This paper provides a project concerning the discharge education program intended to reduce the rate of readmission of children and adolescents receiving treatment for mental health disorders. Children aged between 3 and 17 years have little understanding of how to adhere to medication and instructions after discharge following an inpatient care. Parents and other family members have the responsibility of taking care of these patients. The background of this project is to educate nurses on how to deliver effective discharge education to patients and parents prior discharge to ensure good adherence to medication and management of symptoms. This project aims to ensure a change in the practice whereby all patients with mental disorders and their care providers will be educated on medication and management of symptoms for home-based care. The purpose of this project, therefore, to establish a patient and family education program for children and adolescents discharged from a mental health hospital. Concerning the objectives, the project will reduce the chances of re-hospitalization among children and adolescents hospitalized for treatment of mental health disorders, cost, and management of symptoms from mental health disorders, and enhance better patient outcome and staff satisfaction. The education modules will first be delivered to nurses in the psychiatric ward, and later on, the focused population of patients and parents will be educated on medication adherence and management of symptoms outside the hospital. An Objective Structured Clinical Examination (OSCE) tool will be used to evaluate the effectiveness of this project. This project is very important to the nursing practice since it will enhance the adaptation of patient-centered practice.
Children and adolescents suffering from mental disorders require critical care from their parents and other care providers (Trask, Fawley-King, Garland, & Aarons, 2016). At severe stages of the disease, these patients are hospitalized for medication and cognitive behavior therapy to reduce the severity of the disorder so that it is manageable by the family. Shortly after the discharge, children and adolescents experience a very high re-hospitalization rate, and this is a common problem in other medical problems. The goal of every healthcare facility is to provide quality services through multiple efforts although readmission indicates a poor patient outcome. This problem is a burden to the hospital as well as the family due to the cost of care. Readmission imposes a negative impact on the financial expenses used to manage the mental disorders (Trask,et al., 2016). Additionally, this problem causes a poor nurse satisfaction regarding the quality of the treatment offered to the patient. Readmission before thirty after the discharge also indicates a poor patient outcome. Quality among other internal efforts used to reduce avoidable re-hospitalization has been implemented in healthcare facilities, but the rate remains a problem. For instance, the evidence-based practice involves a designed working formula used to improve the delivery of services as well as the patient outcome. Concerning the children and adolescents suffering from mental health disorders, their treatment therapy is costly because it is also continuous even after discharge from hospitalization. The family has a responsibility to take care of the child or the adolescent by giving medication as guided by the nurse upon discharge (Behere, Basnet, & Campbell, 2017). Another aspect of children and adolescents suffering from the mental disorders is that they cannot adhere to medication thus increasing the rate of re-hospitalization. The purpose of this project, therefore, is to develop a patient and family education program at discharge that will increase medication adherence in children and adolescents aged 3-17, receiving mental health treatment, to prevent frequent re-hospitalization.
Statement of the problem
Re-hospitalization of children and adolescents receiving mental health treatment has numerous effects on the patients and the concerned families. Due to this situation, the family incurs a lot of expenses leading to financial crisis. Similarly, the hospitals also experience high cost of care delivery following the re-admission cases. Additionally, this problem leads to loss of nurse satisfaction due to the poor outcome which is never their expectation. At the discharge, lack of patient and family education causes poor adherence to medication and eventually a poor outcome (Loch, 2014). Concerning the mental health disorders, a continuous medication is required for better outcome and management of the conditions. Frequent hospitalization affects primarily individuals with serious mental illness which is a substantial problem. According to Loch (2014), there is little knowledge about the effectiveness of extended hospital stay for patients with chronic mental disorders. Another approach is the transition support services after discharge which has also shown little effectiveness in reducing the readmission. The depth of re-hospitalization of children and adolescents receiving mental health treatment can also be viewed through a lens of prolonged hospital stay which doesn't increase the rate of re-admission shortly after discharge.
