NURS 4900 Capella University Assessing Healthcare Problems Essay

NURS 4900 Capella University Assessing Healthcare Problems Essay

Capstone Project

Chronic health problems have adverse effects on the patients’ health and wellbeing. Conditions that include diabetes, heart disease, and cancer among others increase healthcare spending by the patients and lower their quality of life. Healthcare providers play a crucial role in the promotion of the health needs of patients with chronic health problems. Evidence-based interventions that promote patient-centeredness in care are important in addressing these conditions. Interventions such as interdisciplinary collaboration also promote the optimum health outcomes of patients with chronic illnesses. Therefore, the purpose of this paper is to explore a selected patient health problem, nursing actions, impacts of health policy and state board of nursing, and leadership strategies that should be adopted to address it.

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Description of Patient Problem

The selected patient for this project is my neighbor (Mr. Y) who suffers from diabetes. He also has congestive heart failure as a comorbid condition. The patient was diagnosed with diabetes five years ago and has been treating it with medications, lifestyle, and behavioral modifications. Three months ago, he was also diagnosed with congestive heart failure and initiated treatment. He has been attending follow-up visits to the practice site to ensure the effective management of his condition. Mr. Y noted that his health problems have taken a toll on him. Accordingly, he noted that the costs of disease management have risen significantly. Factors that include frequent emergency department visits, hospitalizations, and purchase of the needed medications have led to a drastic rise in the costs incurred in seeking the care he needs. He also reported that his quality of life has declined significantly due to his loss of social and occupational productivity.

Diabetes with comorbid conditions that include congestive heart failure is relevant to my practice as a baccalaureate-prepared nurse. First, I have the responsibility of providing appropriate care to the patient to minimize unintended harm. Degree-level nurses are expected to utilize critical thinking and problem-solving skills and evidence-based interventions to promote the health and wellbeing of diabetic patients with comorbid conditions. Degree-prepared nurses also empower patients in self-management of their chronic conditions. They educate diabetic patients about the importance of dietary modifications, treatment adherence, and lifestyle transformation to minimize diabetes complications and worsening of comorbid conditions (Powers et al., 2020). Consequently, Mr. Y’s problem is relevant to my practice as a baccalaureate-prepared nurse.

Nursing Actions Related to the Patient Problem

Nurses play crucial roles in promoting Mr. Y’s health and realization of his needs. Nurses play central roles in providing diabetic care to patients in primary and secondary care. They act as the link between diabetic patients and other healthcare providers involved in diabetes management. They collaborate with other healthcare providers to provide patient-centered care that addresses the psychosocial, physical, spiritual, and social needs of patients with diabetes (Nikitara et al., 2019). Through their role in interdisciplinary teams, nurses lead, counsel, motivate, coordinate, and assist the care that Mr. Y needs for his health problems.

Nurses also play educational roles in caring for Mr. Y. Health education in diabetes is important in preventing its progression and development of comorbidities. Nurses educate patients with diabetes about the importance of medication adherence to achieve optimum outcomes. They also assist patients in developing diabetes self-management programs that would help them achieve the desired glycemic control and minimize the utilization of healthcare services (Azami et al., 2018). Nurses also hold discussions with Mr. Y on issues that include his concerns, beliefs, and misconceptions that may affect his utilization of the recommended interventions and healthcare services.

Nurses also implement nurse-led interventions that improve the outcomes in diabetes management. Often, nurse-led interventions improve the outcomes in diabetes management by strengthening patient-centeredness and continuity of care. They also ease the pressure that diabetes has on healthcare systems. Nurse-led interventions that focus on diverse aspects of diabetes management, including dietary and lifestyle modification have been proven effective in improving glycemic control, knowledge, self-management skills, and reduction of comorbidities (Azami et al., 2018). Therefore, nurses can implement nurse-led interventions to improve diabetes outcomes for Mr. Y.

