Dialysis for the purpose of maintaining health
Introduction
The study focuses on dialysis for the purpose of maintaining health and improving life. The factors under consideration are those that gear towards a wellness solution for individuals with type II diabetes. Type II diabetes is known by the other name of diabetes mellitus and is a highly disabling condition that impacts adversely on the quality of life. The impact is not only on the patients, but also on their families and communities, who are the secondary victims of the condition. Limited information makes the condition an increasingly difficult burden for the family and community. The study targets individuals in the entire public because diabetes can affect anyone. It will also ensure that individuals within the public understand the significance of dialysis programs because they improve and prolong life. The key stakeholders in this assessment include medical practitioners and patients with kidney failures on dialysis. Other stakeholders include marketing and pharmaceutical companies, stakeholders include producers of dialysis machines, and families of people suffering from the condition.
This essay will also explore the assessment of Life & Wellness Solutions, Dialysis@Home Health Company because the main objective of this company is to improve people’s lives by giving quality and safe healthcare services at their areas of residence. The logical model pert chart will be used to give information to the public about home dialysis concerning kidney failure. The model will further give information about treatment preferences and prevention measures together with managing the condition of the patient at home. Several aspects of the company will be assessed depending on the needs of its stakeholders, the objectives and goals of the company and program resources. This study will use interviewing method to find out the perceptions of individuals on home dialysis and if they are ready to participate. Thus, with one focus of the program being on education and awareness, the problem of diabetes mellitus will cease to be a burden because of the increased support and assistance offered to the victims and their families. This study will also be compared with data from other similar studies from the Center for Disease Control and Prevention (CDC) or National institutes of Health (NIH).
Target Audience
The focus on educational programs means that the target audience for the study includes patients, their families, and caregivers, as well as the medical personnel, involved in providing dialysis services. In essence, the study targets all members of the public because whether one is diabetic or knows a person who is diabetic, there is no telling what future changes can bring the problem of diabetes mellitus closer to an individual.
Setting
The setting may differ depending on the target audience. For instance, workshops and seminars are an effective setting for health care professionals and nurses while the waiting bays for the dialysis process will provide an efficient setting to disseminate the information to patients and family members, along with caregivers, using brochures and mini presentations.
Goals & Objectives
Dialysis is aimed at improving the lives of diabetic patients. It is an emerging trend and thus, has received minimal publicity. The objectives will include
- Ensuring that the public understands the importance and availability of dialysis programs for improving the quality of life and prolonging the life of a patient.
- Ensuring that patients and caregivers understand the entire process of dialysis to negate any myths and reservations on the same.
- Disseminating information that will ensure adequate support and effective care for type II diabetes patients.
Interventions
The intervention measures regarding type II diabetes call for various policies and awareness programs for the victims and families. Dialysis as a result of diabetic problems, particularly renal failure, is the next best alternative to a kidney transplant. Individuals without a graft match for the transplant process have to incur the financial burden of lifetime costs of the dialysis program. Studies suggest that the costs of peritoneal dialysis are relatively lower than the costs of haemodialysis. Given the above cost estimates, policy issues should include sequential dialysis care after peritoneal dialysis with subsequent haemodialysis on incident and requirement basis. Other policies should touch on the nutritional and environmental dimensions of controlling diabetes mellitus.
Political and Legal Issues
Cost is the overriding issue in the management of type II diabetes. The medical insurance providers and health care professionals have their separate politics on the matter with the person on the receiving end being the patient. Therefore, legal bodies should establish sufficient provisions to ease patients’ access to care and treatment using the dialysis programs and to ensure that whether individuals have health coverage or not, they still receive sufficient support in accessing the services.
Human Resources Issues
Human resource matters revolve centrally on the patient and the community surrounding him or her. The unavailability of sufficient information may hinder the support programs for the family and caregivers towards ensuring the physical and psychological well-being of the diabetic patient. The process is traumatizing and draining. Thus, the human resource constituting the nurses and doctors should ensure that they offer as much psychological support and counseling as possible to the patient. The community also forms another human resource whose inadequate access to information may hinder their support to the patient undergoing the process of dialysis. The neighborhood should understand the physical capabilities of the patients in relation to their involvement and participation in the community.