According to Timlin, Hakko, Heino, and Kyngas, (2014), outpatient follow-up is also a strategy used to provide services after the discharge to reduce re-hospitalization. Achieving a fully attended outpatient follow-up is costly for the healthcare and also the patient thus making it an ineffective measure. Many patients don't benefit from outpatient follow-up, and they end up getting re-admitted for intensive care. According to the study above, it is clear that out-patient follow-up does not reduce the rate of readmission. By establishing a practice strategy whereby the patient and the family will be educated about the continuous medication after the discharge will decrease the risk of re-hospitalization since this strategy will enhance adherence to medication (Taylor et al., 2016). Lack of patient and family education, therefore, has highly contributed to the increased readmission of children and adolescents receiving mental health treatment.
Concerning the assessment of this organization, implementation of patient and family education will be effective in reducing the re-hospitalization of mental health patients aged 3-17. Increased patient and family education will solve the following challenges that were assessed during the discharge process. In this organization, patient and family lack knowledge on the impact of non-adherence to medication and recommended interventions that could lead to re-hospitalization. The parents also lack understanding of medication adherence to manage the ongoing symptoms, and therefore they could not provide adequate care to their patients after discharge. The parents were not informed regarding the usefulness of outside resources for children and adolescents with mental health disorders that could help in managing the disease outside the healthcare setting. The above challenges contributed to readmission of these patients shortly after the discharge.
From the organization, there are no outpatient pediatric psychiatrists to provide follow-up services thus making it difficult for the patients and the family to consult concerning the recommended interventions. Another challenge is that there are poor patient and family understanding of education and recommended interventions provided on discharge medications which make it difficult to manage the mental disorder away from the healthcare setting. Concerning the lack of understanding of the discharge summary and how to administer to prescribed medication increases the risk of re-hospitalization. This challenge also involves the nurses in charge when discharging the patient who is supposed to provide a succinct explanation on how to manage the symptoms with the medication or any other recommended intervention. Patients and families also lack knowledge of the available community resources such as free clinic and medication for children thus making it difficult to manage the mental disorders away from the healthcare. Additionally, some have insurance issues due to denied services which make it expensive to manage the disorders due to financial burden and again, it is difficult for them to access outpatient resources for non-funded patients. Medical insurance is very important concerning management of chronic disease that requires regular follow-up. Some parents also refuse to consent to medication during the discharge thus contributing to increased risk of readmission. Other families get overwhelmed with how to deal with the symptoms concerning the various mental health disorders thus making it difficult to manage their patient outside the healthcare setting.
Also, from the assessment, the nurses at the hospital organization at discharge lacked quality education aimed at handling the numerous challenges that hampered the smooth transition from an inpatient setting to the community setting thus leading to readmission. Most patients and families are less informed about how to go with medications despite their occupations and therefore they rely so much on education provided at the discharge or outpatient services. Parents also, lack education and have limited knowledge on accessing available resources and difficulties in outpatient services after the discharge thus resulting in readmission for inpatient care (Urma & Huang, 2017).
This organization is also ready for a change to reduce the re-hospitalization of patients with mental health disorders. Concerning its readiness, the hospital is closely attached to others stakeholders such as National Institute of Mental Health (NIH) (Shea et al., 2014). NIH provides scientific findings concerning management and treatment of various mental disorders. Another stakeholder is the American Hospital Association that connects with other national behavioral organizations such as National Association of Psychiatric Health Systems (NAPHS). The above stakeholders play a significant role in implementing quality practice in the hospital that will enhance reduction of re-hospitalization of patients with mental disorders after inpatient discharge (Shea et al., 2014). Implementation of evidence-based practice is an effective way of reducing re-hospitalization as described by Adams and Nielson (2012). The study claims that through evidence-based practice, implementation of patient and family education will enhance achieving a better patient outcome after the discharge. The evidence-based practice on implementation will involve patients, nurses, families, and other stakeholders such as NIH and NAPHS (Urma & Huang, 2017).
The purpose of this project is to establish a patient and family education program for children and adolescents discharged from a mental health hospital. Children and adolescents are at risk of getting readmitted after discharge since they depend largely on their parents concerning medical care. Parents and or the family members must be included in the education program to ensure that the adolescent adheres to the recommended medication and interventions after discharge.
The key objective of this project is to reduce the chances of re-hospitalization among children and adolescents hospitalized for treatment of mental health disorders. Another objec...
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