Name
Capella University
NURS-FPX6218
Instructor’s name
October, 2024
Proposing Evidence-Based Change
Allergic contact dermatitis is another widespread and frequently disabling skin disease that results from contact with specific allergens and chemicals. It is an example of type IV hypersensitivity (or delayed type hypersensitivity) and is one of the most common causes of occupational and environmental diseases. ACD results from acquired and inherited factors; such as original skin pathologies, genetic factors, as well as contact with irritating substances (Valizadeh et al., 2022). From the paper, it was ascertained that nurses play a big role in the management of ACD this is by; skin care, and topical treatments, educating the patients about allergens and lastly respecting the patients’ feelings. This therefore means that with adequate management ACD can be well managed and the patient’s quality of life is greatly enhanced. Managing ACD requires looking for effective approaches to managing skin disorders outside the conventional American health system.
Executive Summary
Proposed Change
For healthcare institutions to address the issue and improve patient care, some changes should be made: Patients with ACD should be educated about the illness, and their allergens, and modify their behavior to decrease the disease’s inflammatory response (Emich, 2021). Synthetically rubber-sensitive patients should select a range of gloves, which does not contain the offending rubber accelerator, such as carbamates or any other substance.
The most effective treatment for ACD consists in identifying the cause of the skin reaction and subsequent removal of the culprit. In some cases, nurses may be able to treat severe allergic contact dermatitis with antihistamines and either topical or oral steroid medications. Since the discovery of the cause, the Allergen must be avoided to prevent the reoccurrence of this condition.
ACD poses high risks to the quality of life, much more so when it occurs in a particular body region (Estalella et al., 2023). As it has been already shown, the results in patients with ACD are significantly better if patients were identified early. This is a problem that directly affects medical practitioners internationally.
Local or Regional Health Care System for the Proposed Change
Life with ACD can be challenging, as the condition often affects sleep, undermines relationships, and can also risk a job.
Of the many local healthcare systems that require course correction in handling Allergic contact dermatitis (ACD) is the North Central Health Care (NCHC) system based in Wisconsin (Naegle et al., 2023). For instance, when it comes to ACD the following interventions and strategies used by the Mayo Clinic need to be adhered to by the NCHC. The patient must appreciate various types of allergens including nickel, fragrances, and preservatives among cosmetic and personal care products. ACD can improve patients’ overall quality of life by reducing itching, redness, swelling, and formation of blisters.
ACD can be resolved with the help of patient education on avoiding allergic factors in the NCHC system (Naegle et al., 2023). They should change patient education and environment, and learn how to deny skin care to reduce the development of ACD (Valizadeh et al., 2022). Further, clients, especially those with ACD conditions, should also undergo ACD awareness and management education by their healthcare providers. In addition, one can also spread the word on social media that patients should avoid coming into contact with such raw materials to reduce ACD incidences.
Nurses can be very helpful in planning, evaluating as well as implementing the training of the patients (Feng et al., 2020). They can elaborate that ACD originated from immunologic fundamentals, preventive measures for allergies, how corticosteroids should be taken, and other undesirable side effects.
Expectations
As a consequence, it has to be noted that such knowledge about a disease’s function does not always lead to the modification of the patient’s behavior. In order to motivate that person, it is necessary to consider the growth stage of a person, his/her background knowledge, and experience of working with healthcare professionals (Feng et al., 2020). Better outcomes can be achieved with this approach.
There should be clear standards, such enhancements as learning lessons should be worked out to improve the healthcare system and to show people how they can prevent getting allergic contact dermatitis (Hämel et al., 2020). This includes informing the people about allergy conditions including the origins of the allergic response, symptoms that occur, and the best way to go about the therapy. A healthcare provider should focus on the reduction of the risk of recurrence by recommending protective clothing, steroid-free clothing, and lotions during care of the skin.
Desirable Outcomes
Patient results we want to see include the following:
- Identifying the chemicals or substances that cause ACD.
- Prevention from allergens.
- Patient Satisfaction: The patient can assess the method of delivering the medication, the period of administration, and the results.
In this case, the interdisciplinary team that is within an institution aims at increasing patient outcomes (Fulmer et al., 2021). Doctors may decide to administer medicine when needed. Nevertheless, the choice of the drug and its dosage should be discussed with a pharmacist. The treatment plan for the patient and the specific area of the body should be made and then graphic education and consultation with different specialists.
Limiting Factors
As much as there is an attempt to achieve the right outcomes in addressing ACD, the following factors hinder its achievement; Increasing costs of health care in the United States (Fulmer et al., 2021). The cost of management of ACD is higher realised since the majority of the insurance companies partially cover the cost of the treatment leaving the patient to meet part of the expenses. Such costs are burdensome to the patient, and even more so to patients with low incomes.
Who will Pay for the Care?
