week 8 replies
Leading week 8 replies
respond to the four colleagues and Suggest an additional strategy on how your colleague may implement the quality improvement model they selected in their healthcare organization or nursing practice. Include 2 references per response
Brytnee:
Quality improvement (QI) is vital in healthcare as it strives to enhance patient outcomes and experiences while optimizing resource utilization. By continuously monitoring and evaluating the quality of care provided, healthcare providers can identify areas for improvement and implement evidence-based practices (EBP) to enhance patient safety and satisfaction. Multiple strategies are used to conduct QI initiatives, and a root cause analysis (RCA) is one such method. RCA is a systematic process that aims to identify the underlying causes of adverse events or near-misses (Deshpande et al., 2023). RCA involves an identified problem, followed by data collection related to the issue (Sipes, 2020). Then, providers review possible causes of the problem through a fishbone diagram (Sipes, 2020). After identifying causational topics such as poor policies or workflows, scholars work to enact changes that influence these outcomes, followed by more data collection and evaluation of the results (Sipes, 2020). Finally, the results are shared amongst stakeholders, faculty, and staff to see if these changes are worthwhile (Sipes, 2020). RCA and the plan-do-study-act (PDSA) model can have similar steps; however, the power of the RCA technique is the power of hindsight. Therefore, by analyzing the root causes of issues, healthcare providers can develop strategies to prevent similar incidents from occurring in the future.
Correctional medicine poses unique challenges, and RCA is a valuable tool for quality improvement in this area. In an article by Hollway and Grunwald (2019), they report that when sentinel events occur in law enforcement, the focus is often shifted to the individuals at fault versus the factors that could have contributed to the error. Additionally, focusing on an RCA model for those incarcerated with substance abuse disorders (SAD) or mental health (MH) diagnoses can further help providers optimize current therapies to reduce adverse events such as suicide. As mentioned, patients released from confinement settings are at significant risk during their first weeks for adverse events and potential re-arrest (Riblet et al., 2019). Due to these significant risks, an RCA is beneficial in a correctional setting to aid patients in achieving positive health outcomes within the community by examining actions that can lead to adverse events.
Adverse events in any institution warrant investigation and modifications as necessary to spur improvements in techniques and therapies. Unfortunately, suicides do occur in a confinement setting, as they do in the community as well, and an RCA can be beneficial in improving QI initiatives to prevent such happenings. One problem with suicides within the penal system is the effects of access, screening tools, therapies, or treatments related to MH and suicide outcomes. Next, stakeholders, such as nursing staff, supervisors, and correctional command, are onboarded to assist in creating solutions while collecting data on suicide rates (Han, 2023). Data can be collected from outside sources for rates of successful suicides within a confinement setting, along with risk factors associated with patients' charts, such as MH diagnoses and past attempts. Then, with stakeholders on board, new policy changes or existing procedures can be examined to see where improvements can be made (Han, 2023).
Additionally, stakeholders and staff must assess potential causes of suicides within a fishbone diagram when examining the potential for policy changes. For instance, a more comprehensive screening exam during intake, flyers in the housing units, communication among staff members and across disciplines, or resources on the television or tablets can increase access to patients needing assessment. Lastly comes implementing activities to rectify the problem, along with data collection, analysis, and the creation of the results for peers (Han, 2023). If the results are compelling, there is an increase in MH visits, initiated therapies, and improved MH referral processes and staff communications. Overall, RCA is a powerful technique that healthcare providers can use to develop strategies to prevent similar incidents and adverse events from occurring in the future.
Marie:
Model Selection
In the realm of healthcare quality improvement, combating hospital-acquired infections (HAIs) is a critical endeavor. Employing a structured approach such as the Plan, Do, Study, Act (PDSA) model can significantly enhance efforts towards this goal. The PDSA model offers a systematic framework for iterative testing of interventions, allowing healthcare teams to implement evidence-based strategies, evaluate their effectiveness, and refine approaches as needed (Wang et al., 2022).