Motivating Participation
The act of disseminating information, as the study provides, is the first step towards encouraging participation in the dialysis programs. While the process fundamentally targets the patient, participation is not limited to this group of people. Upon receiving adequate information on the dialysis process and its intricacies, the family and community members will participate in the form of providing support and motivation. It is as simple as attending the dialysis session with the patient and offering distractions during the process to ensure his or her psychological well-being.
Important and Changeable P.R.E.S
In light of the project to ensure the sufficient dissemination of information to the public, family, patients, and medical staff, changeable aspects include the progression of the condition and availability of alternative interventions. Thus, while the patient is undergoing dialysis, it is important for the family and the society to have measures in place to increase the probability of a transplant that will enhance the patient’s quality of life more than the dialysis process.
Logic Model Pert Chart
The focus of the input segment in the logic model is all the requirements towards facilitating the campaign on providing information to the public concerning home dialysis as a result of kidney failure. The information will also include treatment options and preventions measures along with the management of the condition for the victim using home dialysis. A majority of kidney failure patients and their families rely on the treatment options their doctors prescribe not knowing that the doctors have an additional role of ensuring profit maximization in their facilities of practice. Most are forced to dig deeper into their pockets while they can access affordable options. For instance, a family that is forced to deal with the cost of dialysis when to them getting a match for the process of transplant is cheaper will benefit from the campaign. The input is thus data and information from different bodies that have a stake in the control of kidney failure. The information will also include available policies especially concerning medical insurance in providing affordable care for the patients.
The input in the campaign will direct the primary activities which will utilise the resources. The activities and input, therefore, link in the sense that they are predeterminations of each other. The activities will focus on information dissemination for the various primary and secondary victims of the scourge of kidney failure. The information will also target tertiary victims who are individual neither suffering from kidney failure nor knowing an individual or family member who does. The reason for targeting this group is that the disease may be genetically associated, but there are unique cases of individuals without family history becoming victims and having the need for management and care including information on the process of dialysis. Another link in the process is the output which will be derivative of the inputs.
Budget
The proposition will require rigorous campaign initiatives and calls for change from different stakeholders. The aim of the campaign will be to disseminate information to the public on the causes of kidney failure for those free from the condition. The management process including home dialysis for the victims and finally the treatment options for those with enough resources that include having available donors for transplant processes. With a campaign of this magnitude, the budgets will have to cater for the cost of reaching the entire public because one way or another, an individual can be a primary, secondary or tertiary victim.
The budget will, therefore, include the cost of producing the information leaflets which will entail design and printing. Other costs will go towards Hiring venues for seminars and conferences along with public awareness campaigns. The budget item may reduce when hospitals and other organizations set to offer their venues for free. Providing public training on the care of kidney failure patients with a public simulation of the process of dialysis for awareness will require more budgetary allocations thus the cost for booking resources and venues. The payment towards conference and seminar keynote speakers and presenters along with their accommodation, transports and allowances. The item is towards the realization that the campaign will rely on the input of professionals to provide valid information to the public. Communication costs towards organizing the various campaign processes will be another requirement. Litigation costs for legal action in changing various policies and a final item of subsidiary costs to cover for unexpected expenses
Stakeholders
The primary stakeholders in the process include the medical practitioners and the patients suffering from kidney failure who are on dialysis. Other stakeholders include producers of dialysis machines, marketing and pharmaceutical companies in the line of kidney failure, Families of individual suffering from the condition, and the general public.
Market
The target market for the campaign process includes the individuals in the nutrition sector who ought to pass information regarding dietary causes and aggravation of kidney failure. The patients along with their families form the primary market for the procedure. The medical practitioners including the doctors, nurses and caregivers are also stakeholders. The society especially the workmates and neighbors of patients along with the entire public because one can never tell when the information from the campaigns will be of benefit to them or their families become victims of kidney failure.
Marketing Process
The marketing process will follow through with the activity section in the chart. The first step is the dissemination of information through mass production of leaflets and procedures. The second marketing process the campaign will follow is that of the public demonstration using a simulation of the dialysis process while explaining to the public the various steps in the process and their effect on the patient. The steps that follow will target specific caregivers along with medical personnel to provide information on the care of the patients along with available treatment options so that individuals can have the freedom of acting within their means. The final step of the process will target the general public to educate them on dietary measures in managing the condition and avoiding it all together. With the information, there will be fewerases of kidney failure in the public.
