Healthy People 2020 Case Study
Healthy People 2020 is a program launched in 2010 that provides a science-based 10-year national objectives for improving the health of all Americans. This program established benchmarks and monitored progress in the healthcare system over time with the aim of encouraging collaborations across the communities and sectors, empowering individuals towards making informed health decisions as well as measure the impact of prevention activities in the country (CDC, 2008).
Healthy people 2020 indicate that older adult have been classified as one of the fastest growing age groups globally. The first “baby boomers” who represented a group of individuals who were born between 1946-1946 turned 65 years in 2011 (American Hospital Association, 2007). American …show more content…
Hospital Association, (2007) estimates that more than 37 million older adult will be managing more than one condition associated with old age by 2030. The older adult populations are at a high risk of developing chronic illnesses and other related disabilities including diabetes mellitus, various types of arthritis, dementia, cancer, and congestive heart failure that may result to fall among the hospitalized older adult patients.
The main objectives of the Healthy People 2020 on older adults have been designed to promote quality and healthy outcomes among the member of this population. Rubenstein, and Josephson, (2006) assert that there are many factors that affect the health status, functioning and the quality life of the elderly people especially those of 65 years and older. In order to maintain the quality of life, and wellness of the elderly people, it is important to ensure that older people receive constant preventive health services (Rubenstein, & Josephson, 2006).
Describe why a thorough assessment of falls for health issue among older adults is critical to the development of action plan to achieve the best quality of life for this population.
A thorough assessment of falls among the older adult population is critical to the development of action plan in other to achieve the best quality of life among the older adult population because falls are a primary cause of injury and disability in the hospital setting and can be costly to treat (Simpson, Rosenthal, Cumbler, & Likosky, 2013) Falls among hospitalized older adult population have continued to be a major concern for care providers and health care workers. (Agency for Healthcare Research and Quality, 2012). The functional and financial consequences resulting from falls have remained severe (Cox, Thomas-Hawkins, Pajarillo, DeGennaro, Cadmus, & Martinez, 2014; Simpson, Rosenthal, Cumbler, & Likosky, 2013). Falls account for more than 50% of all fractures and were the second most common cause of spinal cord and brain injuries among the older adult population. Falls have continued to be the leading cause of death among older adults in the United States (Titler et al., 2005). According to the Director of Risk Management of Arrowhead Regional Medical Center, there is increase in fall rates more frequently the first week of hospitalization, due to new and unfamiliar environment or when there is a change in mental status or health condition as a result of post-operatively, post-procedure, or change in medication treatment, or transfer from one level of care to another.
When a hospitalized older adults patient falls, the possibilities for further injury rise as well as the medical attention, nursing interventions and increase hospital length of stay, thereby increasing the cost of care. Several common adverse outcomes caused by falls are bone fractures, head injury, and injury to soft tissue (Titler et al., 2005). According to the study conducted by Spetz, Jacobs, and Hatler, (2007), older adult patients who fell and were injured as a result of the fall had $4,233 higher charges and a length of stay of 12.3 days longer. This ultimately cost the hospital’s budget to increase by 61% in charges, and 71% increase to house the patients during their extended length of stay. However, these costs do not include the costs of lawsuits, if any; expenses associated with rehabilitation outside of the hospital; or the pain and suffering the patient experiences. The cost of health care is and will continue to be a major issue in health policy decisions (Titler et al., 2005). The high cost associated with falls among the older adult population validates the importance of patient safety within the hospital setting. For example, fall prevention and intervention strategies to be implemented for patients who are at risk for falls include surveillance, bed alarms, hourly rounding, assistive devices to aid in ambulation, signage, wristband, yellow socks with a non-slid sole indicating risk for fall, and patient education (Spetz et al., 2007). In Titler’s study of patients at risk for falling, nursing interventions are focused on fall prevention. When these preventative nursing interventions were implemented more frequently, the cost and rate of falls decreased; however, when these preventative interventions were neglected, the cost of care significantly increased (Titler et al., 2005).
Identify and describe the tenets of the community/population assessment model you used for your assessment
The community /population assessment model to guide this assessment was PRECEDE-PROCEED theoretical model which is a guideline for performing community evaluations and implementing interventional plans to improve community health based on a series of intuitive steps (Green & Kreuter, 2005; McCaw & Kotz, 2009).
