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NURS FPX 6026 Assessment 1 Analysis of Position Papers for Vulnerable Populations

Student Name

Capella University

NURS-FPX 6026 Biopsychosocial Concepts for Advanced Nursing Practice 2

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Date

Analysis of Position Papers for Vulnerable Population

Sickle Cell Disease (SCD) is a critical health issue in the African American community due to its high prevalence. Implementing an interprofessional, patient-centered approach encompassing early diagnosis, continuous care, and genetic education is essential but often encounters opposition. This paper critically examines these opposing views, communicates an initial stance, and clearly condenses existing positions, with the aim of enhancing understanding and consensus to improve care outcomes for this population.

Health Outcomes and Assumptions: SCD in African Americans

The position advocated in this context is focused on proactive genetic screening, targeted treatment strategies, and an integrated health care approach as methods to enhance health outcomes for African Americans with Sickle Cell Disease (SCD). This stand acknowledges the specific genetic characteristics of SCD that make it a pressing health concern in this population. However, this position is not without assumptions that underpin the strategy (Winn et al., 2023). The following are the three main assumptions:

  • Early Diagnosis through Genetic Screening: This approach is based on the assumption that early identification of SCD through newborn screening can enable immediate initiation of preventive measures and treatments, thereby reducing the likelihood of complications and improving health outcomes. Yet, this presupposes the availability of resources and systems in place for universal screening, as well as parental consent for such procedures (Winn et al., 2023).
  • Continuous Care: Assumed within this assumption is that there is accessibility to consistent and specialized healthcare services for SCD patients. This includes regular check-ups, immediate care during crises, and long-term management strategies, which hinge upon the availability of skilled healthcare providers, as well as financial and geographical access to care for the patients (Winn et al., 2023).

NURS FPX 6026 Assessment 1 Analysis of Position Papers for Vulnerable Populations

  • Genetic Counseling and Education: The success of this component rests on the assumption that tailored genetic counseling can help individuals and families understand the risks, complications, and management of SCD. It presupposes that this understanding can contribute to better self-management, treatment adherence, and health-seeking behaviors among patients. It also assumes that genetic counselors are available and that patients are willing to participate in such counseling sessions (Winn et al., 2023).

It is crucial to critically evaluate these assumptions in the context of the existing healthcare system, socio-economic realities, and individual circumstances that could impact their validity. For instance, limitations in access to healthcare services, socio-economic disparities, cultural beliefs, or lack of awareness about SCD could pose significant challenges to these assumptions (Winn et al., 2023). Therefore, while advocating for this position, it’s essential to address these potential obstacles to effectively improve the health outcomes of African Americans with SCD.

Interprofessional Team’s Role and Challenges

In the intricate landscape of Sickle Cell Disease (SCD) management, the interprofessional healthcare team’s role is pivotal in orchestrating comprehensive and personalized care that considers the disease’s multifaceted nature. The team comprises diverse healthcare professionals contributing a unique skill set that holistically addresses the physical, emotional, and psychosocial aspects of SCD. Physicians steer the medical management of SCD, monitoring the disease course, and tailoring treatment strategies to the patient’s needs.

Their decision-making influences long-term treatment plans, including potential for disease-modifying interventions like bone marrow transplantation. Nurses bridge the gap between physicians and patients, executing treatment plans, managing symptoms, and providing health education. They are often the patient’s first point of contact in the healthcare system and play a key role in monitoring the patient’s health status and coordinating care (Sedrak & Kondamudi, 2019).

NURS FPX 6026 Assessment 1 Analysis of Position Papers for Vulnerable Populations

In the context of SCD, genetic counselors are particularly crucial due to the genetic nature of the disease. They provide risk assessment, impart knowledge about disease inheritance, and offer emotional support to patients and families, guiding them through decisions about family planning and potential treatments (Woollard et al., 2021). Finally, social workers and psychologists take on the essential task of mitigating the psychosocial challenges associated with living with SCD. They provide mental health support, assist in navigating the healthcare system, and advocate for patient rights and access to resources, thus ensuring the patient’s wellbeing extends beyond just physical health (Sedrak & Kondamudi, 2019).