Plan
In the planning phase of the PDSA model, healthcare professionals must first identify the specific HAI concern and establish measurable objectives. This may involve targeting prevalent HAIs like central line-associated bloodstream infections or surgical site infections. Subsequently, a comprehensive plan is devised, encompassing evidence-based interventions such as rigorous hand hygiene protocols, environmental cleaning procedures, antimicrobial stewardship initiatives, and staff education programs (Smith & Jones, 2022).
Do
During the implementation phase, interventions are executed on a small scale within a specific unit or department. Adherence to infection prevention protocols, including proper hand hygiene practices and aseptic techniques, is crucial. Concurrently, data on HAI rates are meticulously collected both before and after the implementation of prevention strategies (Johnson et al., 2022).
Study
Following the implementation, the study phase involves rigorous analysis of the collected data to evaluate the effectiveness of the interventions. By comparing HAI rates pre- and post-implementation, healthcare teams can gauge the impact of their efforts. Additionally, compliance with infection prevention protocols is assessed, and any encountered barriers or challenges are identified for further refinement (Brown & Garcia, 2022).
Act
Based on the findings gleaned from the study phase, the act phase entails taking decisive actions to standardize successful changes and refine ineffective strategies. If the interventions demonstrate a reduction in HAI rates, they can be scaled up to broader hospital units or departments. Concurrently, addressing identified barriers to compliance and adjusting prevention strategies are paramount for sustaining improvements over time (Wilson & Smith, 2022).
In conclusion, the PDSA model serves as a potent tool in the ongoing battle against HAIs. Through its iterative approach of planning, implementing, studying, and acting, healthcare organizations can systematically drive quality improvement efforts, ultimately safeguarding patient safety and enhancing overall healthcare outcomes.
Crystal The Plan-Do-Study-Act (PSDA) model is used to assess if an implemented change is working; it is based on the idea of “breaking down the task into steps, evaluating the outcome, improving it, and testing again” (Agency for Healthcare Research and Quality, 2024, p. 1). This method is broken down into four different question categories, the first is Plan which as the questions “what are we going to do?” (Centers for Medicare & Medicaid, n.d., p. 2). The second part is Do, which asks “when and how did we do it?” (CMS, n.d., p. 2); the third part is Study which asks “what were the results?” (CMS, n.d., p. 2) and the last part of this model is Act which asks “what changes are we going to make based on our findings?” (CMS, n.d., p. 2).
This model allows for changes in patient care to be evaluated and changed if needed, this could be used in several different areas of the hospital and not just in patient care. A serious event that could occur while a patient is in the hospital would be to not having the right resources for emergent care. For instance, the implementation of a rapid response team to oversee patient care when ICU beds are not available. A study completed in Brazil looked at three major components: a tool that could help detect progression of clinical conditions, building a rapid response team to attend to high risk patients, and the assessment of the interventions (Almeida et al., 2019). This study took place from January 2013 till December 2014, the rapid response team assessed 2,296 patients during this time. The data reflected a decrease in mortality rates from 8.3% in cycle 1 to 5.0% by cycle 4 (Almeida et al., 2019). The data also showed that there was a decrease in the bed need for ICU after starting the rapid response team, it started at 45.9% bed need and decreased to 19.0% after the team was initiated (Almeida et al., 2019). The PDSA method was utilized by having four separate six-month cycles where data was collected.
