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NURS FPX 6218 Assessment 1 Proposing Evidence-Based Change

ACD is a type of skin disease that results from direct exposure to specific allergens and chemicals and can dramatically change the lives of those afflicted. This is called delayed type IV hypersensitivity, a common occupational and environmental health factor. Such factors may be acquired or inherited; these include skin diseases that exist before contacting the products, hereditary factors, or exposure to irritants (Nassau & Fonacier, 2020). Nurses play a significant role in managing ACD by performing skin care, applying topical agents, educating patients about allergens, and being sensitive to how they feel about it, according to Thyssen et al. (2022). When correctly managed, symptoms of ACD can adequately be controlled, improving the life quality of patients diagnosed with the condition. The task of searching for effective treatment for ACD should be sought from other systems than the American healthcare system.

Executive Summary

  • Proposed Change

Cuca et al. opined that gaps endemic to healthcare institutions must be closed to support improved healthcare outcomes among patients with ACD. Educating patients about the diagnosis form will help them understand what caused the allergy and what changes they can make to respond to it. Those already sensitive to synthetic rubber should select a variety of gloves with the rubber accelerator they cannot be allergic to, for instance, carbamates or a different compound (Dejonckheere et al., 2019).

The best management of ACD comprises determining the source of the allergen and ensuring it is obliterated from the environment. At times, the symptoms of SCAD can be severe and can only be treated by the nurse using antihistamines and dermal or oral corticosteroids. Once the specific allergen has been ascertained, these patients must steer clear of it to avoid a relapse (Lipman & Tosti, 2021).

ACD significantly alters an individual’s quality of life attributable to worsening conditions or deterioration of the affected body parts. From the outcomes listed above, it has been ascertained that ACD patients diagnosed early achieve better outcomes. This is one of the emerging concerns in the medical field that is of dire concern to medical practitioners globally (Ahlström et al., 2019).

Local or Regional Health Care System for the Proposed Change

There is one particular local healthcare system that ACD must reconsider its approach to The North Central Health Care system in Wisconsin, specifically in the United States (NCHC, 2023). For instance, when managing ACD in the NCHC, the institution must use the interventions and strategies of the Mayo Clinic (Mayo Clinic, 2023). Most care patients and their families must be aware of possible allergens in cosmetics and personal care products, including nickel, fragrance, and preservatives. In their study, Uter et al. (2020) stated that ACD can worsen a patient’s quality of life because of reactions like itch, erythema, swelling, and formation of blisters.

A task related to the NCHC system that patients should be taught is how to avoid allergens, whereby ACD complications may occur. Regarding improvements to reduce ACD, they should consider altering patient education and environment and learning how to take care of their skin correctly. Consequently, clinics caring for asthma patients should equip their personnel with knowledge regarding the clinical presentation of ACD and adequate treatment and management directions (Haque et al., 2022). Furthermore, it is also feasible to incorporate the education of patients regarding the avoidance of allergens that reduce the incidence of ACD through social media platforms (Nguyen et al., 2021).

Effectively, nurses can achieve patient education and training through their roles in organizing, assessing, and implementing patient training. This will help ACD stress the immunologic background, preventive measures for allergies, proper application of corticosteroids, and potential complications (Thyssen et al., 2022).

  • Expectations

Knowing how a disease works can provoke a strong focus on anxiety-provoking stimuli without necessarily eliciting new behavior. When addressing the need to encourage the development of behaviors that enhance the person’s present and future quality of life, aspects of growth, prior learning, and contact with healthcare professionals should be considered. Thus, the stated approach can yield more effective positive outcomes.

Measurable and easily understandable guidelines should be set to improve overall health care and educate the lower mortality on tackling AC Dermatitis. This includes informing people about the condition, such as where the allergic response is triggered, the symptoms brought about by the condition, and the recommended therapy. Healthcare workers should avoid cross-contamination of data and utilize protective garments and hypoallergenic skincare merchandise to reduce the likelihood of its reappearance (Uter et al., 2020).

Desirable Outcomes

Patient results we want to see include the following  Patient results we want to see include the following:

Establishing the toxins or triggers that cause allergic contact dermatitis (ACD).

