NRSG 312 Unit 3 – Individual Project

NRSG 312 Unit 3 – Individual Project 

NRSG 312 Unit 3 – Individual Project 

Introduction

Universal health care is one of the policies of ensuring equitable access to healthcare. Certain barriers exist that impede access and utilization of health services by the vulnerable population owing to various undermining factors. The provision of health education and other targeted health preventive services and interventions to high-risk vulnerable populations is integral in meeting healthcare needs and addressing existing healthcare disparities (Amboree et al., 2022). This paper will focus on elderly individuals especially those admitted to nursing homes as the vulnerable population of choice. The aspects that will be touched on will include the description and attributes of this population, an associated community agency with the services offered, interprofessional collaboration, and the role of the agency in promoting educational interventions to the high-risk vulnerable population. An evidence-based COVID-19-related community-based education intervention will also be proposed with the effectiveness and expected impact on health outcomes elaborated.

The Vulnerable Population

The social determinants of health are essential factors that determine the health vulnerability status of a particular population. The vulnerable population comprises a group of individuals with a higher predisposition to poor physical, psychological, and social health outcomes and inadequate access to healthcare services (de Groot et al., 2019). Some of the factors that contribute to the vulnerability status include low socioeconomic status, racial or ethnic minority, age, and insurance coverage status among others (Amboree et al., 2022). This population is deprived of their right to health and thus measures should be adopted to protect and serve the health needs of this population while cushioning them from adverse health risks and outcomes stemming from their vulnerability.

Features of the Vulnerable Population

Various factors determine and contribute to the vulnerability of a population. These include inadequate access to primary care services, unemployment, poor economy, inadequate insurance, low education level, low health literacy, and other social, political, environmental, and health factors (Bhatt et al., 2019). Other individual attributes such as one’s gender, age, ethnicity, culture, religion, and linguistic inclination may also contribute to challenges in accessing high-quality healthcare. Identification of the vulnerable population, especially within the healthcare setting is key in ensuring that targeted interventions are delivered in conformity with the needs and preferences of all patients regardless of their vulnerability status.

Demographic Information about the Vulnerable Population

Nursing homes offer acute and long-term care to individuals who fall within the vulnerable population. These individuals have specific demographic and other characteristics that meet the placement requirements. These include advanced age, low education level, living alone, lack of homecare services, inadequate social support, being a tenant rather than owning a house, poor self-rated health, functional impairment, cognitive impairment, polypharmacy from various comorbidities, and previous admissions (Stolz et., 2019). Severe illness with consequent clinical impairment, low socioeconomic status, and female gender are also associated with increased chances of being placed in a nursing home. The limited resources in most nursing homes exacerbate the vulnerability of the older population receiving nursing home services. Situations that necessitate resource-intensive interventions such as public health emergencies like the COVID-19 pandemic may have adverse implications on the health outcomes of individuals in these facilities.

Community Agency Serving the Vulnerable Population

The elderly population has various complex medical and non-medical social needs. Home and community-based support agencies can adequately address some of these needs. One such organization is the Medicaid home and community-based services organization. Home and community-based services enable elderly individuals to stay and be cared for at home with reduced need for long-term institutionalization in facilities such as nursing homes (Norman et al., 2018). This organization coordinates the care and support of elderly people in collaboration with other home-based primary care providers. This ensures an enhanced quality of life and better general health outcomes. Additional information on this organization was obtained from an interaction with the deputy director.

Services Provided by the Community Agency

There are various services provided and supported by Medicaid home and community-based service organizations. These include home-based nursing health services, medical and non-medical transport services, respite care, provision of wheelchairs, nutritional support, subsidized housing, and assistive technology (McLean et al., 2020). Other geriatric needs that are supported are personal care, activities of daily living, caregiver training, service application and referrals, patient follow-ups, and treatment recommendations adherence (Norman et al., 2018). The adoption of telehealth approaches to care delivery has been beneficial, especially in bridging gaps in access to support services in the context of the COVID-19 pandemic. Barriers to adequate utilization of home and community-based services should be addressed to ensure continuity of care, especially for elderly individuals requiring long-term support. The eligibility requirements should be inclusive of all elderly individuals for better coverage.

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Interprofessional Collaboration with the Community Organization

Interprofessional collaboration among community service providers and other stakeholders such as the healthcare teams is pivotal in the care of the elderly population. The expected benefits include optimization of cohesive care service delivery, improved holistic high-quality geriatric care, better continuity of care with reduced fragmentation, and better resource efficiency (Moncatar et al., 2021). Shared decision-making and engagement will also result in satisfaction and better outcomes from synergistic expertise and skills. Collaboration between primary healthcare providers and community-based providers will foster good transition care to prevent preventable frequent geriatric readmissions. Barriers to collaborative efforts such as limited organizational resources, inadequate communication, and interprofessional distrust should be addressed with sustainable solutions.

