Question:
What is the issue?
Are there any focussing events?
What is the significance, e.g.
* To view the healthcare system
* Patients and service users only
* To learn more about your field of nursing,
These can be internationally and/or nationally as well as locally.
What have the actions taken by government to address this issue?
Has the policy been evaluated?
Are patients and users of services more likely to be healthy because of the policy?
How can actors impact the development policy? e.g.
* Professions
* Service users / Volunteer organisations
* Public or media
How does political philosophy influence policy development?
What is the effect of this policy / strategy upon nursing practice?
How can nurses use their power as nurses to challenge or deliver this strategy / policy?
What impact will this policy have on patients and users of services?
Answer to Question: NUR6055 Policy Politics And Nursing
Introduction
The assignment below aims to explore the A and E crisis. This was four-hour care that was goal driven.
The A and E department have been publicly acknowledged in the country for the past twelve months despite the immense pressure.
Newspaper headlines reported continuously on the crisis in emergency departments. In winter, however, it went smoothly with very few changes to the policy (British Medical Association 2013.
The assignment is seen as an assessment of the causes of the wait time. This includes the review of political drivers for maintaining low waiting periods.
The influence of the nurse that is on achieving the targets of A and B in the terms for waiting times.
Policy context
The A&E offices in the UK were under enormous strain during the winter 2014/2015. These included a reduction of nursing staff who provide intensive care, short cuts to social services, population growth and maturing.
2015), it is evident that the NHS’s frontline crisis care team is as worried as possible.
1948 saw the birth of the NHS, which gave the general population access to human services at no cost. People with long-term illnesses and those who require emergency care were able to use the NHS to transport their medical needs. The wellbeing administration was in full swing and it was noticed that about a third of a billion people had waited to receive some kind of restorative treatment.
The increased demand caused a shortage of resource. It was possible to meet the demand immediately if necessary.
The NHS was subject to further changes after 1960. Specialist hospitals were replaced by district general hospitals. Many services are now provided by specialists.
The A and E department determines the specific area of population to follow and provide the services (Huber 2013).
In the year 2000, the NHS plan was finally being implemented.
Una year later, the NHS was receiving a fresh review and reforming its implementation to ensure that no one was left in hospital for more than four hours.
The total attendance increased rapidly and the Department of the Health (2006) was able to produce data showing that 3.1 Million A and E attendees attended the first quarter of 2002/2003, and 3.4 Million in the second.
2004’s 4 hour wait was clearly justified by efforts to decrease the patient’s waiting time for care, appraisal or discharge. However, it is unclear if there was any specific clarification in the writing.
Political Context
The NHS Plan set out the requirements for patients that were seen within two hours. There was an expectation of a specific target being met by about ninety eight percent of those who attend A and E.
The Government made it compulsory that waiting time be cut down in the NHS.
The target that is based upon the care of A-E raised concerns in literature. In 2003, British Medical Association made alarming statements about the situation concerning emergency departments. 2014).
A new government was formed in response to the loss of the general election decision of 2010 and the creation of a Moderate & Liberal Democrat coalition. One of their priorities was to make sure that the A&E focuses were updated (Barbosa et.al. 2016).
This was a great development for crisis staff. It would have provided an opportunity for people to get involved in front administrations.
In 2010, the coalition government presented the objective that 95% patients would be seen in the A&E office within 4 hours. It was suggested this modification was presented because the prior government’s goal stipulations were not clinically valid (Keift et al. 2014).
Buckley 2016, Buckley 2016. The reduction of the time limits was expected to ensure that patients could be seen, triaged, admitted at the general healing facility and released in the allotted time.
The idea is to make A andE more informal with the objectives. This will allow for better understanding and prevent A andE from becoming a line that creates quick lines for patients. There is also the possibility of appraisals being increased and streamlined in order not to rupture targets.
Even though this is an important goal, there are still opportunities to confirm that A and E have been missing the target of four hours since Q2 of 2012/2013. Also, that for 79 consecutive weeks the national 4hr target was not being met.
