Tag: Clinical-Nursing

Affordable Care Act (ACA) Population Health Policy Analysis

Select a current or proposed health care policy that is designed to improve a specific population’s access to quality, cost-effective health care. In a paper of 1,000-1,250 words, include the following:

Explain the policy and how it is designed to improve cost-effectiveness and health care equity for the population. Is the policy financially sound? Why or why not? How does the policy account for any relevant ethical, legal, and political factors and the nursing perceptive one must consider when implementing it?

To what state, federal, global health policies or goals is this particular policy related? How well do you think the policy is designed to achieve those goals?

Finally, discuss the advocacy strategies you would employ on behalf of your population to ensure they have access to the benefits of the policy. Explain, from a Christian perspective, the professional and moral obligation of advanced registered nurse to advocate for and promote health and prevent disease among diverse populations.

You are required to cite five to 10 sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

 

Affordable Care Act (ACA) Population Health Policy Analysis

Population Health Policy Analysis

Introduction

Access to quality, comprehensive health services care is crucial to health promotion and maintenance,   disease management, and prevention of illnesses and the reduction of preventable disability and untimely deaths and the achievement of health equality for all people in the United States. The paper discusses a current health care policy intended to improve a particular population’s access to cost-effective and quality health care.

An explanation of the Policy

The Affordable Care Act (ACA) is a monumental health care legislation that was signed that was enacted in 2010.   The legislation intended to ensure more Americans had health insurance coverage and regulate the costs of health care services and improve the quality of the Country’s health care system.  The ACA majorly aimed at increasing coverage, and thus improving access to health care and at the end y improving health and reducing health disparities (Serakos & Wolfe, 2016).

How the Policy is Designed to Improve Cost-effectiveness and Health Equity for the Population

The ACA has several strategies to target diverse populations and make sure that more got covered. Young people can now stay on the insurance plans of their parents until they attain the age of 26.  Bigger employers are needed to provide comprehensive, affordable health time to employees who work full time. People without employer-sponsored insured are required to buy insurance individually or face a tax penalty. To help low-income families and individuals, the ACA expanded Medicaid eligibility to nonelderly individuals with a yearly income of 133% of FPL. These provisions aim to increase insurance coverage and also make insurance plans more affordable (French et al., 2016; Mclntyre & Song, 2019).

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The ACA has also reformed private insurance by imposing novel regulations on insurance firms and their policies. For instance, the ACA bans insurance firms from increasing the price of premiums for or decline to provide coverage to individuals with pre-existing medical conditions. Additionally, insurance policies are required to offer a bare minimum of preventive services without the requirement of cost-share (French et al, 2016) Affordable Care Act (ACA) Population Health Policy Analysis.

Is the Policy Financially Sound?

The ACA has led to increased coverage of millions of individuals and change the way health care is delivered. However, the policy seems not to be financially sound because it has led millions of people without coverage. According to Machikanti et al (2017), the majority of expansion under the ACA was based on the Medicaid expansion, which has not been working in favor of the middle and working-class who get less support, especially those earning over 400 percent of FPL. AS a result, enrollment to exchanges has been low, with the fraction of the employees getting health benefits from employers decreasing steadily.   These individuals are exposed to high premiums and huge out of cost expenses.

How the Policy Accounts for political and Legal Factors

The ACA accounts for numerous legal as well as political factors.  The legislation has endured numerous legislative challenges since it was passed. The House of Representatives has advanced more than fifty bills to revoke the entire ACA or some of its provisions, with the Senate voting in favor of some of them. The Trump administration has been undermining the law by making proposals to terminate financing or cost-sharing reductions and cutting funds directed towards enrollment outreach and education.  Also, the current government has given authority to states to modify their Medicaid programs in manners that could lead to reduced enrollment, for instance, by making it mandatory for disabled beneficiaries to work for them to be eligible for benefits (Mclntyre & Song, 2019).

The health policy has also faced legal battles, particularly concerning state Medicaid expansion. A key requirement of the ACA is for states to expand Medicaid to low-income individuals, which were seen as unconstitutional.  The 2012 ruling by the Supreme Court abates the power of the law to coerce states to expand Medicaid by offering states the choice of expanding Medicaid without the risk of losing federal funding (Callaghan & Jacobs, 2016; Mclntyre & Song, 2019). Another legal battle involves rolling back subsidies on the marketplaces.  Also, there is another ongoing litigation regarding regulations linked to contraceptive coverage (Mclntyre, & Song, 2019).

The Nursing Perceptive One Must Consider when Implementing the Policy

When implementing the ACA, nurses must provide quality and improve patient outcomes through care coordination. According to Cleveland et al (2019), in 2012, the hospital readmission reduction program was established under the ACA. The programs mandate hospitals to gather and file a report of the fraction of patients rehospitalized within thirty days following the discharge. It is deemed that lack of or poor coordinated care transitions and provision of poor quality care is the cause of high rates of readmission. Nurses can increase quality by assessing the healthcare resources and goals of the patient and recognizing the requirement for consultations and referrals with other specialists. As care coordinators or through direct care, nurses are essential in implementing the ACA and maximizing financial return Affordable Care Act (ACA) Population Health Policy Analysis.

The State, Federal and Global Goals the Policy is Related

The ACA is related to the federal, state, and global goals of enabling individuals to access health care services by expanding coverage and lessening of coverage and costs of health care services. Because the capability of a person to have access to health care services partly dependent on the accessibility of resources, insurance coverage immensely contributes to the accessibility as well as affordability of health care. The ACA increases the accessibility to health care by increasing the availability and affordability of health insurance and supporting states to expand their Medicaid programs by providing federal subsidies (Ruskin et al., 2016).

The ACA was well designed to achieve the aforementioned goals.  The ACA requires all people in the United States to possess health insurance and provides financial aid via cost-sharing reductions and tax credits and safeguards against medical bankruptcy. Also, the ACA imposes penalties for insurance firms who discriminate against individuals based on pre-existing conditions. The ACA created health insurance marketplaces that permit consumers to make comparisons of insurance options based on quality, benefits, and price. Also, the ACA seeks to ensure high-quality care ensuring accountability, promoting efficiency, and improving quality outcomes by emphasizing safety and prevention across healthcare settings (Ruskin et al., 2016).

According to Willison and Singer (2017), the ACA upgraded the scope and quality of coverage through making improvements in benefit design, entailing the implementation of the essential health benefits (EBHS). EHBS are minimum health benefits comprising of ten groupings of care, which must be covered by all small group and individuals plans, as well as marketplaces.

Around twenty million previously individuals have attained health insurance since the ACA was signed into law. This has in turn increased demand for health care services amid the surging shortage of health care providers in the country, including physicians and nurses. According to Potter et al (2017), the ACA impacts where and how nursing care is offered. More nursing services are required in community-based care settings.  Consequently, more nurses are required to practice in senior centers, schools, and community care centers. This requires nurses to be able to identify service gaps, assess for resources, and assist clients to receive care.

The Advocacy Strategies I would Employ on Behalf of My Population to ensure they have access to the Benefits of the Policy

As an advanced registered nurse, I can advocate for the training and employment of more nurses to increase the supply of nurses to ensure populations can benefit from the ACA.  I would also advocate for nurses to be allowed to practice autonomously because they can provide safe and quality care, and be acknowledged as full partners with doctors, Cleveland et al (2019) assert that eliminating obstacles to practice for nurse practitioners have enabled nurses to fully partner with doctors and other providers in most states.

From the Christian perspective, advanced registered nurses are morally and professionally obligated to engage in patient advocacy, promote health, and prevent diseases among diverse groups of individuals. Nurses have the responsibility can advocate the implementation of novel directions that will result in the promotion of health and prevention of disease among diverse populations regardless of their age, ethnicity, socioeconomic status, gender, and religion.  Nurses are inspired by the Bible to advocate as a scheme of fulfilling God’s command for them to seek justice. In Isaiah 1:17, the Bible directs individuals to seek justice and to break yokes of injustices (Isaiah, 58:6).  According to Cleveland et al (2019), Nurses constantly advocate for and offer life-sustaining and lifesaving care for fragile and vulnerable populations.  Nurses advocate for access to efficient, effective, and consistent health care for all individuals in society.

Conclusion

The ACA is an influential health care policy that expanded insurance coverage for Americans and reduced the costs of health care. designed with the key goal of increasing insurance coverage for vulnerable populations, the health policy has led to coverage of millions of Americans who were previously uninsured, including low-income individuals and people with chronic conditions as well as young adults Affordable Care Act (ACA) Population Health Policy Analysis. The ACA has increased availability and affordability of health insurance by supporting states to expand their Medicaid programs by providing federal subsidies The policy has also improved the quality of care by  establishing health care marketplaces which permit health care consumers to make comparisons of insurance options based on quality, benefits, and price

References

Callaghan, T., & Jacobs, L. R. (2016). Interest Group Conflict Over Medicaid Expansion: The Surprising Impact of Public Advocates.
American Journal of Public Health, 106
(2), 308-313. doi: 
10.2105/AJPH.2015.302943

Cleveland, K., Motter, T., & Smith, Y. (2019). Affordable Care: Harnessing Power of Nurses.
The Online Journal of Issues in Nursing, 24
(2), Manuscript 2.

French, M. T., Homer, J., Gumus, G., & Hickling, L. (2016). Key Provisions of the Patient Protection and Affordable Care Act (ACA): A Systematic Review and Presentation of Early Research Findings
. Health Services   Research, 51
(5), 1735-1771. doi: 
10.1111/1475-6773.12511

Machikanti, L., Helm, S., Beyamin, R. M., & Hirsch, J. A. (2017). A Critical Analysis of Obamacare: Affordable Care or Insurance for Many and Coverage for Few. 
Pain Physician, 20
(3), 111-138.

Mclntyre, A., & Song, Z. (2019). The US Affordable Care Act: Reflections and Directions at the close of a decade.
PLoS Medicine, 16
(2), e1002752. doi: 
10.1371/journal.pmed.1002752

Potter, P. A., Perry, A. G., Stockert, P., & Hall, A. (2017).
Fundamentals of Nursing -E-BooK
.  New York: Elsevier Health Sciences.

Ruskin, K. J., Rosenbaum, S. H., & Stiegler, M. P. (2016).
Quality and Safety in Anesthesia and Perioperative Care.
  New York: Oxford University Press.

Serakos, M., & Wolfe, B. (2016). The ACA: Impacts on Health, Access, and Employment
.  Forum for Health Economics & Policy, 19
(2), 201-259. doi: 
10.1515/fhep-2015-0027

Willison, C. E., & Singer, P. M. (2017). Repealing the Affordable Care Act Essential Health benefits: Threats and Obstacles.
American Journal of Public Health, 107
(8), 1225-1226. doi: 
10.2105/AJPH.2017.303888
  Affordable Care Act (ACA) Population Health Policy Analysis

NURS-FPX4010 Assessment 2: Interview and Interdisciplinary Issue Identification

Interview and Interdisciplinary Issue Identification

My Interview with a fellow nurse working at our facility’s intensive care unit (ICU)department was very informative. I understood the root cause analysis of the increased prevalence of ventilator-associated pneumonia (VAP). Throughout the Interview, the colleague demonstrated a high rise of the infection, and was attributed to the various Gram-negative bacteria, for example, the pseudomonas aeruginosa, Escherichia coli, and Klebsiella pneumonia. Research by Papazian et al. (2020), states that they causative pathogens and the rate of drug resistance pathogens may vary depending on the hospital and the data of microbial surveillance needed in that particular region. She further went and showed me the various data statistics of each year on the ventilator-associated pneumonia, and the case was very high, which made me furious. I inquired from her if at all they have sought ways to overcome it, and she stated that they have been incorporating various evidence-based measures in practice and also administering the patients with the required drugs NURS-FPX4010 Assessment 2: Interview and Interdisciplinary Issue Identification.

As one of the healthcare team members, I was keen to inquire about the best indicator of ventilator-associated pneumonia in their facility. She told me that they have been conducting portable chest radiography on all the patients at risk of developing the infection and those with the signs. Other healthcare team members that I will work with will include the Intensive Care Nurse, the physician, the occupational therapist, and the Nutritionist. The Occupational therapist will engage the patient in numerous respiratory activities such as chest exercises that will help ease the secretions and manual chest exercises. For the nutritionist, he will regularly conduct an assessment of the patient’s macro and micronutrient needs; fluid and electrolyte balance issues. The evaluation was of the infection was also assessed using microbial analysis of the respiratory secretions, for example, sputum. An aggressive surveillance of the causative agent of the disorder is essential in understanding the leading factors of the ventilator-associated pneumonia and also the microbial milieu in each unit of care. I retrieved all the necessary information needed to review the relevant interventions to be put into place. I later thanked her for her precious time and then proceeded with my work.

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From the Interview, the issue raising the alarm is the increased rates of ventilator-associated pneumonia infections among the patients admitted to the Intensive care unit (ICU). Some of the relevant collaborative approaches from the literature that could aid in identifying the issue include the standardization of care using the SBAR approach and the use of E-consult coordination. According to Shahid and Thomas (2018), the Situation Background Assessment Recommendation tool helps the caregivers to communicate more effectively and accurately regarding the patient’s issues. This tool also facilitates the standardization of the communication process by guiding the interdisciplinary team to use the standardized forms and checklists when reporting on the various internal processes affecting them. The recommendation bit of the tool is now where all the healthcare teams will identify the potential solution to the issue that is occurring at the workplace.

The first step I will do with my other team members will be to adopt referral management software in practice to identify the person responsible for a particular patient problem. This is simply because each team member focuses on identifying patients’ needs and the care goals that need to be sorted. It is thus crucial for them to coordinate with the patient’s family members to ensure that they are educated on how to address the ongoing care and also how to prevent its recurrence (Karam et al.,2021). The team members can also engage in various activities such as physical exercise, hygiene measures, diet provision, and drug administration for prevention, especially for the patients on Mechanical ventilators. This care intervention ensures that the responsible care personnel is consulted on the most appropriate form of care to be implemented to overcome the issue at hand. Extensive education and training on the use of the approaches should be disseminated among the staff members and not solely reserved to be used by the top physicians and administrators NURS-FPX4010 Assessment 2: Interview and Interdisciplinary Issue Identification.

References

Karam, M., Chouinard, M. C., Poitras, M. E., Couturier, Y., Vedel, I., Grgurevic, N., & Hudon, C. (2021). Nursing care coordination for patients with complex needs in primary healthcare: A scoping review—i
nternational journal of integrated care
, 
21
(1).

doi: 10.5334/ijic.5518

Papazian, L., Klompas, M., & Luyt, C. E. (2020). Ventilator-associated pneumonia in adults: a narrative review. 
Intensive care medicine
, 
46
(5), 888-906.

Shahid, S., & Thomas, S. (2018). A narrative review is a situation, background, assessment, and recommendation (SBAR) communication tool for handoff in health care. 
Safety in Health
, 
4
(1), 1-9.

 

NURS-FPX4010 Assessment 2: Interview and Interdisciplinary Issue Identification

Assessment 2 Instructions: Interview and Interdisciplinary Issue Identification

For this assessment, you will create a 2-4 page report on an interview you have conducted with a health care professional. You will identify an issue from the interview that could be improved with an interdisciplinary approach, and review best practices and evidence to address the issue.

 

As a baccalaureate-prepared nurse, your participation and leadership in interdisciplinary teams will be vital to the health outcomes for your patients and organization. One way to approach designing an improvement project is to use the Plan-Do-Study-Act (PDSA) cycle. The Institute for Healthcare Improvement describes it thus:

 

The Plan-Do-Study-Act (PDSA) cycle is shorthand for testing a change in the real work setting—by planning it, trying it, observing the results, and acting on what is learned. This is the scientific method adapted for action-oriented learning…Essentially, the PDSA cycle helps you test out change ideas on a smaller scale before evaluating the results and making adjustments before potentially launching into a somewhat larger scale project (n.d.).

 

You might also recognize that the PDSA cycle resembles the nursing process. The benefit of gaining experience with this model of project design is that it provides nurses with an opportunity to ideate and lead improvements. For this assessment, you will not be implementing all of the PDSA cycle. Instead, you are being asked to interview a health care professional of your choice to determine what kind of interdisciplinary problem he or she is experiencing or has experienced in the workplace. This interview, in Assessment 2, will inform the research that you will conduct to propose a plan for interdisciplinary collaboration in Assessment 3.

 

It would be an excellent choice to complete the PDSA Cycle activity prior to developing the report. The activity consists of four questions that create the opportunity to check your understanding of best practices related to each stage of the PDSA cycle. The information gained from completing this formative will promote your success with the Interview and Interdisciplinary Issue Identification report. This will take just a few minutes of your time and is not graded.

 

Reference

Institute for Healthcare Improvement. (n.d.). How to improve. http://www.ihi.org/resources/Pages/HowtoImprove/default.aspx

 

Demonstration of Proficiency

Competency 2: Explain how interdisciplinary collaboration can be used to achieve desired patient and systems outcomes.

