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Discussion 1: Evidence Base in Design

NURS 6050 Discussion 1: Evidence Base in Design

Discussion 1: Evidence Base in Design

S.Res.295 is a resolution bill introduced to help stop the abuse seen among the elderly. Abuse of any kind must be punishable by law. But an abuse to the elderly, minors, or disabled population, is unacceptable. Elderly abuse is something that we see every day, but unfortunately, elderly abuse is seen mainly in extended care settings, and within the abused family. Elderly abuse can come in the form of sexual, verbal, physical, emotional, and neglect. Senator Chuck Grassley introduced to congress this resolution designating June 15, 2021, as “World Elder Abuse Awareness Day” and the month of June as “Elder Abuse Awareness Month” on June 06, 2021. In his resolution, he elaborated his reason for proposing this day/month be designated as “Elder Abuse Awareness day/month.” Some of his reasons were; elder abuse is an ongoing problem seen in the U.S.; One in 60 people over the age of 60 in the U.S. today go through abuse of some kind each year; 90 percent of the reported abuse seen among the elderly is from family or trusted individual, elder abuse are also seen in long-term care facilities and in nursing homes. He also stated that since “Congress, in passing the Elder Justice Act of 2009 (42 U.S.C. 1395i–3a et seq.), the Older Americans Act of 1965 (42 U.S.C. 3001 et seq.), the Elder Abuse Prevention and Prosecution Act (34 U.S.C. 21701 et seq.), the American Rescue Plan Act of 2021 (Public Law 117–2), and the Consolidated Appropriations Act, 2021 (Public Law 116–260), recognized the importance of protecting older people of the United States against abuse and exploitation,” making June 15, 2021 “World Elder Abuse Awareness Day” and the month of June “Elder Abuse Awareness Month” should also be considered by the house (“Actions – S.Res.295 – 117th Congress (2021-2022): A resolution designating June 15, 2021, as “World elder abuse awareness day” and the month of June as “Elder abuse awareness month,” 2021).

Evidence-Based to Support the Policy

According to Andela et al., (2021), elderly abuse and neglects seen in nursing homes among nurses and nurses’ aid are related to the shortage of caregivers and lack of resources needed to take care of these elderly ones. It is very unfortunate that some places like the U.K. revealed that 34% of the public in their country do not see domestic abuse or domestic violence towards the elderly as abuse but rather as a social care issue (Gray, 2021). A cross-sectional study by Şen & Meriç, (2020) shows that elderly abuse is mainly seen among elderly over the age of 65, single, low-income, who had primary school or below education, and those who do not have social security.

We must advocate for our patients who are being abused, especially the elderly ones. Elderly abuse can lead to serious morbidity and premature mortality. Although 10% of adults in the U.S. today report been abused, the fear of been abused even more when they speak up has caused most of them not to report (Baker et al., 2016). As a future Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP), I found this Act very interesting. I will make sure that I raise awareness to help advocate for these elderly ones going through any form of abuse. It is essential to make the elderly understand that it is not a normal lifestyle. Some may assume it and know that it is necessary to speak up when they find themselves in an abusive environment.

References

Actions – S.Res.295 – 117th Congress (2021-2022): A resolution designating June 15, 2021, as “World elder abuse awareness day” and the month of June as “Elder abuse awareness month”. (2021, June 24). Congress.gov | Library of Congress. https://www.congress.gov/bill/117th-congress/senate-resolution/295/all-actions?r=1&overview=closed&s=2#tabs

Andela, M., Truchot, D., & Huguenotte, V. (2021). Work Environment and Elderly Abuse in Nursing Homes: The Mediating Role of Burnout. Journal of Interpersonal Violence, 36(11–12), 5709–5729. https://doi-org.ezp.waldenulibrary.org/10.1177/0886260518803606

Baker, P. R. A., Francis, D. P., Hairi, N. N., Othman, S., & Choo, W. Y. (2016). Interventions for preventing abuse in the elderly. The Cochrane Database of Systematic Reviews, 8, CD010321. https://doi-org.ezp.waldenulibrary.org/10.1002/14651858.CD010321.pub2

Gray, Veronica. 2021. “Tackling Domestic Abuse in the Elderly.” Journal of Community Nursing 35 (3): 22–23. https://search-ebscohost-com.ezp.waldenulibrary.org/login.aspx?direct=true&db=rzh&AN=151175038&site=eds-live&scope=site.