Despite the potential for comprehensive care offered by this interprofessional team approach, numerous challenges might impede its effectiveness. Communication and collaboration, though essential for coordinated care, can be complicated by differences in professional backgrounds, creating the potential for miscommunication that might negatively impact patient care. Moreover, the systemic biases and racial disparities that exist within the healthcare system might present barriers to equitable healthcare delivery. In this context, African Americans with SCD might face hurdles accessing resources and receiving quality care, which could exacerbate health disparities (Winn et al., 2023).

NURS FPX 6026 Assessment 1 Analysis of Position Papers for Vulnerable Populations

Another significant challenge is the complex nature of SCD itself, marked by severe pain crises and related psychosocial issues. The team members must be adequately equipped with the specialized knowledge and skills needed to navigate these complexities. A lack of specialized training or resources can limit the quality of care provided. Lastly, engaging patients and families in decision-making processes and care plans is critical but can be complicated by cultural beliefs, health literacy levels, and individual disease perceptions.

To tackle the complexities of SCD, it is paramount to critically understand and enhance interprofessional team dynamics and systemic operations (Brandow et al., 2020). Through improved communication, collaborative decision-making, and continuous learning, we can advocate for systemic changes, ensuring better health outcomes for African Americans dealing with SCD.

Critical Evaluation of Evidence and Identification of Knowledge Gaps 

Drawing upon a wealth of research, it’s apparent that a comprehensive, team-based approach is indeed effective in managing SCD. For instance, studies have demonstrated that newborn screening followed by regular medical supervision can notably decrease mortality and enhance the quality of life for individuals with SCD. This evidence is in line with our earlier position, thereby supporting the need for an interprofessional team in delivering comprehensive care (Sedrak & Kondamudi, 2019).

However, some areas of uncertainty emerge that point towards knowledge gaps in our understanding of SCD and its management. One such area is the management of acute pain crises. Despite the existence of pain management guidelines, patient response is highly variable. This indicates a need for personalized pain management strategies that take into account the unique genetic, physiological, and psychosocial factors of each patient, hinting towards a potential role for genetic counselors and psychologists within the interprofessional team (Winn et al., 2023).

NURS FPX 6026 Assessment 1 Analysis of Position Papers for Vulnerable Populations

Furthermore, there’s an urgent need to comprehend the full extent of psychosocial implications of SCD. Living with SCD isn’t just about managing physical complications; it also involves psychological stress, social stigmatization, and disruptions in education and employment. The current focus of healthcare models is predominantly on addressing physical complications, while psychosocial aspects are often under-addressed (Constantinou, 2020). This points to a significant knowledge gap, and reiterates the importance of including social workers and psychologists in the interprofessional team.

Lastly, we need to better understand the role of racial disparities in SCD care. While we know that systemic biases and inequities exist in healthcare, how they specifically influence health outcomes in SCD isn’t fully understood. Future research that investigates these disparities could potentially inform strategies to ensure equitable healthcare delivery, thereby further strengthening the role of the interprofessional team in facilitating improvements. (Constantinou, 2020).

Critical Evaluation of Contrary Perspectives and Creating Buy-In for the Interprofessional Approach

Opinions challenging the interprofessional approach usually arise from worries about resource distribution and a conventional inclination towards finding a cure. These contrasting views require critical assessment within the context of managing SCD. A common argument against an interprofessional care model is its resource intensiveness. Critics argue that the costs, in terms of money, personnel, and logistics required to uphold a comprehensive care team, may not be warranted given the limited healthcare resources (Winn et al., 2023).

However, this argument tends to overlook the potential for long-term cost-effectiveness of the model. Enhanced disease management from a coordinated approach can reduce hospitalizations and emergency department visits, thereby reducing healthcare expenses. Furthermore, this approach emphasizes preventive care, early detection, and management of complications, all of which can improve patients’ quality of life and potentially increase life expectancy. Thus, while the initial investment may be significant, the long-term benefits and cost savings could outweigh these costs (Phillips et al., 2022).

