Applying Research Skills: Limited Access to Healthcare

Equitable access to healthcare for all is important for the realization of optimum health outcomes globally. However, most of the populations in America currently experience challenges in accessing the care that they need because of factors such as cost, geographical location, and shortage of physicians in remote locations. Nurses and other healthcare providers should be proactively involved in implementing responsive strategies to address the limited access to healthcare for the diverse populations. The incorporation of novel technologies such as telemedicine could help overcome this problem in healthcare.

As a nurse, I am responsible for ensuring the promotion and protection of diverse population’s right to access high-quality, safe and efficient care. A recent experience with a diabetic patient elevated my understanding of the severe impacts that limited access to healthcare has on patients and their significant others. The patient was elderly, residing in a rural setting and had diabetic foot. He had not received diabetes care for the last two months because of the distance to specialized care, unaffordable care, and lack of diabetes specialists in her location. As a result, he came with a septic, diabetic wound and hyperglycemia, requiring his admission to the hospital for further management. This experience raised my interest on the use of telemedicine to address limited access to healthcare for different populations.

Identifying Academic Peer-Reviewed Journal Articles

A search for relevant literature on the effectiveness of telemedicine in reducing limited access to healthcare was performed in different databases. They included PubMed, ProQuest Central, CINAHL, and EBSCO. The keywords that were used in the process included telemedicine, telemedicine and access to healthcare, telemedicine and eliminating barriers in healthcare, and telemedicine efficacy in healthcare. The search was only limited to peer-reviewed journals that focused on medicine or nursing and published within the last five years in English language.

Assessing Credibility and Relevance of Information Sources

The credibility of sources of research data must be established. I ensured that the selected articles for the project were published within the last five years to ensure the evidence was relevant to the practice. I also selected articles published by authors with extensive experience in nursing and medical fields. I also read the abstracts to eliminate articles that did not answer or focus on the research topic.

Annotated Bibliography

McLendon, S. F., Wood, F. G., & Stanley, N. (2019). Enhancing diabetes care through care coordination, telemedicine, and education: Evaluation of a rural pilot program. Public Health Nursing, 36(3), 310–320. https://doi.org/10.1111/phn.12601

The above study evaluated the effectiveness of telemedicine, care coordination and education in enhancing diabetes care. The researchers used patients with glycated hemoglobin of more than 8% where the interventions included telemedicine endocrinology consults, nurse care management, and education about diabetes self-management. The aim was to determine the effect of these interventions on diabetes management and complication prevention. The results of this study showed that the interventions led to statistically significant reduction in A1C, improvements in diabetes self-management scores, reduced hospital utilization, and strong participant satisfaction. The interventions also reduced inpatient costs by 96% and emergency department costs by 51.4%. The authors concluded the effectiveness of telemedicine, care coordination, and education in improving access to healthcare for patients with diabetes. The article was included in this annotated review because it shows the effectiveness of telemedicine in reducing challenges in accessing healthcare for the vulnerable populations.

Harkey, L. C., Jung, S. M., Newton, E. R., & Patterson, A. (2020). Patient Satisfaction with Telehealth in Rural Settings: A Systematic Review. International Journal of Telerehabilitation, 12(2), 53–64. https://doi.org/10.5195/ijt.2020.6303

The above study is a systematic review that evaluated patients’ reports of their satisfaction with telehealth in rural settings. The researchers compared outcomes in the selected studies with standard in-person therapy. The researchers utilized articles that were obtained from databases that included MEDLINE, CINAHL, Cochrane, and PsychINFO. The search yielded four articles that met the inclusion criteria and were used in the research. The study results demonstrated that the use of telehealth resulted in high satisfaction levels in all the included studies. The authors concluded that telehealth is an effective intervention that can be used to increase healthcare access in rural communities. In addition, it is feasible for use since it has a high rate of acceptability among the rural dwellers. The study was included in this review because it provides insights into the potentials of telehealth in reducing challenges in accessing healthcare as well as the level of acceptability among the disadvantaged, including those residing in rural areas.

Palozzi, G., Schettini, I., & Chirico, A. (2020). Enhancing the Sustainable Goal of Access to Healthcare: Findings from a Literature Review on Telemedicine Employment in Rural Areas. Sustainability, 12(8), Article 8. https://doi.org/10.3390/su12083318

The above study is a literature review on telemedicine use in rural areas. The study aimed at examining the ways in which telemedicine can be used in the modern world to enhance the sustainable goal of increase access to healthcare. The researchers noted that telemedicine is an effective solution for those living in rural areas because of the lack of healthcare infrastructure that limit their inclusion in the universal healthcare coverage for specialist care. The authors performed a literature review of the existing studies to identify the different telemedicine strategies used to address challenges in accessing healthcare and their sustainability. The analysis of results from the selected studies showed that telemedicine improved both diagnostic and emergency cares in rural areas. It also reduces the cost of healthcare services, increase quality of care outcomes, and expands specialist care coverage. Therefore, the authors recommend the consideration of telemedicine as among the strategies used by the global nations to expand access to healthcare. This article was selected for this review because it shows the benefits of telemedicine on increasing healthcare access. It also shows that telemedicine is a sustainable solution to limited access to healthcare.

