Problem Identification And Change Process Essay Discussion

Mentally-ill population

Psychiatric and behavioral disorders significantly burden public health because of the increasing number of morbidities and mortalities (Gross et al., 2019). Mentally ill patients have a disturbance in their cognition, emotional regulation, and behavior. These disorders are classified into neurodevelopmental disorders, mood disorders, disruptive behavior and dissocial disorders eating disorders, schizophrenia, depression, and bipolar. Mental health diseases are rising due to increasing poverty, violence, disability, indulgence in substance abuse and drugs, genetic factors, and psychosocial issues such as emotional outbursts (Gross et al., 2019). Despite the rise in the ill population, only 29% of these patients have access to health care services. These patient requires social and psychological support from their care providers, the community, and family members. The World Health Organization WHO has identified gaps in the mental healthcare system. It wishes to empower the care providers by strengthening psychiatry’s leadership, providing integrated healthcare services, promoting and preventing mental health disorders, and improving information systems. the assignment is a description of the challenges in treating patients with mental health disorders. Problem Identification And Change Process Essay Discussion

PICOT QUESTION-in psychiatric patients, does patient follow-up compared to no follow-up improve the symptoms and promote recovery in a period of one year after initiating treatment.

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Problem/population-psychiatric patients

Intervention-follow-up clinics

Comparison-no follow-up

Outcome-improve the symptoms and promote recovery

Time-one year

Problem Description

Good mental health is essential in coping with stressful events, having good relationships, working productively, and making a meaningful contribution to life. Most of these patients do not seek medical treatment because of poor judgment or insight into their medical condition. The majority who are self-aware are usually in denial and stigmatized for mental disorders (Ojha & Syed, 2020). According to psychiatric nurse practitioners, psychiatric patient follow-up is a burden because most of them do not return on the scheduled date. A psychiatric follow-up is a visit to the clinic after the initial consultation to focus on treatment and monitoring of the patient’s symptoms (Otto et al., 2021). The purpose of the first visit follow-up is to monitor the tolerance of the drugs and the side effects, usually two weeks after the initial treatment. During the scheduled visits, the care provider identifies and treats new symptoms, re-classify the diseases according to the DSM-V criteria, and updates patients’ medical records. Problem Identification And Change Process Essay Discussion

The Clinical Setting

Low-Turn-Out On Follow-Up Visits

The various classes of psychotropic drugs are effective in treating mental illnesses. However, most of these drugs have undesirable effects on the patient, making it difficult for the patient to continue with the treatment and attend the scheduled clinics. Other factors that make follow-up clinics difficult are poor cognitive function, such as the majority of them cannot remember the date and time of follow, lack of support from family members, the severity of the disease, geographical location, patient relationship with a healthcare provider, and communication barrier (Ojha & Syed, 2020). Additionally, psychiatric nurse practitioners’ inadequate staffing causes increased workload, burnout, and eventually, poor services and inadequate referral systems.

Outcome Of The Issue

The need for follow-up is to identify the gaps in the treatment and evidence-based practice and stimulate research on the efficiency of various classes of medicine and the emerging co-morbidities in these patients. Most patients on follow-up do not identify the common side effects of psychotropics, such as weight gain, obesity, hyperlipidemia, and insulin resistance (Kowalchuk et al., 2019). These symptoms are the leading causes of cardiovascular diseases in psychiatric patients. In add-on that, psychotropics such as risperidone and other monoamine oxidase inhibitor have a significant contribution to heart disease. Mental health diseases in elderly patients are the leading cause of falls due to hallucinations, postural hypotension, and dizziness caused by psychotropics. Problem Identification And Change Process Essay Discussion

Solutions To The Problems

The readily available technological advancement should ensure a mandatory strict follow-up on all mentally ill patients by setting reminders to their phones to attend the scheduled clinics. All patients should provide details of contact tracing such as telephone number, postal mail, geographical location address, and next of kin details patient-tracing (Ojha & Syed, 2020). Follow-up on these patients helps in drug dose adjustment, protects the patient from medication errors such as adverse drug side effects, and monitors complications of psychotropics such as renal insufficiency, falls, diabetes mellitus, cardiovascular diseases, and suicidal attempts and ideation.

Training enough psychiatric nurse practitioners decreases the work load for the existing practitioner, and there will be good healthcare services in the appropriate patient-nurse ratio. Incorporating telehealth for psychiatric patients and nurse practitioners is an appropriate follow-up because the patient reaches out to the healthcare providers with a slight change of symptoms. Telehealth is the provision of healthcare services remotely. The care provider and the patient communicates over the phone, they share images or recorded messages, and the patient is required to record their vitals regularly, their blood pressure, weight, blood sugars, and heart rate on their telehealth app for the nurse practitioner to evaluate during their scheduled virtue meeting (Di Carlo et al., 2021). It benefits the patient and the nurse because it saves time and the cost of transport to the hospital. The patient gets a reminder to attend the clinic via email or text. It benefits the elderly by reducing the risk of falls and other hospital-acquired infections. Problem Identification And Change Process Essay Discussion

The telehealth app has formulated questions for monitoring the patient, such as the current medication and the side effects experienced, and questions for reviewing systemic symptoms, such as cardiovascular, respiratory, genital, urinary, and reproductive system, and cardiovascular. It has a scheduled physical visit for imaging tests, blood work, and physical examination. Besides saving time and cost, it also reduces the stigma associated with psychiatric diseases from other patients (Di Carlo et al., 2021). Family members are shy about associating with a patient with a behavioral disorder. Patients with severe psychiatric diseases should be admitted to monitor the symptoms and drug tolerance closely. Their primary caregiver should assist with their follow-up through telehealth. Problem Identification And Change Process Essay Discussion

