diabetes and aging are given due consideration while dispersing care
• Failure to ensure adequate post-discharge support: Lack of adequate efforts from the care provider to ensure that the patient effectively carries out the post-discharge care instructions
• Lack of consideration for the patient’s financial standing: The patient’s poor financial standing was not considered during the design and management of the patient’s care
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To ensure that Mr. Decker’s physiological, social, religious, and psychological needs are effectively addressed, the needs assessment tool adopted is the Patient Centered Assessment Method. The method is an integrated needs assessment tool that assesses patients’ physical, social, psychological, and mental well-being needs. The tool was selected because it is action oriented. It facilitates the addressal of patients’ holistic needs, expanding beyond the realm of physiological health care to address their psychosocial needs (Maxwell et al., 2018). Informational Needs for Patient’s Optimal Care:
An effective assessment of Mr. Decker’s current care needs depends on the following types of information:
• Mr. Decker’s clinical information, namely age, allergies, weight, current diagnosis, and medical history (Kelley et al., 2013)
• Personal information such as his schedules, preferences, typical behaviors, and interests, which will provide clarity on how Mr. Decker’s care needs are to be addressed (Kelley et al., 2013)
Strategy for Gathering Additional Necessary Assessment Data
As a personal interview does not help gather all the information necessary for the adequate delivery of care, the following data collection strategies are formulated nursing essay help:
• Thoroughly scanning Mr. Decker’s activities across social media platforms to collectinformation about his behavior patterns, his daily routines, and the significant events he has been a part of will help provide clarity on his personalized needs and the various interrelated factors affecting his care.
• In-depth interviews with close relatives and friends about Mr. Decker’s habits, nature, and recent activities will help understand the factors that affect care and facilitate personalized care measures that suit his situation.
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• The electronic health record systems at Mr. Decker’s preceding health care providers are important sources of clinical information. Health information exchange systems are set up to access Mr. Decker’s longitudinal clinical data from different health care providers to get clarity on the various factors such as diabetes and aging that have a bearing on his current condition. The clinical history will help ensure that Mr. Decker’s care addresses these interrelated factors and facilitates a holistic treatment. https://anyessayhelp.com/tag/nursing-essay-help/
Societal, Economic, and Interdisciplinary Factors Affecting Patient Care
The factors affecting Mr. Decker’s health care outcomes are the following:
• Aging: The physiological changes that occur in an aging person present immense challenges in the diagnosis, treatment, and recovery of geriatric patients (above 60 years of age) with sepsis. Geriatric patients usually show atypical, non-specific symptoms such as altered mental status, lethargy, dehydration, loss of appetite, and weakness, making the diagnosis challenging. Being an inflammatory consequence to an infection, sepsis is conventionally diagnosed using systemic inflammatory response syndrome criteria, which are not normally met by geriatric patients. According to Clifford et al. (2016), geriatric patients undergo pharmacokinetic changes, namely degeneration in the ability to absorb, metabolize, distribute, and eliminate drugs. These pharmacokinetic changes have significant implications on the treatment of sepsis and, consequently, result in the need for special considerations while treating geriatric patients. Also, geriatric adults usually witness immunosenescence (changes in the immune system), which impedes the swiftness of the recovery process in geriatric patients (Clifford et al., 2016).
• Financing for health care: Mr. Decker is a 79-year-old man whose accessibility to health care depends primarily on Medicare, the national insurance health care program. Although Medicare covers hospitalization and medical insurance, the level of care depends on the type of insurance plan opted. The 2019 cost estimates for Medicare stand at 437 U.S. dollars as the premium per month for the hospital insurance plan (Part A) and 135.50 U.S. dollars as the premium per month for the medical insurance plan (Part B), with higher costs for other high-end plans (U.S. Centers for Medicare and Medicaid
Services, n.d.). Mr. Decker’s dismal income status has affected the nature of the Medicare plan he could afford, thus impacting care outcomes.
