Interacting with patients is simultaneously an advantage and a challenge for nursing practitioners because the outcomes are difficult to predict. Indeed, problems with certain populations might occur in NPs practice if the beneficiaries of an organization have specific needs or socio-economic statuses (Curley, 2020). For instance, groups with low-income levels and difficulties affording primary health care require a unique communicational approach. The PICOT statement related to the issue in NPs practice involving specific beneficiaries can be connected to their tendency to skip the appointments. The question is: “In impoverished patients, what is the efficiency of treatment if they refuse to attend follow-ups, compared with ones who had a timely return visit?” This paper aims to describe the selected NPs practice issue, provide a literature review and recommend a specific change to influence the problem.
Patients skip appointments for multiple reasons, and practitioners can impact their decision-making to improve the situation. Furthermore, the practice problem is severe because missed follow-ups worsen the effectiveness of treatment, making additional financial burdens if the clients’ conditions worsen (Arpey et al., 2017). NPs must identify why the impoverished beneficiaries refuse to re-attend their physicians, retrieve the aspects they can influence, develop and implement solutions in their interaction with patients. Conducting research and literature review is a workable strategy to gather sufficient evidence necessary for decision-making.
Modern scholarly articles reveal that the reasons for the impoverished populations to skip the follow-up appointment are specific and address their financial abilities and life priorities. The lack of attendance occurs due to clients’ forgetfulness, language barrier, insufficient funds for transformation, lack of education, and understanding of follow-ups’ importance are the main reasons for skipping a visit (Arpey et al., 2017). Research conducted in 2018 emphasized the urgency of the practice issue as the results revealed that the average rate of missed return visits is 23%, and it is damaging the healthcare industry’s performance (Dantas et al., 2018). NPs can use these statistics as an argument to encourage their colleagues to implement the change and influence the problematic situation.
The scope of literature about the selected issue also suggests that NPs can update their communicational approaches and visit protocols and include the relevant patient education. Shrestha et al. (2017) state that “missed clinic appointments reduce clinic efficiency, waste resources, and increase costs; limited data exist on subspecialty clinic attendance” (p. 436). Practitioners can motivate the clients by explaining the outcomes of skipping visits, the treatment price if the worsening conditions were not timely addressed, and improving organizational strategies such as phone reminders.
A change in the impoverished patients’ perception of follow-up appointments is complicated and includes multiple aspects that require revision. My recommendation for NPs willing to influence the problem is to adjust their communication with the selected beneficiaries and enable physicians and administrators to participate. The concept of population-based problem solving must address specific characteristics, and for the impoverished clients, the costs of transportation, insurance, and priority setting are to be considered (Curley, 2020). I would also emphasize that NPs must clearly explain the consequences of missing a follow-up. Besides, clinical office managers’ activities must include reminders for patients with severe or chronic conditions to avoid forgetting about their visit.
Nursing practice issues can relate to specific populations and require unique evidence-based solutions. The literature review suggested that unstable financial situation, lack of education, and understanding of follow-ups’ importance cause skipping a visit. NPs can change the current situation by adjusting their communication, improving patient education, and encouraging managers and physicians to participate. Dealing with the selected practice issue is beneficial for organizations with an impoverished population.