Question

The setting is a moderately sized community, with a population of about 150,000 people. It is a cluster of homes, with a short distance between other clusters of homes. It was once a manufacturing city, but has now been met with decline. The neighboring areas are smaller communities but healthcare is centered around this clinic. Your facility is in the center of this community. Your group is tasked with establishing a new ambulatory care clinic to meet the needs of the aging population in this region. There is a hospital about 20 miles away, but it is felt that the area is under-served, thus the need for this clinic. This is the final department to be established – the ambulatory care, with services for urgent care, pediatrics, and a diabetes care center. The area has few physicians but has a large pool of family nurse practitioners that have demonstrated interest in this endeavor. Your group was chosen because of your previous background and expertise as well as, the diverse members who bring a variety of management skills with them

Identification of a framework or philosophy of nursing should be developed; Identify the style of nursing you would use; Analyze the major factors that are escalating the cost of healthcare today and apply those factors to the nursing healthcare delivery system

Answer 1

An ambulatory care clinic should include

                                      * All facilities for patient care like modern health status checking instruments

                                        outpatient services,ambulence,nurses,doctors,attenders,pharmacy and lab

                                        facilities.

Nursing frame work for such a clinic are

                                                 * Ambulatory care nurses should be knowledgeble in multidisciplinary

                                                   aspects of care and use their critical thinking abilities during patient

                                                   care.

                                                 * Give guidance to old age patients and relatives regarding their current

                                                   health status and check ups available in the clinic for diabetis melitus

                                                    hypertension and other lifestyle diseases.

                                                * Provide health education sections using brochures and role play to get

                                                   awareness about communicable diseases.

                                                * Give information regarding emergency numbers and facilties available

                                                   for transportation.

                                                * Conduct small health surveys near areas to identify common

communicable and life style diseases in that small population to

   provide proper guidance and care.                                                    

* A multidiscipilinary style of nursing should use in this areas.

* Major factors escalating cost of health care are

                                                  * Use of high cost electrical equipments.

                                                  * Cost of hospital stay.

* Cost of new technologies.

* High wages of speciality physicians.

* Cost of emergency and oncology drugs.

* Cost of transportation.

* Cost of surgical procedures.

* In nursing health care delivery system the above factors have a major influence so nurses try to

   * Make patients aware of insurance and health policies available for

   poor people.

   * Professional nursing care during and after surgical procedures which

   reduce risk of infection and reduce length of hospital stay.

   * Complete discharge procedure as soon as possible from nurses side

to avoid overcharges.