The Cost-Effectiveness of ARN’s in Managing Patients with Addiction and Mental Issues in A Correctional Setting
Overview
In the United States, studies establish that more than 45 million individuals are diagnosed with mental illness on an annual basis (Henderson, 2008). Studies go further to approximate that within a period of six months, health conditions of more than 30 million individuals deteriorate due to lack of mental healthcare treatment. These statistics provide sufficient evidence to prove that there is need to increase availability of preventive services to mentally ill patients.
The problem of mental illness is highly underestimated (Wheeler, 2004). For instance, Wheeler establishes that the main causes of disability include obsessive-compulsive disorder, schizophrenia, bipolar disorder, and main depression. In the United States, studies show that depression is the main contributor of main disabilities. Individuals exposed to particular risks are unattended and disfranchised from society because of poor status. In order to ensure healthcare reforms, McLoughlin and Geller (2010) insist that healthcare systems should be community based, readily available, flexible and able to offer various services that are capable of addressing consumer requirements, particularly underserved individuals. With increasing numbers of deinstitutionalized patients suffering from psychiatric conditions, community service demands continue to increase at an exponential rate. Moreover, the costs of providing community based mental healthcare continue to increase (Happell, 2012).
Effectiveness of APRN’s
In order to ensure that they are successful in providing their services, APRNs are equipped with relevant skills, training, and education. Research shows that patients experience the same outcomes when receiving services from physicians and APRN. The outcome in APRN is higher patient satisfaction at lower costs in comparison to physician services. According to Courtenay and Nicola (2008), nurses can deliver as much as 75 percent of healthcare services and more that 85 percent of pediatric services that come from the primary-care physicians. For instance, educating a nurse practitioner costs more than three times than a physician training does. Family nursing practitioners earn incomes that are typically considered to be less in comparison to those for family physicians. A study conducted by Hudspeth (2006) established that in comparison to physicians, FNPs are capable of providing more health promotion and ordered less costly lab tests. The mentally ill patients targeted by family nursing practitioners conformed better in comparison to the physician’s patients in taking treatments, keeping appointments, and following suggested behavioral changes. Moreover, a study conducted by Aiello-Laws (2009) establishes that healthcare services provided by physicians is similar to that of FNPs. Selected healthcare services provided by nursing practitioners were also more effective in comparison to those from physicians. Moreover, the Nursing practitioners constantly demonstrated better results during counseling, assessment, provision of screening services, consultation time, and follow-up and satisfaction level.
Project Aim
Given the scarcity of significant study findings in this study area, this project aims at conducting comprehensive exploratory study in order to understand significance and cost-effectiveness of APRNs in managing patients with addiction and mental issues. In order to attain this information, qualitative research is of significance because limited knowledge is available in relation to this research question. This project is aimed at comparing the cost-effectiveness of an APRN to the cost effectiveness of a physician in treating incarcerated women with addiction and mental issues.
Professional Goal
As a Family Nurse Practitioner, individuals should have unique skills required to work with patients and individuals exposed to various healthcare complications. In particular, this project exposed FNP to the knowledge on cost-effectiveness of APRNs in managing patients with addiction and mental issues in a correctional setting. While FNP promotes health while preventing diseases, an increasing number of individuals are exposed to various APRN problems. For these individuals, their conditions may deteriorate, shortening their lifespan. This problem underlines the need to conduct research and provide findings on ways of ameliorating the condition.
On an annual basis, several patients will be diagnosed with various mental conditions. The FNP plays the role of extending care services to individuals suffering from mental conditions. For instance, the literature reviews provided in various studies explain that FNP play a significant role in healthcare system (Bowring-Lossock, 2006; Wortans, 2006). Based on this understanding, the recent improvements and progresses in nursing practices and available research findings suggest that the roles of FNP have emerged exceedingly successful in other nursing areas. However, it is unexpected that limited numbers of studies have been conducted in the field of FNP. Therefore, such a study would comprehensively equip FNP with the additional skills and knowledge required to deal with complications associated with mental health conditions. This project addresses this issue as an urgent matter.
Project Objectives
The objective of this study is to evaluate the cost-effectiveness of APRNs in managing patients with addiction and mental issues in correctional setting. In particular, the research presents findings from qualitative and quantitative studies that targets patients receiving treatment and care from nurse practitioners in comparison to those from a licensed medical officers. The literature that is particularly significant to mental health studies mainly relates to the perceived scope and nature, rather than to particular outcomes. As a way of appreciating the possible benefits of nursing practitioners, it is important to explore literature on broader healthcare field. Studies provide significant evidence to prove that the level of satisfaction is similar when comparing the healthcare services provided by medical practitioners and nurse practitioners. However, a study conducted by Elsom (2005) established that patients expressed higher level of satisfaction in services provided by nurse practitioners. Elsom further establishes that general practitioners take a shorter period to deliver particular service in comparison to nurse practitioners. For instance, an appointment between a nurse practitioner and patient taker two minutes longer (10 minutes) in comparison to an appointment with a patient and general practitioner (8 minutes). These findings are supported by a study by McLoughlin and Geller (2010). However, McLoughlin and Geller establish that patients express higher level of satisfaction in services and information coming from nurse practitioners. The results of a random survey conducted by Wortans (2006) established that the patient satisfaction level among patients is similar in services provided by doctors and nurses.
The relevance of this project is further reinforced by the results from a systematic analysis undertaken by Perraud (2006). This researcher established that high level of patient satisfaction with the availed nurse’s healthcare services. These patients expressed satisfaction with the issued prescriptions, return visits, referrals and healthcare outcomes. Most importantly, Perraud explained that nursing practitioners could avail longer consultations services compared to general practitioners. Most importantly, the interviewed patients explained that nurses were able to provide longer consultations and more assistance in terms of knowledge. For instance, these nurses availed written materials that were informative and educative to patients. However, Perraud cites no variation in healthcare outcomes, prescriptions, and return consultations.
