Research Paper on Quality and Safety in Health and Patient Care

Background or introduction

This research aims at using numbers to establish a value for health professionals. It performs a quantitative study of pain management in palliative care. According to Unne & Rosengren (2014), pain is a common symptom associate with palliative care. This study is therefore among other various studies that have analyzed the staff's application of evidence-based measurement tools for pain estimation. Providing quality care for patients is vital. Therefore, the health systems should be sustainable economically and be by proper clinical practices and patient consultations. The evidence based care, therefore, depends on three basic approaches, i.e., the staffs' skills and experiences, patient desires and needs and the resent indications based on the present researchers. Efforts should also be put forth to achieve the required quality and safety in health and patient care.

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Literature review

Previous researches indicate the importance of searching for more information by using data that measures and monitors the performance of health care processes. The article, therefore, makes use of the visualization of pain and pain management processes through measurements to increase employee performance and participation in understanding work improvements. Various studies indicate the use of the PDSA methodology to increase adherence to evidence-based practice as a way of improving quality care and safety of patients. Moreover, staff motivation for learning is also imperative to ensure continuous advancement in patient care.

Discussion of methodology

The study made use of statistical and quantifiable outcomes to provide a real description of pain management and routines that can be applied to improve pain management. The quantitative methods include systematic collection of empirical and quantifiable data to summarize and provide generalizations on pain management in palliative care.

Data collection and analysis

The team established nine questions in line with the staff's daily work with the management of pain and palliative care. A 14-day period was provided to answer them. These questions provided a baseline for improving efforts and establishing a status report. They included: 1) Number of patients being asked about their pain and the number that reported the pain; 2)Number of pain ratings basing on the FLACC, ESAS, VRS and NRS; 3) Number of pain assessments; 4) Number of patients that were monitored as a result of pain; 5) the number of adjustments for pain treatments; 6) the number of patients who were taken through the pain management process; 7) the number of patients who scored more than 4 on the ESAS; 8) the number of patients whose pain was discussed during team meetings and the pain ratings discussed at team meetings; 9) the number of patients enrolled in a pain management plan. All the patient visits were also analyzed (165 for the North team and 153 for the South team).

Data analysis

The quantitative approach used involved measurement and quantification of the selected data. Descriptive statistics were used to analyze the nine questions in Microsoft excel. Pain management data was analyzed and documented by reviewing the medical records as shown by the VRS.

Conclusions

The results of the study indicate significant similarities and differences in the documentation of pain in pain management and palliative care. There were increases in the number of ratings of patient pains between the first, second and third time periods. The medical records attributed the use of direct activities such as drug treatments to the fewer pain assessments. There was an increase in pain relief due to the use of pain assessment instruments, i.e. NRS, VAS, and FLACC. There was adequacy in the quality of goals of the health district, and 80% of pain management should be conducted by validated pain assessment instruments.

The evidence presented in each section of the journal article adequately supports the researcher's conclusion. Unne & Risengren (2014) argue that good clinical practices should be provided with proper consultations with the patients to provide the required high-quality care for them. Patient consultation might involve the frequent inquiry on them at the different time intervals to understand the levels of their pain. The methods used in data collection such as the questionnaires provide vital details in line with the pain assessments, treatment adjustments and pain ratings that are in line with the findings of the research.

The article protects the human subjects and conforms to the cultural considerations in the nursing profession. It aims at protecting the human subjects by providing an analysis of pain in patients as a common symptom in palliative care. It tries to control the problem by providing high-quality care for the patients. Moreover, the study conforms to the cultural considerations of the profession by ensuring that the devised methods of study and health systems are economically sustainable and by proper clinical practices and patient involvement. It ensures that the methods and solutions suggested are in line with the values, standards, and policies of the nursing profession.

The study stipulates various strengths as well as limitations.

Strengths

The study achieved its objective of identifying the differences with regards to the method of estimating pain within palliative care in north-eastern Sweden. The documentation of the research data was easy to find and relate to the medical records and showcased a clear and systematic way of documenting the pain ratings.

Limitations

The limitation of the study is the small sample size applied, i.e. only two teams on one health care district were included in the research. Moreover, it encourages a mix of data that contributes to generalization from the questions set by the staff, patient reviews, death surveys, and medical records.