Summarize an interview focused on past or current issues at a health care organization.

Describe collaboration approaches from the literature that could be relevant in establishing or improving an interdisciplinary team to address an organizational issue.

Competency 3: Describe ways to incorporate evidence-based practice within an interdisciplinary team.

Identify an issue from an interview for which an evidence-based interdisciplinary approach would be appropriate.

Competency 4: Explain how change management theories and leadership strategies can enable interdisciplinary teams to achieve specific organizational goals.

Describe change theories and a leadership strategy that could help develop an interdisciplinary solution to an organizational issue.

Competency 5: Apply professional, scholarly, evidence-based communication strategies to impact patient, interdisciplinary team, and systems outcomes.

Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.

Apply APA formatting to in-text citations and references, exhibiting nearly flawless adherence to APA format.

Professional Context

This assessment will introduce the Plan-Do-Study-Act (PDSA) Model to create change in an organization. By interviewing a colleague of your choice, you will begin gathering information about an interprofessional collaboration problem that your colleague is experiencing or has experienced. You will identify a change theory and leadership strategies to help solve this problem.

 

Scenario

This assessment is the first of three related assessments in which you will gather interview information (Assessment 2); design a proposal for interdisciplinary problem-solving, (Assessment 3); and report on how an interdisciplinary improvement plan could be implemented in a place of practice (Assessment 4). At the end of the course, your interviewee will have a proposal plan based on the PDSA cycle that he or she could present to stakeholders to address an interdisciplinary problem in the workplace.

For this NURS-FPX4010 Assessment 2: Interview and Interdisciplinary Issue Identification assessment, you will need to interview a health care professional such as a fellow learner, nursing colleague, administrator, business partner, or another appropriate person who could provide you with sufficient information regarding an organizational problem that he or she is experiencing or has experienced, or an area where they are seeking improvements. Consult the Interview Guide [DOCX] for an outline of how to prepare and the types of information you will need to complete this project successfully.

Remember: this is just the first in a series of three assessments.

Instructions

For this assessment, you will report on the information that you collected in your interview, analyzing the interview data and identifying a past or current issue that would benefit from an interdisciplinary approach. This could be an issue that has not been addressed by an interdisciplinary approach or one that could benefit from improvements related to the interdisciplinary approach currently being used. You will discuss the interview strategy that you used to collect information. Your interview strategy should be supported by citations from the literature. Additionally, you will start laying the foundation for your Interdisciplinary Plan Proposal (Assessment 3) by researching potential change theories, leadership strategies, and collaboration approaches that could be relevant to issue you have identified. Please be certain to review the scoring guide to confirm specific required elements of this assessment. Note that there are differences between basic, proficient and distinguished scores.

 

When submitting your plan, use the Interview and Issue Identification Template [DOCX], which will help you to stay organized and concise. As you complete the template, make sure you use APA format for in-text citations for the evidence and best practices that are informing your plan, as well as for the reference list at the end.

 

Additionally, be sure to address the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so you understand what is needed for a distinguished score.

 

Summarize an interview focused on past or current issues
at a health care organization.

Identify an issue from an interview for which an evidence-based interdisciplinary approach would be appropriate.

Describe potential change theories and leadership strategies that could inform an interdisciplinary solution to an organizational issue.

Describe collaboration approaches from the literature that could facilitate establishing or improving an interdisciplinary team to address an organizational issue.

Communicate with writing that is clear, logically organized, and professional, with correct grammar and spelling, and using current APA style.

Additional Requirements

Length of submission: Use the provided template. Most submissions will be 2 to 4 pages in length. Be sure to include a reference page at the end of the plan.

Number of references: Cite a minimum of 3 sources of scholarly or professional evidence that support your central ideas. Resources should be no more than 5 years old.

APA formatting: Make sure that in-text citations and reference list follow current APA style NURS-FPX4010 Assessment 2: Interview and Interdisciplinary Issue Identification.

Portfolio Prompt: Remember to save the final assessment to your ePortfolio so that you may refer to it as you complete the final Capstone course.

 

Scoring Guide

Summarizes an interview focused on past or current issues at a health care organization. Notes strategies employed in the interview to ensure that sufficient information was gathered.

Identifies an issue from an interview for which an evidence-based interdisciplinary approach would be appropriate, providing one or more specific reasons to justify this approach.

Describes potential change theories and leadership strategies that could help develop an interdisciplinary solution to an organizational issue. Notes which sources seem most credible or relevant to the specific organizational issue.

Describes collaborative approaches from the literature that could be relevant in establishing or improving an interdisciplinary team to address an organizational issue. Notes which sources seem most credible or relevant to the specific organizational issue.

Organizes content with a clear purpose. Content flows logically with smooth transitions using coherent paragraphs, correct grammar/punctuation, word choice, and free of spelling errors.

Exhibits strict and flawless adherence to APA formatting of headings, in-text citations, and references. Quotes and paraphrases correctly. NURS-FPX4010 Assessment 2: Interview and Interdisciplinary Issue Identification

NURS-FPX4010 Assessment 3: Interdisciplinary Plan Proposal

Interdisciplinary Plan proposal

As highlighted during the interview with a colleague in the Intensive care unit (ICU), compliance with better and evidenced-based practice interventions in reducing the prevalence of hospital-acquired infections at the workplace require interdisciplinary collaboration among the healthcare workers. Noncompliance to standard practices, for instance, hand hygiene for patients and providers’ utilization of the available personal protective equipment, increases the susceptibility to hospital-acquired infections, with Ventilator-associated Pneumonia being the most prevalent one (Papazian et al.,2020). The goal of the proposed plan is to ensure that the most effective evidence-based strategies needed to prevent the occurrence of Ventilator-associated Pneumonia at the facility are enforced with minimal resources. In my opinion, the most effective approaches that can be put into place to mitigate the occurrence of the VAP will include antimicrobial therapy, safety precautions when handling the patient, and venovenous extracorporeal membrane oxygenation (VV ECMO) NURS-FPX4010 Assessment 3: Interdisciplinary Plan Proposal.

Ventilator-associated Pneumonia is a lung infection that usually develops when a person stays long in a mechanical ventilator. An infection tends to occur when microorganisms get into the tube and are transmitted to the patient’s lungs and upper airways in a critically ill patient. The resulting signs and symptoms of the affected person usually include purulent tracheal discharge, fever, respiratory distress and tracheal aspirate, and radiological evidence of Pneumonia. This condition is an interdisciplinary issue in that many healthcare personnel from various disciplines are required for it to be overcome and managed effectively. Some of the interdisciplinary personnel involved include the occupational therapist, the intensivist, the nurse and the physician. The occupational therapist will help engage the patient in various physical exercises such as chest exercises and manual lung hyperinflation to remove the secretions. The physician and the intensivist will be engaged in various tests and prescriptions of the recommended drugs to curb the issue. Incorporating all the above-named healthcare personnel will ensure that the patient attains a high-quality status and recovers promptly.

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Change theories in nursing represent generalized knowledge about how change works. For this case study, the primary long-term outcome that needs to be achieved before the impact of reducing hospital-acquired infections is the availability of various healthcare resources required to bring about change (Hussain et al.,2018). The most appropriate change theory that might bring about change in this field is the Kurt Lewins Unfreezing-Change-Refreezing Model. For change to occur, the theory requires that leaders reject prior knowledge and replace it with new information that they retrieve from various evidenced based sources. This theory is more likely to help the interdisciplinary team succeed in bringing about change since it emphasizes more on the importance of driving forces that push in for a change.

In lieu of that, the healthcare personnel will be required to let go of the old care pattern of caring for the patients hospitalized in the Intensive care unit and then integrate the new ways of care. The moving stage of the Kurt Lewin’s change model will persuade them that the initial status quo is not beneficial and may need to view the problem from a new dimension. Last stage is the refreezing stage, which involves establishing change as a new habit in the workplace NURS-FPX4010 Assessment 3: Interdisciplinary Plan Proposal. Additionally, the transformational leadership will instill various change aspects in the change process as it will create valuable and positive change in the healthcare workers, minimizing the occurrence of hospital-acquired infections.

Some collaboration plans needed by the Interdisciplinary team to improve the likelihood of achieving the plan’s objective include information exchange activities, consultation, and intervention implementation. The physician must exchange relevant patient care information with the nurse and other healthcare teams to prevent medical errors in the care course. Some of the best practices of interdisciplinary collaboration may include infection prevention by an infection preventionist and a respiratory therapist at least twice a week(Flores et al.,2021).To add to that, the pharmacist will also be needed to calculate the exact dose needed to minimize the recurrence of the infection in the patient.

For the plan to succeed, some of the organizational resources that might be needed include the human resources, knowledge about infection prevention, equipment and supplies, and an adequate financial budget. The most important machine that will be required is the mechanical Ventilator, several endotracheal tubes, nasogastric tubes, and also a crash cart in case an emergency erupts when caring for the patient. The most crucial human resources that will facilitate the reduction of the Ventilator-associated Pneumonia will include the physician intensivist, pharmacists, physiotherapists, occupational therapists, and the social workers. Suppose the improvements described in the plan are not made. In that case, there is a high likelihood that the resources will go to waste, resulting in an increased mortality rate resulting from the infection NURS-FPX4010 Assessment 3: Interdisciplinary Plan Proposal.

Financial budget

Expense

Cost to be Incurred

Purchase of the Equipment

2000$

Training of the Healthcare workers

1000$

Recruitment of the Healthcare workers

1000$

Insurance

500$

Personal Preventive Equipment’s

500$

Drugs

1000$

Soft ware

600$

Miscellaneous

500$

 

References

Flores‐Sandoval, C., Sibbald, S., Ryan, B. L., & Orange, J. B. (2021). Healthcare teams and patient‐related terminology: a review of concepts and uses. 
Scandinavian journal of caring sciences
, 
35
(1), 55-66.

https://doi.org/10.1111/scs.12843

Hussain, S. T., Lei, S., Akram, T., Haider, M. J., Hussain, S. H., & Ali, M. (2018). Kurt Lewin’s change model: A critical review of the role of leadership and employee involvement in organizational change. 
Journal of Innovation & Knowledge
, 
3
(3), 123-127.

https://doi.org/10.1016/j.jik.2016.07.002

Papazian, L., Klompas, M., & Luyt, C. E. (2020). Ventilator-associated Pneumonia in adults: a narrative review. 
Intensive care medicine
, 
46
(5), 888-906.

 

NURS-FPX4010 Assessment 3: Interdisciplinary Plan Proposal

Assessment 3 Instructions: Interdisciplinary Plan Proposal

For this NURS-FPX4010 Assessment 3: Interdisciplinary Plan Proposal assessment you will create a 2-4 page plan proposal for an interprofessional team to collaborate and work toward driving improvements in the organizational issue you identified in the second assessment.

 

The health care industry is always striving to improve patient outcomes and attain organizational goals. Nurses can play a critical role in achieving these goals; one way to encourage nurse participation in larger organizational efforts is to create a shared vision and team goals (Mulvale et al., 2016). Participation in interdisciplinary teams can also offer nurses opportunities to share their expertise and leadership skills, fostering a sense of ownership and collegiality.

 

You are encouraged to complete the Budgeting for Nurses activity before you develop the plan proposal. The activity consists of seven questions that will allow you the opportunity to check your knowledge of budgeting basics and as well as the value of financial resource management. The information gained from completing this formative will promote success with the Interdisciplinary Plan Proposal. Completing this activity also demonstrates your engagement in the course, requires just a few minutes of your time, and is not graded.

 

Demonstration of Proficiency

Competency 1: Explain strategies for managing human and financial resources to promote organizational health.

Explain organizational resources, including a financial budget, needed for the plan to be a success and the impacts on those resources if nothing is done, related to the improvements sought by the plan.

Competency 2: Explain how interdisciplinary collaboration can be used to achieve desired patient and systems outcomes.

Describe an objective and predictions for an evidence-based interdisciplinary plan to achieve a specific objective related to improving patient or organizational outcomes.

Explain the collaboration needed by an interdisciplinary team to improve the likelihood of achieving the plan’s objective. Include best practices of interdisciplinary collaboration from the literature.

Competency 4: Explain how change management theories and leadership strategies can enable interdisciplinary teams to achieve specific organizational goals.

Explain a change theory and a leadership strategy, supported by relevant evidence, that are most likely to help an interdisciplinary team succeed in collaborating and implementing, or creating buy-in for, the project plan.

Competency 5: Apply professional, scholarly, evidence-based communication strategies to impact patient, interdisciplinary team, and systems outcomes.

Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.

Apply APA formatting to in-text citations and references, exhibiting nearly flawless adherence to APA format.

Reference

Mulvale, G., Embrett, M., & Shaghayegh, D. R. (2016). ‘Gearing up’ to improve interprofessional collaboration in primary care: A systematic review and conceptual framework. BMC Family Practice, 17.

 

Professional Context

This assessment will allow you to describe a plan proposal that includes an analysis of best practices of interprofessional collaboration, change theory, leadership strategies, and organizational resources with a financial budget that can be used to solve the problem identified through the interview you conducted in the prior assessment.

 

Scenario

Having reviewed the information gleaned from your professional interview and identified the issue, you will determine and present an objective for an interdisciplinary intervention to address the issue.

 

Note: You will not be expected to implement the plan during this course. However, the plan should be evidence-based and realistic within the context of the issue and your interviewee’s organization.

 

Instructions

For this assessment, use the context of the organization where you conducted your interview to develop a viable plan for an interdisciplinary team to address the issue you identified. Define a specific patient or organizational outcome or objective based on the information gathered in your interview.

 

The goal of this assessment is to clearly lay out the improvement objective for your planned interdisciplinary intervention of the issue you identified. Additionally, be sure to further build on the leadership, change, and collaboration research you completed in the previous assessment. Look for specific, real-world ways in which those strategies and best practices could be applied to encourage buy-in for the plan or facilitate the implementation of the plan for the best possible outcome.

 

Using the Interdisciplinary Plan Proposal Template [DOCX] will help you stay organized and concise. As you complete each section of the template, make sure you apply APA format to in-text citations for the evidence and best practices that inform your plan, as well as the reference list at the end.

 

Additionally, be sure that your plan addresses the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so you understand what is needed for a distinguished score.

 

Describe an objective and predictions for an evidence-based interdisciplinary plan to achieve a specific goal related to improving patient or organizational outcomes.

Explain a change theory and a leadership strategy, supported by relevant evidence, that is most likely to help an interdisciplinary team succeed in collaborating and implementing, or creating buy-in for, the project plan NURS-FPX4010 Assessment 3: Interdisciplinary Plan Proposal.

Explain the collaboration needed by an interdisciplinary team to improve the likelihood of achieving the plan’s objective. Include best practices of interdisciplinary collaboration from the literature.

Explain organizational resources, including a financial budget, needed for the plan to succeed and the impacts on those resources if the improvements described in the plan are not made.

Communicate the interdisciplinary plan, with writing that is clear, logically organized, and professional, with correct grammar and spelling, using current APA style.

Additional Requirements

Length of submission: Use the provided template. Remember that part of this assessment is to make the plan easy to understand and use, so it is critical that you are clear and concise. Most submissions will be 2 to 4 pages in length. Be sure to include a reference page at the end of the plan.

Number of references: Cite a minimum of 3 sources of scholarly or professional evidence that support your central ideas. Resources should be no more than 5 years old.

APA formatting: Make sure that in-text citations and reference list follow current APA style.

Note: Faculty may use the Writing Feedback Tool when grading this assessment. The Writing Feedback Tool is designed to provide you with guidance and resources to develop your writing based on five core skills. You will find writing feedback in the Scoring Guide for the assessment, once your work has been evaluated.

 

Portfolio Prompt: Remember to save the final assessment to your ePortfolio so that you may refer to it as you complete the final Capstone course
NURS-FPX4010 Assessment
3: Interdisciplinary Plan Proposal.

 

SCORING GUIDE

Describes an objective and predictions for an evidence-based interdisciplinary plan to achieve a specific goal related to improving patient or organizational outcomes, including methods from the literature that may be used to determine success.

Explains a change theory and a leadership strategy, supported by relevant evidence, that is most likely to help an interdisciplinary team succeed in collaborating and implementing, or creating buy-in for, the project plan, providing real-world examples relevant to the health care organization that is the context for the plan.

Explains the collaboration needed by an interdisciplinary team to improve the likelihood of achieving the plan’s objective, including best practices of interdisciplinary collaboration from the literature. Provides real-world examples relevant to the health care organization that is the context for the plan.

Explains organizational resources, including a financial budget, needed for the plan to succeed and the impacts on those resources if nothing is done to make the improvements sought by the plan. Provides real-world examples relevant to the health care organization that is the context for the plan.

Organizes content with a clear purpose. Content flows logically with smooth transitions using coherent paragraphs, correct grammar/punctuation, word choice, and free of spelling errors.

Exhibits strict and flawless adherence to APA formatting of headings, in-text citations, and references. Quotes and paraphrases correctly NURS-FPX4010 Assessment 3: Interdisciplinary Plan Proposal.