An example of a PDSA model being used in within the organization I work would be to implement a report sheet that can be filled out between nursing shifts and can be presented during treatment rounds to help keep the flow of communication, provide accurate patient information, medication needs, and make sure the other important topics are addressed. Communication is key in patient care and when misinformation is given or information is unknown and not provided mistakes can be made. Aside from miscommunication and lack of needed information, our morning treatment team seems to run over a lot due in inaccurate information reporting, not having the needed information available, or the team gets off topic. There have been multiple times where medication issues could have happened due to the lack of known information during treatment team. A PDSA method would be a good way to assess a new report sheet for nursing which would provide updated information from the charting system and would help the providers be able to give medication orders without fear of not knowing something important first such as allergies, history of adverse reactions, recently given medications, and assessment of side effects. The plan would be create a report sheet and test it for a one month period and reassess if the report sheet needs further information on it or if there are items that are not needed and then repeat the PDSA cycle to retest. The study portion, or results, that will be assessed are the accuracy of medication information, allergies, any emergency treatment options recently given, any side effects such as extrapyramidal symptoms (EPS), any recent blood work or testing that was done, and the amount of time each meeting takes can be assessed if there are improvements. Lastly, the act part is any changes that would need to be made to the report sheet for it be more useful.
Sharon:
Quality Improvement Models
Oncology nursing has been one of the most challenging settings in healthcare, and I have found myself in it. Managing the patient's symptoms and treating the cancer with different therapies has proven to be very stressful for everyone involved in the care. Quality improvement initiatives are consistently reviewed and changed. The stressful environment creates room for several nursing errors.
Quality Improvement Model
The selected model is the Plan, Do, Study, Act (PDSA). The PDSA model is a powerful problem-solving approach used for continuous improvement. It is described as the following (Nash et al., 2019).
Plan (P): In this stage, you plan the change you want to implement. Define your objectives, outline the steps, and make specific predictions about the expected outcomes.
Do (D): Time to execute the change. Implement the planned intervention or modification. This could involve adjusting a process, introducing a new practice, or making any other relevant change.
Study (S): After implementing the change, study the results. Observe what happens, collect data, and analyze the impact. Did it achieve the desired outcome? What worked well, and what didn't?
Act (A): Act according to what has been learned during the study phase. If the change was successful, consider scaling it up. If not, refine your approach or try a different strategy. The key is to learn and adapt continuously.
Quality Improvement Model in Response to an Adverse Event
One of the nursing practices that requires improvement is the administration of blood products. The hospital has implemented several policies and initiatives to prevent adverse reactions, but several incidents are still reported. In this situation, the PDSA can be implemented to collect data from nurses and to hear the staff's perceptions of the model and the changes to be made. Staff can help identify areas that can be improved, including resource development, upskilling or training, and enhancing communication and handover processes (Foley et al., 2023). Blood administration modules can be revised, and new models, such as an eLearning training and skill development program, can be used. The number of adverse blood administration reports can be monitored to see if the tool is practical and changes are needed.
Patel et al. 2022 explain that nurses can consistently assess symptoms and quality of life to understand better patient needs; therefore, using the PDSA framework enables adjustments so project outcomes, such as completion rates, can improve over time. Consequently, it is essential to use the correct tool to evaluate practice gaps for a positive result and to involve the appropriate stakeholders.
Transforming Week 8 replies
respond to the four colleagues by expanding upon their responses or sharing additional or alternative perspectives. Include 2 references each
DEM Precious:
The Intersection of Social Determinants of Health on HIT and Patient Outcomes
According to the World Health Organization (WHO), health literacy includes the cognitive and social abilities needed to locate and understand information regarding health matters essential for the drive and capacity to promote and sustain one's well-being. The American Medical Association (AMA) is also in tandem with this definition, proposing health literacy as a variety of skills that help people gather and understand healthcare information and use it for suitable health decisions (American Medical Association, 2015). The core concept of health literacy, therefore, does not merely center on the role of health IT in accessing and using health information; it goes further to unveil the social determinants, such as education level and income, that influence the actualization of individual health competence. It impacts people concerning disease management and proactive decisions for preventing infections, some of which can be life-threatening. This paper argues that social determinants of health significantly influence the effectiveness of health literacy and Health Information Technology (HIT), impacting patient outcomes.
