Nursing practice and health care - Essay Example

Hospitals stays are becoming shorter with the average patient staying 6.1 days in the late 1990s for acute admittance, as compared to 11.3 days in the early 1970s (Department of Health, 2003a). The practices for the most ideal outcomes which enhance independent living are constantly evaluated as to their appropriateness to modern day living. The issue of discharge and its effects on patients is critical to discuss as most patients want to return to life as it was previous to their admission. Also, it is the post-modern aim of the NHS that service delivery focus on acute care which is unable to be provided efficiently by other health care service organizations.

This paper will review the positive and negative impacts of hospital discharge on patients, their relatives, carers and health professionals. Secondly, local practices as experienced at placement at the Lewisham Hospital will be detailed. And the alignment of local practices with National Strategies will be identified. Finally, a conclusion shall synthesise the main points of the paper and demonstrate that decreasing in-hospital stays can have a positive effect on patients. The adult patient has many developmental tasks to meet, whatever their lifespan stage; young adult, middle adult or older adult.

The health of the adult client occurs along a health-illness continuum. Many factors will affect adult health; genetic makeup, cognitive abilities and education level; ethnicity and cultural background; age, gender and developmental stage; lifestyle and environment; socio-economic background; geographic area; and their health promotion and maintenance (Brooker & Nichols, 2003; Hinchcliff, 2003). Obvious benefits to patients of shorter hospital stays include their savings as consumers of health care treatments and care, and that shorter stays are much preferred by patients in general.

Clearly public and private savings on health care costs will occur due to shorter stays. Social costs for conditions such as Alzheimer's can be 4 times as expensive in nursing homes as compared to home care service provision (Henderson, 2002). With informal care, as experienced with family or carers, the monthly costs per patient in 1996 were almost $1, 549. In contrast, the more formal or professional setting of a nursing home incurred costs of approximately $3, 130. Also the formal costs in community settings averaged $ 683 as most of community costs are informal, being met by relatives and caregivers.

So that 98% of formal costs were actually billed and payable. Figures were established by multiplying the hours of care by the hourly wage rate for home health aids and personal care attendants. A Swedish study, as reported in Henderson (2002), made comparisons between costs per patient per day for elderly patients according to 1995 values and exchange rates, across different health delivery settings (hospital, nursing home and in-home care). The costs ranged from 627 for hospitalization to 164 in nursing homes, to 0 within their own home with a carer or relative.

The results of the Swedish study are echoed by the National Services Framework (DH, 2001a). It is important that the patient's need are met, that they be provided support to maximize their independence, and