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Evidence Based Practice on Addressing Complaints among Aged Patients

The central goal of an effective healthcare is promoting patient quality outcome regardless of age, gender, ethnicity or race. Medical practitioners are, therefore, tasked with ensuring all patients receive quality services which are evaluated based on their perception and satisfaction. However, there are several challenges that call for nursing interventions. Notably, these challenges are not health related although they have an impact on the quality of services a patient receives while in s medical facility (Carney et al., 2016). Among these challenges include the interaction between nurses and patients, language barrier between the health care stakeholders and miscommunication or poor understanding between the aged and healthcare providers. As a result, an increase in complaints and grievances is on the rise which has a major effect on a patient’s healing process while introducing other challenges such as depression and anxiety. It is, therefore, imperative to develop an evidence based practice that evaluates complaints and grievances among the aged which is the foundation of this paper. While language barrier, personal attributes, poor communication, and failure to be involved in the treatment plan are some of the sources of grievances and complaints amongst the aged, effective training and having a special nursing staff to deal with this population is central to reducing this challenge.

Problem Description, its Significance, and Target Population

Currently, the primary objective of healthcare facilities is ensuring f quality services among all patients regardless of their age, gender, creed, or otherwise. With the recent escalation in the aged population as discussed hereunder, there are several downsides which include the increase in health related conditions thus a high number of this population in the healthcare facilities. One of the main issues associated with this is that of complaints and grievances emanating from an array of issues such as poor quality of services and personal needs not being met (Skalen, Nordgren & Annerback, 2016). For instance, an aged patient who has been confined to their bed and is rendered immobile, a major challenge is accessing their personal needs. As a result, they may end up complaining and grieving over poor services especially when evidence based practices such as hourly rounding have not been implemented in the medical facility. Another source of these complaints is misunderstandings between healthcare providers and the patient (Adams, Maben & Robert, 2017). This can emanate from other aspects such as language barrier as a result of first nations not being proficient in English. A healthcare provider may in this regard not understand a patient’s needs leading to complaints. Further, personal attributes of an aged person may be challenging to handle. These include the inability to submit for assistance and also, as Carney et al. (2016) suggest, most of them may have cultural beliefs hindering interaction. Also, lack of involvement of these patients in the type of care they receive may be a source of complaint.

The target population can be categorized into two. These include the patients and the nurses. To the patients, they are the complainants while the nurses are responsible for reducing this challenge. Globally, expectancy among the aged has been on the rise as a result of provision of effective and quality healthcare provided (Colby & Ortman, 2015). This has been centered on advancement in technology and vast research and development on how the health of this population can be enhanced. The aged are characterized by an array of factors associated with complaints and grievances. These include a change in their anatomy and psychological welfare. As a result, the increase in health complications among them may result in other challenges as mentioned above such as immobility. For an aged patient who is immobile, meeting their personal requirements may be challenging and inadequate assistance may result in complaints. Another challenge associated with this population is communication barrier since a number of them may not understand English as the common language, particularly the Aboriginal.

The other target population is the nursing staffs who are at the receiving end of these complaints. It has, therefore, been noted as an important aspect to develop strategies through which nurses can reduce the complaints such as patient centered care (Bouwman et al., 2016). The setting of this EBP is in the oncological units with patients suffering from chronic health conditions. The significance of the complaints and grievances among the aged is centered on their psychological welfare among other factors such as dissatisfaction with the services. The mental health of these individuals is at stake if they are not satisfied with the quality of care they receive, if they are not involved in their health welfare, if their requests are not being addressed in time and if they are not being understood by the nurses (Levin & Hopkins, 2014). On the other hand, these complaints do not sit well with the nurses as their competence is challenged. In this regard, this EBP is based on enhancing the interaction between patients and nurses through addressing communication barriers and equipping nurses with effective skills of addressing the aged patient’s needs.

Clinical Guideline and Best Practice

The current approach to reducing complaints and grievances is patient-centered care. In this model of providing healthcare services, the central focus is responding to feedback from a patient and reducing the sources of their complaints. This approach recognizes that patients have a right to complain when they are not satisfied with the quality of care they receive such as treatment and their requests not being addressed timely (Reader, Gillespie & Roberts, 2014). Currently, the federal and accreditation regulations and standards prompt organizations to develop processes that reduce these complaints among all patients including the aged. While minor complaints can be solved by the present staff during the voiced concern period, major grievances require comprehensive investigations (Bruggemann, 2017). Among the best practices that aim at reducing these complaints is that by Center for Medicare and Medicaid Services (CMS) where the requirements of addressing these complaints are outlined in the Conditions of Participation. Some of the proposed interventions are including the patient in decision making, addressing their issues and eliminating the language barriers and sources of poor interaction

This EBP is based on the training strategy where nurses will learn how to manage this population. Some of the learning elements included in the training are the language variation, how to handles these complaints and interventions of addressing the sources of the complaints. The intervention draws its concepts from two models, the learning cycle and the feedback loop. The learning cycle is centered on five main phases of monitoring service delivery, identification of actual and potential risks, learning the various lessons, changing and validating the policies and implementation of the changes (Burke, 2017). In the consumer feedback loop, it is based on identifying the complaint, acknowledging its existence, clarifying it, investigating the causes, development of the change and monitoring of the implemented change. In this intervention, addressing the above-identified challenges is based on training the nurses on solving the patient’s complaints, how to interact effectively with the aged patients and meeting their needs. These nurses will also be trained on the issues of language diversity. In this regard, it will be critical to have specific nurses who have knowledge of diversified languages and interaction with the aged individuals.

