HEALTHCARE PRIORITY ISSUE

HEALTHCARE PRIORITY ISSUE

The priority Areas for Nation Action recommended 20 priority areas that should be focused on improving the quality of health care provided to all Americans. The priority areas selected represented the whole continuum of health care from preventive care to termination of lifespan. It also encompasses all age groups, healthcare settings, and health care providers, and collective action is needed to transform the entire health care system (Corrigan & Adams, 2013). Identifying priority areas of care in a country helps in planning and allocation of resources and also know where the national effort is directed.

Immunization is a healthcare priority issue among children and adults. Immunization among children is aimed at increasing the coverage levels to reduce health disparities, especially in metropolitan areas with high populations and low incomes (Bowling, 2018). Vaccines are biological substances that produce immune responses identical to those caused by a natural infection. The current vaccines administered to children between birth and 10years in the U.S.  include BCG, diphtheria-tetanus-pertussis, Haemophilus influenza type b and hepatitis B, measles, rubella, and smallpox. According to the Center for Disease Control, about 20 000 illnesses and 40 000 deaths have been prevented due to immunization services.

Immunization of infants and adolescents has proven to be a success in the past decades, and the health of children has improved, quality and length of their lives have increased. The prevalence, incidence, morbidity, and mortality resulting from infectious diseases has significantly reduced due to improved national policies aimed at infants and adolescents. The vaccines currently added to the existing are Human papilloma, meningococcal B, pneumococcal, and rotavirus. With a large population of immunized children, the unimmunized ones benefit from herd immunity hence improved quality of children’s life. The purpose of immunization is to improve the health care outcomes of children.

RATIONALE AND IMPORTANCE TO NURSING

I chose immunization as a priority healthcare because children are among the vulnerable populations. They have low immunities, and without vaccination, there will be a rise in morbidity and mortality. Many diseases preventable by a vaccine are considered a global burden, and improved health results in reduced morbidity and mortality decreased poverty and more excellent political stability. Reduction of infectious diseases such as polio and measles has helped avoid issues with migrations and also reducing spread in crowded populations. Immunization is one of the goals towards achieving the Health People 2020 and promoting the safety of all children in the country and worldwide. This issue is important because it helps protect children by providing early immunity from threatening diseases.

Promoting health and wellbeing are the crucial functions of a nurse. Immunization of both the nurses and the public helps protect them from preventable diseases and threatening diseases. Health care providers, patients, families, and the community benefit from vaccinations, and the nurses have a responsibility in advocating for immunizations throughout an individual’s health continuum (Singh, Badole,  & Singh,2014).  The immunocompromised, neonates, and pediatrics should be vaccinated since they are at high risk of developing preventable disease complications.

The nurses are key providers of immunizations; hence they should ensure the safety and efficacy of vaccines through proper handling, storage, and administration. Nurses should be knowledgeable in the management of vaccine side effects and adhering to the precautions and contraindications. By assessing the health care needs of a community, the nurses can fill in the gap and foster improved health outcomes for both children and their families. Nurses come in contact with various patients hence should be immunized against hepatitis and tuberculosis; without immunizations, the nurses would render patients vulnerable.

NURSING INTERVENTIONS AND OUTCOMES

Although strategies have been developed to ensure children receive complete immunizations, there are still parents who decline due to medical, religious, philosophical, and socioeconomic reasons. Health care provider-based interventions have been suggested to overwhelm noncompliance; they include patient counseling, improving access to vaccinations, offering combined vaccines, and use EMRs and patient alerts for follow up. Community- and government-based interventions to strengthen parent and patient adherence include civic education and reminder/recall strategies, financial incentives, and providing alternate settings for vaccination.

journal of pediatric nursing by Ann Bowling (2018

According to public health guidelines, enhancing immunization requires the approach of 3Es, which entails education, enforcement, and engineering. The nurses should listen, guide, and inform parents on the significance of vaccines on the health of their children. Many parents in the 21^st century are uncertain due to being unsure of vaccines’ safety and the misconceptions about vaccines. Education needs to emphasize on addressing parental concerns about immunizations, sharing data-supported evidence, and clarifying any fallacies parents have about vaccinations. It is also good to involve parents in decision making and promoting enforcement through prescribing rules and regulations that facilitate adherence to the immunization schedule.

journal of nursing by Davis (2016)

To attained improved compliance rates, the nursing interventions include ensuring that parents understand the immunization schedule through proper education. The nurse should inform the mother on the return dates and documents them on the clinic book and EMR. Follow up should also be done if the mother fails to turn up. Besides, using a tracking system and promoting the importance of immunization helps facilitate adherence and compliance.

