Vulnerable Population: Ostomy Management – Research Proposal Example

VULNERABLE POPULATION: OSTOMY MANAGEMENT Precede Social diagnosis Adjusting to life as an ostomy patient can be less difficult with the aid of a well-trained nurse. A number of diseases that require surgical procedures and which eventually result in an ostomy exist. In this list, we have carcinomas of the bowel and other organs such as bladder and female reproductive organs. In addition to these, inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis are other disease units that may necessitate an ostomy. Given the intensive care needed and the nature of the recovery therapy, the need to have a skilled nurse to help with the process is imperative. Statistics show that between 20 and 70 percent of ostomy patients suffer complications that include peristomal skin problems, pouch leakage, to name but a few. This makes them require intensive attention to sustain their physical health an improve the quality of their lives.
Epidemiological, behavioral and environmental diagnosis
Records show that around 75000 people undergo ostomy surgery every year (Ringhofer, 2015). As low as this figure may seem, the disheartening story is the trauma that such patients go through due to absence of adequate nurse practitioners to help in the recovery process, inadequate supply of ostomy supplies, financial constraints due to the high management costs, as well as lack of a coordinated strategy for management of peristomal complications. The limited availability of these services within reach of the vast majority of patients compels them to travel long distances in search of the same, hence the need for a comprehensive ostomy management program. For instance, Detroit county has a Universal Healthcare Services (UHS) center that offers a broad spectrum of services, both inpatient and outpatient, as well as surgical services, an establishment worth replicating across the country. Moreover, the mission and vision for the UHS medical centers stipulates their objective of provision of safe, high quality, comprehensive and compassionate health care services, thereby reinforcing the need for such services.
Education and ecological diagnosis
A comprehensive ostomy management program should include in addition to availing training avenues to more ostomy care nurse practitioners, decentralization of care units to the most local hospital levels within reach of patients, adequate supply of the requirements for efficient management and care provision, as well as treatment subsidies, if possible, to deserving patients. Through this, it will be possible for patients to have access to quality services. As observed by Fitzpatrick and Ea (2012), the new practitioners should be adequately trained to deliver accurate assessment, documentation, treatment and evaluation of care, a service that ought to be offered based on the recognized national standards and evidence-based guidelines.
Administrative and policy diagnosis
An important observation made so far is that financial constraints play a significant role in assessing ostomy management services. This has resulted in many patients being rendered incapable of affording access to the much needed services, or failure by health units at local levels to avail the necessary elements for quality care provision. Moreover, in Detroit for instance, the nearest ostomy care provision centers are located 66 miles South and 98 miles northwest of the town. To this end, it is important the government consider taking actions that that aim to not only make the services accessible to patients, but also at affordable rates.
The current ostomy treatment and management structure is such that patients must go through preoperative ostomy site marking, regardless of the urgency of the procedure, joint position requirement set by the American Society of Colons and Rectal Surgeons and the Wound Ostomy Continence Nurse Society (Fazio, Church and Wu, 2012). However, this prerequisite will not negatively affect delivery of services in whatever way. On the contrary, the reforms suggested in this paper will make the provision of the said services even more comprehensive.
Preceed
Implementation
In proceeding with the above program, the government should first consider increasing the supply of care tools to hospitals at local levels to increase accessibility. Additionally, introduction of treatment subsidies to the most deserving poor patients may be available for choice, though the recent healthcare program, once completely effective and available to all, could prove much efficient.
Process evaluation
The other suggestion is a long-term goal that involves training more ostomy nurse practitioners and subsequently deploying them to every hospital across the country with the potential of serving ostomy patients. While this must be the more complex aspect of this proposal, it is important especially in the wake of rising ostomy cases across the country. To achieve, a well-drafted roadmap is necessary. Such a plan should specifically establish a minimum quota in the number of nurses needed both in the pilot program and eventually in the long run. Secondly, an initiative to reduce the net cost of receiving such treatment is also necessary given that statistics show that on average, ostomy patients with skin complications spend almost three times the equivalent duration of other patients.
Impact evaluation
The efficacy of this program lie on the fact that ostomy presents devastating effects to patients, especially regarding body image, self-esteem, role function, quality of life, among others. To this effect, the availability of care provision nurses, and their efficiency will translate to mitigation of these effects. In addition to this, the increased number of specialized ostomy practitioners has the potential of allowing for visitor programs by external ostomates for additional support, a practice that will translate to better management of patients.
Outcome evaluation
The program that this paper advances for purely aims at improving the management of ostomy, by implementing such ways as increasing the number of care providers. Complementary to the aforementioned objective is an analysis, and hence suggestion of prospective government intervention under the said circumstance to make ostomy management affordable and accessible to patients across the country. To this effect, an overall improvement in accessibility of ostomy health facilities to patients will be a great achievement. Additionally, establishment of a national decree to increase the number of new ostomates to handle the ever-increasing cases, both in the surgical and more so in the management sectors will also be a great milestone in curbing the effects, as well as the current trends of ostomy among the population and patients.
References
Fazio, V. W., Church, J. M., & Wu, J. S. (2012). Atlas of intestinal stomas. New York: Springer.
Fitzpatrick, J. J., & Ea, E. E. (2012). 201 careers in nursing. New York, NY: Springer.
Ringhofer, J. (2015). Meeting the needs of your ostomy patient. Modern Medicine Network. Retrieved from http://www.modernmedicine.com/modern-medicine/content/meeting-needs-your-ostomy-patient?page=full