Dialysis@Home Health, Life & Wellness Solutions Evaluation
Company evaluation is an important management function. The primary reason for evaluation is to ascertain that a company is in line with the set goals and objectives. This essay seeks to provide an extensive evaluation of the Life & Wellness Solutions, Dialysis@Home Health Company. This company aims at improving people’s lives by offering safe, high quality and efficient healthcare services in their homes.
Description of the evaluation
Due to the fact that the firm focuses on home dialysis treatment much of the evaluation will revolve around the quality of service delivery. The areas that will be evaluated include the outcomes of the treatment, the overall cost of the treatment about conventional treatment, the support resources and any modifications that need to be done at home. These areas were selected based on the level of significance to this service delivery.
Quality of home dialysis treatment: this will be the first area of evaluation. To ascertain the quality of the service delivery, this aspect will be analyzed; depression symptoms, the level of stress to the heart, lowering the risk of death, enhancing the recovery time, improved mental and physical health, improved appetite, improved blood pressure levels among other service quality areas. The assessment will also identify if the quality of these services is congruent to the needs of the patients, the stakeholders as well as the goals of the program. The evaluation design will be to conduct a short interview with the company’s stakeholders and the patients to gauge their perception, attitude and feeling about these services. Interviews will be the most appropriate design because through interviews the researcher will be able to gain more in-depth about the program, less follow-up will be needed, can easily be changed, there is a higher response rate and also the evaluator has more control.
The cost of the program evaluation: The overall cost of conducting a home dialysis treatment will be examined. If the company can gain more benefits with least resources, then the program will be deemed viable and encouraged to continue and expand, however, when the cost of conducting the program is too high than the benefits accrued then other programs such as peritoneal dialysis will be encouraged. Another factor for consideration will be to assess the support services to the program. It will be ascertained whether the company accepts another form of pay such as commercial insurance mode of payment. Similarly, the surveys and observations will be used to obtain information regarding the cost of managing the program. The financial position of the company will be analyzed to ascertain the success of the program. The process of the evaluation will involve first engaging the stakeholders, describing the evaluation program, conduct an interview with the appropriate stakeholders, gather appropriate and credible evidence and finally draw a conclusion from the findings.
To have an accurate evaluation, the evaluation logic model will be employed. Under this model the definitions and the title will be evaluated, the resources used in the process will be analyzed, the activities, outcomes both in the short term as well as in the long term will also be looked at. Moreover, the model will also examine the influential factors as well as the goals of the program. This model will be used to provide direction for the evaluation program.
PREDISPOSING FACTORS
| More Changeable
|
Less Changeable
|
|
| High Importance
|
· Psychological features, such as ambition, tolerance or other personal features
· attitudinal perception of the situation
|
· Genetic composition
· Type of personality that influences one’s decision making · biological peculiarities |
| Low Importance
|
· Religious beliefs
· Social background · economic background in terms of family or personal income
|
· Prescription of value to the circumstances
· Environmental factors that impact understanding of the importance of self in social surrounding
|
REINFORCING FACTORS
| More Changeable
|
Less Changeable
|
|
| High Importance
|
· Decision Making
· Behavior · Attitude · Knowledge
|
· funding
· Community Education |
| Low Importance
|
· Ambulances
· Time · Public Relation |
· Participants
· volunteers · Inputs |
ENABLING FACTORS
| More Changeable
|
Less Changeable
|
|
| High Importance
|
· Diet programs
· Educattion |
· Lack of exercise
· Overeating |
| Low Importance
|
· Failing to take medicine
· Failing to follow docto’s appointment · Lack of information about the treatment · Failing to monitor the blood pressure |
· Stress
· Not relaxing
|
EXAMPLES OF SIMILAR STUDIES
Varying groups have performed similar projects with the aim of improving the well-being of staff in workplaces and patients at home and in hospitals. The scientific and research analysis enables the collection of evidence on the impacts of health-related programs. One of the example of a similar research was on the assessment of the effects of reinforcing, predisposing, and enabling factors on diabetes mellitus (DM) patients. The authors of this study aimed at determining the effects of the three factors on the DM patients that receive home-based treatment. The study involved 78 patients selected through convenience sampling. In the first stage, the study held an educational program that entailed information sessions. The study used a video projector and lecturing methods to present the informative content. The study also involved dynamic group discussions and other educational materials such as CDs and pamphlets. After one month, the research provided an education program. The results revealed significant effects of the enabling factors such as educational classes and the adoption of the diet programs. According to the mean score of the entire study, the significance of the reinforcing factors such as behaviour, attitudes, and knowledge, and the enabling factors increased after the education programs (Borhani, Shafieyan and Mostafa 2).
