SOAP Notes

Unit 2: Escalating Costs in Healthcare

The nursing practice has practitioners experiencing outcomes that are equivalent to what is experienced by physicians. In the current globalized world, bad eating habits and other lifestyle practices have increased the demand for healthcare, especially for chronic diseases. Due to the escalating costs in healthcare, nurse practitioners have set out to reduce these costs in numerous ways (Cleveland, Motter & Smith, 2019). For instance, they help to keep patients out of the hospital through effective prescribing and reducing patients’ hospital visits.

            Usually, cost efficiency is enhanced through the engagement of patients in their healthcare. Notably, patients can relate to nursing practitioners more than physician providers. The nurses are effectively able to encourage patient adherence to the plans laid for their treatment and usually follow up and encourages wellness visits. In my state, nurse practitioners have been estimated to influence 70 percent of a patient’s recovery process (Kaplan & Porter, 2011).  The nurses are also able to manage complex health conditions considering that they spend more time with their patients. They usually encourage questions from patients, which they use to give health education to them, which reduces unnecessary costs in healthcare.

            The nurses also have access to cost-efficient education and training. Compared to other roles such as a physician, nurse practitioners’ training was the most engaging, and nurses had high competency levels (Lawrence, 2018). Nurses are also good caregivers to patients, which increases their chances of learning about their patients. Registered nurses usually enjoy more time with the patients more than the doctor, especially on lighter issues. Similarly, they can use rotation where they encourage every member of the team to experience management of technology.

References

Cleveland, K., Motter, T., & Smith, Y. (2019). Affordable care: harnessing the power of nurses. Online Journal of Issues in Nursing, 24(2).

Kaplan, R.S., & Porter, M.E. (2011). The big idea: How to solve the cost crisis in Health care. The Havard Business Review.  https://hbr.org/2011/09/how-to-solve-the-cost-crisis-in-health-care

Lawrence, H. (2018). Five ways to lower health care costs in the US. Market Watch. www.marketwatch.com/story/5-ways-to-lower-health-care-costs-in-the-us-2018-03-08

Unit 3: The Aging process

In this case, the chief complaint is fall, whereby the victim fell and hurt his shoulder. One of the unfortunate things about the victim is the age of 85 years. Although with mild pain and not very dangerous for the body, he may experience difficulties when moving the arms. Another negative aspect of this situation is increased unsteadiness, decreased appetite, has a long history of smoking, and is widowed, which means the son’s family takes care of him.

            This case should be the same for Opal Smith, who is an 80-year-old woman with diabetes, osteoarthritis, and hearing loss. When walking, she experiences unsteadiness, which increases her risk of falls. Understanding that her blood pressure is high, she is likely to become unconscious, especially when it rises above limits, which increases the chances for falls. In the case of a fall, Opal Smith may take a long time to heal due to type-2 diabetes, which decreases the immunity of the victim.

	Positive findings	Negative Findings
1	Has a fear of fall, which is a high possibility	No trouble with weight and no swelling
2	Unsteadiness when walking	No history of tobacco or alcohol use
3		Has a good memory
4		No anxiety or depression issues
5		Has no increased thirst and dehydration

            However, there are several interventions that Opal Smith can use to reduce the risks of falls. For instance, she can reduce her weight by eating healthy and walking more, which will also reduce the heart rate (Baugreet et al., 2017). In the case she feels unsteadiness in the body, a roller walking support will be good for her. For some time also, she may consider not driving and focus more on walking, which will increase her metabolism. Also, she should take food rich in calcium and magnesium, such as green vegetables and milk (Phillips & Martinson, 2019). As a result, the patient may regain their steadiness, shed some weight, and have stable blood pressure.

References

Baugreet, S., Hamill, R. M., Kerry, J. P., & McCarthy, S. N. (2017). Mitigating nutrition and health deficiencies in older adults: a role for food innovation?. Journal of food science, 82(4), 848-855.

