Tag: Clinical-Nursing

Assessing Community Health Care Needs
 

Community health assessment

Nurse leaders have diverse roles and responsibilities in the community including but not limited to leading in health improvement programs. In some instances however, it is tedious to conduct community health improvement because some of the communities have complex demographic and social structures that render the community too complex to assess. There are better ways however that can help nurse leaders and other community health entities to conduct a community health assessment. One of the most effective community health assessment tools that can be used in complex communities like Jordan is a windshield survey. A windshield survey involves the use of human senses to conduct and obtain the various perspectives pertaining to the health environment within a specified community (Kusimo, 2019). One example on how a windshield survey is done is through the use of the sense of smell to determine the existence of pollution in the environment by smelling gases that are associated with pollution.

One major challenge with a windshield survey is that its results are not consistent because some variations such time gives different results. For instance, there is a significant deviation of results during the day and night, summer and winter. Despite the challenge, a windshield survey remains an important tool for assessing community health.

Jordan city is located in the United States and has a high prevalence for lifestyle conditions such as diabetes despite having several amenities that are meant to improve the health of its residents. Besides, Jordan is a multiethnic community consisting of Asians, African Americans, Native Hawaiians, Hispanics, and non-Hispanic whites.

 
General Condition and Public Health Needs

The population in Jordan is approximately 6,500 and it is highly growing indicating a positive deviation in population within the coming decades. According to the windshield survey, Jordan is depicted a diverse social economic society with high income families distributed on the outer parts of the town and those from low economic backgrounds concentrating along downtown. Jordan has two churches, several parks, a healthcare facility, a senior living home, a food pantry and a community center. Also present in Jordan are educational institutions and several Christian affiliated religious denominations.  St. Francis Health Services represent the largest healthcare facility in Jordan (Capella University, n.d.). According to statistics, Jordan can be described as a health community because more than 92.7% of its residents have access to health insurance, a critical element of health populations. Also, Jordan has a relatively low rate of health conditions such as diabetes as compared to those around neighboring towns.

The fact that Jordan is a relatively healthy population, here is an eminent crisis that looms with the increase in immigrants in the city from Minnesota and Somalia. There has been an increase in the number of immigrants with the population of natives having a significant drop. The immigration crisis is a health challenge for Jordan because the countries of origin for the immigrants in Jordan are Mexico and Somalia, which have a higher poverty rate than Jordan posing a health risk because poverty is associated with poor health Assessing Community Health Care Needs.

Environmental Analysis

Some of the most essential factors that determine the health status of Jordan include the level of education, access to healthcare services and the level of income. For instance, there is a deficit in health promotion programs due to a shortage of healthcare facilities that may impact health negatively. Healthcare facilities are important in determining health because they offer forums for disease prevention and treatment. Also, a large number of low income households have no access to health and social services such as health insurance which in addition to other factors hinder effective and efficient access to healthcare a nightmare for the people of Jordan. Besides, some of the countries from which the immigrants hail such as Somalia are war-torn increasing the levels of poverty and other social vices including terrorism (Markovic, 2021). Some of the vices such as terrorism and war are major cause of post exposure traumatic stress which also affects the health of the populations (Beck et al., 2017).

Also, some of the African immigrants attribute some illnesses to superstition and do not recognize them as disease condition. Depression and some mental illnesses are rarely recognized as disease condition by majority of African population and hence many people feel the shame to seek healthcare interventions for such illnesses leading to poor health outcomes (Omenka, Watson, & Hendrie, 2020). Also, some of the immigrants may fear to seek healthcare services sue to fear of capture and deportation.

Conclusion

Jordan is a fairly health rural area with limited access to healthcare services due to a shortage of facilities and other essential amenities. Besides, the town has challenges to meet the basic essential determinants of health which is a major cause for an increase in morality. The fear of deportation is a major factor that hinders most of immigrants from seeking healthcare services. Most of the immigrants in Jordan are not documented hence, they fear that is they try to seek for healthcare services; they may be recognized as illegal entities, captured and deported.  Besides, poverty is another determinant for the poor health in Jordan. A number of residents have low income which hinders them from accessing quality healthcare services including disease prevention. Language barrier as well as the lack of a medical insurance also hinder access to healthcare.

 
References

Beck, T. L., Le, T. K., Henry-Okafor, Q., & Shah, M. K. (2017). Medical care for undocumented immigrants: national and international issues. 
Primary care: Clinics in office practice
, 
44
(1), e1-e13.

Capella University. (n.d.) Vila health: Environmental analysis and windshield survey. Retrieved Feb, 2020 from
http://media.capella.edu/CourseMedia/MSN6218/vilaHealthEnvironmentalAnalysisWind shieldSurvey/wrapper.asp

Kusimo, O. C. (2019). Findings from a Windshield Survey Conducted in an Internally Displaced Community in Nigeria. 
Health
, 
11
(1), 50-56.

Markovic, V. (2021). Fighting a losing battle? Countering terrorism financing in Nigeria and Somalia. 
South African Journal of International Affairs
, 
28
(2), 167-186.

Omenka, O. I., Watson, D. P., & Hendrie, H. C. (2020). Understanding the healthcare experiences and needs of African immigrants in the United States: A scoping review. BMC Public Health, 20, 1-13. doi:http://dx.doi.org.library.capella.edu/10.1186/s12889-019-8127-9

 

 

Assess the health care needs of a selected community by completing an environmental analysis and a virtual windshield survey. Summarize the results of your assessment in a 3 page executive summary.

Introduction

Health care must be evidence-based, effective, efficient, and affordable; it must provide resources that meet the needs of the community. Nurse leaders must understand and thoroughly evaluate the environment to enable the efficient and equitable allocation of resources. A useful tool for this type of assessment is commonly called a windshield survey. Windshield surveys are what you might expect from the name. They are a way of gathering information about specific aspects of a community while driving around, such as the condition of roads, buildings, and housing.

This assessment provides an opportunity to examine the prevailing health conditions and social determinants of health in a community by completing an environmental analysis and a virtual windshield survey based on communities within the Vila Health system. Although Vila Health is a virtual lab, the communities represented in this simulation are real, enabling you to conduct an actual community health assessment.

Preparation

Executive leaders at Vila Health have asked you to provide them with your assessment of the health conditions in one of the communities served by the Vila Health system. Knowing that a windshield survey is needed to validate any underlying assumptions about the needs of the community and inform evidence-based decision making and strategic planning, you have decided to conduct a first-hand exploration of the community, followed up by an environmental analysis. An environmental analysis examines the factors that can influence the performance of a health care organization, which is important in a rapidly changing health care environment.

To prepare for the assessment, you are encouraged to begin thinking about how an environmental analysis and windshield survey contribute to assessing community health care needs. In addition, you may wish to:

Review the assessment requirements and scoring guide to ensure that you understand the work you will be asked to complete.

Review Guiding Questions: Assessing Community Health Care Needs [DOCX], which includes questions to consider and additional guidance on how to successfully complete the assessment.

Note: Remember that you can submit all or a portion of your draft assessment to Smarthinking Tutoring for feedback before you submit the final version for this assessment. If you plan on using this free service, be mindful of the turnaround time of 24–48 hours for receiving feedback.

The following resource is required to complete the assessment.

Vila Health: Environmental Analysis and Windshield Survey.

Vila Health is a virtual environment that simulates a real-world health care system. In the various Vila Health scenarios, you will apply professional strategies, practice skills, and build competencies that you can apply to your coursework and in your career. The information you gather in this scenario will help you to complete the assessment.

TEMPLATES

Use this template for your community health assessment.

Community Health Assessment Template [DOCX].

Requirements

Complete this assessment in two steps:

If you have not already done so, complete the Vila Health: Environmental Analysis and Windshield Survey simulation.

Write an executive summary of your community health assessment, based on your windshield survey and environmental analysis.

The community health assessment requirements outlined below, correspond to the grading criteria in the scoring guide, so be sure to address each point. Read the performance-level descriptions for each criterion to see how your work will be assessed. The Guiding Questions: Assessing Community Health Care Needs document provides additional considerations that may be helpful in completing your assessment. In addition, be sure to note the requirements below for document format and length and for citing supporting evidence.

Assess, via a windshield survey, the general condition and needs of a community from a public health perspective.

Analyze the environmental factors affecting population health in a community.

Identify the social determinants of health in a community.

Summarize windshield survey and environmental analysis findings for executive leaders.

Write clearly and concisely in a logically coherent and appropriate form and style.

Support findings and conclusions with relevant and credible evidence.

Document Format and Length

Use the Community Health Assessment Template. This APA Style Paper Tutorial [DOCX] can help you in writing and formatting your assessment. If you would like to use a different worksheet for your community health assessment, obtain prior approval from faculty.

