Results Phase 4Students this project will allow you to formulate and hypothetically develop your own research project. The purpose of this project is for the student to complete all the different steps necessary to implement a nursing research project. This project will be subdivided into 4 different papers that will be submitted throughout the entire semester. The final paper will be the combination of the four areas. Please see separate file items for each phase specific instructions. Again follow APA style mandates.Paper will be submit it via turn it in.Phase 4 is all about results, this part of the paper will be based on hypothetically analysis. Meaning since we will not be actual implementing the process, the results described will be based on whatever the students would like the research results to be. You will need to provide results for all of the statistical tools mentioned and provide descriptive data (demographics of the population, different descriptive data points, etc.). Make sure to also include research limitations to improve for future studies. Approximetaly 6 pages.
a_phase_1__2.1.19.doc
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Running head: CHALLENGES IN TRANSITIONAL CARE
Challenges in Transitional Care
Frank Calderon
Florida National University
Dr. Jorge Hirigoyen
2/1/2019
1
CHALLENGES IN TRANSITIONAL CARE
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Challenges in Transitional Care
Introduction to the Problem
The case of failure in transitional care for the elderly and the chronically ill patients
shows the challenges in transitional care. Transitional nursing is the continuity of treatment of
the patients during the movement from one health center to another or home. The incidence rehospitalization of people who have been released from the medical facilities to go home for
recovery is high. According to Ortiz research, in 2015, 35.6% of hospital readmission within
30days of discharge is of elderly patients of age 75- 84. The authors indicate that this is due to
the patients worsening instead of getting better. Caregivers report that they do not know how to
handle the patients that are left in their care. Storm and Aase (2014) elaborate that physicians say
that elderly patients who have acute conditions are in vulnerable positions of breakdown if the
proper transition is absent. This is after evaluating that some of the deaths reported of elderly
patients in home-based and community- based care be caused by poor.
Ye and Quan (2016) point out that in 2012, China had the practice of the medical
practitioners discontinuing patient’s care once the patient is discharged. The recovery care task
was left with caregivers. This practice led to 30 percent of patient declining in their well-being
and regular functioning after been released from the hospital especially the elderly. In the homebased care, they lacked professional monitoring. In addition to the issue in the transition of the
elderly from the hospital to their home, the other failure is the transitional care within the
medical setting. Ortiz (2019) explains that the main case identified is medication mix-up and
CHALLENGES IN TRANSITIONAL CARE
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error during the movement of the patient emergency department to the intensive care unit. It also
includes the surgical unit setting.
Problem Statement
Lack of specialized nursing intervention is the cause of the challenges in transitional care.
It causes the readmission of elderly patients with acute illness. The handoff of patients with no
clear communication to the caregivers on how to take of them cause mishandling of the patient
(Morphet & Williams, 2014). Most caregivers as well not trained on how to provide primary care
to their patient. As a result, they develop other conditions, or their case elevates and hence the
need to go back to the hospital. In some case, the patient may lack friends or family members to
look after him or her. In such a situation, the patient requires a transitional nurse to fulfill his/her
medical needs. The absence of one threatens the life and well-being of the patient.
The difficulties of transitional care within the medical setting are as a result of lack of
specialized nurses who are skilled and knowledgeable about providing professional care. Storm
and Aase (2014) illustrate that the issue of delay in the provision of therapy places the patient at
risk. This is a challenge that results because of unprofessional nurse handling the transfer of the
patient from unit to another. A specialized nurse is aware of the importance of timely and
complete communication. Poor transitional care in chronically ill people exists due to improper
coordination between the emergency department nurse and the one in the ICU. Ortiz (2019)
asserts that lack of organization confuses the right therapy for the patient which in turn causes
the delay in the recovery of the patient or the development of complications.
Furthermore, unlike a regular nurse, a specialized nurse provides quality transitional
care. They are experienced, well-trained and knowledgeable in giving transitional care. A
CHALLENGES IN TRANSITIONAL CARE
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general nurse will administer primary care for an ill person who is hospitalized. It is evident that
the provision of transitional care by ordinary medical practitioners is the cause of low-quality
care. This creates patient and caregiver dissatisfaction.
