Medication delay with home care infusions

Change Proposal Paper Student's Name Institutional Affiliation Course Code and Name Professor's Name Submission Date Home-based infusion therapy is a new healthcare model that lets complex medical patients obtain specialist treatments at home. As this novel technique develops popularity, it presents issues that require careful evaluation and intentional solutions. The change proposal emphasizes cultural competency, technology integration, and quality improvement to improve nursing care during adult home-based infusion therapy. Home-based infusion therapy is complex and requires a complete plan that integrates nursing practices with patient-centered care, promotes technical improvements, and establishes a framework for continuous improvement. This paper examines the clinical problem, suggested change, literature supporting the initiative, and a detailed implementation and assessment strategy using evidence-based approaches to improve patient care in the changing healthcare landscape. Background of Clinical Problem Patient-centered home-based infusion therapy delivers sophisticated medical treatments in patients' homes. This method allows people with lysosomal storage disorders, multiple sclerosis, and chronic intestinal failure to obtain infusion therapies without hospital stays. Home-based infusion therapy has many benefits, including enhanced autonomy and lower healthcare costs, but it faces various obstacles. Cultural competency is a big issue for home-based infusion therapy nurses. Healthcare practitioners must understand and respect the varied social backgrounds of patients getting these treatments. Patient-centered treatment requires cultural competence to match patients' values, beliefs, and preferences (Lin et al., 2019; Solberg & Naden, 2019). Nurses' cultural awareness and response in the home improve patient satisfaction and treatment adherence (Liu et al., 2022). Another problem is integrating technology for communication and monitoring as home-based infusion therapy becomes increasingly common. Telehealth and remote monitoring systems are needed to improve patient-provider communication and treatment monitoring (Rosen et al., 2021). Infrastructure, accessibility, and staff training hinder technology adoption (Cawthra et al., 2022). Technology's full potential to improve patient safety and treatment outcomes requires overcoming these hurdles. Due to the dynamic nature of home-based infusion therapy, a continuous nurse quality improvement approach is necessary. Quality improvement programs reinforce learning, keeping nursing practices current with patient demands (Harvey et al., 2019). This approach is crucial as new technology and patient demographics transform healthcare delivery (Berger et al., 2020). Clinical Problem Statement The rise of home-based infusion therapy, which aims to increase patients' autonomy and quality of life, necessitates reviewing nursing care. Home-based infusion therapy offers customized care, comfort, and lower healthcare costs, but nursing interventions require careful monitoring for efficacy. Effective home-based infusion therapy relies on patient satisfaction. Patient-centered care at home requires a detailed understanding of how nursing care affects patient satisfaction, which is crucial to treatment success (Diez et al., 2021). Home-based infusion therapy patients need positive healthcare experiences, autonomy, and emotional support (Hartley et al., 2020; Rapport et al., 2019). Home nursing care has unique obstacles and opportunities; thus, there is a need to examine patient satisfaction thoroughly. Patients must accurately administer medications, follow regimens, self-monitor, and interact with healthcare providers to succeed with home-based infusion therapy (Hei et al., 2021; Sany, 2020). Home-based care presents unique obstacles, and devising treatments that encourage active patient involvement requires understanding how nurse activities affect treatment adherence (Hei et al., 2021). Such requires investigating how nursing interventions can increase home-based infusion therapy adherence. Health outcomes determine healthcare intervention efficacy. Health outcomes must not be impaired when patients transfer from hospital-based care to home-based infusion therapy. Nursing care is crucial to infusion therapy safety and efficacy. Understanding the intricate relationship between therapeutic processes, nursing interventions, and health outcomes is vital to ensuring that the transition from hospital to home-based infusion therapy does not harm patients (Diez et al., 2021). Thus, the clinical problem is to fill knowledge gaps about how nurse care in home-based infusion therapy affects patient satisfaction, treatment adherence, and health outcomes. Purpose Of The Change Proposal The healthcare delivery landscape is changing; this includes home-based infusion therapy. This proposal will transform the infusion center into a more patient-centered model of care, with improvements in nursing services tailored for home-based infusion treatment due to meeting the standards of patient-centered care. The healthcare sector is now adopting patient-centered models that value individual needs, preferences, and autonomy (Diez et al., 2021). One area where this revolution is happening is in home-based infusion therapies. In particular, this change attempts to align the nursing interventions with the healthcare services provided by home-based infusion therapies to meet specific needs (Diez et al., 2021). On another note, it also suggests improving health outcomes via satisfactory ways in home-based infusions, important determinants of quality, and experience in health care (Rapport et al., 2019). The concept advocates for happy patients, flexibility, excellent experiences in healthcare systems, and caring homes through nursing treatments (Hartley et al., 2020). Such supports the move towards patient-rated outcomes and experiences that characterize the shifting health system in the country (Berger et al., 2020). The change suggestion also aims to increase compliance levels for home-based infusion therapy. Nursing care helps patients stick to their recommended treatment plans; thus, adherence impacts the success of therapy (Hei et al., 2021). These proposed nurse interventions intend to improve treatment adherence through patient