The Role of Advanced Practice Nurse in Treatment
Abstract
The primary purpose of this article is to draw attention to the problem of malnutrition. Unfortunately, the issue of malnutrition has become increasingly significant over the past few years, the problems of both obesity and undernourishment have grown out of proportions, therefore, clearly demanding a solution. Therefore, it is essential that the problem should be addressed from a nursing perspective and that further suggestions regarding the means of reducing the malnourishment rate in the United States should be made.
The study shows that the lack of awareness and the pressure of social media along with the economic issues are the key factors leading to the development of malnourishment problems. Therefore, it is imperative that a program aimed at raising awareness should be designed and that APRNs should promote the concept of a healthy lifestyle in a more agile manner. Once the audience at risk receives detailed instructions on the ways to identify the symptoms of malnourishment as well as address and prevent it, the rates of the health issue under analysis are bound to drop.
Introduction
It is imperative to note that techniques to prevent and limit instances of malnutrition have been actively discussed over the last few years because this issue can be viewed as extremely problematic. One of the most significant problems that should not be overlooked is that this condition can be caused by hospitalization in some situations. It needs to be said older patients are at an increased risk because of numerous internal and external factors that should not be disregarded. The fact that recovery times are increased significantly is a major issue that should be taken into consideration. Wounds are healed much more slowly in most situations. It is paramount to understand the reasons for such poor diets, and how healthy eating behavior can be promoted among patients.
Lit. review
The fact that tools to measure the level of malnutrition have been developed is essential because treatment can be started much earlier in most cases. For example, one of the suggested instruments takes such factors as a decrease in food intake, weight loss, mobility, psychological stress, neuropsychological problems, and body mass index into consideration. A professional can identify the status of the patient based on the data that is received, and it is possible to understand if one is at the risk or is currently malnourished. It should be said that there are no issues with validity and this tool can be regarded as extremely reliable (Sarikaya et al., 2015). The fact that it was previously revised is also quite important because such instruments are always in need of improvement most of the time. Another significant aspect that should not be disregarded is that it can be easily treated in most situations depending on the environment. The identification plays a vital role because therapy can be started promptly. The overall role of proper nutrition should not be disregarded, and it needs to be said that it is especially critical for senior citizens because of changes that are associated with aging (Trabal et al., 2015).
The primary issue that is worth noting is that the numbers of children that suffer from this condition are truly astounding, and it may lead to numerous complications that cannot be reversed. Every trained professional should understand that such a problem should not be taken lightly, and should take necessary measures in case malnutrition is suspected. One of the most significant aspects that should not be overlooked is that the development of a child may be at risk because of a lack of essential vitamins. It needs to be said that currently there is a need for future research on this topic, and available approaches need improvement because mortality rates are still incredibly high most of the time. Also, it should be noted that this problem is not as significant in the United States, but a professional should have an understanding of a course of actions that should be taken in such situations. Such issues as dental caries can be avoided, and long-term complications can also be prevented most of the time. The fact that children have an increased metabolic rate should not be overlooked because they require much more energy, and body fat stores are also not significant enough to deal with metabolic stress (Sarikaya et al., 2015). Also, it is necessary to understand that young patients that suffer from malnutrition have a reduced ability to deal with illnesses, and it may complicate the process of recovery.
The fact that there is no consensus on what screening tools should be used is also an issue. However, cases of slow growth may be identified most of the time. Body mass index should be viewed as vital, and it is quite possible to see if a substantial fall in weight over a particular period is present. Such symptoms as short stature, poor condition of hair, visible vertebrae should not be taken lightly. It is paramount to make sure that tools that are used to measure body weight and height are available in all the healthcare institutions, and their state should be monitored. It is paramount to say that the reliability of results that are received is essential. Every advanced health nurse should be able to recognize health issues that are related to malnutrition such as constipation and reflux and should have an understanding of what measures should be taken in such situations. One should be able to utilize the knowledge that was gained to make sure that patients are provided with high-quality services. For example, a nurse should be able to prepare feeds for infants that are appropriate for a particular age, suggest feeding patterns that are suitable, and have an understanding of what portion sizes are reasonable. It is necessary to understand that culture and traditions also should be taken into account most of the time such dietary practices such as the vegan diet may lead to malnutrition if parents are not careful. A professional nurse has a vital role in most situations, and one should understand that they have a broad range of responsibilities. One should be able to identify if there is a case of emergency and make sure that treatment is started promptly.