Understanding Health Literacy and Its Impact on Patient Care
The notion of definitions is further broadened in terms of health literacy as it intersects with reading and writing while using disseminated health information to make informed decisions (World Health Organization, n.d.). Through proper implementation of health literacy, we can facilitate the improved management of diseases, lower hospitalization numbers, and positively impact health outcomes. On the other hand, a lack of health literacy may cause significant healthcare misuse, highlighting the urgent need for targeted communication strategies (Baker, 2006).
Health Information Technology (HIT)
Health information technology such as EHRs, telemedicine, and e-prescribing is innovatively designed to improve healthcare delivery efficiency and minimize healthcare delivery risks and safety (Office of the National Coordinator for Health Information Technology, n.d.). While HIT can serve as an avenue to improve public access to healthcare information, its outcome depends on how they are utilized. Accessibility issues, such as complex user interfaces or lack of patient education, can hinder the effectiveness of HIT tools. Studies by Health IT.gov (2019) sources prove that successful HIT implementation ensures fast access to medical records and serves as a platform for effective real-time communication among healthcare providers, therefore diagnosing and treating patients promptly and with high accuracy.
Health Economics
Economic factors profoundly influence the accessibility and quality of healthcare by impacting resource allocation and care affordability. As the National Coordinator for Health Information Technology reports (n.d.) that economic barriers prevent access to health technologies and services, the extension of such challenges becomes more apparent, especially regarding health literacy and HIT utilization. These barriers include high costs, lack of adequate health insurance coverage, and the unequal distribution of health resources, thus leading to noticeable inequalities in health access and outcomes. Addressing such economic barriers is necessary to improve health literacy levels via HIT integration and improve medical care delivery efficiency.
Social Determinants of Health
Social determinants like education, income, and social standing strongly impact health outcomes and access to healthcare services: Shah et al., 2020. These factors determine the number of individuals who can grasp, understand, and use health information and services, which is the essence of health literacy. What is more, the poor are less likely than the rich to access health information technology, which is one of the main factors hindering effective health management. These social determinants are necessary for reducing health inequalities and improving the HIT's widespread adoption and effectiveness, resulting in equitable health outcomes throughout sub-populations.
Interrelation of Health Literacy, HIT, and Health Economics
Health Literacy, Health Information Technology (HIT), and health economics are interdependent factors that profoundly affect clinical outcomes (HealthIT.gov, 2019). The increased health literacy of the ailing population might contribute to better use of HIT, which may reduce healthcare costs and economic burdens. Also, economic barriers and poor health technology education may lead to insufficient valuable tools and information access, among which health disparities will escalate, as illustrated by the Office of the National Coordinator for Health Information Technology (n.d.). Such a complex relationship shows that to achieve better health outcomes and to make the system more efficient, integrated strategies comprising education, economic limitations, and technology access are imperative. This means that there is a need for comprehensive policy interventions that address all these aspects holistically.
Strategies to Overcome Barriers
Establishing educational initiatives tailored to diverse backgrounds to address challenges stemming from low health literacy and health information technology (HIT) applications is essential, thus promoting integration and enhancing HIT accessibility (Shah et al., 2020). Creating user-friendly HIT systems that can accommodate different linguistic and cultural needs can also be a great medium to enrich the quality of engagement and output. Dealing with financial constraints is also very important; increasing funding for health education and technology access will significantly close the gap between different socio-economic classes. Collaborative arrangements between different stakeholder groups can be the platform that can drive these strategies. As a result, equity in access to healthcare and empowerment of individuals to effectively manage their health can improved.
In conclusion, the discussion addressed how social determinants of health, health literacy, and Health Information Technology (HIT) affect patient outcomes, focusing on the interplay and integral position of these three components in the healthcare sector. The issue of addressing social determinants that perpetuate the impact of health literacy initiatives and implementing health information technology (HIT) needs to be addressed. Therefore, the calls for ongoing research and forward-thinking policymaking to offset these problems are essential so that healthcare technology gains will benefit the entire society, with no exception. Efforts must be integrated to enhance education, reduce economic barriers, and improve accessibility to technology in order to achieve an inclusive health system.
