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Pediatric Home Infusions
In the present times, the health of individuals plays a fundamental role as far as the economic development of a nation is concerned. When most individuals are unwell, they tend to spend most of their time seeking for quality health care services rather than attending to their daily economic activities. This is the core reason why most governments, both the developed and the developed ones allocate substantial funds to the health sector. Despite this, the number of health consumers have significantly increased in most regions, and this have increased pressured in terms of admission and hospital stays, and this have contributed to the increase of medical errors. In the United States for example, approximately five hundred thousand individuals lose their lives every year due to medical errors (Murphy, 2017). Apparently, this challenge can be greatly minimized if a strategy that would help in reducing the rate of hospital stays can be embraced and implemented.
The rate of hospital stay is also influenced by the type of disease that the patient may be suffering from. In this connection, cancer is one of the terminal diseases and for patient to survive there is need for extensive management of the condition. Effective management of various terminal diseases help in prolonging the life of the cancer patient. This project aims at reducing the rate of hospital stays of patients suffering from cancer, specifically by allowing them to be going home with a CADD prizm pump, which helps in delivering the post hydration and chemotherapy at home. The use of the CADD prizm pump will help cancer patients to be recovering at home rather than within the health facility. In addition, the use of the pump will also help in reducing the cost and rate of hospital admissions, as well as reduce the risk of hospital acquired infections that are caused by bacteria, fungi and viruses. Apparently, the CADD prizm pump can be disconnected once they feel comfortable to do so, or they can go back to the health facility to be disconnected.
Project descriptions and components
This project is one of the major and most feasible change program in the pediatric department. The project aims to reduce the stay of one day and the shorter stay in the pediatric department of approximately half a day. The pediatric patients suffering from cancer will be attending to the hospital for the chemotherapy treatment and depending on their situation, they can be admitted for approximately four days and then be discharged with a CADD prizm pump in order to receive their post hydration and other medications at home. The overall chemotherapy treatment from start to finish is approximately 4-6 months, and this can create a lot of pressure in the pediatric department if all cases of cancer were to be admitted for six months (Gennari et al., 2011). Consecutively, early discharge is also beneficial to the patient. According to Guller and Anstrom (2014), administering drugs and care to patients in their home settings facilitates their health improvement compared to when the patients, especially pediatrics, are admitted within the health facility. Considering that chemotherapy treatment from the start to the end takes time, administration of this treatment is both safe and economically efficient to both the patients and the health facility as a whole. In addition, the use of the prizm pump will allow parents to take control of the treatments that their child is taking.
Moreover, the chemotherapy treatment entails a number of treatment cycles which range between four to eight cycles and each cycle has its set of medication that should be administered to the patient. In this project, the patient will be visiting the health care facility for the administration of each cycle of treatment, but he or she will be discharged with the set medications for that particular treatment cycle. Apparently, if the health situation of the patient happens to worsen during the recovery process at the home settings, he or she can be brought back to the facility for medical care. Apparently, if he or she happens to be recovering well after taking the medications, he will be required to come back to the pediatric clinic during the set date for the consecutive chemotherapy treatment cycle.
Project evaluation plan
The evaluation of this project will be conducted in two ways. First, the health outcomes of the cancer patients who have been discharged and allowed to go home with a CADD prizm pump in order to receive their post hydration and chemotherapy at home. The nurse in charge of the pediatric department will be recording the number of patients who are discharged with the CADD prizm pump within a given period of time (six months) and record patients have successfully used the pump for their post hydration and chemotherapy treatment as well as those who have been discharged with the pump but were brought back to the facility due to the severity of their health condition or pump failure. The number of the patients who have successfully utilized the CAAD prizm pump will be evaluated against those who have used the pump but failure to achieve positive health outcomes. If the number of those who recorded positive health outcomes after using the CADD prizm pump outweighs that of patients who records negative health outcomes after six the end of six months, then the project will be said to be effective. Secondly, the nurses will conduct a survey which will seek to gather the experience of all patients who have been discharged with the CADD prizm pump. The responses of the cancer patients will then be compiled and analyzed in order to establish whether majority of the patients are satisfied with the change or not.