Strategies by the Agency to Facilitate the Delivery of a Health Educational Intervention

Community-based organizations play an integral role in facilitating the delivery of educational interventions. Community agencies have a better potential to reach and impact the vulnerable population. These organizations can promote the dissemination of evidence-based interventions to address the healthcare needs of the elderly population who are predisposed to physical, mental, and functional impairment. This can be achieved through facilitating measures such as adequate and effective training of staff, capacity-building to foster strategic educational interventions, sourcing for adequate funding, enhancing motivation through incentives, and linking interventions to financial reimbursement (Porteny et al., 2020). The staff-related and financial challenges are commonly encountered especially in resource-limited settings which contribute to unsuccessful and unsustainable evidence-based educational intervention programs.

Evidence-based COVID-19-Related Education Intervention

The geriatric population is more predisposed to COVID-19-related adverse health outcomes. This is attributed to their declining health and preexisting comorbidities. Targeted strategies such as education interventions are key in promoting population cooperation and active engagement in evidence-based preventive practices (Kaim et al., 2020). Education interventions can effectively minimize the infection rates and disease burden by improving knowledge and fostering positive behavior change. One COVID-19-related education intervention that is effective is the use of brief tutorial videos (Kaim et al., 2020). This intervention is easily applicable with associated desirable population health outcomes.

The Rationale for the Education Intervention

The choice of tutorial videos as an educational intervention is based on many considerations. The recommendations for the adoption of telehealth in the delivery of healthcare services informed this choice. The use of video tutorials is convenient, cost-effective, and implementable without a breach in the COVID-19 preventive measures since no physical contact is necessary. Visuals can also enhance understanding and retention of COVID-19-related information and knowledge. Adequate empowerment of the elderly in all aspects of the COVID-19 pandemic will also be achieved. The anticipated impact of this intervention includes better uptake and adherence to the preventive measures with resultant better efficacy in disease burden reduction. Increased awareness and individual resilience will also lead to early recognition of disease-related symptoms and early treatment which reduces the possibility of potential adverse outcomes.

Approach to the Education Intervention

A brief tutorial video targeted at the high-risk elderly population will be created. The video will capture vital COVID-19 information that aims to empower knowledge and understanding of the disease. Appropriate positive behavior change that promotes safety from the disease will also be included. Before the educational intervention, the target elderly population will be assessed to determine their level of knowledge, understanding, and perceptions of the pandemic. The participants will then be allowed to watch the video.

Evaluation of Education Intervention Effectiveness

The effectiveness of the education intervention will be evaluated after meaningful engagement of the target elderly population. This will involve assessment tools such as post-intervention questionnaires. These questionnaires will capture any change in knowledge and perception of targeted COVID-19 aspects. The population will also be observed for positive behavior change concerning uptake and adherence to COVID-19 safety measures. Appropriate practices such as handwashing, wearing of facemasks, uptake of COVID-19 vaccinations, and social distancing will be monitored. Exceptions can be made for specific elderly individuals such as those with limiting cognitive and functional impairment.

Conclusion

Healthcare disparities exist due to predisposing social determinants of health that dictate a population’s vulnerability status. The elderly are among the high-risk vulnerable population owing to associated attributes such as declining health, physical, functional and cognitive impairment, low socioeconomic status, unemployment, and low literacy level among others. Community-based organizations can adequately address the existing barriers in geriatric care in collaboration with primary healthcare givers. Vulnerable population education is integral in the implementation and adoption of evidence-based interventions that ensure the well-being of the target population. These include education measures to mitigate the spread of public health emergencies such as COVID-19 that may be associated with detrimental effects on the vulnerable population such as the elderly.

NRSG 312 Unit 3 – Individual Project  References

Amboree, T. L., Montealegre, J. R., Fujimoto, K., Mgbere, O., Darkoh, C., & Wermuth, P. P. (2022). Exploring preventive healthcare in a high-risk vulnerable population. International Journal of Environmental Research and Public Health, 19(8), 4502. https://doi.org/10.3390/ijerph19084502

Bhatt, J., & Bathija, P. (2018). Ensuring access to quality health care in vulnerable communities. Academic Medicine, 93(9), 1271–1275. https://doi.org/10.1097/acm.0000000000002254

de Groot, N., Bonsel, G. J., Birnie, E., & Valentine, N. B. (2019). Towards a universal concept of vulnerability: Broadening the evidence from the elderly to perinatal health using a Delphi approach. Plos One, 14(2). https://doi.org/10.1371/journal.pone.0212633