Phillips, S. M., & Martinson, W. (2019). Nutrient-rich, high-quality, protein-containing dairy foods in combination with exercise in aging persons to mitigate sarcopenia. Nutrition reviews, 77(4), 216-229.

Unit 4: Appropriate Prescribing

In this case, the chief complaint is that a patient wants her blood pressure checked. The patient is 65-years-old and experiences high blood pressure, which may lead to dizziness sometimes. The patient has no other major problems considering that she has no stress, not on medications, no pains on joints and the general body, and has no issues with weight.

	Positive findings	Negative Findings
1	A history of high blood pressure	No trouble with weight and no swelling
2	She feels dizzy sometimes but no medical history	No history of tobacco or alcohol use
3	Unsteadiness when walking	Has a good memory
4	There is erythema on the eye	No anxiety or depression issues
5	Family victims of hypertension, diabetes, and cancer	Has no increased thirst and dehydration

            In this case, the aim would be to determine the real cause of high blood pressure. This can be done through three diagnostic processes. They include;

• The doctor will recommend a 24-hour blood pressure monitoring test, which will confirm whether the patient has high blood pressure. The device used in this test usually records blood pressure at regular intervals in 24 hours. Therefore, the doctor can see variations in blood pressure for the entire stretch.
• An appropriate-sized arm cuff is essential in measuring blood pressure. It is recommended that blood pressure should be measured from both arms to ascertain the right readings.
• Routine tests are crucial for this condition, and the doctor may recommend urine tests, tests for cholesterol, blood, and electrocardiogram. Also, an echocardiogram is good as it measures signs of heart disease.

Some of the factors that were expected to be demonstrated by the patient were not noticed. For instance, she does not have a weight problem, has no diabetes, and experiences no dizziness or weaker joints. This means that there is an underlying problem that needs to be evaluated. Perhaps the problem could show when the patient does regular urine tests where their problem may be identified (Khunti, Kosiborod & Ray, 2018). Also, the evaluating doctor may use measurement indicators to understand fluid balance in both intracellular and extracellular compartments.

References

Khunti, K., Kosiborod, M., & Ray, K. K. (2018). Legacy benefits of blood glucose, blood pressure, and lipid control in individuals with diabetes and cardiovascular disease: time to overcome multifactorial therapeutic inertia?. Diabetes, Obesity, and Metabolism, 20(6), 1337-1341.

Unit 5: Age-Related Functional Changes in Geriatric Client

	Positive findings	Negative Findings
1	A history of sleep dysfunction	No trouble with weight and no swelling
2	Daytime sleepiness	No history of tobacco or alcohol use
3	A history of acute heart failure	Has no skin problems
4	Allergic to PCN and Carbapenems	Has no pulmonary problems
5	No family history was adopted

In this discussion, the patient, who is 97 years-old woman, experiences difficulties when sleeping. She is able to initiate sleep but unable to maintain it, which means she may be awake for hours during the night before she falls back asleep. Due to the fact that she was adopted, her family history is non-existent (Ham et al., 2014). Apart from sleep dysfunction, there are no other major problems apart from the stress that emanates from this inadequacy. Also, she does not walk every day as she likes to due to these problems.

            In this situation, a physical exam is crucial for gathering information and symptoms. Some of the tests she may undergo are;

• Polysomnography. This test evaluates body movements, oxygen levels, and brain waves on how they interrupt sleep in the brain.
• Multiple sleep latency test. This is a study for daytime napping that helps diagnose narcolepsy.
• Electroencephalogram. This test assesses the electrical activity in a person’s brain and ascertains the problems within this activity.

In this issue, lifestyle challenges may be the ones affecting the quality of sleep. With changes, the quality can increase exponentially (Baker et al., 2017). In this case, some sleeping pills may help, breathing devices, a dental guard for teeth grinding, and allergy medication for cold.

References

Baker, A. W., Keshaviah, A., Goetter, E. M., Bui, E., Swee, M., Rosencrans, P. L., & Simon, N. M. (2017). Examining the role of anxiety sensitivity in sleep dysfunction across anxiety disorders. Behavioral sleep medicine, 15(3), 216-227.