Prevention from allergens. The patient assesses the medication’s delivery method, duration, and efficacy. According to patients’ experiences, the main focus of an institution’s interdisciplinary team is to enhance the outcome. The doctor may advise on the need for treatment in some instances. However, patients are advised to seek advice from a pharmacist about the options available for the specific drug and its usage. The patient targeted and the body part involved in the cancer determine the treatment approach, with the subsequent need for continuing education and consultation with experts (Lampel & Powell, 2019).

  • Limiting Factors

That is why several factors hinder the attainment of the ideal objective in tackling ACD’s continually escalating healthcare costs in America. Another factor increasing the expense is insurance coverage issues, where usually, the insurance company only contributes a fraction of the total amount required for treating ACD. These are costs that patients pay directly and are stressful, particularly when they lack adequate funds to meet the expenses (Herman et al., 2021).

The financial burden for care and costs related to ACD ends with the patient paying for diagnosis procedures and medications. This may be a strain for people without insurance coverage, who also require treatment similar to that of their insured counterparts. In addition, such patients cannot afford insurance for their condition, and when the illness is diagnosed late and thus exacerbated, the cost of medical care rises.

The Rationale for the Proposed Change

Specific changes can help ensure ACD patients return home with definite results because they can help minimize the occurrences or intensity of the symptoms related to their allergy conditions. For instance, by avoiding irritants that cause ACD, patients can reduce the inflammation and soreness in the affected skin. Additionally, identifying ACD patients earlier and teaching them about allergens would make the treatment and healing process more efficient, so their quality of life will likely improve significantly (Ahlström et al., 2019).

Therefore, the expected outcomes are to be attained by diminishing the severity and frequency of symptoms of ACD, enhancing the treatment results of ACD, and improving the general well-being of people. These improvements can be explained by research, including a study by the NIH that showed that early diagnosis, when the rash has not progressed to second-degree cheese, and refraining from contacting an allergen may reduce inflammation and discomfort in ACD (Murphy et al., 2019).

Comparative Analysis of the Healthcare System

Accordingly, England, India, and the USA have broad overviews of managing ACD, identified from the determinants of the toxins or triggers that cause ACD, allergen avoidance, and patient satisfaction, as shown in Table 1 of the Appendix. These SCFs work hard to deliver the highest levels of care for ACD; by utilizing them, patients can better cope with the disease.

In light of the ongoing initiatives in the United States to deliver the best level of health care to its citizens, the forum finds it apposite to draw from systems practiced in England and India. If work on the individual and organizational level is carried out correctly, healthcare providers can reach the goal of concentrating on patients’ needs and providing good quality healthcare services. They can also improve the quality of the health with which their patients are being treated due to the better treatment.

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Outcomes must be defined so that their achievement can be verified with high confidence. Outcomes should also be arranged in a logical and realistic sequence. The following sections will examine how these principles apply in practice. Outcomes must be designed in a way that is measurable and possible to achieve. How is this done? The following is the typical sequence of outcomes. Outcomes are sequential in an approach.

For this purpose, the amount of research information that can be accumulated from yearly patient records and self-completed surveys, including the number of patients who clinically recognize the toxins or triggers that cause ACD, the ability of patients to avoid allergens and patient satisfaction.

  • Lessons Learned

Successful healthcare systems have been used in England, India, and the USA, including guideline formulation on the issue of triggers, Allergen avoidance education, and patient satisfaction interventions used in the control of ACD. Among the prospective conclusions that can be made based on these examples, the following possibilities are significant: National procedures should be developed or improved for ACD triggers; information focused on allergen avoidance should be available for the patients; and patient satisfaction schemes should be used. Learning from such principles in healthcare means the patient gains the best results, and the system does its best.

Financial and Health Implications

If implemented, the changes proposed could improve the outcomes of the ACD patient’s beneficiaries financially and in terms of health. The cost implications of managing the disease will decrease since implementing new changes may lead to the early identification of ACD patients, including the offering of patch testing. It should be noted that early condition identification helps avoid significant treatment expenditures needed to eliminate the disease manifestations, such as antihistamines or corticosteroids (Ahlström et al., 2019). This, in turn, leads to early detection. Thus, the patient can receive the proper treatment and cherish the chance to alter their lifestyle in minis, which may, in turn, enhance their quality of life and roll down the expenses of chronic treatments (Herman et al . , 2021).

