Practicum Experience Time Log and Journal
Practicum Placement Agency’s Name:
Preceptor’s E-mail Address:
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List the objective(s) met and briefly describe the activities you completed during each time period. If you are not on-site for a specific week, enter “Not on site” for that week in the Total Hours for This Time Frame column. Journal entries are due in Weeks 3, 7, and 11; include your Time Log with all hours logged (for current and previous weeks) each time you submit a journal entry.
You are encouraged to complete your practicum hours on a regular schedule, so you will complete the required hours.
|Week||Dates||Times||Total Hours for This|
|Activities/Comments||Learning Objective(s) Addressed|
|1||5/31, 6/1, 6/2||8am-4pm||24||Engaged in ongoing staff orientation as well as to gain insight on the challenges and protocols in the urgent care setting. Continued to work with administration on developing a plan to ensure that patient education has improved and continue to learn student expectations.||To explain how the promotion of health and well-being can be integrated into urgent care settings. To gain an initial understanding of the host facility and its theoretical and/or practical needs.|
|2||6/7, 6/8, 6/9||8am-4pm||24||Engaged in meetings with health administrations about their views of the healthcare sector and the growing use of urgent care facilities to provide emergency services and preventive care.||To discuss the affordability and accessibility of urgent care centers through the dissemination of research.|
|3||6/14, 6/15, 6/16||8am-4pm||24||With the assistance of my preceptor; researched the growth of the urgent care discipline within nursing and the benefits the subarea has for the larger population.||To understand and gain knowledge of the specific challenges that urgent care may face today. As well as learning the needs of the population in this setting. For instance, Behavioral health services|
|4||Not on site||Not on site|
This practicum’s evidence-based project will examine the current effectiveness of its host facility’s health literacy and education programs and compare them against the statistics found in literature.
The growth of urgent care facilities has helped patients find an alternative to emergency departments and lower-cost primary care physicians (Adams, 2021; Allen et al., 2021). In some areas, urgent care facilities are used more often than emergency departments during their usual operating hours (Allen, 2021). This means a growing number of patients are realizing the benefits of urgent care and, eventually, may begin to stress the facilities that provide such valuable care.
Levine et al. (2019), reports that many influencers of preventive care are wary to begin promoting it because of the lack of flexibility insurance companies and other healthcare payers show during the reimbursement process. Volume-based reimbursement models are still the norm amongst many healthcare payers (Levine et al., 2019, Interview Findings section, para. 5), and this trend prevents many physicians and facilities from considering how they can provide more long-term value to patients.
The practicum’s evidence-based project will gather data about the facility’s health literacy and education programs by interviewing nurses, administrators, and executives within the facility. The interviews will contain questions about the frequency of the facility’s formal health literacy- and education-related events and activities, the ways informal health literacy- and education-related conversations are initiated, and the prevalence of patient visits that only involve the provision of health literacy- and education-related services. It is expected for this project to achieve the 1st, 2nd, 3rd, 4th, and 9th competencies of the American Association of Colleges of Nursing’s (AACN) (2021) Core Competencies for Professional Nursing Education.
This week’s practicum took 72 hours of work to accomplish the evidence-based project’s goals and objectives and finalize how the project would be executed moving forward.
Practicum Time Log Reflection
This practicum and its evidence-based project provide an opportunity to learn about the growth of urgent care within the healthcare system and how it is being used to address ongoing concerns within the country’s infrastructure. Medline Plus (2020), states that health literacy can be improved by patients’ personal research and the proactive effort of facilities and organizations that are aware of individuals’ potential needs. The AACN’s (2021), Core Competencies for Professional Nursing Education place a high level of value on the acquisition and dissemination of knowledge to patients and other stakeholders who would benefit from a higher level of health literacy. As the collection of information about the host facility’s health literacy- and education-focused activities is completed, I will know more about how urgent care facilities aim to prevent the over demand of their facilities and services and prevent their location from exceeding its current level of organizational capacity. The theory behind this is that an increased level of health literacy amongst the public would lead to a decrease in diagnoses for chronic diseases (Levine et al., 2019).