Diabetes patients often experience barriers in accessing and utilizing the care that they need. They experience barriers due to the cost of care and geographical location of the specialized care services they need. Challenges in accessing their needed care predispose them to worse outcomes, including diabetes complications and its associated comorbidities. Nurses play vital roles in addressing barriers to care experienced by patients with diabetes, including Mr. Y. They advocate the adoption of policies that increase the affordability of care to vulnerable populations. An example can be seen in their role in lobbying for increased funding for community projects that enhance the healthcare outcomes of diabetic patients. Nurses also ensure care coordination services for patients to promote continuity in the care process (Miyamoto et al., 2019). They explore the utilization of interventions that include Telehealth technologies and linking patients with community health nurses to ensure continuity in care for safety, quality, and efficiency in diabetes management.

Effect of State Board of Nursing Practice Standards, Organizational or Governmental Policies

The state board nursing practice standards affect diabetes management and its outcomes. The state board nursing standards provide the practice regulations for nurses alongside their legal and ethical framework for practice. The regulations influence the care outcomes in diabetes in some ways. First, the standards promote safety in diabetes care. Nurses have the professional obligations to ensure that the care rendered to patients has minimal risk of harm (Demidowich et al., 2021). They prioritize ethical requirements that include beneficence and non-maleficence in the treatment of patients with diabetes.

Board of nursing standards also promotes quality in the treatment of patients with diabetes. Accordingly, it strengthens the utilization of care interventions such as evidence-based practice in diabetes management. The standards also strengthen the utilization of care interventions, including interdisciplinary collaboration to ensure optimum care outcomes for diabetic patients. The focus on quality outcomes contributes to efficiency in the interventions adopted for diabetes management in nursing practice. Lastly, state board nursing practice standards affect care given to diabetes patients by increasing a focus on the need for their empowerment. The practice standards recognize the need for patient-centeredness, autonomy, and protection of patients’ rights in the care process (Andrikopoulos et al., 2021; Demidowich et al., 2021). Therefore, nurses focus on motivating patients to play a proactive role in the management of their health problems for optimum outcomes.

Government policies also affect the care given to patients with diabetes. Healthcare policies that include the Affordable Care Act increase the access to care for the vulnerable populations in the state. The Affordable Care Act has increased the proportion of the American population with medical insurance coverage. Its implications include the elimination of barriers to care due to the cost and socioeconomic status of diabetic patients (Huguet et al., 2018). Therefore, government policies have a direct effect on the quality of care that patients with diabetes receive.

Leadership Strategies

Effective leadership approaches are needed to improve outcomes, patient-centered care, and patient experiences in the care of diabetes and its comorbidities. One of the leadership strategies that are needed to achieve optimum outcomes, patient-centeredness, and improved patient experiences is encouraging the active participation of patients in the care process. Nurses and other healthcare providers should ensure that patients with diabetes are involved in making decisions related to their care needs (Sly et al., 2022). The decision-making should consider the values, beliefs, and preferences of the patients for the desired outcomes in the care process to be achieved.

The other leadership strategy that should be adopted to improve outcomes, patient-centered care, and patient experiences in diabetes management is embracing open communication. Open communication between the patient and healthcare providers should be encouraged to enhance care outcomes. Open communication builds trust between the patients and the healthcare providers. Patients should be informed about their health needs, interventions, and their role in disease management (Powers et al., 2020). Open communication empowers patients to play a proactive role in exploring additional ways in which they can achieve their health outcomes.

The other leadership strategy to improve outcomes in diabetes management is encouraging and recognizing the role of the patient in the treatment process. Nurses and other healthcare providers should encourage patients to take responsibility for their health. They should educate patients about the importance of lifestyle and behavioral modification and treatment adherence. They should also educate them to explore the existing social support services they can adopt to improve outcomes of diabetes management. They should also recognize their contributions to the disease management process. They should reward them for their role through methods that include verbal praises to motivate them to play a proactive role in the self-management of diabetes(Nikitara et al., 2019). Encouraging and recognition will contribute to the sustainability of the interventions adopted for diabetes management.