It would be wrong to assume, though, that only children suffer from the condition in question. Malnutrition also affects elderly people, especially those who reside in nursing homes, and, therefore, need the assistance of nurses to shape their diet and make sure that it allows for a healthy lifestyle and proper nutrition. The study displays it quite clear that the rate of the patients’ recovery as far as their functional impairments are concerned is in a direct proportion to the number of nutrients that they retrieve from their daily meals:
The relation of low BMI to functional impairment was less pronounced though and limited to a significant association to immobility. Likewise, in another nursing home sample BMI <21 kg/m² was strongly associated with sarcopenia (37), underscoring the presumed role of good nutritional status in preventing its onset and consequent mobility loss. (Stange, Poeschl, Sthele, Sieber, & Volkert, 2015, p. 361)
Therefore, the study makes it quite clear that the malnutrition issue is much more complicated than most patients give it credit for. Also, it should be said that it is extremely interesting that the percentage of people that are affected by this condition frequently varies. It is caused by the fact that the economic situation in the country and other external factors may have an enormous impact on the eating habits of the population. Also, it is imperative to say that clinical risks are significant most of the time, and an increase in mortality rates is especially worrying.
Another aspect that is frequently overlooked is that deficiency that this condition causes can be viewed as extremely problematic. A lack of iron can lead to such severe complications as a weakened immune system, and patients are at an increased risk of the development of several illnesses. Iodine deficiency is also a critical issue because it may cause problems with the thyroid. A diet that contains necessary vitamins should be taken into consideration in such cases.
The importance of early interventions also should not be overlooked. It is paramount to note that currently there is no consensus on what approach is the most efficient. Another critical aspect that should be taken into account is that the current healthcare system is extremely dependent on technologies, and some of them may be disruptive. It is hard to argue with the fact that the introduction of new medical techniques is essential because it is evident that numerous issues are currently present.
One of the core issues that should not be overlooked is that many hospitals do not understand that every professional should be involved in the process. The role of advanced practice nurses is crucial because it is necessary to develop leadership to make sure that patients are provided with services of the highest possible quality. Another aspect that should not be overlooked is that participation in studies is also quite important, and one should be able to utilize the experience that was gained to provide suggestions and theories on how current approaches can be improved.
One of the recent studies indicates that the duration of the hospital may be significantly reduced if strong nutrition care is provided (Tappenden et al., 2013). It is imperative to say that this aspect should not be disregarded because cost savings can be regarded as substantial most of the time. One of the central issues that healthcare has to deal with is the necessity to minimize expenses, and necessary measures should be taken to make sure that resources are spent efficiently.
The fact that advanced practice nurse has access to tools that would help to increase awareness of this issue is critical. The primary aspect that needs to be discussed is that many individuals still lack an understanding of why malnutrition can be incredibly dangerous, and what measures should be taken to prevent any severe complications (Varitsakul et al., 2013).
It is extremely necessary to make sure that every instance of malnutrition is promptly diagnosed, and the number of incidents can be significantly reduced. It needs to be said that the current situation cannot be viewed as acceptable, and it is paramount to take necessary measures to make sure that the population is educated about the issue. Any case of malnutrition should be taken seriously, and a professional should take necessary measures in case there is any suspicion. One should understand that the presence of such primary symptoms as lack of energy, a reduction in appetite, reduced wound healing, dry skin should not be taken lightly. The prevalence of this condition is truly astounding, and the fact that the number of incidents is still enormous is extremely problematic. It is imperative to say that this problem needs to be addressed, and it is imperative to develop the guidelines that would help professional nurses to understand what course of action is appropriate in such situations.
Also, another critical aspect that should be taken into account is that it is paramount to understand the primary causes of malnutrition. It is necessary to understand that the reasons for this condition may be both internal and external. It needs to be said that social ones are especially problematic because socioeconomic and environmental are extremely hard to resolve. Such risk factors as lack of education on this topic and age should not be overlooked in most situations. It is also necessary to say that a reduction in appetite that was caused by medications also can be perceived as an issue. It is also a known fact that mental problems can lead to similar issues. It should be understood that missed meals in a hospital environment should be taken very seriously, and it is paramount to make sure that the patient eats well if it is possible in a particular situation.
