After studying Module 3: Lecture Materials & Resources, discuss the following:
Describe and discuss the pathological conditions that might affect the sexual responses in older adults.
How and why do you think Nutritional factors, psychological factors, drugs and complementary and alternative medications affect the immune system in older adults.
Submission Instructions:
Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.
Chapter 14
Infection and Inflammation
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Infection is one of the 10 most common causes of death in older adults.
The presentation of infections in older adults is often masked, which can lead to delayed treatment.
The immune system enables the body to defend itself against disease-causing microorganisms and other foreign bodies.
With aging the immune system exhibits a diminished ability to provide such protection.
Introduction
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For infection to occur, there must be a reservoir of an infectious disease, a portal of entry, and a susceptible host.
Source may be a persons own microbial flora (endogenous) or something in the environment (exogenous).
Nosocomial infections: acquired in the hospital
Community acquired: acquired outside the health care facility
The Chain of Infection
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Changes in both cell-mediated and antibody-mediated immune response
Atrophy of the thymus
Diminished cellular (T cellmediated) and humoral (B-lymphocyte) immunity
Production of autoantibodies increases
Skin becomes more fragile and prone to breakdown or abrasion.
Age-Related Changes in the
Immune System
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4
Nutritional factors
Malnutrition
Iron and trace element deficiency
Psychosocial factors
Depression
Drugs
Complementary and alternative medications
Factors Affecting Immunocompetence
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5
Every adult over the age of 65 should receive the influenza vaccination annually.
Community-acquired pneumonia is caused by multiple pathogens.
Pneumococcal vaccine is recommended for everyone over the age of 65.
Infection control measures help to reduce the risk of illness.
Many older adults present with atypical or diminished signs and symptoms.
Influenza and Pneumonia
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Neoplasms occur with greater frequency in older adults.
Common types include lung cancer, breast cancer, and prostate cancer.
Presence of the cancer reveals presence of decreased immune response.
Cancer and cancer treatment can induce additional immune deficits.
Cancer
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Symptoms: extreme fatigue, painful or swollen joints, unexplained fever, skin rashes, and kidney problems
Management objective is to control the severity of symptoms and prevent a flare.
Avoiding the sun, exercising, complying with drugs, limiting stress, and having regular health care visits
Systemic Lupus Erythematosus
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8
Inflammatory polyarthritis of unknown cause
Symptoms: morning stiffness lasting for hours, tenderness, pain on motion, limited range of motion, and joint deformity in the small joints of the hands and feet
Treatment: physical therapy, first-line drugs for RA are nonsteroidal antiinflammatory drugs (NSAIDs), second-line drugs are known as disease-modifying antirheumatic drugs (DMARDs)
Rheumatoid Arthritis
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9
Underrecognized problem among the older adult population: 31% of persons living with HIV and 17% of newly diagnosed cases are in those over the age of 50
The low clinical suspicion of HIV infection and delayed recognition of AIDS-defining infections contribute to the poor prognosis of HIV infection in older adults.
In older adults there is only a short interval from HIV infection to the development of AIDS and death.
Sex education, the use of condoms, and how and when to take an HIV test should be taught to older adults.
HIV in Older Adults
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10
Nosocomial pathogen transmitted person to person, primarily from the hands of health care workers
Occurs when organism is present and normal flora of bowel are disturbed
The hallmark diarrhea is caused by a motility-altering factor that stimulates muscle contractions.
Consistent hand washing between contacts with patients and the use of gloves when handling body substances such as feces
Treatment: discontinue current antibiotic therapy, then treatment with oral vancomycin or fidaxomicin
Clostridium difficile
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Risk factors: age more than 65 years, antimicrobial therapy, chronic renal failure, serious illness, and prolonged hospitalization
Transmitted person to person via hands of health care workers
Dedicated equipment, private rooms, and barrier precautions
Symptomatic patients should be treated with antibiotics indicated through culture and sensitivity.
Vancomycin-Resistant
Enterococcus (VRE)
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Transmitted patient to patient via hands of health care workers
Risk factors: insulin-dependent diabetes mellitus, chronic hemodialysis, illicit intravenous drug use, prolonged hospitalization, prolonged antibiotic therapy, stays in the intensive care unit, burn unit, or with an infected patient
Private room and barrier protection
Symptomatic patients should be treated with antibiotics indicated through culture and sensitivity.
