Unnecessary Care in the Nursing Homes - Research Proposal Example

Unnecessary care in the nursing homes Table of Contents Contents Cover Letter The NHE Grant Committee 1201 15th Street NW Washington, D.C. 20005 22/05/2014 Name…. New York City College of Technology, 300 Jay Street Brooklyn, NY 11201. RE: RESEARCH PROPOSAL FUNDING Dear NHE Grant Committee, the rationale of this script is to present the research proposal as it reflects in the issue of the increased unnecessary care in the nursing homes. The proposal follows the findings of previous studies over the issue of increased transfer of nursing care homes’ residents into hospitals for hospitalization services. The factor raises concerns accordingly as it reflects negatively on the nursing care home services. The research proposal follows through your mission and objective to facilitate quality accommodation services and healthcare for patients within the health facilities. The objective of the research is to establish the factors causing the unnecessary hospitalization and transfer of clients from nursing care homes to the hospitals. Thus, it reflects the mission of the NHE to facilitate quality healthcare facilities. Please consider the research proposal for the funding program to foster your support for development of efficient health care eservices. I appreciate your correspondence in advance. Yours faithfully ……………… Abstract This research proposal establishes the factor of unnecessary care in the nursing homes, as it reflect inefficiency in the nursing care homes. The research proposal establishes the need to investigate the issue of increased unnecessary hospitalizations of residents of the nursing homes. The unnecessary transfer of residents of nursing homes to the hospitals affects the concerns of the service recipients accordingly; hence, the need to engage the research proposal qualitatively. The methodology entails a quota sampling design to evaluate the quality of service as affect the processes of transferring the residents of nursing care homes to the hospitals. Introduction The palliative care services and older adults’ healthcare services face increased claims in which the frail persons encounter unnecessary care within the nursing homes processes. The developments in which there are activities such as increased unnecessary hospitalizations, as well as, misuse of hospitalization services in these settings raise concern over the quality of services within the care facilities. The long-term care in the context entails the facilities and services administered in the nursing care homes. The frail persons needing these services face a multitude of risks to their health while in the nursing home facilities due to increased and unnecessary procedures leading to their hospitalization, as well as, misuse of hospitalization services in their administration of care (Graverholt, Forsetlund & Jamtvedt, 2014). The engagements of the nursing care homes ought to facilitate the care for the patients, leading to improved condition of life for the patients and clients. However, there are increasing relative concerns over the subject of the conduct of the facilitators and procedures engaged in delivering the services. Thus, it is essential to establish a research into the subject of concern, as unnecessary care incorporating unwarranted hospitalizations for the clients and patients in the nursing homes. Problem Statement and Significance Several factors figure the procedures in the nursing care into decisions to hospitalize the clients. However, the issue of concern is that, the factor of unnecessary hospitalization has several impacts in the prospects of the health delivery services, including affecting the hospitals, as well as, the clients. For instance, in the context of the unnecessary hospitalization, the risks concerned contribute accordingly to the establishment of this research proposal. The frail clients usually have reduced ability to sustain their body defense mechanisms; hence, they can easily get infections (Shanley, Whitmore, Confort, Masso, Javasinghe & Griffiths, 2011). Thus, the unwarranted hospitalizations lead to the exposure of the clients of nursing homes to deadly infections, aspects of delirium and risk of functional losses due to their weak bodies. Additionally, the unnecessary hospitalizations also infringe the ability of the hospitals to deliver services to other needy patients. For instance, a nursing home, sending an unnecessary hospitalization claim for client, means they crowd the hospitals. Thus, from the increased unwarranted hospitalization, the issue increases the concern over the medical bed-hold policies and per-diem payments. Therefore, in view of these concerns as they reflect due to the unnecessary hospitalization of clients of the nursing care homes continue to infringe the efficacy of service presentation in the health services. Further, the increased concerns also reflect accordingly as they impact the quality of life, n addition to raising concerns over the competence of the nursing care home facilitators, as increased unnecessary hospitalization could also be due to their negligence and inefficiency to handle the cases at the nursing homes. Thus, this proposal is significant to establish the causes of the increased unnecessary hospitalizations of clients of the nursing homes, and projecting recommendations to address the concern. Literature Review Hospitalizations of patients from the nursing homes as an issue of concern initiated the need to establish the extent of the issue. Thus, from this establishment, various researches sought to establish the extent of these factors as associated to the rates reported in the hospitals (Wysocki, Kane, Golberstein, Dowd, Lum & Shippee, 2014). The previous studies show that the rate of hospitalization of clients form nursing homes regularly occurred after the first five months of admission of the clients in the nursing homes. Moreover, the reports also indicate that, the rates of re-admission after the first hospitalization of the clients increased remarkably, and most patients died while in the hospitalization settings due to associated complications such as infections gained while in the hospital beds. These factors raised the need to establish the factors resulting in the increased unnecessary hospitalization of the patients from the nursing homes (Gaal, Schoonhoven, Minties-de Groot, Defloor, Habets, Voss & Koopmans, 2014). Further, the recent reports from research findings also indicate that, there is a shortage of various hospital facilities such as reduced bed services and medication in the hospital wards. The research into the matter of concern established that, several