Assessing Problem
The promotion of public health is an important role of nurses and other healthcare providers. Nurses and other healthcare providers utilize care interventions such as inter-professional collaboration to ensure the optimum care outcomes for their patients. They also select best practice interventions to ensure the realization of the actual, and potential health needs of their patients. In doing the above, nurses strive to understand the unique needs of their patients, families, and communities as a whole. Therefore, this paper examines the health issue of stroke, influence of state boards of nursing, government and organizational policies on the care given to patients and leadership strategies that will affect care to stroke patients.
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Definition of the Problem
The selected health problem for exploring in the project is stroke. According to the Centers for Disease Control and Prevention (CDC), stroke refers to a condition that develops due to the occlusion of blood supply to a region of the brain or due to bursting of the blood vessel in the brain (CDC, 2021b). Stroke is among the leading causes of death and disability in the USA. Individuals are increasingly predisposed to stroke due to risk factors such as hypertension, cigarette smoking, diabetes, and heart disease (CDC, 2019). The severity of stroke in the country is seen from the statistics that 795000 people develop stroke on a yearly basis, with 610000 of them being first or new diagnoses (CDC, 2021a). Nurses and other healthcare providers have a critical role to play in promoting coping in patients and families affected by stroke due to its adverse health effects. They also have a responsibility of creating awareness among the population to promote healthy lifestyles and behaviors.
The patient I will be working with during my practicum is a 65-year-old male who was diagnosed with stroke. He lives with his family. He has left-side paralysis due to stroke. Stroke affected the client’s ability to engage independently in most of the activities of the daily living. Often, his family members assist him in undertaking his daily activities such as bathing, dressing, and feeding. Stroke has had an enormous impact on the patient and the family. For example, the costs incurred in treating the patient have been significantly high. The patient requires frequent hospital visits for assessment and physiotherapy sessions, which are cost intensive. The burden of the disorder to the family can also be seen from the loss of productivity. Accordingly, the family spends most of their productive time in ensuring the needs of the patient are met. The consequences of the above impacts have been high level of emotional and financial stress to the family, increasing the need for me to work with them in identifying the effective ways of coping with the demands of stroke.
The health problem of stroke is relevant to my practice as a baccalaureate nurse because of a number of reasons. Firstly, stroke is considered among the leading causes of disability and mortality in the USA. The CDC reports that 1 in every 6 mortalities due to cardiovascular disease in the US in 2018 was attributed to stroke. It also reports that a person in the US dies from stroke in every four minutes in the US with one person developing it in every 40 seconds. The cost-burden of stroke is high as seen from the fact that the state incurred $46 billion between 2014 and 2015 in the USA (CDC, 2021a).
The other relevance of stroke to my practice is the fact that it is largely attributable to preventable factors. Accordingly, evidence shows that preventable factors cause stroke. They include hypertension, obesity, diabetes, heart disease, smoking, and physical inactivity. It also arises due to other causes such as metabolic syndrome, high levels of lipids and cholesterol, and poor dietary habits (Virani et al., 2021). The population may be predisposed to the risk factors due to their lack of or low level of awareness. Nurses have a critical role to play in creating awareness among the public, promoting the health of those at risk, and providing optimum care to the affected patients and their families, hence, the relevance of the issue to my practice.
Analysis of Evidence
Nurses have a critical role to play in the prevention and management of stroke in their populations. They utilize national guidelines and evidence-based data in the prevention and management of stroke. The health promotion and prevention strategies they employ in their practice includes the prevention of risk factors through healthy lifestyles and behaviors and treating conditions such as hypertension to reduce the risks of stroke. Nurses also work in collaboration with other healthcare providers to facilitate coping with the demands of stroke among the affected patients and their families. For example, they link patients and families with the existing support groups to ensure their optimum health and coping with demands of stroke. In addition, they adopt care coordination to ensure high quality, safe and efficient care for the affected patients and families. The above interventions align with those I witness in nursing practice in the organization I work.
Evidence-based practice is important in addressing the care needs of patients and families affected by stroke. However, barriers to the use of evidence-based interventions in addressing the problem exist. According to Baatiema et al., (2017), factors such as inadequate institutional support, limited knowledge and skills among healthcare professionals on use of evidence-based therapies, and low level of confidence on the effectiveness of evidence-based therapies act as barriers in practice. The authors further identify that issues such as limited medical facilities to enhance the uptake of evidence, lack of or inadequate peer support among healthcare providers, and complex nature of stroke therapies make it difficult for providers to implement evidence-based interventions in their practice (Baatiema et al., 2017). As a result, it is important for healthcare institutions and providers to examine the enabling factors that will address their above barriers in their practice (Juckett et al., 2020).
Nursing standards are effective in ensuring the realization of the care needs of patients affected by stroke. Accordingly, nursing safeguard the interests of stroke patients and their families by adhering to professional standards that include safety, quality, efficiency, protection of patients’ rights, and advocacy in their practice. Nurses also participate in system design to ensure the needs of stroke patients are met. As seen from the evidence by Adeoye et al., (2019), nurses implement stroke systems of care that focus on aspects such as endovascular therapy, care coordination, and neurocritical care to meet the care needs of stroke patients. Bjartmarz et al., (2017) investigated the effectiveness of nursing standards and guidelines in their research where they found improvement in the consistence, quality, and safety of care given to stroke patients. Bennett (2017) found that nursing standards focusing on patient-centered relationships create a positive culture of care that leads to enhanced emotional wellbeing of the patients and recovery in rehabilitation of stroke patients.
Nurses also have a role to play in policy making to improve outcomes, prevent illness, and reduce hospital readmissions in stroke patients. Accordingly, nurses play a vital role in ensuring the adoption of policies that aim at prevention of stroke and the provision of optimal care to the affected populations. They also advocate for the adoption of interventions to create awareness among the public on the causes, effects and prevention of stroke (Harrington et al., 2020). Through it, the population is motivated to adopted healthy lifestyle and behaviors. Nurses also advocate for policies that enable the use of technologies such as telehealth to reduce hospital visits as well as readmission among stroke patients (Rutledge et al., 2017).
Nursing theories such as Orem’s theory of self-care can be applied in caring for stroke patients. According to Orem, nurses play a vital role in assisting patients meet their self-care needs in cases where they lack power or will to do so. The applicability of the model to stroke is seen from the role that nurses play in helping patients meet their self-care needs. Nurses also help families and patients cope with the increasing demands of stroke (Ghani et al., 2019). Therefore, the model can be used to ensure the provision of optimum care to stroke patients and their families.