Accessing appropriate care is a standard benchmark for determining whether a human services framework offers effectiveness and quality. In order to show that they are responsible for the wellbeing administration, political gatherings have required that these focuses be met.
With each gathering showing thoughts for change and changes, with the objective to influence the electorate to support them (Mason Leavitt & Chaffee 2013).
This has led to three distinct governments looking to execute their political beliefs inside of the NHS over the recent 20-years.
The three government coalitions: Labour, Conservative and Liberal Democrats; and now, a Preservationist or Conservative government, since May 2015. These governments show the interest for patients to not be left holding up. However, this is in an environment of money-related severeness, social service cuts, furthermore proficient disagreements in both the nursing area and the therapeutic areas that identify with authoritative wants, terms and conditions. (Bashir and Khan 2015).
The Views From The Stakeholders
The growing interest in A&E administrations has been credited by the current Wellbeing Pastor, to changes in the GP contract in 2004.
The argument is that GP surgeries are no longer able to offer augmented administrative past legally binding commitments. This led to more people going to A&E to consult a specialist as they couldn’t afford one at their GP hone (Chevalier, 2016).
Perhaps this is political point scoring. 2016).
Moreover, the NHS 111 callline was not activated and the end of the NHS stroll has occurred in focuses. The preservationist government also stewarded the NHS 111 helpline. These events have led to massive reductions in social and essential healthcare assets.
Setback, or the crisis division, was not adequately staffed, had to have basic offices and were regularly disconnected from general local healing facilities.
Patients suffered from insufficient access to essential offices and inordinate delays with a goal to achieve master mind.
The crisis division can take steps to ensure that patients are seen, screened and treated.On landing in the A and E office it is normal that patients are triaged and this implies an evaluation ought to be embraced by a qualified wellbeing proficient who has gotten upgraded preparing with a specific end goal to have the capacity to distinguish time dependant conditions that require early intercession; conditions like sepsis or vascular/cardiovascular occasions, to enhance tolerant results.
Triage frameworks in A and E offices improve patient experience. Deferrals may be lessened if there is early identification of the patient’s medical needs.
Because the triage procedure is necessary to oversee A andE hazard and support persistent stream proves distinguishes that triage is not always withdrawn when staffing levels are low.
The office must have adequate staffing in the A andE departments to be able to work effectively and meet the government’s targets. But, nationwide staffing is becoming a problem.
Particularly nurses are suffering from the burden of inadequate staffing in crisis offices. Subjective semi-organized meetings showed that the primary concern for medical personnel working in the A/E office was meeting the four hour holding time target.
SWOT Analysis
Strength
This is why it’s important to keep time focuses in A or E. It’s a direct effect on patient care. There are fewer patients who have to go to the hospital, and faster examinations. These are all credited to the goal.
With the goal of this task, distinguishing modern nursing evidence was the target (Sincy 2016).
Weakness
The barriers to a 4 hour focus in A&E commonly identify with the pressure that weight staff feel under to reach these objectives, and furthermore, these objectives can result in a mutilation clinical needs (Sincy 2016).
The reasons for this were that nurses leaving Emergency Medicine are being put under pressure to meet goals. It is also because of the culture of provocation, tormenting, and unfortunate weight. Trusts must be able to demonstrate their willingness to accept a national arrangement. 2015).Opportunities
Nursing staff can provide long-term care to patients if they give their time. This improves the quality of patient’s care.
Bedrohungs
Patients who are in long-term waiting can lead to a higher mortality rate.
The Francis Report made it clear that the four-hour delay in delivering target A/E was a terrible thing.
Mid Staffordshire principles examined revealed that A andE’s nursing staff were often ‘tormented. pressurized. and irritated’ in an effort to distort therapy records to fulfill the objectives. (Cherry und Jacob 2016).
The report further noted that the 4 Hour Holding Up Time is a source worry for the Crisis Division and it is more probable that this view is replicated in crisis office around the country. Mid Staffordshire saw nursing staff suffer from trusts for 10 years before they reached their 4 Hour targets.