The significance of the problem to Nursing
The research problem is significant to nursing. The problem is; lack of specialized
nursing is the cause for the challenges in transition care. It directly concerns the nursing
profession. It raises awareness of the weakness of nursing in transitional care. It identifies that
nursing service in transitional care is poor. Patients are sent off without continuity care from
professionals till they fully recover. Moreover, the wrong care is given to the patients when they
are moved within hospitals from one setting to entity as nurses commonly provide the wrong
medication.
The problem also informs the nurses their weakness in communication. It implies that
unspecialized nurse is not keen in providing timely and complete information to facilitate
continuity care. It mainly raises concerns in nurses in units where that transfer takes place. The
problem as well illuminates to nurses that poor professional coordination between them is
resulting in transitional care challenges since it hinders consultation and provision of
information.
It similarly notifies the nurses their shortfall in performing specific crucial nursing roles.
The first one is ensuring the patient with no caregiver receives transitional care from them.
Secondly, it is educating the caregivers on how to handle the patients. In addition to informing
the nurses on the weak areas, it is enlightening them how to improve the nursing job. It is
asserted that specializing in transition care will enhance their task of providing care to patients.
Therefore, it is recommended that nurses who deal with transitional care get additional education
CHALLENGES IN TRANSITIONAL CARE
5
to gain skill. Finally, the problem cautions the nurses on the impact of lack of knowledge and
expertise. It shows that the implications are detrimental to the patients whose health are already
vulnerable.
Purpose of the Research
The purpose of the research is to improve the quality of transitional care. There is a lot of
research about the quality of the general health in the hospital. Therefore, various stakeholders
have invested in facilitating quality treatment. Nevertheless, the issue of transitional care has not
little study and as a result their no broad awareness of the matter concerning transitional care, its
challenges, and importance. This, in return, has led to little attention from the government,
physicians and donor, individuals who can contribute to promoting good transitional care. This
prompted my research on challenges in transitional care to implore the health stakeholders to
look into the issue and promote quality transitional care.
Furthermore, I considered research into the challenges of transitional care would be a way to
inform the nurses on the areas of their weakness and as a result, encourage them to improve. It
will eventually translate to quality transitional care. My research exposes the challenges faced in
transitional care and the problem which is lack of specialized nurses. In addition to the nurses, it
also creates awareness for the caregiver and relevance of seeking help from transitional nurses.
My study likewise enlightens the medical trainers on the significance of including transitional
care in the nursing curriculum. Consequently, all nurses will have basic knowledge of rendering
such care
Finally, through researching the subject on transitional care, I offer a platform for further
research into the area. Therefore, it will promote a better understanding of the issues facing
transitional care. This helps the stakeholders to see the severity of the issue and provide
CHALLENGES IN TRANSITIONAL CARE
6
assistance. Further research will likewise suggest better solutions to address the problem facing
transitional care.
Research Questions
What is the impact of unspecialized nursing in transitional care?
Why do unspecialized nurses promote low-quality transitional care?
What are the pros and cons of specialized nursing versus general nursing?
Master’s Essentials Alignment with My Topic
Master’s essentials align with my topic. It concurs with what my topic implies. The
second essential indicates that organizational and system leadership is crucial in quality and safe
patient care. My topic, on the other hand, illuminates on the importance of leadership in patient
care as some of the challenges like communication and corporation are due to lack of leadership.
Master’s essential III as well support the topic problem which suggests that lack of specialized
nurses is the cause of challenges. The essential state that master-level nurses are aware that
quality care goes hand in hand with the methods and tools used. Similarly, the topic indicates
that the use of unspecialized nurses who have no master is the cause of the low-quality
transitional care.
Essential VII, interprofessional collaboration asserts that masters prepared nurse is a
leader and member of the team who can communicate, cooperate and consult with other
professionals. Similarly, the topic agrees as it suggests that the challenges of lack of
communication, coordination, and consultation. It adds that this due to the use of unspecialized
nurses implying that nurses with maser can overcome the challenges.