Methicillin-Resistant Staphylococcus Aureus (MRSA)
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May not exhibit classic symptoms of infection
Fevertemperature increase may be limited, or no increase may occur at all, so low-grade fever must be taken seriously.
Changes in the behavior: increased malaise or fatigue, combined with other symptoms may indicate the onset of infection.
Fever and inflammation may be reduced, whereas the white blood cell (WBC) count may still reflect an increased value.
History of infections, current disease processes, and medications especially antiinflammatory and immunosuppressant drugs
Infection Nursing Management: Assessment
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14
The risk factors determined during the assessment indicate potential nursing diagnoses
Inadequate nutrition
Potential for infection
Need for health teaching due to knowledge deficits of immunizations, nutrition, or protection against infection from oneself or others
Reduced social interaction associated with infection and immune status
Infection Nursing Management: Diagnosis
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15
The nurse just admitted an older adult with new onset confusion and cough. The family states that the condition came on suddenly. The nurse completes a history and physical assessment on the patient. Discuss the following assessment findings, and state whether or not they are significant and why.
1. History of RA and taking low-dose prednisone
2. White blood cell count is 8.9.
3. Lives in a senior house and dines with other residents
4. Temperature is 99.8F.
5. Last pneumonia vaccine was 5 years ago.
Quick Quiz!
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ANS:
1. History of RA and taking low-dose prednisone
Immune function is already compromised by rheumatoid arthritis and steroids.
2. White blood cell count is 8.9.
Older adults may not have elevated WBC when infection is present.
Answer to Quick Quiz (1 of 2)
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3. Lives in a senior house and dines with other residents
Living in close quarters with others puts older adults at risk for infectious disease.
4. Temperature is 99.8F.
Fever may not be present.
5. Last pneumonia vaccine was 5 years ago.
Pneumonia vaccine should be administered every 5 years in patients with chronic illness.
Answer to Quick Quiz (2 of 2)
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18
The patient with increased risk for infection will:
Avoiding primary or secondary infection
Maintaining or improving immune status
The patient will do the following:
Increase knowledge in areas related to infection prevention, maintenance of immune status, and health practices
Consumes a well-balanced, high-caloric diet on daily basis
Performs self-care activities with minimum energy expenditure and risk of injury
Infection Nursing Management: Planning and Expected Outcomes
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19
Prevent exposure to infections
Enhance immune system to enable patients to better resist infections
Optimum nutritional status is important.
Resolve detected deficiencies
Meals on wheels, assistance with food preparation, or ability to visit a senior center nutrition site
Nursing Interventions
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20
Based on patients responses in meeting their goals and outcomes
One standard for evaluation is whether a patient contracts an infection.
Evaluation
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21 Chapter 10
Sleep and Activity
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Regulation of sleep and wakefulness occurs primarily in the hypothalamus.
Sleep is a state of consciousness characterized by the physiologic changes of reduced blood pressure, pulse rate, and respiratory rate along with a decreased response to external stimuli.
Biologic Brain Functions and Sleep
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2
Sleep begins with the four stages of non-REM sleep, continues with a period of REM sleep, and then cycles through non-REM and REM stages of sleep for the rest of the night.
Variations in the REM and non-REM sleep stages occur with advancing age.
REM sleep is interrupted by more frequent nocturnal awakenings, and the total amount of REM sleep is reduced.
The amount of stage 1 sleep is increased, and stage 3 sleep and stage 4 sleep are less deep.
Stages of Sleep and
the Older Adult
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The sleep-wake cycle follows a circadian rhythm, which is roughly a 24-hour period.
The decrease in nighttime sleep and the increase in daytime napping that accompanies normal aging may result from changes in the circadian aspect of sleep regulation.