Conclusion

In summary, the selected patient for the project is Mr. Y who is suffering from diabetes and congestive heart failure as comorbidity. The patient was diagnosed with diabetes five years ago and congestive heart failure three months ago. The patient has been managing his health problems using medications, lifestyle, and behavioral interventions. The health problems have affected adversely high health, wellbeing, and quality of life. Nurses play crucial roles in promoting Mr. Y’s health. They are expected to utilize interventions that include evidence-based practices, inter-professional collaboration, and health education to improve outcomes of diabetes management. Nursing board standards of practice and government policies affect care outcomes and cost of care in diabetes management. Government policies such as the Affordable Care Act increase accessibility to diabetes care by eliminating barriers to care due to factors that include cost. Nurses and other healthcare providers should explore effective leadership approaches to use in improving care outcomes, patient-centeredness, and patient experiences in the management of diabetes. The leadership approaches that can be explored include open communication, active patient involvement in the care process, and encouragement and recognition.

References

Andrikopoulos, S., James, S., &Wischer, N. (2021). What Gets Measured Gets Improved—Setting Standards and Accreditation for Quality Improvement for Diabetes Services in Australia.Journal of Diabetes Science and Technology, 15(4), 748–754. https://doi.org/10.1177/19322968211009910

Azami, G., Soh, K. L., Sazlina, S. G., Salmiah, M. S., Aazami, S., Mozafari, M., &Taghinejad, H. (2018). Effect of a Nurse-Led Diabetes Self-Management Education Program on Glycosylated Hemoglobin among Adults with Type 2 Diabetes.Journal of Diabetes Research, 2018, e4930157. https://doi.org/10.1155/2018/4930157

Demidowich, A. P., Batty, K., Love, T., Sokolinsky, S., Grubb, L., Miller, C., Raymond, L., Nazarian, J., Ahmed, M. S., Rotello, L., &Zilbermint, M. (2021). Effects of a Dedicated Inpatient Diabetes Management Service on Glycemic Control in a Community Hospital Setting.Journal of Diabetes Science and Technology, 15(3), 546–552. https://doi.org/10.1177/1932296821993198

Huguet, N., Springer, R., Marino, M., Angier, H., Hoopes, M., Holderness, H., &DeVoe, J. E. (2018).The Impact of the Affordable Care Act (ACA) Medicaid Expansion on Visit Rates for Diabetes in Safety Net Health Centers.The Journal of the American Board of Family Medicine, 31(6), 905–916. https://doi.org/10.3122/jabfm.2018.06.180075

Miyamoto, S., Henderson, S., Fazio, S., Saconi, B., Thiede, E., Greenwood, D. A., & Young, H. M. (2019). Empowering Diabetes Self-Management Through Technology and Nurse Health Coaching. The Diabetes Educator, 45(6), 586–595. https://doi.org/10.1177/0145721719879421

Nikitara, M., Constantinou, C. S., Andreou, E., &Diomidous, M. (2019). The Role of Nurses and the Facilitators and Barriers in Diabetes Care: A Mixed Methods Systematic Literature Review. Behavioral Sciences, 9(6). https://doi.org/10.3390/bs9060061

Powers, M. A., Bardsley, J. K., Cypress, M., Funnell, M. M., Harms, D., Hess-Fischl, A., Hooks, B., Isaacs, D., Mandel, E. D., Maryniuk, M. D., Norton, A., Rinker, J., Siminerio, L. M., &Uelmen, S. (2020). Diabetes Self-management Education and Support in Adults With Type 2 Diabetes: A Consensus Report of the American Diabetes Association, the Association of Diabetes Care & Education Specialists, the Academy of Nutrition and Dietetics, the American Academy of Family Physicians, the American Academy of PAs, the American Association of Nurse Practitioners, and the American Pharmacists Association. Diabetes Care, 43(7), 1636–1649. https://doi.org/10.2337/dci20-0023

Sly, B., Russell, A. W., & Sullivan, C. (2022).Digital interventions to improve safety and quality of inpatient diabetes management: A systematic review.International Journal of Medical Informatics, 157, 104596. https://doi.org/10.1016/j.ijmedinf.2021.104596

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This is the Capstone Project and I want the papers to be about the demographic of Diabetes with Congestive Heart Failure seen in the emergency department as those are the main group of patients that I see here in South Carolina

In a 5-7 page written assessment, define the patient, family, or population health problem that will be the focus of your capstone project. Assess the problem from a leadership, collaboration, communication, change management, and policy perspective. Plan to spend approximately 2 direct practicum hours meeting with a patient, family, or group of your choice to explore the problem and, if desired, consulting with subject matter and industry experts. Document the time spent (your practicum hours) with these individuals or group in the Core Elms Volunteer Experience Form.