participation, education, and communication with them (Sany et al., 2020). Also, the reform agenda promises positive health outcomes in a changing healthcare environment. As patients transition from hospital to home infusion therapy, maintenance and improvement of health outcomes are critical. Nursing interventions are necessary for safe and effective home-based infusion therapy (Diez et al., 2021). Consequently, this suggested shift would engage in research concerning interventions that enhance health outcomes to ensure the safety of patients and the efficacy of treatment during the transition into home-based care. Based on evidence-based practice recommendations, this change suggests studies on home-based infusion therapy, patient satisfaction, adherence, and its impact on health outcomes. The plan follows evidence-supported ideas, ensuring that research supports the proposed changes; hence, it can improve patient care within the dynamic healthcare system. PICOT Question In adult patients receiving infusion therapy at home (P), how does nursing care during therapy (I) compared to standard care in a hospital or clinic (C) affect patient satisfaction, treatment adherence, and health outcomes (O) over the proposed 9-month nursing intervention (T)? Literature Search Strategy Employed This project searched research articles on home-based infusion therapy, patient satisfaction, treatment adherence, and health outcomes. The search technique sought diverse evidence to support the planned change project. PubMed and journal-specific databases were searched to find peer-reviewed literature. It targeted relevant studies using "home infusion therapy," "patient satisfaction," "treatment adherence," and "health outcomes" in various combinations. For relevance, it included studies published within the last five years. Only English articles were considered for comprehension and analysis. The study prioritized research, observational, and qualitative studies that addressed the essential aspects of the planned change project. Heinrich et al.'s (2023) study shed light on patients' views on home-based lysosomal storage disorder infusion therapy. The longitudinal observational approach and patient satisfaction focus supported the proposed change initiative. Barrera et al. (2023) examined the safety and patient experience with at-home ocrelizumab infusion for multiple sclerosis, providing essential data on patient satisfaction and practicality. Fatemi et al.'s (2019) qualitative study shed light on the obstacles to home-based infusion therapy for nurses. Pines et al. (2021) examined telehealth apps in United States emergency rooms, providing insights into innovations and issues in non-traditional healthcare settings that potentially apply to home-based infusion therapy. Toscano et al.'s (2023) study on safety results and patients' preferences for home-based intravenous enzyme replacement treatment in Pompe disease and MPS I disorders provided empirical data on patient satisfaction and compliance. Kobylecki & Smith's (2023) study on home apomorphine infusion during the COVID-19 pandemic shed light on home initiation techniques and patient outcomes. In Jones et al.'s (2023) longitudinal cohort study, home parenteral support and needs-based quality of life in chronic intestinal failure patients were examined to determine how changes in home infusion therapy may affect patient well-being. Elsener et al.'s (2023) study on a telehealth-based transitional care management program revealed how telehealth interventions affect readmission rates, which could impact the planned change project's telehealth components. Synthesis of Literature Review The evaluated research seeks to understand home infusion therapy dynamics and patient outcomes. Heinrich et al. (2023) and Toscano et al. (2023) examine the efficacy and safety of home-based enzyme replacement therapy (ERT) for lysosomal storage disorders, focusing on patient satisfaction and outcomes equivalent to center-based therapy. Barrera et al. (2023) demonstrate the safety, practicality, and improved patient experience of at-home ocrelizumab infusion for MS patients. Fatemi et al. (2019) examine home healthcare nurses' concerns and potential impediments to home infusion therapy. Pines et al. (2021) discuss how telehealth applications affected US emergency departments during the COVID-19 pandemic, underlining the need for innovation. Toscano et al. (2023) and Kobylecki and Smith (2023) studied home-based IV enzyme replacement treatment and subcutaneous apomorphine infusion safety, compliance, and patient satisfaction. Jones et al. (2023) examine chronic intestinal failure patients' needs-based quality of life and home parenteral support (HPS). Elsener et al. (2023) discuss how WPH Cares, a telehealth-based transitional care management program, reduces patient readmissions. The trials include various patient populations, improving generalizability. Heinrich et al. (2023) studied 30 Germans with lysosomal storage disorders, while Barrera et al. (2023) examined 99 White female multiple sclerosis patients. Fatemi et al. (2019) investigated 33 Iranian home healthcare nurses' issues from a healthcare professional standpoint. Pinches et al. (2021) interviewed emergency department executives from 14 US institutions to learn about their experiences. Toscano et al. (2023) involved 38 Italian patients receiving home-based intravenous enzyme replacement treatment, and Kobylecki and Partington researched 27 Parkinson's disease patients receiving subcutaneous apomorphine at home. Jones et al. (2023) included a large and heterogeneous sample of 572 chronic intestinal failure patients from 14 NHS sites in their study. Elsener et al. (2023) analyzed WPH Cares on 24,808 eligible patients from diverse backgrounds, assuring broad applicability. The analyzed samples show that home infusion treatment consistently improves results. Heinrich et al. (2023) and Toscano et al. (2023) demonstrate excellent patient satisfaction and equivalent or better outcomes than center-based therapy. Barrera et al. (2023) show that at-home ocrelizumab infusion improves patient satisfaction and confidence. Fatemi et al. (2019) discuss home healthcare nurses' stressors and barriers. According to Pines et al. (2021), US emergency departments adopted telehealth faster during the COVID-19 pandemic, demonstrating new solutions. Koby...