22 Sep Develop an introduction section that includes the professional nurses? role in identifying practice problems. Select an article from the list
- Develop an introduction section that includes the professional nurses’ role in identifying practice problems.
- Select an article from the list provided to use as the basis for this assignment.
- NOTE: this article and the identified practice problem will be the focus for a theoretical intervention, implementation, and evaluation process using the KTA Framework for Units 5, 6, & 7. In those units, you will apply the practice problem to your clinical setting.
- Using the article you selected, identify and state the practice problem.
- Provide a discussion that supports the existence and significance of the practice problem you identify within the article.
- Locate three (3) additional journal articles that provide additional support for the same/similar practice problem.
- Develop a summary of each article that adds support for the existence and significance of the practice problem in healthcare.
- NOTE: the three (3) additional articles you locate and summarize cannot be articles that are referenced in the article you selected from the list
- Ideally the 3 additional articles will have a publication date within the last 5 to 10 years.
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Readmission Rates Among Bipolar Patients
Khalifatu Fawehinmi Clark
Herzing University
NU700: Knowledge for Nursing Practice
Michelle English DNP, FNP-BC
September 29, 2024
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Readmission Rates Among Bipolar Patients
Community health organizations are critical to providing mental health care to
individuals in need, focusing on health as an entire being. Abaatyo et al. (2023) report that there
is a high rate of readmissions among bipolar disorder, with 23.8% of patients being readmitted
within 9.4 months after discharge. Therefore, community support and symptom management are
vital. These organizations ensure their services are accessible through delivery at patients’ homes
or local centers. The present paper aims to review the literature available on high readmission
rates related to relapse in bipolar disorder patients and possible factors influencing it and their
impacts.
Practice Setting
Psychiatric mental health nursing care is employed in community health organizations
where the patient with a psychiatric disorder is handled holistically. These settings are readily
available areas where they provide services at the patient’s homes and other community-based
centers (Owusu et al., 2022). The personnel mostly consist of psychiatric nurses, social workers,
and psychologists, ensuring every patient has a therapeutic care plan. These include the
prescription of medicines, stabilizing the client during emergencies, and counseling on mentally
embracing disorders such as anxiety, depression, or schizophrenia. Patients include children
receiving their first psychiatric intervention and adults with long-term illnesses, which makes it
possible to consider current and specific needs while promoting patients’ early recovery in
familiar environments.
Practice Problem Overview
In my current practice setting at a community health organization, a significant problem
observed is the high rate of readmission due to relapse among patients with bipolar disorder.
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Data indicates that approximately 23.8% of patients experience readmission within an average of
9.4 months post-discharge, primarily linked to inadequate community support and symptom
management (Abaatyo et al., 2023). Compounding this include factors like noncompliance to
medication, psychologically related stress, and inadequate health checkups. The consequences
are quite far-reaching; frequent admissions take a toll on patients’ well-being, burden the
healthcare delivery system, and are costly to families and the system. Solving this problem is
vital for patients’ outcome enhancement and resource utilization in mental health services.
Improved community-based interventions and more appropriate discharge planning should
reduce these readmission rates substantially.
Statement of the Problem
Table 1
Problem Statement Development Table
Questions Answers
What is the problem? The problem is the high rate of readmission
due to relapse among patients with bipolar
disorder.
Who does this affect? This issue affects patients with bipolar
disorder, their families, and the healthcare
system.
How does this problem make you feel? It is concerning and frustrating, as it
highlights gaps in care and support for
vulnerable individuals.
When is it a problem? It becomes a problem during and after
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hospital discharge when patients struggle with
ongoing management.
Why should I care? Addressing this issue is vital for improving
patient outcomes, reducing healthcare costs,
and enhancing community well-being.
How does it affect the customer? It leads to decreased quality of life for
patients, increased stress for families, and a
lack of trust in the healthcare system.
The high rate of readmission due to relapse among patients with bipolar disorder affects
approximately 23.8% of individuals within 9.4 months post-discharge (Murray et al., 2020;
Johnson et al., 2021). This problem poses a significant challenge to both patient well-being and
healthcare resources.