Sleep and Circadian Rhythm
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Difficulty falling asleep, difficulty staying asleep, frequent nocturnal awakenings, early morning awakening, and daytime somnolence
May be transient, short term, or chronic
Affects the older adults quality of life with excessive daytime sleepiness, attention and memory problems, depressed mood, nighttime falls, and possible overuse of hypnotic or over-the-counter medications
Insomnia
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Insomnia: the inability to sleep
5
Increased sleep latency, reduced sleep efficiency, nocturnal awakenings, increased early morning awakenings, and increased daytime sleepiness
Older adults awaken four or more times a night.
Daytime napping is common.
Daytime sleepiness may suggest underlying disease.
Other sleep changes are associated with chronic disease and other health problems.
Age-Related Changes in Sleep
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Environment
Pain
Lifestyle
Dietary influences
Medication use and medical conditions
Depression and dementia
Factors Affecting Sleep
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7
Schedule procedures and care activities to avoid unnecessary awakenings, modify environmental factors to promote a quiet, warm, relaxed sleep setting, and orientate older adults to the institutional setting.
Reduce noise: close doors, lower voices.
Reduce bright lighting at night.
Temperature: warmer is better than colder.
Nonpharmacologic and pharmacologic measures may be used to relieve pain.
Nursing Interventions for
Sleep Environment
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8
Loss of spouse
Retirement
Relocation
Having a roommate in long-term care facilities
Dietary influences
Depression
Dementia
Lifestyle Changes Affecting Sleep
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9
Sleep is influenced by what we eat and drink.
9
Which of the following are true statements about sleep in the older adult? (Select all that apply.)
Reduced REM sleep causes irritability or anxiety the next day.
Insomnia leads to an increase in daytime falls.
Older adults commonly take naps during the day.
Cooler temperature at night is better for sleeping.
Acute or chronic pain interferes with falling asleep.
Quick Quiz!
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10
ANS: A, C, E
Answer to Quick Quiz
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11
Recurrent episodes of cessation of respiration
Apneic episodes may last from 10 seconds to 2 minutes and range from 10 to 100 per hour of sleep.
Three types: central sleep apnea (CSA), obstructive sleep apnea (OSA), and complex sleep apnea
OSA most common in older adults
Sleep Apnea
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12
Due to complete or partial airway obstruction that blocks air flow increasing respiratory efforts
Risk factors: obesity, short or thick neck, jaw deformities, large tonsils, tongue or uvula, narrow airway, deviated septum, smoking, hypertension, and cardiac disease
Symptoms: daytime fatigue; waking with a headache and sore throat or dry mouth, and confusion; trouble concentrating and irritability; and sexual dysfunction
Treatment weight loss, positioning on side, CPAP, mandibular advancement devices and surgery
OSA
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Repetitive kicking leg movements throughout the night
May occur every 590 seconds and each kick causes a brief disruption of sleep.
Report insomnia and excessive daytime sleepiness
Treatments: Drugs such as dopamine agonists and eliminate caffeine-containing products
Periodic Limb Movement in Sleep
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14
Patients report of his or her sleep pattern and sleep-related problems
Determine quality and quantity of sleep.
Review the number of nocturnal awakenings and length of time awake at night.
Typical bedtime rituals or practices
Daytime sleepiness or a strong desire to nap
Assess consumption of alcohol, caffeinated beverages, sedative-hypnotics, OTC drugs, and other practices before bedtime.
Components of the Sleep History
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15
Sleep diary
Sleep laboratory
Epworth Sleepiness Scale (ESS)
Pittsburgh Sleep Quality Index
Further Assessment of Sleep
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Stable schedules and bedtime routines, a sleep-friendly environment, avoidance of any substances that would interfere with sleep, regular exercise (but not immediately before trying to sleep), and stress reduction
Nonpharmacologic interventions: relaxation therapies, stimulus control therapy, and sleep restriction therapy and cognitive behavioral therapy
Drug therapy may be necessary for a short time no more than one or two weeks.
Sleep Hygiene
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17
Routine daily activities, diversional activities, and physical exercise
Changes occur in the activities pursued by older adults as they age or experience acute or chronic illness.
Physical exercise has health-promoting benefits for all older adults.
Activity and Older Adults
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Activities that once were accomplished with ease may require modified approaches or the assistance of others.
Modification of routines and use of assistive devices help maintain independence.
Family members, friends, or paid caregivers may help with shopping and other tasks.