Ham, R., Sloane, P., Warshaw, G., Potter, J., & Flaherty, E. (2014). Ham’s primary care geriatrics: A case-based approach (6th ed.). PA: Elsevier. ISBN:9780323089364.

Unit 6: Safety for Geriatric Clients

In this case, a patient is a 68-years-old man with a chief complaint of feeling dizzy. Also, the patient experiences increased urination and thirst in the morning (Ham et al., 2014). In that regard, he may experience unsteadiness, especially when he gets up from the toilet. This has also constituted mild headaches. On the negative factors, the patient does not demonstrate any trauma or significant hospital admission.

            From his family history, the mother has dementia and hypertension. The father, on the other hand, had diabetes, which are diseases that are common in their family. The patient does not have other siblings but has a family for himself with a wife and two children and used to work in the military.

	Positive findings	Negative Findings
1	A history of dizziness	No trouble with weight and no swelling
2	Mild headache	No history of tobacco or alcohol use
3	Unsteadiness when walking	Has no skin problems
4	There is erythema on the eye	Has no pulmonary problems
5	Family victims of hypertension and diabetes

            An MRI or CT scan is essential To ascertain the intensity of damage or the underlying problem for the prolonged dizziness. This will be done bearing in mind that the patient may be risking to have a stroke. The below diagnostic processes may ascertain the cause and the real problem;

• A physical examination. In the physical exam, the doctor will check body movements on walking and body balance maintenance.
• The doctor will also test eye movement by observing eye path when tracking a moving object.
• Posturography. In this test, the patient stands on a platform bare feet, and the doctor checks the parts of the balance system.

Dizziness can be a problem, especially for an older person (Muncie Jr, Sirmans & James, 2017). When the situation persists, prescription drugs and other treatments may be initiated. For instance, preventative medicine for migraines, medications to relieve nausea and dizziness, and water pill. Also, taking a low-salt diet is good to reduce dizziness episodes.

References

Ham, R., Sloane, P., Warshaw, G., Potter, J., & Flaherty, E. (2014). Ham’s primary care geriatrics: A case-based approach (6th ed.). PA: Elsevier. ISBN:9780323089364.

Muncie Jr, H. L., Sirmans, S. M., & James, E. (2017). Dizziness: approach to evaluation and management. American family physician, 95(3), 154-162.

Unit 7: Changes in Mood and Cognition in Geriatric Client

In this case, a 68-year-old woman is on a routine follow up of her depression case. Although having the ability to do all her activities daily, she has been surviving on anti-depression medications. From the family history, her mother has dementia and depression, her father has diabetes, and her maternal grandmother has depression too. Also, paternal grandfather suffered diabetes too.

            The patient does not have swellings or stiffness, has no weight gain/loss, has no chance of appetite or dizziness cases. Her hearing and dentition are in perfect condition, and has no issues with the erythema. When interacting with people, she maintains coherent thoughts and appropriate conversations (Ham et al., 2014). This means that the major problems will be diagnosed addressing the depression case. Some of the diagnostic processes for this case will involve the following;

• In depression cases, talking with the patient as part of the physical examination ensures that they understand some of the symptoms. These symptoms can manifest in different ways across different people, such as irritability, agitation, disrupted sleep, and eating patterns.
• A physical exam may also focus on testing neurological and endocrine systems. Major health concerns in this stage will be identified, and the symptoms showing clinical depression will be identified (Arrieta et al., 2017). For instance, depressive symptoms are often caused by an underactive thyroid known as hypothyroidism.
• The doctor will also seek to understand depression from the perspective of the central nervous system. Some depressive cases may be caused by central nervous system tumors, head trauma, stroke, syphilis, and multiple sclerosis.

With the dominant feelings of hopelessness, worthlessness, and helplessness, the treatment program should aim at making things better through several lifestyle changes. Through the screening process using the screening tools, a professional can always determine the mental health of a person.