The existing patient centered approach and as outlined by CMS and which has been emphasized recently outlines an array of recommendations for addressing patient’s grievances and complaints. These include having a process that not only captures the grievances, but also addresses them (Carney et al., 2016). Another recommendation which is adopted in this intervention is that of educating healthcare providers on the grievance process. In addition, CMS suggests that complaints and grievances should be tracked and improvement approaches implemented. This intervention identifies that the main source of complaints and grievances among the aged is poor interaction between nurses and patients. In this regard, these nurses are educated on approaches through which they can enhance their interaction with the patient such as addressing the patient’s needs in time, understanding language diversity and mitigating the sources of the grievances. This conforms to the CMS approach of tracking the complaints and developing effective intervention strategies. Considering the advantages of this intervention as compared to the existing status quo, these merits are reflected in having a unique set of nursing staff with profound knowledge on how to deal with aged individuals and addressing their needs. Another attribute that surpasses the status quo is on the communication and interaction aspects in this intervention where language barrier among the aged patients, and particularly those from first nations are assisted.

Research Evidence

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Table 1: Research and Evidence

Implementation Plan

The implementation plan follows three major steps which include obtaining the necessary resources, conducting the training and monitoring and evaluation of the effectiveness of the process. The time line for the implementation will be three months. Prior to the implementation procedure, it will be important first to notify the workers of the proposed change. This averts possible risks of resistance to change while citing issues such as less involvement. According to Burke (2017), resistance to change in an organization is a major hindrance to the achievement of organizational goals and objectives. According to Matos & Esposito (2014), it is important for organizational leaders and managers to develop effective change implementation strategies through including the stakeholders and notifying them in advance. Welcoming their suggestions on the matter is critical to ensure inclusivity. In this regard, nurses will first be notified of the impending changes and their suggestions will be prompted. Upon a two weeks notification, the next approach will be obtaining the necessary resources including writing materials that will be used in the lecturing training aspect. Involved nurses will also be given incentives which will enhance their motivation on enrolling in the program. Once the lecturing and on-job training, its effectiveness will be measured through a one-month monitoring and evaluation. The resources and timeline for the EBP implementation is as presented in table 2

Table 2: EBP Implementation Timeline and Requirements

Including the right personnel in an organization is considered a critical factor in ensuring effective change. In this regard, some individuals included in the process will be the management, nursing and support staff. For the management and organizational leadership, their role is providing the proposed resources and facility for the training. In addition, they will be important in ensuring the training process is effective and successful. The nursing and subordinate staffs, who are the target population for the change, will undergo the developed training program. It is important to note some of the resources required in the implementation process which will include funds, writing materials as mentioned above and lecture room. The feasibility of implementing the change is centered on the established rapport between the trainer and nurses. In addition, once the management is committed to implementing the plan, it is easy to achieve the associated goals and objectives of reducing complaints and grievances among the aged. To gain support from the various stakeholders, some of the strategies will include presenting to them the importance of the EBP. To the nurses and other workers involved in the training, offering them incentives will be the source of motivation for getting involved. Implementing the EBP has numerous merits. These include enhanced relationship between patients and healthcare providers, promoting quality of stay at the hospital, enhanced psychological welfare of the patient and improved organizational reputation (Reader, Gillespie & Roberts, 2014). Upon the integration of the acquired interaction skills and workforce who can reduce complaints and grievances among the aged, the primary goal of quality patient outcome among all individuals regardless of their diversity affiliation is achieved.

In conclusion, promoting patient welfare is not only centered on providing them with medication and treatment for their conditions, but also addressing their requirements and concerns. The aged are increasing in population, and there are several challenges affecting them such as high-risk factors to their safety and poor interaction with the medical practitioners. In addition, there are issues associated with their satisfaction especially if their needs are not addressed or when they are not incorporated in developing their care. As a result, complaints and grievances are common among this population which should be mitigated. The above EBP is centered on reducing these complaints through promoting the interaction between healthcare providers and these patients. As suggested by CMS, addressing these issues follows a critical approach of understanding the underlying issues and developing corrective measures. The above EBP is based on training nurses on how to enhance their interaction with this population through effective communication and appreciating language diversity. Also included in the training is how to address the patients’ needs and reducing sources of the complaints. Among the merits for this EBP include patient satisfaction, enhanced interaction with the healthcare providers and promotion of their safety once their needs are addressed. 7) study employed, there are very little room for generalizing the study’s findings.