Global healthcare leadership | NURSING | Chamberlain College of Nursing

 

 Social boundaries are what I encounter on daily basis in my current practice. Working in a community heavily populated with minorities of poor socioeconomic status, low educational level, and language barriers, I am frequently faced with patients experiencing social boundaries. These boundaries oftentimes result in poor quality care or access to care for these patients. These patients present for surgery with a multitude of poorly managed health problems which include, hypertension, diabetes, end-stage renal disease, coronary artery disease, congestive heart disease, obstructive sleep apnea, chronic obstructive pulmonary disease, morbid obesity, hyperlipidemia, and so on. These co-morbidities constitute a high anesthetic risk for these patients which continually leads to cancellation of their surgical procedures, postponement of their cases, prolonged hospital stay, or post-operative complications. The frequent commonality among these patients is non-compliant with their care. They are often labeled as “non-compliant” in their charts.

            However, as I interact with some of these patients, I’ve noticed that their medication non-compliance is multifactorial. For most patients, it’s the unaffordability of their medications, some are confused about the medication instructions due to poor education or language barriers and for some, they experience adverse drug reactions (ADRs) and stop taking the medications. According to Wood and Lightfoot (2018), 25% of patients who were non-compliant with their medications before surgery were confused about the medication instructions.  Song et al., (2020) cite ADRs alone as a global clinical problem leading to increased morbidity and mortality. While medication costs and affordability were the most commonly mentioned barriers to medication adherence (Heidari et al., 2019). Poor compliance is very common among hypertensive patients constituting a worldwide problem (Ahmad & Shaheen, 2020).

As a leader, I must be an advocate for my patients. I’ve been able to advocate care for my patients by relating some of these concerns to my interprofessional teams. These include our leadership team, social workers, primary care physicians, and pharmacy. On the nursing level, we assess every patient for health literacy upon admission. We achieve this by communicating clearly, in simple and plain English. As we share information or instructions with patients or caregivers, we ask that they repeat to us their understanding of what was said and ask clarifying questions as necessary. Medical jargon is avoided as much as possible while communicating with patients. A video-assisted language line is provided to assist with communication for non-English speaking patients and social workers are involved with the care of patients with medication affordability concerns. The pharmacy helps find alternatives for medications with adverse effects or high costs.

            To leverage resources to overcome these boundaries, we heavily advocate for family involvement in patients’ care and request that our non-English speaking patients come for their procedures with an English-speaking relative, and with their consent, instructions are given in the presence of caretaker in both their native language and English using a language line. Patients and or caretakers are asked to repeat instructions as given both pre-and postoperatively. A language line is provided in almost all languages and used on every non-English speaking patient. Reasons for non-compliance are addressed with resources provided as necessary and social worker consult is made on every patient having financial difficulties accessing medications or treatments. The facility has provided free walk trails for the members of the community. Patients and families are encouraged to use the trails.

 References

Ahmad, I., & Shaheen, A. (2020). Status of medication compliance among patients with hypertension: A global challenge. Pakistan Heart Journal, 53(4), 210-212. https://doi.org/10.47144/ph.v53i4.1846

Heidari, P., Cross, W., Weller, C., Nazarinia, M., & Crawford, K. (2019). Medication adherence and cost‐related medication non‐adherence in patients with rheumatoid arthritis: A cross‐sectional study. International Journal of Rheumatic Diseases, 22(4), 555-566. https://doi.org/10.1111/1756-185X.13549

Song, Y., Zhang, W., Zhang, S., Wang, T., Jiang, Z., Meng, C., . . . Sun, Y. (2020). Factors influencing administration, recognition, and compliance of medicine among community residents from Jilin province, china: A questionnaire study. BioMed Research International, 1-13. https//doi.org/10.1155/2020/8730212

Wood, D., & Lightfoot, N. (2018). An audit of regular medication compliance prior to presentation for elective surgery. The New Zealand Medical Journal, 131(1480), 75-80.  https://chamberlainuniversity.idm.oclc.org/login?url=https://search-ebscohost-com.chamberlainuniversity.idm.oclc.org/login.aspx?direct=true&db=mdc&AN=30116068&site=eds-live&scope=site

I NEED A COMMENT FOR THIS DISCUSSION BOARD WITH AT LEAST 2 PARAGRAPHS AND USE AT LEAST 3 SOURCES NO LATER THAN 5 YEARS. 

Order a unique copy of this paper
(550 words)

Approximate price: $22

Basic features
  • Free title page and bibliography
  • Unlimited revisions
  • Plagiarism-free guarantee
  • Money-back guarantee
  • 24/7 support
On-demand options
  • Writer’s samples
  • Part-by-part delivery
  • Overnight delivery
  • Copies of used sources
  • Expert Proofreading
Paper format
  • 275 words per page
  • 12 pt Arial/Times New Roman
  • Double line spacing
  • Any citation style (APA, MLA, Chicago/Turabian, Harvard)

Our guarantees

We value our customers and so we ensure that what we do is 100% original..
With us you are guaranteed of quality work done by our qualified experts.Your information and everything that you do with us is kept completely confidential.

Money-back guarantee

You have to be 100% sure of the quality of your product to give a money-back guarantee. This describes us perfectly. Make sure that this guarantee is totally transparent.

Read more

Zero-plagiarism guarantee

The Product ordered is guaranteed to be original. Orders are checked by the most advanced anti-plagiarism software in the market to assure that the Product is 100% original. The Company has a zero tolerance policy for plagiarism.

Read more

Free-revision policy

The Free Revision policy is a courtesy service that the Company provides to help ensure Customer’s total satisfaction with the completed Order. To receive free revision the Company requires that the Customer provide the request within fourteen (14) days from the first completion date and within a period of thirty (30) days for dissertations.

Read more

Privacy policy

The Company is committed to protect the privacy of the Customer and it will never resell or share any of Customer’s personal information, including credit card data, with any third party. All the online transactions are processed through the secure and reliable online payment systems.

Read more

Fair-cooperation guarantee

By placing an order with us, you agree to the service we provide. We will endear to do all that it takes to deliver a comprehensive paper as per your requirements. We also count on your cooperation to ensure that we deliver on this mandate.

Read more

Calculate the price of your order

550 words
We'll send you the first draft for approval by September 11, 2018 at 10:52 AM
Total price:
$26
The price is based on these factors:
Academic level
Number of pages
Urgency