The executive summary portion of your survey and analysis should be 3 pages in length.

Be sure to apply correct APA formatting to all source citations and references.

Supporting Evidence

Cite 5 credible sources from peer-reviewed journals or professional industry publications to support your executive summary.

Additional Requirements

Proofread your executive summary before you submit it, to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your assessment.

Portfolio Prompt: You may choose to save your community health assessment to your ePortfolio.

Competencies Measured

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

Competency 1: Identify the challenges and opportunities facing health care.

Assess, via a windshield survey, the general condition and needs of a community from a public health perspective.

Analyze the environmental factors affecting population health in a community.

Identify the social determinants of health in a community Assessing Community Health Care Needs.

Competency 4: Develop proactive strategies to change the culture of the organization by incorporating evidence-based practices.

Summarize windshield survey and environmental analysis findings for executive leaders.

Competency 5: Communicate effectively with diverse audiences, in an appropriate form and style consistent with applicable organizational, professional, and scholarly standards.

Write clearly and concisely in a logically coherent and appropriate form and style.

Support assertions, arguments, propositions, and conclusions with relevant and credible evidence.

Guiding Questions for Assessment 2

Assessing Community Health Care Needs

This document is designed to give you questions to consider and additional guidance to help you successfully complete the Assessing Community Health Care Needs assignment. You may find it useful to use this document as a pre-writing exercise, an outlining tool, or as a final check to ensure that you have sufficiently addressed all the grading criteria for this assignment. This document is a resource to help you complete the assignment. Do not turn in this document as your assignment submission.

Assess the health care needs of a community and report your findings in an executive summary.

Assess Community Health Needs

Assess, via a windshield survey, the general condition and needs of a community from a public health perspective.

• What areas of the community will you include in your survey?

• What aspects of the physical environment are relevant to your survey? Why?

• What are the limitations of the survey?

• What factors would you consider in assessing risks to your safety while conducting the survey?

• What conclusions can you draw from the survey? What evidence leads you to those conclusions?

Analyze the environmental factors affecting population health in a community.

• What questions are you trying to answer? Assessing Community Health Care Needs

• What health issues are of concern in the community? For example, technological, social, regulatory, political, or economic issues.

• What opportunities and threats are influencing health care providers in the community?

• What conclusions can you draw from the analysis? What evidence leads you to those conclusions?

Identify the social determinants of health in a community.

• What are the social factors that influence community health?

• What are the social factors that influence change?

• What evidence do you have to support your claims?

Summarize windshield survey and environmental analysis findings for executive leaders.

• How will you organize the data and information you have collected?

• What are the information needs and expectations of your target audience?

• What do the data and information tell you about community health needs, challenges, and opportunities?

• What are the key lessons learned from your survey and analysis?

Write clearly and concisely in a logically coherent and appropriate form and style.

• Write with a specific purpose and audience in mind.

• Adhere to scholarly and disciplinary writing standards and APA formatting requirements.

Support assertions, arguments, propositions, and conclusions with relevant and credible evidence.

• Integrate relevant and credible evidence from 3–5 peer-reviewed journals or professional industry publications.

• Is your supporting evidence clear and explicit?

o How or why does particular evidence support a claim?

o Will your reader see the connection?

• Did you summarize, paraphrase, and quote your sources appropriately?

Submission Reminders

• Have you completed your environmental analysis and windshield survey, with supporting evidence to substantiate your conclusions?

• Have you identified the social determinants of health in the community and their effects on change? Have you provided supporting evidence?

• Is your summary of the analysis and survey findings complete and accurate?

o Have you documented your conclusions and lessons learned?

o Is your information clear and coherent?

o Is your summary 2–3 pages in length, not including the title page and references page?

o Did you proofread your writing?

• Are your assertions and conclusions well supported by 3–5 sources of relevant and credible evidence?

Use the following resource to complete the assessment:

Vila Health: Environmental Analysis and Windshield Survey

Introduction

Locations

Jordan

Armatage

Conclusion

Credits

Introduction

Vila Health: Environmental Analysis and Windshield Survey

Effective health care leadership relies on assessments based on reliable information. One key tool is the windshield survey — with a practiced eye, one can make valuable judgments about the health conditions of a community while performing a mobile survey.

In this simulation, you will conduct a virtual windshield survey in either a rural or an urban environment. You will also be provided with resources to help you begin the environmental analysis of one of the two communities. You will use the information you gather to prepare a presentation in which you summarize your findings and propose changes to the health care system.

Location Choices

In whatever order you prefer, select each location to perform your windshield survey. Jordan is a small town in the Minnesota countryside. Armatage is a neighborhood on the south side of Minneapolis.

Jordan

Instructions:

Click and drag to explore the map of Jordan, Minnesota. You may also use the button panel to navigate the map. Click a Map pin to learn about that particular location. Once you have visited all 25 pins, answer the questions that follow.

Jordan City Hall

210 1st St. E.

Jordan’s motto is “warm country feeling, minutes from the cities,” and the quaint downtown City Hall reflects that sentiment. Jordan’s old City Hall, built in 1885, had a brief stint as an events venue, but is currently vacant.

Jordan Middle School

500 Sunset Dr.

The Jordan public schools offer a student and family friendly single campus. The renovated middle school opened in 2015 and is adjacent to the Jordan Community Education and Recreation Center (CERC).

Jordan High School

600 Sunset Dr.

Jordan High School has a student population of approximately 540 students. The school offers athletics, arts programs, and academic extra-curricular activities. Students can also attend vocational classes through Southwest Metro Educational Cooperative where they can earn credit at vocational schools and North Hennepin Community College.

Jordan High School

600 Sunset Dr.

Jordan High School has a student population of approximately 540 students. The school offers athletics, arts programs, and academic extra-curricular activities. Students can also attend vocational classes through Southwest Metro Educational Cooperative where they can earn credit at vocational schools and North Hennepin Community College.

Jordan Elementary School

815 Sunset Dr.

Jordan Elementary School offers programs and specialists in Special Ed, ESL, Title One services, Gifted and Talented, and a variety of other interventions and enrichment programs. Technology is embedded in the daily curriculum in order to encourage the development of 21st century learning skills.

Scott County Library – Jordan

275 Creek Ln. S.

The Jordan public library is open four days a week (Mon & Wed 1-8; Tue & Thur 10 – 5) from May to September and five days (Saturday 10 – 2) from September to May.

St. Francis Health Services

265 Creek Ln. S.

St. Francis Health Services is aligned with Allina Health and Park Nicollet Health Services, two of the largest health providers in the region. The facility provides a full range of inpatient, outpatient, and emergency care.

Jordan Community Education and Recreation Center

500 Sunset Dr.

Completed in January 2016, the new Community Education and Recreation Center includes a 3-gym station with a multipurpose floor, an elevated walking track, a fitness center, community locker rooms, and a community room with kitchenette.

Hope Lutheran Church

201 Hope Ave.

Hope Lutheran Church is one of two Lutheran Churches in Jordan. Other churches include Zion United Methodist Church, Immanual Methodist, St. John the Baptist Catholic Church, St. Paul Lutheran Church, and Tree of Life Church. To the best of our knowledge, there are no synagogues or mosques in Jordan.

River Valley Education Center

100 Hope Ave.

Provides students in grades 5-8 with academic and social skills instruction. These students may have average or above-average learning potential but have been unsuccessful in other special education settings.

St. John the Baptist Church

215 Broadway St. N.

St John the Baptist Catholic Church. Other churches include Zion United Methodist Church, Immanuel United Methodist Church, St. Paul Lutheran Church, Hope Lutheran Church, and Tree of Life Church. To the best of our knowledge, there are no synagogues or mosques in Jordan.

Street Signage

2nd St E and Broadway

Signage reflecting politcal and community climate.

Food Shelf

131 1st St. E.

The food shelf has over 100 active volunteers. On average, the Jordan Food Shelf serves about 20 families a weekend. Clients leave with bags of bread, meat, eggs and milk, along with other groceries. The board is exploring a move to a larger space and would also like to offer free medical care and a thrift store.

City Council / History Center

110 1st St. E.

The City of Jordan operates under a Council-Administrator form of government. The Mayor and Council members are elected for staggered 4-year terms.

Jordan’s Downtown District

Broadway St. & Water St.

Jordan’s downtown is a mix of modern and quaint, run-down and up-and-coming. Moola’s Bar and Jack’s Bar and Grill are both located in downtown. Roets Jordan Brewery and the Nicolinn Mansion B&B represent the tourist-friendly focus the town is trying to project.