Jordan, D. N., Jessen, C. M., & Ferucci, E. D. (2021). Views of Patients and Providers on the Use of Telemedicine for Chronic Disease Specialty Care in the Alaska Native Population. Telemedicine and E-Health, 27(1), 82–89. https://doi.org/10.1089/tmj.2019.0284

The above study aimed at understanding provider and patient perspectives on the benefits, barriers, and best uses of video telemedicine in chronic disease specialty care in an Alaska Native Medical Center. Semi-structured interviews were undertaken after a brief survey. The analysis of data from the participants showed that the greatest benefit of telemedicine was reducing travel and related costs. It also perceived an appropriate condition for managing chronic conditions that required specialist care. The authors recommended the incorporation of telemedicine into the care of the underserved populations to enhance healthcare access. This article was included in the review because it explores the benefits, potential barriers, and best uses of telemedicine in enhancing access to healthcare for all.

Learning from Research

I learned several aspects related to telemedicine for use in addressing limited access to healthcare. First, the studies expanded my understanding of the patient and provider experiences with telemedicine. I learned that patients and providers have a high level of satisfaction using telemedicine to deliver virtual, specialized care. I also learned about the immense benefits of telemedicine to those suffering from chronic illnesses. This includes the reduction of healthcare costs, emergency department visits, and hospitalizations, which enhance the productivity of the affected populations (Harkey et al., 2020; McLendon et al., 2019; Palozzi et al., 2020). I also developed my research knowledge and skills, which I can apply in examining and addressing issues that affect access to healthcare in my community.

References

Harkey, L. C., Jung, S. M., Newton, E. R., & Patterson, A. (2020). Patient Satisfaction with Telehealth in Rural Settings: A Systematic Review. International Journal of Telerehabilitation, 12(2), 53–64. https://doi.org/10.5195/ijt.2020.6303

Jordan, D. N., Jessen, C. M., & Ferucci, E. D. (2021). Views of Patients and Providers on the Use of Telemedicine for Chronic Disease Specialty Care in the Alaska Native Population. Telemedicine and E-Health, 27(1), 82–89. https://doi.org/10.1089/tmj.2019.0284

McLendon, S. F., Wood, F. G., & Stanley, N. (2019). Enhancing diabetes care through care coordination, telemedicine, and education: Evaluation of a rural pilot program. Public Health Nursing, 36(3), 310–320. https://doi.org/10.1111/phn.12601

Palozzi, G., Schettini, I., & Chirico, A. (2020). Enhancing the Sustainable Goal of Access to Healthcare: Findings from a Literature Review on Telemedicine Employment in Rural Areas. Sustainability, 12(8), Article 8. https://doi.org/10.3390/su12083318

NHS-FP4000 U2 A1 Applying Research Skills

Create a 4-6 page annotated bibliography and summary based on your research related to best practices addressing a current health care problem or issue of interest to you.

For this assessment, you will select and research a current health care problem or issue faced by a health care organization. Read each portion of the assessment carefully and use the Suggested Resources to help you complete the assessment. This assessment provides an opportunity to apply research skills to a current health care problem or issue.

As you prepare to complete this assessment, you may want to think about other related issues to deepen your understanding or broaden your viewpoint. You are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, a family member, or a member of your professional community. Note that these questions are for your own development and exploration and do not need to be completed or submitted as part of your assessment.

• How do you approach a problem or issue within your organization, when you observe it?
• How often have you needed to find credible information to solve a personal or professional problem? How did you find the information you needed?
• What are peer-reviewed resources? Why are peer-reviewed resources considered to be credible and valid?
• How would you explore evidence-based best practices in your field of study?

Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum, be sure to address each point. In addition, you are encouraged to review the performance level descriptions for each criterion to see how your work will be assessed.

For this assessment, you will research best practices related to a current health care problem. Your selected problem or issue will be utilized again in Assessment 3. To explore your chosen topic, you should use the first two steps of the Socratic Problem-Solving Approach as described on Campus to aid your critical thinking.