NURS-FPX 4010 Assessment 4 Stakeholder Presentation

Introduction to VAP – NURS-FPX 4010 Assessment 4 Stakeholder Presentation

ØVentilator-associated pneumonia is the most common lung infection when an individual is placed on a ventilator.

ØNormally the infection occurs when germs or other microbial enter through the ventilator machine.

ØThe CDC provides various guidelines that help in preventing its occurrence in practice.

The most common microbial agent for VAP is the staphylococcus aureus; here, the micro aspiration of the bacteria colonizes the oropharynx and the upper airways, which also seeds the lung due to the inhalation of the contaminated aerosols. Research by Luyt et al. (2020), states that the mortality that is associated with hospital-acquired Pneumonia is very high despite the availability of effective antibiotics. The adequacy of various antibiotics helps improves an individual’s state of health together with an improved prognosis. Other than microbial therapy, there exist other forms of treatment for VAP, for example, head elevation, oral hygiene with 2% chlorhexidine, and suctioning of secretions to be in a better position to curb its occurrence; there is a greater need to ensure that the healthcare workers work collaboratively.

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Relevance of the Interdisciplinary team – NURS-FPX 4010 Assessment 4 Stakeholder Presentation

ØWhile the indiscriminate use of antibiotics is a major cause of antimicrobial resistance, adequate use of the empiric antibiotics is a major determinant of a favorable outcome.

ØSome of the relevant interdisciplinary members that should be included in the care course include the intensivist, physician, nurse, medical intensive care unit occupational therapist, and the nutritionist.

ØThe team always aims to attain improved health outcomes and enhanced satisfaction for the clients.

In my opinion, the interdisciplinary team is the most effective approach to incorporate into the study simply because it is through them that various specific patient symptoms are recognized more easily. The inclusion of these teams will help achieve improved outcomes by implementing specific interventions that meet the client’s needs. In order to ensure maximum functioning of the team, an effective patient outcomes and also the roles of the multidisciplinary team should be clearly negotiated and defined (Papazian  et al.,2020).For this to happen, the team members need to ensure that trust and respect is enhanced and also ensure that there is a use of the skill mix within the team. By doing so, the patients’ current issues will be managed effectively since they have the prerequisite skills needed to meet their various needs.

 

Interdisciplinary Plan Summary – NURS-FPX 4010 Assessment 4 Stakeholder Presentation

ØThe main Goal of the interdisciplinary team is to ensure that the infections decrease.

ØThe objective is likely to be met following the implementation various evidence-based care strategies at the workplace.

ØEach team member will be involved in various strategies to decrease the rate of Ventilator-associated Pneumonia at the workplace.

Some of the activities that the interdisciplinary team will participate in include drug administration, oral hygiene for the patients, bed elevation, and monitoring of the patients on mechanical ventilation. The interventions are evidence-based and proven; hence, the likelihood of decreasing infection rates is very high. For instance, the occupational therapist will engage the patient in various functional independence activities of daily living and also decrease the time that the patient spends on the mechanical Ventilator. Besides that, the manager will also need to mobilize sufficient resources for the team and ensure that they are well utilized to meet the patient’s needs. This is likely to result in improved health outcomes and thus decrease the susceptibility to the infections.

Ways to Implement the Interdisciplinary plan in the team – NURS-FPX 4010 Assessment 4 Stakeholder Presentation

ØSome of the features of an effective interdisciplinary team include positive leadership, training, development, and the distribution of sufficient resources.

ØThere exist various competency statements that an effective interdisciplinary team should always demonstrate.

ØThe Kurt Lewin’s model is the most effective approach to implementing the plan in the team.

The increasing complexity of the skills and knowledge needed to provide a comprehensive care for the patients on mechanical ventilators is so alarming; thus, a great need to allocate the medical team to the patients based on their expertise. The first thing that should always be done in any healthcare facility is the training of the employees regarding the various interventions that might positively impact the patients’ health. After they have been trained on how the machines work and how the care is supposed to be given, they will be allowed to practice it as they ensure that they utilize the resources efficiently (Papazian et al.,2020). Lastly, the adoption of a waste management plan will help minimize a lot of wastage that could be incurred unexpectedly. The outcome criteria will help evaluate the effectiveness of the project once it is implemented, and also, the preliminary use analysis of the project will provide an overview of how the resources were used and also spent.

 

Strategies for Managing Human and Financial Resources – NURS-FPX 4010 Assessment 4 Stakeholder Presentation

ØStrategic human resource management at the workplace provides a framework linking people management and the development practices to ensure long-term organizational goals and outcomes.

ØSome of the strategies include,

Management of employee competency and development.

Ensuring that the employees’ workload is right.

Taking availability and accountability into account

Just in time model

At the workplace, skill management entails matching the organizational needs with the available ones. Employment of skilled employees helps ensure that the exact resources are used for the patient with those needs alone and not just wasting them anyhow. The Just in time model is one of the key measures that will help ensure that resources are not wasted. This model involves the production of only what is needed depending on the patient’s needs. The other intervention is the adoption of various Electronic Health Records that provides accountability about the resources that have been spent on any patient, depending on the needs. In the future, this will be very useful as the managers will use it as a baseline in determining the expected resources that need to be produced without a surplus.

 

Evaluation Methods – NURS-FPX 4010 Assessment 4 Stakeholder Presentation

ØA project needs careful planning, effective communication, and attention to succeed.

ØA successful outcome of the project is that which,

There is an increased patient satisfaction

Timely delivery of patient services

Projects fall within the budget

ØIn healthcare, the success of the projects is determined using three criteria, the Goal-based, process-based, and outcome-based criteria.

In healthcare, the evaluation of projects is conducted either monthly or annually, depending on the organization’s protocols. One of the evaluation criteria of the projects that I would use is the Goal based evaluation criteria, it provides the information pertaining how the program is working or operating as it tries to attain its goals (Lennox et al.,2018). It helps ensure that the program works as expected and implements various interventions to magnify its operations. The information on either pathogenicity or infectivity of Ventilator-associated pneumonia can help determine the effectiveness of the Evidence-based prevention strategies. A high infection rate of the VAP in the ICU will mean that the prevention strategies are ineffective and need to be modified.

 

Communication Strategies – NURS-FPX 4010 Assessment 4 Stakeholder Presentation

ØCommunication strategies in healthcare help in the spreading of knowledge and also the associated evidence-based care strategies to the patients and also the interdisciplinary team.

ØSome of the effective communication strategies for both parties include,

Turn-taking

Topic shifting

Active listening

Patient teach-back techniques

Following the patient’s discharge, communication about drug adherence and continuous exercise is paramount. The interdisciplinary team should ensure that they communicate the relevant information following patients’ discharge; this would help prevent the occurrence of infection recurrence. To the healthcare team, effective communication strategies will ensure that the exact care is provided to the patient, depending on their individual needs.

 

NURS-FPX 4010 Assessment 4 Stakeholder Presentation CONCLUSION

ØHealth education is very critical for any patient.

ØProper management of the healthcare resources also ensures that the patient pays for only what they have utilized.

ØIntegration of the most top-notch evidenced strategies helps minimize reinfection at a higher rate.

Targeted strategies to prevent VAP should be implemented to improve the patient’s outcomes and decrease their length of stay at the healthcare facilities. The frontline critical care nurses thus need to understand the factors that predispose the patients at risk of developing the VAP and institute the evidence-based practices that will not compromise the patients’ health.

 

References

Lennox, L., Maher, L., & Reed, J. (2018). Navigating the sustainability landscape: a systematic review of sustainability approaches in healthcare. Implementation Science, 13(1), 1-17.

Luyt, C. E., Sahnoun, T., Gautier, M., Vidal, P., Burrel, S., Pineton de Chambrun, M., … & Chastre, J. (2020). Ventilator-associated Pneumonia in patients with SARS-CoV-2-associated acute respiratory distress syndrome requiring ECMO: a retrospective cohort study. Annals of Intensive Care, 10(1), 1-10.

Papazian, L., Klompas, M., & Luyt, C. E. (2020). Ventilator-associated Pneumonia in adults: a narrative review. Intensive care medicine, 46(5), 888-906.

 

NURS-FPX 4010 Assessment 4 Stakeholder Presentation

Assessment 4 Instructions: Stakeholder Presentation

For this assessment you will create an 8-12 slide PowerPoint presentation for one or more stakeholder or leadership groups to generate interest and buy-in for the plan proposal you developed for the third assessment.

As a current or future nurse leader, you may be called upon to present to stakeholders and leadership about projects that you have been involved in or wish to implement. The ability to communicate a plan—and potential implications of not pursuing such a plan—to stakeholders effectively can be critically important in creating awareness and buy-in, as well as building your personal and professional brand in your organization. It is equally important that you know how to create compelling presentations for others’ delivery and ensure that they convey the same content you would deliver if you were the presenter.

You are encouraged to complete the Evidence-Based Practice: Basics and Guidelines activity before you develop the presentation. This activity consists of six questions that will create the opportunity to check your understanding of the fundamentals of evidence-based practice as well as ways to identify EBP in practice. The information gained from completing this formative will help promote success in the Stakeholder Presentation and demonstrate courseroom engagement—it requires just a few minutes of your time and is not graded.

 

Demonstration of Proficiency

Competency 1: Explain strategies for managing human and financial resources to promote organizational health.

Explain how the interdisciplinary plan could be implemented and how the human and financial resources would be managed.

Competency 2: Explain how interdisciplinary collaboration can be used to achieve desired patient and systems outcomes.

Explain an organizational or patient issue for which a collaborative interdisciplinary team approach would help achieve a specific improvement goal.

Competency 3: Describe ways to incorporate evidence-based practice within an interdisciplinary team.

Summarize an evidence-based interdisciplinary plan to address an organizational or patient issue.

Propose evidence-based criteria that could be used to evaluate the degree to which the project was successful in achieving the improvement goal.

Competency 5: Apply professional, scholarly, evidence-based communication strategies to impact patient, interdisciplinary team, and systems outcomes.

Slides are easy to read and error free. Detailed speaker notes are provided.

Organize content with clear purpose/goals and with relevant and evidence-based sources (published within 5 years) with an APA formatted reference list with few errors.

Professional Context

This assessment will provide you with an opportunity to sharpen your ability to create a professional presentation to stakeholders. In this presentation, you will explain the Plan-Do-Study-Act cycle and how it can be used to introduce the plan (P), implement the plan (D), study the effectiveness of the plan (S), and act on what is learned (A) to drive continuous improvement. By using this cycle, the stakeholders will have a tool and a proposal to expand on these ideas to drive workplace change and create improved processes to solve an interprofessional collaboration problem.

 

Scenario

In addition to summarizing the key points of Assessments 2 and 3, you will provide stakeholders and/or leadership with an overview of project specifics as well as how success would be evaluated—you will essentially be presenting a discussion of the Plan, Do, and Study parts of the PDSA cycle. Again, you will not be expected to execute the project, so you will not have any results to study. However, by carefully examining the ways in which your plan could be carried out and evaluated, you will get some of the experience of the thinking required for PDSA.

When creating your PowerPoint for this assessment, it is important to keep in mind the target audience: your interviewee’s organizational leadership. The overall goal of this assessment is to create a presentation that your interviewee could potentially give in his or her organization NURS-FPX 4010 Assessment 4 Stakeholder Presentation.

 

Instructions

Please follow the Capella Guidelines for Effective PowerPoint Presentations [PPTX]. If you need technical information on using PowerPoint, refer to Capella University Library: PowerPoint Presentations.

 

Be sure that your plan addresses the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so you understand what is needed for a distinguished score.

 

Explain an organizational or patient issue for which a collaborative interdisciplinary team approach would help achieve a specific improvement goal.

Summarize an evidence-based interdisciplinary plan to address an organizational or patient issue NURS-FPX 4010 Assessment 4 Stakeholder Presentation.

Explain how the interdisciplinary plan could be implemented and how the human and financial resources would be managed.

Propose evidence-based criteria that could be used to evaluate the degree to which the project was successful in achieving the improvement goal.

Communicate the PowerPoint presentation of the interdisciplinary improvement plan to stakeholders in a professional manner, with writing that is clear, logically organized, and respectful with correct grammar and spelling using current APA style.

There are various ways to structure your presentation; following is one example:

 

Part 1: Organizational or Patient Issue.

What is the issue that you are trying to solve or improve?

Why should the audience care about solving it?

Part 2: Relevance of an Interdisciplinary Team Approach.

Why is using an interdisciplinary team relevant, or the best approach, to addressing the issue?

How will it help to achieve improved outcomes or reach a goal?

Part 3: Interdisciplinary Plan Summary.

What is the objective?

How likely is it to work?

What will the interdisciplinary team do?

Part 4: Implementation and Resource Management.

How could the plan be implemented to ensure effective use of resources?

How could the plan be managed to ensure that resources were not wasted?

How does the plan justify the resource expenditure?

Part 5: Evaluation.

What would a successful outcome of the project look like?

What are the criteria that could be used to measure that success?

How could this be used to show the degree of success?

Again, keep in mind that your audience for this presentation is a specific group (or groups) at your interviewee’s organization and tailor your language and messaging accordingly. Remember, also, that another person will ultimately be giving the presentation. Include thorough speaker’s notes that flesh out the bullet points on each slide.

 

Additional Requirements

Number of slides: Plan on using one or two slides for each part of your presentation as needed, so the content of your presentation will be 8–12 slides in length. Remember that slides should contain concise talking points, and you will use presenter’s notes to go into detail. Be sure to include a reference slide as the last slide of your presentation.

Number of references: Cite a minimum of 3 sources of scholarly or professional evidence that support your central ideas NURS-FPX 4010 Assessment 4 Stakeholder Presentation. Resources should be no more than five years old.

APA formatting: Make sure that in-text citations on your slides and in your notes pages and reference slide reflect current APA Style and Format.

Portfolio Prompt: Remember to save the final assessment to your ePortfolio so that you may refer to it as you complete the final Capstone course.

 

SCORING GUIDE

Explains an organizational or patient issue for which a collaborative interdisciplinary team approach would help achieve a specific improvement goal, noting potential consequences of not addressing the issue.

Summarizes an evidence-based interdisciplinary plan to address an organizational or patient issue, noting specific sources of evidence used to develop the plan.

Explains how the interdisciplinary plan could be implemented and how the human and financial resources would be managed, providing real-world examples relevant to the context of the health care organization.

Proposes evidence-based criteria to evaluate the degree to which the project was successful in achieving the improvement goal, noting specific sources of evidence used to develop the criteria.

Slides are easy to read and clutter free. Slide background is “visually” pleasing with a contrasting color for the text and may utilize graphics. Detailed speaker notes are provided.

Organizes NURS-FPX 4010 Assessment 4 Stakeholder Presentation content with clear purpose/goals. Power point slides support main points, assertions, arguments, conclusions, or recommendations with relevant and evidence-based sources (published within 5 years) with a flawless APA formatted reference list.

Applying Library Research Skills – NHS4000: Developing a Health Care Perspective

The Application of Research Skills on the Problem of Medication Errors

The acknowledgement of human error as an important factor contributing to avoidable sickness and mortality by the healthcare sector paved the path for technology to become one of the most life-saving discoveries ever. The Institute of Medicine’s (IOM) role in this cannot be contested. The IOM report, To Err Is Human, caused the change of heart. It was discovered that close to one hundred thousand avoidable fatalities were happening in healthcare facilities as a result of human mistake (Bates & Singh, 2018). This annotated bibliography’s practice topic of concern, medication mishaps, falls squarely within this category. The purpose of this paper is to present an annotated bibliography of four current peer-reviewed articles on medication errors.

Problem Summary, Personal Interest, and Professional Experience with the Issue

Every healthcare facility is concerned about improving quality in relation to medication administration errors or MAEs. It has long been recognized that medication administration errors made by nurses have a major negative impact on morbidity and death. Research by the likes of Simiyu et al. (2018) has revealed that at about half of the time every day, wrong time administration of medications by nurses occurs. Then the second most common error is documentation of the medication given about a third of the time all day. Last is the error of wrong technique that happens about 28% of the time.

The fact that MAE repercussions are so severe is what piqued my curiosity in the aforementioned subject. Therefore, I am curious about practical ways to prevent MAEs. In my professional life, I have repeatedly encountered MAEs as a result of colleagues’ and even my own forgetting to give a patient their medication on time.

The Database Search Strategy Employed

To find data supporting preventive measures against MAEs, a search of the following databases was carried out: Scopus, PubMed, ScienceDirect, Cochrane, and CINAHL. Among the key words and phrases utilized in the search were “errors,” “medication administration,” “prevention,” and “nurses.” These were combined with the Boolean “AND” operator before being entered into the search engines of the pertinent databases. 951 items in all were discovered. There were 15 full-text articles left after abstracts and unclear articles were filtered out and removed. Below is a list of four of these with annotated bibliographies. Since they were all published in journals that underwent peer review, they are all reliable. Since they are all current and were all published within the last five years, they are also highly pertinent.

