Urgent, urg

Is this an Evidence Based Article?

Name of Journal and Year article was written?

Yes

Name of the Journal: Medical Care Research and Review.

Year: 2021

State the problem

What was the goal of the project?

Does this project correlate with your problem? State how?

What are you trying to achieve? Does this article support this goal?

Problem: Policies affect the ability of home care workers to effectively deliver care to patients to allow them to avoid seeking care in healthcare facilities. There are regulations that prohibit the delegation of healthcare maintenance tasks to home care workers as these tasks need to be performed by registered nurses (RNs).

Goal of the study: The goal of the study was to identify how nurse delegation regulations affect the ability of home workers to perform their care roles to the ailing adults receiving home care. The researchers interviewed home care workers, agency leaders, and state leaders from Texas, Oregon, Montana, and Massachusetts. The study identified delegation regulations, lack of training, and home care nursing shortages as the main factors affecting the delegation of health maintenance tasks to home care workers by registered nurses.

The goal of the group project was to identify a plan that would enhance delegation of care to LPN’s and PCTs by RNs. The study conducted this project correlates with the group project as it proposes the strategies that can be used to improve delegation of care by registered nurses, including training and competency testing to improve the ability of LPN’s and PCTs to perform delegated tasks. The study identified the effect of restrictive state regulations on the ability of health care workers to perform delegated tasks even though they were willing to perform them. The goal of the group project is to propose a plan of change that would improve the delegation of tasks by registered nurses, which is what the researchers of the selected article proposed to improve the delivery of care.

Strengths (Internal)

Effectiveness: The researchers were able to identify the impact of different categories of restrictiveness in state legislation on the delegation of health maintenance responsibilities from registered nurses to home care assistants. This finding was realized by analyzing different themes, such as workers willing to do more with training; patient safety, delegation and training; impact of insufficient home care worker, and how the use of technology could assist nurse delegation.

Nurse practice act: Different leaders from states such as Texas and Montana stated that the nurse practice act protects patients from safety risks that may arise when care is provided by unskilled personnel. Training was identified as an appropriate strategy of expanding the roles that could be delegated by registered nurses to enhance care delivery.

Workers willing to perform more care tasks with training: Home care workers from Massachusetts and Montana were willing to perform more health care maintenance tasks if they received more training. This indicates that training could enhance delegation of tasks by registered nurses.

Weakness (Internal)

Size: The finding of this study might not be generalizable in all the states. State laws outlining which task are permitted for delegation from one state to another. The study involved only four states, which may not be sufficient to represent all the states.

Nursing shortages: Leaders in different states like Montana and Massachusetts revealed that there was shortage of nurses. Acute shortage of nurses was reported in Montana where one nurse supervisor was overseeing all workers in different offices. Due to the poor nurse-patient ratio, workers reported that there was challenge with getting timely assistance with necessary task that the worker was not permitted to assist with such as administration of medication.

Opportunities (External)

Patient satisfaction: Home care maintenance tasks allows people living with disabilities live as independently as they can, as provided for by long-term service and supports (LTSS). Although the need for LTSS will soon overcome the home care manpower, which include home health aides and personal care aides, personal care assistants facilitate custodial care and help with daily living activities such as bathing, housekeeping and dressing.

Training: The researchers revealed that the training of personal care aides was lacking in most states, although most of their services are reimbursed by Medicaid.

Technology: Leaders and home care workers talked about the ability for technology to positively impact on the lives of home care workers and those of their patients. Some portrayed positive attitude about the new technologies that could be utilized in home care to help in the delivery of care to clients, especially in areas with insufficient nurses and rural areas.

Threats - (External)

Validity: The researchers identified the varying state regulations impacted the perception of healthcare workers and agency leaders on their ability to care for the ill adults receiving care from their homes. The researchers collected information that was based on the individual understanding of the interviewees and may not be the actual organizational and state regulations.

Staff buy in: The researchers identified the variations that exist between state policies may differ from organizational-level regulations on the tasks that can be delegated. Therefore, the views of the individuals interviewed may not represent all clinical care scenarios. A proper understanding of the state and organizational regulations is needed for the interviewees to give accurate information.