Lagoon (Veteran’s) Park

102 Park Dr.

Park features a small creek and falls, 16-acre Mill Pond, as well as a sand swimming beach, playground, gazebo, picnic shelters and grills, fishing pier, volleyball court, horse shoe pits, and restrooms. Ice skating rink and warming house on Mill Pond in winter. The entrance’s patriotic display features a flagpole ensemble, historic cannon, and a bench dedicated to home-town hero Spc. Joshua R. Anderson, killed in action in Iraq, January 2008. Running paths and sidewalks are common in Jordan.

Residential Area

Timber Ridge Court, just north of Sunset

Located near the High School, this neighborhood is characterized by large lots, well maintained homes, and an abundance of recreational vehicles and boats.

Oak Terrace Senior Living

622 Aberdeen Ave.

Oak Terrace Senior Living of Jordan is a retirement community that offers Independent Living, Assisted Living, and Memory Care.

Residential Area

Intersection of Stone Creek, Prospect Pointe

While Jordan does not have named neighborhoods, the residential areas are quite different in appearance and apparent socio-economic makeup. This section of Jordan features homes in subdivisions such as Bridle Creek.

Radermacher’s Fresh Market

500 2nd St. W.

In 1954, Roman Radermacher opened his first grocery store on Water Street in Jordan. In 1972, the family built a modern supermarket on First Street. In 1981, the store in Jordan moved to its current location on 500 West 2nd Street.

Jordan Baseball Park

401–599 Rice St. S.

Jordan’s baseball field, sometimes referred to as the “Mini-Met” also features a basketball court, skateboard park, and winter ice skating rink.

Downtown Area Neighborhood

2nd St. E. & Mill St.

This neighborhood near the downtown district reflects a lower socio-economic standard than the newer housing areas on the outer boundaries of town.

Jordan Town Sign

Approximately 4200 Country Trail W.

Jordan’s population is actually closer to 6500 residents and the town has numerous retail, service and industrial businesses. The City of Jordan boasts that “as growth occurs, the people and the Jordan City Council strive to keep the community’s small-town flavor.”

Residential Area

4th St. W & West St. N.

While Jordan does not have named neighborhoods, the different residential areas do have individual characteristics. This area appears to be a middle-class neighborhood.

Immanuel United Methodist Church

301 N. Varner St.

Immanual Methodist is one of two Methodist Churches in Jordan. Other churches include Zion United Methodist Church, St. John the Baptist Catholic Church, St. Paul Lutheran Church, Hope Lutheran Church, and Tree of Life Church. To the best of our knowledge, there are no synagogues or mosques in Jordan.

Shopping Plaza

310 El Dorado Dr.

While economic conditions are overall good in Jordan, there are vacancies and empty buildings both downtown and in outlying shopping areas.

An environmental analysis can provide important information to planning and program implementation.

Here are some links to get you started on the environmental analysis for Jordan, Minnesota:

https://jordanmn.gov/city-departments/economic-development/

https://datausa.io/profile/geo/jordan-mn/

Armatage

Instructions:

Click and drag to explore the map of the Armatage neighborhood in Minneapolis, Minnesota. You may also use the button panel to navigate the map. Click a Map pin to learn about that particular location. Once you have visited all 25 pins, answer the questions that follow.

Cindy’s Barber Shop

5408 Penn Ave. S.

Cindy’s Barbershop captures the personality of the neighborhood and serves as a gathering spot for young and old.

Dreadlocks for Dingoes

5410 Penn Ave. S.

Dog ownership is very popular in Minneapolis and this boutique serves the local populace and their pets.

Kwan’s Chinese Cuisine

5412 Penn Ave. S.

One of several eateries in the community, Kwan’s has been a neighborhood staple for quick, classic Chinese food for over 30 years.

Red Wagon Pizza

5416 Penn Ave. S.

The Armatage neighborhood has several pizza establishments – ranging from Dominoes to Pizzaria Lola, an upscale fusion pizzaria.

Snap Fitness

5409 Penn Ave. S.

A local fitness center. Snap Fitness centers specialize in a “no frills” model that offers no-contract memberships and 24 hour access to the facility.

Settergren Ace Hardware

5405 Penn Ave. S.

An independent hardware store, Bayer’s had been in business for over 45 years before Settergren’s opened this store next door to Bayers.

Pennhurst Cleaners

5401 Penn Ave. S.

Pennhurst Cleaners was a family owned business and been in business for over 25 years. The building now has a For Lease sign and a boarded up window.

Bus Stop

54th St. & Penn Ave. S.

Public Transportation makes this neighborhood very accessable to downtown and city government buildings.

Jump! Children’s Publisher

5357 Penn Ave. S.

Jump! Library is a local book publisher.

Penn Avenue Family Dental

5346 Penn Ave. S.

Drs. Robert McNab and Fred Allis have been shared this neighborhood dentistry practice for several years.

Road Construction

54th St. & Penn Ave. S.

Road construction in the Armatage neighborhood.

Café Maude

5411 Penn Ave. S.

A neighborhood bistro named for Maude Armatage, the neighborhood’s namesake.

Lutheran Church of Christ the Redeemer

5440 Penn Ave. S.

Lutheran Church with a progressive focus. This is the only church in the Armatage neighborhood.

Armatage Community Center

2500 W. 57th St.

The Armatage Community Center participates in the Minneapolis Summer Meal Program for youth 18 and under.

Residential Housing

Penn Ave. S. & 56th St. Area

While most homes are smaller homes built in the 50s and 60s, teardowns are not uncommon.

Multi-family Units

Xerxes and 55th St.

While housing is primarily single family units, there are several multifamily apartments as well.

Pizzaria Lola

5557 Xerxes Ave. S.

More restaurants in the Armatage neighborhood.

Cavé Vin

5555 Xerxes Ave. S.

An upscale neighborhood restaurant, Cavé Vin is a family owned local restaurant with a French and new-American menu.

Armatage Elementary School

2501 W. 56th St.

Armatage Montessori School is a public magnet in Southwest Minneapolis. The Montessori education method is designed to offer child-centered environment that encourages children’s natural learning impulses.

Super USA Convenience Store

5965 Penn Ave. S.

A neighborhood convenience store.

Dominos Pizza

5957 Penn Ave. S.

Dominos Pizza provides national fast food options to residents.

Gas Stations

6001 & 6004 Penn Ave. S.

BP and Minnoco Gas provide gas and automobile servicing to residents of the area.

Wagner’s Nursery

6024 Penn Ave. S.

Wagners has been a business in the neighborhood for many years. Note the farmers market stand in the parking lot.

Residential Housing

Penn Ave. S. & 56th St. Area

Mid-century ramblers are common in this neighborhood.

An environmental analysis can provide important information to planning and program implementation.

Here are some links to get you started on the environmental analysis for the Armatage neighborhood in Minneapolis, Minnesota:

https://www.minneapolismn.gov/neighborhoods/armatage/index.htm

Welcome to the Armatage Neighborhood!

Conclusion

You have completed the windshield survey activity. After surveying your chosen community, you should have a better sense of the prevailing health conditions and social determinants in that location.

You can download your responses to the questions you answered earlier as well as the provided web links for the environmental analysis.

The following Must Be included:

1. Assesses, via a windshield survey, the general condition and needs of a community from a public health perspective. Specifies applicable safety concerns and the limitations of the survey.

Use this template for comunity health assessment:

2. Analyzes the environmental factors affecting population health in a community. Clearly articulates key health issues, opportunities, and threats. Conclusions are well-supported by credible evidence.

3. Identifies the social determinants of health in a community. Draws well-reasoned conclusions from credible evidence and articulates underlying assumptions and uncertainties.

4. Summarizes environmental analysis and survey findings for executive leaders. Information is detailed, accurate, and logically organized. Provides insightful lessons learned.

5. Writes clearly and concisely in a logically coherent and appropriate form and style. Main points, ideas, arguments, or propositions are well-developed and engaging. Adheres to all applicable disciplinary and scholarly writing standards and conventions.

6. Supports assertions, arguments, propositions, and conclusions with relevant, credible, and convincing evidence. Skillfully combines error-free source citations with a perceptive and accurate synthesis of the evidence.

The following template must be used for assessment:

Community Health Assessment

Your Full Name (no credentials)

School of Nursing and Health Sciences, Capella University

NURS-FPX6218 Leading the Future of Health Care

Assessing Community Health Care Needs

Instructor’s Name

Month, Year

Community Health Assessment

Note: Delete this note and all instructions from the worksheet before submitting it.

Executive Summary

General Condition and Public Health Needs

Based on your windshield survey, summarize the general condition and needs of your selected community from a public health perspective.

Environmental Analysis

Based on your environmental analysis, summarize the environmental factors affecting population health in your selected community, including the social determinants affecting community health.

Conclusions

Be sure to support your conclusions with relevant and credible evidence.

