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NUR1201 The Patient Experience: Partnering In Care 2

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Question:

Topic Focus: ‘Preventing falls and harm from falls’ and ‘My health record’(e-health record).

Background Information

Reflection is a way of thinking and working for Registered Nurses and is useful in raising our conscious awareness of aspects of care that may or may not be hidden from our view. This raised awareness about these aspects of care improves our understanding as nurses and assist us in directing action strategies that can improve both the patient and their family’s experience and the ‘partnering in care’ strategies that we utilise. Improving the ‘patient care experience and partnering in care’ and using Gibbs Reflective cycle (1988) as a framework in combination with drawing upon relevant theory provides a foundation for nurses to operate from and as such is required for task 2.

Body of Essay – Gibbs reflection

  1. Description: (guide only 120 words)Describe the patient’s experience. Aim to focus on a particular relevant aspect, identify key themes and justify these themes of care focus.
  1. Feelings and Thoughts: Describe and examine your feelings and thoughts in response to your description. Identify the values and beliefs that connect you to your feelings and thoughts and evaluate your response to the patient’s experience in terms of those feelings and thoughts. For example, why did you feel that way?

  2. Values and Beliefs: Describe some values and beliefs of yours that may have impacted on your feelings and thoughts about what went on. After reflecting about the ‘values and beliefs’ that connect to your feelings and thoughts, identify where these values and beliefs originate from? Why are these values and beliefs important? Who are they important to and why? Are they important to you, the patient and the patient’s family?
  1. Analysis Analyse the patient experience and partnering in care case scenario, identify and explain the care displayed in the case scenario (inadequate and adequate care).  Draw upon some literature to support your analysis of the case scenario and relate it to the scenario by providing examples.Aim to make sense of this patient experience in terms of how you reacted to it.
  1. Conclusions Drawn:Identify the conclusions/new meanings that can be drawn here.
  1. Action Plan: Describe an action plan that you would initiate based on your conclusions and say how this action plan you describe will improve patient care?
 

Answer:

Introduction

Most healthcare facilities use patient engagement whereby patients share their experiences. This approach is very fundamental in improving the quality of care and outcomes in the healthcare setting. According to Ahmed, Burt & Roland (2014), actively involving patients to work with health practitioners across various healthcare levels helps in improving service delivery within the system. For example, a case is presented involving a 75 years old patient, where we realize that involving him and getting to understand his experience can be helpful in improving future care plans for individuals with comparable complications. This essay talks about the experience of the patient in addition to my personal feelings about the same. It further highlights some of the values and beliefs impacted on me by the patient’s experience. The essay also talks about preventing falls and e-health.

Patient Experience

Mr. Bill experienced a serious fall that caused him severe injuries which have impacted his life to date. He wrecked his right shoulder and injured his right elbow. In fact, the fall took off the skin under his right elbow. At the time of the fall, there was nobody around to help him get out of the gutter, therefore, had to struggle to get himself out. Once he got home, his wife and the visitors at home wanted to take him to the hospital. He, however, declined because he did not want to go to a public hospital because of his former experience at a comparable facility. He instead chose to contact his personal doctor who directed him on the next course of action. After the diagnosis, he again experienced another fall in the house after feeling dizzy. His GP diagnoses his situation and finds out he is anemic but the reason for being anemic could not be substantiated so he was put on a pill cam. This is a form of e-health medication whose aim is to monitor Bills internal organs and take photos that may be useful in identifying the source of the anemia. Other conditions that are also diagnosed include allergic rhinitis, hypertension, and type 2 diabetes.

In my opinion, care in public hospitals should be hastened to improve care outcomes. This may include the introduction of e-health technologies such as electronic health record, electronic medical records, and mobile health among others. Additionally, as we are told that Bill suffered another fall weeks after diagnosis, it could be important to introduce measures that may help in preventing falls. Technologies such as e-health could be fundamental in preventing long queues and long waiting hours experienced by patients before being attended to (Blaya, Fraser, & Holt, 2010). From the case scenario in our study, Mr. Bill refused to seek medication from a public hospital due to his previous experience at a facility of a similar dimension. It is important to note that if care at the public hospital was better and faster than it has been reported in this scenario, then he could not have opted out of going to seek medication and instead wait until next day to see his personal doctor. I imagine a situation where the injuries got worse leading to health deterioration. It could have been tragic. Such imaginations are some of the factors that have influenced my thoughts and feelings owing to the fact that he waited up to the following day instead of just going to a public hospital and receive urgent care. More patients would opt for seeking care from public hospitals if the quality of care was improved and patient-centered care made better (Epstein & Street, 2011).

 


It is clear from our scenario that a family is one among the foremost vital values anyone may possess. I am certain that my belief in quality care and the value of a family were a number of the factors that influenced my thoughts and feelings regarding what transpired. The origin of these two values is that sturdy family bonds that people share alongside the goodwill of taking care of other family members. Having a family around you when you are sick is extremely vital. This is true because the family is that the most immediate caregiver. Taking the example of Mr. Bill, his wife drove him to the doctor the following day and for many alternative weeks once he still couldn't use his arms. This is further proof that the family was crucial to the healing of Bill in the aftermath of his injury. Additionally, my belief in quality affordable care must have also impacted my feelings. This is because, from the scenario, we are told that there is some time in the past when Bill had to wait for eleven hours before receiving appropriate medical attention. Quality care is thus elementary in any care setting to guarantee positive care outcomes.

