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NURS FPX 6616 Assessment 2 Summary Report on Rural Health Care And Affordable Solutions

HNURS FPX 6616 Assessment 2 Summary Report on Rural Health Care And Affordable Solutions

Student Name

Capella University

NURS-FPX 6616 Ethical and Legal Considerations in Care Coordination

Prof. Name

Date

Summary Report on Rural Health Care and Affordable Solutions

The paper aims to analyze the presence of inter-professional team providers and resources available in Potter County, Pennsylvania, to address the high mortality rates due to over-dose of opium. This paper will assist in understanding the cultural competencies that the team needs to address in evidence-based data support. Moreover, ethical considerations are required keeping in mind legal issues in the organizational step. 

Specific Population Needs and Community

Potter County has less than 17 thousand people, and non-Hispanic whites are the vast majority, making up 97% of the population (Pew Research Center, 2018). Pew Research shows that 22% of the population is more than 65 years of age. Also, 14% of the population falls in the poverty line category. The health issue prevailing in this county is opium use disorder (OUD). For the last two decades, the OUD has been extremely high. The need of this community is backed by international literature using access to medication treatment and reversal medications for opioid overdose. Pennsylvania Overdose Information Network (ODIN) analyzed drug overdose incidents. The age range of the victims lays 20-39 (Barboza & Angulski, 2020). 

NURS FPX 6616 Assessment 2 Summary Report on Rural Health Care And Affordable Solutions

The possible factors leading to drug-overdose medications are poverty, illiteracy, and resources available. The opioid is used in different patterns like prescription drugs, injections, for pain, and in combination with other pain-related medications. There are two categories of reasons: consumer-based and provider based in terms of accessibility, availability, and acceptability. This issues include the unavailability of clinics, physicians, or mediation treatments in the area. The studies show that more availability increases the utilization of treatments as well. Consumer-based accessibility related to far-off areas to access medication services surprisingly, younger people face more difficulty than older people. The acceptability issue includes hesitation and dissatisfaction with medication treatment.

The provider-based availability issue includes a lack of qualified personnel and infrastructure; acceptability issues include lack of time or time; acceptability issues include self-doubts, lack of confidence, and interest in providing medication services. So, overall, the prevailing issue is due to multiple factors which need to be taken care of through reverse opioid overdose medication and improving access to medication as well. 

Current Available Inter-professional Team Providers and Resources

Avera Gettysburg Hospital is a potter county hospital that aims to provide an interdisciplinary team. It combines expert specialists, primary care providers, sophisticated technology, and cutting-edge research. It has conducted a Community Health Needs Assessment (CHNA) that gave information about the state and made them address consumer and provider-based barriers. The Hospital addressed the community’s needs by expanding its services and included wellness programs for lifestyle changes like biking and walking tracks. It also improves hospice services and home care services.

The current resources, including remote health services, awareness, and changes at all levels, enhance health and medication services. Healthcare outcomes have been improved, supported by Inter-professional Education and Collaborative Practice (IPECP). IPECP assists in collaboration with different healthcare providers to learn and support better outcomes (Martin et al., 2021).

NURS FPX 6616 Assessment 2 Summary Report on Rural Health Care And Affordable Solutions

The interventions for opioid overdose are carried out at micro, meso , and macro levels (Qudah et al., 2022). At a micro level, the change in the attitude of consumers and providers is developed through education, awareness, and training. This way, they could change their attitude, creating a barrier in opioid medication for non-Hispanic whites. Self-confidence, skills, and positive habits are developed at the micro level. At the meso level, the resources are utilized through psychosocial changes; recovery coaches and behavioral health centers are integrated onsite and remotely. Rehab facilities and timely access through technology integration are also part of the intervention. At the macro level, policies, regulations, and FDA oversight assisted in positive results. Overall, the base interventions use alternative therapies and medication for opioid use disorder. 

Areas of Cultural Competency the Team Must Address

The interdisciplinary team itself is not culturally the same, and the communities they address also have people from different cultures. It is mandatory for nurses to develop cultural competency skills that can help minimize barriers at the end of providers at least. Cultural competencies mean respecting and acknowledging the differences in values and choices of a specific community. The U.S. Department of Health and Human Services (HHS) develops CLAS (national standards for culturally and linguistically appropriate services in health care) in this regard (Hilty et al., 2020).

In this case, non-Hispanic whites are in the majority, so a team should be aware of the practices and beliefs that impact their living style and choice patterns. Self-medication, injecting opium and heroin, and accidental wrong mediations have led to deaths. The team should be well educated about the cultural elements to let county people communicate properly. The competencies of language skills and value understanding will enable the team to develop patient-centered and customized health plans. Eventually, the practices will lead to the root cause of opioid use disorder and switch them through psychosocial interventions and medical care.

Technology-Based Outreach Strategies

The technology-based strategies were included to address the issues of availability and accessibility of both consumers and providers. As the lack of infrastructure and lack of qualified specialists were barriers to provider-based services, technology assists in bridging the gap effectively. The consumer-based barriers included the long distances, unavailability of medications, and primary care physicians or specialists. It all led to the adverse rates of opioid overdose. There are less than 10% of physicians in rural counties in the USA, so the best solution is the collaboration of interdisciplinary teams through technology.