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The
Annotated Bibliography

Wondmieneh, A., Alemu, W., Tadele, N., & Demis, A. (2020). Medication administration errors and contributing factors among nurses: A cross sectional study in tertiary hospitals, Addis Ababa, Ethiopia.
BMC Nursing, 19
(4), 1-9. 
https://doi.org/10.1186/s12912-020-0397-0

In tertiary care institutions in Ethiopia’s capital, Addis Ababa, the aim of this study was to evaluate the severity and contributing variables of errors in medication administration among nurses. The article was chosen because it specifically tackles the practice issue of MAEs among nurses. In this cross-sectional study, 298 randomly chosen nurses worked as nurses. The survey received 298 responses from nurses, or 98.3%. Of these, 203 (68.1%) acknowledged making errors in medicine administration in the previous twelve-month period preceding the study Applying Library Research Skills – NHS4000: Developing a Health Care Perspective.

Poor instruction, a lack of the administration of medicines recommendations, a dearth of professional experience, disruptions during the administration of medications, and late-night hours were all significant predictors of medication administration errors in this study. It may be necessary to retain experienced nursing staff, offer ongoing training on how to safely administer medications, make a medication administration guideline available for nurses to use, and create an environment that supports safe medication administration in order to improve the standard and safety of medication administration.

Weingart, S.N., Zhang, L., Sweeney, M., & Hassett, M. (2018). Chemotherapy medication errors.
The Lancet Oncology, 19
(4), e191–e199. 
https://doi.org/10.1016/S1470-2045(18)30094-9

The article’s goal is to provide information on the prevalence of pharmaceutical errors related to chemotherapy and suggest ways to avoid them. This article was chosen because it clearly addresses the practice problem that was selected, which is the justification. Even though chemotherapy is a well-established treatment option, mistakes can result in a significant risk of patient harm. The scientists examined published studies from 1980 to 2017 in order to appreciate the extent and type of medication errors in cancer chemotherapy and to find effective solutions to help minimize mistakes.

Chemotherapy errors arise at all stages of the medication usage process, impacting at least one to three percent of adult and pediatric oncology patients, and occurring at a rate of one to four per one thousand orders. One area where risk is increasing is the use of oral chemotherapy. Despite the fact that several of them seem to lessen chemotherapeutic errors, the bulk of therapies have little empirical support. More study is needed to understand and lower the incidence of chemotherapy drug mistakes.

Simiyu, K.N., El-Banna, H.M., Fattah, M.A., & Omondi, L.A. (2018). Nurses’ medication administration errors at medical surgical units.
American Journal of Nursing Science, 7
(3), 88-99.
https://doi.org/10.11648/j.ajns.20180703.12

The goal of the study was to evaluate medication administration mistakes made by nurses in general medical and surgical units. The main reason the article was chosen is that it discusses research done on MAEs by nurses working in medical-surgical units. Using stratified random sampling with the medical and surgical units as the strata, 100 nurses were proportionately selected for the descriptive cross-sectional study. The study included a total of 200 observations by adding two more observations of each nurse while dispensing medication. Two different technologies were used to obtain the data for the current inquiry.

The interviewer provided a questionnaire about medicine delivery errors as well as a disguised drug administration observation checklist. Data was collected over a period of four months and subsequently analyzed using descriptive and inferential statistics to seek for correlations between variables. The study’s findings revealed that, respectively, 27%, 23%, and 15% of the nurses who took part in it admitted to giving medication at the wrong time, at the wrong rate, or after getting a written order to stop. Nurses must recognize the prevalence of MAEs as a patient safety indicator in order to comprehend and prevent MAEs through rationalized drug management policies and guidelines.

Koyama, A.K., Maddox, C-S.S., Li, L., Bucknall, T., & Westbrook, J.I. (2019). Effectiveness of double checking to reduce medication administration errors: A systematic review.
BMJ Quality & Safety, 29
(7), 1-9.
http://dx.doi.org/10.1136/bmjqs-2019-009552

The study’s goal was to perform a systematic assessment of research that evaluated the evidence for the value of double checking in lowering MAEs. Because the paper focuses specifically on MAEs and their prevention, it was picked. Five databases were searched for studies examining the use and effectiveness of double checking on reducing medication delivery errors in a hospital setting.

A collection of thirteen research investigations were looked at, and it was found that double-checking adherence rates varied from 52% to 97% of administrations. The claim that a lower incidence of MAEs or less harm results from double versus single medication administration checks is not sufficiently supported by the available data. More research is required to demonstrate whether double checking actually improves patient safety to the point where the large costs required are justified.

Conclusion

The aforementioned annotated bibliography amply demonstrates that MAEs currently pose a concern to patient protection. Since nurses are the ones who deliver pharmaceuticals, evidence-based quality improvement activities aimed at them are required. The numerous recommendations for prevention that are backed up by literary evidence are the four sources analyzed in this annotated bibliography’s main contribution.

References

Bates, D.W., & Singh, H. (2018). Two decades since
To Err Is Human
: An assessment of progress and emerging priorities in patient safety.
Health Affairs, 37
(11), 1736-1743.

https://doi.org/10.1377/hlthaff.2018.0738

Koyama, A.K., Maddox, C-S.S., Li, L., Bucknall, T., & Westbrook, J.I. (2019). Effectiveness of double checking to reduce medication administration errors: A systematic review.
BMJ Quality & Safety, 29
(7), 1-9.
http://dx.doi.org/10.1136/bmjqs-2019-009552

Simiyu, K.N., El-Banna, H.M., Fattah, M.A., & Omondi, L.A. (2018). Nurses’ medication administration errors at medical surgical units.
American Journal of Nursing Science, 7
(3), 88-99.
https://doi.org/10.11648/j.ajns.20180703.12

Weingart, S.N., Zhang, L., Sweeney, M., & Hassett, M. (2018). Chemotherapy medication errors.
The Lancet Oncology, 19
(4), e191–e199. 
https://doi.org/10.1016/S1470-2045(18)30094-9

Wondmieneh, A., Alemu, W., Tadele, N., & Demis, A. (2020). Medication administration errors and contributing factors among nurses: A cross sectional study in tertiary hospitals, Addis Ababa, Ethiopia.
BMC Nursing, 19
(4), 1-9. 
https://doi.org/10.1186/s12912-020-0397-0

 

Applying Library Research Skills – NHS4000: Developing a Health Care Perspective

Create a 2-4 page annotated bibliography and summary based on your research related to best practices addressing one of the health care problems or issues in the Assessment Topic Areas media piece faced by a health care organization that is of interest to you.

Introduction

In your professional life, you will need to find credible evidence to support your decisions and your plans of action. You will want to keep abreast of best practices to help your organization adapt to the ever-changing health care environment. Being adept at research will help you find the information you need. For this assessment, you will review the Assessment Topic Areas media piece and select one of the health care problems or issues to research, which will be a current health care problem or issue faced by a health care organization that is of interest to you.

Instructions

Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum, be sure to address each point. In addition, you are encouraged to review the performance-level descriptions for each criterion to see how your work will be assessed.

For this assessment, research best practices related to a current health care problem. Your selected problem or issue will be utilized again in Assessment 4. To explore your chosen topic, you should use the first two steps of the Socratic Problem-Solving Approach to aid your critical thinking.

View the Assessment Topic Areas media piece and select one of the health care problems or issues in the media piece to research. Write a brief overview of the selected topic. In your overview:

Summarize the health care problem or issue.

Describe your interest in the topic.

Describe any professional experience you have with this topic.

Identify peer-reviewed articles relevant to health care issue or problem.

Conduct a search for scholarly or academic peer-reviewed literature related to the topic and describe the criteria you used to search for articles, including the names of the databases you used. You will select four current scholarly or academic peer-reviewed journal articles published during the past 3–5 years that relate to your topic.

Refer to the NHS-FPX4000: Developing a Health Care Perspective Library Guide to help you locate appropriate references.

Use keywords related to the health care problem or issue you are researching to select relevant articles.

Assess the credibility and explain relevance of the information sources you find.

Determine if the source is from an academic peer-reviewed journal.

Determine if the publication is current Applying Library Research Skills – NHS4000: Developing a Health Care Perspective.

Determine if information in the academic peer-reviewed journal article is still relevant.

Analyze academic peer-reviewed journal articles using the annotated bibliography organizational format. Provide rationale for inclusion of each selected article. The purpose of an annotated bibliography is to document a list of references along with key information about each one. The detail about the reference is the annotation. Developing this annotated bibliography will create a foundation of knowledge about the selected topic. In your annotated bibliography:

Identify the purpose of the article.

Summarize the information.

Provide rationale for inclusion of each article.

Include the conclusions and findings of the article.

Write your annotated bibliography in a paragraph form. The annotated bibliography should be approximately 150 words (1–3 paragraphs) in length.

List the full reference for the source in APA format (author, date, title, publisher, et cetera) and use APA format for the annotated bibliography.

Make sure the references are listed in alphabetical order, are double-spaced, and use hanging indents.

Summarize what you have learned from developing an annotated bibliography.

Summarize what you learned from your research in a separate paragraph or two at the end of the paper.

List the main points you learned from your research Applying Library Research Skills – NHS4000: Developing a Health Care Perspective.

Summarize the main contributions of the sources you chose and how they enhanced your knowledge about the topic.

Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:

Assessment 2 Example [PDF].

Additional Requirements

Your assessment should also meet the following requirements:

Length: 2–4 typed, double-spaced pages, not including the title page and reference page.

Font and font size: Times New Roman, 12 point.

APA tutorial: Use the APA Style Paper Tutorial [DOCX] for guidance.

Written communication: Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.

Content: Provide a title page and reference page following APA style.

References: Use at least four scholarly or academic peer-reviewed journal articles.

APA format: Follow current APA guidelines for in-text citation of outside sources in the body of your paper and also on the reference page.

Competencies Measured

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

Competency 2: Apply scholarly information through critical thinking to solve problems in the field of health care.

Assess the credibility and relevance of information sources.

Analyze academic peer-reviewed journal articles using the annotated bibliography organizational format.

Summarize what was learned from developing an annotated bibliography.

Competency 4: Write for a specific audience, in appropriate tone and style, in accordance with Capella’s writing standards.

Apply academic peer reviewed journal articles relevant to the health care problem or issue being researched.

Produce text with minimal grammatical, usage, spelling, and mechanical errors.

Integrate into text appropriate use of scholarly sources, evidence, and citation style

Applying Library Research Skills – NHS4000: Developing a Health Care Perspective

Lewin’s Theory of Planned Change in Nursing – NURS 4106 Week 6 Assignment

INTRODUCTION

High-acuity respiratory patient population.

Complex interdisciplinary care coordination.

Telemetry-related alarm fatigue risks.

Need for nurse-led quality change.

Lewin’s structured change framework.

There are unique challenges in delivering quality care in a pulmonary step-down unit within an acute care facility. That is because of the high acuity of patients with complex respiratory diagnoses. The patients receiving care in the unit typically require advanced respiratory support, continuous monitoring, and coordinated interdisciplinary interventions that involve nursing, occupational therapy, physical therapy, speech therapy, and respiratory therapy. As a telemetry unit, the pulmonary step-down unit faces additional risks such as alarm fatigue that further complicates staff workflow and patient safety. There is a need for effective nurse-driven change initiatives in the unit to address the persistent safety and quality concerns. Lewin’s Theory of Planned Change offers a structured framework for implementing sustainable improvements by guiding organizations through unfreezing the existing practices, changing by moving towards new deliberate behaviors, and refreezing the change into standard practice. Applying this theory enables nurses to lead evidence-based change while fostering staff engagement and long-term adherence (Gielen et al., 2022) Lewin’s Theory of Planned Change in Nursing – NURS 4106 Week 6 Assignment.

1: ALARM FATIGUE

Excessive nonactionable telemetry alarms.

Delayed response to emergencies.

Increased patient safety risks.

Pulmonary alarms occur frequently.

Priority nurse-led safety improvement.

A significant quality care problem in the unit is alarm fatigue linked with continuous telemetry and respiratory monitoring. There are excessive non-actionable alarms that desensitize the staff, thereby increasing their risk of delaying response to critical events. Albanowski et al. (2023) note that alarm fatigue contributes to missed alarms and adverse patient outcomes, particularly in telemetry-intensive environments. The Joint Commission (2024) identifies alarm management as a national patient safety goal, emphasizing that it impacts care quality. Among patients with pulmonary issues, frequent oxygen desaturation and ventilator alarms heighten the risk of alarm fatigue. Without staff education and a systematic alarm customization, alarm fatigue would continue to undermine situational awareness, patient safety, and staff morale. As such, alarm fatigue is a priority area for nurse-led quality improvement.

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2: INTERDISCIPLINARY COMMUNICATION

Interdisciplinary communication frequently breaks down.

Handoff errors delay patient care.

Miscommunication increases adverse outcomes.

Pulmonary care requires unified planning.

Nurses lead structured communication tools.

Breakdown in interdisciplinary communication, especially during care coordination and handoffs among nursing, rehabilitation, and respiratory therapy services is a significant quality care problem. Ineffective communication is linked to patient dissatisfaction, care delays, and medical errors. Shrivastava et al. (2025) explains that inadequate interdisciplinary communication significantly compromises continuity in step-down and acute units. In pulmonary care settings, miscommunication regarding mobility status, swallowing precautions, or oxygen delivery methods can result in prolonged hospitalization, hypoxia, or aspiration. Lewin’s Theory of Planned Change in Nursing – NURS 4106 Week 6 Assignment The complexity of respiratory care necessitates structured, timely communication strategies to ensure all disciplines share a unified care plan. Nurses are well positioned to identify communication gaps and champion standardized tools to enhance interdisciplinary collaboration.

3: PATIENT-TO-NURSE RATIOS

Unsafe patient-to-nurse staffing ratios.

High workloads increase nurse burnout.

Delayed interventions worsen outcomes.

Limited interdisciplinary care coordination.

Need data-driven staffing advocacy.

Unsafe patient-to-nurse ratios is a significant quality care problems that directly affects patient outcomes and nurse well-being. Patients in the pulmonary step-down unit often require frequent assessments, titration of oxygen therapy, and rapid intervention for respiratory deterioration. Griffiths et al. (2024) explains that high patient-to-nurse ratios cause nurses to have high workloads that are linked to increased mortality, higher rates of failure-to-rescue, and burnout. In addition, inadequate nurse staffing limits the ability of nurses to coordinate interdisciplinary care and promptly respond to alarms. It is essential to address staffing concerns as a measure for maintaining quality, safety, and workforce sustainability. Data-informed staffing models and nurse-driven advocacy are critical to migrating risks linked to high-acuity respiratory care environments.

CHANGE
THEORY

Lewin’s Theory of Planned Change provides a practical framework for implementing nurse-driven improvements that target there three quality care problems. During the unfreezing stage, nurse can be involved in presenting data from the unit on incidences of alarm fatigue, communication errors, and adverse outcomes related to staffing. Their involvement in presenting the data can help to build awareness and urgency. The change stage involves implementing targeted interventions, such as standardizing alarm parameters to address alarm fatigue, implementing SBAR-based interdisciplinary handoff protocols to address communication concerns, and adopting acuity-adjusted staffing assignments to addressing staffing concerns. Interdisciplinary engagement, pilot testing, and education are essential in the change stage Lewin’s Theory of Planned Change in Nursing – NURS 4106 Week 6 Assignment. Finally, the refreezing stage solidifies the change through performance metrics, ongoing education, and integrating new practices into policies. Through the change model, nurses can lead sustainable change that enhances safety, interdisciplinary collaboration, and quality outcomes in pulmonary step-down unit (Gielen et al., 2022).

REFERENCES

Albanowski, K., Burdick, K. J., Bonafide, C. P., Kleinpell, R., & Schlesinger, J. J. (2023). Ten Years Later, Alarm Fatigue Is Still a Safety Concern.
AACN advanced critical care, 34
(3), 189–197.
https://doi.org/10.4037/aacnacc2023662

Gielen, A. C., Peterson, D. V., Ottoson, J. M., Green, L. W., & Kreuter, M. W. (2022).
Health Program Planning, Implementation, and Evaluation: Creating Behavioral, Environmental, and Policy Change
. Johns Hopkins University Press.

Griffiths, P., Saville, C., Ball, J., Culliford, D., Jones, J., Lambert, F., Meredith, P., Rubbo, B., Turner, L., Dall’ora, C., & Workforce Health Outcomes Study Group (2024). Nursing Team Composition and Mortality Following Acute Hospital Admission.
JAMA network open, 7
(8), e2428769.
https://doi.org/10.1001/jamanetworkopen.2024.28769

Joint Commission. (2025).
National Patient Safety Goals® Effective 2025 for the Hospital Program
.
https://digitalassets.jointcommission.org/api/public/content/9be383450fc941df806b76c5fbdd9ae6?v=3c600c3a

Shrivastava, S. R., Chong, S. V., & Bobhate, P. S. (2025). Facilitating effective communication through the adoption of SBAR tool in medical training.
Journal of education and health promotion, 14
, 249.
https://
doi.org/10.4103/jehp.jehp_1213_24

 

Instructions – Lewin’s Theory of Planned Change in Nursing – NURS 4106 Week 6 Assignment

Presentation

What are best ways to implement and maintain change over time? One way is through the use of Lewin’s Theory of Planned Change. It involves three stages:

Unfreezing (understanding change is needed)

Moving (process of initiating change)

Refreezing (establishing a new status quo)

Now, it is time for you to think about quality care problems that exist in your area. What are the top three problems that you see? When considering these problems, what evidence supports why these are problems? Using Lewin’s Theory of Planned Change, how can this theory be used to implement change surrounding these problems.