Another example of a similar study focused on inequities reduction and improving quality to achieve the best health care. The major goal of this study was to conduct an interdisciplinary research to explore, monitor, and identify intervention opportunities to improve inequality in health care. The study involved 76 patients of cancer and cardiac problems from three different cultures. The researchers engaged in discussions and interviews with the patients and the family members. They also held educational programs and training sessions using videos projectors. According to the study, the ethnic and racial inequalities highly contribute to reduced health care access, outcomes, and use of medical services. In some areas, the two factors are irrefutable. Notably, the racial and ethnic factors are not limited to the uninsured and low-income patients, but also among privately insured populations (Mayberry, Nicewander, Qin and David 105). Additionally, the inequality occurs as a result of cultural perceptions, ineffective patient-provider communication, provider bias, cultural barriers, and intentional or unintentional bias. The study explains the importance of research from individual and environmental dimensions to examine factors such as sociocultural norms, socio network, values, cohesion, care-seeking behaviors, and individual health promotion. Such research should engage community-based partners and other key shareholders to identify the origin and perspective to the inequity determinants (Mayberry et. al., 107). Therefore, this second example emphasized on predisposing factors and their effects on health care.
The third example is a research on the development of health service interventions that apply precede-proceed models. The precede-proceed model is a theoretical framework that directs or develops realistic nursing interventions to enhance the chances of being successful in the health care environments. The term precede refers to the reinforcing, enabling, and predisposing constructs in diagnosis, education, and evaluation. The second term, proceed, refers to implementation and evaluation. The study’s major objective was to analyze the applicability of this model to chronic illness intervention. The precede-proceed model has been applied previously in global health care to guide the planning, identification, implementation, and evaluation of health improvement initiatives. The study used a reflective case study approach to examine the applicability of this model in improving the interventions in the targeted chronic care in two distinct populations. The two populations entailed aging rural people that had unmet palliative care needs as well as urban disadvantaged populations that were at a high risk for cardiovascular disease (Phillips, Rolley and Patricia 4). According to this study, the model minimized the risk of subjectivity through the synthesis of disparate data to ensure the best health outcomes. The model enhanced a focus approach that considered relevant factors. It also narrowed the evidence-practice gap that exists in nursing practice.
To sum up, the current study on dialysis for health, life, and wellness solutions can borrow various aspects from the above three studies. Firstly, the study should embrace the use of education programs. The first example proved education as an influencing factor in health awareness. Secondly, the study should establish ways of solving the culture and ethnic biasness in health care provision. The second example explains the two as the major factors that contribute to medical inequity. Thirdly, the study can borrow the use of precede-proceed model from the third example. The model has been proved in reducing the risk of subjectivity and narrowing the evidence-practice gap among the nursing practitioners. Lastly, the study should emulate the use of videos and CDs to present the informative contents to the infected and the affected.
Some of instruments that we plan to use conduct our assessment will be the meeting with some of the medical staff and doctors and technicians who perform the dialysis for patients.
The clients will be our patients receiving the dialysis treatments and the medical staff including the physicians. Our target population will be patients who are currently part of the home health dialysis and receive treatment at home, as well as patient’s diagnosed with kidney failure and are receiving treatment at the hospital.
We will be using some data from the Center for Disease Control and Prevention (CDC) or National institutes of Health (NIH) so we can compare the patients receiving treatment in other states in the country.
Once we have target our population and acquired all the appropriate information to analyze the facts and review the plan we are trying to improve by discovering what works best for patients and not for insurance companies. In other words, we are trying to improve a system that will benefit patients the most so they have the best possible care during their treatment and while they are receiving dialysis.