Introduction
Nurses in all professional roles work to effect positive patient outcomes and improve organizational processes. Professional nurses are leaders in problem identification, planning, and strategy implementation—skills that directly affect patient care or organizational effectiveness.

Too often, change agents jump to a conclusion that an intervention will promote the envisioned improvement. Instead, the ideal approach is to determine which interventions are appropriate, based on an assessment and review of credible evidence. Interventions could be patient-facing or involve a change in policy and process. In this assessment, you’ll identify and make the case for your practicum focus area, then explore it in depth from a leadership, collaboration, communication, change management, and policy perspective.

This assessment lays the foundation for the work that will carry you through your capstone experience and guide the practicum hours needed to complete the work in this course. In addition, it will enable you to do the following:

Develop a problem statement for a patient, family, or population that’s relevant to your practice.
Begin building a body of evidence that will inform your approach to your practicum.
Focus on the influence of leadership, collaboration, communication, change management, and policy on the problem.
Preparation
In this assessment, you’ll assess the patient, family, or population health problem that will be the focus of your capstone project. Plan to spend approximately 2 hours working with a patient, family, or group of your choice to explore the problem from a leadership, collaboration, communication, change management, and policy perspective. During this time, you may also choose to consult with subject matter and industry experts about the problem (for example, directors of quality or patient safety, nurse managers/directors, physicians, and epidemiologists).

To prepare for the assessment, complete the following:

Identify the patient, family, or group you want to work with during your practicum The patient you select can be a friend or a family member. You’ll work with this patient, family, or group throughout your capstone project, focusing on a specific health care problem.
Begin surveying the scholarly and professional literature to establish your evidence and research base, inform your assessment, and meet scholarly expectations for supporting evidence.
In addition, you may wish to complete the following:

Review the assessment instructions and scoring guide to ensure that you understand the work you’ll be asked to complete and how it will be assessed.
Review the Practicum Focus Sheet: Assessment 1 [PDF], which provides guidance for conducting this portion of your practicum.
Note: Remember that you can submit all, or a portion of, your draft assessment to Smarthinking Tutoring for feedback, before you submit the final version for this assessment. If you plan on using this free service, be mindful of the turnaround time of 24-48 hours for receiving feedback.

Instructions
Complete this assessment in two parts.

Part 1
Define the patient, family, or population health problem that will be the focus of your capstone project. Assess the problem from a leadership, collaboration, communication, change management, and policy perspective and establish your evidence and research base to plan, implement, and share findings related to your project.

Part 2
Connect with the patient, family, or group you’ll work with during your practicum. During this portion of your practicum, plan to spend at least 2 hours meeting with the patient, family, or group and, if desired, consulting with subject matter and industry experts of your choice. The hours you spend meeting with them should take place outside of regular work hours. Use the Practicum Focus Sheet [PDF] provided for this assessment to guide your work and interpersonal interactions. Document the time spent (your practicum hours) with these individuals or group in the Core Elms Volunteer Experience Form.

CORE ELMS
Complete the NURS-FPX4900 Volunteer Experience Form in CORE ELMS. Include a description of your relationship to the patient, family, or group in the Volunteer Experience comments field.

Requirements
The assessment requirements, outlined below, correspond to the scoring guide criteria, so be sure to address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, note the additional requirements for document format and length and for supporting evidence.