Literature Overview of the Problem
The problem of treatment and readmissions because of relapse in patients with bipolar
disorder has drawn much attention within the last few years in the field of psychiatry, and there
is evidence of multiple factors associated with this ongoing issue. BD is a manic-depressive
illness marked by disruptions of bipolar syndrome in terms of management, where prognosis
strongly predicts hospitalization. Conducted examinations also show a high percentage
readmission rate, and relapse among bipolar individuals can be as high as 69.4% within the first
year after discharge (Abaatyo et al., 2023). Such frequency not only supports the view on a
chronic character of the disorder but also underlines the shortcomings of the existing treatment
strategies.
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The identified predictors of readmission include comorbid psychiatric disorders,
noncompliance to medication, and lack of support on discharge. For instance, Palacios-Ariza et
al. (2023) found that patients with bipolar disorder have higher readmission rates if they also
have personality disorders or alcohol dependency. Also, patient readmission is influenced by the
length of different hospitalizations and the quality of discharge plans (Palacios-Ariza et al.,
2023). These findings suggest that before setting off the severe acute phase of bipolar disorder,
the coping interventions must factor in such psychosocial factors that provoke relapse.
Despite the growing availability of data showing these trends, there is still a significant
lack of knowledge about the approaches that can be applied to decrease readmission rates.
Comprehensive models that include these identified service types in usual practice have not been
established. However, some researchers have paid attention to the effectiveness of community-
based care and crisis intervention services (Taban et al., 2024). This gap signifies that there is
still a dire lack of studies emerging on the identification of effective relapse prevention and
management of hospital readmission risks.
Moreover, the possible use of machine learning for discharging hospital admissions for
treatment of bipolar disorder-related symptoms has not been adequately investigated (Palacios-
Ariza et al., 2023). An opportunity for predictive analytics to help alert carers to specific patients
before a crisis arises may bring about a major change in the delivery of care in psychiatric
facilities. However, existing research gives relatively little information about the real-life
application of such technology in psychiatric healthcare. Further, the role of culture and context
is well understood to impact the management of bipolar disorder and its related readmission
rates. Low-resource settings like Uganda require studies that analyze data from such settings to
determine how the patterns of the symptoms can be used to predict readmissions (Abaatyo et al.,
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2023). It is important to appreciate these dynamics in the effort to design community-based
interventions that might help reduce the raw effects of BD on people and health delivery
systems.
Therefore, the present study aims to find out the prevalence of readmissions in bipolar
disorder patients and the factors that lead to rehospitalization and to fill the important gap in the
literature focusing on intervention strategies. Future research should focus on modeling whole
system solutions and using advanced analytics in planning, designing, and delivering community
care strategies to address this issue. In so doing, it becomes possible to improve the quality of
patient care, thus decreasing the strain that contemporary healthcare systems have as a result of
repeated readmissions in bipolar disorder.
Implications
The implications of high readmission rates in bipolar disorder patients are not only
significant for the patients themselves but also concern healthcare practitioners and practice
environments. For patients, repeated admissions only worsen their mental status, increase
stigmatization, and decrease their quality of life since the illness is chronic (Berghöfe et al.,
2020). Many struggles are experienced in managing these cases through increased frustration
resulting from limited effective interventions and resources for healthcare givers, leading to
burnout (Berghöfe et al., 2020). From real-world experiences, high readmission levels are not
only resource-demanding and expensive but also provide suboptimal patient care by drawing
much attention and effort away from other clients (Abaatyo et al., 2023). Therefore, the cycle of
relapse and readmission means that there is an urgent need to address current and future better
care for strategies and support systems for bipolar disorder.
Conclusion
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The high rate of readmission due to relapse among patients with bipolar disorders shows
that there are many deficiencies as regards community support and symptom control. Several
factors have been identified explaining the problem, such as medication non-adherence and
insufficient discharge planning, which have also been discussed, as well as the paramount
importance of effective community-based interventions. By addressing these challenges, the
specific healthcare system boosts the quality of life of the patients and, in return, reduces
readmission cases. Finally, improving the care of bipolar disorder patients is helpful to their
well-being and austerity, as well as to efficiently use scarce healthcare resources to build a strong
community mental health system.