• Social support: Mr. Decker has limited social support in the form of an aged wife who lives with him, a daughter who visits them occasionally, and his nephew and nephew’s wife, who offer occasional assistance. This limited social support has had a significant bearing on his ability to carry out the care instructions laid out by the care providers. Many studies provide evidence about the impact of social support on health outcomes. In a study by Schöllgen et al. (2011), the participants interviewed reported that increased social support was associated with functional and subjective improvements in health (as cited in Rapoza et al., 2016). A study conducted by White et al. (2009) found that geriatric adults with insufficient social support reported poorer health outcomes than geriatric adults who were satisfied with their present social support (as cited in Rapoza et al., 2016). The inadequacy of social support in Mr. Decker’s case has been the basis for the worsening of his health condition from a simple toe wound to sepsis.
• Diabetes: The fact that Mr. Decker is also diabetic has impacted his care by making him vulnerable to contracting infections at a higher rate and facing increased chances of prolonged mortality as a result of sepsis. This can be substantiated by the fact that diabetes causes a decline in the functioning of a patient’s immune cells, diminishing the ability to clear bacterial formations and increasing infection complications (Frydrych et al., 2017).
Relating Patient Care and Care Coordination Outcomes to Professional Standards
The outcomes of patient care and care coordination can be accounted for by measuring the patient safety and quality outcomes of patient care and care coordination. Patient safety outcomes for specific patient care coordination are measured against the standards laid out in the National Quality Forum’s safety report for 2017 and The Joint Commission’s National Patient Safety Goals for 2019. The rationale for measuring safety outcomes based on the National Quality Forum’s safety report is the comprehensiveness of the report and the credibility of the
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forum, whose primary focus is the development of safety measures (National Quality Forum, n.d.). The rationale for selecting The Joint Commission’s National Patient Safety Goals as a standard for patient safety is that the goals are developed based on the suggestions of a highly interdisciplinary advisory group and the analysis of national sentinel event data (Armstrong, 2014). The quality outcomes of care coordination will be measured using the Care Coordination and Transition Management Logic Model for registered nurses as the standard (Haas & Swan, 2014a). The rationale is that the logic model not only lays out care coordination quality outcomes but also offers holistic linkages between nurse competencies, care coordination, and outcomes (Haas & Swan, 2014b). Also, the logic model offers an innovative approach for interprofessional teams focusing on patient-centered care (Haas & Swan, 2014a).
The Joint Commission annually releases patient safety goals, which have been deemed nationally as qualitative standards for patient safety. Some significant standards for patient safety are identification of a patient by both name and date of birth, dispersal of the right test results to the right patient, accurate labeling of medicines, medical device alarms going off in real time, and ensuring infection prevention, which will set the right benchmark for ensuring effective patient safety outcomes (The Joint Commission, 2019). In terms of The Joint Commission’s standards for patient safety, the care to Mr. Decker was characterized by 100% infection prevention during acute care, accurate administration of medicines with no adverse effect on the body, and a successful operation without any complication. Some important care coordination quality outcomes defined by the Care Coordination and Transition Management Logic Model are the needs assessment’s taking into account patient needs, preferences, and goals; transmission of the patient’s care plan with zero errors; constant updating of care coordination plans; evidence- based practices’ achieving treatment outcomes of 80%; and optimal understanding of the interdisciplinary roles between team members (Haas & Swan, 2014b). On this front, the specific patient care coordination witnessed 70% treatment outcomes, the patient’s care plan was able to accommodate 90% of the patient’s needs and preferences, and the care plan was updated in a timely manner with zero issues reported within the cross disciplinary team.
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Evidence-Based Practices for Successful Implementation of Patient Care Coordination
The following evidence-based practices have been identified to be effective in implementing successful care coordination for patients with sepsis:
• GENeralized Early Sepsis Intervention Strategies (GENESIS) is an initiative launched for the continuous improvement of the quality of care for patients with sepsis. GENESIS is a comprehensive program with highly pertinent treatment measures such as implementing institutional assessments for the prevalence of sepsis and mortality, identifying sepsis emergencies, executing 6-hour sepsis bundle interventions via highly coordinated sepsis teams, and implementing feedback. In their study on the impact of GENESIS on a treatment group of 4,801 patients, Cannon et al. (2012) found an average in-hospital mortality reduction of 14% and a reduction in the duration of stay of 5.1 days in comparison to patient groups that did not receive treatment under GENESIS psychology essay help (as cited in Perez, 2015).