patients in the hospital settings who come from the nursing care home services. These establishment then raise the concern that, what the factor leading to the unnecessary hospitalization of the patients who should be in the nursing homes receiving their care. Further, the nursing homes face increased allegations of incompetence as previous reports indicate, after reports establishing that there are unnecessary transfers of patients and clients to hospital facilities. These precedent establishments from previous reports form the basis for establishing this proposal, as it will seek to establish elaborately the factors leading to the increased unnecessary hospitalization of the clients from the nursing care homes. The establishment of the factor of unnecessary care in the nursing homes raises concerns over the quality of service as they present. In this context, the projective description of the issue as a matter of influential impact to the trust of the clients and prospective clients on the nursing homes reflects a negative image. Public relations and image remains key in the healthcare service delivery, as patients and clients attend medical care where they trust to get effective and efficient health services (Kirseborn, Wadensten & Hedstrom, 2013). Therefore, this proposal seeks to establish the factors in the nursing homes that contribute to the increased issue of unnecessary hospitalization of the clients. Further, the proposal will establish the factor of the objective impacting quality of service in the nursing homes, as a subject of investigation over the unnecessary care in the nursing homes. This proposal purposes to establish the factors and effects thereof of the issue in consideration, as it relates to the increased concern over the quality of service. Methods The approach to the research design will incorporate the use of purposive, quota sampling. The method to research entails qualitative approach entailing all the procedures engaged in qualitative data gathering, recording, and analysis, as well as, reporting of the findings. The purposive quota sampling as a design of the research procedure will entail the process of engaging the participants accordingly, to select the participants of the study from the vast populations in the health sector as apply to the study (El, 1966). The factor that several participants will draw from varied nursing care homes, hospitals and clients of the hospital facilities, the quota sampling approach will assist accordingly in projecting the success of the research proposal. Further, in engaging the participants of the proposed research, the study will approach the methodology from qualitative perspective, considering the data gathered will formulate opinionated findings of the research proposal (Hennink, Hutter & Bailey, 2011). The participants will draw from the nursing home managers, nurse facilitators, and community hospital management, as well as, they will draw from nurses in the hospitals. The study will also feature the clients of the nursing homes and their relatives, as well as, hospital patients and relatives to establish their thought on the issue of concern. The participants will engage an average of over 200 persons to establish authentic and reliable findings. Further, the interviews and questionnaires, as well as, literature review processes of gathering data will focus accordingly to eliminate aspects of biases. Further, after establishing and analyzing the findings, the research team will facilitate reports and publish them. Ethical Implications The research will feature the ethical establishments of the quality of the service of care within the nursing homes. In the health delivery policies, patients have right to quality and competent care. Thus, the report will focus on the ethical aspects associated with the factors resulting to the unnecessary hospitalizations in the nursing homes (Singh, 2010). Additionally, the study will establish the qualification of the nurse facilitators in the nursing homes. Moreover, the establishments will focus on the policy issue of the medical-bed policies and medication facilitation and administration. It will also establish the staffing factor in the context of the nursing homes, elaborating accordingly on the factor of the unnecessary care in the care nursing homes. These establishments will implicate the ethics as practiced in the service delivery processes, engaging the necessary changes as the findings will establish from the study and recommendations of the research team. Conclusion The strategies in the nursing homes and local health facilities remain of concern in the subject of unnecessary care in the nursing homes. The processes of transferring of nursing home resident to the hospitals is often an unnecessary factor the situations and reasons given for the transfer implicate inability of the nursing care homes to facilitate quality services. Thus, this research proposal is essential in projecting the service delivery processes within the nursing care homes. References Gaal, B. I., Schoonhoven, L., Minties-de Groot, J. J., Defloor, T., Habets, H., Voss, A., & Koopmans R,. M. (2014). Concurrent Incidence of Adverse Events in Hospitals and Nursing Homes, Journal of Nursing Scholarship, 46(3), 187-198. Doi:10.1111/jnu.12063 El, B. M. F. (1966). The quota sampling method. The Hague: Institute of Social Studies. Graverholt, B., Forsetlund, L & Jamtvedt, G. (2014) Reducing hospital admissions fom nursing homes: a systematic review, BMC Health Services Research, 14(1), 1-16. Doi:10.1186/1472-6963-14-36. Kirseborn, M., Wadensten, B., & Hedstrom, M. (2013). Communication and Coordination during Transition of Older Persons between Nursing Homes and Hospitals still in Need of Improvement. Journal of Advanced Nursing, 69(4), 886-895. Doi:10.1111/j.1365- 2648.2012,06077x. Hennink, M. M., Hutter, I., & Bailey, A. (2011). Qualitative research methods. London: SAGE Singh, D. A. (2010). Effective management of long-term care facilities. Sudbury, Mass: Jones and Bartlett Publishers. Shanley, C., Whitmore, E., Confort, D., Masso, J., Javasinghe, S., & Griffiths, R. (2011). Decisions about transferring nursing home residents to hospital: highlighting the roles of advance care planning care and support from local hospital and community health services, Journal of Clinical Nursing, 20(19/20), 2897-2906. Doi:10.1111/j. 1365- 2702.2010,03635x. Wysocki, A., Kane, R. L., Golberstein E., Dowd, B., Lum, T., & Shippee, T., (2014). The association between long-term care setting and potentially preventable hospitalization among older dual eligibles. Helath Services Research, 49(3), 778-797. Doi: 10.1111/1475-6773.12168. Read More