Define a patient, family, or population health problem that’s relevant to your practice.
Summarize the problem you’ll explore.
Identify the patient, family, or group you intend to work with during your practicum.
Provide context, data, or information that substantiates the presence of the problem and its significance and relevance to the patient, family, or population.
Explain why this problem is relevant to your practice as a baccalaureate-prepared nurse.
Analyze evidence from peer-reviewed literature and professional sources that describes and guides nursing actions related to the patient, family, or population problem you’ve defined.
Note whether the authors provide supporting evidence from the literature that’s consistent with what you see in your nursing practice.
Explain how you would know if the data are unreliable.
Describe what the literature says about barriers to the implementation of evidence-based practice in addressing the problem you’ve defined.
Describe research that has tested the effectiveness of nursing standards and/or policies in improving patient, family, or population outcomes for this problem.
Describe current literature on the role of nurses in policy making to improve outcomes, prevent illness, and reduce hospital readmissions.
Describe what the literature says about a nursing theory or conceptual framework that might frame and guide your actions during your practicum.
Explain how state board nursing practice standards and/or organizational or governmental policies could affect the patient, family, or population problem you’ve defined.
Describe research that has tested the effectiveness of these standards and/or policies in improving patient, family, or population outcomes for this problem.
Describe current literature on the role of nurses in policy making to improve outcomes, prevent illness, and reduce hospital readmissions.
Describe the effects of local, state, and federal policies or legislation on your nursing scope of practice, within the context of this problem.
Propose leadership strategies to improve outcomes, patient-centered care, and the patient experience related to the patient, family, or population problem you’ve defined.
Discuss research on the effectiveness of leadership strategies.
Define the role that you anticipate leadership must play in addressing the problem.
Describe collaboration and communication strategies that you anticipate will be needed to address the problem.
Describe the change management strategies that you anticipate will be required to address the problem.
Document the time spent (your practicum hours) with these individuals or group in the Core Elms Volunteer Experience Form.
Organize content so ideas flow logically with smooth transitions.
Apply APA style and formatting to scholarly writing.
Additional Requirements
Format: Format your paper using APA style. APA Style Paper Tutorial [DOCX] is provided to help you in writing and formatting your paper. Be sure to include:
A title page and reference page. An abstract is not required.
Appropriate section headings.
Length: Your paper should be approximately 5-7 pages in length, not including the reference page.
Supporting evidence: Cite at least five sources of scholarly or professional evidence that support your central ideas. Resources should be no more than five years old. Provide in-text citations and references in APA format.
Proofreading: Proofread your paper, before you submit it, to minimize errors that could distract readers and make it more difficult for them to focus on its substance.
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

Competency 1: Lead people and processes to improve patient, systems, and population outcomes.
Define a patient, family, or population health problem that’s relevant to personal and professional practice.
Competency 2: Make clinical and operational decisions based upon the best available evidence.
Analyze evidence from peer-reviewed literature and professional sources that describes and guides nursing actions related to a defined patient, family, or population problem.
Competency 5: Analyze the impact of health policy on quality and cost of care.
Explain how state board nursing practice standards and/or organizational or governmental policies could affect a defined patient, family, or population problem.
Competency 7: Implement patient-centered care to improve quality of care and the patient experience.
Propose leadership strategies to improve outcomes, patient-centered care, and the patient experience related to a defined patient, family, or population problem and document the practicum hours spent with these individuals or group in the Core Elms Volunteer Experience Form.
Competency 8: Integrate professional standards and values into practice.
Organize content so ideas flow logically with smooth transitions.
Apply APA style and formatting to scholarly writing.

Practicum Focus Sheet
Assessment 1
Note: Expect to spend at least 2 hours with the patient, family, or group you’ll be working with
during this portion of your practicum, assessing the health problem you’ve defined from a
leadership, collaboration, communication, change management, and policy perspective. This
includes time you may elect to spend in consultation with subject matter or industry experts.
You’ll report on the results of this work as part of your next assessment.
For this portion of your practicum, consider the following:
• Identify the patient, family, or group you intend to work with.
• Think about what you hope to learn.
o What’s your rationale for choosing this particular patient, family, or group?
• Consider how you’ll present your ideas about the problem to the patient, family, or group
and convince them of its significance.
• Which leadership, collaboration, communication, and change management skills will you
need to apply in order to work successfully with your chosen patient, family, or group?
• Which potential barriers do you foresee in presenting the problem to this patient, family,
or group?
• Which change management strategies might you employ to overcome these barriers?
o For example, you might consider creating a sense of urgency supported by data or
policy requirements.