Impacts of Peripheral Neuropathy on the Elderly
In a 5-7 page written assessment, assess the effect of the patient, family, or population problem you've previously defined on the quality of care, patient safety, and costs to the system and individual. Plan to spend approximately 2 direct practicum hours exploring these aspects of the problem with the patient, family, or group you've chosen to work with and, if desired, consulting with subject matter and industry experts.
Introduction
Organizational data, such as readmission rates, hospital-acquired infections, falls, medication errors, staff satisfaction, serious safety events, and patient experience can be used to prioritize time, resources, and finances. Health care organizations and government agencies use benchmark data to compare the quality of organizational services and report the status of patient safety. Professional nurses are key to comprehensive data collection, reporting, and monitoring of metrics to improve quality and patient safety.
Preparation
In this assessment, you’ll assess the effect of the health problem you’ve defined on the quality of care, patient safety, and costs to the system and individual. Plan to spend at least 2 direct practicum hours working with the same patient, family, or group. During this time, you may also choose to consult with subject matter and industry experts.
To prepare for the assessment:
Review the assessment instructions and scoring guide to ensure that you understand the work you will be asked to complete and how it will be assessed.
Conduct research of the scholarly and professional literature to inform your assessment and meet scholarly expectations for supporting evidence.
Review the Practicum Focus Sheet: Assessment 2 [PDF], which provides guidance for conducting this portion of your practicum.
Note: As you revise your writing, check out the resources listed on the Writing Center’s Writing Support page.
Instructions
Complete this assessment in two parts.
Part 1
Assess the effect of the patient, family, or population problem you defined in the previous assessment on the quality of care, patient safety, and costs to the system and individual. Plan to spend at least 2 practicum hours exploring these aspects of the problem with the patient, family, or group. During this time, you may also consult with subject matter and industry experts of your choice. Use the Practicum Focus Sheet: Assessment 2 [PDF] provided for this assessment to guide your work and interpersonal interactions.
Part 2
Report on your experiences during your first 2 practicum hours, including how you presented your ideas about the health problem to the patient, family, or group.
Whom did you meet with?
What did you learn from them?
Comment on the evidence-based practice (EBP) documents or websites you reviewed.
What did you learn from that review?
Share the process and experience of exploring the influence of leadership, collaboration, communication, change management, and policy on the problem.
What barriers, if any, did you encounter when presenting the problem to the patient, family, or group?
Did the patient, family, or group agree with you about the presence of the problem and its significance and relevance?
What leadership, communication, collaboration, or change management skills did you employ during your interactions to overcome these barriers or change the patient’s, family’s, or group’s thinking about the problem (for example, creating a sense of urgency based on data or policy requirements)?
What changes, if any, did you make to your definition of the problem, based on your discussions?
What might you have done differently?
Requirements
The assessment requirements, outlined below, correspond to the scoring guide criteria, so be sure to address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, note the additional requirements for document format and length and for supporting evidence.
Explain how the patient, family, or population problem impacts the quality of care, patient safety, and costs to the system and individual.
Cite evidence that supports the stated impact.
Note whether the supporting evidence is consistent with what you see in your nursing practice.
Explain how state board nursing practice standards and/or organizational or governmental policies can affect the problem’s impact on the quality of care, patient safety, and costs to the system and individual.
Describe research that has tested the effectiveness of these standards and/or policies in addressing care quality, patient safety, and costs to the system and individual.
Explain how these standards and/or policies will guide your actions in addressing care quality, patient safety, and costs to the system and individual.
Describe the effects of local, state, and federal policies or legislation on your nursing scope of practice, within the context of care quality, patient safety, and cost to the system and individual.
Propose strategies to improve the quality of care, enhance patient safety, and reduce costs to the system and individual.
Discuss research on the effectiveness of these strategies in addressing care quality, patient safety, and costs to the system and individual.
Identify relevant and available sources of benchmark data on care quality, patient safety, and costs to the system and individual.
Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form.
Use paraphrasing and summarization to represent ideas from external sources.
Apply APA style and formatting to scholarly writing.
Additional Requirements
Format: Format your paper using APA style. APA Style Paper Tutorial [DOCX] is provided to help you in writing and formatting your paper. Be sure to include:
A title page and reference page. An abstract is not required.
Appropriate section headings.
Length: Your paper should be approximately 5–7 pages in length, not including the reference page.
Supporting evidence: Cite at least 5 sources of scholarly or professional evidence that support your central ideas. Resources should be no more than five years old. Provide in-text citations and references in APA format.
Proofreading: Proofread your paper, before you submit it, to minimize errors that could distract readers and make it more difficult for them to focus on its substance.
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:
Competency 3: Transform processes to improve quality, enhance patient safety, and reduce the cost of care.
Explain how a patient, family, or population problem impacts the quality of care, patient safety, and costs to the system and individual.
Competency 5: Analyze the impact of health policy on quality and cost of care.
