Research Study Proposal–Part III: Data Collection Methods for Problem Statement Presentation

Research Study Proposal–Part II: Literature Review and Research Question

HCS/542

September 18, 2017

Lane Baggett Research Study Proposal–Part II: Literature Review and Research Question

Overview

The ever-changing role of nurses has led to a significant dynamic and focus on community participatory health promotion and prevention. Unfortunately, many nurses are unequipped with appropriate skills, education, and knowledge to deal with healthcare in community settings. While hospitals have been the major foundation of health care delivery, home based care has become a common form health delivery today (Cramm, Hoeijmakers & Nieboer, 2014). There is a growing recognition that many health problems have antecedents in the community and can therefore be prevented through improved population programs. The growing number of the aging population has increased the significance of long-term care in the home and community settings. With this changing role of nurses, knowledge and competence in the care of culturally diverse communities is required on the part of nurses. This article will formulate a research question and review some of the literature on the subject matter.

Literature Review

There has been a recent hype among the scholars who have embarked on research that has focused on home based care healthcare service delivery in the community. Some of the scholars who have significantly contributed to this field include McGillivray, Augart, Cranwell, Goerzen, Hong, Lee & Donnelly (2017) in their article that was titled “Enhancing social diversity and communication in an assisted living facility for older adults: a community health nursing project”. According to the authors, community health improvement requires participation, ordination and a better understanding of the health needs and status of the targeted population in the community. The paper was a project that was meant to come up with something to aid the assisted people living in the community who were independent. The authors used interviews, literature reviews, and brainstorming sessions to collect data for the research and found out some of the salient areas in community healthcare provision. The study found its strength in the methodology used which made it possible for the study to base its findings based on firsthand information. The study used 142 participants which is a good number for a research finding. One major weakness of the study was the fact that the study was specifically based on a single needy population, assisted living people in old age. Because of this, the study did not reveal some of the needs of the assisted living people who are of tender age. Because of this limitation, it is important that further studies are done to found out interventions that can be implemented to fulfill the needs of assisted living people of middle and tender age in the community.

A study that was done by Yang, Woomer, Agbemenu & Williams, (2014) assert that most nurses lack the understanding and attitudes towards poverty and poor people in the community. According to the authors, most of the community healthcare providers find it difficult to interact with patients from low socio-economic backgrounds. The article also brings out enough evidence that communication is an issue among community nurses something that limit their coordination, collaboration in their teamwork with patients as they endeavor to provide patient-centered care among home based patients (Yang et al., 2014). One factor that gave the study significant strength is the factors that simulation experiment was conducted by professors and health students who had enough knowledge in conducting such studies. a briefing that was done after every session was also important as far as the legitimacy of the study was concerned since it provided firsthand experience from the experiment participants. The only limitation in the study is the fact that it was conducted on low income people simulation experience. Because of this, a study should be done to assess the experience of the nurses working with middle income people. This will provide experience of how such environment will impact communication, coordination and collaboration among the teams.

Another significant study that was done on the subject matter is the study that was done by Cramm et al., (2014) that was titled “Relational coordination between community health nurses and other professionals in delivering care to community‐dwelling frail people”. The study was aimed at investigating the impact of coordination and communication and how it differs between primary care professionals and community health nurses as compared to other professionals in the community. The second aim of this study was to investigate the relationship between different levels of relational coordination and primary care professionals' satisfaction with the care delivery of community health nurses (Cramm et al., 2014). According to the authors, coordination and communication breakdown among community nurses arise from the notion that activities should be directed to frail people in the communities needs. The study was legitimate as the study used a good sample number and all the participants in the study were regular volunteers who worked with community health nurses. The authors found out that there is high level of rational coordination and communication among community health nurses as compared to other primary health care providers. It was also evident that healthcare delivery satisfaction was influenced by high levels of communication and coordination. The only weakness that is evident in the study is the fact that the study focused only of frail people in the community. A study should be done in future to assess’ satisfaction on other community based health issues.

According to Goodwin, Dixon, Anderson, & Wodchis, (2014), community health care service delivery among aged people should be managed and nurtured by professional nurses. The authors assert that most of the nurses fail to deliver health services to the needy population because they lack communication and coordination skills. The authors assert that there are no nursing skills that can be utilized to provide effective service delivery but it should be a combination of different nursing skills to enhance service delivery in community or rather home based nursing practices. The study was conducted among different countries with different healthcare models and approaches (Goodwin et al., 2014). This strategy was imperative as it helped to provide experience in different community settings which helped to legitimize the study findings. According to the article, community nurses can use or rather embrace technology as a form of communication and coordinating with their patients to ensure effective healthcare delivery among the assisted living in communities with different social, cultural and economic shortcomings. The authors conclude by asserting that teamwork among the nurses working in the communities is the only bedrock to their effective healthcare provision as it will enhance communication and coordination.

Another article that has been published on the imperativeness communication and coordination in community nursing is a study that was done by Press, Gerber, Peng, Pesko, Feldman, Ouchida, & Casalino, (2015) that was titled “Post discharge communication between Home health nurses and physicians: measurement, quality, and outcomes”. The authors assert that natural language processing (NLP) of text from electronic medical records (EMRs) can be used to identify failed communication attempts between home health nurses and physicians. The authors also investigated predictors of communication failure, and to assess the association between communication failure and hospital readmission. The study was conducted through a retrospective cohort study among the visiting nurses from New York which is one of the leading freestanding home health provider agencies (Press et al., 2015). The authors found out that there are high levels of failed communication among the community nurses who provide health services in the community. The authors found out that failed communication between patients and nurses was high among the black American patients and lower among the families with high income. The study revealed that there are low levels between communication failure and readmission in a more serious community nursing health issues.

Research Question

This research will seek to answer the question on the imperativeness of coordination and effective communication in home based healthcare among aging people.

References

Cramm, J. M., Hoeijmakers, M., & Nieboer, A. P. (2014). Relational coordination between community health nurses and other professionals in delivering care to community‐dwelling frail people. Journal of nursing management, 22(2), 170-176.

Goodwin, N., Dixon, A., Anderson, G., & Wodchis, W. (2014). Providing integrated care for older people with complex needs: lessons from seven international case studies. London: King's Fund.

McGillivray, M. E., Augart, S., Cranwell, J., Goerzen, M., Hong, M., Lee, R., & Donnelly, T. T. (2017). Enhancing social diversity and communication in an assisted living facility for older adults: a community health nursing project. International Journal of Nursing Student Scholarship, 4,1-22.

Press, M. J., Gerber, L. M., Peng, T. R., Pesko, M. F., Feldman, P. H., Ouchida, K., ... & Casalino, L. P. (2015). Post discharge communication between Home health nurses and physicians: measurement, quality, and outcomes. Journal of the American Geriatrics Society, 63(7), 1299-1305.

Yang, K., Woomer, G. R., Agbemenu, K., & Williams, L. (2014). Relate better and judge less: poverty simulation promoting culturally competent care in community health nursing. Nurse education in practice, 14(6), 680-685.