PRECEDE stands for Predisposing, Reinforcing and Enabling Constructs in Educational Diagnosisand Evalauation, while PROCEED stands for Policy, Regulatory, and Organizational Constructs in Educational and Environmental Development (Green & Kreuter, 2005). This model was developed to help assess communities in a more holistic way, by incorporating a variety of variables as inputs to form an evaluation, then deploying actions to address the identified issues by making relevant changes in the community (Green & Kreuter, 2005). The first phase of the PRECEDE model is social diagnosis, followed by the second phase, epidemiological, behavioral, and environmental diagnosis (Green & Kreuter, 2005). The third phase is an educational and ecological diagnosis, followed by the final phase of PRECEDE, administrative and policy diagnosis (Green & Kreuter, 2005). In this community diagnosis, the social diagnosis includes relevant demographic factors, and the epidemiological factors are described in terms of the falls among older adults, symptoms, and prevalence. The healthcare environment form essential parts of an older adult mental wellbeing and development, and deficits in Arrowhead Regional Medical Center in San Bernardino County area pertaining to these factors are identified. After community needs have been identified, policy changes may be implemented, or programs developed, which can address these issues. The PROCEED portion also includes four phases: implementation, process evaluation, impact evaluation, and outcome evaluation (Green & Kreuter,
2005). Similarly, the community diagnosis framework proceeds from description, through analysis, toward action (Haglund, 1987). Lewin change theory also guides this research as it attempts to drive forces, facilitating change among nurses in the desired direction in fall risk assessment, implementation, evaluation and contributes to overall fall prevalence among older adults within the ARMC community, as well as ways to overcome the challenges presented by falls with injuries. Lewin developed the change theory of nursing focusing on three models of change, include unfreezing, changing, and refreezing (Change Theory, 2011). The theory consists of three major concepts driving forces, equilibrium, and restraining forces. Lewin emphasized the responsibility of an organization to identify different forces and try to strengthen those that are positive for the sake of facilitating change. In the unfreezing stage, individuals go through the changing process, which requires the need to feel supported and loved. The change stage normally referred as the moving process. In this stage, staff members need to change their perception and behavior that support the change process. The staff should feel liberated and motivated during this stage. (Lewin, 2013).
Refreezing is the final stage of the change theory. The change made in the other stages becomes new and consistent. The staff continues to be supportive and become comfortable in evaluating the change process. This theory promotes acceptance by involving the staff in the planning and implementation process. Healthcare providers in acute care hospitals may apply this theory by awareness of expected changes, which must be implemented for the safety of the hospitalized patients minimizing falls (Halfon, Eggli, Van, & Vagnair, 2001).
Healthy people 2020 indicate that older adult have been classified as one of the fastest growing age groups globally. The first “baby boomers” who represented a group of individuals who were born between 1946-1946 turned 65 years in 2011 (American Hospital Association, 2007). American …show more content…
Hospital Association, (2007) estimates that more than 37 million older adult will be managing more than one condition associated with old age by 2030. The older adult populations are at a high risk of developing chronic illnesses and other related disabilities including diabetes mellitus, various types of arthritis, dementia, cancer, and congestive heart failure that may result to fall among the hospitalized older adult patients.
The main objectives of the Healthy People 2020 on older adults have been designed to promote quality and healthy outcomes among the member of this population. Rubenstein, and Josephson, (2006) assert that there are many factors that affect the health status, functioning and the quality life of the elderly people especially those of 65 years and older. In order to maintain the quality of life, and wellness of the elderly people, it is important to ensure that older people receive constant preventive health services (Rubenstein, & Josephson, 2006).
Describe why a thorough assessment of falls for health issue among older adults is critical to the development of action plan to achieve the best quality of life for this population.
A thorough assessment of falls among the older adult population is critical to the development of action plan in other to achieve the best quality of life among the older adult population because falls are a primary cause of injury and disability in the hospital setting and can be costly to treat (Simpson, Rosenthal, Cumbler, & Likosky, 2013) Falls among hospitalized older adult population have continued to be a major concern for care providers and health care workers. (Agency for Healthcare Research and Quality, 2012). The functional and financial consequences resulting from falls have remained severe (Cox, Thomas-Hawkins, Pajarillo, DeGennaro, Cadmus, & Martinez, 2014; Simpson, Rosenthal, Cumbler, & Likosky, 2013). Falls account for more than 50% of all fractures and were the second most common cause of spinal cord and brain injuries among the older adult population. Falls have continued to be the leading cause of death among older adults in the United States (Titler et al., 2005). According to the Director of Risk Management of Arrowhead Regional Medical Center, there is increase in fall rates more frequently the first week of hospitalization, due to new and unfamiliar environment or when there is a change in mental status or health condition as a result of post-operatively, post-procedure, or change in medication treatment, or transfer from one level of care to another.