On the other hand, failure to implement the proposed changes could be financially and healthwise unproductive and costly. ACD, if untreated or diagnosed early but left untreated, could worsen to a stage where first-line treatment is insufficient, and a more intensive form of therapy, like the administration of oral or intravenous steroids, may be needed. This might lead to significant expenses for the individual and the healthcare system. Moreover, early diagnosis is still absent, which might result in a lower quality of life for the patient since the disease progresses and can endanger work and basic daily living. A survey that was carried out in the United States of America revealed that offering some form of access to patch testing went a long way in significantly bringing down the expenses of managing ACD (Goldenberg et al., 2020). Further, the symptoms experienced by the people who did the patch testing were much lower, and their quality of life was much better than those who could not afford the test.

Conclusion

The changes proposed to improve the overall health status of those with ACD can, therefore, impact the financial and health aspects. From the above evidence, such changes may lead to the following benefits: they will be cheaper than the current system, and the mental health of candidates with ACD will improve. Some strategies adopted by the UK, India, and the United States are the outbreak of strategies to enhance early detection of ACD, identification of allergens and toxins, and facilities to assist patients with the disease. However, These strategies have been identified as effective in cutting costs commonly associated with treating ACD and enhancing patient satisfaction. Hence, expecting to make the changes that will help to obtain a higher quality of healthcare for the patients diagnosed with ACD can have the potential for financial and, mainly, health improvement.

Click below to explore more related samples:
NURS FPX 6218 Assessment 2 Assessing Community Health Care Needs
NURS FPX 6218 Assessment 3 Planning for Community and Organizational Change
NURS FPX 6218 Assessment 4: Advocating for Lasting Change

References

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Ahlström, M. G., Thyssen, J. P., Wennervaldt, M., Menné, T., & Johansen, J. D. (2019). Nickel allergy and allergic contact dermatitis: A clinical review of immunology, epidemiology, exposure, and treatment. Contact Dermatitis, 81(4), 227–241. https://doi.org/10.1111/cod.13327 

Brites, G. S., Ferreira, I., Sebastião, A. I., Silva, A., Carrascal, M., Neves, B. M., & Cruz, M. T. (2020). Allergic contact dermatitis: From pathophysiology to development of new preventive strategies. Pharmacological Research, 162, 105282. https://doi.org/10.1016/j.phrs.2020.105282 

Dejonckheere, G., Herman, A., & Baeck, M. (2019). Allergic contact dermatitis caused by synthetic rubber gloves in healthcare workers: Sensitization to 1,3‐diphenylguanidine is common. Contact Dermatitis, 81(3), 167–173.
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Goldenberg, A., Ehrlich, A., Machler, B. C., & Jacob, S. E. (2020). Patch test clinic start-up. Dermatitis, 1.
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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) provides guidelines to assist healthcare professionals in determining the toxins or triggers that induce ACD. (NICE, 2019)

India has the Indian Association of Dermatologists, Venereologists, and Leprologists (IADVL), which studies the toxins or triggers that induce ACD. (Gopinath et al., 2020)

The Agency for Toxic Substances and Disease Registry (ATSDR) has an extensive database of ACD triggers and toxins. (Hamza et al., 2022)

Allergens avoidance

The Royal College of Physicians (RCP) provides resources to help patients identify and avoid allergens.

(Michaelis et al., 2019)

The Allergy Research Foundation of India (ARFI) educates the public about allergen avoidance. (Rifu et al., 2022)

The National Institute of Allergy and Infectious Diseases (NIAID) has the Allergen Avoidance Program (AAP) to help people identify and avoid allergens. (Spergel & Togias, 2020)

Patient Satisfaction

British Association of Dermatologists (BAD) has developed a range of interventions to help ensure patients receive the best possible care for ACD (Abbott et al., 2020).

The National Institute of Mental Health and Neurosciences (NIMHANS) has launched a program to improve patient satisfaction in India (Khan et al., 2022).

The Centers for Disease Control and Prevention (CDC) has a Patient Satisfaction Program to help improve patient quality of life (Krpata, 2019).

 

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