The 72 hours of observation for this week’s practicum activities focused on the evaluation of the host facility’s health literacy and education efforts. To collect information, I initiated formal and informal conversations about nurses’ educational conversations with patients before, during, and after their need for care. Without discussing patients’ confidential details, nurses revealed that many patients lack a basic level of health literacy when they come in for emergency care. A higher number of the nurses’ patients were unaware of how their daily habits contributed to their declining health and need for emergency intervention. These revelations matched the findings of Levine et al. (2019), researched as some nurses also noted that patients had developing ailments that could potentially be diagnosed as chronic diseases in the near future. After these patients’ conditions were stabilized, the nurses educated them about their daily habits and how they contributed to their situations. This means many patients only learn about the ways they can increase their health literacy after they experience adverse events.
The Affordable Care Act (ACA) is a piece of legislation that worked to lower the financial burden on Americans who come from low-income backgrounds and socio-economic areas (Assistant Secretary for Planning and Evaluation, 2022). To accomplish this, the ACA expanded patients’ access to preventive care services like vaccinations, tests for sexually transmitted diseases, contraception’s, cancer screenings, and doctor’s visits for children with no prior ailments (Assistant Secretary for Planning and Evaluation, 2022). The expansion of this access led to millions more people being able to receive them without the use of cost-sharing schemes and payment plans (Assistant Secretary for Planning and Evaluation, 2022). Despite this progress, the growth of urgent care centers shows that many patients are still unable to access affordable forms of preventive care without experiencing adverse events first (Adams, 2021).
Adams (2021), reports that urgent care centers could take on at least 36 million of the visits emergency departments receive. When explaining how this is the case, however, Adams noted that there is a lack of empirical data available which shows how and why urgent care facilities have become such a viable alternative for emergency departments. Since urgent care centers are freestanding facilities which do not require insurance to access, uninsured or low-income individuals could receive preventive or emergency care at the fraction of the cost needed to receive similar services at traditional emergency departments and inpatient centers. The lack of information presenting how this can be sustained could be solved by the completion of this practicum’s evidence-based project. This is because the project’s research will work to discover a correlation between patients’ increased level of health literacy and the overall decline of adverse diagnoses and behavior-related emergency visits within the host facility.
The Political and Financial Considerations of this Practicum’s Evidence-Based Project
The ACA is a legislation that promoted the importance of preventive care services. Politically, it provided assistance for patients that experienced difficulty consistently accessing the healthcare services they needed to maintain a high quality of life. The ACA is applicable to this practicum experience because it explains the size of urgent care facilities’ potential market and how many patients with insurance are still in need of political and financial assistance from the ACA’s protections and regulations. Nurses and administrators within the host facility have acknowledged the role high insurance costs play in their patients’ lives. Without the opportunity to receive free market preventive and emergency care, many of them would face catastrophic consequences (Assistant Secretary for Planning and Evaluation, 2022).
Administrators within the facility also acknowledged the impending financial strain urgent care facilities are due to experience. Adams’ (2021) article notes the billions of dollars urgent care facilities save for patients and the healthcare infrastructure as a whole. However, the lack of associated revenues and resources to maintain these savings could overwork urgent care facilities and the nurses and physicians within them. This practicum experience’s evidence-based project aims to discover whether or not the host facility’s proactive provision of health literacy and education programs can lead to a decreased workload in its regular operations. A positive discovery could be used to propose a standardized model of practice that can help other urgent care facilities manage future demand as well.
Adams, L. (2021). Research suggests urgent care centers reduce health care costs by providing alternative to emergency department. Academy Health. https://academyhealth.org/blog/2021-07/research-suggests-urgent-care-centers-reduce-health-care-costs-providing-alternative-emergency-department
Allen, L., Cummings, J., & Hockenberry, J. (2021). The impact of urgent care centers on non- emergent emergency department visits. Health Services Research, 56(4), 721-730.
American Association of Colleges of Nursing. (2021). The essentials: Core competencies for professional nursing education. https://www.aacnnursing.org/Portals/42/AcademicNursing/pdf/Essentials-2021.pdf
Assistant Secretary for Planning and Evaluation. (2022). Access to preventive services without cost-sharing: Evidence from the Affordable Care Act. Assistant Secretary for Planning and Evaluation Office of Health Policy. https://aspe.hhs.gov/sites/default/files/documents/786fa55a84e7e3833961933124d70dd2/preventive-services-ib-2022.pdf
Levine, S., Malone, E., Lekiachvili, A., & Briss, P. (2019). Health care industry insights: Why the use of preventive services is still low. Preventing Chronic Disease, 16. https://www.cdc.gov/pcd/issues/2019/18_0625.htm
MedlinePlus. (2020). Health literacy. National Library of Medicine. https://medlineplus.gov/healthliteracy.html
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