Positive circumstances that result from having A and/or E time focuses extended are particularly related to their effect on patient care. Patients tend to be less mobile, the examinations are performed more quickly and the patient’s journey is improved all can be attributed to the objective (Holloway and Galvin 2016,
Both reviews were made 10 years ago. At the time, staffing levels in A-E and furthermore enrollment and maintenance of medical caregivers was higher than it currently is. This was because the money related emergency couldn’t be fully grasped.
It was important to be able to differentiate between current nursing evidence and the supporting target in order for this task to succeed.
It is evident that too much time in A andE can have adverse outcomes for patients. Additionally, there are increased chances of death and confusion if patients are left untreated.
It is not only about the amount of time patients need to wait for their treatment and appraisal. Other important factors to patient fulfillment and positive outcome measures include excellent correspondence from staff and furthermore the physical and mental fitness of the clinical staff.
Because of the anxiety experienced by staff in the crisis offices under current circumstances, it is possible that there will be some issues at the patient journey end.
The burdens of having a four hour focus in A&E frequently identifies with the weight personnel feel put under to achieve these objectives and furthermore, that these objectives may prompt to a contortion clinical needs (Steven E. et al. 2014).
Crisis Drug nursing staff have been forced to leave because of their inability to maintain a healthy weight.
Nursing’s Influence on Policy Development
Despite their huge calling, the impact of nurses on approach improvement has been minimal.
The best people to help improve strategy are medical caretakers. They are more aware of the uncertain connection between the NHS, as an association, and the general society they serve (Ampe et.al. 2017).
Associations such as the Illustrious School of Nursing and Nursing and Birthing assistance Board contribute to the improvement of national arrangements. There are benchmarking resources set up for the need to be able cover the impact of government strategy on the conveyance of healthcare. However, it remains constant to confirm that medical caretakers can still be substitutes for approach execution failure.
The 4 hour wait in A and E was not something the nursing calling could make a big commitment to. 2013).
The local nursing calling should execute national arrangement. There is also a need for them to take some responsibility for government-received targets and manages.
While it may seem absurd for medical caretakers to assume this responsibility, and in addition to influencing how arrangement is performed in the workplace environment, there are little steps that can be made that will make a significant impact on strategy advancement.
As an example, medical assistants at a local level can be effective in implementing change. They will understand the changes in nursing practice and keep up to date with any advancements in arrangements.
Another option is for medical staff at the local level to learn about administration, detailing and clinical methods with the aim of being able to communicate with key faculty in order to highlight excellent practice or raise concerns.
The NMC is also responsible for directing the practice of proficient leadership and practice.
Given the weight and demands that staff can make to meet four hour waiting times, it is essential that quality, well-being and patient care are maintained.
Conclusion
A major part of improving patient involvement in A&E care is focusing on familiarizing patients with A&E.
With the introduction and use of the NHS.
A andE is focused on care conveyance. Evidence shows that most patients remain in A&E for around 3 hours and 43minutes to be granted and 2hrs and 17 minutes until they are seen and released home.
Patients who need affirmation without regard to being treated or seen may have accomplished the normal target. However, they remained inside A&E because of insufficient administrations to support a protected release or lack of access to an inpatient bed.
While the four hour target can be achieved and patients won’t be waiting for too long to be evaluated and treated, the move from the A/E section might be delayed by factors that are beyond the control office (Ghinolfi und al. 2014).
It is vital that medical caretakers are more aware of the extensive political effects that can be caused by A andE delays.
A decrease in social services spending plans and a higher demand for beds in inpatient intensive healing centres beds has increased the likelihood of a “bottleneck.” This is regardless of the fact that nurses have to meet the 4 hour time frame.
As such, medical assistants should adhere strictly to their codes of practice and not pay much attention to external weight.
Although this is not an easy job, the Francis report has shown us what could happen if patient care is put ahead of the approach drivers and goal desires.
However, this shouldn’t deter medical staff from sticking to their strategy. Although the patient benefits are obvious, it is vital that the nursing profession maintains competent guidelines regarding patient care. This will ensure that these objectives can be achieved.
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