Changes in Nursing Delivery in Response to Current Pressures on the Healthcare System

Changes in Nursing Delivery in Response to Current Pressures on the Healthcare System
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Changes in Nursing Delivery in Response to Current Pressures on the Healthcare System
Current trends in Australia’s healthcare point to an increasing demand for healthcare services due to a higher number of patients seeking medical care. There is a high rate of patient acuity leading to more patients requiring specialized and intensive medical care, and an increasing older population. Coupled with rising nurse shortage and increasing rates of chronic conditions, the healthcare sector is overwhelmed with an unmanageable demand for healthcare services. To cater for these patients, the healthcare sector has witnessed significant changes in terms of funding, the role of the private sector and the adoption of new technologies in service delivery to meet patient needs. In this regard, this essay argues that some of the major changes taking place in Australia’s healthcare sector include the need for increased funding, more private-sector involvement and adoption of technology to take care of an increasing rate of patient acuity.
Increasing patient acuity is one of the leading factors that have resulted in more patients seeking intensive and specialized medical care (American Hospital Association, 2012). Patient acuity is the level or intensity of medical care by a registered nurse necessary to achieve a positive outcome in a patient. Patient acuity determines the length of hospitalization and level of staffing. The higher the rate of patient acuity, the longer the hospitalization period and higher level of nurse staffing required. In the contemporary healthcare environment, the number of patients requiring intensive care has increased, creating pressure on the available resources. To address this situation, governments and other stakeholders are compelled to inject more resources to cater for increasing patient needs due to prolonged hospitalization.
Healthcare givers are responding to increasing patient acuity by providing more intensive care services aimed at shortening the length of hospital stay as well as minimizing delays in attending to new cases (Needleman, 2013). Prolonged hospital stays by patients requiring intensive care not only consumes more resources, but also prevents the nursing staff from admitting new patients. This is because the existing patients need to be discharged first to create space for new ones. The provision of intensive care services ensures that patients are attended to and treated within a short period to save time. In addition, intensive care allows for quick diagnosis of symptoms and administration of effective treatment periods. Similarly, hospitals seek to create more space by discharging patients early to post-acute care services such as skilled nursing facilities and home-based care. This trend means that the mainstream healthcare sector is unable and lacks the resources to cater for rising patient needs. As a result, they shift some of the responsibility to privately funded and non-traditional healthcare providers. However, one negative consequence of early discharge of patients to post-care service providers is that it increases the workload for nurses working in intensive care units, home-based care, and skilled nursing facilities (Berry & Curry, 2012). Increased workload often results in low nurse satisfaction and subsequent shift into other professional fields. Similarly, healthcare providers are concerned about increasing costs in meeting the high demand for medical care, leading to cost-cutting measures such as reducing the level of nurse staffing. However, this measure negatively impacts on the outcome of patients in critical care since the reduction of the nurse force compromises on the quality of service delivery (Penoyer, 2010). Consequently, governments and healthcare givers attempt to avoid this situation by increasing the level of funding to key healthcare sectors and encouraging the participation of private care givers to accommodate some of the patient needs. I addition, the adoption of technology such as the use of electronic databases to keep patient records helps to save time in terms of accessing vital patient information whenever it is needed.