Dependency in basic ADLs increases the risk of relocation to a long-term care facility or to the home of a family member.
Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs)
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Important to maintain health, preserve the ability to perform ADLs, and improve the general quality of life
Prevents of heart disease, reduces elevated blood pressure and risk of osteoporosis, promotes appropriate weight and more restful sleep
Preserves mobility and reduces the risk of falls by promoting muscle strength and joint flexibility
Physical Exercise
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Moderate-intensity aerobic exercise for 150 minutes a week
Drink water before and after exercise
Clothing should allow for easy movement and perspiration.
Athletic shoes should provide both support and protection.
Outdoor exercise should be avoided in extremely hot or extremely cold weather.
Stop exercising and seek help for chest pain or tightness, shortness of breath, dizziness or lightheadedness, or palpitations during exercise
Physical Exercise Tips
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Retirement, relocation, and the loss of a spouse
Alzheimers disease, when it progresses, cognitive impairment increases, which adversely affects the ability to initiate and participate in routine daily activities
Older adult with advancing dementia also loses the ability to initiate diversional activities and to participate in activities that were once enjoyed.
Lifestyle Changes that
Affect Activity
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22
Activities should be meaningful, have a purpose, and foster a sense of well-being for the participants.
Physical exercise is important for general physical well-being.
Exercise may reduce agitation or wandering.
Rhythmic movement of a rocking chair may reduce agitation.
Going for a walk may redirect the impulse to wander.
Activities that tap into the older adults past life experiences and interests may stimulate memory.
Activity and Alzheimers Disease and Other Dementias
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23 Chapter 11
Safety
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The leading cause of fatal and noninjuries in older adults
Results in higher rates of morbidity and mortality among those older than 75 because of the higher incidence of frailty and a limited physiologic reserve
Leading cause of hip fractures
Education is the cornerstone of fall prevention and management.
Falls
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Older individuals may not perceive a slip that results in a fall to the floor to be an actual fall; rather it may be termed a slip, trip, or accident, but not a fall.
Anything that causes a person to unintentionally move from one level plane to another
Definition of Falling
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3
Is a concept that holds negative connotations because it is associated with a decline, drop, or descent to a lower level
Involves several related variables and most likely is determined according to an individual perception of how serious the fall is in terms of daily living
The health care professional may equate a fall with a decline in patient health or function or a worsening of a patients condition
Meaning of Falling to Older Adults
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Visiondepth perception, problems with glare
Hearingdecrease in directional hearing, hearing loss
Cardiovascularorthostatic hypotension
Musculoskeletalosteoarthritis, muscle weakness, reduction in steppage height, which may increase risk for tripping
Neurologicslowed reaction time
Normal Age-Related Changes That Contribute to Falling
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5
Is not determined solely on the basis of number and kind of diseases, but on how risk factors influence areas of mobility, transferring, and negotiating within the environment
Best determined by observation of mobility
Risk categorized according to intrinsic (illness or disease-related) or extrinsic (environmental) risk
Research has shown that the individual with frailty and physical functional limitations is at greatest risk for falling.
Fall Risk
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6
Combined effect of normal age-related changes and concurrent disease
Relates to gait, balance, stability, and cognition
Intrinsic Fall Risk
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7
Environmental hazards, both indoors and outdoors
Steps
Floor surfaces
Edges and curbs
Lighting
Grab rails
Extrinsic Fall Risk
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8
Hip fractures, head trauma, and internal bleeding affect a small percentage of older individuals who fall.
High mortality rate associated with hip fractures
Physical restraints can increase risk and should never be used.
Injury by attempting to remove the restraints: strangulation and asphyxiation
Elevation of both side rails can cause falls from attempts to climb over side rails.
Risk for Serious Injury
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9
Behavior modification requires older patients to recognize behaviors that are contributing to problem and then to make conscious attempts, whenever a behavior is performed, to change or alter it.