Our main goal is to use the findings to judge and create the plan to be able to present to the stakeholders and provide solutions to improve some of the things that are not working properly and could be improved upon.
Some of the problems we consider important are the number of treatments and how providers and insurance companies are handling the payments. Another issue is whether or not patients will be receiving a certain number of sessions versus other patient’s conditions and medical background. We will analyze the type of population based on age, condition, and insurance coverage.
Our population will be a variety of individuals ranging from 18-85 years old; most of the patients receiving dialysis are in different stages of their life, depending on their medical condition and doctor’s assessment. Some physicians may suggest more sessions while insurance companies might decline or limit the number of sessions received per patient. Our goal will be to try to find the right balance for the patient, cost, and coverage. We will be sharing this information with the agency and stakeholders involved in the home dialysis organization. By sharing our findings, we are enabling the individuals involved to take action and to cooperate with the assessment execution and to improve the process in which they are currently doing business, as a home health dialysis organization.
Here are some of the questions that might come up during the meeting with company staff and stakeholders will be:
- What type of service your company is providing versus other companies offering the same dialysis services?
Answer: we provide the best possible care for patients who suffer from a kidney failure and provide the best possible care in the comfort of their own homes, performing dialysis sessions without having to leave their house.
- What type of improvement you expect from your patients receiving dialysis at home and how much difference you think it makes receiving treatments at home in comparison with treatments at the hospital?
Answer: It makes a big difference for patients since we can provide services and to ill patients in a professional and compassionate way.
- Is the technician trained and able to assist with any additional health issues that might arise during the dialysis sessions?
Answer: Yes, all of our staff is trained to perform the dialysis functions and certified.
These are some questions that we will be asking our audience of patients receiving dialysis at home or at the hospital:
- Are you happy with the way technicians are handling your therapy sessions and performing the treatments?
Answer: Yes, but I would like to have someone who can assist me with other conditions related to my treatments without having to run to a hospital to receive additional care.
- How happy and satisfy are you with services being received?
Answer: I am happy with the services being received, I just wish it was not so expensive.
- How are they payments being handled and all the billing for the home dialysis?
Answer: The organization takes care of all the paperwork and the necessary billing issues to give patients a better peace of mind while they are being treated.
In conclusion, it is unquestionably clear that evaluation is a significant exercise that needs to be regularly carried out to determine the success. For the evaluation process to be effective, there must be a plan to be followed which entails involving the stakeholders, describing the program, carrying out evaluation to gain useful insights for the program to draw a credible and accurate conclusion. It also entails making a budget for all expenses incurred during the evaluation process. Furthermore, entails putting into consideration of various factors for instance, enabling and predisposing factors. Home dialysis treatment is good if the services being delivered are quality. The evaluation process is critical during this process because it helps in identifying the quality of services being delivered to the patients. Furthermore, it helps in finding out if services offered are in line with the needs of the patient. Home dialysis can be independently and safely carried out at home with expected important improvements in the utilization of resources and health. Interviewing was the most appropriate research method used in carrying out evaluation because the researcher will be in a position to gain more in-depth with regard to the program.
References
Borhani, Mahboobeh, Zahra Shafieyan and Mostafa Qorbani. “Effects of Predisposing, Reinforcing and Enabling Factors on Self-Care Behaviors of the Patients with Diabetes Mellitus in the Minoodasht City, Iran.” Journal of Diabetes and Metabolic Disorders 14(2015): 27. Web. 23 Mar. 2016.
Mayberry, Robert, David Nicewander, Huanying Qin and David Ballard. “Improving Quality and Reducing Inequities: A Challenge in Achieving Best Care.” Proceedings of Baylor University Medical Center 19.2(2006): 103–118. Web. March 23, 2016.
Phillips, Jane, John Rolley and Patricia Davidson. “Developing Targeted Health Service Interventions Using the PRECEDE-PROCEED Model: Two Australian Case Studies. Nursing Research and Practice 2012(2012): 1-8. Web. 23 Mar. 2016.
National Kidney Foundation, (2016). Information retrieved on March 10th, 2016 from https://www.kidney.org/atoz/content/dialysisinfo