In this Assignment, you will explore quality care problems in your area. While providing evidence to support each of them, you will also apply Lewin’s theory to your nurse driven change. This information will be analyzed through a slide presentation.

Resources

To prepare:

Review the Required Learning Resources, specifically resources related to Lewins’ Change Theory

Consider your clinical practice area and potential quality care problems

Research evidence for potential practice problems

The Assignment

Construct a 5–7 slide presentation, with notes, in which you complete the following:

Identify three different quality care problems within your area.

Present one piece of evidence for each of the potential practice problems (3 total)

Apply Lewin’s change theory to a nurse driven change to a quality care or safety problem

Important Reminder: 
Be sure to include speaker’s notes for every slide in your presentation. You may either embed the notes directly in the “Notes” section beneath each PowerPoint slide or provide them as a separate Word document.

 

Lewin’s Theory of Planned Change in Nursing – NURS 4106 Week 6 Assignment Readings

Spath, P., & Devane, A. (2023). 
Introduction to healthcare quality management
Links to an external site.
 (4
th
 ed). Health Administration Press.

Chapter 10, “Managing the Use of Healthcare Resources” (pp. 315–319)

Burnes, B. (2020). 
The origins of Lewin’s three-step model of change.Links to an external site.
 
The Journal of Applied Behavioral Science, 56
(1), 32–59. https://journals.sagepub.com/doi/full/10.1177/0021886319892685

Kotter. (n.d.). 
The 8 steps for leading change.
Links to an external site.
 https://www.kotterinc.com/methodology/8-steps

Prosci. (n.d.). 
The prosci ADKAR model.
Links to an external site.
 https://www.prosci.com/methodology/adkar

Sutherland, K. (n.d.). 
Applying Lewin’s change management theory to the implementation of bar-coded medication administration.
Links to an external site.
 
https://www.printfriendly.com/p/g/xVnXSE

Media

Forde-Johnston, C. (2023). 
Lewin’s change management model explained using two example nursing projects
Links to an external site.
 [Video]. YouTube. https://youtu.be/GZKzUKp_KFMhttps://youtu.be/GZKzUKp_KFM

 

 

NURS_4106_Week6_Assignment3_Rubric – Lewin’s Theory of Planned Change in Nursing 

NURS_4106_Week6_Assignment3_Rubric

Criteria

Ratings

Pts

This criterion is linked to a Learning OutcomeIdentified three different quality care problems within the area.

30 to >22.5 ptsMasters Expectations
The response comprehensively and clearly identified three different quality care problems… The response includes relevant, specific, and appropriate examples that fully support the identification.

22.5 to >18.0 ptsAchieves Expectations
The response identified three different quality care problems… The response includes relevant, specific, and appropriate examples that support the identification.

18 to >0 ptsDoes Not Meet Expectations
The response inaccurately and vaguely identified three different quality care problems, or it is missing… The response includes inaccurate and vague examples that do not support the identification, or it is missing.

30 pts

This criterion is linked to a Learning OutcomePresented one piece of information for each of the potential practice problems (3 total).

60 to >45.0 ptsMasters Expectations
The response comprehensively and clearly presented one piece of information for each of the three practice problems… The response includes relevant, specific, and appropriate examples that fully support the presentation.

45 to >36.0 ptsAchieves Expectations
The response presented one piece of information for each of the three practice problems… The response includes relevant, specific, and appropriate examples that support the presentation.

36 to >0 ptsDoes Not Meet Expectations
The response inaccurately and vaguely presented one piece of information for each of the three practice problems, or some or all are missing… The response includes inaccurate and vague examples that do not support presentation, or it is missing.

60 pts

This criterion is linked to a Learning OutcomeApplied Lewin’s Change Theory to a quality care or safety problem.

40 to >30.0 ptsMasters Expectations
The response comprehensively and clearly applied Lewin’s change theory to a quality care or safety problem… The response includes relevant, specific, and appropriate examples that fully support the application.

30 to >24.0 ptsAchieves Expectations
The response applied Lewin’s change theory to a quality care or safety problem… The response includes relevant, specific, and appropriate examples that support the application.

24 to >0 ptsDoes Not Meet Expectations
The response inaccurately and vaguely applied Lewin’s change theory to a quality care or safety problem, or it is missing… The response includes inaccurate and vague examples that do not support the application, or it is missing.

40 pts

This criterion is linked to a Learning OutcomeProfessional writing: Context, organization, audience, purpose, tone, style, clarity, flow

10 to >7.33 ptsMasters Expectations
Demonstrates full awareness of writing context, audience, and purpose… Content is generally clear, logical, and well organized with appropriate sentence and paragraph structure… Tone is highly professional, scholarly, and free of bias… Style is consistently appropriate for a professional setting/workplace context… Mostly free of spelling, punctuation, and grammar/syntax errors Lewin’s Theory of Planned Change in Nursing – NURS 4106 Week 6 Assignment.

7.33 to >6.0 ptsAchieves Expectations
Demonstrates some awareness of writing context, audience, and purpose… Content is mostly clear, logical, and well organized with adequate sentence and paragraph structure… Tone is adequately professional, scholarly, and/or free of bias… Style is mostly appropriate for a professional setting/workplace context… Contains few spelling, punctuation, and/or grammar/syntax errors.

6 to >0 ptsDoes Not Meet Expectations
Demonstrates minimal awareness of writing context, audience, and purpose… Content lacks clarity, logic, and/or discernible organization; does not use proper sentence and paragraph structure… Tone is not professional/scholarly and/or contains bias… Style is inconsistent with a professional setting/workplace context… Contains significant spelling, punctuation, and/or grammar/syntax errors.

10 pts

This criterion is linked to a Learning OutcomeProfessional writing: Originality, source credibility, and attribution of ideas

10 to >7.33 ptsMasters Expectations
Writing fully reflects original thought and paraphrasing and adheres to reference requirements, including the use of credible evidence to support a claim while incorporating appropriate citations and references in APA format.

7.33 to >6.0 ptsAchieves Expectations
Writing adequately reflects original thought and paraphrasing and adheres to reference requirements, including the use of credible evidence to support a claim while incorporating appropriate citations and references in APA format.

6 to >0 ptsDoes Not Meet Expectations
Writing does not reflect original thought and paraphrasing and does not adhere to reference requirements, including the use of credible evidence to support a claim while incorporating appropriate citations and references in APA format.

10 pts

Total Points: 150 Lewin’s Theory of Planned Change in Nursing – NURS 4106 Week 6 Assignment

NRNP/PRAC 6635 Comprehensive Psychiatric Evaluation Template

Week 5 6635 Prac

Select a patient that you examined during the last 5 weeks. Review prior resources on the disorder this patient has.

In Week 5: Assignment 2, Part 1, you submitted the Video Evaluation Presentation.

In Week 5: Assignment 2, Part 2, you will submit the documentation.

Conduct a Comprehensive Psychiatric Evaluation on this patient using the template provided in the Learning Resources. There is also a completed exemplar document in the Learning Resources so that you can see an example of the types of information a completed evaluation document should contain. All psychiatric evaluations must be signed, and each page must be initialed by your Preceptor. You will submit your document in Week 5 Assignment, Part 2 area and you will include the complete Comprehensive Psychiatric Evaluation as a Word document, as well as a PDF/images of each page that is initialed and signed by your Preceptor. You must submit your document using Turn It In.
Please Note:
 Electronic signatures are not accepted. If both files are not received by the due date, Faculty will deduct points per the Walden Late Policies.

Develop a video case presentation, based on your progress note of this patient, that includes chief complaint; history of present illness; any pertinent past psychiatric, substance use, medical, social, family history; most recent mental status exam; and current psychiatric diagnosis, including differentials that were ruled out.

Include at least five (5) scholarly resources to support your assessment and diagnostic reasoning.

Ensure that you have the appropriate lighting and equipment to record the presentation.

This is my patient:

40 year old male presents with PTSD, and Adjustment Disorder. Patient is recently released from prison due to robbing a pharmacy due to an addiction issue. Patient is in a toxic relationship for about 6 months now. Family does not approve. Girlfriend spending all his money. She is very controlling, and has made threats that if she can’t have him, nobody can along with she has a gun and she can set him up to go back to prison with his parole officer. Patient feels trapped. Patient sleeps well, he does drink a lot of coffee though out the day, but still feels tired. His mood is alright, appetite is ok. His other stressors are his father has stage 4 cancer and his mother has dementia. Vit D was suggested. Prescribed medications are Clonazepam 0.5 mg BID and ½ TID, and Venlafaxine XR 300. Will follow up with patient in January.

NRNP/PRAC 6635 Comprehensive Psychiatric Evaluation Template

College of Nursing-PMHNP, Walden University

PRAC 6635: Psychopathology and Diagnostic Reasoning

NRNP/PRAC 6635 Comprehensive Psychiatric Evaluation Template

Patient Initials:
J.S.  
Age:
40 years  
Sex:
Male  
Race:
Caucasian  
Date:
01/01/2026

CC
(chief complaint): “I feel trapped in my relationship and feel stressed about everything in my life.”

HPI
: J.S. is a 40-year-old Caucasian male reporting for psychiatric follow-up on PTSD and adjustment disorder. He has recently come out of prison due to a robbery in a pharmacy in connection with previous substance use and is on parole. He states more distress associated with six-month toxic relationship involving financial exploitation, emotional abuse, control, and threat involving a gun and interference with parole causing him to feel scared and imprisoned, but there is no physical violence. He has PTSD symptoms such as hypervigilance, intrusive thoughts, and anxiety involving the perceived threats without nightmares or flashbacks. His mood is described as “alright,” but is emotionally exhausted; appetite and sleep duration are normal, but he complains of fatigue in the daytime and reports excessive caffeine consumption. Denies suicidal or homicidal ideation. Other stressors are that his father has stage IV cancer and his mother has dementia. He denies any serious side effects, is medication compliant, and was adviced to take vitamin D.

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Past Psychiatric History
:

G
eneral Statement: The patient initially received psychiatric care when he was in his early 30s due to legal substance use related problems. There was an increase in formal psychiatric care in incarceration.

C
aregivers (if applicable): Not applicable.

H
ospitalizations: One past inpatient psychiatric hospitalization at the age of 34 because of substance-induced mood symptoms and detoxification. Denies committing suicide attempts or self-harm. Denies homicidal behavior.

M
edication trials:

Sertraline: trialed in the past, minimal benefit.

Fluoxetine: discontinued due to emotional blunting.

P
sychotherapy or
P
revious Psychiatric Diagnosis:

Diagnosed with PTSD and substance use disorder during incarceration.

Participated in cognitive behavioral therapy and trauma-focused group therapy while incarcerated; found therapy moderately helpful.

Currently not engaged in psychotherapy.

NRNP/PRAC 6635 Comprehensive Psychiatric Evaluation Template

Substance Current Use and History:

Caffeine:
Heavy use, approximately 6–8 cups of coffee daily.

Alcohol:
Occasional use, 1–2 beers weekly; denies binge drinking.

Illicit substances:
History of opioid misuse related to pharmacy robbery; reports abstinence for over one year.

Nicotine:
Smokes approximately ½ pack per day.

Denies history of withdrawal seizures or delirium tremens.

Family Psychiatric/Substance Use History:

Father: No psychiatric history; currently diagnosed with stage IV cancer.

Mother: Dementia, no known prior psychiatric history.

No known family history of suicide.

One uncle with alcohol use disorder.

Psychosocial History:
The patient was born and brought up in the Midwest and raised by both parents. He has a younger sister whom he rarely has time to interact with. He is in a volatile housing situation with his girlfriend and is divorced without children. He finished high school and has a bit of vocational education. He is currently unemployed and on parole searching to work. His criminal record is noteworthy due to a felony conviction, and he is still on strict parole compliance measures. His trauma history involves incarceration related trauma and continuous emotional abuse in his current relationship. He denies violent behavior history and notes that he is afraid of his personal safety because his partner threatens him.

Medical History:
No chronic medical illnesses reported. No history of seizures or traumatic brain injury.

Current Medications
:

Venlafaxine XR 300 mg PO daily – for PTSD and mood symptoms (2 years).

Clonazepam 0.5 mg PO BID and 0.25 mg PO TID PRN anxiety.

Vitamin D supplementation recommended (OTC).

Allergies
:

Medications:
No known drug allergies.

Food:

Environmental:
Seasonal pollen – causes mild rhinorrhea.

Reproductive Hx
: Denies sexual dysfunction. Heterosexual. Sexually active with current partner.

ROS
:

General:
Reports fatigue; denies fever, weight change.

HEENT:
Denies headaches, vision changes, hearing loss.

Skin:
No rashes or lesions.

Cardiovascular:
Denies chest pain, palpitations.

Respiratory:
Denies shortness of breath or cough.

Gastrointestinal:
Denies nausea, vomiting, diarrhea.

Genitourinary:
Denies urinary symptoms.

Neurological:
Denies dizziness, syncope, weakness.

Musculoskeletal:
Denies joint or muscle pain.

Endocrine:
Denies heat/cold intolerance.

Psychiatric:
Endorses anxiety, hypervigilance; denies SI/HI, hallucinations, or manic symptoms.

Physical exam:

General:
Well-nourished male, appears stated age, mildly tense posture.

HEENT:
Head atraumatic; pupils equal and reactive; mucous membranes moist.

Cardiovascular:
Regular rate and rhythm; no murmurs.

Respiratory:
Clear breath sounds bilaterally; unlabored respirations.

Neurological:
Alert, oriented ×4; no focal deficits observed.

Diagnostic results
:

Recent basic metabolic panel within normal limits (per patient report).

Vitamin D level pending due to fatigue complaints.

PHQ-9: Mild depressive symptoms.

GAD-7: Moderate anxiety.

PTSD Checklist (PCL-5): Elevated, consistent with PTSD.

Assessment

Mental Status Examination:

J.S. is a 40-year-old Caucasian male who looks his stated age and is well-groomed in casual clothes. He is cooperative, somewhat guarded, tense in posture and a bit restless. Speech is fluent and consistent with normal rate and tone. He reports his mood as “Alright,” but stressed, and his affect as anxious and constricted, which is not congruent with the stated mood. The thought processes are goal-oriented and logical without delusions, obsessions, or paranoia and the focus of thought content is to relationships and legal stressors. He denies hallucinations or mania. He is alert and oriented to person, place, time, and situation with intact memory and sufficient concentration. His awareness of his mental health conditions and relational stressor factors is decent and his judgment is slightly impaired as shown by his continued engagement in a high-risk emotionally abusive relationship despite understanding the possible consequences. Denies the presence of suicidal or homicidal ideation, intent or plan at this time.

Differential Diagnoses:

Post-Traumatic Stress Disorder (Primary Diagnosis):
Post-Traumatic Stress Disorder is a trauma-related condition marked by persistent distress following exposure to a traumatic event (Mann et al., 2024).  DSM-5-TR criteria involve exposure to the trauma, intrusive symptoms, hyperarousal, and dysfunctional impairment that persists more than one month (Du et al., 2022). The patient has a history of incarceration-related trauma, hypervigilance, intrusive thoughts, and anxiety linked to perceived threats as lasting more than one year, which supports this diagnosis.

Adjustment Disorder with Anxiety:
Adjustment Disorder and Anxiety is an emotional distress that is responsive to stressful events that happen during a three-month period and is resolved after six months when the stressor ceases to occur (Bambrah et al., 2022). This diagnosis is considered because of the recent stressors like confinement, illness in the family, and conflict in relationships. The diagnosis is however eliminated as the major diagnosis since the symptoms experienced by the patient are chronic, go beyond the normal duration of adjustment disorder and can be better attributed to PTSD.

Generalized Anxiety Disorder (GAD):
Generalized Anxiety Disorder is an excessive, uncontrollable worry that occurs on more than one domain with a physical and cognitive manifestation that lasts at least six months (Munir & Takov, 2022). Despite the patient having chronic worry, tension and fatigue, this diagnosis is eliminated since his anxiety is rather situational and trauma-related than pervasive and generalized in various life situations.