In most cases, a patient of ACD is financially responsible for the diagnosis, all forms of treatment, and medications attributable to the condition (Khatsenko et al., 2020). Reading this expense may be even tricky for those with no health insurance as they may be restricted by coverage and only given certain treatments or certain medications to try. Additionally, when the patient cannot afford health insurance, the disease progresses and the cost of treatment rises.
The Rationale for the Proposed Change
It has been established that allowing for specified changes can result in better patient outcomes because the occurrences of ailments arising from allergic reactions are transformed hence the need to manage ACD patients. For example, by eradicating contact with antigens that lead to ACD, patients will be able to minimize inflammation that is associated with the disease (Thandar et al., 2022). In addition, early diagnosis of ACD patients and provision of information concerning the allergens might lead to effective treatment and faster recovery, which in turn boosts the life standard of such patients.
These the expected positive changes that have been expected as follows; Severe and frequent symptoms associated with baby ACD should decrease, treatment results should be enhanced, and last but not least, the baby’s quality of life should be enhanced as well (Khatsenko et al., 2020). These improvements can be justified by research for instance the National Institutes of Health (NIH) assessed that early detection of ACD then avoiding exposure to the allergens leads to reduction of inflammation and discomfort.
Comparative Analysis of the Healthcare System
As outlined in Table 1 given in the appendix, the healthcare systems of England, India, and the United States all offer comprehensive guidelines for handling ACD that include identifying the toxins or inducers of ACD, allergens control, and patient satisfaction (Thandar et al., 2022). These healthcare services aim at doing the best that is expected of them on ACD and the resources that come with it will assist patients in overcoming the difficulties that they are bound to encounter.
It is therefore appropriate for the United States which aspires to offer the best to its citizens to learn from the experiences of these two countries England and India (Hossain et al., 2023). Healthcare providers are thus in a position to know their patients to give them the best quality of service. With the appropriate tools and approach to patient care, they can give their patients the maximum quality service and health care they deserve.
How to Make Outcome Measurable?
To make the outcomes measurable, one can gather the number of patients who have succeeded in identifying the toxins or triggers that cause ACD, the proportion of patients who have been able to avoid allergens, the percentage of patients Who are satisfied with the results as shown by the surveys conducted among the patient (Hossain et al., 2023).
Lessons Learned
The present paper has found evidence of the successful implementation of ‘trigger’ criteria in the healthcare systems of England, India, and the USA, knowledge about allergens and related avoidance measures, and improved patient satisfaction interventions (Bachynsky, 2020). Promising practices that can be derived from such examples are; the development of national standardized guidelines and databases, patient education on allergen avoidance, and the creation of patient satisfaction instruments. Thus, if all the said lessons are implemented in the healthcare system, better patient outcomes and the best quality services will be provided.
Financial and Health Implications
Applying the changes proposed to improve the healthcare of ACD patients could have economic and health impacts. The containment of healthier ACD patients through access to patch testing shall help the government achieve its goal of containing the costs of treating this condition (Bachynsky, 2020). Thus, when probable cause is diagnosed at an early stage, it is easier to control it and therefore eliminate expensive solutions like antihistamines and corticosteroids. They also get to seek the right treatment early and change the right habits to minimize the symptoms they need to endure (Hämel et al., 2020). It may also improve their standard of living, in addition to greatly alleviating the cost of expensive therapy, many of which may take a lifetime to complete.
On the other hand, the lack of implementation of the proposed changes may imply the organization’s deficit as well as the health of individuals. When the ACD is left untreated during its early stage, its condition worsens and may require additional treatment with systemic steroids. It may lead to expensive treatment for the affected person and or the healthcare system (Estalella et al., 2023). As a consequence, the expenses for this person and the total healthcare costs may be significantly increased. Also, the absence of early symptom recognition results in a low quality of life for the patient, as the disease significantly hinders their work productivity and daily functioning (Valizadeh et al., 2022). Research carried out in the USA showed that a reduction in the cost of treating ACD by some figures was achieved by increasing access to patch testing. Also, the research revealed that subjects with patch testing had fewer symptoms and a higher quality of life than those lacking such a test.
NURS FPX 6218 Assessment 1 Conclusion
The measures put forward to ensure better heuristic results for ACD patients have organizational financial and health consequences. The research findings point towards the fact that making such changes is capable of leading to lower costs as well as a better quality of life for patients with ACD. The UK, India, and the USA have each created early diagnosis plans for ACD, their allergens/toxins database, and support services for patients with the disease (Emich, 2021). Implementing these strategies has been found to decrease the costs incurred in the treatment of ACD and increase patient satisfaction. Consequently, it is probably worthwhile to make the proposed changes to improve the health status of ACD patients, as it will have great financial and health implications.
