NRS 493 Week 10 Care Delivery and Clinical Systems Essay

This final submission should also outline what students have discovered about their professional practice, personal strengths and weaknesses that surfaced during the process, additional resources and abilities that could be introduced to a given situation to influence optimal outcomes, and, finally, how the student met the competencies aligned to this course.

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The final journal should address a variable combination of the following, while incorporating your specific clinical practice experiences:

1. New practice approaches
2. Interprofessional collaboration
3. Health care delivery and clinical systems
4. Ethical considerations in health care
5. Practices of culturally sensitive care
6. Ensuring the integrity of human dignity in the care of all patients
7. Population health concerns
8. The role of technology in improving health care outcomes
9. Health policy
10. Leadership and economic models
11. Health disparities

While APA style is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

RN to BSN

2.3: Understand and value the processes of critical thinking, ethical reasoning, and decision making.

4.1: Utilize patient care technology and information management systems.

4.3: Promote interprofessional collaborative communication with health care teams to provide safe and effective care.

5.3: Provide culturally sensitive care.

5.4: Preserve the integrity and human dignity in the care of all patients.

**To complete this weekly assignment you have two choices, you can simply submit a statement that you have read and understand the assignment (such as ‘I understand what is required for the weekly journal assignment’) or you can submit your journal work but the journal assignment will not be graded until week 10…prior to week 10 it is a reminder each week in the assignment submission area.

Here are some details regarding both assignments to help you in planning the next 10 weeks.

• Practicum Reflective Journal is due in the final weeks of the course but you want to work on it throughout the course, it has 9 focuses, you need to ensure you include all 9 focuses, to get credit for the 9 focuses you will need to either highlight the focus or state the focus at the beginning of the entry (For example: ‘I had a great time talking with my preceptor about the BSN role vs the ADN role and we discussed new practice approaches with the requirement for a BSN for new grads…’ or you can list the focus first in your journal entry ‘New Practice Approaches: I spoke with my preceptor and we talked about the requirement for a BSN degree for new grads…) If I cannot find the focus easily listed you may loose points for your final submission. 

PICOT Literature Review

Seniors in managed long-term healthcare lack adequate care, which leads to most of them acquiring severe mental illness. Most of the mental health problems reported in assisted care facilities and nursing home centers are attributed to the lack of adequate care given to these senior citizens.  This paper takes the stance that a person-environment match helps residents to engage in more prosocial attitudes within two months, while those who do not get the intervention will experience aggression. This is if the caregiver gives poor services, including a lack of proper or clear communication with a person with dementia or rushing them.

A Comparison of Research Questions

The research question in the article by Soilemezi et al. (2019) was to explore the role of the home environment and then ascertain potential barriers and contributors in home-dementia support and care to establish guidelines for future research and clinical practice.  According to the article, creating a home environment that is friendly to dementia patients’ care is essential in modifying the home environment for effective home-based dementia care. The research question in the article by Wong & Leland (2018) was to ascertain whether the model framework of person-environment occupation improves dementia care within the home setting. Accordingly, the study reviewed past literature that has studied the interaction between occupation, person, and the environment to facilitate participation and quality dementia care for the residents of a particular home.

The research question in the study by Ouyang (2018) was to ascertain whether applying the person-environment fit theory improves the well-being of older adults of Chinese origin. The research question in the study by Jao et al. (2016) investigates the effective method of developing a person-environment apathy rating for dementia patients. The research question of De et al. (2018) examined the location, engagement, and interaction of home-based dementia care facilities.

A Comparison of Sample Populations

Soilemezi et al. (2019) used a sample of 12 databases to conduct a systematic review of literature that has conducted qualitative research on the experience and perception of people with community-based dementia care.  The article by Wong & Leland (2018) used a total of 24 research articles that have studied the Person-environment occupation model as an occupational therapy that promotes innovative approaches to care for dementia patients. The study listed the components of the model framework based on the person-environment occupation, the relationship between these components, and the strategies used to engage nursing homes to achieve an effective outcome in dementia care.