QUALITY IMPROVEMENT INITIATIVE AND PATIENT CARE

Quality improvement involves a set of activities designed to monitor, analyze, and improve quality processes to improve healthcare outcomes (Karon, & Zimmerman, 2016). QI is systematic and continuous actions that lead to measurably improved outcomes and the health status of a targeted patient population.  The Institute of Medicine defines quality in healthcare as a direct correlation between the level of enhanced services and the desired health outcomes of individuals and populations.

The quality improvement initiatives to be implemented in attaining enhance immunization rates and improved compliance include clinical and financial partnerships and lowering the cost of care. The department of health and non-governmental organization should direct its efforts in improving access, safety, effectiveness, and providing patient-centered care. When focus and actions are aimed at providing accessible and safe immunization services, there will be an increase in the rate of immunization. People will be willing to seek and complete immunizations on their children due to assured safety.

Educational campaigns are implemented through financial partnerships to promote the success of the initiatives. Proper planning and financial stability are needed to reach all the citizens, especially the metropolitan and remote areas. Provision of patient-centered care initiatives helps promote patient satisfaction by putting into account their values, experiences, and addressing their concerns Moreover, involving them in decision making makes them responsible and take accountability for the outcome of care.

NURSING, QUALITY, AND OUTCOME

Those who work in the provision of services in the organization are best at assessing the needed change in the healthcare delivery processes. According to this statement, it is the role of the nurse to assess the healthcare delivery processes and work towards the improvement of operations in the healthcare setting. Nurse managers participate in reshaping the healthcare environment by inspiring and empowering staff in their efforts to facilitate quality outcomes (Sheffer et al., .2019). The professional nurses carry out interdisciplinary processes intending to achieve organizational QI goals and to measure, improve, and analyze nurse-sensitive indicators affecting patient outcomes.

The chief nursing officer (CNO), a member of administrative leadership, is involved in incorporating the goals of the organization in the process of attaining positive patient outcomes by communicating hospital strategies to all levels of staff. The nurse managers identify the NSIs used on evaluating patient outcomes and communicates with bedside nurses on how to achieve the quality initiative strategies and goals. The nurse executive provides the vision and mission and avails the necessary resources needed for the success of the quality improvement efforts. The direct care nurses are the critical quality patient outcomes and are involved in the implementation of protocols and standards of quality improvement known to improve patient outcomes.

The professional nursing values that improve patient care include accepting responsibility and accountability for their action and maintaining the confidentiality of patients. By maintaining confidentiality, patients can open up about their health and personal problems, which will help in planning patient-centered care (Sellman, 2015). It helps in understanding the condition of the patient better; hence the administration of the right treatment and proper management is given. Responsibility and accountability is a professional value that ensures that nurses adhere to the code of ethics at all times. It enables nurses to do the right thing always are they will be accountable for the patient outcomes. They also are responsible for the accomplishment of all tasks related to patient care, and they take full accountability for the consequence of their actions.

References

Bowling, A. M. (2018). Immunizations-Nursing Interventions to Enhance Vaccination Rates. Journal of pediatric nursing, 42, 126.

Corrigan, J. M., & Adams, K. (Eds.). (2013). Priority areas for national action: transforming health care quality. National Academies Press.

Davis, W. S., Varni, S. E., Barry, S. E., Frankowski, B. L., & Harder, V. S. (2016). Increasing immunization compliance by reducing provisional admittance. The Journal of School Nursing, 32(4), 246-257.

Institute of medicine. Committee on identifying priority areas for quality improvement. (2015). Priority areas for national action: Transforming health care quality. National Academic Press.

Karon, S. L., & Zimmerman, D. R. (2016). Using indicators to structure quality improvement initiatives in long-term care. Quality Management in Health Care, 4(3), 54-66.

Shefer, A., Briss, P., Rodewald, L., Bernier, R., Strikas, R., Yusuf, H., … & Hinman, A. R. (2019). Improving immunization coverage rates: an evidence-based review of the literature. Epidemiologic reviews, 21(1), 96-142.

Sellman, D. (2015). Professional values and nursing. Medicine, Health Care, and Philosophy, 14(2), 203-208.

Singh, M. C., Badole, C. M., & Singh, M. P. (2014). Immunization coverage and the knowledge and practice of mothers regarding immunization in rural area. Indian Journal of public health, 38(3), 103-107.