Patient acuity is also aggravated by aging since older persons require specialized and long term care. Older persons require regular care due to their vulnerability to diseases and infections, a situation caused by their low immunity and physical weakness. The major cause of the rising number of older persons is increasing life expectancies in the developed countries, leading to more aged patients requiring specialized care in nursing homes and other facilities for older people (Cjaza&Sharit, 2009). Improving healthcare services in the developed world and improved quality of life as a result of economic stability enable individuals to live longer, thereby increasing the number of years they require special care to compensate for their weakening bodies. In Australia, for instance, life expectancy has increased steadily since the late 70’s, in which people born after World War Two have better chances of living longer than those born earlier. According to the Australian Institute of Health and Welfare, “Men aged 65 in 2010–2012 could expect to live another 19.1 years (an expected age at death of 84.1 years) and the life expectancy of women aged 65 in 2010–2012 was 22.0 years (an expected age at death of 87.0 years)” (AIHW, 2012). The report by the institute further shows that children born between 2010 and 2012 can live even longer than older generations. This trend indicates to a situation whereby the number of old-age patients (individuals requiring specialized care due to their advanced age) will continue to rise as a result of longer life expectancies (Australian Bureau of Statistics, 2012). As older people live longer, they will put more pressure on existing healthcare resources. This scenario is already becoming a reality in the United States, where the aging baby boomer generation (which has attained the eligibility age for Medicare benefits -65 years) is increasing at the rate of 10, 000 persons per day (American Medical Association, 2012). This means that the country will have to invest more resources in home care and nursing services that cater for older persons, such as hospices and nursing homes. Studies on the current demographic trends in the U.S. population indicate that over 22 percent of Americans will be aged 65 years and above by the year 2030, and majority of this group will be over 75 years old (Czaja & Sharit, 2009). The American situation is worsened by the fact that majority of the baby-boomer generation nurses are coming into retirement, which will create more nurse shortage in the near future. In this regard, significant investment in the human resource department is necessary not only to replace potential retiree nurses, but also to keep up with the rising demand for healthcare services.
The need to improve people’s quality of life as the major focus in healthcare makes it necessary to expand existing social support services as a means of allowing older people and those requiring special medical care lead healthy lives. At the same time, there is a need to make healthcare services more affordable and readily accessible to many people, especially underprivileged and marginalized groups. In the U.S., the passage of the Affordable Healthcare Act was intended to achieve this goal, by providing cheap healthcare insurance to middle and lower class families (American Hospital Association, 2012). This move requires the government and other stakeholders (such as employers) to incur additional costs to make healthcare affordable to low earners. One immediate implication of this development is that the healthcare sector will be burdened with the task of catering for a higher number of people who are now capable of seeking healthcare services. Fulfilling this huge responsibility requires additional investment in the human resource, infrastructure, healthcare facilities, and other social support services to accommodate the inevitable high number of persons seeking medical attention.
Improving economic levels and government efforts to provide affordable healthcare will undoubtedly increase use of healthcare services and resources. The eligibility of the baby boomer generation for Medicare benefits will have an immediate impact on expenditure in healthcare as more resources and a larger nursing workforce will be necessary to meet the rising demand (American Medical Association, 2012). The level of nurse staffing has a direct impact on patient outcome since it determines patient satisfaction (Liang, et al., 2012). Increasing the number nurses is vital in delivering quality care to patients. This is because a sufficient nursing force reduces the amount of workload for individual nurses, which allows them to commit enough time and resources in attending to patients. The same case can be said of South Australia, which is expecting a higher number of older persons requiring specialized medical care in the near future. According to the 2007-2017 Health Care Plan for South Australia, the demand for care services for people aged above 65 years is poised to increase in coming years (South Australia Dept. of Health, 2009). It is evident from these statistics- increasing life expectancy levels within the Australian population, eligibility for Medicare by the U.S. baby boomer generation, and South Australia’s projected rise in the number of healthcare seekers in the near future- that the need to increase funding to meet increasing patient needs is a major concern across many healthcare sectors.
Investment in nursing homes to take of the needs of older patients is one of the merging developments in healthcare delivery (Swedish Institute, 2013). An increasing number of old people are living alone, which requires more investments in nursing homes for the old (South Australia Dept. of Health, 2009). Old people require constant care, which may not be necessarily medical-oriented. In this regard, staying in hospitals may not be appropriate since regular medical attention may not be required as much as constant monitoring of their health and provision of day-to-day social care. However, the people who offer this kind of care are trained or registered nurses, who are capable to provide instant medical care as the need may arise. Accordingly, the healthcare system has evolved in such a way that secondary healthcare in hospital settings is linked with primary healthcare in home-based care and nursing homes services. This is because the latter provides services not just aimed at improving the quality of live for older persons, but also providing preventive care to protect them against situations and incidences that can result in hospitalization.
Increasing patient acuity has resulted in more roles and responsibilities for nurses to deal with increasing rates of chronic conditions such as heart disease and obesity (Keats & Wiggins, 2014). This is especially the case in the developed world, where high income levels have led to lifestyle changes such as high food consumption rates and intake of high calorie diets (National Heart Foundation of Australia, 2012). The developed world, including Australia, Japan, and South...