• Another effective practice can be the adoption of a centrally coordinated, multifaceted quality improvement program implemented by many hospitals in Brazil (Noritomi et al., 2014). Noritomi et al. (2014), in their study of 10 private hospitals implementing the program, found the initiative to include two phases. The first phase comprised establishing a local committee, setting up a screening procedure for the early detection of sepsis, carrying out proven treatments, establishing guidelines for empirical-based antimicrobial therapy, formulating specific routines for swift laboratory sampling, and establishing routines to enable the efficient administration of antibiotics. The second phase included the collection of data and creation of reports on the rate of compliance and mortality in line with the benchmarks set by the hospital. This practice is a promising one to adopt as Noritomi et al. (2014) found that the studied hospitals showed a decrease in mortality rates from 55% before the implementation of program to 26% after the implementation of the program.
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Best Practices from the Perspective of Population Health on Patient Outcomes
From the population standpoint of improving the health outcomes of geriatric patients with sepsis, the following care practices are found to be credible and effective:
• As geriatric patients show atypical, nonspecific symptoms (Clifford et al., 2016), a study by
Singer et al. (2016) found the sequential organ failure assessment score a valuable tool in
determining signs of organ disfunction and mortality and, thus, helpful in the diagnosis of sepsis. Singer et al. (2016) found that the sequential organ failure assessment score has widespread familiarity in the clinical care community and serves as an acceptable marker for mortality risks.
• The Surviving Sepsis Campaign guidelines, which are widely accepted, formulate the Sepsis Six bundle as a best practice for the treatment of sepsis (Lat et al., 2018). Hancock (2015) describes the Sepsis Six bundle as an early intervention program that calls for each patient to receive three diagnostic and three therapeutic steps to treatment within the hour ofrecognition of the health condition (as cited in Lat et al., 2018).
Benefits of Multidisciplinary Approach to Patient Care
Mr. Decker is an old patient with multiple diagnoses and several complex and multiple needs. A multidisciplinary approach to health care through effective consultation and collaboration involving Mr. Decker, family support, and interdisciplinary teams serves as the only approach that can address the complex multimorbidity, social issues, and psychological issues faced by him (Department of Health & Human Services, n.d.). This multidisciplinary approach to patient care can also reduce the gaps due to societal, economic, and interprofessional factors. The approach is built on egalitarian-based collaboration between interdisciplinary teams that helps
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break the hierarchy existing in traditional health care organizations and, thus, improves the satisfaction of employees in the workplace (Hughes, 2018).
The adoption of a multidisciplinary approach to patient care ensures improved patient outcomes. In their study on improving operating room efficiency, Oyderk et al. (1988) found that the adoption of multidisciplinary operating room teams improved turnover time by 16 minutes and considerably decreased delays when compared with operating room teams that are not multidisciplinary, resulting in reduced hospitalization costs (as cited in Epstein, 2014). This study supports the argument that a multidisciplinary approach to patient care helps reduce the duration of stay, reduce hospitalization costs, and improve patient satisfaction. https://anyessayhelp.com/tag/history-essay-help/
Conclusion
A comprehensive needs assessment of patient care is presented in this paper through the
case of Mr. Decker. This paper successfully identifies the various interrelated factors, such as
aging, diabetes, social support, and financial conditions, that need to be addressed for a patient to
achieve optimal care. The studies presented in the paper have identified credible standards for
the specific care coordination outcomes to draw measures from. This paper successfully
identifies holistic and judicious evidence-based practices for managing sepsis. Finally, a strong case for a multidisciplinary approach to care coordination is presented with empirical evidence.
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References
Armstrong, G. (2014). Nursing and quality: A historical perspective. In G. Lamb (Ed.), Care coordination: The game changer: How nursing is revolutionizing quality care (pp. 13– 28). http://library.capella.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true& db=nlebk&AN=719342&site=ehost-live&scope=site&ebv=EB&ppid=pp_17
Clifford, K. M., Dy-Boarman, E. A., Haase, K. K., Maxvill, K. H., Pass, S., & Alvarez, C. A. (2016). Challenges with diagnosing and managing sepsis in older adults. Expert Review of Anti-Infective Therapy, 14(2), 231–241. https://doi.org/10.1586/14787210.2016.1135052
Department of Health & Human Services. (n.d.). An interdisciplinary approach to caring.