References

List your APA-formatted references here.

Appendix

Table 1: Windshield Survey and Environmental Analysis

Table directions:

1. Add table rows, as needed, for additional categories.

2. Enter the information (questions, observations and impressions, SWOT category, and references) for each category in columns 2–5.

Category Questions Observations and Impressions SWOT Category References

(See note 1.)

Community Size

Population

Age

Ethnicity

Health Issues

Health Care Services

Churches

Schools

Businesses

Buildings

Restaurants

Other

Notes:

Cite applicable sources for each category of information, either the Internet or the Vila Health: Environmental Analysis and Windshield Survey simulation Assessing Community Health Care Needs

NR520 Module 4: Theory-Guided Strategies to Reduce Medication Administration Errors During Nursing Practicum

Think about your practicum project and the issue you identified in Module 3. What issue or problem did you identify? (Note: You may have also selected a prominent nursing practice issue that is of interest to you.)

Analyze scholarly literature related to the issue/problem of and strategies for resolution. Review different nursing theories that could support a resolution to the practice issue or problem you have identified. NOTE: Many students may be inclined to choose Lewin’s Change Theory. This is not a nursing theory and would not apply to the required content for this assignment.

In a three-to-six-page scholarly paper, address the following elements. Include a minimum of three scholarly sources, current within 5 years, to support your work. See rubric for specific, required content

criteria within each section of the presentation:

o Introduction

o Description of Issue or Problem

o Nursing Theory

o Application of Theory

o Conclusion

Title page, pagination, subheadings, body of paper, citation of sources, and reference page must follow APA guidelines as found in the current edition of the manual.

NR520 Module 4: Theory-Guided Strategies to Reduce Medication Administration Errors During Nursing Practicum

Medication administration errors (MAEs) pose a significant threat to healthcare accountability, quality of care, and patient safety. Despite advances in safety protocols, barcode medication administration, and electronic prescribing, errors persist in clinical settings. Nursing practicums are particularly vulnerable to MAEs because nursing students are still developing confidence, clinical judgment, and technical skills. These practicums expose students to real-world challenges, including time pressures, frequent interruptions, high patient acuity, and difficulties with interdisciplinary teamwork. Together, these factors increase the mental workload nurses carry and may jeopardize safe medication practices. Simply emphasizing procedural compliance is insufficient. Instead, a theoretical framework is needed to understand how nurses develop judgment and competence over time. Medical and nursing theories offer valuable insights into the experiential, behavioral, and cognitive aspects of practice improvement. This paper reviews MAEs observed during practicums, analyzes current research, and applies Benner’s Novice-to-Expert Theory to propose evidence-based solutions.

Description of the Problem

During the nursing practicum, it became evident that nursing students and novice nurses are more susceptible to medication errors. Observations showed inconsistent safety checks, misunderstandings of drug mechanisms, delays in administering medication, and near misses. Workflow interruptions were common, often caused by conflicting clinical priorities, staff interactions or alarms, and disruptions during medication preparation. These problems reflect recent research suggesting that medication errors mainly result from individual factors—such as decreased situational awareness, anxiety about performance, limited pharmacology knowledge, and fatigue—as well as system factors like challenges with medication technology usability, communication barriers, staffing changes, and high workload (Naseralallah et al., 2023; Kellett et al., 2024).

GET HELP HERE

Multitasking and interruptions can cause medication errors. Cognitive psychology research shows that interruptions interfere with working memory, increasing the risk of mistakes and slips during tasks such as dosage verification and calculations (Park et al., 2023). In addition, nursing students and novice nurses often adhere strictly to rules and protocols without fully considering the clinical context, increasing the risk of errors when faced with patient situations that differ significantly from standard scenarios. They tend to hesitate to report near misses because they fear the consequences or blame, which limits opportunities for organizational learning (Arkin et al., 2023).

Importantly, MAEs in practicum settings highlight systemic problems within clinical and educational environments rather than focusing solely on individual mistakes. Clinical areas crafted mainly for seasoned nursing practitioners can inadvertently overwhelm novice nurses and nursing students who are still honing automatic skills and pattern recognition. To minimize MAEs, there is a need to apply strategies that focus on creating a safe system, promoting cognitive growth, and enhancing skills. It is essential to choose the right nursing theory that allows the interventions to be customized according to learners’ developmental levels NR520 Module 4: Theory-Guided Strategies to Reduce Medication Administration Errors During Nursing Practicum.

Nursing Theory

Benner’s Novice-to-Expert Theory offers a valuable framework for comprehending the development of competence and its importance for safe medication practices. Based on Dreyfus’s Model of Skill Acquisition, five levels of nursing expertise can be outlined, including novice, advanced beginner, competent, proficient, and expert. Each of the five stages and the transitions between them involve notable changes in clinical abilities, decision-making, and perception. Novices rely on explicit features and rules. Advanced beginners begin to recognize meaningful, recurring patterns. Competent nurses improve their prioritization and planning skills. Proficient and expert nurses develop a holistic understanding and intuitive judgment (Lamichhane, 2025).

Recent research continues to affirm the significance of Benner’s theory in modern clinical education. The research indicates that novice nurses encounter greater cognitive challenges, are more prone to making errors, and tend to make slower decisions under time constraints (Pol-Castañeda et al., 2022). Benner’s theory focuses on experiential learning and mentorship, reinforcing evidence that patient safety and clinical skills benefit from guided practice and reflective feedback (Cunja et al., 2025). In addition, the theory highlights the importance of considering context when making decisions, which is especially relevant in medication administration, as patient-specific factors influence monitoring, timing, and dosing.

Benner’s framework is particularly focused on nursing, highlighting how practitioners integrate perception, experience, and knowledge. It treats medication safety not as a simple technical skill but as a developing interpretive and cognitive competence. Recognizing that learners progress through distinct developmental stages, Benner’s theory helps design tailored clinical and educational approaches. This approach is especially useful for managing MAEs identified during practicum.

Application of Theory

Applying Benner’s theory underscores the need for developmentally appropriate strategies that evolve with the learners’ skills to reduce medication errors. At the novice level, nursing students should receive clear guidance, have explicit rules and guidelines, and engage in repetitive practice. Resources such as close supervision, detailed medication protocols, and standardized checklists are essential for reducing cognitive load and uncertainty (Park et al., 2023). Simulation-based education proves highly effective at this stage; high-fidelity simulations enable nursing students to practice error detection, barcode medication administration, dosing calculations, and medication preparation in a safe setting (Pol-Castañeda et al., 2022). Moreover, simulated interruptions train learners to stay focused and recover swiftly from disruptions.

For advanced beginners, effective learning should foster understanding within context and support pattern recognition. Using guided reflections, clinical scenario discussions, and case-based learning helps learners interpret patient-specific factors impacting pharmacotherapy (Cunha et al., 2025). Clinical preceptors are critical because they demonstrate expert reasoning; techniques such as “thinking aloud” during medication administration reveal implicit clinical judgments and improve situational awareness. Providing constructive feedback encourages correct practice and turns mistakes into valuable learning opportunities rather than punishments (Arkin et al., 2023).

Environmental interventions improve educational strategies, as evidence indicates that reducing interruptions significantly lowers MAEs. Increasing staff awareness of medication safety times, using visual cues such as signs or vests, and establishing dedicated “no-interruption” zones help maintain cognitive function during essential tasks (Kellett et al., 2024). Additionally, streamlining workflows and effectively managing workloads can further reduce the risk of errors.

As nursing students and practitioners develop their professional skills, interventions should gradually shift from strict adherence to rules to a focus on clinical judgment, anticipation, and prioritization. Participating in interprofessional collaboration activities enhances communication clarity, thereby reducing errors stemming from misunderstandings or ambiguous instructions. Debriefing sessions and reflective journaling help cultivate the metacognitive skills essential for safe practice. Overall, Benner’s theory supports a variety of interventions that align system design, mentorship, and education with the learner’s evolving clinical competence.

Conclusion

MAEs remain a significant risk and challenge in healthcare, particularly in nursing practicum settings. The principal concern is the higher risk of MAEs among nursing students and novice nurses, driven by factors such as organizational culture, environmental complexity, and cognitive development. Recent studies indicate that inexperience, communication issues, workload stress, and interruptions are primary causes of MAEs
NR520
Module 4: Theory-Guided Strategies to Reduce Medication Administration Errors During Nursing Practicum. Consequently, developing a framework that illustrates high nurses gain clinical judgment and competence over time is essential.