Hado, E., & Flinn, B. (2021). Home and community-based services for older adults. https://doi.org/10.26419/ppi.00153.001

Kaim, A., Jaffe, E., Siman-Tov, M., Khairish, E., & Adini, B. (2020). Impact of a brief educational intervention on knowledge, perceived knowledge, perceived safety, and resilience of the public during the COVID-19 crisis. International Journal of Environmental Research and Public Health, 17(16), 5971. https://doi.org/10.3390/ijerph17165971

McLean, K. J., Hoekstra, A. M., & Bishop, L. (2020). United States Medicaid Home and community‐based services for people with intellectual and developmental disabilities: A scoping review. Journal of Applied Research in Intellectual Disabilities, 34(3), 684–694. https://doi.org/10.1111/jar.12837

Moncatar, T. J. R., Nakamura, K., Siongco, K. L., Seino, K., Carlson, R., Canila, C. C., Javier, R. S., & Lorenzo, F. M. (2021). Interprofessional collaboration and barriers among health and social workers caring for older adults: A philippine case study. Human Resources for Health, 19(1). https://doi.org/10.1186/s12960-021-00568-1

Mor, V., Thomas, K. S., & Rahman, M. (2018). Defining and measuring nursing home placement. Journal of the American Geriatrics Society, 66(10), 1866–1868. https://doi.org/10.1111/jgs.15546

Norman, G. J., Wade, A. J., Morris, A. M., & Slaboda, J. C. (2018). Home and community-based services coordination for homebound older adults in home-based Primary Care. BMC Geriatrics, 18(1). https://doi.org/10.1186/s12877-018-0931-z

Porteny, T., Alegría, M., Del Cueto, P., Fuentes, L., Markle, S. L., NeMoyer, A., & Perez, G. K. (2020). Barriers and strategies for implementing community-based interventions with minority elders: positive minds-strong bodies. Implementation science communications, 1, 41. https://doi.org/10.1186/s43058-020-00034-4

Stolz, E., Mayerl, H., Rásky, É., & Freidl, W. (2019). Individual and country-level determinants of nursing home admission in the last year of life in Europe. Plos One, 14(3). https://doi.org/10.1371/journal.pone.0213787

Assignment Details

Assignment Description

Vulnerable Population Education

Focusing on the vulnerable population you described in the Unit 3 discussion, choose a community agency that serves that vulnerable population. Contact a community agency leader within that organization (like the director of the organization) to interview over the phone or through email to learn more about the agency. Develop an evidence-based COVID-19-related community-based education intervention project for the vulnerable population that includes interprofessional collaboration with the community-based agency.

Describe the vulnerable population.
    Describe what makes the population vulnerable.
    Provide demographic information about the population.
Identify a community agency that serves the vulnerable population.
    Provide the organization’s name.
    Provide the name and position (title) of the community agency leader within the organization that you contacted and interviewed.
    Describe the services provided by the community agency.
Describe interprofessional collaboration with the community organization 
    How would this agency facilitate the delivery of an educational intervention impacting the health of the vulnerable population?
Propose an evidence-based COVID-19 related education intervention to improve the vulnerable population's health outcomes. 
    Explain the rationale for the education intervention you chose.
    Explain how you anticipate the education intervention will improve health outcomes for the vulnerable population.
    Discuss the method or approach you propose to deliver the education intervention.
    Discuss how you would measure whether the education was effective.

Examples of education and evaluation methods that might be delivered include the following:

Staff training using a two-page handout on COVID-19 policies for community-based organizations serving vulnerable populations followed by a short quiz 
Creating COVID-19-related health education materials on a brochure for a vulnerable population served by a community-based organization followed by return demonstration of using hand sanitizer 

This assignment is part of experiential learning for this course and must be successfully completed in order to pass the course. If the student fails to successfully complete any part of the Unit 3 IP assignment, the instructor will specify the failure in the grade comments and assign a “0” grade. The student may resubmit the assignment one time with corrections and a 20% penalty of total possible points.

Students are not to have any in-person contact with the vulnerable population or community agency during the pandemic. The education and evaluation plans are proposals that will be created in the Unit 4 IP but not delivered in-person to the vulnerable population.

NRSG 312 Unit 3 – Individual Project Rubric

The Individual Project (IP) Grading Rubric is a scoring tool that represents the performance expectations for the IP. This Grading Rubric is divided into components that provide a clear description of what should be included within each component of the IP. It is the road map that can help you in the development of your IP. Individual Project Grading Rubric

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