Though this project can be effective as far as reducing the length of hospital stays and allowing patients to bond physically and emotionally with the family members and friends during the chemotherapy treatment process, it is associated with some limitations. For example, the use of the CADD prizm pump calls for basic knowledge of the user, and considering that most of the patients and/or even the family members are uneducated, the use of this pump is a challenge to them. Considering that even the health staffs do make errors in the medication, diagnosis, prescription, manufacturing the formulation to be used, dispensing the formulation, monitoring therapy, and administering the drug, then cancer patients are deemed to record a higher rate of medical errors when they are given the autonomy to administer the chemotherapy treatment by themselves (Aronson, 2009). In addition, this means that the nurses in the pediatric unit must first take time to orient the cancer patients concerning how to use the CADD prizm pump and the chemotherapy medications that they prescribe to them before discharging them. Since staff ratio is a major challenge in both the developing and the developed nations, nurses in the pediatric unit may not have adequate time to orient cancer patients concerning the dosage of chemotherapy medications as well as the use of CADD prizm pump.
According to Negron and Cohen (2013), inadequate staffing is likely to hinder the achievement of positive patient health outcomes and this increases the risk of comorbities and mortalities. In addition, chemotherapy treatment tends to be a serious mode of treatment especially due to the various side effects that it is associated with, including anemia, hair loss, bruising, bleeding, constipation, appetite changes among others (American Cancer Society, 2016). For this reason, adequate nursing care is necessary and this project does not facilitate this. Consecutively, in case of emergencies, the cancer patient may end up succumbing to the severity of the illness since he or she cannot manage to access emergency medical care faster compared to when he or she is admitted within the health facility.
Summary and recommendations
It is, therefore, evident that discharging cancer patients with a CADD prizm pump can be an effective change that would not only facilitate the reduction of prolonged hospital stays of cancer patients but also enable them to recover in a safe place and in the comfort of their loved ones. Parents tend to have control of the medications and care that their child is taking. However, this project is associated with some limitations including the need to extensively orient the cancer patients and their family members concerning the use of the pump and medications to be administered and challenges of responding to emergencies. Apparently, the room for project improvement is never full and there are a myriad of recommendations that can be implemented in future in order for more positive outcomes to be achieved. For example, the pediatric unit should encourage parents or guardians of the patient to keep a journal or record of how the latter is recovering at home. This would help the nurses to establish the effectiveness of the chemotherapy treatment in every cycle. In addition, the pediatric unit should establish counselling and orientation sessions for educating patients and their family members on how to use the CADD prizm pump before discharging them from the health facility. This would greatly reduce the risk of making medical errors at home.
Guller, U., & Anstrom, K. J. (2014). Outcomes of early extubation after bypass surgery in the elderly. Ann Thorac Cardiovascular Surgery, 781-788.
American Cancer Society, (2016). Chemotherapy Side Effects. Retrieved from, https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/chemotherapy/chemotherapy-side-effects.html
Aronson J.K., (2009). Medication errors: what they are, how they happen, and how to avoid them. QJM: An International Journal of Medicine, Volume 102, Issue 8, 1 August 2009, Pages 513–521, https://doi.org/10.1093/qjmed/hcp052
Gennari, A., Stockler, M., Puntoni, M., Sormani, M., Nanni, O., Amadori, D., & Bruzzi, P. (2011). Duration of chemotherapy for metastatic breast cancer: a systematic review and meta-analysis of randomized clinical trials. J Clin Oncol, 29(16), 2144-2149.
Murphy, M. (2017). Investigating avoidable patient deaths. Bmj, 223, j223. http://doi.org/10.1136/bmj.j223
Negron, B., & Cohen, E. (2013). Back to the Future: A standardized approach to delivering effective Nursing Care. Nurse Leader, 11(2), 52-56.