Primary Diagnosis: Post-Traumatic Stress Disorder

The diagnosis of Post-Traumatic Stress Disorder is appropriate since the patient has a definite history of exposure to traumatic experiences associated with incarceration and continued perception of threat accompanied with consequent symptoms of hypervigilance, intrusive thoughts and anxiety that persist significantly beyond one year and create functional distress. These are trauma-specific symptoms, which are worsened by situations that remind him of the lack of control and safety and cannot be adequately explained by a mood disorder, substance use, or a transient response to recent stressors. The long-term duration, symptomatology, and correlation to the DSM-5-TR criteria indicate that PTSD is the most approppriate and comprehensive diagnosis for this patient NRNP/PRAC 6635
Comprehensive Psychiatric Evaluation
Template.

Reflections:

This case demonstrates the complexity of dealing with patients with a psychiatric issue that is complicated by legal intervention and the instability of the psychosocial situation. I concur with my preceptor’s PTSD diagnosis but would emphasize more on intimate partner violence risk assessment and safety planning. Ethical issues are not confined to confidentiality. There exist plausible threats of firearms and fraud with parole that increase the duty-to-protect and mandatory-reporting factors as well as cooperation with legal systems. Consideration should be made over benzodiazepine prescribing considering substance use history and parole status (Volkow & Blanco, 2023). This patient is strongly affected by social determinants of health such as unstable housing, unemployment, legal restrictions, and caregiving stress. Trauma-informed care, substance relapse prevention, caffeine reduction, sleep hygiene, and linking to domestic violence resources are some areas of health promotion that need to be addressed NRNP/PRAC 6635 Comprehensive Psychiatric Evaluation Template. It would be necessary to support culturally and developmentally adequate psychoeducation, psychotherapy referral (trauma-focused CBT) and coordination with parole services. In the event of independent management, I would focus on benzodiazepines tapering, increased psychotherapy involvement, social work-based safety planning, and social work-based environmental risk reduction to enhance long-term outcomes.

 

PRECEPTOR VERFICIATION:

I confirm the patient used for this assignment is a patient that was seen and managed by the student at their Meditrek approved clinical site during this quarter course of learning.

 

Preceptor signature: ________________________________________________________

 

Date: ________________________

 

 

References

Bambrah, V., Wyman, A., Friedman, E., & Eastwood, J. D. (2022). Examining the longitudinal associations between adjustment disorder symptoms and boredom during COVID-19.
Behavioral Sciences
,
12
(9), 311.
https://doi.org/10.3390/bs12090311

Du, J., Diao, H., Zhou, X., Zhang, C., Chen, Y., Gao, Y., & Wang, Y. (2022). Post-traumatic stress disorder: A psychiatric disorder requiring urgent attention.
Medical Review
,
2
(3), 219–243.
https://doi.org/10.1515/mr-2022-0012

Mann, S. K., Marwaha, R., & Torrico, T. J. (2024, February 25).
Posttraumatic stress disorder (PTSD)
. PubMed; StatPearls Publishing.
https://www.ncbi.nlm.nih.gov/books/NBK559129/

Munir, S., & Takov, V. (2022).
Generalized anxiety disorder
. National Library of Medicine; StatPearls Publishing.
https://www.ncbi.nlm.nih.gov/books/NBK441870/

Volkow, N. D., & Blanco, C. (2023). Substance use disorders: A comprehensive update of classification, epidemiology, neurobiology, clinical aspects, treatment and prevention.
World Psychiatry
,
22
(2), 203–229.
https://doi.org/10.1002/wps.21073 
 NRNP/PRAC 6635 Comprehensive Psychiatric Evaluation Template

NURS 6060: Faith, Ethics, and Interprofessional Collaboration in Advanced Practice

End of Term Paper

The student will create, and write a formal written analysis of a selected health care dilemma in nursing (8-11 pages) and discuss how healthcare systems play a part in the final outcome of the decision-making process.  This paper will be written in American Psychological Association (APA) format. The student will integrate a minimum of 5 sources from textbooks, peer reviewed journal articles, professional web sources (directed toward health care providers, not public sites), written texts, and provided reference lists.  Students should also heavily reflect from their assigned text readings from throughout the semester and from all textbooks.

This paper is meant to be a summative presentation of the information you have learned during the semester for NURS 6060: Faith, Ethics, and Interprofessional Collaboration in Advanced Practice.  The grading rubric for this paper is provided in the course drop box.  References should be incorporated for a majority of the paper.  All definitions should be supported with references. Submissions should be made on a Word Document (doc or docx).

BUY HUMAN-WRITTEN PAPER HERE 

The outline of the content is provided below for your guidance.  Students will be evaluated in terms how well they address the issues/questions provided in each of the areas below.  Students should be prepared to provide information with enough clarity, accuracy, precision, relevance, depth, breadth, logic, significance, and fairness as it applies to the discussion components listed.  Information should be provided as to help the reader to a complete and logical conclusion of each paper’s section.  Students should follow the outline listed below to help provide structure to the content of their paper.  Please use the content section below as sub-headers within the paper.  (Content points per section is identified in parenthesis)

 

Introduction

Patient Scenario (15 points)

Provide a description of a fictitious, but realistic patient scenario in which a patient has a complex, chronic healthcare problem (Example: Type 2 diabetes, rheumatoid arthritis, debilitating osteoporosis, stroke, etc.).

Include demographics and a brief discussion of the disease process and the complexities associated with this health problem. This should be one paragraph only as to why this is a concern with ethical implications.

Incorporate
only relevant
components of a patient’s history as relevant for application in the paper/discussion.

(Section should be no more than one page in length.)

Patient Environment /History (10 points)

Elaborate on how culture and a person’s social roles can influence a person’s participation in health care and health care decisions. (cite)

Discuss components in this patient scenario about how past/current health history, cultural history (including health beliefs & religion), social history (including family and community roles the patient may play a part in) and other relevant information that may help the nurse practitioner better understand the patient and their beliefs.

Interprofessional Collaboration (20 points)

Define “Interprofessional Collaboration” (IPC) and the role it plays in today’s healthcare system. (Cite)

Besides the nurse or family nurse practitioner, physician, and members of their immediate staff, identify at least 3 additional healthcare members/professionals who can contribute to your identified patient’s healthcare as part of IPC. (Cite)

Delineate the role each one can play or how they can contribute to the patient’s outcome. (Each must be cited)

Patient Outcomes (20 points)

Define realistic patient outcomes for your identified patient. What are the long term goals for this patient? (Hint: is it a cure to the problem? Is the medical problem the only problem to address?)

What would be a “healthy outcome” for this patient?

Discuss why these goals/outcomes were selected and how you will work toward the achievement of them. (Make sure IPC is addressed in how it will specifically address the outcome) NURS 6060: Faith, Ethics, and Interprofessional Collaboration in Advanced Practice.

(NOTE: IPC and Patient Outcome orders can be switched if is better for the flow of the paper.

Identify and discuss one professional ethical principle (besides autonomy) that can be promoted through interprofessional collaboration in this scenario. Discuss how team members can be integrated in promoting ethics.  (15 points)

Christian Ethics and the Nurse (15 points)

Define Christian ethics from your readings

Discuss a Christian Ethical consideration for this scenario. (See Module 1)

Discuss where it is supported in scripture.

Describe how you can stand as a Christian Nurse in this scenario (supported by Scripture and readings).

Closing summation

References

NURS 6060: Faith, Ethics, and Interprofessional Collaboration in Advanced Practice

Module 1:The Nurse Practitioner and Christian Ethics

 

Module 1:The Nurse Practitioner and Christian Ethics

Module 1:The Nurs: Practitioner and Christian Ethic

Requi edReading

Shely, J.A.,& Miller, A.B.(2006).Called to care:A Christian worldview for nursing(2nd ed.).

Chapters 1,2,3

2.Eurkhardt, M.A,&Nathaniel,A.K.(2020). Ethics & Iss es in Contemporary Nursing: Nusing Ethicsfort e 21 Century. Boston,MA:Cei gage Leamin

Chapters 1,2,4,5

Holladay,T.(200B). The relationship principles ofJesus.

Days 1-7

Reconmended Review

ANA code of ethics

AMA code of ethicsB

SROMArticle山民

Ethics-Definitions Short山园

Ethical Challenges in an Era of Healthcare Reform

Module Objectives:(Associated Course Objectives listed in parentheses

At the completion of this unit, the learner will be able to:

Discuss the internal conflicts a Christian may have as they practice as an advanced practice nurse.(AC1)

2. Define Christian ethics and make applications as it applies to the health care setting and making health care decisions. (CC1)

3. Discuss their personal philosophy of approaching people of differing beliefs,values and ethics.(AC2)

4. Apply Biblical principles and ethical concepts in preparation to addressing the patient.(PC1)

5. Apply Christian principles and ethical decision-making when dealing with patients in the primary health care setting (AC1)MODULE 1 TASK LIST

Have you ever read this Scripture: “The stone that the builders rejected has become the cornerstone…- Mark 12:10

For those of you who may not know. A cornerstone is a stone used in masonry walls to start the foundation for a building. It was a stone that represented the starting place in the construction of a building. As the first stone laid, the cornerstone is the essential chief foundation stone in which the placement of all other stones or bricks was compared to prior to being set in stone.A proper cornerstone allowed those constructing the building to develop straight and true walls

based upon the exactness of the first laid stone.A solid life in Jesus must be compared to that of the conerstone. Our works and foundations must be compared to the initfial foundation stone of Jesusif we are to have a life that honors and

glorihes God.

Likewise,building up a career starts with having a secure foundation. A solid education.A solid clinical base. A solid ethical foundation. Too many times,nurse practitioners and nurses enter a career that is swayed by many professional and

cultural influences. A Christian healthcare provider is no different. You will be facing many tough decisions in your career as a provider. Some of them may even be in your offce orflor!! Each one wil be different because each encounter wil

bring new people, aged wisdom,and different environmental infuences. This is whyit is so critical to have a solid foundation to base our decisions on.This is why having Christ as your cornerstone is critical.While each decision wil be different,

the decision-maker wil be the same. Holding fast to Christ and yout faith and values will enable you to make consistent Christ-like decisions.You will find that with a firm foundation that is unwavering by culltural influences or peer pressure will

provide you with an easier decision.

How do we gain this frm foundation? How do we keep Christ as the cornerstone for our life and profession as a professional nurse ornurse practitioner? How can we gain confidence in making the right decisions in awkward situations? Ahhh,

that is what this module is aboutt As you read through Holladay’s book,you wil learn how making a relationship with others is based upon our relationshlp with Christ. Then, as you begin reading your other texts, bring these concepts with yout

Ihope youwill se how invaluable this cornerstone relationship with Christ trul is in your practice,in you interaction with patients, &in your life!

So for this module,here is the list of tasks to be done.

WEEK1

If you have not done so, please introduce yourself in the Discussion area under”Class introductions.”(HERE IS THE LINK) Thave setings placed so that you wil not be able to view other people’s postings until after you have posted yours.[1

want to try to keep some originality to your posting. You wil understand why later..

If you have not done so, you will need to watch the orientation video (It is located in the previous section) and submit your assignment from Intensives, submitting the required work HERE(Intensive Participation Submission Box): It is due on

the Friday of the first week.

3.Download the notes for the presentations of this module (Here is the direct links):

#1-Module 1: Introduction隔

#2-Module 1: Faith也

#3·Module 1:Christian Ethics.出屎

(downloading the notes is not required and is nothing that will be tested,but may be helpful in your upcoming papers).MODULE 2 Reading Assignments and Objectives

Module 2: The Nurse Practitioner and the Person

Required Reading:

Shely, J.A,Miler. A.B,&Fenstermacher,K.H.(2021).Caled to Care. Intervarsity Press.(3rd ed htes/online.vitalsource.com/books/9781514000939B

Chapters 4,5,&6(Chapter6 really pulls at your heart strings)

Burkhardt.M.A,&Nathaniel,A.K.(2020).Ethics and issuesin contemporary nursing;Nursing and ethics for the 21st Century (1sted).

Chapters 3,6,7,11 & 18

Holladay.T.(2008). The relationship principles of Jesus.

Days 8-25

Supplemental review:(Not required to read all, but you wil need to print one off and review/highlight and bring to our meting during week5J

Bioethics article- Euthanasia下载

Bioethics article- Abortion

Journalof Chisian Nursing Home nage-GSThis sagod outsideresure foryouto utilze n dscusions.Consier bokmaring and searching forarictes o thi site oron BracketLibrar. s

Principles in Healthcare EthicsB(Great summary and discussion of some of the principles of professional ethics-Yes, I could have presented it last module, but you had a lot last module also).(Note: this is also a good source to cite when

discussing professional and nursing ethics)

Objectives:

At the completion of this unit, the learner will be able to:

Assess levels of spiritual distress in patients/families and develop ways to address spiritual health with family.

2.Discuss potential social, cultural, familial,&spiritual influences that may infuence healthcare decisions made by the patient &farmily.

Discuss Christian ethics and healthcare ethical principles as they apply to the health care setting and making health care decisions. (AC 2 & CC2)

Evaluate patient’s spiritual health, spiritual distresses, beliefs and backgrounds as they develop approaches to patient scenarios (PC 1 & PC 3)

Apply Christian principles and ethical decision-making when dealing with patients of differing age, race, culture or health status (PC 1 & AC1)

Compare and Contrast potential health outcomes based upon implementation of medical and Christian ethical decisions.

Content:

Refection of who our patient is, the person behind the ilnes, the social,cutural,familial & socalinfluences when we interact with them in a cinical setig

Examining what the patient may be considering when they make health are decisions that may conflict with our own choics,scetyschoices.or acepted medical practice.

Areview of how medical and Chistin ethicl principle contribute to th interaction between nurse practitioners and patients.What cthical considerationsarein play?

What ethical principles may conflict? What situational context plays a part in conflicting ethical principles.IVIUDULE Z IASK LISI

The Parable of the Good Samaritan

25On one occasion an expert in the law stood up to test Jesus. Teacher. he asked. what mustido to inherit eteral lfe?”

26What is writen in the Law?” he replied.”How do you read it?

2Hte answered, Love the Lord your God wit alyour heart and wit al your soul and withall our strengt and with alyour mindBt and. Love your neighbor as yourselfeb

28-You have answered correctly:” Jesus replied,”Do this and you wilive:”

29But he wanted to justfy himsel,so he asked Jesus. And who is my neighbor?”

30in reply Jesus said:“A man wasgoing down from Jerusalem to Jericho, when he wasattacked by robers.They stripped hin of his clothes,beat him and went away leaving him half dead.31Apriest happened to be going down the same road,

and when he saw the man.he passed by on the other side.32So too,a Levite, when he came to the place and saw him, passed by on the other side.23But Samaritan,ashe traveled, came where the man was; and when he saw him,he took pity

on him 34He went to him and bandaged his wounds,pouring on oil and wine. Then he put the man on his own donkey, brought him to an inn and took care of him35The next day he took out two denarilj Bl and gave them to the innkeeper.

Look after him; he sid, and when i retum,I will reimburse you for any extra expense you may have!

36″Which of these thre do you think was a neighbor to the man who fellinto the hands o robbers?”

37 The expert in the taw replled, The one who had mercy on him.

Jesus told him.”Go and do likewise’

Luke 10:25-37.

“with all humility and gentleness, with patience,bearing with one anotherin love”

Ephesians 4:2

“Go and do likcewise”. Four simple words. I think we all say we would love our patients no matter what. in fact, most of you, if not allof you,mentioned trying to establish that relationship with each of them,reaching out to them in love,even in

the midst of unwelcomed circumstances.We all want to show love and mercy.and we all want to befriend that person who is hurting. So helping someone in need should not be a problem,right?

However.we are going to find that sometimes wanting to do what is necessary and being able to do what is right may not always coincide. Consider the abbreviated scenario from your book. Aman suustains a gunshot wound to the abdomen.

Following emergency surgery., it is determined nothing can be done for him and he will die. He is closed back up and sent for recovery. The nursing orders are to keep the patient NPO to prevent furtheer complications and to monitor him. He is

running an incredibly high temperature and is driting in and out of consciousness. One time,he asks for a drink of water. lce water for his thirst. That’s ali he wanted. What would we do? I think we are all thinking some kind of plan right now,

but are we ethically right? Are we obeying God by following those institutional rulesthat are set forth by earthly authority (which weare commanded to do in the Bible) or are we obeying God by showing love and compassion? And how is it we

are showing love and compassion? Somewhere,something will not be done as directed. Ethical conflicts.

As you may have previously studied, the Good Samaritan wasa controversial figure. He was shunned by a nation and yet he gave compassion to a man from that nation. You may have read how the traveler looked past the personal

characteristics of the person who was hurting and treated the ailments of him. The approach to some patients with issues may be easy in that you treat the person,regardless of the decisions the patients make. However.you will be faced with

decisions that willbe difcult to make. This module,we are going to be looking at some ethical principles and applying them to patient scenarios. When you read the scenarios,you will see conflicting ethical considerations at play.possibly more

than one or two. In this module we will be learning about who the patient is who presents to us? What do they bring to the relationship? What are patient roles? What are patient values? What are cultural values? What are the patient’s

priorities?