NURS FPX 6616 Assessment 2 Summary Report on Rural Health Care And Affordable Solutions

Telehealth and telemedicine are the most important strategies of this study (Butzner & Cuffee, 2021). It will enable healthcare providers and consumers through mobile and digital health solutions. Multiple diagnoses can be done via video conference or electronic medical record. The wearable devices and sensors can help cater to the older adults of Potter County. Remote monitoring is extremely helpful in providing care to disabled and pregnant women in the community. 

Possible Telehealth Legal Issues

Potter County needs to be a better-established urban community that is well aware of the technology integration so that legal issues can generate at the providers’ end. The importance of Telehealth services is known to many, but old county members and less educated can doubt the services. In addition, the availability issue arises again when access to a computer and the internet is mentioned. Few legal issues generate with the ill practice of Telehealth services (Panter, 2021). First is licensing, physicians are licensed to work in a particular state, but Telehealth is beyond the boundary, so it is mandatory to check the patient’s state to avoid legal repercussions.

Patient-physician relations must develop first at in-person meetings to better provide and consume the services because face-to-face consultation is still the golden standard. Tele-prescribing is another legal issue as it is not allowed to prescribe a controlled drug without in-person checkups. Fraud and abuse are also possible if state and federal regulations are not followed properly. Lastly, privacy and confidentiality can lead to legal issues if a data breach occurs.

Continuation of Ethical Care in the System

Potter County people are adversely affected by availability, accessibility, and acceptability concerns. The huge number of opioid-related deaths and prevailing opioid use disorder has led to this chance to improve the health of non-Hispanic whites. Telehealth and telemedicine solve the issues of availability and accessibility concerns easily. However, ethical norms are planned to be prioritized in the care system for opioid victims. The four principles of ethics, which include autonomy, beneficence, non-maleficence, and justice, are standards of the interdisciplinary team. These services aim to involve patients in an autonomous treatment plan ethically. Their consent for recording, saving, and sharing information among interdisciplinary teams is necessary (Solimini et al., 2021).

Similarly, to save disabled, low-income, pregnant women from traveling long distances, Telehealth services benefit them and save them from potential financial or health-related harm. The right to Affordable care is universal, and the potter county community is no different. So, Telehealth is a resource available and accessible to everyone for their benefit. 

Conclusion

Potter County is in Pennsylvania, where non-Hispanic whites are in the majority and suffer from opioid use disorder in great numbers. The county is less in population, and the literacy rate is down. Many older adults are part of the community and have a significant poverty line population. The issues are accessibility, availability, and acceptability at both ends: consumer and provider. The interdisciplinary team of Arena hospital consists of primary care, specialists, and technology integration techniques to improve the psychosocial life of people as well. Cultural competencies are a must for the team to improve healthcare outcomes. In addition to that, Telehealth strategies have been added, but it has legal issues like licensing, relationship, fraud/abuse, tele prescribing, and confidentiality. However, the team aims to continue Telehealth services keeping ethical principles in vision. 

References

Barboza, G. E., & Angulski, K. (2020). A descriptive study of racial and ethnic differences of drug overdoses and naloxone administration in Pennsylvania. International Journal of Drug Policy, 78, 102718. 

https://doi.org/10.1016/j.drugpo.2020.102718 

Butzner, M., & Cuffee, Y. (2021). Telehealth interventions and outcomes across rural communities in the united states: Narrative review. Journal of Medical Internet Research, 23(8), e29575. 

https://doi.org/10.2196/29575 

Hilty, D. M., Gentry, M. T., McKean, A. J., Cowan, K. E., Lim, R. F., & Lu, F. G. (2020). Telehealth for diverse rural populations: Telebehavioral and cultural competencies, clinical outcomes and administrative approaches. MHealth, 6(6), 20–20. https://doi.org/10.21037/mhealth.2019.10.04 

Martin, P., Pighills, A., Burge, V., Argus, G., & Sinclair, L. (2021). Promoting interprofessional education and collaborative practice in rural health settings: Learnings from a state-wide multi-methods study. International Journal of Environmental Research and Public Health, 18(10), 5162. 

https://doi.org/10.3390/ijerph18105162 

Opioid Epidemic. (2019). Department of Health. https://www.health.pa.gov/topics/disease/Opioids/Pages/Opioids.aspx 

Panter, M. (2021, January 25). Potential Legal Implications of Telemedicine and Telehealth. Law Technology Today. 

https://www.lawtechnologytoday.org/2021/01/implications-of-telemedicine-and-telehealth/ 

Pew Research Center. (2018, May 22). Demographic and economic trends in urban, suburban and rural communities. Pew Research Center’s Social & Demographic Trends Project. https://www.pewresearch.org/social-trends/2018/05/22/demographic-and-economic-trends-in-urban-suburban-and-rural-communities/ 

Qudah, B., Maurer, M. A., Mott, D. A., & Chui, M. A. (2022). Discordance in addressing opioid crisis in rural communities: Patient and provider perspectives. Pharmacy, 10(4), 91. https://doi.org/10.3390/pharmacy10040091

Solimini, R., Busardò, F. P., Gibelli, F., Sirignano, A., & Ricci, G. (2021). Ethical and legal challenges of telemedicine in the era of the COVID-19 pandemic. Medicina, 57(12), 1314. 

https://doi.org/10.3390/medicina57121314