DEM Chidinma:
The term "social determinants of health (SDOH)" refers to changeable social structures, their elements, and the social resources and health risks that these structures manage, allocate, and withhold (Hahn, 2021). These factors can have an impact on an individual's health and lead to various outcomes, such as adjustments to demographic distributions and health trends. It includes lack of transportation, food poverty and limited access to nutritious food options, and lack of stable housing (Palakshappa et al., 2020). Economic stability, neighborhood and physical environment, lack of access to care, and health literacy are other factors included in social determinants of health (Pera et al., 2021).
SDOH provide a particularly complex set of issues to address, particularly in rural and disadvantaged areas where resources are scarce and there is a dearth of knowledge regarding the ways in which social determinants impact health. Numerous problems surround SDOH, such as inadequate healthcare-based solutions for the main issues of access to care, poverty, and food insecurity, inconsistent data and measurement, and a lack of standardization in what variables define the SDOH and the appropriate screening tools to track these variables (Hoffberg, 2021).
The nursing profession especially advanced practice nurses have an important role to play in addressing the SDOH. Cultural competence has been identified as an important factor in reducing health disparities therefore to have a greater awareness of the many cultural practices, beliefs, and values in the population they serve, nurses can take part in cultural competency training programs. Additionally, to customize care plans based on each patient's unique cultural preferences, they can carry out comprehensive cultural assessments during patient contacts (Osmancevic et al., 2023).
SDOH assessment tools such as food, housing, transportation, education, employment, personal safety, and financial strain are used to identify the social risks that reflect a patient’s unmet social needs. Comprehensive health evaluations, which involve inquiries about social determinants like housing, work, and education, can be performed by nurses. To systematically identify patients' social requirements and hazards, they can employ proven screening tools. They can also periodically reassess patients' social determinants to address evolving needs and circumstances (Tiase et al., 2022). To promote structural reforms that address socioeconomic inequities, nurses engage in policy advocacy at the local, regional, and national levels. They also cooperate with community organizations to push for policies and resources that address larger social determinants impacting health (American Association of Colleges of Nursing, 2006). They can create clear protocols for referring patients to the right resources, guaranteeing smooth care coordination, and they can forge strong relationships with social services, support groups, and local community resources.
Effective use information technologies by nurses to support the delivery of equitable care to all patients.
With mobile health applications, patient portals, telehealth services, electronic health records (EHRs), and health information exchange systems, nurses can successfully leverage information technologies to assist the delivery of equitable care to all patients. Nurses can contribute to the reduction of health disparities by assisting in the removal of geographic obstacles to healthcare access using telehealth services. To guarantee that patients in remote or underserved areas receive the care they require, nurses can use telehealth platforms to conduct remote consultations, track patients' health status, and give health education (Hassmiller & Wakefield, 2022).
An extensive perspective of a patient's medical history, including previous diagnoses, treatments, and results, is offered via electronic health records, or EHRs. This lessens inequities brought on by a lack of information by enabling nurses to make knowledgeable judgments about patient care. EHRs also make it easier for various healthcare practitioners to coordinate patient care, guaranteeing that every patient receives consistent, excellent care (Campbell, 2023). Health information exchange (HIE) systems are another tool that nurses can use to help provide all patients with fair treatment. Care coordination is enhanced by these platforms, which enable safe patient information sharing between healthcare professionals. Nurses can contribute to the reduction of inequities brought about by fragmented care by making sure that all pertinent health information is available to all clinicians involved in a patient's care (Sarkar, 2022).
In conclusion, Nurses may contribute to ensuring that all patients, irrespective of their social, economic, or geographic conditions, have access to high-quality, individualized treatment by utilizing these information technologies.
