Over the last few years, stroke has become a major cause of death and disability in the United States. For instance, Mrs. K.M, a 68-year-old female who has a past medical history involving type 2 Diabetes Mellitus and hypertension, has recently suffered a stroke, and after rehabilitation, she is ready to be discharged home. Before suffering a stroke, Mrs. K.M lived at her own place, but after the discharge, her daughter thought it would be the best decision for her mother to join their family. Therefore, there is the need to evaluate the implementation of a care coordination plan.
In detail, the care coordination plan facilitates the continuity of care when the patient is discharged from the health facility. The primary reason for implementing a care coordination plan is to organize the patient’s services to provide quality healthcare. Additionally, the care coordination plan allows nurses to provide basic needs for the patient and her family. Moreover, the patient enhances her outcomes and reduces the fragmented care. This paper focuses on the patient’s recent stroke and past medical history involving type 2 diabetes mellitus and hypertension. Additionally, the paper outlines numerous ethical decisions and how they are associated with establishing patient-centered health interventions. Further, it discusses relevant health policy implications for the coordination care plan and how nurses can assess care coordination, including healthy people 2030 and patients’ experience and satisfaction.
Patient-Centered Health Interventions
According to the American Stroke Association, one out five stroke survivors are likely to suffer from other diseases. Therefore, nurses can implement care coordination to acquire the appropriate interventions and tools to prevent possible complications. For instance, Mrs. K.M chose the appropriate home health therapy providers to provide healthcare at home. Within the first two weeks of the plan implementation, the patient registers for stroke education and joins a support group. Acquiring stroke education is essential since it determines a patient’s healthy eating behaviors, exercise activities offer information on the likelihood of suffering another stroke. Moreover, enhancing stroke knowledge is essential in preventing secondary stroke by recognizing and responding to the signs and symptoms (Pistoia et al., 2016). Additionally, Mrs. K.M can consider multiple community sources, including Methodist Healthcare Stroke Education and St. Luke’s Baptist Stroke Education.
According to World Health Organization, over one billion people are suffering from hypertension globally. Hypertension was the primary cause of Mrs. K.M’s current stroke. Additionally, the patient revealed that she did not follow a healthy diet, and in most cases, she failed to check her blood status. Moreover, Mrs. K.M often failed to meet a cardiologist to evaluate her condition. Individuals should consider initiating healthy lifestyles since it helps them to manage hypertension. Nurses should emphasize diet as the primary intervention in the coordination care plan (Fisher & Curfman, 2018). For instance, the patient should join hypertension-related nutrition classes in the first two weeks of implementing care coordination. As a result, she will overcome stroke and diabetes. Mrs. K.M can choose the best nutrition classes, such as the Nutrition Associates of San Antonio.
Ethical Decisions in Establishing Patient-centered Health Inventions
Ethical decision-making is a crucial component in looking after the cooperation and significant integrity of nurses. World health organization presented the first rule of ethos and was made to describe instructions used during the preparation of health care personnel.
Pistoia et al. (2016) support such an idea implying that it is appropriate, caregivers should get into agreements based on the needs and control of their ill. Ethical care in nursing has the ability and willingness to perform duties that lead to the best health results for the patient. Nurses are responsible for using fundamentals of self-determination, fairness, contribution, and hoping for success when planning care. Some of these fundamentals were put in place when organizing Mrs . K.M’s cooperative plan. Self-determination has helped her know whether to proceed with the suggested ideas or give her a sense of determining other factors that could contribute much to her plan and interests. Fairness brings the assurance of equity, and this guideline has contributed to all the information needed in the care plan (Fisher & Curfman, 2018). The formulations introduced to the patient’s ability will make it to have successful results in stroke prevention. Another principle is avoiding harm which intends to be safe and the patient’s best condition in terms of health.
Health Policy Implications
Patient protection and affordable care policies were established to promote better results and minimize insurance premiums. In detail, the primary objectives of the Accessible Medicaid Expansion are to upgrade the effectiveness and happiness of sick people, maintain the welfare of the public, and decrease expenses. According to Callister et al. (2020), the PPACA regulations promote clinical outcomes through measures to ensure good journalism for such procedures as efficient crisis intervention, adherence to treatment, and chronic illness treatment. Underneath Medicare and Medicaid, the Health Reduced Setup Initiative has been formed. This initiative aims to relate compensation to the effectiveness of medical assistance to enhance interprofessional collaboration to achieve the final set objectives.
