Nursing Care, Literature Review Example

According to the American Nurses Association, “nursing-sensitive indicators reflect the structure, process and outcomes of nursing care” (ANA, n.d.). The structure of nursing care is generally determined by the education level and certifications that the nursing staff holds in addition to his or her experience. Indicators of process include nurses’ job satisfaction, assessment, and intervention. Patient outcomes are correlated with the quantity and quality of care received. Many healthcare professionals have conducted studies to ensure that there will be quality improvement in patient satisfaction and outcomes in hospitals of the southwest region of Montana. This paper will analyze the findings of these studies and determine whether there is a need for future research on the topic.

A study entitled “The interpretation of “culture”: Diverging perspectives on medical provision in rural Montana” suggests that providing healthcare professionals with knowledge about the cultural beliefs and other ideologies of their patients will assist the health quality of minority groups and enhance healthcare practices overall (Johnston et al., 2006). This study implicates a need for the adaption of the structure aspect of nursing-sensitive indicators because it asks for nurses to pay greater attention to certain non-medical aspects of their patients’ health. To determine whether cultural competency is a necessary trait in the healthcare field, the investigators conducted a qualitative, interview-based investigation. Specifically, they aimed to determine how culture was exhibited by Mexican agricultural workers and rural healthcare providers in the state of Montana. They found that a majority of healthcare workers focused on the cultural characteristics that made their patients unique. Overall, they found that cultural competency was a major issue in this area. This study should be conducted to extend to areas with more diverse populations to determine the relationship between cultural competency of nurses as it pertains to specific cultures; in addition, the study should be configured so as to provide suggestions as to how we can prevent discrimination in healthcare.

An essential way to improve both the structure and patient outcome aspects of nursing-sensitive indicators is to implement programs that make nurses aware of the most frequent problems they will face while serving their community. Because the demographics of southwest Montana differs greatly compared to the rest of the United States, nurses in this geographic region will need to be more aptly trained in certain areas of healthcare than nursing programs have prepared them for. Although a major way to ensure this skill is through practice and experience, hospitals and private practitioner offices in the area should offer additional training to nurses to ensure that they are prepared to manage these types of patient cases. For example, the article “Radioactive Pain Relief: Health Care Strategies and Risk Assessment Among Elderly Persons with Arthritis at Radon Health Mines” discusses a health issue unique to southwest Montana. This article proposes the health benefits of radon exposure for people with arthritis (Erickson, 2007). Since many other parts of the United States don’t have access to this sort of treatment, it is likely that it hasn’t been considered feasible elsewhere. However, this may be an important for patients in Montana because there is a high prevalence of arthritis and many conventional treatments don’t seem to help. To analyze whether this method works, the researcher used a qualitative study design based on loosely structured and open-ended interviews which were then analyzed for patterns. Patients were recruited over a period of 5 years from a southwestern Montana radon health mine. Statistical analysis revealed that a majority of the patients believed that the radon therapy was helping their arthritis. To ensure that radon actually has a positive effect however, patients with arthritis should be randomized to radon exposure or not in addition to their current therapy. Improvement should be noted in both groups and then a student’s t-test should be used to compare the two groups.

Unfortunately, not many studies have been conducted that specify nursing practices in southwest Montana; however, studies of regions with similar demographics can be used and we can use inferences from these studies to draw conclusions about our target population. For example, “The Economic Importance of Southwest Healthcare Services to Bowman County, North Dakota” is an ecologic study that details healthcare needs according to economic status in North Dakota (Huso, 2010). Since southwest Montana has a similar economic distribution, we can assume that the two study populations are somewhat comparable. The aim of the study was to demonstrate the impact that Southwest Healthcare Services has on Bowman County. Surveys and census data were used to collect economic and health information and statistical analysis was used to draw relationships. The author found that Southwest Healthcare Services improves the quality of life for people in Bowman. It would therefore be useful to determine the impact of southeastern Montana healthcare services on the economy of the people and determine how this improves this populations’ quality of life and therefore the patient outcome aspect of nursing-sensitive indicators.

A major aspect regarding healthcare for the southwest Montana area is the ability of patients to actually access the care that healthcare institutions offer them. Nursing-sensitive indicators can only be positive if the nurse actually has an opportunity to do his or her job and assist public health. In “Frontier residents’ perception of health care access”, the author discusses that it may be difficult for people to access healthcare due to “cost, lack of insurance, and lack of available resources” (Smith, 2008). In this article, the author aims to “explore frontier residents’ health care access resources, investigate frontier residents’ utilization of health care services, search for reasons frontier residents seek healthcare, and explore the residents’ overall satisfaction regarding their health care access options”. To do so, the author used open ended questions and a qualitative approach by interviewing 11 residents in southwestern Montana. He found that while people were generally satisfied with the healthcare they were getting, many people didn’t regularly visit clinics due to the price of gas, the distance of the clinic or hospital, weather, taking off of work, and insurance deductibles or copays. Since these were major problems for residents of southwestern Montana, it is important to conduct a study that will help healthcare professionals persuade these people that it is necessary to seek medical advice despite these barriers.

Another article that attempts to answer questions regarding healthcare access in southwestern Montana is entitled “Rural Montana: Mobile Health Clinics” (Mensch, 2011). Here, the author uses the same study design, research questions, collection procedures, and conceptual framework as the previously mentioned study, however she interviewed 12 southwestern Montana residents instead of 11. Although Mensch had the same findings as Smith, she proposed that a solution to the lack of patient access to care in this region would be to implement mobile health clinics that come to the patient instead of requiring the patient to come to the clinic or hospital. It may be worthwhile to investigate this plan and studies should be conducted to determine whether this type of plan would be feasible and whether it would truly improve quality of care and patient outcome for the residents of southwestern Montana.

The conceptual framework that will be used to conduct future studies on this topic will be qualitative in nature due to the use of surveys and interviews as measures of the outcome. The goal this project will be to determine what makes southwestern Montana’s health needs unique from other populations and geographic regions and based on these facts determine how we can best deliver health services to residents. Variables that will be measured include health outcome, demographic distribution, and prevalence of illnesses. This study will build upon previous studies by considering what is currently known and stated in the literature and using this information to draw useful conclusions about the study population.

References

ANA. (n.d.). Nursing-Sensitive Indicators. Retrieved from http://www.nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/PtientSafetyQuality/Research-Measurement/The-National-Database/Nursing-Sensitive-Indicators_1

Erickson, BE. (2007). Radioactive Pain Relief: Health Care Strategies and Risk Assessment Among Elderly Persons with Arthritis at Radon Health Mines. The Journal of Alternative and Complementary Medicine. Retrieved from http://online.liebertpub.com/doi/abs/10.1089/acm.2006.6213

Huso E. (2010). The Economic Importance of Southwest Healthcare Services to Bowman County, North Dakota. The University of North Dakota. Retrieved from http://ruralhealth.und.edu/projects/flex/cahprofiles/economic_bowman.pdf

Johnston ME, Herzig RM. (2006). The interpretation of “culture”: Diverging perspectives on medical provision in rural Montana. Social Science and Medicine. Retrieved from http://www.sciencedirect.com/science/article/pii/S0277953606003170

Mensch, DL. (2011). Rural Montana: Mobile Health Clinics. Retrieved from http://scholarworks.montana.edu/xmlui/handle/1/1862

Smith RJ. (2008). Frontier residents’ perception of health care access. Retrieved from http://scholarworks.montana.edu/xmlui/handle/1/2308