https://www2.health.vic.gov.au/hospitals-and-health-services/patient-care/olderpeople/resources/improving-access/ia-interdisciplinary
Epstein, N. E. (2014). Multidisciplinary in-hospital teams improve patient outcomes: A review. Surgical Neurology International, 5(Suppl 7), S295–S303. https://doi.org/10.4103/2152-7806.139612
Frydrych, L. M., Fattahi, F., He, K., Ward, P. A., & Delano, M. J. (2017). Diabetes and sepsis: Risk, recurrence, and ruination. Frontiers in Endocrinology, 8(271), 1–22. https://doi.org/10.3389/fendo.2017.00271
Haas, S. A., & Swan, B. A. (2014a). Developing the value proposition for registered nurse care coordination and transition management role in ambulatory care settings. Nursing Economic$, 32(2), 70–79. https://ecommons.luc.edu/nursing_facpubs/11/
Haas, S. A., & Swan, B. A. (2014b). Quality and safety outcomes for patients and families. In G. Lamb (Ed.), Care coordination: The game changer: How nursing is revolutionizing
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quality care (pp. 133–152). http://library.capella.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&d b=nlebk&AN=719342&site=ehost-live&scope=site&ebv=EB&ppid=pp_17
Hughes, C. (2018, July 12). Multidisciplinary teamwork ensures better healthcare outcomes.
https://www.td.org/insights/multidisciplinary-teamwork-ensures-better-
healthcare-outcomes
Kelley, T., Docherty, S., & Brandon, D. (2013). Information needed to support knowing the patient. Advances in Nursing Science, 36(4), 351–363. https://doi.org/10.1097/ANS.0000000000000006
Lat, S., Mashlan, W., Heffey, S., & Jones, B. (2018). Recognition and clinical management of sepsis in frail older people. Nursing Older People, 30(2), 35–38. http://doi.org/10.7748/nop.2018.e975
Maxwell, M., Hibberd, C., Aitchison, P., Calveley, P., Pratt, R., Dougall, N., Hoy, C., . . . Cameron, I. (2018). The Patient Centered Assessment Method for improving nurse-led biopsychosocial assessment of patients with long-term conditions: A feasibility RCT. Health Services and Delivery Research, 6(4). https://doi.org/10.3310/hsdr06040
National Quality Forum. (n.d.). Patient safety.
http://www.qualityforum.org/Show_Content.aspx?id=57035
Noritomi, D. T., Ranzani, O. T., Monteiro, M. B., Ferreira, E. M., Santos, S. R., Leibel, F., & Machado, F. R. (2014). Implementation of a multifaceted sepsis education program in an emerging country setting: Clinical outcomes and cost-effectiveness in a long-term follow- up study. Intensive Care Medicine, 40(2), 182–191. http://doi.org/10.1007/s00134-013-3131-5
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Perez, D. (2015). An evidence based approach to sepsis: Educational program (Doctoral project). ProQuest. (Order No. 10014646) http://doi.org/10.34917/8220151
Rapoza, K. A., Vassell, K., Wilson, D. T., Robertson, T. W., Manzella, D. J., Ortiz-Garcia, A. L., & Jimenez-Lazar, L. A. (2016). Attachment as a moderating factor between social support, physical health, and psychological symptoms. SAGE Open, 1–13. https://doi.org/10.1177/2158244016682818
Singer, M., Deutschman, C. S., Seymour, C. W., Shankar-Hari, M., Annane, D., Bauer, M., . . . Angus, D. C. (2016). The third international consensus definitions for sepsis and septic shock (Sepsis-3). Journal of the American Medical Association, 315(8), 801–810. https://doi.org/10.1001/jama.2016.0287
The Joint Commission. (2019). National Patient Safety Goals Effective January 2019. https://jointcommission.org/assets/1/6/NPSG_Chapter_HAP_Jan2019.pdf
U.S. Centers for Medicare and Medicaid Services. (n.d.). Medicare costs at a glance.
https://medicare.gov/your-medicare-costs/medicare-costs-at-a-glance
Financial information for publicly traded companies is available to the public and can be found on a domestic company’s 10-K Annual Report on the company’s investor relations page (e.g., Apple Financial Information) or the U.S. Securities and Exchange Commission (SEC) site under Filings & Forms and on many other financial sites including Yahoo! Finance.
Mergent Online is a financial industry tool available to SNHU students for free.
To Find a Publicly Traded Company
• Log in to Blackboard, select the Online Student Services tab at the top of the page, and under Academic Support, select the Shapiro Library link.
