Respond to each post below by Explaining how their chosen national healthcare issue/stressor may also impact your work setting and what (if anything) is being done to address the national healthcare issue/stressor.
150 words each. 2 references and 2 intext citation each discussion below.
Patricia discussion
A big challenge I’ve found in my profession as a geriatric nurse is health literacy among older persons following the deployment of the electronic health record (EHR). The HITECH Act of 2009 requires healthcare businesses to switch to EHRs and participate in meaningful use measures to improve care delivery (Marshall & Broome, 2017). Despite recent advances in health information technology (HIT) for successful health management, older Americans appear to be less eager or able to use HIT for health-related tasks, such as patient portals or smartphone applications. Patient portals are critical patient interaction technologies that help physicians achieve meaningful use and Medicare criteria.
The advantages of using patient portals in health care practices include patient access to their health records, secure communication with clinicians, and the simplicity of specific chores such as appointment scheduling and bill payment (Heath, 2018). Nonetheless, patient portal adoption is low, despite the tool’s potential benefits. According to a 2017 Government Accountability Office (GAO) report, while over 90% of healthcare providers offered patient portals, less than one-third of patients used this service on a regular basis (Heath, 2018). Healthcare organizations, physicians, and nurses must grasp the barriers associated with this new technology in order to give higher quality treatment to patients.
Health literacy in older adults According to the Arizona Department of Health (n.d.), meaningful use of EHRs enhances care quality, safety, and efficiency, lowers health disparities, engages patients and families in treatment, improves care coordination efforts, and promotes population and public health. One of the requirements for meaningful use of EMRs is that consumers have access to their information and can engage in their treatment; unfortunately, many older persons are unprepared due to a lack of health literacy. According to Levy, Janke, and Langa (2015), approximately 10% of older adults with low health literacy used the Internet to access health information, as opposed to 31.9% of those with high health literacy. Levy et al. (2015) found that EHR participants were younger, more educated, and in better physical and cognitive health compared to the general population (285). While the goal of meaningful use requirements was to eliminate inequities in care, the majority of Americans receiving health care, adults 65 and older, are finding it increasingly difficult to participate in new HIT.
Not only is patient engagement in HIT required for payment, but meaningful usage documentation is thought to improve the quality and safety of treatment for the patients we serve. Because many of the older persons admitted to my unit face cognitive or emotional barriers to learning, leadership had to devise novel approaches to improving compliance with meaningful use measures. After implementing the Cerner EHR in 2016, my facility began to promote the benefits of new HITs, such as the patient portal, in new admission packets, posters across the hospital, and on the organization’s website. Despite ads, many older persons did not use patient portals due to a lack of health literacy. In 2019, my facility opted to convert EHR to the system EPIC.
Joceyln discussion
National Healthcare Issue: Rising Prematurity Rates
I work in the Neonatal ICU, and one of the national healthcare issues affecting Neonatal Intensive Care Units (NICUs) is the rising rate of preterm births. According to the Centers for Disease Control and Prevention (2024), preterm birth rates have been increasing steadily in recent years. Premature infants often require specialized medical care in NICUs, leading to extended hospital stays and intensive medical interventions.
The rising rate of preterm births in the United States is significantly impacting Neonatal Intensive Care Units (NICUs), leading to increased patient volumes and overcrowding. This increased demand can lead to staff burnout, higher patient-to-nurse ratios, and strained financial resources, affecting the quality of care (Chen et al., 2019).
The social determinants that most significantly affect the rising rates of preterm births include socioeconomic status, access to healthcare, and maternal health and behaviors. Families with lower socioeconomic status often have limited access to nutritious food, stable housing, and prenatal care, all of which are critical for a healthy pregnancy. Economic instability can lead to increased stress linked to preterm labor (Girardi et al.,2023)
In response to these challenges, our NICU has implemented several strategies to improve care and manage resources effectively. These include expanding and upgrading facilities to accommodate more patients, providing continuous education and specialized staff training, and enhancing family support programs. Additionally, our NICU has integrated advanced technology for better patient monitoring and real-time specialist consultations and introduced wellness programs to support staff well-being and reduce burnout. These measures aim to maintain high-quality, compassionate care for preterm infants despite the increasing demands on the healthcare system.
Our health system has implemented programs to manage chronic conditions and promote healthy behaviors among expectant mothers. This includes smoking cessation programs, substance abuse treatment, and management of chronic diseases such as hypertension and diabetes. We offer a dedicated maternal wellness program for regular health monitoring, counseling services, and workshops on managing chronic conditions and healthy lifestyle choices during pregnancy.