CHALLENGES IN TRANSITIONAL CARE
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The topic as well matches with essential IX. It is concerned with master-level practice. It
states that nurses with master’s level have scientific knowledge and the capability to apply it into
practice. My topic suggests that unspecialized nurses are not as competent as the specialized
ones who have a master’s degree. Therefore, they pose challenges in transitional care which
wouldn’t have been the case if specialized nurses conducted the care. This essential as well claim
that master’s prepared nurses can influence positive healthcare result. The topic echoes that
specialized nurses perform transitional care better compared to general nurses.
CHALLENGES IN TRANSITIONAL CARE
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References
Morphet, J., Griffiths, D. L., Innes, K., Crawford, K., Crow, S., & Williams, A. (2014).
Shortfalls in residents’ transfer documentation: Challenges for emergency department
staff. Australasian Emergency Nursing Journal, 17(3), 98-105.
Ortiz, M. R. (2019). Transitional Care: Nursing Knowledge and Policy Implications. Nursing
Science Quarterly, 32(1), 73-77.
Storm, M., Siemsen, I. M., Laugaland, K., Dyrstad, D., & Aase, K. (2014). Quality in transitional
care of the elderly: Key challenges and relevant improvement measures. International
Journal of Integrated Care, 14(2).
Ye, Z. J., Liu, M. L., Cai, R. Q., Zhong, M. X., Huang, H., Liang, M. Z., & Quan, X. M. (2016).
Development of the Transitional Care Model for nursing care in Mainland China: a
literature review. International journal of nursing sciences, 3(1), 113-130.
Running Head: DESIGN PHASE 2
1
Design Phase 2
Frank Calderon
Florida National University
2/27/2019
DESIGN PHASE 2
2
Design Phase 2
Methodology and Design of the Study
The study of transitions included the acute admissions of elderly individuals to the
hospitals up to the nursing homes of from the home to a home with a home-based care services.
Additionally, it included the discharge transitions of elderly from hospitals to a nursing home or
home also to home-based care services. Therefore, the methodology included participant
observation of admission and discharge transition process. This involved an open-ended
conversation with the patients and also with the patient’s next of kin’s while involving the health
care personnel (Design and Methodology of a Mixed Methods Follow-up Study to the 2014
Ghana Demographic and Health Survey, 2017). The observation also entails a collection of data
which is guided by a thematic guide which is adapted to the admission and discharge transition
in the health facilities.
During the observation, the admission includes observing the patient being handed over
from the ambulance to the paramedics and healthcare professionals in the emergency
departments so that the patient can be observed until he is handed over to the medical ward for
further treatments. During this research, the observation covers the data on interaction,
coordination as well as dialogue between the health practitioners and the patient. The observation
ends when the researcher has a short conversation with the patient and also with the healthcare
personnel on the admission day so as to help in clarification of some aspects pertaining to the
current admission as well as the entire process of admission.
DESIGN PHASE 2
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Additionally, the observation of transitions of discharge commenced at the hospital ward
on the expected day of discharge. It involved the conversation between the researcher and the
healthcare practitioner and the person who is going to be discharged. The interaction also with
the coordination and dialogue taking place between the healthcare practitioner and the patient is
observed. Such a conversation is very helpful since it helps in understanding the discharge
processes and discharge transition. Short follow of up conversation also helps in understanding
more the processes and the bases of decisions made before a patient is discharged (Design and
Methodology of a Mixed Methods Follow-up Study to the 2014 Ghana Demographic and Health
Survey, 2017).
Sampling Methodology
The sampling method used in the research was sampling which was utilized in the
recruitment of the participants to take part in the study. Additionally, the homecare offices in
various municipalities of the country were contacted and informed on the project and the need
for the nursing leaders to participate in interviews which will enable the researches to get the
necessary information which will also enhance their research. From these interviews, data is
collected which also shed light on the nursing leaders role and experience in the process of
transition especially for the older patients from the hospital to home. This implies that the
interviews are conducted only for data collection (Sahu & Singh, 2016).
