Assessing Health Problem Assignment Sample
Practicum Focus Sheet
The patient that I intend to work with in this project is Mr. X, a 40-year old male with history of recurrent asthma. The patient is married and has two children. Mr. X was recently admitted to the hospital due to unresponsive asthma. According to him, he has been experiencing asthma attacks for the last five years, which he manages using prescribed inhaled corticosteroids. Mr. X was chosen for this project because he expressed interest to learning more about asthma and its effective management to prevent recurrences in the future. He is ready to embrace any lifestyle or behavioral interventions to manage the disease. By working with this patient, I intend to learn more about coordination of care. I also intend to learn the principles of patient-centeredness and continuous quality care in practice (Ignatavicius et al., 2020). I also intend to learn about effective evidence-based practices that can be used when working with patients, families and groups from different ethnic backgrounds.
The effective management of asthmatic attack experienced by the patient will depend largely on the understanding of the patient and his level of involvement in care. I will therefore use simple, easy to understand and accurate messages to convince the patient about the significance of disease management. I will also involve him and his family in examining the ways in which environmental risks can be minimized to prevent recurrent attacks. I will embrace transformational leadership style to influence the patient to embrace the desired interventions for the effective management of asthma attacks. I will also focus on ensuring that he plays an active role in exploring ways of promoting the effective management of the condition. I will embrace open communication between the patient and the family to foster their understanding of care process and care needs (Chung et al., 2019). I will also guide them on the use of the various interventions for asthma management as a way of managing change. Some of the potential barriers that might be experienced include the client’s tight schedule and poor uptake of the interventions to be used in the management of his health problem. I will embrace strategies such as developing a plan for meeting the client and his family and ensuring active involvement of the patient in examining ways of managing his health problem.
Analysis of Evidence
Asthma is one of the health problems that most patients admitted in the hospital experience. The obstruction of the airflow, hyper-responsiveness and sensitivity to various stimuli characterize asthma. According to statistics, about 300 million people globally are affected by the disease. The goals of treatment in asthma is to prevent its recurrence and remodeling of the airways and hospital admission rate (Ignatavicius et al., 2020). Generally, the treatment of asthma entails the use of pharmacological agents and health education on the importance of avoiding environmental allergens or triggers for asthma attacks. The pharmacological drugs used for the treatment of asthma include short-acting beta agonists, inhaled corticosteroids, long-acting beta agonists, leukotriene receptor agonists. Health education in the management of asthma focuses on raising the level of awareness of the patients towards the triggers for asthmatic attacks such as pollen, stress, tobacco smoke, upper respiratory tract infections, and cold (Pereira, 2016).
The use of evidence-based practices in asthma management has been shown to result in treatment outcomes that include safety, quality and efficiency in care. However, the use or consistent utilization of evidence-based practice interventions in asthma management faces a number of barriers. One of the barriers is the poor adherence by the patients and healthcare providers on the effective management of asthma. Ineffective adherence to the prescribed treatment by the patients increases the risk of recurrence of asthmatic attacks (McQuaid, 2018). Similarly, poor adherence to clinical guidelines for best practices in asthma worsen the outcomes of treatment in asthma.
The treatment outcomes in asthma depends largely on the stage of its management. Early identification is associated with enhanced outcomes of treatment that include management of recurrence and symptoms of the disease. However, the effectiveness of evidence-based practices used in asthma face the challenge of patients failing to identify and act to address the warning symptoms of asthmatic attack. The attitude that the patients have towards traditional methods of asthma management also affect the effectiveness of evidence-based interventions. For example, patients have been shown to rely on the use of unorthodox methods such as ginger, turmeric, hot water, and tea to relief symptoms of asthma. The consequence include poor treatment outcomes due to low adherence level to treatment (Chung et al., 2019). The use of complementary medicine also hinders the effectiveness of evidence-based interventions, as patients substitute the recommended pharmacological treatment methods with complementary medicine.
Nurses have a critical role to play in the management of asthma. They provide care that aligns with the stated professional and institutional policies and standards of care. One of the nursing policies that regulate the provision of nursing care to patients with asthma is utilizing patient-centered care to promote safety in care. Nurses provide patient-centered assessment, planning, implementation and evaluation of plans of care. The assessment aims at identifying the care needs of the patients and their abilities to achieve independence in self-management of the disease. The implementation and evaluation focuses on the effectiveness of the adopted interventions in meeting the developed patient needs in care process. According to Pereira, (2016), patient-centeredness in asthma care improves treatment outcomes such as safety, adherence and patient satisfaction with care. In addition, patient-centered education ensures that the treatment guidelines are adhered to for enhanced outcomes (McCabe & Connolly, 2019).
Nurses also utilize nursing theories to guide the care that they give to patients with asthma. Nursing theories provide frameworks for assessing, planning, implementing and evaluating care. An example of the use of theory in asthma management is seen in the research by Mersal and El-Awady (2017) where the theory of self-care by Orem was used to enhance self-management of asthma in school age children. The use of self-care theory by Orem was associated with enhanced self-efficacy and utilization of asthma management activities by school aged children.