Ouyang (2018) also used a sample of 18 databases to conduct a systematic review of literature that has conducted qualitative research on applying the person-environment fit theory to improve the well-being of older adults of Chinese origin. Jao et al. (2016) used a sample size of 15 scholarly reviewed literature that studied person-environment apathy ratings in the home-based care for dementia. It also identified literature that has studied both formal and family care with a focus on the role that the home environment plays in facilitating effective dementia care through the elimination of care barriers and challenges. The sample used in the study by De et al. (2018) was 35 peer-reviewed literature that had studied small-scale living care and green care facilities.

A Comparison of the Limitations of the Study

The limitations of the study by Soilemezi et al. (2019) are that it is a subjective qualitative research that may have omitted many issues. The observer never confirmed the actual use of environmental strategies that were reported as positive in some articles. Most of the literature was in the English language, thus eliminating those in Greek and German languages, which further limited data collection. Resource constraints barred the planned need to contact the authors for clarification. The limitation of the study by Wong & Leland (2018) is that it failed to report the relationship between the participants and the research, which could have affected the study’s reliability and validity. The generalization of the study was limited in that the thematic review took place in a workshop where family care takes place, thereby compromising the confirmation of its transferability.

Ouyang’s (2018) study’s limitations are that some of the environmental strategies could be obsolete or outdated due to changes in legislation. However, the researchers used CASP to familiarize themselves with these limitations, thereby capitalizing on the study’s strengths to conduct a robust review. The study’s limitations by Jao et al. (2016) is that it used thematic synthesis, which de-contextualizes the findings given that the themes are interpreted from one setting to another setting despite its inapplicability. The study’s limitation by De et al. (2018) is that it was not feasible to include international cross-cultural comparison literature.

Conclusion and Recommendations for Further Research

While a significant portion of these senior citizens have reported cognitive impairments, others have reported behavioral complications, which indicates the dissertation by those who ought to provide them with care. Previous studies have linked this kind of complication to the fact that the gender gap between the patients’ staff has resulted in stronger young male patients tend to show aggressive behavior towards the feeble female nursing staff. In this PICOT literature review, it is argued that there exists little study that has been conducted to ascertain whether the implementation of a person-environment match in seniors in managed long-term health care reduce problems related to dementia. The literature reviews recommend that future studies focus on the home environment to ascertain the potential barriers and contributors in-home dementia support and care so that guidelines can be established for future research and clinical practice. 

References

De Boer, B., Beerens, H. C., Katterbach, M. A., Viduka, M., Willemse, B. M., & Verbeek, H. (2018, December). The physical environment of nursing homes for people with dementia: Traditional nursing homes, small-scale living facilities, and green care farms. In Healthcare (Vol. 6, No. 4, p. 137). Multidisciplinary Digital Publishing Institute.  Available at https://www.mdpi.com/2227-9032/6/4/137/pdf

Jao, Y. L., Algase, D. L., Specht, J. K., & Williams, K. (2016). Developing the Person-Environment Apathy Rating for persons with dementia. Aging & mental health, 20(8), 861-870.

Ouyang, Z. (2018). The Well-being of Chinese Older Adults: Application of the Person-Environment Fit Theory. Cambridge Scholars Publishing.

Soilemezi, D., Drahota, A., Crossland, J., & Stores, R. (2019). The role of the home environment in dementia care and support: a systematic review of qualitative research. Dementia, 18(4), 1237-1272. Available at https://researchportal.port.ac.uk/portal/files/6568315/The_role_of_the_Home_Environment_in_Dementia_Care.pdf

Wong, C., & Leland, N. E. (2018). Applying the Person-Environment-Occupation Model to Improve Dementia Care. OT Practice: CE-1-CE-7. Available at https://pdfs.semanticscholar.org/5eb7/670fc279edf2593ae9a5231b026e04f2b908.pdf