• Select the A-Z Database List link, and in the Search for Databases field, enter Mergent Online, click on GO, and then click on Mergent Online in the results.
• This is the direct link: http://www.mergentonline.com.ezproxy.snhu.edu/basicsearch.php
• Enter a company name in the Company Search - Enter symbol or Company Name field in the first section (top, left) and wait one moment for a drop-down menu to appear.
• If it is a publicly traded company (meaning its stock trades on an exchange where you can buy and sell shares), it will appear in the list below and you will see the company stock ticker symbol and name.
• Click on the company name in the list for details, and confirm that this is the company you intended to search for by reading the Business Summary.
• Review the information in the blue box at the top of the page and make note of the company’s assigned Sector and Industry.
To Find Historical Stock Prices
• Click on the Equity Pricing tab.
• The Time Period defaults to 3 years.
• Click on Report above the Controls box.
• Once you see the Historical Pricing, choose Download near the top right of the screen.
• Save the Excel file to your computer.
• Use the Close price to calculate the percent increase or decrease in the stock price over the seven weekday or three-year period (“rate of return” in rubric).
• For example, Apple’s stock price on 8/19/16 closed at $109.36. Seven weekdays earlier, on 8/11/16, it closed at $107.93. If you had bought 100 shares of Apple stock on 8/11/16 at $107.93 and sold them on 8/19/16 at $109.36, you would have earned $143 before taxes, which is a 1.32% rate of return. The calculation is (109.36-107.93)/107.93 x 100 which equals 1.32%.
• Apple’s stock price closed on 8/19/2013 at $72.53. The three-year rate of return is 50.77%.
To Download Financial Statement Data
• Select the Company Financials tab to retrieve financial statement data.
• Balance Sheet data will appear, and it defaults to Annual.
• Five years’ worth of data will appear, and you can change to 3 years by selecting that option to the right of the Annuals/Balance Sheet above the Balance Sheet data.
• Choose Refresh at the end of the next row.
• Choose Download near the top right of the screen.
• Save the Excel file to your computer.
• Change Balance Sheet to Income Statement and then Cash Flow to get your other financial statements.
To Find a Competitor
• Click on the Competitors tab.
• Select Public Global to the right of Competitor at the top of the list of companies.
• Click on company name to review the Business Summary to confirm that this is the company you are interested in.
• Review Sector and Industry listed at the top and determine if you want to use this competitor for your competitive analysis.
To Find Industry Data
• Click on the Competitors tab.
• Select Public Global to the right of Competitor at the top of the list of companies.
• Choose at least five competitors.
• Click on each company name to review the Business Summary to confirm that this is the company you are interested in.
• Review Sector and Industry listed at the top and determine if you want to use this competitor for your industry analysis.
• Determine what financial indicators you would like to compare and collect the needed data from the company financial statements for your ratio or Free Cash Flow (FCF) calculations.
• Average your calculated results to get an industry average (for example, add the five company FCF’s together and then divide by five).
Please post any questions to your course’s General Questions discussion forum.
Neonicotinoid Toxicology Article Summary: Human Exposures to Neonicotinoids in Kumasi Ghana
Reference: Nimako, C., Ikenaka, Y., Akoto, O., Bortey‐Sam, N., Ichise, T., Nakayama, S. M., ... & Ishizuka, M. 2021. Human Exposures to Neonicotinoids in Kumasi, Ghana. Environmental Toxicology and Chemistry.
Major Points:
• The study examined risks associated with human exposure to neonicotinoids in Kumasi, Ghana and the evaluation of neonicotinoid exposures in the consumer population was determined.
• Liquid chromatography – electrospray ionization tandem mass spectrometry system was used to analyze the urine samples.
• This controlled study by Nimako et al. (2021) is critical because it provides the initial information on how neonicotinoid consumers are exposed to the substance simultaneously.
• 75 urine samples were conducted from healthy volunteers between the ages of 13 and 80 years old.
• Based on analysis, this study is found that there were positive correlations between volume based and creatine-adjusted urinary concentrations of NNIs.
• The study found that 92% of the population were exposed to multiple NNIs.
• Seven native neonicotinoid compounds and three neonicotinoid metabolites.
• Overall, this study established the base for further studies on. neonicotinoid exposure in Africa