Veterans Heodialysis Case Study

One of the most significant problems facing the United States in the coming decades is one that is widely acknowledged. However, simply because it is acknowledged does not mean that sufficient economic or technological preparations have been put into place to address this challenge. This is where RAI comes in

The American Nephrology Nurses’ Association (ANNA) is the professional association that represents nurses who work in all areas of nephrology. The ANNA was established in 1969, as a nonprofit organization. The organization promotes excellence in and appreciation of nephrology nursing so a positive impact can be made on the lives of people living with kidney disease. Members of the organization practice in areas such as hemodialysis, chronic kidney disease, peritoneal dialysis, acute care, and transplantation. ANNA believes that the demand for quality nephrology patient care will continue to grow in the future, particularly with the variety of changes occurring within health care. The American Nephrology Nurses’ Association acts consistently on their own core beliefs, including the responsibility of nephrology nurses to enhance the quality of care delivered to people with kidney disease. As an organization, the responsibility to provide the educational programs necessary to create, preserve, and augment competence in practice is their purpose. In addition to their values and purpose, the organization has outlined their desired outcomes. These include: more interaction and commitment of members to ANNA; more diversity in age, race, and gender, as well as professional levels and subspecialties. The ANNA believes that nephrology nurses are in a unique position to enhance the quality of care delivered to individuals living with kidney disease. The organization offers continuing education, with a focus on nephrology, in hopes of creating a larger impact on the care of these individuals. The ANNA believes that continuing education is essential to the development, maintenance, and augmentation of competence in practice. As well as, a team-based approach and inter-professional collaboration as the basis of

According to Porter-O’Grady, 2016 et al p 324, our healthcare systems today are at the center of what is considered major change. Much of the change today is directly related to the foundational principles, concepts and associated with complexity in systems and relationships, and an understanding by nurse leader and

Cetiner is the primary nurse for four dialysis patients. She tends to all of their complex needs as she strives to improve their outcomes. She delivers care in a manner that preserves patient autonomy, dignity and rights. This is evidenced by all four patients exceeding unit/network benchmarks in adequacy, access and anemia management. She became an advocate for a Veteran who lives in a nursing home and has no family, resulting in improvement of care. She diligently worked with one Veteran to avoid multiple hospital admission for fluid overload. She developed a treatment program along with the Medical Director to manage the patient’s fluid both during and after the hemodialysis treatment. She has provided much support to one of the Veterans with many socioeconomic issues ultimately affecting his treatment. Because of her due diligence with his non- compliance he now stays for his entire treatment on a regular basis

Ms. Conlon applies the nursing process to systems or processes at the unit/team/work group level to improve care. Deirdre has been the primary nurse for 6 hemodialysis patients. She has involved patients and families in monthly interdisciplinary meetings to promote self-efficacy and quality of life. With the help of the interdisciplinary team Deirdre has worked collaboratively to address and reinforce nutritional needs, social/family issues, barriers to care, and safety concerns. All of her primary care patients have maintained a goal of 100% for dialysis adequacy (benchmark is 85%) and a vascular access rate of 100% and dictated by KDOQI standards.

Overview In the past few years there has been increasing discussion about how to provide adequate care for the increasing number of veterasn who are eligible for care through the Veterans’ healthcare administration (VHA). There are concerns is that the VHA is not providing the level of access, efficiency, and quality of care that veterans expect. Lee & Begley, (2016) suggest access to care for the veteran population may be resulting in poor health outcomes. In response to these concerns, the Veterans ' Access to Care through Choice, Accountability, and Transparency Act (VACAA) of 2014, also known as the Veterans Choice Act, was created to improve Veterans’ healthcare. The VACAA proposed to do this by expanding the number of options veterans have for receiving healthcare, by providing access for healthcare at non-VA care centers as well as providing for an increase in staffing at VA facilities (U. S. Department of Veterans Affairs, 2016).

