Nursing for Fragmentation of Care and Patient - myassignmenthelp

Question: Discuss about theNursing for Fragmentation of Care and Inadequate Patient. Answer: End-stage kidney disease (ESKD) is the most severe type of kidney disease that requires dialysis or kidney transplantation for survival of patient. The prevalence of the disease in Australia is understood from the estimation that prevalence will increase by 60% in the year 2020 compared to 2011 (aihw.gov.au., 2017). Diabetes is one of the biggest risk factor for developing ESKD and management of modifiable risk factors such as type 2 diabetes can reduce the progression from chronic renal disease to ESKD. However, I disagree with fact and my personal opinion is that early detection and optimal management of renal disease in the early stage is crucial to prevent the profession from renal disease to ESKD. I will justify my opinion with the use of evidence based research to support the impact of early screening on improving health of people. Ifavor management of renal disease in the early stage to prevent ESKD because of several barriers identified in providing optimal care in late-stage of chronic kidney disease found in recent research evidence. Luckett et al. (2017) discussed that the complexity in ESKD is reflected by high rates of hospitalization, initiation of hemodialysis, transplantation and high health care cost. In addition, other barriers to optimal care in late-stage CKD includes delayed referral to nephrologist, fragmentation of care, inadequate patient education and poor communication between staffs. Early referral to nephrologist is essential to optimize medical management of patient, however due to delayed referral, several other complications are seen in patient such as bone disease anemia. Limitation is found in preparing unified care plan for patients with renal disease because of poor coordination between primary care physician and specialist physician thus increasing the risk for hospitalization. Lac k of disease stage education also prevents patient to take necessary precaution to prevent progression to ESKD (Fishbane et al., 2014). Hence, continuity of care and increasing early screening and management of renal disease patient is essential to reduce rate of complication and prevent ESKD. This can help to closely match health care services as per the needs of renal disease patient. Early screening and management of ESKD is also reflective of advanced care planning for chronic kidney disease. This can pave way for changing current advanced care planning practice, developing skills of health care professionals in coordinated care and identifying chronic kidney disease- specific approaches to manage renal disease and prevent KSD. A recent study done in Australia also gave the evidence that current nephrologist and respiratory specialist have poor advanced care planning knowledge and the current renal care services in Australia are sub-optimal (Luckett et al., 2017). Hence, training and appointment of dedicated advanced care planning facilitators are essential to promote health of renal disease patient and prevent ESKD. Another aspect that is important to prevent ESKD and fulfill the goal of improving advanced care planning for ESKD patient includes raising awareness of chronic kidney disease in general public and among primary health care professionals. This is important because current primary care professionals in Australia are not aware about guidelines for screening and management of chronic renal disease (Fishbane et al., 2014). Hence, modifying management of renal disease from treatment to primary prevention can reduce incidence of ESKD. References: aihw.gov.au. (2017). Projection of prevalence of treated end-stage kidney disease in Australia 2012-2020. Retrieved from: https://www.aihw.gov.au/reports/chronic-kidney-disease/prevalence-treated-end-stage-kidney-disease-2012/contents/summary Chen, T., Harris, D.C. (2015). Challenges of chronic kidney disease prevention. Med J Aust, 203(5) Fishbane, S., Hazzan, A. D., Halinski, C., Mathew, A. T. (2014). Challenges and opportunities in late-stage chronic kidney disease.Clinical kidney journal,8(1), 54-60, doi: 10.5694/mja15.00241 Luckett, T., Spencer, L., Morton, R. L., Pollock, C. A., Lam, L., Silvester, W., ... Clayton, J. M. (2017). Advance care planning in chronic kidney disease: a survey of current practice in Australia.Nephrology,22(2), 139-149.