1. View the Assessment Topic Areas media piece linked in the Resources and select one of the health care problems or issues in the media piece to research. Write a brief overview of the selected topic. In your overview:
   • Describe the health care problem or issue.
   • Describe your interest in the topic.
   • Describe any professional experience you have with this topic.
2. Conduct a search for scholarly or academic peer-reviewed literature related to the topic and describe the criteria you used to search for articles, including the names of the databases you used.
   • You will want to access the applicable Undergraduate Library Research Guide related to your degree (found at the NHS Learner Success Lab) for tips to help you in your search.
   • Use keywords related to the health care problem or issue you are researching to select relevant articles.
3. Assess the credibility of the information sources you find.
   • Determine if the source is from an academic peer-reviewed journal.
   • Determine if the publication is current.
   • Determine if information in the academic peer-reviewed journal article is still relevant.
4. Select four current scholarly or academic peer-reviewed journal articles published during the past three to five years that relate to your topic.
5. Explain the relevance of the information sources.
   • Describe how the health care problem or issue is addressed in each source.
   • Discuss what kind of contribution each source provides on your selected topic.
6. Analyze the scholarly literature or academic peer-reviewed journal articles using the annotated bibliography organizational format.
   • The purpose of an annotated bibliography is to document a list of references along with key information about each one. The detail about the reference is the annotation. Developing this annotated bibliography will create a foundation of knowledge about the selected topic.
   • List the full reference for the source in APA format (author, date, title, publisher, et cetera) and use APA format for the annotated bibliography.
   • Make sure the references are listed in alphabetical order, are double-spaced, and use hanging indents.
   • Follow the reference with the annotation.
7. In your annotation:
   • Identify the purpose of the article.
   • Summarize the source:
     • What are the main arguments?
     • What topics are covered?
   • Include the conclusions and findings of the article.
   • Write your annotation in a paragraph form. The annotation should be approximately 150 words (1 to 3 paragraphs) in length.
8. In a separate paragraph or two at the end of the paper, summarize what you learned from your research.
   • List the main points you learned about.
   • Summarize the main contributions of the sources you chose and how they enhanced your knowledge about the topic.

Example Assessment: You may use the assessment example, linked in the Assessment Example section of the Resources, to give you an idea of what a Proficient or higher rating on the scoring guide would look like.

Additional Requirements

1. Length: At least 4–6 typed, double-spaced pages, not including the title page and reference page.
2. Font and font size: Times New Roman, 12 point.
3. APA Template: Use the APA Style Paper Template as the paper format and the APA Style Paper Tutorial for guidance. See the Resources for these documents.
4. Written communication: Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
5. Content: Provide a title page and reference page following APA style.
6. References: Use at least four scholarly or academic peer-reviewed journal articles.
7. APA format: Follow current APA guidelines for in-
   

   

   text citation of outside sources in the body of your paper and also on the reference page.

8. Turnitin: Submit your assessment to Turnitin prior to grading. Then, only submit your final assessment to faculty for grading.

Note: Review the Applying Research Skills Scoring Guide for the grading criteria applied to this assessment.

If you would like assistance in organizing your assessment, or if you simply have a question about your assessment, please do not hesitate to ask your courseroom instructor or the teaching assistants in the NHS Learner Success Lab for guidance and suggestions.

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APA Writing Checklist

Use this document as a checklist for each paper you will write throughout your GCU graduate program. Follow specific instructions indicated in the assignment and use this checklist to help ensure correct grammar and APA formatting. Refer to the APA resources available in the GCU Library and Student Success Center.

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☐ APA paper template (located in the Student Success Center/Writing Center) is utilized for the correct format of the paper. APA style is applied, and format is correct throughout.

☐  The title page is present. APA format is applied correctly. There are no errors.

☐ The introduction is present. APA format is applied correctly. There are no errors.

☐ Topic is well defined.

☐ Strong thesis statement is included in the introduction of the paper.

☐ The thesis statement is consistently threaded throughout the paper and included in the conclusion.

☐ Paragraph development: Each paragraph has an introductory statement, two or three sentences as the body of the paragraph, and a transition sentence to facilitate the flow of information. The sections of the main body are organized to reflect the main points of the author. APA format is applied correctly. There are no errors.

☐ All sources are cited. APA style and format are correctly applied and are free from error.

☐ Sources are completely and correctly documented on a References page, as appropriate to assignment and APA style, and format is free of error.

Scholarly Resources: Scholarly resources are written with a focus on a specific subject discipline and usually written by an expert in the same subject field. Scholarly resources are written for an academic audience.

Examples of Scholarly Resources include: Academic journals, books written by experts in a field, and formally published encyclopedias and dictionaries.

Peer-Reviewed Journals: Peer-reviewed journals are evaluated prior to publication by experts in the journal’s subject discipline. This process ensures that the articles published within the journal are academically rigorous and meet the required expectations of an article in that subject discipline.

Empirical Journal Article: This type of scholarly resource is a subset of scholarly articles that reports the original finding of an observational or experimental research study. Common aspects found within an empirical article include: literature review, methodology, results, and discussion.

Adapted from “Evaluating Resources: Defining Scholarly Resources,” located in Research Guides in the GCU Library.

☐ The writer is clearly in command of standard, written, academic English. Utilize writing resources such as Grammarly, LopesWrite report, and ThinkingStorm to check your writing.