This evidence impacts highly to the nursing practice. It would help to establish a systematic pain management routine in health care centers to help the staff to improve palliative care and improve their visualization and awareness of pain management. The findings of the study would also develop the nursing practice by enhancing the team's awareness in understanding the clinical practices, increasing their understanding of the importance of policies, items and evidence-based guidelines via double-loop learning to enhance staff participation. This would enhance a positive working environment and encourage a sense of coherence, comprehensibility, meaningfulness, and manageability among the nurses.

Qualitative research (Comparing inter-professional and inter-organizational collaboration in healthcare)

Background or introduction

This study compares the inter-professional and inter-organizational collaboration within the healthcare systems. Collaboration in public health care systems has been studied basing on their relationships with multi-disciplinary teams within and across the boundaries of various organizations and sectors. According to Karam et al. (2018), collaboration is vital within health care providers since no single profession can meet all of a patient's requirements in a health care setting. Inter-professional collaboration can also be addressed as two or more professions in health care that have specific roles, perform tasks that are interdependent and share a common goal. It negotiates an agreement that appreciates the expertise, values, and contribution that each provides to patient care.

Literature review

There has been an observed move towards community-based healthcare systems that is opposed to the traditional model (in-hospital). Due to a background of limited financial platforms, comorbid chronic diseases, and aging population, a redesign in health care system is fundamental to reduce the socio-economic effects of patient complexities on individuals and the society. In this case, the community-based care services are developed into well-organized networks of organizations and professionals with the main objective of providing patient care at the appropriate place and with more emphasis on primary care. Inter-professional collaboration has therefore been proven to improve the healthcare processes as well as the outcomes. In this context, the nursing role keeps expanding while the nurses tend to be extremely autonomous within their areas of specialization.

Methodology

This journal review bases on the Joanna Briggs Institute's synthesis methodology. This method provides a statement of the research question, definitions of the inclusion criteria, search strategies, assessment of the methodological quality of papers that have been considered for inclusion, limitations, conclusions, and implications of the research.

Data analysis

This process commenced by examining the contexts under which collaboration was being examined. The researchers assembled the highlighted papers into two groups: the first group containing the papers that discuss the inter-professional collaboration; the second containing papers that discuss inter-organizational collaboration. This stage performs a constant comparison of the original concepts of the various frameworks. They compared the main attributes and features of each original concepts and collapsed them into a refined list of final concepts. A link between the concepts is established and summarized into a single map. The two maps are then compared to spot the similarities and differences that could be spotted across the two groups.

Conclusion

The similarities that exist between frameworks of inter-professional and inter-organizational collaborations include communication, respect, trust, mutual acquaintanceship and power, shared goals and consensus and task characteristics. The differences between the frameworks of inter-professional and inter-organizational collaboration include formalization, the need for clarification of professional roles, the focus and the need for collaborative leadership.

The evidence presented in each section of the article supports the research's conclusion. Karim et al. (2018) acclaim from the onset of the study that no single profession can meet all the patient's requirements. Moreover, there exists a considerable variation in the definition of collaboration in the health and social care domains. All these facts that are discussed in the paper attribute to some similarities and differences among the professions that enable them to complement each other and therefore make complete the healthcare system.

The article protects the human subjects and cultural considerations. The main purpose of inter-professional and inter-organizational collaboration is to ensure patient well-being within the healthcare system. It aims at ensuring full functionality of the system and provision of healthcare irrespective of limitation of financial resources from the patient's side, aging population or those suffering from comorbid chronic diseases. It provides distinctions that can be made and the components that include team identity, clarification of professional roles and formalization that would enhance inter-professional and inter-organizational collaboration which is a vital cultural consideration in the healthcare industry to facilitate achievement of their goals.

Strengths and limitations of the study

Strengths

The review provides a myriad of similarities between the conceptual frameworks of inter-professional and inter-organizational collaborations in healthcare systems. It also provides concepts that are of particular concerns to inter-organizational collaboration and inter-professional collaboration. It clarifies the particularities and main features of inter-organizational and inter-professional...