Şen, F., & Meriç, M. (2020). Determination of abuse and depression in the elderly. Journal of Elder Abuse & Neglect, 32(1), 60–71. https://doi-org.ezp.waldenulibrary.org/10.1080/08946566.2019.1691697

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Great job on your post, and I am happy to see that you plan to make elder abuse a priority in your practice as an AGPCNP.  I found a questionnaire in a research article by Simmons et al. (2021) that you may find helpful for your future practice to assess your level of

Discussion 1 Evidence Base in Design
Discussion 1 Evidence Base in Design

preparedness for evaluating elder abuse.  The evaluation tool measures health care providers’ vigilance in recognizing elder abuse, and the name of the tool is Responding to Elder Abuse in GERiAtric Care – Provider questionnaire (REAGERA-P). This tool starts with a case study for the provider to read, followed by a self-efficacy scale for managing and identifying abuse. This assessment tool also focuses on personal and organizational barriers when discussing the abuse with elders. For example, personal barriers include confidence in correctly identifying elder abuse or concern about how questioning abuse may affect the provider-patient relationship.  Organizational barriers include a lack of time to manage such a complicated issue or inadequate referral protocols (pp. 1-14).  Another excellent resource for you would be the Board of Directors of elderabuse.org.  According to Lachs et al. (2020), elderabuse.org is the first national charity in the United States dedicated to eliminating elder abuse through policy, research, and public advocacy.  The mission of elderabuse.org is to end the scourge of elder abuse by funding high-quality, evidence-based clinical programs, education, research, and advocacy groups around the country (pp.124-127). According to the American Nurses Association (n.d.), advocacy is a pillar of nursing, precisely what S.Res.295 resolution bill is intended to assist providers with.

References

American Nurses Association (ANA). (n.d.) Advocacy. https://www.nursingworld.org/practice-policy/advocacy/

Lachs, M. S., Adelman, R., Breckman, R., & Burnes, D. (2020). Elderabuse.org: A National Charity Fighting Elder Abuse via Direct Service, Research, and Advocacy. Generations44(1), 124–127.  https://eds-a-ebscohost-com.ezp.waldenulibrary.org/eds/pdfviewer/pdfviewer?vid=7&sid=65ebce9b-361c-494d-94a5-a450b40e8b03%40sessionmgr4008

Simmons, J., Wenemark, M., & Ludvigsson, M. (2021). Development and validation of REAGERA-P, a new questionnaire to evaluate health care provider preparedness to identify and manage elder abuse. BMC Health Services Research21(1), 1–14. https://doi.org/10.1186/s12913-021-06469-2.

The prevalence of burnout and stress among are healthcare professionals date way before the COVID-19 pandemic. The reality of the US health care environment before the arrival of COVID-19 was already concerning due to shortages of nurses, doctors, respiratory therapists, and other healthcare workers (Ross, 2020). Most healthcare providers are working very long hours with less staffing. The media focus at the beginning of the pandemic was mainly on the number of ventilators and hospital beds, and completely lacking in those discussions was the question of available qualified, healthy healthcare professionals to care for the rest of the population (Ross, 2020). According to Shah et al. (2021), the covid 19 pandemic worsened burnout by worsening the already existing healthcare worker shortages in facilities and hospitals. The lack of nurses and other healthcare providers put so much pressure on the remaining few professionals to shoulder all the responsibility of providing care. The Covid 19 pandemic exacerbated the burnout rates in the healthcare workforce to the extent of suicide for some (Kaine, 2021). This discussion will review a policy that can affect all of us directly or indirectly as healthcare providers, the Dr. Lorna Breen Health Care Provider Protection Act. The Dr. Lorna Breen Health Care Provider Protection Act addresses behavioral health and well-being among health care professionals (congrsss.gov, 2021). Healthcare professionals’ stress and burnout have been studied throughout the nation, especially with the pandemic exacerbating the problem. (Kaine 2021).