This module, we are going to ask the questions that inspired Jesus to tell the parable:”Wha ismy neighbor?” The answer, you may find,may not be the person you are thinking about and it may not be the obvlous answer_Module 3: The Nurse Practitioner and the Environment

Module 3: The Nurse Practitioner and the Environment

Required Reading:

Book readings

Shelly, J.A., & Miller, A.B. (2006). Called to care: A Christian worldview for nursing (2nd ed.).

Chapters 7, 8, & 9 – THESE CHAPTERS ARE MADE OPTIONAL THIS MODULE.

Burkhardt,M.A.,& Nathaniel.A.K.(2013). Ethics and issues in contemporary nursing: nursing ethics for the 21st Century.

Chapters 9, 10, 14, 16 – These readings are REQUIRED

Holladay,T.(200B). The relationship principles of Jesus.

Days 26-40 – These readings are REQUIRED.

AssignedArticles:(Now don’t freak out! You are not asked to read themalL See tasklist for more information.

MeLaney., E.Morassaei, S, Hughes,L. Davies,R.,Campbell M,&Di Prospero, L.(2022).A framework for interprofessional team collaboration ina hospital setting:Advancing team competencies and behaviors. Heailthcare Management Forum,

35(2), 112-117. https://doi.org/10.1177/08404704211063584

Thompson,D,& Stevens,M.(2023).Overcoming barriers to interprofessional collaboration in healthcare.Journal of Interprofessional Care,37(2),145-157.https://doi.org/10.1080/13561820.2023,1892765

Green,B.N,&Johnson,C.D.(2015.Interprofessional colaboration in research. education, and clinical practice: working together for abetterfuture.隔 Journal OI Chiropracthe Education,29(1),1-10.doi:dx,dol.org/10.78991JCE-14-36

Guciardi, E., Espin, S.Morganti,A.&Dorado, L.(2016).Exploring interprofessional collaboration during the integratian of diabetes teams into primary care,(2016).BMC Family Practice,171-14.doi:10.1186/s12875-016-0407-1

Hetinger.L,& Gwozdek,A.(20151. Utilizing Communitv-Based Education as a Soringboard for Interprofessional Colaboration届Aces,29(3.10-13.

Phillips,G.MacKusick,C.L.&Whichello,R(2018).Workplace incivlity in nursing; a literature review through the lens of ethics and spiritualitx属选.Journal of Christian Nursing,35(1),E7-E12.doi:10.1097/CNJ00000000000467

Mueler,C.A.Tetzlaff,B.Theile,G. Fleischmann,N,Cavazzini,C..Geister,C.&..Hummers-Pradier, E.(2015).Interprofessional collaboration and communication in nursing homes:a qualitative exploration of problems in medical care for

nursing hoime residents : study protoco出届 LJournal OfAdvanced Nursing,71(2).451-457.do:10.111/jan.12545

Gabrielson.5. Looi, G.E,Zingmark.K,&Savenstedt,5.(2014).Knowledge of the natientas decision-making power;staf members perceptions of inte

situationsin asychiatric innatient care也

Scandinavian Journal Of Caring Sciences,28(4),784-792.doi:10.1111/scs.12111

Young, J. (2023). AMA code of medical ethics opinions related to interprofessional collaboration. AMA Journal of Ethics, 25(5), 361-364. https://journalofethics.ama-assn.org/

ethics-opinions-related-interprofessional

collaboration/2023-05

Objectives:

At the completion of this unit, the learner will be able to:

1.Discuss relationships associated with interprofessional collaboration that will work toward improving healthcare delivery.

2.Discuss and apply facilitators of interprofessional collaboration that will lead to improving healthcare delivery

3.Discus barriers that prohibit interprofessional collaboration that hinder the progresstoward iproving healthcare and ways these barriers can be removed.

Evaluate the healthcare environment for utilization of interprofessional collaboration.

Apply Christian principles toward interacting with members of other healthcare professions.Module 3 Intro and Task List

3For through the grace given to melsay to everyone among you not to think more highy of himself than he ought to think; but to think so as to have sound judgnent,as God hasalotted to each a measure of faith.4For just as we have many

members in one bodyand al the members do not have the same function,?so we. who are many, are one bodyin Christ, and individually members one of another. Since we havegifts that differ acording to the grace glven to uss each ofusis to

exercise themaccordingly: If prophecy,according to the proportion of his faith;7if serrvice, in his serving orhe who teaches,in his teaching;or he who exhorts, in his exhortation; he who gives, with liberality;:he who leads,with diligence: he

who shows mercy, with cheerfulness.

Romans 12:3-8

The concept of working in harmony with one another is not a contemporary concept,but rather one laid dowm by our Lord since the beginning of creation. Since early biblical times.we are witness to times when God Himself designated certain

people with tasks of the community. The Levites, for example, while part of the sraeite nation,were to be set apart and given the role of taking care of God’s Tabernacle/Temple. Nehemiah and the rebuilding of the wall of Jerusalem(starting in

Nehemiah Chapter 2:11 to the end (can you envision the site in verse 2:18? Think that would work today?-Ido!). Look at the division of the laborin Nehemiah Chapter 3!And the teachings of Jeus carry that same concept as well. Luke writes

in the book ofActs how early Christians came together to help each other and how each one gave of their means when one was in trouble or hacked Acts 2:42-47). Paul writes in his tetter to Jews and Gentiles in Rome (as well asother letters to

Christan churches) describing the church as equal parts in the body of Christ (Romans 12:4-13). The gift of service is also alluded to in the letters. Serving does not necessarily mean to serve within the bulding designated as the church meeting

place. Serving others in spirit and in truth we have as Chistians. Serving wih othersisan even greater blessing to the Christian servant (Can vou see why?or se the diference?).

Wewill begin study about interprofessional coMaboration and what it truly means.We will also be reviewing resources around us and how we can use those resources to best help patients. If you noticed from your assigned readings. I made one

ofyour books optfona for this module. Th is since I am assigning some aditional joural readings.Please fel fre to raditasit isavery complimentaryread to ourstudies.

So for this module,here is the list of tasks to be done.

WEEK7

1.Review the “Iintroduction to Module 3” located in Echo360ALP or under the Module 3 tab.

2.Review the discussion/presentation created by myself and Ms. Helpenstil. t is titled (and link provided:”Interprofessional Collaboration属

3.Complete your readings for this module.A).The only required text readings are from Burkhardt &Nathaniels “Ethics & Issues in Contemporary nursing”and Holladay’s “The relationship principles of Jesus.”

4.Next there are several joura articles thatare posted for you to review. One artice is required 2022-framework for PCtam in hospitalaef出隔 and one paper is required:

Common+barniers+to+interorofessionalthealthcaretteam+workpdf.出漏(Note that the second one is from 1996.My question to you is this. Have we evolved in the last 25years? Are the same barriers in place,evolved into something

diferent, or totally gone? Iam going to ask this in ourF-2-Fdiscussion next week so please have support from your readings to back up your answer.

5.Please choose at least TWO other articles to review foryour readings or review other journal articles related to IPC and your medical problem of interest. fin your review of the literature,you find another article related to IPC,please feel

tret ad t. PEAR: Your fnal aperwil be overa hat conditon vu are lel tose n ou pratice,soif ther something vou wan to reve ater pes have thatin mind as ou ar okling)

6.Review the”Module 3 Discussion Board Posting/Case Study” in thhis module and begin writing on this as time allows.[the grading rubric alludes to 3 different sources. There are guidelines as to what types of references you will need].

7.it you have any questions or trouble geting acess to BigBlueButton on your computer, please contact me by text. You should be able to acces it the same as last tíme and according to most students, they wiere able to acess t using the link

below.

8.WEEK8

9.MSN students: On Monday or Wednesday(March 2 or March 4),youwill need to connect to the BigBlueButton for our discussion. Click on the tíme you are joining.You will need to attend either the Monday or Wednesday hangout

discussion,but not both The times and dates are listed in the course calendar. Plan to allocate 60minutes for his event Some occasions we may end early, but Iwil never keep us longer than thi time frame. Last time it went very nicely,5o

we will pray for continued easiness,Module 4: The Nurse Practitioner and a Healthy Outcome

So we do not lose heart,Though our outerselfis wasting away. bur innerself is being reneved day by day. For this light momentaryafliction is preparing for us an eternal weight of glory beyond all comparison,as welook not to the things that

are seen but to the things that are unseen.For the things that are seen are transient, but the things that are unseen are eternal-2 Cor4:16-18

Fromanursing polnt of view,this module is one that truly changed my life and my approach to thinking as a nurse and as a nurse practitioner.You are right: i didn’t have this course whenlwasyounger,but it reallyls a summary of what l have

learned over the years and from my study of the scriptures. Iwish T had this when iwas in Nurse practitionerschool as the teachings within helped me reshape what a thealthy”outcomei…I hope by the end of this module, it will become one

of your favorites, too!

-Dr.B

Module4:The Nurse Practitioner and a Healthy Outcome

Required Readings

Book readings:

Shelly,I.A.,Miler,A.B.,& Fenstermacher,K.H.(2006).Called to care:AChristian vision for nursing (3rd ed) Intervarsity press.

Chapters 10,11,12–Cilicalones to read READTHESEFRST

Cutcome!! I promise

For those who desire additional knowledge:

Burkhardt,M.A,&Nathaniel,A.K.(2020).Ethics and isues in contermporary nursing Nursing ethics for the 21st century[1sted]. Elsevier

Chapters 14,16,20- Two of these chapters wil just be review? (How cool is that?)

Holladay,T.(2008) The relationship principles of Jesus,

AT LEAST:Chapters 39 and 40.In aditon, students moy elect torefect back on their reodings from other chopters in this book and reference them in their discussions (Pleose refer to diferent readings than what you have prevousl referenced ifyou use in

your discussion post).

Joumal Article of Choice:Students will be searching for an article on their own that they can apply to the discussion board.Please review the discussion board to determine the type of article you will need.It will need to be journal article

Dublished within the last5year twil be aplied to our readings and online discussion IPSSSSI fhismeans vouare going to have to dscu55

your niscussion posI so be neady!

Objectives:

At the completion of this unit, the learner will be able to:

1.Discusshealthy outcomes as they relate to the paticnt the nurse pgractitioner. and health care providers and a Chrisfan clinical environment

2.Distuss and agplyfacilitators of a hcalthy outcomg at a physical and spiritual level

3.Defne “Healthy Outcomes’at aphysical and spiritual level.

4.Evaluate the healthcare environment forways to work toward healthy outcomes.

5.Apoly Christian principles toward directing patients and families toward healthy outcomes.Module 4 Introduction and Task List

So we do nat lose heart.Though our outer self s wasting away. ourinner self is beting renewed day by day. For this light momentary affiction is preparing for us an eternal weight of glory beyond all comparison,as we look not to the things

that are seen but to the things that are unsen. For the things that are sen are transient, bu the things that are unseen are eternat: 2 Corinthians 4:16-18.

Greetings to all This Module we will be looking at Healthy Goals and Outcomes.

I thinkits fair to say that society views health asa person being whole and free from any type of deformity.injury. orillnesses.But let’s stand back fora moment. is this what the Bible saysis the important thing? In several instances, Jesus

talks about gaining the world,but losing one’s soul. The idea is that the spirittual soul is of the utmost value in this world. In addition, Chapter 5 of Matthew. Jesus talks about losing bodyparts instead of losing one’s soul. The emphasis of

the discusion is that havingan Intact soul that belongs to God is what is important in this life here onEarth. And let’s faceit. we are all going to dle. While i would like to leave this earth like Enoch, the chances of this occuring are almost

nil. Sowe have to look at what we necd to strive for sa health care provider. (Leaving ike Eiah would also be prety col might ad Moses to that ist also..)

During our lives, the one thing we can count on is the change we are going to cncounter during our ives. Whether new stresses with family,friends, job orschool or anew disease process that has come up.we will constantly be lookinng at

some modihcation in our lives.in fact,aswe grow.our bodies are consistently changing. The kdeaf relationships, ife and family we envisian is rarely the perfection we come to expect when when we use outside sources as our

comparisons. Holladay talks about loking past the ideal and looking to toward our heavenly Father as ourstrength and our guide to the ideal example.We are reminded howwe should ive for the present and moving from this point on,

rather than simpl trying to reach perfecton here on earth. Shely. Miler& Fenstermacherwi be helping us exp?ore what an inward peace and healt truly looks ike.

Besides loking at health outcomesat the patent level, we willalso be looking att health outcomes on a community level. Burkhardt and Nathaniel willexamine stepsAPRNs can pursue to help create healthy qutcomes for our patfients not

only in the clinical setting but at the community level as wel. So for this module,here is the list of tasks to be done.

WEEK10

Review the “Introduction to Module 4 Part 1.Part 2,5 Part 3” located in Echo360ALP and as a link below. Ahandout is aavalablefvou would like to take notes lyouwill be appbing the module presentationu the disoission. sa this

might be a gnod thingh.也屏

Complete the assignad readings for this module.(See the ones I have highlighted to start with.) You will note that some of the directed readings have beenn assigned before. But this time,trulyreview these readings with the ideal of

“Shalom”in mind. Your review should be a fittle quicker. I have provided some aditional direction for Holladay’s text to lay an addifional foundation. butyou are free to review any ofhis chapters that refliects on the ultimate outcome.

3.For this module, you areasked to rescarch an article that speaks to”Healthy Outcomes” for a health condition thatis ess than “idel”and how putcomes should be modified. Try to choose something that is not what you are used to

dealng with (Like Alzheiniers, or Down’ssyndrome, Aunism Spectrum Disorder, or Post TraumateStress Disorder-These are atew examples,but feel free to choose from one of your own interests,but remember to expand your

leaning! Please avoid topics already done asit doesn’t expand your learning!).

4.Please choose at least one joural articles to review for your readings and your medical problem of interest.

5.Revlew the Module 4 dlscusslon baard posting in this module and begin writng on this as time alows.

f you have any questions or trouble getting access to Face-2-Face on your computer. please contact Harding Technokogy at 501-279-5201.You should be able to accessit the same aslast tiíme and according to most studenti, they were

able to access it using the link below.Module 5: The Professional Nurse/FNP’s Practice: Let’s get real..

Module 5: The Nurse Practitioner’s Practice: Let’s get rea..

Required Reading:

Book readings: Depth of reading is up to you, but please make sure you complete the readings.

Shelly,J.A.,&Miller,A.B.(2006).Called to care:A Christian worldview for nursing(2ded.).

Chapters 13,14,15

Burkhardt,M.A.&Nathaniel, A.K.(2022). Ethics and issues in contemporary nursing: Nursing ethics for the 21st century.

Chapters 19-(Note the table about autonomy)

Chapter 20-Very short but important for your future practice.

3.Holladay,T.(2008). The relationship principles of Jesus.

There are no assigned readings from this text,however, students are welcome to apply concepts reviewed as they are able.

Objectives:

At the completion of this unit, the learner will be able to:

1.Discuss what it means to develop the clinical setting as”Holy Ground”

2.Discuss steps that the student can take to help develop a positive Christian clinical environment.

3.Discuss and apply facilitators of empowerment for nurses at a physical and spiritual level.

4.Evaluate the healthcare environment for ways develop a Christian,interprofessional collaboration to work toward healthy outcomes.

5.Apply Christian principles toward developing their own personal practice as a family nurse practitioner,

Content:

Module 5:The Nurse Practitioner’s Practice: Let’s get rea..

1.What will a health care visit look like?

2.What will your clinic look like?

3.What will your collaboration look like?

NURS 6060: Faith, Ethics, and Interprofessional Collaboration in Advanced Practice

Assessment 1: Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations

Strategies for Fall Prevention in Older Adults

Introduction

This capstone project aims at addressing the health issue of medication nonadherence among older adults living with chronic conditions. Drug nonadherence refers to the inability to accept prescriptions as endorsed by medical care experts, which can prompt chronic weakness results, expanded hospitalizations, and higher medical care costs (Mittaz Hager et al., 2019). This issue is especially predominant among the older populace, who frequently have complex medication regimens and may confront provokes in dealing with their prescriptions because of mental deterioration, actual impediments, or absence of help (Blum et al., 2021). According to a leadership perspective, nurse leaders need to perceive the effect of prescription nonadherence on understanding results and go to proactive lengths to resolve this issue. Promoting a culture of medication safety, providing patients and healthcare providers with education and resources, and implementing evidence-based interventions to improve medication adherence are all components of effective leadership (Blum et al., 2021).

Cooperation is fundamental in handling medicine nonadherence, as it requires the contribution of various partners, including patients, relatives, medical services suppliers, and local area associations. By cultivating joint effort, attendants can work with shared navigation, empower open correspondence, and foster extensive consideration designs that think about patients’ singular necessities and inclinations. Communication is crucial when dealing with medication nonadherence (Mittaz Hager et al., 2019) Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations . To assess patients’ understanding of medication regimens, identify obstacles to adherence, and provide appropriate education and support, nurses must communicate effectively with patients. Clear and succinct correspondence between medical care suppliers is additionally urgent to guarantee exact medicine compromise and forestall prescription mistakes (Blum et al., 2021).