It is, however, important to state that the care provided in the presented case scenario had numerous inadequacies like long waiting hours before seeing a doctor. An example is when Bill had kidney stones and had to seek treatment from a public hospital. This, however, did not go as expected because he waited for eleven hours before receiving medical attention. The pain he was experiencing was too much and he had to take pills after every three to four hours to reduce the pain. I believe that this is just negligence from the hospital. No individual should be waiting for eleven hours to get medical attention no matter how busy the facility is. It is thus valid o point out that, nursing standards and Bill’s rights were violated by this hospital. I can, therefore, agree with Kusnanto that instant care delivery that follows nursing standards is that the best way to ensuring quality care and patient satisfaction.

It is also worth noting that other aspects of care as seen from the scenario were quite adequate. Mr. Bill in the case scenario says that he was satisfied with the services offered by his personal GP. This proves that the person-centered approach from Bill’s general practitioner was top notch. He was made a party to every health decision regarding his well-being. He additionally sheds some light on the physiotherapists he was sent to and he even claims that he is one of the best in business. From this scenario, we can ascertain that the quality of care from the personal GP was high and thus Bill was more satisfied with the health outcomes. According to Rathert, Wyrwich & Boren (2013), these types of care are quite important in improving patient outcomes.

I can confidently conclude that some public hospitals do not offer the best healthcare services. This could be due to the fact that they receive a large number of patients on a daily basis thus increasing the amount of work. This enormous number of clients in most cases causes overcrowding in the hospital and this negatively affects the quality of care. The following are some of the undesirable indicators of the above revelation. Firstly, the waiting hours before a patient is attended to are always look like in Bill’s case. These extended waiting hours may cause pain and agony to the patient and their families. Additionally, health deterioration may be experienced as a result of the extended waiting hours thus lowering the patient’s quality of life. These two indicators may, therefore, be fundamental in directing future changes in care. This can be done by prioritizing the interests of the patient. The private facility also had some health inadequacy in that it failed to address the issue of falling and prevent falls. This was evident when Bill had another fall weeks after treatment.

However, it is important to note that the care provided in private health facilities is one of the best in the country. They apply a patient-centered approach and quick service delivery. These are some of the positive indicators. Patients are normally incorporated in the decision-making process regarding their well-being using the patient-centered approach (Barry & Edgman-Levitan, 2012). For example, Bill was always involved in the decision-making involving his health unlike in his father’s case when the doctor made the decision to amputate his legs without properly involving him. According to Manary, Boulding, Staelin & Glickman (2013), private hospitals also respond to clients swiftly and thus improving the quality of care and health outcomes. The two positive indicators can be useful in directing future changes in healthcare.

Basing my reasons on the conclusions made above regarding the case scenario, I would initiate some action plans. One of the action plans would be aimed at dealing with overcrowding and negligence in the public hospital. One of the biggest problems faced by public health facilities is the high number of patients they receive daily. Most residents cannot afford the prices charged in private hospitals and will always opt for the public ones.  This can, however, be improved by increasing the capacity of public hospitals.  The families should additionally play a major role in care because they are the primary caregivers. It could also be necessary to introduce measures that would help in preventing falls and educating the patients on how to avoid accidents of similar kinds in the future. It is further believed that using e-health can be fundamental in improving the standards of care and patient satisfaction. According to Blaya et al. (2010), e-health technology helps in keeping the medical and health records of the patient in an electronic form. This makes access to patient information easier thus reducing the length of waiting hours and eliminating the problem of overcrowding.

Conclusion

Anyone wishing to properly understand patient experience has to practice patient engagement. In doing this, the caregivers get to come up with the best care plan for the client and also for future practice that may involve similar scenarios. This additionally helps nurses and doctors to know the improvements that should be made in different areas. Furthermore, if both the patient and their families can understand their roles in in care then the quality of care can be massively improved. It is thus obvious from the case that a patient-centered approach is the best way to provide quality care and improve health outcomes.

 

References

Ahmed, F., Burt, J., & Roland, M. (2014). Measuring patient experience: concepts and methods. The Patient-Patient-Centered Outcomes Research, 7(3), 235-241.

Barry, M. J., & Edgman-Levitan, S. (2012). Shared decision making—the pinnacle of patient-centered care. New England Journal of Medicine, 366(9), 780-781.

Blaya, J. A., Fraser, H. S., & Holt, B. (2010). E-health technologies show promise in developing countries. Health Affairs, 29(2), 244-251.

Epstein, R. M., & Street, R. L. (2011). The values and value of patient-centered care.

Kusnanto, H. Patient-Centered Care. Review of Primary Care Practice and Education (Kajian Praktik dan Pendidikan Layanan Primer), 1(2), 52-53.

Manary, M. P., Boulding, W., Staelin, R., & Glickman, S. W. (2013). The patient experience and health outcomes. New England Journal of Medicine, 368(3), 201-203.

Rathert, C., Wyrwich, M. D., & Boren, S. A. (2013). Patient-centered care and outcomes: a systematic review of the literature. Medical Care Research and Review, 70(4), 351-379.

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