Data released in October 2014 indicated an average wait time of approximately 50 days for new primary care appointments, with a range of 2 to 122 days across all VA/VHA facilities (VA, 2014c). The OIG found that VHA was not meeting the outline standards, forcing some veterans to wait as many as 60 days for an initial evaluation. This caused a great setback in meeting the measurements set forth by OIG and caused a hindrance on veterans who have returned home from war and dealing with physical and mental health aliments and disabilities. The research study will be conducted to examine the circumstances preventing veterans from receiving new patient appointments in a timely matter. Since 2012, this researcher has witnessed the VA make great efforts to implement recommendations from OIG, however, the shortage of (1) healthcare provider availability, staffing, and (2) scheduling practices with out-of-date technology continues to cause delay in effective

Introduction The Department of Veterans Affairs (VA) FY 2014-2020 Strategic Plan, outlined the strategic goal to “Manage and improve VA operations to deliver seamless and integrated support” and established the objective to “Enhance Productivity and Improve the Efficiency of the Provision of Veterans Benefits and Services.” The MyVA Plan outlines the need to “Modernize VA’s culture, processes, and capabilities that put the needs, expectations and interests of Veterans and their families first.” To this end, the Veterans Benefits Administration must view operations through this lens and determine how to achieve this noble vision.

My name is Technical Sergeant Travis Sandlin, I am writing on behalf of my father and every veteran that utilizes VA hospitals. Through trial and error it has come to our attention that the existing method and management of patient records is ineffective, unorganized, and outdated. A well-designed automated system

A positive force for change centers on the nurse’s strong desire to change current practices. The combination of the turnover rate, low morale, and higher percentage of new nurses, is the driving

Running head: PROFESSIONAL WRITING WILSON N432 The Future of Nurse Practitioners Lakeisha C. Wilson University of Mississippi Medical Center School of Nursing PROFESSIONAL WRITING WILSON N432 The Future of Nurse Practitioners As the largest group of health care professionals, nurses hold the key to effective health care system change. Without the nurses and their leadership skills and expertise, we know that the efforts to address the challenges facing the healthcare system will be in vain. So much of what nurses do directly addresses health care reform goals concerning better quality care for more people at a lower cost. Throughout the years nurses have made a tremendous effort to reduce the rates of medical errors,

Physiologic Stress and Illness in Combat Veterans There is a bidirectional relationship that exists between physiologic stress and a higher incidence of illness in combat veterans. There are several factors contributing to this including anxiety, anger, and depression. These constant physiologic stressors put additional strain on the body, which increase cardiovascular

Organizational Behavior Analysis Brief Description and History of the Organization DaVita Dialysis Center was founded in 1999, with the goal to develop programs to enrich lives. It was originally called Total Renal Care (TRC), but during its restructure it was renamed with the term, DaVita, Italian for “giving life.” CEO, Kent Thiry saved the company from the brink of bankruptcy through his leadership style. The corporate headquarters were originally in El Segundo, California, but were moved to Denver, Colorado. Today, it has grown to be an organization with over 53,000 teammates around the nation. The company has expanded to 2,251 outpatient dialysis centers in the United States and 118 outpatient dialysis centers in 10 foreign countries. It treats patients with acute kidney failure, chronic kidney failure, and end stage renal disease. The company’s core values are accountability, continuous improvement, fulfillment, fun, integrity, service excellence, and team. The core values are integrated in the organization’s vision for leadership to stress collaboration and a team-based environment. Teammates feel an emotional level of trust and mutual commitment.

It is with great concern that I ask all of you to do a better job of managing your employees to help achieve the company’s goal of transforming health care. Although there are KC-based employees who are committed to the success of the company, it is your responsibility as managers to ensure all workers work together as a team towards a single organizational goal. While I leave you to decide on how to implement the change within your groups, I expect to see outcomes within two weeks. Since you are in charge of your employees, I will hold you accountable at the end of the said

Specific Objectives The group will able to; * Define dialysis * Describe the history of dialysis * Explain the principles of dialysis * Enumerate the indication of dialysis * Explain details about hemodialysis * Describe details about peritoneal dialysis * List down the Psychosocial Issues In ESRD Patients * Dietary Management Dialysis Patient * Nursing Responsibilities Introduction The introduction of dialysis as a lifesaving treatment for kidney failure was not the result for any large scale research