Observe a team in practice within your practicum site. Reflect on the group’s communication and cooperation. How well did this group interact as a team? Are there areas that could be improved? No research citations are required for this discussion question.

Assignment Details

As health care organizations continue to evaluate methods to control costs, they utilize initiatives to limit expensive tests, curtail the length of hospital stays, and reduce the number of referrals to specialists.

• What are your thoughts about whether high-quality patient care and controlled costs can live in harmony?
• How can these types of initiatives impact the provider–patient relationship?

Explain the rationale underlying your position, and feel free to share any personal experiences.

Deliverable Length:  Main post: 300 words 

 JC

There are many types of elder abuse. Choose two types and discuss challenges you perceive in abolishing them. Justify why you consider them as the most crucial. Discuss how you can advocate and protect the elderly from abuse.

The 2 most crucial types of elderly abuse to me, that I see is self neglect and neglect by a trusted other. “Although self-neglect is not specifically identified as a form of abuse in all state laws, it is the type most frequently encountered and addressed by adult protective services agencies. It also is commonly addressed by nurses in home care settings and is recognized by geriatric health care practitioners as a complex clinical issue. An ethical issue that is central in many—if not most—cases of self-neglect is determination of the person’s capacity to refuse services that may be unwanted, as discussed  in”  (Miller).

Self-neglect develops gradually and is often associated with lack of resources, such as food, money, and housing; other times adequate resources are available, but the older adult may refuse services. Self-neglect occurs within the context of interactions among several risk factors in the older adult and his or her social and physical environments. Typically, older adults who become self-neglecting experience a combination of the following risks: (1) physical disability or medical conditions, (2) cognitive impairments or mental illness, and (3) inadequate social supports. Also, prior traumatic personal experiences, such as physical or sexual abuse or exposure to violence, are associated with increased prevalence of self-neglect in older adults who have no cognitive impairment” (Lien, Rosen, Bloeman, et al., 2016) (Miller).

How I could advocate and protect them from self-neglect according to the text:

• “Facilitation of referrals for comprehensive and interdisciplinary assessment
• Interventions to address functional limitations (e.g., making suggestions about assistive devices, facilitating referrals for rehabilitation therapists)
• Interventions to improve management of chronic conditions (e.g., medication management strategies, education about self-care)
• Assessment and interventions related to risks for falls and other safety concerns
• Facilitation of appropriate and acceptable support services (e.g., home-delivered meals, personal care assistance)” (Miller).

The second one I see often is neglect by a trusted other, why it is crucial: “Neglect by trusted others can be intentional, unintentional, or both, depending on factors such as motivation, knowledge, and skill level of the responsible person. Also, neglect may evolve gradually as the health and functional levels of the caregiver or the dependent older adult change. For example, caregivers may initially be well intentioned and provide good care, but become overwhelmed or lack the skills as the needs of the care recipient increase. Other times, caregivers may experience functional or cognitive impairments and not only become incapable of providing care to others but also be in a position of needing care for themselves” ( Miller).

How I could advocate and protect them from neglect from a trusted other:

• “These situations often involve a combination of acute and chronic risk factors that can be addressed by health care professionals.
• Nurses are in key positions to identify risks for actual or potential domestic elder abuse.
• Nurses have key roles in working with family caregivers who are actual or potential perpetrators of elder abuse.
• Nursing interventions such as caregiver education or referrals to appropriate resources may be effective in preventing or resolving some situations of domestic elder abuse” (Miller).

Discussion Question  

Formulating the Research Question, Problem Statement, Research Purpose

In the Week 1 discussion forum you had an opportunity to present a potential problem and an innovative solution specific to your role specialization. In addition, you have reviewed the literature to identify qualitative and quantitative research articles and submitted annotated bibliographies to provide evidence supporting the problem.

Considering the feedback provided to you by the faculty member it is now time to prepare your problem statement, research purpose, and research question.

First share your refined problem and proposed solution (given your review of literature this may have changed depending on the evidence you were able to provide). Next, follow the steps to help define your research question.

1.Craft the problem statement and research purpose. 

2.Design your research question aimed at solving (a part of) the problem and include the following components which will focus the literature review.  

PICOT Question:  

Patient, Population or Problem 

1.What are the characteristics of the patient or population? 

2.What is the condition or disease you are interested in?  

Intervention or exposure 

3.What do you want to do with this patient (e.g. treat, diagnose, observe)?  

Comparison 

4.What is the alternative to the intervention (e.g. placebo, different drug, surgery)?  

Outcome 

5.What are the relevant outcomes (e.g. morbidity, death, complications)? 

6.Ensure that the research question is answerable, feasible and clinically relevant