The analysis demonstrates that if a substantial number of their victims return to the facility one month after release, emergency departments are punished for a refund. The projected cost of re-entry to Medicare is calculated at seventeen million dollars yearly. The primary objective of case management is to avoid recurrence by supplying the body with adequate resources (Luchsinger et al., 2019). Beneath Healthcare Law, financial institutions have been established to encompass teams of physicians and hospitals engaging in the healthcare benefits scheme. Organizations work jointly to give Medicare beneficiaries comprehensive care. Moreover, such associations aim to provide Uninsured people with the best available hospital treatment.
Evaluation in Care Coordination
Professionals in this sector have observed that patients typically do not integrate treatment when released from their hospitals, raising the chance of suffering problems following release and readmission into the hospital. In the event of adequate treatment management, hospitalizations and rehospitalization cases are decreased. Swan et al. (2019) believe that integrated treatment results may be monitored and controlled in digital documents of clinical outcomes and can help assess effects in people with comorbidities and other diseases related to age. The Integrated Treatment Map has been produced by the Medical Research and Quality Authority to administer quality health care. The Panorama combines medical and nursing experiences.
Quality care is assessed by the Medical Professional and Infrastructure User Evaluation in the Institution. The poll consists of nine themes, with the first topic being communication with physicians and the other dialogue with caregivers. Thirdly, medical personnel respond, and fourthly, symptom control. Fifthly, contact regarding therapeutic goods and, sixthly, data outflow (Luchsinger et al., 2019). The seventh area is the sanitary medical surroundings, and the eighth area is the calm clinic surroundings. The last phase is the care transfer. Service quality and treatment outcomes are not the same at the National Institute for Health and Quality. The Centres for Medicare and Medicaid also argued that quality care is assessed by whether anything was truly going on when it happened in the medical environment and that contentment depends on the client’s expectations being fulfilled during the medical conference.
Healthy People 2030
Normal individuals have a higher, more meaningful, disease-free existence, handicap, injury, and premature mortality as their goal. They want primary health care to be realized, differences erased, and the wellbeing of all populations enhanced (Swan et al., 2019). The aim of normal individuals is also to provide emotional and spatial settings that encourage excellent health for everyone and improve the standard of living, overall wellness, and good actions. With correct synchronization treatments, these aims can be achieved.
Conclusion
The care coordination plan facilitates the continuity of care when the patient is discharged from the health facility. The care coordination plan allows nurses to provide basic needs for the patient and her family. Nurses can implement care coordination to acquire the appropriate interventions and tools to prevent any possible complications. The primary objectives of the Accessible Medicaid Expansion are to upgrade the effectiveness and happiness of sick people, maintain the public’s welfare, and decrease expenses. Integrated treatment results may be monitored and controlled in digital documents of clinical outcomes and can help assess effects in people with comorbidities and other diseases related to age.
References
Callister, C., Jones, J., Schroeder, S., Breathett, K., Dollar, B., Sanghvi, U. J., … & Jones, C. D. (2020). Caregiver experiences of care coordination for recently discharged patients: a qualitative metasynthesis. Western journal of nursing research, 42(8), 649-659.
Fisher, N. D., & Curfman, G. (2018). Hypertension—a public health challenge of global proportions. Jama, 320(17), 1757-1759.
Luchsinger, J. S., Jones, J., McFarland, A. K., & Kissler, K. (2019). Examining nurse/patient relationships in care coordination: A qualitative metasynthesis. Applied Nursing Research, 49, 41-49.
Pistoia, F., Sacco, S., Degan, D., Tiseo, C., Ornello, R., & Carolei, A. (2016). Hypertension and stroke: epidemiological aspects and clinical evaluation. High Blood Pressure & Cardiovascular Prevention, 23(1), 9-18.
Swan, B. A., Haas, S., & Jessie, A. T. (2019). Care coordination: roles of registered nurses across the care continuum. Nursing Economics, 37(6), 317-323.
