Priority Areas for National Action
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Health care priority of Immunization
Childhood vaccines or immunizations are overwhelming when parents are new. Vaccine schedules recommended by agencies and organizations, like the centers of disease control, American Academy of Pediatrics, and the American Academy of Family Physicians, cover almost 14 different preventable disorders.
Vaccinations are substances meant not only to protect a child from harmful diseases, such as polio, tetanus, and diphtheria, but also to keep other children safe by eliminating or significantly decreasing dangerous diseases known to spread from one child to another. When children are exposed to a mild/inactivated form of a disease in vaccine form, their immune system, which is the body’s protective system against disease-causing germs, can build up antibodies that protect them from contracting the disease if and when they are exposed to the actual active disease.
Over the years, vaccine usage have generated alot of questions over it’s safety,but no convincing or alarming evidence of harm has been recorded. Although some reaction to the vaccine have been recorded, the important thing to note is that the positive impact of Immunization far outweigh the possible side effects
Population it affects
Coverage levels for children under 3 years of age remain significantly lower among urban and low socio-economic status populations (Rodewald et al., 1999). In 1998, approximately, 70% of children aged between 19 and 35 months from low socio-economic households got the combined series of recommended immunizations, compared with about 77 percent of those from higher socio-economic households (United States Department of Health and Human Services, 2000). In California, results of the 1999 California Kindergarten Retrospective Survey indicate that African American and Hispanic children continue to be immunized at lower rates than Caucasians and Asians (Center for Health Improvement, 2001).
Significance
Vaccinated children develop immunity to exposed antigen through development of antibodies without suffering from the actual diseases that vaccines prevent. Early Childhood vaccination has shown to be one of the most effective way the Centers for Disease Control and Prevention Advisory Committee on Immunization Practice issues annual recommendations; to sustain the momentum to ensure high levels of immunization coverage for children and to decrease disparities in levels of childhood immunization coverage in metropolitan areas with large populations of low-income residents.
Rationale for Selection
Vaccines are biological substances that interact with a person’s immune system to produce an immune response identical to that caused by the natural infection (United States Department of Health and Human Services, 2000). As a result, they prevent the illness and disability associated with preventable infectious diseases. Large number of vaccinated children gives a herd protection Immunity to the unvaccinated small no of individual resulting in whole society protection. Vaccination is usually cost friendly because it Saves a range from $2 to $24 for every dollar spent (United States Department of Health and Human Services, 2000). Combined series vaccines include diphtheria-tetanus-pertussis or diphtheria tetanus, poliovirus, a measles-containing vaccine, Haemophilus influenza type b, and hepatitis B (The Commonwealth Fund, 2002).
Recent research report has indicated that healthy children younger than 24 months have a greater risk of hospitalization because of influenza infection, which has also shown to be higher than healthy adults over 50 years old who were routinely recommend to be immunized (American Academy of Pediatrics, 2002; Rennels and Meissner, 2002). Moreover, national and local budget has lowers due to the decrease in the economy which is expected to impact the effectiveness band flexibility of the immunization system. Moreover, studies have recorded a strong link between low socioeconomic status and vaccine coverage rates, for example, children who are poor and live in urban areas may have immunization rates below those in other areas of the United States (Institute of Medicine, 2000a; Rodewald et al., 1999).
As noted earlier, immunization coverage levels for children under 3 years of age is relatively lower in urban and low socio-economic status populations (Rodewald et al., 1999).
Priority importance of healthcare issue to nursing
Nurses as health care service providers meet diverse patients and communities from different socio-economic status ,different geographical location and from different social background.They also handle individuals from varying demographic characteristics which include; race, gender, and ethnicity, not forgetting different in lifestyles, hobbies, travel and work locations, and treatment preferences. These groups of individual have varying degrees of disease exposure,as some would record higher risk of contracting immunizable condition,while others would be from geographical location that are very difficult to reach available vaccination centers.
In order to find a solution to ensure that these varying individual attain maximum vaccination coverage, nurses should help identify the vaccine that mostly needed, disadvantaged areas where vaccine haven’t reached and most risk groups and education requirements for these groups. Because nurses handle patient hand in hand,they should emphasize importance of vaccination to all individual and ensure all people in their area get to know the existance and importance of vaccination.
Interventions designed to improve patient care
Educating the client about Immunization is crucial subject during immunization awareness. It should emphasize the parental concerns and worries about immunizations, answering raised questions, sharing data supported evidence and clearing any misconceptions parentor guardians may have about vaccinations (Barrows et al., 2015; Edwards et al., 2016; Wade, 2014). When the parents gets knowledge of all of the above including cleared myths and misconceptions about vaccination they would have no reasons to avoid the scheduled immunizations. Pediatric nurses have a forefront role and responsibility to discuss with parents the positive impacts of vaccines not forgetting the morbidity and mortality risks linked to vaccine complications and side effects as compared to infection with vaccine preventable diseases. Pediatric nurses should take the front role in sharing with parents the evidence reinforcing that the risk of a complication is less l than the risk associated with contracting the disease itself (Barrows et al., 2015; Edwards et al., 2016; Wade, 2014).