References

Arrieta, J., Aguerrebere, M., Raviola, G., Flores, H., Elliott, P., Espinosa, A., … & Franke, M. F. (2017). Validity and utility of the Patient Health Questionnaire (PHQ)‐2 and PHQ‐9 for screening and diagnosis of depression in rural Chiapas, Mexico: A cross‐sectional study. Journal of clinical psychology, 73(9), 1076-1090.

Ham, R., Sloane, P., Warshaw, G., Potter, J., & Flaherty, E. (2014). Ham’s primary care geriatrics: A case-based approach (6th ed.). PA: Elsevier. ISBN:9780323089364.

Unit 8: Management of Incontinence in the Geriatric Client

In this case, AW is a 65-year-old woman with a chief complaint of regular accidents now and then. During her young days, her body was functioning normally until recently that she developed inactive urinary incontinence, which has lowered her self-esteem and ability to be around different people. The patient has a history of hysterectomy that was caused to irregular periods (Ham et al., 2014). According to the preliminary investigation, she had an infection on the urinary tract, constipation, hypothyroidism, and Vitamin D deficiency. On family history, her father is alive with a history of hypertension, while her mother died two decades ago. The patient has no history of smoking or sexual contraceptives. She also does not experience cardiovascular nor endocrine. Therefore, this condition is diagnosed in different ways;

• Most of the evaluations for this condition require a history of the urinary performance and urinalysis and measurement of the postvoid residual volume of the urine. The practitioner will evaluate conditions that require a referral or specialized work.
• The next step when the patient is not set up for referral is identifying the symptoms for stress incontinence where suggested methods of treatment are initiated.
• The next step would be to conduct other advanced tests to define the cause and determine the best treatment methods.

Most nursing homes have recorded these problems among the members of their community. Most older men above the age of 60 have a 25-35 percent prevalence rate. In that regard, these symptoms need to be diagnosed early to ensure the situation does not become worse.

References

Ham, R., Sloane, P., Warshaw, G., Potter, J., & Flaherty, E. (2014). Ham’s primary care geriatrics: A case-based approach (6th ed.). PA: Elsevier. ISBN:9780323089364.

Unit 9: Sexuality and the Geriatric Client

The patient, in this case, is an 85-year-old man that reported a burning with urination, which has persisted for about one week. Also, whenever he has urine, there is an urgency for doing so. Although he is drinking a lot of fluids, the pain is still persistent. The patient has hypertension, chronic pain syndrome, and spondylosis of the lumbosacral region. Some of the negative aspects are that he does not smoke and does not have a history of recreational drugs (Ham et al., 2014). The mother did not have any such health records before she died. He does not have a fever, open wounds, or weight loss. Also, he is vaccinated for deadly viruses such as Influenza, Hep A, TDaP, and shingrix vaccine. Therefore, several methods of diagnoses may be used;

• The doctor will review the symptoms and perform a physical examination, whereby he will test for microbes in the urine. The sample of urine should be clean without contamination from yeast or bacteria from the skin.
• The doctor will seek to understand the number of white blood cells in the urine, which will indicate an infection. Also, a urine culture is essential to test for fungi or bacteria.
• Another special testing, especially for people with transplants of an organ, can be performed. For instance, the doctor can aim to carry out the tests for UTIs and other viruses.

Infection on the urinary tract may lead to severe consequences for the victim, such as kidney failure and bacteria entering the bladder. In that regard, the infection must be addressed immediately after the diagnosis. Considering that it also affects the immune system, other diseases may find it easy to affect the victim.

References

Ham, R., Sloane, P., Warshaw, G., Potter, J., & Flaherty, E. (2014). Ham’s primary care geriatrics: A case-based approach (6th ed.). PA: Elsevier. ISBN:9780323089364.

Unit 10: Anemia, Infectious Disease

In this case, a 71-year-old JL reports feeling tired always for a couple of months. Also, recently she has been experiencing shortness of breath on the staircase, and also she has been sleeping more than usual. Her memory is not in a good state, but there is no evidence of massive dysfunction. However, the patient has no symptoms of fever, history of drug abuse, or swellings. Also, his depression is well-managed, and only her paternal grandmother had issues of hypertension (Ham et al., 2014). She also has no drug allergy or loss of appetite, which means she is functioning normally. Therefore, some diagnostic processes may identify some of the possible causes.