When a hospitalized older adults patient falls, the possibilities for further injury rise as well as the medical attention, nursing interventions and increase hospital length of stay, thereby increasing the cost of care. Several common adverse outcomes caused by falls are bone fractures, head injury, and injury to soft tissue (Titler et al., 2005). According to the study conducted by Spetz, Jacobs, and Hatler, (2007), older adult patients who fell and were injured as a result of the fall had $4,233 higher charges and a length of stay of 12.3 days longer. This ultimately cost the hospital’s budget to increase by 61% in charges, and 71% increase to house the patients during their extended length of stay. However, these costs do not include the costs of lawsuits, if any; expenses associated with rehabilitation outside of the hospital; or the pain and suffering the patient experiences. The cost of health care is and will continue to be a major issue in health policy decisions (Titler et al., 2005). The high cost associated with falls among the older adult population validates the importance of patient safety within the hospital setting. For example, fall prevention and intervention strategies to be implemented for patients who are at risk for falls include surveillance, bed alarms, hourly rounding, assistive devices to aid in ambulation, signage, wristband, yellow socks with a non-slid sole indicating risk for fall, and patient education (Spetz et al., 2007). In Titler’s study of patients at risk for falling, nursing interventions are focused on fall prevention. When these preventative nursing interventions were implemented more frequently, the cost and rate of falls decreased; however, when these preventative interventions were neglected, the cost of care significantly increased (Titler et al., 2005).
Identify and describe the tenets of the community/population assessment model you used for your assessment
The community /population assessment model to guide this assessment was PRECEDE-PROCEED theoretical model which is a guideline for performing community evaluations and implementing interventional plans to improve community health based on a series of intuitive steps (Green & Kreuter, 2005; McCaw & Kotz, 2009).
PRECEDE stands for Predisposing, Reinforcing and Enabling Constructs in Educational Diagnosisand Evalauation, while PROCEED stands for Policy, Regulatory, and Organizational Constructs in Educational and Environmental Development (Green & Kreuter, 2005). This model was developed to help assess communities in a more holistic way, by incorporating a variety of variables as inputs to form an evaluation, then deploying actions to address the identified issues by making relevant changes in the community (Green & Kreuter, 2005). The first phase of the PRECEDE model is social diagnosis, followed by the second phase, epidemiological, behavioral, and environmental diagnosis (Green & Kreuter, 2005). The third phase is an educational and ecological diagnosis, followed by the final phase of PRECEDE, administrative and policy diagnosis (Green & Kreuter, 2005). In this community diagnosis, the social diagnosis includes relevant demographic factors, and the epidemiological factors are described in terms of the falls among older adults, symptoms, and prevalence. The healthcare environment form essential parts of an older adult mental wellbeing and development, and deficits in Arrowhead Regional Medical Center in San Bernardino County area pertaining to these factors are identified. After community needs have been identified, policy changes may be implemented, or programs developed, which can address these issues. The PROCEED portion also includes four phases: implementation, process evaluation, impact evaluation, and outcome evaluation (Green & Kreuter,
2005). Similarly, the community diagnosis framework proceeds from description, through analysis, toward action (Haglund, 1987). Lewin change theory also guides this research as it attempts to drive forces, facilitating change among nurses in the desired direction in fall risk assessment, implementation, evaluation and contributes to overall fall prevalence among older adults within the ARMC community, as well as ways to overcome the challenges presented by falls with injuries. Lewin developed the change theory of nursing focusing on three models of change, include unfreezing, changing, and refreezing (Change Theory, 2011). The theory consists of three major concepts driving forces, equilibrium, and restraining forces. Lewin emphasized the responsibility of an organization to identify different forces and try to strengthen those that are positive for the sake of facilitating change. In the unfreezing stage, individuals go through the changing process, which requires the need to feel supported and loved. The change stage normally referred as the moving process. In this stage, staff members need to change their perception and behavior that support the change process. The staff should feel liberated and motivated during this stage. (Lewin, 2013).
Refreezing is the final stage of the change theory. The change made in the other stages becomes new and consistent. The staff continues to be supportive and become comfortable in evaluating the change process. This theory promotes acceptance by involving the staff in the planning and implementation process. Healthcare providers in acute care hospitals may apply this theory by awareness of expected changes, which must be implemented for the safety of the hospitalized patients minimizing falls (Halfon, Eggli, Van, & Vagnair, 2001).