An enormous number of adverse effects that are caused by many medications can also be regarded as one of the core issues. The presence of comorbidities can also be extremely problematic because it complicates the treatment in most cases, and sometimes it is not an easy task to identify what has led to such a condition (Shueren et al., 2014). Anemia should be regarded as especially problematic because it increases mortality in most situations. Any alterations to nutritional requirements that are caused by diseases can be viewed as critical. It is paramount to say that any changes in taste and smell can also have an impact on the diet of a particular individual.
Nutrition screening is essential because it allows identifying any issues that are present, and they can be resolved promptly to avoid severe complications. Some of the tools that are currently available have proved their effectiveness, and no issues with validity are present. Another critical aspect that should not be overlooked is that
The development of screening tools is essential in most cases, and they can be altered depending on the needs of a particular patient.
The advanced care nurse should actively participate in the process to ensure that numerous internal and external factors are taken into account.
It is necessary to note that an education plan is especially important in most situations. The biggest problem that is currently present is that the number of cases that are not reported is truly astounding, and an enormous amount of resources should be devoted to the education of the population. It is imperative to say that many individuals still lack the understanding of why this is a significant issue and may lead to severe complications.
Impact on APRN
The problem of maltreatment discussed above affects not only the process of administering the services of an APRN to the patients with a malnutrition issue but also how APRNs perceive their job and responsibilities. Particularly, the need to address an increasingly large number of issues related to malnutrition presupposes dealing with the personal issues that the patient is likely to have. While malnutrition is often linked closely to one’s social and financial status (e.g., the lack of proper nutrition can be explained by the lack of financial resources required to maintain a healthy lifestyle), the importance of personal issues is not to be underrated, either. Therefore, when facing the issue in question, APRNs often have to adopt a patient-centered approach (Dwamena et al., 2012), which is a major step in the right direction. According to the existing definition, the patient-centered approach allows for six essential outcomes:
Exploring the patient’s illness experience; understanding the whole patient; the doctor and patient finding common ground for managing the illness; the incorporation of health promotion and self-care to the consultation; paying attention to the quality of the doctor-patient relationship, and being realistic about what can be achieved. (Kitson, Marshall, Bassett, & Zeitz, 2012, p. 9)
Therefore, by seeking ways to address the issue of malnutrition, APRNs design the tools that promote the evolution of nursing and the development of new strategies that will help improve the quality of the services provided by APRNs.
In other words, the development of the issue may trigger a further increase in the rates of APRNs’ competencies as long as the problem is addressed appropriately and the necessary studies are carried out. The adoption of a patient-centered approach and the focus on the individual characteristics of the target population as the means of managing the issue in a manner as efficient and expeditious as possible can also be viewed as one of the key effects of the situation under analysis.
Therefore, despite being an admittedly negative phenomenon, the development of the malnutrition issue may contribute to the further evolution of the nursing practice in general and the means of addressing patients’ problems in particular. Even though a patient-centered approach can be viewed as rather challenging for nurses, it still allows for the best outcomes for patients as it helps identify the treatment method that applies to a specific case and is aimed at addressing a particular factor or a set of factors that have caused the nutrition issues.
The resources used in the review provided above can be deemed fairly credible, as they come from peer-reviewed journals. In other words, the articles used as support for the statements made in the paper were written by scholars and, therefore, can be deemed as academic resources. Furthermore, the specified resources have been published comparatively recently. Each of the articles used in the review was published between 2010–2015; although the five-year gap is rather big, it still helps keep the focus on the studies that have been published recently and, thus, offer credible information. Thus, the significance of these studies on the current research cannot possibly be doubted.
Awareness
Studies also show that there is a considerable lack of awareness on the subject matter (Steiber et al., 2015). According to recent research, there is a range of misconceptions regarding the issue of nutrition, each leading to a variety of negative outcomes from obesity to anorexia. Indeed, recent studies point to the fact that the malnutrition issue is enhanced significantly by the lack of awareness among the target denizens of the population (Force, 2013). Particularly, the assumption that malnutrition (e.g., obesity or anorexia) is easy to address affects the lives of numerous denizens of the U.S. population. By taking the problem lightly and believing that they are going to handle the possible issues rather easily, people underestimate the weight of the possible negative outcomes and adopt unhealthy eating habits. Therefore, awareness regarding the specified threat and the means of managing it must be spread.