Benner’s Novice-to-Expert Theory provides a nursing-focused view on how decision-making, perception, and performance develop across different stages. By tailoring MAE-reduction strategies to each level of nursing expertise, clinical leaders and educators can implement targeted interventions that enhance patient safety and support professional growth. This is a theory-based solution that includes mentorship programs, reflective practices, structured supervision, simulation exercises, and methods to reduce interruptions. Incorporating nursing theory into practical improvements ensures that strategies go beyond targeting procedural adherence to the experiential and cognitive aspects of safe medication administration. This theory-based approach enhances clinical education while improving patient safety outcomes.

Reference

Arkin, L., Schuermann, A. A., Loerzel, V., & Penoyer, D. (2023). Original Research: Exploring Medication Safety Practices from the Nurse’s Perspective.
The American journal of nursing, 123
(12), 18–28.
https://doi.org/10.1097/01.NAJ.0000996552.02491.7d

Cunha, L. D. M., Ventura, F., Pestana-Santos, M., Mota, M., Lomba, L., & Santos, M. R. (2025). Decision support strategies for bedside nursing clinical reasoning: A scoping review.
International journal of nursing studies advances, 9
, 100393.
https://doi.org/10.1016/j.ijnsa.2025.100393

Kellett, P. L., Franklin, B. D., Pearce, S., & Benn, J. (2024). Resilience in nursing medication administration practice: a systematic review with narrative synthesis.
BMJ open quality, 13
(4), e002711.
https://doi.org/10.1136/bmjoq-2023-002711

Lamichhane, G. (2025). Shaping professional nursing practice using Benner’s novice to expert theory
. British journal of nursing (Mark Allen Publishing), 34
(22), 1133–1137.
https://doi.org/10.12968/bjon.2024.0387

Naseralallah, L., Stewart, D., Price, M., & Paudyal, V. (2023). Prevalence, contributing factors, and interventions to reduce medication errors in outpatient and ambulatory settings: a systematic review.
International journal of clinical pharmacy, 45
(6), 1359–1377.
https://doi.org/10.1007/s11096-023-01626-5

Park, O., Jeon, M., Kim, M., Kim, B., & Jeong, H. (2023). The Effects of a Simulation-Based Patient Safety Education Program on Compliance with Patient Safety, Perception of Patient Safety Culture, and Educational Satisfaction of Operating Room Nurses.
Healthcare (Basel, Switzerland), 11
(21), 2824.
https://doi.org/10.3390/healthcare11212824

Pol-Castañeda, S., Carrero-Planells, A., & Moreno-Mulet, C. (2022). Use of simulation to improve nursing students’ medication administration competence: a mixed-method study.
BMC nursing, 21
(1), 117.
https://doi.org/10.1186/s12912-022-00897-z 
 NR520 Module 4: Theory-Guided Strategies to Reduce Medication Administration Errors During Nursing Practicum

Vila Health – Planning for Community and Organizational Change – NURS-FPX6218 Leading the Future of Health Care

Planning for Community and Organizational Change

After assessing the most immediate issue that affects the Jordan community, Jordan Middle School proved to have an urgent need for a mental health program that would benefit middle school students. That is because the students are more vulnerable to mental health issues after the middle school teacher notifies that the school has had a case of a student who committed suicide just before graduation. Since then, most students have been affected by the incidence. Therefore, this proposal paper will identify the need to engage in a mental health program for the Jordan Middle school student community, deal with stakeholders’ unfounded conclusions, why organizations face change barriers, and use barriers as opportunities. The paper will also evaluate the strategy for helping organizational stakeholders understand and evaluate the proposed changes to an existing health care system and develop a grant proposal and associated budget for a proposed change Vila Health – Planning for Community and Organizational Change.

Mental Health Program Benefits and Implications

The proposed change for Jordan Middle School starts with a mental health program essential to create awareness among the children regarding various mental health issues and how to deal with different circumstances. Initially, the middle school teacher indicates that apart from problems with mental health like suicide, the students also have a hard time dealing with bullying. The school has even tried to bring along counselors but still feels that the mental health issues awareness is yet to be fully addressed. Hence, the mental health program for the middle school students will help bridge the existing gap, especially for these students believing that they are the only people struggling in the world. According to Feiss et al. (2019), school-based mental health practices are essential since they are a solid student support system. Hence, when school-going individuals become mentally healthy, they will most likely be more productive in schools, thus giving these communities positive change drivers. That is unlike when students develop undetected mental health issues where some become drug addicts terrorizing the communities while others become suicidal, thus blurring the community’s future.

Consequently, the school community will also benefit since once the program facilitators streamline students’ mental health, the schools will experience minimized cases of bullying, thus providing all students with a friendly environment. According to Berger (2019), most scholars have identified the need for schools to develop comprehensive mental health programs since most studies show that such programs have been one reason why students complete their education successfully. It offers them social skills, caring connections with other students and community members and increases self-awareness. The issue of stakeholders who might fail to resonate with the mental health program may arise since most people believe that mental health issues only affect adults. In such a case, the school will need to organize a meeting with all stakeholders to help sensitize them about why mental health program is necessary for the school. Such sensitization will help the stakeholder support the proposed plan implementation for the sake of the middle school students’ well-being.

Potential Barriers to Change

The main potential barriers that may affect the mental health program for Jordan Middle School are failed support from the parents and school management and logistics barriers.

Failed Support from the Parents and School Management

Change is inevitable, and it also turns out to be the most challenging plan for organizations and communities, especially if the change planners have no vision towards the change. According to Maynard et al. (2019), the issue of mental health for students may arise from both the school environment and the students’ home environment. In such a case, the parents, one of the stakeholders, may be out of reach when the change implementers need them. If the clinicians find those students who may need clinical intervention, there is a high likelihood that the clinicians will require their parent’s consent. In such a case, the planned change implementers need to strategize how the parents can occasionally be part of the program to ensure that they will not derail any of its plans. Consequently, some teachers and school management may oppose the planned change since some may believe that the program may affect the school’s reputation. In such a case, the planned change initiators will need to clarify that the program mainly wants to cater to the students’ mental well-being to prevent adverse effects of issues like anxiety and depression that may result from the student’s past experiences.

Logistic Barriers

Logistic barriers may also be a potential barrier since most school environments prove to be crisis-driven and hectic. The main reason is that there is a possibility of facing problems with finding the time and acquiring space within the school environment where the planned change initiators will hold the program. In such a case, the program implementers may find it challenging to ensure that the students arrive for the program on time since once some students fail to meet the program meeting time, the program may turn out to be ineffective for them (Maynard et al., 2019). That is considering that the program has to run parallel to the regular learning program of Jordan Middle School, while the psychiatrists will most probably be undertaking part-time schedules. Hence, before the program implementation starts, there will be a need to ensure that the change team has comprehensive talks with the school management to prevent such barriers, especially in establishing the appropriate student schedules and the space that will be more appropriate for the program.

Articulate Strategies for Changing Barriers into Opportunities and Resolving Conflict

Through identifying the change barriers that may affect the Mental Health Program for Jordan Middle School, it will be necessary for the change implementers to find effective ways to use these barriers as opportunities that will help in making the implementation process a success. According to Carsley et al. (2018), competing responsibilities are the main barrier that impacts all change processes, especially with the non-implementers that endorse the change. In that case, the barrier that may arise from the student’s parents and school management not supporting the implementation present an excellent opportunity for the change plan implementers. That is because they will need to seek help from the community clinicians that may be well known and trusted by the community members. These community clinicians will effectively engage the parents and school administration to ensure that they understand the importance of having a mental health program in the school (Powell et al., 2020). Also, these community clinicians will effectively carry out the follow-ups for those students that may be under treatment. As a result, these clinicians will help reduce the financial burden and time used by primary change team clinicians, thus preventing instances of these clinicians from experiencing burnout as they try to balance their duties, thus increasing their productivity in the program.

Regarding the logistics barrier, the change team will need to conduct evidence-based research on how other change teams on mental health programs in schools ensured that the barrier did not affect the plan. According to Powell et al. (2020), when change teams engage in evidence-based research, they have higher chances of using the most appropriate method that fits their change plan. They are presented with opportunities to evaluate different ways to solve the problem.

Stakeholder Communications

The main stakeholders for the planned change in Mental Health Program in Jordan Middle school include the Jordan teachers, school management, students, and parents. The stakeholders will also have the community and other reliable clinicians. Through these stakeholders, the planned change team will manage to intervene in the current mental health crisis that Jordan Middle School students are undergoing. Hence, the planned change will need to collect enough data through interviews and questionnaires from the teachers and students, and the surrounding communities to ensure that the decision-makers will have a complete picture of the current situation in the school.

