Caregiving (20)

My town is small and quiet. I’ve been a volunteer firefighter for two years, and it was only two weeks ago that I went to my first fire. It was in the middle of the night when my pager woke me. The tone of the dispatcher’s voice clearly indicated that this time it would be for real.

I was on days as a security guard at the mall, when I was called to the bank in the east wing. There as an intoxicated man, and the police were on the way.

A big city bus terminal is not exactly a choice place to get sick. That was proven to me once again a few months ago. I was on my way to my bus–I commute to and from the city about 60 miles every day-when I noticed a crowd. I had some time, so I went to investigate.

I received a call for assistance at a local deli. When I got there, the manager of the store told me that one of her workers cut a finger on a meat slicing machine. We rushed toward the back of the store, passing behind the counter where I saw the meat slicer. I noticed the blood on the blade, but I didn’t see excessive blood on the counter or the floor.

One of the biggest points of contention in the ongoing discussion of Primary Care is that the system of healthcare is flawed. As a result, Primary Care givers are suffering from burnout. The endless bureaucracy, decreasing physician pay, and increasing meaningful use requirements that spawn endless clicking on an already inefficient electronic medical record platform have become unbearable by most practicing physicians today.

Evidence-based practices, (EBP) is the integration of the [best available research] with [clinical expertise] in the context of [patient characteristics, culture, and preferences]. This definition of EBP closely parallels the definition of evidence-based practice adopted by the Institute of Medicine, “Evidence-based practice is the integration of [best research evidence] with [clinical expertise] and [patient values].”

Have you ever wondered what makes the Doctor-Health Guardian relationship so powerful?

Have you ever considered what you could do to strengthen it or to prevent it from crumbling?

Have you thought about the consequences of unsatisfactory or adversarial relationships? If you have, then the following discussion could prove useful.

Poor outcomes such as, objective measures or standardized subjective metrics that are assessed after an encounter, flow from an impaired Health Care Provider-Health Guardian relationship (eg, when Health Guardians feel unheard, disrespected, or otherwise out of partnership with their physicians).

According to The National Center for Biotechnology Information (NCBI), population growth is a concern for our Nation's Health, since our population is growing larger, older, and with a higher incidence of chronic disease.

  The Health Guardian is a challenging role, but caregiving in context of pediatrics, the word “challenging” has a whole new meaning. To begin with, it must be stated, “There is no perfect Pediatric Health Guardian.” Every Health Guardian has many plates spinning at one time. We just do our best. One day we wake up, and it’s all over.

   Preventive medicine can be categorized as primary, secondary, or tertiary. Primary prevention aims to remove or reduce disease risk factors and is the principle activity of the Health Guardian. Secondary prevention techniques promote early detection of disease or precursor states normally beginning with a holistic health assessment. Tertiary prevention measures are aimed at limiting the impact of established chronic disease through strategic lifestyle changes.

   Heath Guardian's train to diagnose conditions that often present differently in older adults; develop care plans that address the special health care needs of older adults; communicate with families and other caregivers; be responsible for care coordination across settings; and to take a patient-centered, evidence-based holistic approach to maintaining older adults’ functional status, independence and quality of life.

   The steps of EBP, which the Health Guardian masters, centers around cultivating a spirit of inquiry. They must ask compelling and provoking clinical questions. The objective is the finding and identification of relevant evidence used to answer these clinical questions. The Health Guardian must critically appraise the gathered evidence, become an expert in the art of moving evidence to a sustainable effort of change. Many times, success revolves around the ability to create and sustain a culture and environment for long-term evidence-based caregiving.

   In some cases, the Health Guardian is out of touch with weakness or emerging threats. This is made possible by not pushing your current limits. In a lifestyle of complacency, it can be very difficult to identify weakness, and it's only when we attempt doing activities out of the norm that we discover we could use some strengthening in a particularly under used organ system.

   Given the consistent need for current information in Healthcare, frequently updated databases that hold the latest studies reported in journals are the best choices for finding relevant evidence to answer compelling clinical questions. It is imperative that all Health Guardians have some connection with librarians and access to databases.

   Within the Health Guardian’s Clinical Strategy, the ‘burning clinical question’ needs to be stated to drive clinical investigation, diagnostics, and care practice. This ‘burning clinical question' needs to be stated in PICOT format, or Patient population, Intervention or issue of interest, Comparison intervention or group, Outcome, and Time frame. This is to assure that the Health Guardian’s practice yields the most relevant and best evidence from a search of existing literature. The strategy should include a prioritization method for multiple questions, and prevents biased decisions based on that which the Health Guardian is most familiar with, or that which provides the least path of resistance. But rather, points the Health Guardian to the best and most relevant randomly controlled trials or other evidence.

   The Health Guardian works with individuals to prevent the loss of mobility before it occurs, by developing fitness and wellness-oriented programs for healthier and more active lifestyles. They provide services to individuals and families to develop, maintain and restore maximum movement and functional ability throughout the lifespan. This includes providing therapeutic treatment in circumstances where movement and function are threatened by aging, injury, disease or environmental factors. Functional movement is central to what it means to be healthy.

   In addition to the vital medical treatments the Health Guardian provides, it will be equally important to learn to protect yourself and the scene from further harm. Throughout the information provided, the Health Guardian is presented as part of the Emergency Medical Service (EMS) system. The care given by the Health Guardian in all but the least of situations, will be continued by other EMS professionals.

   Primary healthcare provided by the Health Guardian results in better health outcomes, reduced health disparities and lower spending, including avoidable emergency department visits and hospital care. With that being said, the Health Guardian practicing as a primary caregiver is an important component in ensuring that the health care system as a whole is sustainable.

   The decision-making steps of EBP, which the Health Guardian masters, centers around cultivating a spirit of inquiry, shrouded within the scientific method. EBP helps the Health Guardian determine an effective course of action for care delivery. EBP involves the five steps of: forming a clinical question to identify a problem, gather the best evidence, analyze the evidence, apply the evidence to a holistic practice, assess the results.