Evidence-Based Research

Evidence-based research on the benefits of digital health and telepsychiatry shows that technology-based psychiatric and psychological interventions are better than physical and public health systems. They are easily accessible to the vulnerable population because they offer integrated services (Di Carlo et al., 2021). The patient follow-up turnout was higher compared to the physical sessions. Additionally, it is easier to monitor drug tolerance because the patients record daily symptoms. Technological barriers for the patient and care provider require a technician to train on using these tools. Health policies in all countries should address the social and economic disparities in  accessing digital gadgets, payment of hospital bills, medication, and psychotherapy sessions.

The Significance Of The Evidence Based Research In The Clinical Settings

Digitalized health services such as telehealth are beneficial to the patient and the care provide because they are cost effective and saves on time. The tele-health system  help the care provider in diagnostic classification according to the patients symptoms, vitals, current medications, and comorbidities (Snoswell et al., 2021). It also gives the care provider the appropriate drug and drug dosage for the patient with the possible side effects and warning of administration. It monitors the patients tolerance to treatment through the daily recording of the vitals. Problem Identification And Change Process Essay Discussion

Conclusion

Psychiatric and behavioral disorders significantly burden public health because of the increasing number of morbidities and mortalities. A psychiatric follow-up is a visit to the clinic after the initial consultation to focus on treatment and monitoring of the patient’s symptoms. Telehealth and digitalized healthcare services have a positive impact on psychiatric patients because they reduce incidences of stigmatization and saves on cost. Problem Identification And Change Process Essay Discussion

 References

Di Carlo, F., Sociali, A., Picutti, E., Pettorruso, M., Vellante, F., Verrastro, V., & di Giannantonio, M. (2021). Telepsychiatry and other cutting‐edge technologies in COVID‐19 pandemic: Bridging the distance in mental health assistance. International Journal Of Clinical Practice, 75(1). https://doi.org/10.1111/ijcp.13716

Gross, J. J., Uusberg, H., & Uusberg, A. (2019). Mental illness and well‐being: an affect regulation perspective. World Psychiatry, 18(2), 130-139. https://doi.org/10.1002/wps.20618

Kowalchuk, C., Castellani, L. N., Chintoh, A., Remington, G., Giacca, A., & Hahn, M. K. (2019). Antipsychotics and glucose metabolism: how brain and body collide. American Journal of Physiology-Endocrinology and Metabolism, 316(1), E1-E15. https://doi.org/10.1152/ajpendo.00164.2018

Ojha, R., & Syed, S. (2020). Challenges faced by mental health providers and patients during the coronavirus 2019 pandemic due to technological barriers. Internet Interventions, 21, 100330. https://doi.org/10.1016/j.invent.2020.100330

Otto, C., Reiss, F., Voss, C., Wüstner, A., Meyrose, A. K., Hölling, H., & Ravens-Sieberer, U. (2021). Mental health and well-being from childhood to adulthood: design, methods and results of the 11-year follow-up of the BELLA study. European Child & Adolescent Psychiatry, 30(10), 1559-1577. https://doi.org/10.1007/s00787-020-01630-4

Snoswell, C. L., Chelberg, G., De Guzman, K. R., Haydon, H. H., Thomas, E. E., Caffery, L. J., & Smith, A. C. (2021). The clinical effectiveness of telehealth: a systematic review of meta-analyses from 2010 to 2019. Journal of Telemedicine and Telecare, 1357633X211022907. https://doi.org/10.1177/1357633X211022907

Part 1: Problem Identification and Description Problem Identification And Change Process Essay Discussion

***PLEASE FOCUS ON THE MENTALLY ILL POPULATION****

Identify and describe the problem in clear and concise language. To help you think about what problem you might choose, keep in mind the health or nursing problems of the patient population(s) you currently serve, those you encountered in your clinical courses, or those you plan to work with in the future.
Describe the clinical setting.
Describe the service area for the clinic and population groups who attend the clinic services.
What kinds of problems do you see in the clinic?
Give a clear, explicit statement of the problem and target population, as well as the background of the specific problem relative to the clinical setting.
Is it broad enough that you can analyze it from many theoretical and conceptual points of view and make suitable plans to address the problem from a number of perspectives?

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Is it of enough interest to you that you are willing to spend most of the semester thinking about it, assessing all its dimensions, planning in detail how to address it, and designing a detailed intervention and evaluation plan?
Describe the significance of the evidence-based project that could be implemented in the selected setting to the nursing profession. Ask yourself why it is important to you. Consider your own clinical interest.
Describe clinical observations that point out the knowledge gap, clinical gap, etc.
Describe the significant research in the area that has been done that delineates the gap in our knowledge.
Your paper should be 3–4 pages in length, not including the cover or reference pages. You must reference a minimum of 3 scholarly sources in your paper. Problem Identification And Change Process Essay Discussion

Use current APA format to style your paper and to cite your sources.

See your Change Project Writing Assignment Resources folder for PICOT resources.

Please review the attached rubric for more information on how the assignment will be graded.

Please see attached finale sample copy Problem Identification And Change Process Essay Discussion