Explain how state board nursing practice standards and/or organizational or governmental policies can affect a patient, family, or population problem’s impact on the quality of care, patient safety, and costs to the system and individual.
Competency 8: Integrate professional standards and values into practice.
Use paraphrasing and summarization to represent ideas from external sources.
Apply APA style and formatting to scholarly writing.
Impacts of Peripheral Neuropathy on the Elderly
Peripheral neuropathy (PN) in the elderly impacts the patient's safety, quality of care, and costs to the patient and the system. PN in geriatrics, among other geriatric syndromes, negatively impacts the patient's quality of life. The patient's safety is negatively affected due to the condition and the associated complications. The patient and their family incur many costs to manage PN and other possible infections.
A 2-hour meeting with the 73-year-old neighbor with PN and his wife revealed that the man is debilitated with nerve pain and numb feet. The meeting reflected that PN negatively impacts the man's overall safety and quality of life due to the extreme pain he experiences. The wife reported that they spend a lot of money on PN management since they do not have insurance coverage. He was hospitalized after two emergency visits last month due to adverse medication reactions. PN led to a severe safety event of depression. She explained that a nurse leader effectively communicated PN management strategies to enhance positive health changes. Based on the clinical facility's policies, the healthcare team collaborated to impact positive changes in the neighbor's condition. The use of simple language addressed a communication barrier related to medical terms. The neighbors concurred on PN's presence, relevance, and significance in people's health. Visual aids might have been used to enhance effective communication on the problem.
PN is independently and commonly associated with mortality in the elderly in both diabetic and non-diabetic individuals (Hicks et al., 2021). It impacts the patient's quality of care and life since it increases the risk factor for mortality for the elderly. The affected individuals experience reduced lower extremity sensation, which can cause significant morbidity and mortality (Hicks et al., 2021). In addition, the elderly with PN have a higher likelihood of significant amputation, falls, and foot ulcers than the elderly without PN. Hicks et al. (2021) reported a twofold likelihood of mortality among adults with PN and a foot ulcer than individuals without a foot ulcer and PN. The elevated mortality rate is attributable to significant amputations and infected foot ulcers. PN can also increase the likelihood of concomitant cardiac autonomic neuropathy, especially in patients with diabetes (Hicks et al., 2021). Neuropathic pain in PN patients interferes with daily activities and can cause psychosocial impairment, disability, and reduced quality of life (Anastasi & Klug, 2021).
Anastasi and Klug (2021) explained that PN increases mortality risk, impairs quality of life, and causes significant morbidities. It impacts patients' safety since it leads to chronic infections, foot injury, poor wound healing, pain, loss of protective sensation, tingling, amputations, foot ulcerations, fractures, nerve fiber loss, poor balance, and falls. It negatively impacts the quality of care since it leads to reduced sensation in the feet, which consequently causes tissue infections, damage, and amputation. Increased financial costs and functional impairments related to PN affect the quality of life and care. PN increases the healthcare costs for both diabetic and non-diabetic individuals. Patients with PN can have a twofold rise in health costs, while those with painful and severe PN can have a fourfold increase in healthcare costs (Anastasi & Klug, 2021). Healthcare systems incur many costs to purchase automated wheelchairs and mechanical crutches for PN patients and stock PN medications. Approximately 27% of $245 billion, the total annual healthcare costs in the US for diabetic individuals in 2012, was attributed to diabetic PN (Anastasi & Klug, 2021). In addition, patients with PN are highly likely to suffer from depression, negatively impacting treatment adherence and patient outcomes. Evidently, there is the poor quality of care, reduced patient safety, and increased costs for managing the condition and its complications.
The supporting evidence from the literature is consistent with the impacts observed at the facility during the nursing practice. The health facility incurs much money to stock PN medications and to purchase automated wheelchairs to facilitate patients' movements from one location to another. PN patients at the facility have a diminished quality of life, and their safety is compromised. They use wheelchairs since they experience numbness, pain, loss of sensation and balance, disability, or frequent falls. Some undergo amputations due to foot injuries, poor wound healing, and chronic infections associated with PN. Several PN elderly patients at the facility are depressed, which leads to poor treatment adherence. Their families incur many healthcare costs associated with PN, such as traveling, purchasing wheelchairs, and medication costs. Some patients also die in the wards while receiving PN treatment or due to PN complications. In addition, diabetic patients with PN suffer from cardiac autonomic neuropathy. The increased PN complications and risks negatively impact the patient's safety and quality of care since there is a reduced extent of achieving the desired health outcomes.
The state board of nursing practice standards and governmental or organizational policies can positively affect PN's negative impacts on patient safety, quality of care, and costs to individuals and the system. National quality improvement policies enhance patient safety and better health outcomes. For instance, standards and policies can support technological innovations that improve patient safety by reducing variation in nursing practice and automating tasks (Astier et al., 2020). Consequently, technological innovations would improve the quality of care, reduce p...