One must admit that malnutrition issue is often linked directly to not only being misinformed concerning the proper eating habits but also a variety of social issues, poverty being the key one. Unable to choose from the variety of healthy products that are comparatively costly, people are forced to consume their cheaper substitutes of deplorable quality, therefore, subjecting themselves to the threat of malnutrition. The specified social issue also needs to be discussed and managed properly by APRNs; however, the specified problem has to be dealt with at an administrative level by suggesting the creation of centers that will help people in need. By building the centers that will provide the corresponding nursing services for free one will be able to manage the aforementioned issue rather efficiently.
The lack of awareness described above as one of the key impediments to addressing the nutrition issue among the U.S. population can be attributed to a variety of myths regarding the nutrition process that are widespread in modern media and, therefore, affect people’s lives directly shaping their behavioral patterns. The current concepts of beauty, which are foisted onto people with the help of visual media, including Photoshopped magazine covers, billboards, etc., trick people, especially young ones, into choosing an improper diet to achieve the results that are likely to contradict the principles of healthy eating. As a result, the people following the present-day beauty standards often face the problem of malnutrition, starving themselves to a deplorable state. The severe depression following a failure to comply with the above-mentioned beauty standards, in its turn, may cause one to eat an excessively large amount of food and, as a result, face obesity, which is one of the greatest malnutrition issues not only in the U.S but also all over the world: according to the statistical data retrieved recently,
Implications
Overall, it is paramount to say that the most attention should be devoted to counseling and education because it is evident that the lack of knowledge is a critical problem that should not be overlooked in most cases. Indeed, as the studies mentioned above show, in most cases, the development of the disorder can be prevented or, at the very least, addressed in an appropriate manner so that the problem should not aggravate to the point where its effects become drastic. However, patients tend to overlook most of the primary symptoms of the disorder, therefore, causing the problem to develop until it becomes evident and evolves into a major health issue. Herein the necessity to increase awareness on the subject matter lies.
Particularly, the information provided by the latest studies on the issue of malnutrition and the role of an APRN in it display quite clearly that the use of the latest tools of information transfer should be encouraged so that the patients as well as the target audience in general, including the at-risk groups, should be provided with the necessary factors regarding the condition under analysis.
As a result, APRNs will be able to locate the needs of the patients in a more accurate matter; moreover, the unique needs of individuals can be taken into account when designing the appropriate nursing strategy.
Additionally, the use of the corresponding IT tools will help increase awareness among the target denizens of the population. As the analysis of the recent studies carried out above shows, people have very few sources to choose from when trying to find out about proper nutrition strategies. Seeing that popular modern media is dominated by prejudices regarding the subject matter, patients are very likely to misinterpret the concept of nutrition and subject themselves to malnutrition as a result of being misinformed. Therefore, APRNs must use the resources available, including IT tools, such as social networks, to promote the concept of a healthy lifestyle and good nutrition rules. As long as the target patients have enough trustworthy resources that convey the basic principles of proper eating habits they are likely to adopt the necessary eating behavior patterns. Once the patients receive information from trustworthy sources they are likely to develop healthier behavioral patterns.
Therefore, as a leader, an APR is supposed to make sure that the staff realizes the significance of contemporary sources of information and uses them actively to promote the principles of healthy eating among the target denizens of the population. The specified goal can be achieved by designing a training program in the course of which the staff members will be taught the basics of using contemporary media tools for raising awareness and addressing the needs of patients. Furthermore, IT tools can be used to improve the process of communication between the nurses and, therefore, enhance the efficacy of the corresponding nursing services provided to the patients, particularly, diagnosing the problem and administering treatment to the target denizens of the population.
Apart from the obvious changes to how the concept of a healthy diet is perceived by the target denizens of the population, one will have to consider changing how the nursing staff operates in the designated environment. Particularly, one must make sure that the process of providing the target members of the population with the required information and services needs to be taken responsibly by the nursing staff. Herein the need to reconsider the nursing ethics lies; it is crucial that the very foundation thereof should be based on virtue ethics and the idea of assisting those in need.
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