Grant Proposal and Associated Budget for a Proposed Change

Grant Proposal

From:
Jordan Middle School Planned Change Team

To:
Funding Authorities

Topic: Grant Proposal for Jordan Middle School Mental Health Program

After researching Jordan Middle School’s problems, the research team identified that the students have significant mental health issues. Currently, most students are dealing with grief issues concerning one of the students that committed suicide while still in school. Also, some students may still suffer from bullying, leading to adverse mental health effects like depression and anxiety that risk the students’ well-being. In that case, the research team has identified the need to develop a Mental Health Program for the students to create awareness of issues concerning mental health. The program will run for two years, and the following is the first-year budget.

Budgetary Requirements

Costs

Number of the Program Beneficiaries

Cost per Student/clinician ($)

Total Cost (Annually) ($)

Stage One: Screening and Enrollment

(Assumption that 90 percent of the students will comply)

1,100

20

22,000

Stage Two: Clinical Evaluation (With an assumption that 20% have mental health issues)

220

40

8800

Stage Three: Referral

(Assuming that 30 percent of the positive cases will need a referral)

66

 

50

3300

Community Clinicians

6

150

900

Building Renovation and Utility cost

80,000

Total Cost

115000

 

Conclusion

The paper has evaluated the need to engage in a mental health program for the Jordan Middle school student community, deal with stakeholders’ unfounded conclusions, why organizations face change barriers, and use barriers as opportunities. The paper has also assessed the strategies necessary in helping organizational stakeholders understand and evaluate the proposed changes to an existing health care system and developed a grant proposal and associated budget for the proposed change.

 

References

Berger, E. (2019). Multi-tiered approaches to trauma-informed care in schools: A systematic review.
School Mental Health
,
11
(4), 650-664. https://doi.org/10.1007/s12310-019-09326-0

Carsley, D., Khoury, B., & Heath, N. L. (2018). Effectiveness of mindfulness interventions for mental health in schools: A comprehensive meta-analysis.
Mindfulness
,
9
(3), 693-707. https://doi.org/10.1007/s12671-017-0839-2

Feiss, R., Dolinger, S. B., Merritt, M., Reiche, E., Martin, K., Yanes, J. A., … & Pangelinan, M. (2019). A systematic review and meta-analysis of school-based stress, anxiety, and depression prevention programs for adolescents.
Journal of youth and adolescence
,
48
(9), 1668-1685. https://doi.org/10.1007/s10964-019-01085-0

Maynard, B. R., Farina, A., Dell, N. A., & Kelly, M. S. (2019). Effects of trauma‐informed approaches in schools: A systematic review.
Campbell Systematic Reviews
,
15
(1-2). https://doi.org/10.1002/cl2.1018

Powell, B. J., Haley, A. D., Patel, S. V., Amaya-Jackson, L., Glienke, B., Blythe, M., … & Weinberger, M. (2020). Improving the implementation and sustainment of evidence-based practices in community mental health organizations: a study protocol for a matched-pair cluster randomized pilot study of the Collaborative Organizational Approach to Selecting and Tailoring Implementation Strategies (COAST-IS).
Implementation science communications
,
1
(1), 1-13. https://doi.org/10.1186/s43058-020-00009-5

 

Vila Health – Planning for Community and Organizational Change – NURS-FPX6218 Leading the Future of Health Care

Draft a 5 page change proposal to executive leaders, soliciting their support for a change to the health care system in the community you selected in the previous assessment.

Introduction

To improve health care outcomes within a community, leaders must understand the needs of specific populations. In addition, it is important that leaders are able to gather and present persuasive evidence to decision makers to obtain the necessary funding and establish these needs as priorities for budget and resource planning. Thus, proposed changes should support improved outcomes and align with the current or needed health care policy.

This assessment provides an opportunity to propose a community health care change that is based on the community health assessment you completed in Assessment 2.

Preparation

Your community health assessment was well received by the executives at Vila Health. Consequently, they have asked you to recommend a change in the community that will improve health outcomes. They have also asked you to submit your recommendation in a formal change proposal. You are confident that you can present a strong case for change, including a financial plan, that will ensure the success of this initiative.

In this assessment, you will draft a change proposal to executive leaders to solicit support for a change to the current community health care system. To prepare for the assessment, you are encouraged to begin thinking about your justification for establishing the recommended change as a priority, a strategy for leading change, and how the change will be funded. In addition, you may wish to:

Review the assessment requirements and scoring guide to ensure that you understand the work you will be asked to complete.

Review Guiding Questions: Planning for Community and Organizational Change [DOCX], which includes questions to consider and additional guidance on how to successfully complete the assessment.

Note: Remember that you can submit all or a portion of your draft change proposal to Smarthinking Tutoring for feedback before you submit the final version for this assessment. If you plan on using this free service, be mindful of the turnaround time of 24–48 hours for receiving feedback.

The following resource is required to complete the assessment.

Vila Health: Planning for Change.

Vila Health is a virtual environment that simulates a real-world health care system. In the various Vila Health scenarios, you will apply professional strategies, practice skills, and build competencies that you can apply to your coursework and in your career. The information you gather in this scenario will help you to complete the assessment.

TEMPLATES

Use this template for your change proposal.

Change Proposal Template [DOCX].

Requirements

Complete this assessment in two steps:

If you have not already done so, complete the Vila Health: Planning for Change simulation.

Draft a change proposal to justify your recommendation for improving the health of the community and establish the change as a priority for the next budget cycle. Consider the feasibility of your proposed change, in terms of overall scope, funding, and timeframe.

The change proposal requirements outlined below, correspond to the grading criteria in the scoring guide, so be sure to address each point. Read the performance-level descriptions for each criterion to see how your work will be assessed. The Guiding Questions: Planning for Community and Organizational Change document provides additional considerations that may be helpful in completing your assessment. In addition, be sure to note the requirements below for document format and length and for citing supporting evidence.

Identify the benefits of proposed health care system changes and its implications for a community.

Describe potential barriers to change in an organization or community.

Develop strategies for changing barriers into opportunities and resolving conflict.

Develop a strategy for helping organizational stakeholders understand and evaluate the proposed changes to an existing health care system.

Develop a grant proposal and associated budget for a proposed change to an existing health care system.

Write clearly and concisely in a logically coherent and appropriate form and style.

Support assertions, arguments, propositions, and conclusions with relevant and credible evidence.

Document Format and Length

Use the Change Proposal Template. This APA Style Paper Tutorial [DOCX] can help you in writing and formatting your assessment. If you would like to use a different template or document format for your change proposal, obtain prior approval from faculty.

Your change proposal should be 5 pages in length, not including the title page and references page.

Be sure to apply correct APA formatting to all source citations and references.

Supporting Evidence

Cite 5 credible sources from peer-reviewed journals or professional industry publications to support your change proposal.

Additional Requirements

Proofread your change proposal before you submit it, to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your analysis.

Portfolio Prompt: You may choose to save your change proposal to your ePortfolio.

Competencies Measured

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

Competency 1: Identify the challenges and opportunities facing health care.

Identify the benefits of proposed health care system changes and its implications for a community.

Competency 2: Compare the effects of different health care finance models and policy frameworks on resources and patient outcomes.

Describe potential barriers to change in an organization or community.

Develop a grant proposal and associated budget for a proposed change to an existing health care system.

Competency 4: Develop proactive strategies to change the culture of the organization by incorporating evidence-based practices.

Develop a strategy for helping organizational stakeholders understand and evaluate the proposed changes to an existing health care system.

Develop strategies for changing barriers into opportunities and resolving conflict.

Competency 5: Communicate effectively with diverse audiences, in an appropriate form and style consistent with applicable organizational, professional, and scholarly standards.

Write clearly and concisely in a logically coherent and appropriate form and style.

Support assertions, arguments, propositions, and conclusions with relevant and credible evidence.

The following must be included:

1. Identifies the benefits of proposed health care system changes and its implications for a community. Articulates clear goals or outcomes for proposed changes that are well-supported by credible evidence.

2. Describes potential barriers to change in an organization or community. Identifies the causes of resistance and supports claims with credible evidence.

3. Develops strategies for changing barriers into opportunities and resolving conflict. Strategies reflect clear vision and drivers of change, including a viable approach for resolving conflict.

4. Develops a strategy for helping organizational stakeholders understand and evaluate the proposed changes to an existing health care system. Describes the effects of these changes on the organization and identifies the specific information needs of the decision makers.

5. Develops a grant proposal and associated budget for a proposed change to an existing health care system that presents a compelling argument for funding. Budget line items reflect clear and specific needs that are well-articulated and justified in the proposal.

6. Writes clearly and concisely in a logically coherent and appropriate form and style. Main points, ideas, arguments, or propositions are well-developed and engaging. Adheres to all applicable disciplinary and scholarly writing standards and conventions.

7. Supports assertions, arguments, propositions, and conclusions with relevant, credible, and convincing evidence. Skillfully combines error-free source citations with a perceptive and accurate synthesis of the evidence.