Teaching patients with osteoporosis the ways to incorporate calcium-rich foods in their diet on a daily basis, and about the risk factors for the development of osteoporosis
Identify and treat causes of delirium
Reducing the Risk for
Serious Injury
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10
Isolated falling: one-time event that was most likely purely accidental
Cluster falls: observed among individuals with specific diseases who decompensate
Premonitory falls: produced by specific medical illnesses, e.g., new onset seizures
Prodromal falling: onset of frequent falling heralding an acute medical problem
Intentional falls: fall on purpose, possibly with a desire to do harm
Fall Classification
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Physical injury ranges from trivial traumaskin tears and sprains to serious injury-hip fractures, internal bleeding, or subdural hematomas.
Osteoporosisserious injury
Psychological trauma like post fall trauma is influenced by to personality changes, depression, anxiety, and stress-related syndromes.
Fear of falling interferes with activity and fosters dependence
Fall Consequences
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12
The nurse is caring for an older adult patient who was admitted for pneumonia. The nurse institutes fall precautions based on which of the following assessments? (Select all that apply.)
The patient has rheumatoid arthritis.
The patient fell at home last month.
The patient is hard of hearing.
The patient uses the call light frequently.
The patient is taking antihypertensives twice a day.
Quick Quiz!
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13
ANS: B, C, D
Answer to Quick Quiz
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14
Historythe acronym SPLATT can help evaluate:
Symptoms at the time of the fall
Previous fall
Location of the fall
Activity at the time of the fall
Time of the fall
Trauma post fall
Physical examfocused examination based on the patients presenting complaints, also sensory, cardiovascular, musculoskeletal, and neurologic systems
Evaluation After a Fall
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15
Sternal nudge
Tinetti assessment tool for balance
The timed up and go (TUG)
Special Testing for Gait and Balance
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Goals: identify the underlying cause, reduce the incidence of recurrent falls, and prevent serious injury
Fall diary
Bed or chair alarms
Video surveillance cameras
Safety belts in wheelchairs and the lap buddy
Injury epidemiology
Nursing Management of Falls
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17
Examples of burn Injuries:
Burns, cigarette smoking, fireplace hazards, kitchen hazards, space heaters
Examples of nonburn Injuries:
Carbon monoxide poisoning, chemical injuries, cooling fans, food-borne illnesses
Safety and the Home Environment
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Core body temperature of less than 95F
Risk factors
Clinical manifestationsfatigue, apathy, confusion, lethargy, shivering, numbness, slurred speech, impaired coordination, and possible coma
Managementsponge baths with cool water, fans to circulate cool air, decreasing the room temperature, placing ice packs on the groin and axilla, and cooling blanket
Hypothermia
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Core body temperature greater than 105F
Risk factors
Clinical manifestationsanhidrosis, confusion to coma; hallucinations, combativeness, bizarre behaviors, and syncope
Managementpassive external rewarming with blankets for mild; active core rewarming with IV fluids for moderate to severe
Hyperthermia
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20
60% of those who suffered medical problems or died during Hurricane Katrina were frail older adults (AARP, 2013)
We Can Do Better; Lessons Learned for Protecting Older People in Disasters and Recommendations for Best Practices in the Management of Elderly Disaster Victims
Disasters
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21
Storage of medications at home can become a safety and drug-effectiveness issue
Most drugs degrade when left in direct sunlight, with or without excessive heat
Appropriately dispose of all outdated prescriptions when new ones are written
Proper disposal of used wound dressings and needles or syringes
Storage of Medications and Health Care Supplies in the Home
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22
Fear of crime reduces subjective well-being.
Neighborhood strategies to protect older adults living alone
Daily telephone calls to specific persons on a call list
Raising and lowering window shades or curtains at specific times of the day and evening, which will be monitored by a specific person
Mail carrier alerts when mail is not picked up daily from mailboxes of enrolled older persons
Living Alone
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Maintaining independence includes the ability to travel to shopping centers and health care providers offices, to visit family and friends, and to participate in recreational activities.
A decline in an older adults ability to drive safely may result in the loss of driving privileges.
Driving evaluations are essential for older adults with suspected dementia.
Traffic sign identification test
Automobile Safety
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24
Vertigo
Seizure disorders
Stroke sequelae
Macular degeneration or retinal hemorrhage
Unstable cardiac arrhythmias
Disorders That Adversely Affect
Driving Ability
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25
A scale to rate the potential for abuse or neglect helps nursing personnel become aware of the incidence and prevalence.