According to a study examining the roles of nursing roles in emergency sections, Perraud (2006) came up with the same results. The satisfaction level by nurse practitioners was nearly equal with the quality of services provided by general practitioners. In particular, patients interviewed in Perraud’s study explained that nurses had a higher likelihood of providing specific advisory services and emergency care, health and follow-up services. The patients, in this case expressed satisfaction in service provided after being served by a nurse practitioner. Unluckily, no findings have been provided in previous studies supporting the perception that nurses roles in healthcare setting is more important to other healthcare practitioners. Therefore, it becomes difficult to determine the findings expected from a study conducted to investigate this issue. However, some literature reviews are available to explain the importance of each role of healthcare practitioners in healthcare. Individuals encountering long term mental health complications have a high likelihood of experiencing poor health. The likelihood of recording high mortality among this population is based on the fact that their conditions may make them more prone to respiratory and cardiovascular diseases. Other complications have been explained in Wortans (2006) among patients suffering from mental conditions. According to Wortans, these health complications are caused by exposure to inappropriate behaviors such as smoking, alcohol abuse, inadequate diet, and inactive lifestyles.
Methods
Primary and secondary data will be used in this research. In secondary research, the researcher will obtain information from various already available resources. Major source of information will include findings from previously conducted researches, healthcare publications, newspapers and magazines. The primary research will employ a comprehensive data collection survey. In this survey, the research will gather data from respondents using questionnaires and interviews. In the interviews, the target respondents are incarcerated women with addiction and mental issues. In particular, the study will target individuals receiving treatment and care. These respondents will be provided with briefing on the study purpose. After orientation, the copies of questionnaires will be given to interested respondents. The questionnaires contain full explanation of the study aim and relevant information that should be provided.
After the interview session, the participants will also be provided with an opportunity of raising any further issues that may be relevant for the study. This information will be included in analysis and as a basis for future studies. Although the interview will not have a predetermined time constraint, every respondent will provide information within duration of 10 to 20 minutes.
Timeline
Because of time limitation, this project is scheduled to last for a period of one month. This duration will allow the researcher to conduct a comprehensive research with an aim of gathering relevant information to address the research question. The research timeline is summarized as follows.
- Provide training to the individuals that will be used to gather the relevant information.
- Conduct a survey in order to gather the relevant information by disbursing questionnaires and through interviews
- Submit the data from the survey in order to facilitate analysis
- Conduct two follow-up interviews for ascertaining that the information provided by the respondents is relevant
- Submit the data from follow-up survey in order to facilitate analysis
- Cross-examine the collected data for accuracy in order to prevent biasness
- Prepare a comprehensive discussion and analysis paper in order to cost-effectiveness of an APRN to the cost effectiveness of a physician in treating incarcerated women with addiction and mental issues.
- Submit the prepared paper for evaluation.
- Draw a conclusion, recommendations, and guideline for future research.
Resources
In order to achieve the objectives of this project, the researcher will utilize the main equipment and resources available to enhance achievement of the targeted objectives within the specified duration of time. In this research, primary and secondary data will be sought. The primary data will be collected using questioners that will target particular sampled respondents. Given that time is a major constraint in this research, the research will target a limited number of respondents. The total number of targeted respondents is also limited because of financial constraint. These respondents will be providing relevant information that will be used for generalization. Primary research will collect information from various resources. These resources include previously conducted studies, magazines, newspapers and healthcare reports.
Deliverables
The findings of this research will support the available literature available on cost-effectiveness of an APRN and effectiveness of a physician in treating incarcerated women with addiction and mental issues. This information will be comprehensively analyzed in a comparative study that will seek to understand whether APRN is more effective in comparison to physician. This project will also provide significant basis from which to develop a quantitative methodological approach.
References
Aiello-Laws, L. (2009). Putting Evidence into Practice. Clinical Journal of Oncology Nursing, 13(6): 649-655.
BOWRING-LOSSOCK E. (2006). The forensic mental health nurse – a literature review. Journal of Psychiatric and Mental Health Nursing, 13(1): 780–785.
Courtenay, M. & Nicola, C. (2008). The impact and effectiveness of nurse-led care in the management of acute and chronic pain: a review of the literature. Journal of Clinical Nursing, 17(15): 2001-2013.
Elsom, S. (2005). Mental health nurse practitioner: Expanded or advanced? International Journal of Mental Health Nursing, 14(1): 181–186.
Happell, B. (2012). Community mental health nurses, caseloads, and practices: A literature review. International Journal of Mental Health Nursing, 21(1): 131–137.
Henderson, H. (2008). Community mental health nursing: Keeping pace with care delivery? International Journal of Mental Health Nursing, 17(1): 162–170.
Hudspeth, Randall S. Avoiding regulatory complaints when treating chronic pain patients with opioids. Journal of the American Academy of Nurse Practitioners, 23(10): 515-520.
McLoughlin, K. & Geller, J. (2010). Interdisciplinary Treatment Planning in Inpatient Settings: From Myth to Model. Psychiatric Quarterly, 81(3): 263-277.
Perraud, R. (2006). Advanced Practice Psychiatric Mental Health Nursing, Finding Our Core: The Therapeutic Relationship in 21st Century. Perspectives in Psychiatric Care, 42(4):
Wheeler, K. (2004). Integrating Education and Research in an APRN Mental Health Service. Journal of Community Health Nursing, 21(3): 141- 152.
Wortans, I. (2006). The role of the nurse practitioner in psychiatric/mental health nursing: exploring consumer satisfaction. Journal of Psychiatric and Mental Health Nursing 13 (1): 78–84.