Effect of State Board Nursing Practice Standards and Organizational Policies Affecting Asthma Management
State board of nursing practice standards and government policies affect the outcomes of treatment in asthma. State board of nursing practice standards guide the focus on the provision of patient-centered care in asthma management to promote safety in care. The state board also develops competencies that nurses must demonstrate in providing care to patients with asthma. The regulations developed by the government also influence the outcomes of management in asthma. For instance, the state implements provisions by the CDC’s National Asthma Control Programs in the public health systems to increase the awareness, management, and control of asthma in the population. The National Asthma Control Program (NACP) develops the public health response to be utilized for asthma, promote sustainability of asthma control program, strengthen the surveillance system and increase the role of healthcare providers in asthma management and prevention (Chung et al., 2019).
Nurses play critical roles policy making to improve outcomes, prevent illness, and reduce readmissions due to asthma. Nurses advocate the provision of effective care that promote safety, quality and efficiency in the management of asthma. Nurses ensure that barriers to health in patients with asthma are addressed. The barriers that influence the management and health outcomes in asthma management include level of awareness, access, availability and affordability of asthma care. Nurses therefore advocate the adoption of policies that eliminate health inequalities and strengthen the provision of case-specific care to patients with asthma. Nurses also advocate the implementation of evidence-based strategies for asthma management in their states and health organizations.
They champion the use of best practices in asthma management that promote value in care and realization of patient outcomes. In doing these roles, local, state and federal policies influence the scope of nurses in addressing the health needs of the patients with asthma. Accordingly, nurses ensure that the care that they offer to asthma patients promote the protection of safety needs and rights of the patients in the care process. State and federal policies also stipulate the competencies that nurses should demonstrate to provide appropriate care to asthma patients (Ignatavicius et al., 2020). For example, nurses must be certified and registered by the state boards to demonstrate their competencies in promoting safety in nursing practice. In addition, continued professional development is needed to ensure that high quality care is given to asthma patients using best practices.
Effective leadership is needed for the optimization of treatment outcomes for patients with asthma. Nurse Managers and registered nurses play a critical role in promoting lifestyle and behavioral transformation in the management of asthma. Accordingly, nurses influence patients to embrace the needed strategies such as treatment adherence through health education. Nurses also introduce change initiatives in their practice to improve the treatment outcomes in asthma. For example, Onubogu (2019) shows that nurses can utilize theories of change such as Kotter’s change model to introduce improvement initiatives in the management of asthma. The use of change models facilitate the incorporation of best clinical practices in asthma management to minimize recurrence and worsening of symptoms. Therefore, nurses have a role to utilize their leadership skills in improving the treatment outcomes and disease burden of asthma.
Active stakeholder collaboration is needed for the effective management of asthma in communities. Nurses and other healthcare providers should work together in determining the health needs of asthma patients, implementing strategies and evaluating their effectiveness. Effective referral systems are also needed to ensure that optimum management of complex cases is achieved in the state (Ignatavicius et al., 2020). Open communication between healthcare providers and patients should therefore be promoted to build trust and enhance the treatment outcomes. Open communication is essential to ensure that patients understand the treatment approaches to their health problem and express their views and concerns on the approaches to treatment. The effective management of asthma also requires the implementation of strategies that promote continuous improvement in the management of the disease (Pereira, 2016). For example, there is a need to offer training to healthcare providers to equip them with the essential knowledge and skills alongside creating culture that is characterized by learning to promote innovation. Therefore, organizational transformation is needed for the adoption of change management strategies that improve treatment outcomes in asthma.
In conclusion, the effective management of asthma in diverse populations depends on the level of patient and provider involvement in the care process. Nurses and other healthcare providers should however explore effective strategies to addressing barriers in the management of asthma in populations. Policy advocacy is also needed to ensure that the interventions that are adopted promote equity in health. Most importantly, nurses should explore the ways in which continuous improvement in the management of asthma using evidence-based initiatives can be achieved.
- Chung, K. F., Israel, E., & Gibson, P. G. (2019). Severe Asthma. European Respiratory Society.
- Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2020). Medical-Surgical Nursing – E-Book: Concepts for Interprofessional Collaborative Care. Elsevier Health Sciences.
- McCabe, E. M., & Connolly, C. (2019). From intention to action: Nurses as policy advocates for asthma care in schools. NASN School Nurse (Print), 34(2), 113–116. https://doi.org/10.1177/1942602X18786394
- McQuaid, E. L. (2018). Barriers to medication adherence in asthma: The importance of culture and context. Annals of Allergy, Asthma & Immunology, 121(1), 37–42. https://doi.org/10.1016/j.anai.2018.03.024
- Mersal, F., & El-Awady, S. (2017). Evaluation of bronchial asthma educational package on asthma self-management among school age children based on Orem’s self-care model in Zagazig city. International Journal of Advanced Nursing Studies, 7, 8. https://doi.org/10.14419/ijans.v7i1.8648
- Onubogu, U. (2019). How to Implement Change in Asthma Management in a Developing Country. Open Journal of Respiratory Diseases, 9(1), 26–35. https://doi.org/10.4236/ojrd.2019.91003
- Pereira, C. (2016). Asthma: From Childhood Asthma to ACOS Phenotypes. BoD – Books on Demand.