Older persons with physical or mental frailties are more vulnerable to abuse and neglect than are independent older adults.
Need for assistance with basic ADLs may overstress the caregivers.
Stress and strain of caregiving tasks is often the cause for initial abuse or neglect.
Abuse and Neglect
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Neglect
Psychological or emotional abuse
Financial abuse or exploitation
Physical abuse
Sexual abuse
Abandonment
In 90% of abuse and neglect cases, a family member is identified as the perpetrator.
Six Areas of Abuse or Neglect
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Firearms are associated with high rates of suicide among older men and women.
Age group with the highest rate of successful suicide attempts with firearms is persons age 80 or older.
Dangers of firearms include the potential for accidental injury during weapon cleaning and handling.
Risk of a criminal entering a home and taking the weapon away from an older person with fatal consequences
Firearms
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28 Chapter 12
Sexuality and Aging
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1
Sexuality is an important part of health, general well-being, and quality of life.
Sexuality includes various types of intimate activity, as well as the sexual knowledge, beliefs, attitudes, and values of individuals.
Nurses play a key role in the assessment of changes related to aging, disabling medical conditions and drugs, and can intervene at an early point to enhance sexuality.
Older Adults Sexual Needs
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2
Sexuality is a central aspect of being human throughout life and encompasses sex, gender identities and roles, sexual orientation, eroticism, pleasure, intimacy, and reproduction is experienced and expressed in thoughts, fantasies, desires, beliefs, attitudes, values, behaviors, practices, roles, and relationships . Sexuality is influenced by the interaction of biologic, psychological, social, economic, political, cultural, ethical, legal, historical, religious, and spiritual factors
The World Health Organizations
View on Sexuality
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3
Despite evidence supporting not only the need for, but the importance of, sexual expression in older adults, health care professionals carry out few interventions to facilitate expressions of sexuality.
Benefits of sexual expression include increased happiness, energy, and relaxation, decreased pain, improved cardiovascular health, decreased depressive symptoms, increased self-esteem, and improved satisfaction with relationships.
Sexual Expression
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Society regards sexuality in older adults as undignified.
Nurses often share societys ageist beliefs about the asexuality of older adults, which may lead to nurses discouraging sexual activity.
Older adults may face difficulties with sexual expression.
Because of discomfort, myths, ageism, and lack of training in sexual health, problems with newly developed or chronic sexual dysfunction are ignored.
Barriers to Sexual Expression
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5
The orgasm response changes in both sexes.
Reduced availability of sex hormones results in less rapid and less extreme vascular responses to sexual arousal.
Erectile dysfunction
Sexual dysfunction in older women encompasses loss of sexual desire, problems with arousal, inability to achieve orgasm, and painful intercourse.
Normal Changes of the
Aging Sexual Response
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6
Changes in the genitourinary tract related to menopause
Genital symptoms include: dryness, burning, and irritation
Sexual symptoms include: decreased lubrication, thinning of the vaginal wall, decreased elasticity and vaginal rugae, leading to pain, and bleeding during intercourse
Urinary symptoms include: urgency, dysuria, and recurrent urinary tract infections
Genitourinary Syndrome of Menopause
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7
Illness, surgery, and medication
Human immunodeficiency virus45% of age 55 years and older account for adults with HIV; are likely to be diagnosed late in disease, experience progression more quickly, and die sooner after diagnosis than younger adults
Malignanciesbreast, prostate, colon cancer
Dementiachanges in cognition and judgment occur, can cause either a decrease in sexuality, or sexual disinhibition
Conditions Affecting
Sexual Responses
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8
These adults long for physical closeness and seek out physical touch but their intentions may be misinterpreted as sexual in nature
May express sexually disinhibited behaviors, which include sexually explicit or suggestive language, exhibitionism, repeated attempts to have sex or aggressive sexual demands
Nonpharmacological in
SHOW MORE…
strategic management
2
Recommendations
Name Student
Institution Affiliation
Course Title
Instructors Name
Date of Submission
Summary
Advocates for the rights of the Asian immigrant and refugee communities to get health care services. Serving the people of their community and providing the care they need may become a financial burden for AHS due to the advocacy and provision of care included in its mission statement. Inadequate financing threatens to derail the AHS system. Adding new technology, providing new services, hiring and retaining medical professionals in an era when they are being offered more money by for-profit organizations and those who are bilingual as well as multilingual to accommodate the community’s growing population are all made more difficult by a lack of funding (Chung & Chin, n.d.). When the Affordable Care Act was finally enacted, financing became a major concern because of all the additional programs that had to be added to the AHS’s budget. When a non-profit, we also lacked the resources to aid this community as its demographics shifted due to a combination of factors, including the aging and departure of some long-time residents and the arrival of new immigrants. The AHS understood that patients should always come first, and that community advocacy was essential to finding solutions to these difficulties (Asian Health Services, 2017).
