NURS FPX 4900: Capstone Implementation Reflection Project Essay

NURS FPX 4900: Capstone Implementation Reflection Project Essay

NURS FPX 4900: Capstone Implementation Reflection Project Essay

  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.

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.

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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.

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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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Teleheath intervention was replaced with compiling a pamphlet/brochure that gives resources for no-low income populations for care, Rxs, transportation for medical, etc

Present your approved intervention to the patient, family, or group and record a 10-15 minute video reflection on your practicum experience, the development of your capstone project, and your personal and professional growth over the course of your RN-to-BSN program. Document the time spent (your practicum hours) with these individuals or group in the Core Elms Volunteer Experience Form.

Introduction
Baccalaureate-prepared nurses have many opportunities to reflect on their contributions to patient care outcomes during clinical experiences. Research suggests that creating and sharing video reflections may enhance learning (Speed, Lucarelli, & Macaulay, 2018).

For this assessment, you’ll present your approved intervention to the patient, family, or group and reflect on various aspects of your capstone practicum experience. Such reflection will give you a chance to discuss elements of the project of which you are most proud and aspects of the experience that will help you grow in your personal practice and nursing career.

Reference
Speed, C. J., Lucarelli, G. A., & Macaulay, J. O. (2018). Student produced videos—An innovative and creative approach to assessment. Sciedu International Journal of Higher Education, 7(4).

Instructions
Complete this assessment in two parts: (a) present your approved intervention to the patient, family, or group and (b) record a video reflection on your practicum experience, the development of your capstone project, and your personal and professional growth over the course of your RN-to-BSN program.

PART 1
Present your approved intervention to the patient, family, or group. Plan to spend at least 3 practicum hours exploring these aspects of the problem with the patient, family, or group. During this time, you may also consult with subject matter and industry experts of your choice. Be sure you’ve logged all of your practicum hours in CORE ELMS.

Use the Intervention Feedback Form: Assessment 5 [PDF] as a guide to capturing patient, family, or group feedback about your intervention. You’ll include the feedback as part of your capstone reflection video.

Part 2
Record a 10-15 minute video reflection on your practicum experience, the development of your capstone project, and your personal and professional growth over the course of your RN-to-BSN program. A transcript of your video is not required.

You’re welcome to use any tools and software with which you are comfortable, but make sure you’re able to submit the deliverable to your faculty. Capella offers Kaltura, a program that records audio and video. Refer to Using Kaltura for more information about this courseroom tool.

Note: If you require the use of assistive technology or alternative communication methods to participate in these activities, please contact DisabilityServices@Capella.edu to request accommodations. If you’re unable to record a video, please contact your faculty as soon as possible to explore options for completing the assessment.

Requirements
The assessment requirements, outlined below, correspond to the scoring guide criteria, so 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 supporting evidence.

Assess the contribution of your intervention to patient or family satisfaction and quality of life.
Describe feedback received from the patient, family, or group on your intervention as a solution to the problem.
Explain how your intervention enhances the patient, family, or group experience.
Describe your use of evidence and peer-reviewed literature to plan and implement your capstone project.
Explain how the principles of evidence-based practice informed this aspect of your project.
Assess the degree to which you successfully leveraged health care technology in your capstone project to improve outcomes or communication with the patient, family, or group.
Identify opportunities to improve health care technology use in future practice.
Explain how health policy influenced the planning and implementation of your capstone project, as well as any contributions your project made to policy development.
Note specific observations related to the baccalaureate-prepared nurse’s role in policy implementation and development.
Explain whether capstone project outcomes matched your initial predictions.
Discuss the aspects of the project that met, exceeded, or fell short of your expectations.
Discuss whether your intervention can, or will be, adopted as a best practice.
Describe the generalizability of your intervention outside this particular setting.
Document the time spent (your practicum hours) with these individuals or group in the Core Elms Volunteer Experience Form.
Assess your personal and professional growth throughout your capstone project and the RN-to-BSN program.
Address your provision of ethical care and demonstration of professional standards.
Identify specific growth areas of which you are most proud or in which you have taken particular satisfaction.
Communicate professionally in a clear, audible, and well-organized video.
Additional Requirements
Cite at least three scholarly or authoritative sources to support your assertions. In addition to your reflection video, submit a separate APA-formatted reference list of your sources.

Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

Competency 2: Make clinical and operational decisions based upon the best available evidence.
Describe one’s use of evidence and peer-reviewed literature to plan and implement a capstone project.
Competency 3: Transform processes to improve quality, enhance patient safety, and reduce the cost of care.
Explain whether capstone project outcomes matched one’s initial predictions and document the practicum hours spent with these individuals or group in the Core Elms Volunteer Experience Form.
Competency 4: Apply health information and patient care technology to improve patient and systems outcomes.
Assess the degree to which one successfully leveraged health care technology in a capstone project to improve outcomes or communication with a patient, family, or group.
Competency 5: Analyze the impact of health policy on quality and cost of care.
Explain how health policy influenced the planning and implementation of one’s capstone project, as well as any contributions the project made to policy development.
Competency 7: Implement patient-centered care to improve quality of care and the patient experience.
Assess the contribution of an intervention (capstone project) to patient, family, or group satisfaction and quality of life.
Competency 8: Integrate professional standards and values into practice.
Assess one’s personal and professional growth throughout a capstone project and the RN-to-BSN program.
Communicate professionally in a clear and well-organized video.