Another argument proposes a focus on cure-oriented research instead of disease management. While finding a cure for SCD is essential, this does not negate the necessity for high-quality, comprehensive care. The journey to finding a cure is often long and uncertain, and patients with SCD cannot be left with subpar care while waiting for a potential cure. The immediate need is to improve disease management to relieve symptoms, prevent complications, and improve quality of life (Korkortsi, 2021).

NURS FPX 6026 Assessment 1 Analysis of Position Papers for Vulnerable Populations

Addressing these counterarguments objectively is vital to gaining acceptance for the interprofessional approach. Advocating for a balanced view where resources are allocated to both the ongoing search for a cure and the provision of comprehensive care could help reach a consensus. It’s crucial to emphasize the long-term benefits of the interprofessional approach, which includes potential cost savings, improved patient outcomes, and enhanced quality of life for individuals with SCD.

By highlighting the personalized and holistic nature of interprofessional care, we can address the unique challenges faced by individuals with SCD, including psychosocial stressors and systemic inequalities, often overlooked in traditional care models. Thus, the interprofessional model should not be seen merely as an additional expense, but as a necessary shift towards a more equitable and patient-centered healthcare system.

Conclusion

SCD management in the African American community necessitates a comprehensive, interprofessional approach. Despite potential disagreements about resources and research focus, critically evaluating these perspectives can enable a more effective buy-in for this approach. Employing clear communication strategies and respecting diverse perspectives can enhance patient-centered care, improving life quality for SCD patients. Hence, this paper underscores the value of an interprofessional approach to SCD management, highlighting its potential benefits to patients and the healthcare system.

References

Brandow, A. M., Carroll, C. P., Creary, S., Edwards-Elliott, R., Glassberg, J., Hurley, R. W., Kutlar, A., Seisa, M., Stinson, J., Strouse, J. J., Yusuf, F., Zempsky, W., & Lang, E. (2020). American Society of Hematology 2020 guidelines for sickle cell disease: Management of acute and chronic pain. Blood Advances4(12), 2656–2701. https://doi.org/10.1182/bloodadvances.2020001851 

Constantinou, C. (2020). Health-related quality of life and health behaviors in children and adolescents with sickle cell disease. Eprints.mdx.ac.uk. Retrieved from http://eprints.mdx.ac.uk/29936/ 

Korkortsi, R. E. K. (2021). Assessment of quality of care for children with sickle cell disease in the south tongu district of Ghana: Nurses’ perspective. Asian Journal of Research in Nursing and Health4(4), 58–74. http://research.asianplos.com/id/eprint/159/ 

Phillips, S., Chen, Y., Masese, R., Noisette, L., Jordan, K., Jacobs, S., Hsu, L. L., Melvin, C. L., Treadwell, M., Shah, N., Tanabe, P., & Kanter, J. (2022). Perspectives of individuals with sickle cell disease on barriers to care. PLOS ONE17(3), e0265342. https://doi.org/10.1371/journal.pone.0265342 

NURS FPX 6026 Assessment 1 Analysis of Position Papers for Vulnerable Populations

Sedrak, A., & Kondamudi, N. P. (2019, May 6). Sickle Cell Disease. In StatPearls [Internet]. StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK482384/

Winn, A., Basu, A., & Ramsey, S. D. (2023). A framework for a health economic evaluation model for patients with sickle cell disease to estimate the value of new treatments in the United States of America. PharmacoEconomics-Open7(2), 313–320. https://doi.org/10.1007/s41669-023-00390-6 

Woollard, L., Gorman, R., & Rosenfelt, D. J. (2021). Improving patient informed consent for haemophilia gene therapy: The case for change. Therapeutic Advances in Rare Disease2, 263300402110472. https://doi.org/10.1177/26330040211047244