NURS FPX 6218 Assessment 1 References
Bachynsky N. (2020). Policy implications: The triple aim, quadruple aim, and interprofessional collaboration. Nursing Forum, 55(1), 54–64. https://doi.org/10.1111/nuf.12382
Emich C. (2021). Teaching evidence-based practice piece by PEACE. International Journal of Nursing Education Scholarship, 18(1), 10.1515/lines-2020-0094. https://doi.org/10.1515/ijnes-2020-0094
Estalella, I., Román, Ó., Reichenberger, T. N., & Maquibar, A. (2023). Impact of a teaching strategy to promote evidence-based practice on nursing students’ knowledge and confidence in simulated clinical intervention choices. BMC Nursing, 22(1), 361. https://doi.org/10.1186/s12912-023-01540-1
Fulmer, T., Reuben, D. B., Auerbach, J., Fick, D. M., Galambos, C., & Johnson, K. S. (2021). Actualizing better health and health care for older adults. Health Affairs (Project Hope), 40(2), 219–225. https://doi.org/10.1377/hlthaff.2020.01470
Feng, Z., Glinskaya, E., Chen, H., Gong, S., Qiu, Y., Xu, J., & Yip, W. (2020). Long-term care system for older adults in China: policy landscape, challenges, and prospects. Lancet (London, England), 396(10259), 1362–1372. https://doi.org/10.1016/S0140-6736(20)32136-X
Hossain, E., Rana, R., Higgins, N., Soar, J., Barua, P. D., Pisani, A. R., & Turner, K. (2023). Natural language processing in electronic health records about healthcare decision-making: A systematic review. Computers in Biology and Medicine, 155, 106649. https://doi.org/10.1016/j.compbiomed.2023.106649
Hämel, K., Toso, B. R. G. O., Casanova, A., & Giovanella, L. (2020). Advanced practice nursing in primary health care in the Spanish national health system. Ciencia & Saude Coletiva, 25(1), 303–314. https://doi.org/10.1590/1413-81232020251.28332019
Khatsenko, K., Khin, Y., & Maibach, H. (2020). Allergic contact dermatitis to components of wearable adhesive health devices. Dermatitis: Contact, Atopic, Occupational, Drug, 31(5), 283–286. https://doi.org/10.1097/DER.0000000000000575
Naegle, M. A., Kelly, L. A., Embree, J. L., Valentine, N., Sharp, D., Grinspun, D., Hines-Martin, V. P., Crawford, C. L., & Rosa, W. E. (2023). American Academy of Nursing consensus recommendations to advance system-level change for nurse well-being. Nursing Outlook, 71(2), 101917. https://doi.org/10.1016/j.outlook.2023.101917
Thandar, M. M., Rahman, M. O., Haruyama, R., Matsuoka, S., Okawa, S., Moriyama, J., Yokobori, Y., Matsubara, C., Nagai, M., Ota, E., & Baba, T. (2022). Effectiveness of infection control teams in reducing healthcare-associated infections: A systematic review and meta-analysis. International Journal of Environmental Research and Public Health, 19(24), 17075. https://doi.org/10.3390/ijerph192417075
Valizadeh, L., Zamanzadeh, V., Alizadeh, S., & Namadi Vosoughi, M. (2022). Promoting evidence-based nursing through journal clubs: an integrative review. Journal of Research in Nursing: JRN, 27(7), 606–620. https://doi.org/10.1177/17449871211022799
Appendix
Table 1
| Desired Outcomes | England | India | United States |
| Determining the toxins or triggers that induce ACD | The National Institute for Health and Care Excellence (NICE) gives guidelines to help healthcare workers identify toxins or stimuli that cause ACD (Valizadeh et al., 2022). | India has the Indian Association of Dermatologists, Venereologists, and Leprologists (IADVL), which researches the toxins or agents that cause ACD (Naegle et al., 2023). | The Agency for Toxic Substances and Disease Registry (ATSDR) has a huge ACD triggers and toxins database derived from the Toxicological Profiles references and other sources (Hämel et al., 2020). |
| Allergens avoidance | The Royal College of Physicians (RCP) offers tools that patients can use for allergen avoidance. | A non-profit organization called Allergy Research Foundation of India (ARFI) assists individuals in learning about allergens (Feng et al., 2020). | This authority has the Allergen Avoidance Program (AAP) of the National Institute of Allergy and Infectious Diseases (NIAID) to help individuals recognize allergens in their lives (Emich, 2021). |
| Patient Satisfaction | To support patients’ care for ACD, the British Association of Dermatologists (BAD) has come up with many interventions (Feng et al., 2020). | A Public Sector Organisation namely the National Institute of Mental Health and Neurosciences (NIMHANS) has initiated a Patient Satisfaction Programme in India (Hämel et al., 2020). | To enhance the quality of life of patients, the Centre for Disease Control and Prevention (CDC) instituted the Patient Satisfaction Program (Naegle et al., 2023). |