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References
Abaatyo, J., Kaggwa, M. M., Favina, A., & Olagunju, A. T. (2023). Readmission and associated
clinical factors among individuals admitted with bipolar affective disorder at a psychiatry
facility in Uganda. BMC Psychiatry, 23(1), 474. https://doi.org/10.1186%2Fs12888-023-
04960-0
Berghöfer, A., Martin, L., Hense, S., Weinmann, S., & Roll, S. (2020). Quality of life in patients
with severe mental illness: A cross-sectional survey in an integrated outpatient health
care model. Quality of Life Research, 29, 2073-2087. https://doi.org/10.1007/s11136-
020-02470-0
Owusu, E., Oluwasina, F., Nkire, N., Lawal, M. A., & Agyapong, V. I. (2022, September).
Readmission of patients to acute psychiatric hospitals: Influential factors and
interventions to reduce psychiatric readmission rates. In Healthcare (Vol. 10, No. 9, p.
1808). MDPI. https://doi.org/10.3390%2Fhealthcare10091808
Palacios-Ariza, M.A., Morales-Mendoza, E., Murcia, J., Arias-Duarte, R., Lara-Castellanos, G.,
Cely-Jiménez, A., Rincón-Acuña, J.C., Araúzo-Bravo, M.J. & McDouall, J. (2023).
Prediction of patient admission and readmission in adults from a Colombian cohort with
bipolar disorder using artificial intelligence. Frontiers in Psychiatry, 14, 1266548.
https://doi.org/10.3389/fpsyt.2023.1266548
Taban, M., Nooraeen, S., Tanha, K., Moradi-Lakeh, M., & Malakouti, S. K. (2024).
Effectiveness and cost-effectiveness of community-based mental health services for
individuals with severe mental illness in Iran: A systematic review and meta-
analysis. BMC Psychiatry, 24(1), 256. https://doi.org/10.1186/s12888-024-05666-7
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,
|
Criteria |
Ratings |
Pts |
|
This criterion is linked to a Learning Outcome Topic Addresses all components of the assignment. |
40 to >37.9 pts Advanced Comprehensively addresses all components of the assignment. 37.9 to >31.9 pts Competent Addresses all or most components of the assignment adequately and/or components are not addressed or not addressed comprehensively. 31.9 to >0.0 pts Emerging Addresses all or most components of the assignment but not adequately and/or components are not addressed. 0 pts Incomplete Missing or Assignment was not submitted and/or not submitted on time |
40 pts |
|
This criterion is linked to a Learning Outcome Support and Evidence Uses evidence to support main tenets, points, or arguments presented in the assignment. |
40 to >37.9 pts Advanced Uses comprehensive, appropriate evidence to support the main tenets of the assignment. 37.9 to >31.9 pts Competent Uses adequate but minimal evidence to support the main tenets of the assignment and/or the evidence cited is weak, unrelated, or does not support the part of the assignment in which is it cited. 31.9 to >0.0 pts Emerging Does not adequately use appropriate evidence to support the main tenets of the assignment. 0 pts Incomplete Missing or Assignment was not submitted and/or not submitted on time |
40 pts |
|
This criterion is linked to a Learning Outcome Organization and Coherence Uses a logical progression of ideas and presents a clear articulation of main tenets. Almost entirely free of spelling, punctuation, and grammatical errors. Written coherently, using APA format or another format as required. |
35 to >33.25 pts Advanced Clear, logical, coherently written and appropriately formatted 33.25 to >28.0 pts Competent Assignment has some organizational, writing, and/or APA problems which distract from its flow and understandability. 28 to >0.0 pts Emerging Assignment has many organizational, writing, and/or APA problems which distract from its flow and understandability. 0 pts Incomplete Missing or Assignment was not submitted and/or not submitted on time |
35 pts |
|
This criterion is linked to a Learning Outcome Cumulative Impression The assignment, as a whole, is scholarly, compelling, and impressive. |
35 to >33.25 pts Advanced The assignment as whole reflects graduate level scholarship. It is compelling, impressive, and contributes to expansion of knowledge. 33.25 to >28.0 pts Competent The assignment as whole is adequate as graduate level scholarship but needs polishing. It does not reflect a clear contribution to expansion of knowledge. 28 to >0.0 pts Emerging The assignment is unclear or inadequately structured with multiple content, organizational, writing, or APA problems. 0 pts Incomplete Missing or Assignment was not submitted and/or not submitted on time |
35 pts |
Graduate Assignment Rubric – 150 Points (2)
Graduate Assignment Rubric – 150 Points (2)
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