MOM Justina:
The social determinants of health are the social and physical components in people's environments. They influence many facets of health, including care quality and outcomes. Economic stability, educational accessibility, access to quality treatment, the physical environment, and the social context are all essential socioeconomic determinants of health. Health equity and accessibility have been associated with the social determinants of health. People with low literacy, low money, and unequal access to healthcare facilities are more likely to receive subpar care and outcomes. Healthy People (2020) recognizes numerous socioeconomic determinants of health that influence care quality, cost, patient satisfaction, and outcomes. For example, transportation may have an impact on access to care. Patients are more likely to have trouble getting to and from healthcare facilities. They end up missing their medical appointments. Health information technology is crucial for tackling the socioeconomic factors that affect healthcare equity. When patients use health information technology like telehealth, telemedicine, and virtual and mobile care, they no longer worry about transportation, housing, or income. One can be attended to at home or in his comfort zone rather than traveling to the physical location. Health information technology has the potential to expand medical care accessibility, reduce drug prices, and improve patient outcomes (Thornton & Persaud, 2018). Addressing the barriers and challenges associated with socioeconomic determinants of health (SDOH) is critical in nursing practice for promoting health equity and improving patient outcomes. Nurses can use tactics such as building cultural competence to understand and respect other ideas, values, and behaviors and adopting culturally sensitive care plans that consider patients' cultural backgrounds and preferences (Thornton & Persaud, 2018). Providing comprehensive health promotion and illness prevention education by developing instructional materials in different languages and formats to ensure accessibility. Advocating for patients at the individual and community levels to address social and economic inequities while collaborating with interdisciplinary teams to address systemic health challenges. Conducting comprehensive assessments, including social determinants, during patient contacts using standardized screening instruments to identify social needs such as housing instability or food hardship. Creating a robust referral network to connect patients with community resources and social services in conjunction with social workers, community health workers, and other professionals who address patients' social needs (Gagnon et al., 2022). Furthermore, these barriers and challenges can be addressed by measuring and treating patients' health literacy levels to ensure understanding of healthcare instructions and employing plain language and visual aids to improve communication. Identifying patients in crisis and linking them to appropriate options for rapid assistance, including collaboration with crisis intervention teams and mental health professionals and advocating for policies that address social determinants of health, such as affordable housing, education, and job opportunities, by participating in community and professional organizations to influence policy changes. It is recognizing and responding to the consequences of trauma on patients' health and well-being by providing a secure and supportive environment for those who have suffered trauma. It is working with community organizations, non-profits, and government agencies to solve systemic challenges through collaborations with community leaders to improve healthcare delivery and community participation and reflecting on personal biases and attitudes that may influence patient care through continuing self-awareness and cultural competence training and employing technology to enhance communication, education, and care coordination by investigating telehealth solutions to provide accessibility for patients with transportation or mobility issues. By applying these measures, nurses may play an essential role in addressing social determinants of health and contributing to more equitable healthcare systems (Thornton & Persaud, 2018). Using information technology to support and improve nurse management outcomes is feasible by deploying information systems. This also enhances patient care quality and promotes evidence-based nursing. It may improve patients' access to evidence. Health information technology (HIT) has promoted patient-centered care, allowing patients to select the type of therapy they prefer. It has increased the number of treatment options available to patients, allowing them to be tested, diagnosed, and treated in their homes. Individuals can access their medical records, obtain medications, make appointments, and contact their doctors. A healthcare provider can log in with a single click from a smartphone or computer. Integrating HIT into clinical practice is critical for recognizing healthcare needs, reaching consensus, analyzing available options, selecting the most cost-effective solution, planning efficiently, and training nursing staff. Electronic medical records, documentation, patient portals, and telemedicine systems are commonplace in today's healthcare organizations. HIT has been related to cheaper medical expenses, more access to care, and improved patient outcomes (Ang, 