• Most of these cases are caused by a lack of balance between blood cells. A complete blood count (CBC) is essential in this case to count the number of blood cells within a blood sample. This will show the level of hemoglobin and hematocrit in the blood.
• The unusual size of the red blood cells may constitute the problem. In that case, the doctor will determine the size and shape of the red blood cells. Some scenarios may also require the doctor to test for color and find the reason for the unusual size and shape.
• Additional tests are also recommended in the diagnosis, considering that the disease engages the bone marrow too. In that regard, a sample of the bone marrow will be collected and evaluated to determine the cause.

Often, the feeling of tiredness can be associated with inadequate iron in the body and vitamins. Therefore, it is essential to take foods or supplements rich in these elements and nutrients.

References        

Ham, R., Sloane, P., Warshaw, G., Potter, J., & Flaherty, E. (2014). Ham’s primary care geriatrics: A case-based approach (6th ed.). PA: Elsevier. ISBN:9780323089364.

Unit 11: CAD, Atrial Fibrillation, Congestive Heart Failure Peripheral Vascular Disease, TIA’s and Stroke

In this case, a 66-year-old reports that his legs feel tired when he walks and has felt pain for over a month. The legs sometimes are pale and may feel numbness and tingling. From the patient’s family history, the mother had hypertension, but the father did not have health problems. The sister has asthma that bounds her to use the inhaler for support. He is allergic to Penicillin, which causes a rash on his skin. The patient has no history of drug abuse or alcohol consumption (Ham et al., 2014). Also, the patient has no weight changes, and the overall health is good. Therefore, to ascertain the presence of whichever illness he has, a diagnostic process will comprise of the following.

• The doctor, in this case, will consider doing tests and physical examination on the body muscles. For instance, he or she will check the patient’s reflexes, senses, and muscle tone.
• Another test that can be used is the MRI or CT scans that will show the inner structures of the body, which will lead to understanding the problems within the muscles.
• Also, a blood test is another option to test for an infection or to check for signs. Electromyography can also be used to test the muscles’ nerve activity.

Therefore, when the cause of the problem is established, a treatment option can be suggested. For instance, occupational or physical therapy can bear effective results.

References

Ham, R., Sloane, P., Warshaw, G., Potter, J., & Flaherty, E. (2014). Ham’s primary care geriatrics: A case-based approach (6th ed.). PA: Elsevier. ISBN:9780323089364.

Unit 12: Cultural and Social Considerations in the Aging Family

In this case, a 71-year-old man reports high blood sugar from 280 to 320 when checked. Although he terms his diet as good, there are increased cases of urination and thirst. There are also instances of numbness and tingling on his feet. However, there are no pains or wounds, no dizziness, no nausea or vomiting, but has cases of swelling as a side effect from Lyrica allergy. The patient, in this case, is single and lives with a girlfriend, does not use tobacco or recreational drugs (Ham et al., 2014). The mother had hyperlipidemia, and the paternal grandfather died of a heart attack. Maternal grandfather died of heart disease, and my maternal grandmother too. Therefore, several diagnostic processes are essential to understand the reason.

• A hemoglobin A1C test is conducted, and it indicates the average blood sugar level in a person for a couple of months before. It measures the blood sugar for one oxygen-carrying protein in the red blood cells.
• The patient should do routine sugar monitoring and should also check urine content often. Whenever the sugar level goes high, which is often detected in the urine, the patient should always seek a doctor’s help to lower it safely
• The doctor can also set a range for target blood sugar. The patient will test themselves, and if out of the range, they will seek a doctor’s help.

References

 Ham, R., Sloane, P., Warshaw, G., Potter, J., & Flaherty, E. (2014). Ham’s primary care geriatrics: A case-based approach (6th ed.). PA: Elsevier. ISBN:9780323089364.