In essence, the semi-structured interview guide dictated what the interviews should cover
and how it should be carried out. It starts with the general, discussion of transition processes and
the patients experienced pertaining to transitions received at homecare. The participants in this
regards will focus on all the experiences on the transition from the hospital to their homes, and
DESIGN PHASE 2
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then researchers will decide on what next (Johnson, Pennell, Stoop, & Dorer, 2018). The guide
for the interview also entails themes which include the organization of the internal and external
cooperation, the personal resources together with values which guide the quality of the care
services.
Necessary tools
Various technologies and tools are used in the research process. However, the primary
consideration if the health information technology tools which help to smoothen the transition
processes of the patients. It is worth noting that health IT involves numerous technologies such
as electronic health records. The electronic health records entail saving of patient’s information
electronically on computers which will enable retrieving exercise to be very easy. Additionally,
it includes clinical decision support which also enables the health care personnel to make an
effective decision which ensures that the patients are handled very well and the decisions made
helps them to regain their good health.
In essence, the health IT performs very significant tasks in various aspects of transitions.
It helps in capturing the information pertaining to the patient which helps in informing the
transition processes as well as the clinical history of the patients and what needs to be done
during the transition process. It is coherent that the design of the health IT has the ability to
support the transition process especially in supporting the individuals who are involved in the
transition processes (Riba, Parikh, & Greden, 2019). With the information technology as well,
the healthcare professionals will be able to connect to the home care services where the elderly
have been taken so that they can be taken care of until they get well or improve on their health
before they are being taken to their respective homes.
DESIGN PHASE 2
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Any algorithms or flow maps created
The various algorithms created during the research include the Fourier transform which
helps in enhancing the senses of individuals. This is because the Fourier transform has been
dubbed to be one of the most significant algorithms in the healthcare sector. This transformation
is a mathematical technique which is used in breaking the complex signals which in turn will
enable the healthcare personnel to see the variation in their activities and what needs to be
attained. This helps in ensuring that they attain the objective of the organization. It is also used in
medical imaging which helps in creating date to check whether the patients who had undergone
imaging are fit to be discharged to be taken care of at homes.
There is also a Mumps algorithm which is a healthcare operating system which was
developed in the 1960s but has been improved lately to reflect on the current needs of the
patients and the medical sector. Therefore, it can be denoted as a computer program which is
used in the healthcare today to run multiple programs and enable the healthcare personnel to
understand the status of numerous patients and decide on the next course of action. This
operating system is currently used in the powering of the entire hospital departments which helps
in the management of clinical records to enable the healthcare facilities to save a lot of time in
assessing the health care records for patients and improve the workplace efficiency (Morr & AliHassan, 2019).
Consequently, the probabilistic data matching is another algorithm which enables
numerous computer searches which are deterministic to be carried out. This is because it carried
DESIGN PHASE 2
6
out byte by byte comparison which can mainly be used for typographical or data entry processes.
Such probabilistic algorithms are depicted to look for a various bit of information especially in
the medical records while ranking them according to the likelihood of the patients adopting very
well to the medication and estimate the time which the patient can remain within the hospital
before they are discharged to home care through a transition which will see them gain good
health. This probabilistic data help in retrieving of useful information which helps in research.
Further, the medical algorithms as well as aids for decision making which will help in
promoting safe healthcare as it also helps the healthcare personnel to enable them not to make
mistakes when carrying out their tasks. It is worth noting that with the increase in awareness of
the medical errors recently, it is also believed that the health professionals are using these
techniques into guiding them to offer quality care services and understand the patients and those
who need to go to various homecare homes when they need specialized care. A medical
algorithm in this regard can be a low tech as a lookup or a decision tree which helps in carrying
out complex decision making through the help of programming (Morr & Ali-Hassan, 2019).
Therefore, the medical algorithms remove some of the medical uncertainty decision which in
turn will help in improving the efficiency and most importantly the accuracy of the teams
provided.
Notably, the health score which helps in quantifying illness also is another algorithm
which helps in evaluating the health status of the patients and deciding whether they should be
discharged to the …
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