Description of the health policy

The Dr. Lorna Breen Health Care Provider Protection Act was introduced in 2020 by Senator Kaine, who has been leading the talks on the mental health impact of the pandemic on health care workers (congesss.gov, 2021). This policy aims to provide the resources for healthcare providers to get the needed care now during the pandemic and in the future (Kaine 2021). The policy calls for the Department of Health and Human Services (HHS) to award grants to hospitals, medical professional associations, and other healthcare facilities for programs to promote mental health and resiliency among health care professionals (congesss.gov, 2021). It is also calling for the Centers for Disease Control and Prevention (CDC) to launch a campaign encouraging health care workers to seek support and treatment for mental and behavioral health concerns without consequence (Congress. Gov, 2021). As Kaine (2021) stated, the trauma that most healthcare workers are subjected to through the pandemic will leave lifelong emotional and physical damage. Thus, the need for setting this resource for the healthcare workers who risked their lives daily to save others. The grants from HHS are to provide relevant mental and behavioral health training of health care students, residents, or professionals with evidence-informed strategies to reduce and prevent suicide, burnout, mental health conditions, and substance use disorders (Kaine, 2021). In summary, the policy will focus on removing barriers to accessing care and treatment and identifying strategies to promote resiliency, thereby improving mental and behavioral health amongst healthcare providers (Congress.gov, 2021).

Evidence bases to support the proposed policy

The U.S. Senate Passage of the Dr. Lorna Breen Health Care Provider Protection Act has been praised by many organizations, including the American Medical Association (AMA), American College of Emergency Physicians (ACEP), Association of American Medical Colleges (AAMC), the American Foundation for Suicide Prevention (AFSP), the American Hospital Association (AHA), the American Psychiatric Association (APA), American Nurses Association (ANA), and The Physicians Foundation (THE LEGISLATION, n.d.). American Nurses Association (ANA) (2021) applauded the timely and unanimous passage of the Dr. Lorna Breen Health Care Provider Protection Act by the United States Senate on August 6th, 2021. ANA (2021) states that this critical legislation will help reduce and prevent mental and behavioral health conditions, suicide, and burnout among health care professionals who continue to be overwhelmed by the COVID-19 response and recovery efforts. The bipartisan sponsorship of this policy is evidence base to support its proposal. Given the information above, this bill is a national plea for all healthcare workers to get the resources needed to manage mental health and burnout.

References

ANA Enterprise. (2021, August 11). ANA Applauds U.S. Senate Passage of the Dr. Lorna Breen

Health Care Provider Protection Act. https://www.nursingworld.org/news/news-releases/2021/ana-applauds-u.s.-senate-passage-of-the-dr.-lorna-breen-health-care-provider-protection-act/

Dr. Lorna Breen Health Care Provider Protection Act, S.610, 117th Cong. (2021-2022)

https://www.congress.gov/bill/117th-congress/senate-bill/610

Kaine, T. (2021, March 4). Kaine Leads Colleagues in Bipartisan, Bicameral Legislation to

Support Health Care Workers’ Mental Health amid COVID-19. United States Senator from Virginiahttps://www.kaine.senate.gov/press-releases/kaine-leads-colleagues-in-bipartisan-bicameral-legislation-to-support-health-care-workers-mental-health-amid-covid-19

Ross, J. (2020). The Exacerbation of Burnout During COVID-19: A Major Concern for

Nurse Safety. Journal of Peri Anesthesia Nursing.

https://www.jopan.org/article/S1089-9472(20)30111-8/pdf

Shah, M.K., Gandrakota, N., Cimiotti, J.P., Ghose, N., Moore, M. & Ali, M.K. (2021, February 4).

Prevalence of and Factors Associated with Nurse Burnout in the US. JAMA.

doi:10.1001/jamanetworkopen.2020.36469.

THE LEGISLATION. (n.d.). The Dr. Lorna Breen Health Care Provider Protection Act.

Evidence Base in Design

When politics and medical science intersect, there can be much debate. Sometimes anecdotes or hearsay are misused as evidence to support a particular point. Despite these and other challenges, however, evidence-based approaches are increasingly used to inform health policy decision-making regarding causes of disease, intervention strategies, and issues impacting society. One example is the introduction of childhood vaccinations and the use of evidence-based arguments surrounding their safety.

In this Discussion, you will identify a recently proposed health policy and share your analysis of the evidence in support of this policy.

Resources

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.

WEEKLY RESOURCES

To Prepare:

  • Review the Congress website provided in the Resources and identify one recent (within the past 5 years) proposed health policy.
  • Review the health policy you identified and reflect on the background and development of this health policy.

By Day 3 of Week 7

Post a description of the health policy you selected and a brief background for the problem or issue being addressed. Which social determinant most affects this policy? Explain whether you believe there is an evidence base to support the proposed policy and explain why. Be specific and provide examples.

By Day 6 of Week 7

Respond to at least two of your colleagues* on two different days by either supporting or respectfully challenging their explanation on whether there is an evidence base to support the proposed health policy they described.

*Note: Throughout this program, your fellow students are referred to as colleagues.

The Legislation