Unit 13: Substance Abuse and Addiction in the Aging Family

In this case, a 69-year-old woman reports falling at home after feeling fatigued for two days and tremors. Due to unsteadiness, she was also feeling shaky and with a mild headache. However, he had no history of visual changes, dizziness, numbness, or tingling (Ham et al., 2014). She has some nausea but generally was healthy and experienced some mild anxiety. THEREFORE, diagnostic procedures would be vital to understand this problem,

• Addiction to drugs requires an evaluation strategy, which is assessed by a psychiatrist or a psychologist. These are the tests used to monitor treatment and recovery.
• According to the American Psychiatric Association, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) recommends the use of mental health professionals to carry out the process.

One way to approach this is through detoxification, which will erase the chemical compositions in the body and make it fresh. The patient will also withdraw from other drugs such as depressants and stimulants. In that regard, they will substitute them temporarily with substances such as buprenorphine, naloxone, or a combination of both. Although not demonstrated in this case, some other patients may need admission to a treatment cancer home or a hospital.

References

Ham, R., Sloane, P., Warshaw, G., Potter, J., & Flaherty, E. (2014). Ham’s primary care geriatrics: A case-based approach (6th ed.). PA: Elsevier. ISBN:9780323089364.

Unit 14: Caregiving and Family Dynamics in the Aging Options Menu: Forum

Taking care of the elderly is often stressful and overwhelming for most families. Such families need several strategies to cope with ensuring their health is intact, and they are happy. One of the strategies is to set boundaries whereby one says ‘no’ to draining tasks and finds a replacement through researching resources for caregivers (Soleimaninejad, Valizadeh-Haghi & Rahmatizadeh, 2019). Another strategy is to always communicate and keep in touch with family members while also seeking their support (Günüşen, Wilson & Aksoy, 2018). Also, physical activities will keep the body active and away from stress.

            When helping them make decisions about care for their loved ones, I would start by setting their boundaries and limitations (Hamid & Musa, 2017). This is knowing what they are comfortable sacrificing and what they are not. Also, taking them to psychologists would help them have a clear mind of their goals and objectives.

            When taking care of an aging person, the extended family may have different and varying opinions about that care (Bourgeois, 2018). However, one should realize that their opinions would only be valid when they are in that position. Instead, one should listen to only the constructive criticism and opinions that would make the elderly’s life better and leave the rest (Schmidhuber et al., 2017). Also, having boundaries on what one can say about your performance is crucial to avoid stress.

References

Bourgeois, M. S. (2018). Family caregiver issues and training. Psycnet

Günüşen, N. P., Wilson, M., & Aksoy, B. (2018). Secondary traumatic stress and burnout among Muslim nurses caring for chronically ill children in a Turkish hospital. Journal of Transcultural Nursing, 29(2), 146-154.

Hamid, A. A., & Musa, S. A. (2017). The mediating effects of coping strategies on the relationship between secondary traumatic stress and burnout in professional caregivers in the UAE. Journal of mental health, 26(1), 28-35.

Schmidhuber, M., Haeupler, S., Marinova-Schmidt, V., Frewer, A., & Kolominsky-Rabas, P. L. (2017). Advance directives as support of autonomy for persons with dementia a pilot study among persons with dementia and their informal caregivers. Dementia and geriatric cognitive disorders extra, 7(3), 328-338.

Soleimaninejad, A., Valizadeh-Haghi, S., & Rahmatizadeh, S. (2019). Assessing the eHealth literacy skills of family caregivers of medically ill elderly. Online Journal of Public Health Informatics, 11(2).

Unit 15: Transitional Care Model

 The transitional care model is essential in the healthcare industry, and as a nurse, one needs to be equipped with different strategies to address some of the challenges that emanate from this model and to improve the transition process (Naylor et al., 2018). The first strategy includes focusing on the care model rather than the business model. In this way, one can connect with hospital discharge planners and utilize management techniques to facilitate effective communication (Sarah Chittenden & Joey Misuraca, 2019). Therefore, the care model will prioritize the opinions and wants of the patient first before considering the business model.