Manager
Healthcare managers are crucial to any business because of the role they play in strategic problem-solving. AHS’s healthcare administrators need a long-term strategy for allocating scarce resources to their most pressing needs: their patients and their employees. The need for a multilingual and bicultural staff cannot be overstated. Healthcare administrators must staff each division with a speaker of one of the eleven Asian languages likely to be spoken by patients. Hire people who are fluent in more than one language; this should be a standard practice. Managers in the healthcare industry play a crucial role in both keeping existing employees and bringing in new ones (Asian Health Services, 2017). Profitable businesses can afford to pay their employees more, but effective communication also plays a major impact. A wonderful work culture may be established by simply listening to employees, considering their input, and encouraging teamwork (Asian Health Services, n.d. ).
Managers in the healthcare industry may utilize strategic planning to innovate new patient and community-oriented services. The community and the people they serve will benefit from the addition of additional services, and the government will provide more money to support the expansion of existing programs. Regarding the ACA, hospital administrators should provide all medical staff members sufficient EHR training. Better charting, assistance with treatment in between office visits, reimbursement, and regulatory rules for ACA compliance may all be achieved with properly trained staff (Chung & Chin, n.d.).
Driving
The American Hospital Association has a number of groups with a vested interest in the organization’s success, such as a staff union and patients (who make up “more than half of the board members,” giving them a formal voice in determining AHS’s priorities and strategies) (Chung & Chin, n.d.). To further advocate for its members and the local community, AHS also engaged with community leaders. Different internal and external stakeholders have various needs and requirements, and their input shapes both current and future organizational strategies. One way to get key stakeholders engaged in strategic planning is to provide them with a variety of services they’ll find useful. Undoubtedly, not everyone will care about every single one of AHS’s strategic plans under development, but some of them will. It’s helpful to get them engaged and make them feel wanted by holding open meetings and encourage them to attend. In order to get people interested in AHS, it will need to pique their attention and perhaps live up to their expectations (Asian Health Services, n.d. ).
Better align
AHS is making concerted efforts to harmonize its strategic planning and policymaking with its stated goals and objectives. Hirota “showed via her thinking and decades of labor at AHS that AHS had to be handled not merely as a non-profit bleeding-heart enterprise, but also as an innovative business” (Asian Health Services, 2017). Customers come first, but “ensuring the maximum degree of stratification” is also crucial to a company’s success (Asian Health Services, 2017). AHS recognizes the importance of addressing not just the medical requirements of its patients, but also the social problems that may have an impact on them. The most pressing need is for translators to bridge the communication gap between the Asian population and the rest of the world. With its advocacy activities, AHS is actively working for safer streets and “pressing the government to adequately regulate occupational chemical exposures inside nail salons” (Asian Health Services, 2017). Clinic updates and new technologies are also part of the organization’s plans. My one piece of advice for AHS is to set up a division staffed by case managers who interact directly with patients and are therefore better equipped to represent their interests and those of the community at large. This has the potential to enhance AHS’s interaction with the people they serve.
References
Asian Health Services. (n.d.). Retrieved from Rediscovering a Blue Ocean:
https://learn.snhu.edu/d2l/lor/viewer/viewFile.d2lfile/301243/23322,1/
Asian Health Services. (2017). Our Mission.
Chung, K. & Chin, W. N. (n.d.) Asian Health Services: Rediscovering a Blue Ocean. Retrieved from
https://learn.snhu.edu/d2l/lor/viewer/viewFile.d2lfile/636747/23322,1/