Guiding Questions for Assessment 3

Planning for Community and Organizational Change

This document is designed to give you questions to consider and additional guidance to help you successfully complete the Planning for Community and Organizational Change assignment. You may find it useful to use this document as a pre-writing exercise, an outlining tool, or as a final check to ensure that you have sufficiently addressed all the grading criteria for this assignment. This document is a resource to help you complete the assignment. Do not turn in this document as your assignment submission.

Change Proposal

Draft a change proposal to justify your recommendation for improving the health of the community and establish the change as a priority for the next budget cycle.

Identify the benefits of proposed health care system changes and its implications for a community.

• What are the direct benefits of your proposed changes?

• How will improvements in overall health affect the community?

• What evidence supports your claims?

• What is the possibility that stakeholders jump to conclusions that are unfounded, given the nature and scope of the change? How would you avoid this risk?

Describe potential barriers to change in an organization or community.

• Why do people resist change?

• What factors in the organization and community create or contribute to resistance?

• What evidence do you have to support your claims?

Develop strategies for changing barriers into opportunities and resolving conflict.

• What are the drivers of change in organizations and communities?

• What is your vision for change?

• What are the expected outcomes and timeline? Vila Health – Planning for Community and Organizational Change

• How will you communicate with stakeholders and overcome resistance?

• How will you resolve conflict among competing interests?

Develop a strategy for helping organizational stakeholders understand and evaluate the proposed changes to an existing health care system.

• Who are the key stakeholders in the organization?

• What influence do they have on your proposal?

• How will your proposed changes affect the organization?

• What data and information will you provide to decision makers?

Develop a grant proposal and associated budget for a proposed change to an existing health care system.

• Be specific and thorough in identifying budgetary requirements.

• Consider how you can present a compelling argument to the funding authority.

Write clearly and concisely in a logically coherent and appropriate form and style.

• Write with a specific purpose and audience in mind.

• Adhere to scholarly and disciplinary writing standards and APA formatting requirements.

Support assertions, arguments, propositions, and conclusions with relevant and credible evidence.

• Integrate relevant and credible evidence from 5 peer-reviewed journals or professional industry publications.

• Is your supporting evidence clear and explicit?

o How or why does particular evidence support a claim?

o Will your reader see the connection?

• Did you summarize, paraphrase, and quote your sources appropriately?

Submission Reminders

• Have you identified the benefits of proposed health care system changes and the implications for the community? Have you provided supporting evidence?

• Have you described potential barriers to change in the organization or community and provided supporting evidence?

• Have you developed sound strategies for changing barriers into opportunities and resolving conflict?

• Is your plan for helping organizational stakeholders understand and evaluate proposed changes to the existing health care system complete?

• Is your proposal well-supported by 5 sources of relevant and credible evidence?

• Is your proposal properly formatted and 5 pages in length, not including the title page and references page?

• Did you proofread your writing?

The following resource is required to complete the assessment.

Vila Health: Planning for Change.

Vila Health: Planning for Change

Intro

To improve health care outcomes within a community, you need to provide persuasive evidence to decision makers in order to demonstrate your project as a priority for budget and resource planning. One important step to gathering such evidence comes from talking to stakeholders in the community. What are the problems people are facing and how will your project provide a solution to those problems?

Select each location to familiarize yourself with the needs and issues being faced by each community. Jordan is a small town in the Minnesota countryside. Armatage is a neighborhood on the south side of Minneapolis.

Jordan

Jordan City Council or History Center

City Council Member:

We’re seeing more poverty in Jordan and need to address that. I think as a community, we sometimes live in the past and for good reasons. Traditionally, we’ve been kind of a “Lake Wobegon” kind of place — everything and everyone was above average. When I first was elected to the city council, the population here was 94% white. Our last census put that at 89%. Now, don’t misunderstand me — I think diversity is good for this community. All I’m saying is that we need to be aware of the ways this community is changing and make sure we support the growth and change.

Jordan Middle School

Middle School Teacher:

I worry about a lot of these kids. There’s a serious drive to get more mental health education and awareness into the schools, but it isn’t happening very quickly here. We’ve looked at ways we can bridge the gaps, but I don’t see much more than figurative band-aids. We had a situation in the high-school last year with a very popular student who committed suicide just before his graduation. Because this is a small community, a lot of the middle school kids knew him, so we brought in grief counsellors. I just think kids need to have a place where mental health issues are discussed. They think they’re the only one in the world struggling with certain issues, and it would help to know that’s not true. There’s also so much attention to bullying, but are we doing enough? Vila Health – Planning for Community and Organizational Change

Residential Area

Jordan Parent:

There aren’t words strong enough to express how frightened I am about this whole opioid thing. My kids are still young — 11 and 9 — but when do you start to worry? My sister-in-law has been put through the wringer dealing with her oldest. Rehab — court — jail. The kid’s only 25 and he’s got a record a mile long. He was a nice kid, too. That’s the thing. So, how do we keep our kids safe from this poison?

Food Shelf

Food Shelf Manager:

The need for our services has been growing steadily ever since we moved into our current space. When we moved in here, we were serving less than 100 families a month. That was three years ago. Now, we’re seeing almost 200 families a month. Donations help, but we have a limited budget and we have to do our best to make sure our shelves stay stocked. So, yes. There is an over emphasis on carbs and processed foods. I wish there was a way to offer better quality protein and fresh fruits and vegetables. We got a donation of apples in one time from one of the orchards — they were seconds that didn’t look so nice, but were still good. You’d have thought they were gold. It broke my heart to see how excited people were over reject apples, but I figure there were a bunch of pies being baked that week.

Jordan Community Education and Recreation Center

Recreation Center Manager:

I’ll be honest — the kids I am seeing are out of shape and often not well prepared for school. I don’t like to sound like an old fogey, but they spend so much time on their phones and other electronics. They aren’t riding their bikes, they aren’t playing baseball, they aren’t reading… It’s all Mariobox and Fortcrafter and it’s taking a toll on the overall health of these kids.

Shopping Plaza

Property Manager:

We have a lot of vacant retail and commercial property in this town. It’s a shame, because I think there’s a lot of potential for many of these sites, but it’s hard for small business owners. You used to see, like a women’s clothing store or a little coffee shop, but those businesses have a hard time competing against the bigger chains. So, they go under and there’s a vacant property on either side of one that’s still hanging in there. That hurts the one’s that are still there. It would be great to get something into these properties, even if it isn’t necessarily a store or a restaurant.

Veteran’s Park

Parks Department Representative:

Funding cuts have taken a toll on a lot of our after-school programs. That’s bad enough, but because there aren’t organized events, the parks are turning into the place where kids hang out after dark. Most mornings, particularly after a weekend, the parks are littered with beer cans and worse. We’ve gotten complaints from parents of young children that they go to the playground and there’s beer cans and booze bottles everywhere.

Jordan City Sign

Bike Club President:

We have a very active membership, but recruitment has been difficult. The problem is that the bike trails we do have aren’t very long and they don’t connect to anything. A lot of our members who are avid bikers will use the roads to get places, but novice bikers want trails and ours are pretty random and short.

Senior Living Center

Jordan Family Member of Senior Center Client:

I work at a restaurant and really depend on the adult day care here. The trouble is that Mom isn’t always in the frame of mind where she can do the adult day care. Right now, I can get my brother’s wife, Tessa, to stay with her when she’s having a bad day, but Tessa’s pregnant and won’t be able to do that once the baby comes. I don’t want to put Mom in a nursing home, but she can’t be alone, she can’t always come here, and the cost of a home health aide is more than I make some days.

St. Francis Health Services

Urgent Care Nurse:

This isn’t political, but the situation with health insurance is getting worse, not better. I see so many people in the Urgent Care clinic with complaints that should have been addressed by a primary care giver — but the person doesn’t have a primary care giver. We’re seeing complications from undiagnosed or untreated diabetes. Hypertension. I’ve had two people in the last year who came in for general aches and pains and were in stage IV cancer. There’s no need for a lot of these problems to get so bad, but people can’t afford insurance and so they don’t see a doctor unless they’re sick.

Jordan City Hall

County Social Worker:

Something people don’t really ever address is how to deal with the day to day costs of chronic health conditions. I have people who are really living paycheck to paycheck and they don’t know how to pay for their prescriptions. Or there are people who have hypertension and take their meds, but they don’t have a primary care physician. There are so many things I could mention, but the short version is that there are a lot of people who need help in managing chronic conditions.

Armatage

Residential Housing

Neighborhood Council Member:

This is a pretty working-class neighborhood. I mean, people are doing well, but there’s a mix of everyone here and that’s the way we like it. If you look at the business directory, you can see that we’ve got a good range of services and businesses in what is essentially a residential neighborhood. Admittedly, it would be nice to have some kind of clinic for everyday health concerns, but really, how many neighborhoods have something like that. We do have a local dentist, a chiropractor, and a massage studio. Oh, and a mental health clinic.

