Program: All inclusive nursing care for bypass postoperative patients
The literature review concludes that although bypass surgery patients require specialized preoperative and postoperative care, multidisciplinary nursing care is more appropriate. In the research proposal, it was noted that a bariatric patient requires holistic care after a bypass surgery which specialized nursing care is limited to provide. Having observed at least fifteen journal works that support that the solution to the research problem is to employ all inclusive nursing workforce, this implementation plan provides oversight on how the solution will be effected in the bariatric medical sections.
The target population
The target population for this implementation plan is the bariatric medical workforce and patients. The bariatric workforce includes the gastric surgeon staff, nurses, dietitians and counselors. Bariatric patients are characterized by excessive body weight (BMI over 35). The patients suffer obesity, cardiovascular diseases, diabetes type 2 (Mellitus), obstructive sleep apnea, asthma and musculoskeletal. Obesity has a direct impact on an individual’s mortality. The increased vulnerability to other comorbidities as highlighted reduces mortality. Patients also suffer from self-esteem issues due to their body sizes. The fact that there are things that they would like to do but cannot do affects how they relate to other people and themselves. For instance, there are a bunch of dressing styles they cannot embrace, and physical activities they cannot indulge.
Obesity may be due to poor dieting, genetic or health complications. Therefore, the patients are of different ages, both young and old. The worst affected are the youths at the adolescents since they are unable to relate with their age mates. Older people, however, are at the greatest danger especially when obesity triggers the other related comorbidity.
In the history of bariatric treatment, medics have used antiobesity drugs, diet prescription and behavior and physical therapy to treat the early stages of obesity. In server cases, weight loss surgery is used as the conventional treatment. Different policies guide the kind of treatment that may be administered to a patient depending on their age and critical health conditions.
Obtaining necessary approvals
Hospital and healthcare service providers always advocate that patients seek health care from a qualified specialist. It is no different with bariatric patients, seeking bariatric specialist is appropriate. This implementation plan however considered a situation after a bypass surgery.
A bypass surgery also referred to as coronary artery bypass graft is a type of treatment that is offered to bariatric patients on an obstructed coronary artery to corrected abnormal blood flow. Conducting a bypass surgery helps reduce the risk of death to patients with a dysfunctional left ventricular. The dysfunction is caused by the loss of elasticity of a coronary artery due to a thickening wall. Full recovery after a bypass surgery and any other bariatric treatment can only be achieved if the appropriate care is provided to a post-operative patient.
As prior noted, obesity may be a lifestyle disease, often related to poor dieting practices. Some medical complications also contribute to worsening the condition. Therefore, the follow-up procedures employed bariatric patients in the preoperative and postoperative stages is critical to the recovery of a patient.
Based on these observations, the success of this implementation plan is dependent on the support it will gain from the medical community. In a hospital set up, it will require the support of the management and the staffs which include the surgeons, nurses and health care support staff such the counselor and the dietitian. Approval from these groups will ensure that the suggested solution is not only implemented but also improved to offer more effective treatment.
Current Care procedures
Dartmouth-Hitchcock, 2006 highlights some of the essential bypass surgery post-operative care procedures. The procedures are offered at different stages for different reasons. A follow-up procedure is mandated after one week after an operation. This procedure is conducted to check the state of the surgical wound. The nurses check the patient’s state as influenced by other medical issues. For instance, a diabetic patient’s glucose level is monitored to ensure that it is not life threatening especially because of the postponed medication during the surgery. The next procedure is of diet, after the surgery, the diet advances progressively from fluids to solid.
After this procedure, the patient is offered critical advice concerning the possible impacts of the surgery. To this effect, they are often issued with a handbook containing information about dieting, surgery risks, supplements and any therapy instructions. After this procedure, the patient is discharged. After ten days, a post-operative wound check is conducted to remove any skin staples. Future checks up are performed ranging from a period of four months to two years. Various lab tests are conducted to check the level of bariatric recovery. If the results are promising, the patient is advised on sleep and pressure repeat testing.
The above procedure is conducted by the same medical staff who conducted the surgery. The problem is that there is a possibility for an oversight that may result in serious future health complications. That is, the preoperative procedures are used to determine the elements of the post-operative procedures. For instance, if a patient is diagnosed with diabetes mellitus during the preoperative check up, the post-operative check-ups are confined to the diabetes mellitus. The proposed solution to such problems to employ all-inclusive care services where staffs who never participated in the preoperative stage can still be incorporated in the post-operative stage to monitor not only the known health elements but also other factors that may arise. For instance, unsuccessful surgery would require that the patient is provided with more psychological support. It would also attract other health complications such as depression and hypertension.
Rationale for selecting proposed solution
The goal of any medical care is to improve the patient’s health holistically. More, even, the health care offered must be inclusive in that the service provider must be in a position to see other health issues that may develop due to the current issues. If this is the case, the health care process becomes a health improvement process and not just health restoration. Notably, treatment is not the end of a good health care service. Follow-up is critical to ensure that the patient responds positively to the treatment offered and to correct any health issues that may be caused by the treatment process. Sometimes, medications have adverse side effects that can deteriorate the patient’s condition. The impact of such medication may be outwardly experienced or may be exhibited by a distorted immune system.
Offering effective postoperative care to a bariatric patient is the only way to ensure that health is restored with minimal treatment side effects that may be experienced after the treatment. As observed above, the use of specialized nurses skills may not be effective due to complications bias. The suggested solution is thus effective to ensuring that a bariatric patient gets back their health body mass after a bypass surgery.
Review of Literature
The report from the review of literature contains research work by other scholars who share the idea that an all-inclusive nursing care is more effective to the recovery of a bariatric patient after a bypass procedure as compared to specialized nursing services.
Jennifer, Angela and Dawn (2015) notes that bariatric patients treated through a bypass surgery have an increased risk of other comorbidities such as hypertension, diabetes and cardiovascular diseases. This supports the proposed solution required that the post-operative support provides, is holistic to ensure that a patient is free from these complications.
UnitedHealth care, 2016 provides insightful information concerning the policies that govern the bariatric bypass surgery. These policies include the maturity qualification and medical reactions that must be considered. This also supports the proposed solution in that, in the attempt to determine whether a patient qualifies for a bypass surgery, the medical team must be all inclusive.
The proposed solution will directly impact the organizational structure and working culture and workflow in the organization. In the current situation, both the preoperative and postoperative procedures and health care services are primarily offered by the surgeon staff. Specialized nurses are them assigned to patients to administer medication until a discharge is issued.
With the new proposed procedures, there will be no such a workflow since an all-inclusive medical team will interactively participate and share the information that is required to ensure that the patient received a holistic care. This will also affect the working culture. The organization will adopt a horizontal organization structure, and consequently, the culture will be interactive. The proposed solution will accommodate both the senior and the junior staff in making decisions concerning the right treatment to administer to a bariatric patient. Each of the staff in the all inclusive team will be required to provide an informed report concerning the patient including any advice for further tests. This is what will be considered a holistic nursing care.
The implementation process will require specific resources to ensure that all the involved parties are informed concerning the changes and what is expected of them under the new set of procedures. More importantly, the staff’s willingness and motivation to adopt the changes will be critical. The staff will be provided with a handout containing a detailed explanation concerning the new plan. Also, a launch will be conducted to acquaint the staff with all the information, to respond to their concerns and to consider their contributions to the new plan. An assessment will be conducted using a set of tools such as survey and questionnaires incorporating the patients and the staff. An information system will be installed to be used to enable the all-inclusive team to share information in the real time efficiently. The management will evaluate the plan to after three successful surgeries. The report generated from this evaluation will be used to improve the plan.