Most parents feel neglected during decision making about the vaccine schedule,to counteract this, the health care practitioner should always involve the parents during this process. Since pediatric nurses who deals directly with children often form a trusting warm relationship with parents and the child as a basis for care provision to their children, the nurses are usually available and tasked with responsibility of addressing any concerns that the parents may have regarding vaccines (Barrows et al., 2015; Edwards et al. 2016;Wade, 2014). Ambulatory care nurses should practice prediction guidance and issue parents with recorded information concerning the specific immunizations scheduled for the following visit.Being handed on a written plan gives a chance for the parents time to review the vaccine information and be more involved in the decision making process. Some parents may demand to be issued alternative vaccination schedule as they believe receiving multiple vaccines at a single visit will overload their child’s immune system (Barrows et al., 2015). This is an good strategy that may help to reduce the parent’s fears and gain cooperation with key goals of Immunization. This actions would make the patient feel that they have been involved in vaccination care of their childrens.
It is also equally beneficial for nurses to be involved in increasing immunization coverage by participating in vaccination law enforcement. The most important public health goal is to ensure that the public is protected by helping come up with reasonable rules and regulations that facilitate adherence to the recommended schedule for immunizations. Individual rights or protection of the public should be mantained during the enforcement. For example, for now children in all 50 states are mandated to have received a certain number of immunizations before starting school, but in some states, parents opposed to immunizations may week an exemption due to medical, philosophical or religious reasons (Wade, 2014). Pediatric nurses should find a way to enforce by lobbying their state legislators to allow medical exemptions as the only reason a child may enter school without having received their immunizations.
Quality initiative to improve patient care within health facility
Educating -Parents should be given information about each vaccine and the role it plays in ensuring good health of their children.To gain the patient trust and ensure that parents give informed consent to have their child immunized, the physician or any care provider should give information on the nature(known features), prevalence, and risks of the disease, the type of immunization product to be used; expected benefits, risk of side effects; and required follow-up. In addition, the concept of individual immunity as a contribution to community well-being should be discuss.
Enforcement– Parents should be reminded of the benefits of maintaining accurate immunization records. Verbal communication of this information at the time of vaccination can be reinforced by written documents. One way to verify that parents have understood the information is for the physician to question them at the next office visit. In order to ensure safety
Importance- Quality improvement is meant for enhancing safety, effectiveness, and efficiency. So, redesigning healthcare system requires indulgence in specialized methods and tools known to assist improvement. Simple and intuitive electronic medical records software such as iPatientCare Electronic Health Record gives user-centric design to doctor’s offices or hospitals. This tool helps hospitals to get more reliable and efficient in the healthcare process and devote more time to satisfactory healthcare services.
Why Quality Improvement in Healthcare is Important to implement for patient
Safety: Well planned and organized measures are intended towards optimizing care for the patients it serves and avoiding or reducing harm. It takes not a culture of safety, quality, and transparency.
Effective: By improving the process, an organization reduces the chances associated with failure and redundancy. The improved healthcare system is more on data-driven science.
Patient-centered: Improved efficiency of managerial and clinical processes leaves transition space for doctors and staff to provides responsive, respectful and value-based care to a patient.
Proactive: Improved processes recognize and solve the problems even before they occur.
Cost-effective: Quality improvement processes are budget neutral. It avoids the cost associated with process failure, poor outcomes, and errors. Reliable and streamlined processes are less expensive to maintain.
Nursing values
Teaching-We believe one of the most important roles of a nurse is to assist patients and their families with receiving information necessary for maintaining a patient’s optimal health. A nurse provides patients and families with information that is based on their assessed learning needs, their abilities, their learning preference, and their readiness to learn. Fundamental to the provision of patient education is a nurse’s belief that patients have the right to make informed decisions about their care. Nurses provide information that is accurate, complete, and relevant to client needs. A nurse often clarifies information provided by other members of the health care team
Empathy and Caring-A nursing school should teach its students the true value of empathy and compassionate care. At Goodwin University, we believe empathy is a nurse’s ability to understand, be aware of, be sensitive to, and vicariously experience the feelings, thoughts, and experiences of the patient and their family. The faculty believes that it is the nurse’s ability and willingness to “tune in” to and focus on the patient’s experiences that is fundamental to the methods nurses use to manage care. Empathy is based upon respect for the dignity of the client and an appreciation for the independence and self-actualization of the patient
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