            The other strategy is to understand a patient’s functional status. In this notion, the clinicians and hospital staff will seek to fully understand the patient’s condition, their activities, and cognition of their daily living (Scott et al., 2017). In that regard, they will be in a better position to predict the best places to go for post-acute care and the therapy requirements before discharge.

            Finally, the staff should conduct more effective handoffs. In this stage, the primary care providers meet with the staff members face-to-face and explain the transition process and the review of all requirements for the patient (Zhang et al., 2017). In this stage, the necessary adjustments to the process of care are made and effected. Also, the receiving caregivers are advised on how best to handle the patient (Prince et al., 2019). Therefore, the transition process becomes smooth and efficient.

References

Naylor, M. D., Hirschman, K. B., Toles, M. P., Jarrín, O. F., Shaid, E., & Pauly, M. V. (2018). Adaptations of the evidence-based Transitional Care Model in the US. Social Science & Medicine, 213, 28-36.

Prince, M., Allen, D. H., Chittenden, S., Misuraca, J., & Hockenberry, M. J. (2019). Improving Transitional Care: The role of handoffs and discharge checklists in hematologic malignancies. Clinical Journal of Oncology Nursing, 23(1).

Sarah Chittenden, R. N., & Joey Misuraca, R. N. (2019). Improving Transitional Care. Clinical Journal of Oncology Nursing, 23(1), 36-42.

Scott, A. M., Li, J., Oyewole-Eletu, S., Nguyen, H. Q., Gass, B., Hirschman, K. B., … & Project ACHIEVE Team. (2017). Understanding facilitators and barriers to Care transitions: insights from the project ACHIEVE site visits. The Joint Commission Journal on Quality and Patient Safety, 43(9), 433-447.

Zhang, P., Hu, Y. D., Xing, F. M., Li, C. Z., Lan, W. F., & Zhang, X. L. (2017). Effects of a nurse-led transitional care program on clinical outcomes, health-related knowledge, physical and mental health status among Chinese patients with coronary artery disease: a randomized controlled trial. International Journal of Nursing Studies, 74, 34-43.

Unit 16: Discussion-Reflection

            One of the normal changes past the age of 50 years is decreased ability for heavy work. The abnormal part is being unable to do anything. Secondly, people past that age develop withdrawal from society partially. The abnormal part is withdrawing completely, which is unhealthy.

            Some of the syndromes managed by advanced practice nurses for the older adult population include high blood pressure, falls, functional decline, malnutrition, feeding problems, dizziness, and sleeping problems.

            Clinical protocols depend on formal methods set in the diagnosis procedures of different ailments. Some of the protocols dictate the usage of the modeling language and mathematical techniques to evaluate quality improvements. These protocols determine anomalies applied in the validation of set procedures. However, these protocols may not always capture the patient’s needs and dwell on what is important. Therefore, it is essential to formalize the protocols that cover the health aspects of a patient, including social, physical, and sociocultural aspects.

            One of the therapeutic interventions to improve elderly health is to increase exercise sessions for them. Also, they will enhance stretches, massages, mind-exercise, and talking to them. In that regard, the patients’ mental, physical, and emotional well-being will be enhanced significantly. This can be coordinated by the caregivers and other stakeholders within this structure.

            Through national planning, healthcare for older people is enhanced. Some of the resources in this practice include health insurance for them, provision of specialized physicians, nurses, and dentists for them. Also, they offer stimulus packages for them and have an exchange visitor program.

            In healthcare management, different health workers with different roles have different backgrounds. This means they have contrasting beliefs about how a patient is to be treated or handled. As a result, it complicates the decision-making process as most cannot reach an agreement. Also, gender differences affect the decision-making process based on varying perceptions. However, good communication and leadership ensure that every worker understands the reason for the decisions made. Therefore, open communication that contributes to constructive sharing may encourage performance and a better environment for patients.