Population health problem

Fall prevention in older adults is a population health issue that is relevant to my practice. Because they can result in severe injuries, decreased quality of life, increased healthcare utilization, and even death, falls are a significant public health concern among the elderly population (Mittaz Hager et al., 2019). As a medical nurse, I have seen the negative effect of falls on older adults and perceive the significance of carrying out systems to forestall falls and limit their results.

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Summary of the problem

The issue I will investigate is older adults’ fall prevention. Falls among older people have critical outcomes, including wounds, diminished personal satisfaction, and increased medical services costs (Mittaz Hager et al., 2019). I will analyze techniques to forestall falls and limit their effect through authority, joint effort, correspondence, change the executives, and strategy drives (Dalgaard et al., 2019). This research aims at developing evidence-based interventions, advancing interdisciplinary coordinated efforts, promoting communication among older adults and their families, and promoting strategies that help fall anticipation. The goal is to make older adults’ environments safer, lessen the number of injuries caused by falls, and improve their overall health.

The group to work with

I intend to collaborate with a group of elderly residents of a senior living community during my practicum. The group will consist of people over 65 who are at risk for falling or who have fallen before. I will team up with the occupants, their families, and the medical services suppliers locally to evaluate their fall gambles, teach them about fall avoidance techniques, and execute mediations to lessen the occurrence of falls (Blum et al., 2021). By working with this group, I hope to better the safety and well-being of older adults living in residential settings by addressing their particular requirements and challenges.

Information substantiating the presence of falls

Fall prevention among older people is a vast and significant issue upheld by convincing information and proof. As the Centers for Disease Control and Prevention (CDC) indicates, falls are the primary source of injury-related passings and nonfatal wounds among more established grown-ups. Many older adults experience falls every year, bringing about breaks, head wounds, and decreased versatility. The economic impact is significant, as healthcare costs related to falls are estimated to cost $50 billion annually in the United States. Moreover, falls significantly affect the personal satisfaction of elderly citizens and their families, prompting dread of falling, loss of freedom, and diminished social commitment. This issue highlights the critical requirement for robust fall anticipation systems to work on understanding results, decrease medical care use, and improve the general prosperity of older adults and their families.

Relevance of the problem

The issue of fall prevention among elderly citizens is profoundly pertinent to my training as a baccalaureate-arranged nurse. As a medical attendant, I’m focused on advancing careful consideration and improving the well-being results of people across life expectancy. More established grown-ups are a weak majority with novel medical care needs, and falls represent a critical gamble to their prosperity (Pieruccini‐Faria et al., 2020). By tending to fall anticipation, I can apply my insight into proof-based practice, authority, joint effort, correspondence, change the executives, and strategy to create and carry out mediations that advance security, upgrade patient results, and work on the general nature of care. As a healthcare leader, advocate, and caregiver, fall prevention enables me to have a significant impact on the lives of older adults and their families Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations .

Evidence-based literature

Numerous studies and guidelines offer helpful insights and suggestions for nursing practice in this area. A study by Pieruccini‐Faria et al. (2020) did a meta-analysis and systematic review of fall prevention programs for older adults who live in the community. The creators distinguished different viable methodologies, including exercise programs, multifactorial intercessions, and home well-being adjustments. These results are in line with my nursing practice because I have observed that exercise programs designed to improve strength, balance, and gait stability reduce the risk of falling among elderly people. Another study by Dalgaard et al. (2019) emphasized the significance of complete fall risk appraisals, including assessing various factors, such as medicine use, vision, and natural perils. Their findings align with how I practice nursing because I frequently conduct in-depth fall risk assessments that consider both intrinsic and extrinsic factors that can lead to falls.

Proficient sources, like the American Geriatrics Society (AGS) and the Public Committee on Maturing (NCOA), give proof-based rules to fall prevention among older adults (Pieruccini‐Faria et al., 2020). The AGS/British Geriatrics Society’s fall prevention guideline emphasizes interventions like individualized exercise programs, medication reviews, and environmental changes. Similarly, the Falls Free Initiative of the NCOA recommends methods for multifactorial fall risk assessment and management (Pieruccini‐Faria et al., 2020). The significance of interdisciplinary collaboration in fall prevention is consistently emphasized in the literature. For instance, Chew et al.’s study (2021) emphasizes interdisciplinary teams’ role in reducing hospital fall rates through targeted interventions and staff training. Since I frequently collaborate with physical therapists, occupational therapists, and other healthcare professionals to develop comprehensive fall prevention plans, this finding is consistent with my nursing practice.

Assuming the information needs validity and straightforwardness or depends on a defective approach, conflicts with laid-out research discoveries, or is not upheld by trustworthy sources, it might show that the information is questionable.

Effect of Nursing Practice Norms and Approaches on Fall Avoidance among the elderly citizens

Nursing practice norms laid out by state sheets and hierarchical and legislative strategies are essential in resolving the issue of fall counteraction among older people (Pieruccini‐Faria et al., 2020). The nursing scope of practice is shaped by these standards and policies, which also have an impact on the outcomes for patients, families, and populations (Mittaz Hager et al., 2019). We can learn more about how these standards and policies affect fall prevention efforts by looking at the most recent research. State board nursing practice standards establish the requirements for nursing practice in a given jurisdiction (WHO, 2021). These principles give a structure to attendants to convey protected and capable consideration, including fall counteraction intercessions. State boards may, for instance, specify the specific assessment tools or protocols that nurses should use to identify elderly fall risks. By sticking to these guidelines, medical attendants can guarantee that extensive fall risk appraisals are led, empowering early distinguishing proof and designated intercessions (Chew et al., 2021).

Hierarchical strategies likewise assume a fundamental part in fall prevention. Medical services offices frequently foster approaches that lay out normalized conventions for fall risk distinguishing proof, anticipation techniques, and reaction to falls (Chew et al., 2021). These strategies might incorporate rules for carrying out bed cautions, utilizing assistive gadgets, or establishing a protected climate. By following authoritative arrangements, medical attendants can guarantee reliable and proof-based fall avoidance rehearses across care settings. For example, medical caretakers can work with interdisciplinary groups to execute these strategies, advancing a culture of security and decreasing the rate of falls among more seasoned grown-ups. Fall prevention efforts may also be impacted by government policies, such as reimbursement or quality improvement initiatives (Pieruccini‐Faria et al., 2020). Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations For example, government offices might carry out arrangements that boost medical services offices to focus on fall anticipation by binds repayment to fall rates or executing quality improvement programs. Patients’ outcomes may improve due to healthcare organizations investing in resources and implementing interventions supported by evidence. Medical caretakers can use these strategies to advocate for assets, carry out accepted procedures, and drive change at the authoritative level (Pieruccini‐Faria et al., 2020).

Proposing Administration Systems to Further Develop Fall Avoidance Results and Patient Involvement with older adults

Viable authority methodologies are fundamental to further develop results, patient-focused care, and the patient experience connected with fall prevention in older adults. Change, collaboration, communication, and the implementation of evidence-based practices all rely heavily on leadership (Pieruccini‐Faria et al., 2020). Here are some suggested leadership strategies:

Develop a Fall Prevention Task Force- Lay out a multidisciplinary group comprising of medical caretakers, doctors, actual specialists, word-related advisors, and other crucial medical care experts. The team can team up to foster normalized conventions, rules, and informational materials for fall avoidance. A comprehensive and coordinated approach to addressing fall hazards is guaranteed by this strategy (Pieruccini‐Faria et al., 2020).

Promote Staff Education and Training- Give progressing instruction and prepare projects to improve the information and abilities of medical care suppliers concerning fall anticipation techniques. This incorporates teaching attendants about proof-based evaluation devices, mediation, and correspondence methods for connecting with patients and families in fall prevention endeavors.

Implement Quality Improvement Initiatives- Participate in fall prevention-focused quality improvement projects. This might entail carrying out routine audits, looking over data from the fall, and figuring out where things can be improved. Through ongoing evaluation and feedback, leadership can facilitate incorporating evidence-based practices into daily workflows and monitor progress.

Advocate for Policy Changes- Work with authoritative pioneers and policymakers to advocate for strategies focusing on fall counteraction. Participating in healthcare committees, collaborating with government agencies, and supporting initiatives that promote safe environments and fall prevention resources are all examples of this.

Implementing these leadership strategies can help healthcare providers to improve and upgrade the patient experience connected with fall avoidance in more established grown-ups. Compelling administration is crucial in driving joint effort, advancing correspondence, and overseeing change, eventually creating a security culture and diminishing fall gambles (Dalgaard et al., 2019). To ensure accurate record-keeping and demonstrate the practical application of the proposed strategies in a real-world setting, the practicum hours spent with the individuals or group will be documented in the Capella Academic Portal Volunteer Experience Form per the requirement.

Conclusion

In conclusion, this project has examined fall prevention in older adults, a significant patient, family, or population health issue. Through evaluating the issue according to different viewpoints, including administration, coordinated effort, correspondence, change the board, and strategy, we have acquired experiences in the intricacies and difficulties included. The literature review has guided nursing actions to address the issue by providing a foundation of evidence-based knowledge. We have investigated the effect of nursing practice guidelines, arrangements, and authority systems on other developing results and upgrading patient-focused care. The significance of powerful administration, coordinated effort, and correspondence in driving change and advancing patient security has been accentuated. By carrying out the proposed methodologies and consolidating nursing hypotheses or systems, we can progress toward accomplishing improved results, forestalling falls, and giving a positive patient encounter. Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations  Through the practicum hours enjoyed with the distinguished people or gatherings, true application and encounters have advanced the undertaking’s degree. This project has laid the groundwork for the capstone experience, giving baccalaureate-prepared nurses the tools they need to become leaders in problem identification, strategy implementation, and planning, ultimately leading to improved patient care and organizational efficiency.

References

Abraham, J., Kupfer, R., Behncke, A., Berger-Höger, B., Icks, A., Haastert, B., … & Möhler, R. (2019). Implementation of a multicomponent intervention to prevent physical restraints in nursing homes (IMPRINT): A pragmatic cluster randomized controlled trial. 
International journal of nursing studies
, 
96
, 27-34.

Blum, M. R., Sallevelt, B. T., Spinewine, A., O’Mahony, D., Moutzouri, E., Feller, M., … & Rodondi, N. (2021). Optimizing therapy to prevent avoidable hospital admissions in multimorbid older adults (OPERAM): cluster randomised controlled trial. 
bmj
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374
.

Chew, S. M., Lee, J. H., Lim, S. F., Liew, M. J., Xu, Y., & Towle, R. M. (2021). Prevalence and predictors of medication nonadherence among older community‐dwelling people with chronic disease in Singapore. 
Journal of Advanced Nursing
, 
77
(10), 4069-4080.

Dalgaard, F., Pallisgaard, J. L., Numé, A. K., Lindhardt, T. B., Gislason, G. H., Torp‐Pedersen, C., & Ruwald, M. H. (2019). Rate or rhythm control in older atrial fibrillation patients: risk of fall‐related injuries and syncope. Journal of the American Geriatrics Society, 67(10), 2023-2030.

Mittaz Hager, A. G., Mathieu, N., Lenoble-Hoskovec, C., Swanenburg, J., de Bie, R., & Hilfiker, R. (2019). Effects of three home-based exercise programmes regarding falls, quality of life and exercise-adherence in older adults at risk of falling: protocol for a randomized controlled trial. 
BMC geriatrics
, 
19
, 1-11.

Pieruccini‐Faria, F., Sarquis‐Adamson, Y., Anton‐Rodrigo, I., Noguerón‐García, A., Bray, N. W., Camicioli, R., … & Montero‐Odasso, M. (2020). Mapping associations between gait decline and fall risk in mild cognitive impairment. Journal of the American Geriatrics Society, 68(3), 576-584.

World Health Organization. (2021). Step safely: strategies for preventing and managing falls across the life-course.

 

 

 SCORE GUIDE –  Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations 

 

Define a patient, family, or population health problem that’s relevant to personal and professional practice.

Clearly and succinctly defines a patient, family, or population health problem that’s relevant to personal and professional practice. Fully substantiates the presence and relevance of the problem.

 

Analyze evidence from peer-reviewed literature and professional sources that describes and guides nursing actions related to a defined patient, family, or population problem.

Analyzes evidence from peer-reviewed literature and professional sources that describes and guides nursing actions related to a defined patient, family, or population    problem. Applies relevant, unambiguous criteria for evaluating the evidence, and exhibits clear insight into potential barriers to evidence-based practice and theoretical guiding frameworks.

 

Explain how state board nursing practice standards and/or organizational or governmental policies could affect a defined patient, family, or population problem.

 

Provides an explanation, with examples, of how state board nursing practice standards and/or organizational or governmental policies could affect a defined patient, family, or population problem, based on a perceptive and coherent synthesis of current literature. Provides clear insight into how policy affects the nursing scope of practice.

 

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 Capella Academic Portal Volunteer Experience Form.

 

Proposes leadership strategies, supported by examples, to improve outcomes, patient-centered care, and the patient experience related to a defined patient, family, or population problem. Exhibits clear insight into the necessary role of leadership and the need for collaboration, communication, and change management in addressing the problem. and Documents the practicum hours spent with these individuals or group in the Capella Academic Portal Volunteer Experience Form Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations

 

INSTRUCTIONS: Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations 

In a 5-7 page written assessment, define the patient, family, or population health problem. Assess the problem from a leadership, collaboration, communication, change management, and policy perspective.

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.

oo 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. Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations .

Focus on the influence of leadership, collaboration, communication, change management, and policy on the problem.

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.

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 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 Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations .

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.

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.

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.

 

Competencies Measured – Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations 

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 Capella Academic Portal 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 – Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations 

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 the time you may elect to spend in consultation with the subject matter or industry experts.

You’ll report on the results of this work as part of your next assessment.

Identify the patient, family, or group you intend to work with:

The subject is a 55-year-old retired peace officer. In 2002 was diagnosed with Diabetes and hypertension. He was a range master in charge of qualifying and re-qualifying peace officers. The subject lived and worked in Las Vegas, Nevada, where temperatures can easily reach 110-115 degrees in the peak of summer. H trained 8-10 hours in an outside desert shooting range to qualify both experienced and new officers. Many of the officers did not bring water to the range. The subject would give out his water to the officers who did not bring water. After about a month, he developed vision problems, a pounding rapid pulse, profuse sweating, great thirst, and frequent urination and went to his primary care provider.

When he presented with an elevated blood pressure of 250-260’s over 120’s heart rate of 125 beats per minute. The medical assistant immediately called the physician, who advised that EMS would be called for transport to the nearest hospital. Ultimately, he spent one week in the hospital and received the diagnosis of heat exposure, heat exhaustion, diabetes, elevated triglycerides,  and hypertension.

 

Think about what you hope to learn?

 

o What’s your rationale for choosing this particular patient, family, or group?

Rationale is that Diabetes affects about 1 in 10 Americans, approximately 37 million, 90 to 95% are type 2.

 

Consider how you’ll present your ideas about the problem to the patient, family, or group

and convince them of its significance Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations

 

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 Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations

Why are cytochrome P450 enzymes (CYPs) important in drug metabolism? The majority of medications are metabolized by what CYP enzyme?

SCENARIO 1

Why are cytochrome P450 enzymes (CYPs) important in drug metabolism? The majority of medications are metabolized by what CYP enzyme? Utilizing the Medscape pill identifier, enter the following characteristics to identify the medication. What CYP enzyme metabolizes this medication? Write a sample prescription for it.

Imprint (ATO 40) Shape (Oval) Color (White) Form (Tablet) Scoring (None)

 

Cytochrome P450 enzymes (CYPs) emerge as an important aspect in the metabolism of drugs. The enzymes are especially ideal in enhancing the oxidation of organic substances and play a critical part in the detoxification of the body from drugs. The CYPs help in converting the lipophilic substances and turning them into polar substances that are readily excreted from the system. The CYPs also have a role in activating the prodrugs which are given in an inactive form and require the impacts of such agents to get metabolized into their active form. Further, the CYPs are also able to potentially metabolize dangerous substances like carcinogens into less hazardous materials. The most popular CYP enzyme is the CYP3A4 enzyme. This substance is able to greatly metabolize close to 50 percent of all medications (Zhao et al., 2021). The enzyme contains huge contents of substrate specificity that has crucial drug-drug interactions and variations in medicines metabolism in patients.

When applying the Medscape pill identifier using the produced attributes of (Imprint (ATO 40) Shape (Oval) Color (White) Form (Tablet) Scoring (None) depicts that this medication is Atorvastatin 40mg well known as Lipitor effective in reducing the levels of cholesterol in the body. The CYP enzyme that is active in metabolizing the Atorvastatin is CYP3A4. Persons using this drug should take caution about the drug’s side effects (Esteves et al., 2021). A sample prescription of the drug is:

Patient name: Joe

DOB: 1995

Medication: Atorvastatin

Strength: 40 mg

From: tablet

Amount: 30

Administration: take one PO per day during the evening

Refills: 11

Prescribed by:

Date:

Scenario 2