2019). The HIT is critical for safe patient care because of its data storage and retrieval capabilities, ability to provide patient information quickly, and comprehensible format. It improves medication safety by increasing readability, lowering the likelihood of medication errors, and ease with which patient data can be retrieved. Furthermore, technology speeds up the flow of information between doctors, reduces the risk of medical errors, enhances medication safety, expands access to medical knowledge, and promotes patient-centered care. HIT also allows patients access to personal medical information, helping them better understand their illnesses and encouraging them to participate actively in shared decision-making. It can improve follow-up for missed appointments, consultations, and diagnostic testing outside the patient encounter (HealthIT.gov., 2019). This can be accomplished through nursing informatics, which focuses on the best ways to provide exemplary patient outcomes by utilizing the entire process and best practices to deliver the best possible care to patients. Nurse informaticists frequently concentrate on process design, clinical workflow assessments, and developing new diagnosis and treatment strategies. They assess several treatment options and use objective data and analysis to determine which actions will result in the most patient-centered, value-based care. Providing clinical professionals with training is one of the most important ways a nurse informaticist may improve patient outcomes. They can use data to identify endemic difficulties in a healthcare institution and provide recommendations on successfully addressing these issues. These teachings can be included in new employee orientation, ongoing internal training, or external education and certification (Thornton & Persaud, 2018).
MOM Althea:
In nursing practice, addressing social determinants of health (SDOH) has become more important for fostering holistic patient care and improving health outcomes. This is because SDOH are factors that influence social conditions. To lessen the impact that SDOH has on both persons and communities, nurses adopt a variety of different measures. One of the most important strategies entails carrying out extensive evaluations to determine the social and economic elements that have an impact on the health condition of patients. This involves determining the stability of housing, the availability of nutritious food, the obstacles to mobility, the work status, and the social support systems being utilized (Artiga and Hinton, 2021). To improve patient involvement and adherence to treatment, nurses may build individualized care plans that take into account the specific requirements and circumstances of each individual patient by having a thorough awareness of these determinants.
Nurses confront a multitude of obstacles and problems in their efforts to incorporate these techniques into clinical practice, even though tackling SDOH is of critical relevance. The capacity of nurses to conduct extensive evaluations and offer comprehensive assistance for patients who are experiencing social issues is frequently hindered by limited resources, such as time limits and staffing shortages which is currently experienced at my facility. Furthermore, because of the complexity of SDOH, it is necessary to collaborate and coordinate across several disciplines, including hospital facilities, community groups, and social service agencies. On the other hand, fragmented healthcare systems and walled approaches to care frequently undermine effective collaboration, which in turn results in gaps in the provision of social services to patients (Town et al., 2024).
Moreover, Williams et al., (2019), stress that racism's devastating effect on people's well-being, drawing attention to the ways in which discrimination and structural injustices play a role in perpetuating health disparities in disadvantaged communities, clarify the multi-faceted ways in which racism affects health at all stages of life. Williams et al., (2024), posits the need to address social determinants of health in order to achieve health equality and decrease health inequalities by revealing the widespread prevalence of racial discrimination and its negative impacts on mental and physical health which are a common practice.
In order for nurses and healthcare professionals to overcome these obstacles and challenges, it is imperative to adopt and implement creative techniques and make use of the tools that are available to them in order to incorporate patient safety and health issues into everyday clinical practice especially at IOP clinics where clients are seen for dual treatment of substance use and mental illness. It is possible that this will require the use of screening tools and established protocols to systematically evaluate and treat the social needs of patients during their interactions with healthcare providers. In addition, nurses and DNP prepared nurses can lobby for policy changes and healthcare reforms that are targeted at resolving structural injustices and increasing access to important social services. These services include affordable housing, food assistance programs, and transportation services (Williams et al., 2019). The advancement of population health and the reduction of health inequalities linked with SDOH are both areas in which nurses may play a crucial role if they advocate for health equity and social justice respectively (Zhang et al., 2024).