Residential Housing

Resident:

Something that I don’t think anyone knows is that several of the homes in this neighborhood have lead paint and lead in the plumbing. I only learned about this when I was doing some research into the situation in Flint. Apparently, in the Minneapolis, service lines to residential properties installed prior to 1930 were usually made out of lead piping. And, if that isn’t unnerving enough, service lines are the responsibility of the property owners. Service lines that are made of lead can’t be repaired; they can only be replaced — which costs a fortune. But the main issue, in my opinion, is that most people have no idea if their home has these service lines and they have no idea whether or not their home drinking water has any lead in it at all. You’d think after the issues in Flint that we’d be talking about this, but apparently not.

Armatage Elementary School

School Principal:

I know this is something a lot of communities are dealing with, but the vaccination situation is suddenly an issue. We’ve never had a problem before, but I’ve had several parents inquiring about vaccination exemptions. I share the information I have about vaccination requirements, but I think there’s something going on where anti-vaccination information is circulating in the community.

Armatage Community Center

Community Garden Organizer:

This garden is doing so well. We had three applicants for every open space. It would be great, though, if we could expand what we’re doing. It isn’t just about the food, though that’s so important. We’re building community here, too. One of the things I love most about the garden is watching kids come to understand food in a more fundamental way. They start with the garden thinking it’s kind of fun, but the first time they have a meal that is made with food they saw growing is like a revelation for them. They suddenly get it. I don’t think we’re going to get more space, so it would be good to come up with some other ideas for how we can expand.

Red Wagon Pizza

Restaurant Owner:

You know, people say they want healthy choices, but I’ll tell you what — money talks. I tried to put some healthy options on the menu. What a disaster! The stuff didn’t move, when people ordered it, they complained that the portions were too small — the portions were based on meeting with a nutritionist, for gosh sake! Bottom line… it was a total failure. My customers want burgers, bacon, cheese, and fries. And I’ll tell you — you go to the hipster places in this neighborhood — they might be offering microgreens and Portobello mushroom burgers, but those aren’t the things that are keeping the place in the black — not by a long shot.

Bus Stop

Urgent Care Nurse:

I live in this neighborhood and one of the things I wish we had was a clinic or urgent care facility. So often I hear about people having to take city busses to get to a health care provider. There’s nothing available for people who have a sick kid or have something going on themselves. We’re an urban neighborhood, so not everyone drives. That’s fine most of the time, but there are two situations where that can be a problem — when someone’s sick and when someone is trying to do grocery shopping for a family. That’s not easy to do when you depend on the busses.

Penn Avenue Family Dental

Dentist:

This is a very diverse community and there’s a wide range of issues when it comes to people’s dental health. This practice tries to do as much education as possible, but there are still a lot of people who don’t understand how dental health affects other aspects of health. I don’t know what we could do differently, but it would be nice to see more outreach into the community, particularly into some of the immigrant communities, such as the East African immigrants. They’ve come from a country going through decades of civil war and strife — dental care is often the last thing on their minds. It would be nice to help them understand how taking care of their teeth will have wide-ranging benefits.

Pennhurst Cleaners

Developer:

Right now, the whole city is in transition. This neighborhood is a good example of the kinds of issues I’m seeing all over the city. The neighborhood is primarily residential and it’s an old, established neighborhood. You have some people who are trying to address housing affordability and others who are concerned that rental units will bring instability to the neighborhood. What people don’t realize is that change is already happening. They can’t stop change, but they can help direct it.

Cindy’s Barber Shop

Police Representative:

There’s no doubt that violence in this neighborhood has increased in the last several years. I wouldn’t say we have gangs per se, but we’re seeing an uptick in aggravated assaults and other violent crimes. Of course, a lot of that is domestic violence, which is a real shame. Some of these women have gone through so much in their lives — fleeing war and violence in their home country — and they’re still putting up with violence when they get here. Doesn’t seem right, does it?

Conclusion

You have completed the stakeholder interviews. You should now have a better sense of the health and social issues being faced by members of these communities.

The following template must be used for assessment:

Change Proposal

Your Full Name (no credentials)

School of Nursing and Health Sciences, Capella University

NURS-FPX6218 Leading the Future of Health Care

Planning for Community and Organizational Change

Instructor’s Name

Month, Year

Title of Paper

Note: Delete this note and all instructions from the template before submitting your proposal. Use headings to organize your text, rather than bullets.

Summary

Benefits and Implications

Identify the benefits of proposed health care system changes and its implications for a community.

• Consider the goals and potential outcomes of the proposed changes.

• What are the direct benefits of your proposed changes?

• How will improvements in overall health affect the community?

Potential Barriers to Change

Describe potential barriers to change in an organization or community.

• What factors in an organization and community create or contribute to resistance to changes?

• What other factors can create barriers to change?

Articulate strategies for changing barriers into opportunities and resolving conflict.

• What are the drivers of change in organizations and communities?

• How will you communicate with stakeholders and overcome resistance?

• How will you resolve conflict among competing interests?

Stakeholder Communications

Articulate a strategy for helping organizational stakeholders understand and evaluate proposed changes to the existing health care system.

• Who are the key stakeholders in the organization?

• What influence do they have on your proposal?

• Consider the effects of these changes on the organization and the specific information needs of decision makers.

References

List your APA-formatted references here.

Appendix A: Grant Proposal

Need Statement

• Define the problem that this change is addressing.

• Describe the scope of the problem.

o Who is affected? How will you describe this population?

o How many people does this problem affect?

• Identify the barriers you are likely to encounter when implementing this change?

• Identify the sources of information you used to define the need for change.

• Identify any other change initiatives or studies that are addressing this problem.

Program Description

Describe the proposed change initiative and how you plan to implement it. Address the basic questions of who, what, when, where, why, and how.

Goals and Objectives

Describe the goals and objectives of the change initiative.

Program Evaluation

Explain how this change initiative will be evaluated.

• Who will have oversight responsibilities?

• How and how often, will this initiative be evaluated?

• Who is the recipient of the evaluation reports?

• What is the extent of stakeholder involvement in evaluation?

Summary

• Explain why this change is important to the community.

• Explain how the goals and objectives of this change initiative align with those of the funding organization and why their financial support is vital to the success of this initiative.

• Be sure to thank the funding agency for considering and supporting this initiative.

Appendix B: Project Budget

Table directions:

1. Add table rows, as needed, for each budget category.

2. Enter the information (startup, first-year budget figures, other sources of revenue, and justification) for each budget category line item in columns 2–5.

Categories Startup 1st Year Other Sources

of Revenue Justification

Salary and Wages

• Project Manager

• Support Staff

• Other

•

•

Fringe Benefits

•

•

•

Consultation or Contract Services

•

•

•

Equipment

•

•

•

Materials

•

•

•

Travel

•

•

•

Miscellaneous or Other

•

•

•

Total Expenses

High-Alert Medications Independent double checks

Consider a current or former practice area and select a health-related policy that is in place to assure quality and safety. Topics may include patient care policies, drug policies, security and privacy policies, or employee health policies.

In a three-to-six-page scholarly paper, address the following elements. Include a minimum of three scholarly sources, current within 5 years, to support your work. See rubric for specific, required content criteria within each section of the presentation:

Introduction

Policy Background and Purpose

Factors Influencing Policy

Policy Impact and Implications

Conclusion and Recommendations

Title page, pagination, subheadings, body of paper, citation of sources, and reference page must follow APA guidelines as found in the most current edition of the manual.

Rules of grammar, spelling, word usage, punctuation, and sentence and paragraph structure are followed and consistent with formal, scholarly writing as noted in the most current edition of the APA Manual

High-Alert Medications Independent double checks

Module 6: A Health-Related Policy

The prevalence of medication errors within healthcare systems is on the rise. These preventable threats predispose patients to multiple safety issues, including adverse drug reactions (ADRs) or death in severe cases. Therefore, incidence of medication errors in healthcare organizations is a significant performance indicator. Medication error index depicts medical facility’s values for patient’s safety, treatment outcomes, and well-being. For this reason, healthcare organizations focus on reducing incidence of medication errors reported within their system over a specific period. A significantly high percentage of medication errors reported in clinical settings is associated with human/staff mistakes (Chalasani et al., 2023). Thus, healthcare organizations focus on reducing rate of medication errors through policy change. This paper discusses, double nurse verification for high-alert medications (HAMs), which is a health-related policy that should be implemented within contemporary healthcare systems to lower high rates of medication errors.

Policy Background and Purpose

A significantly high number of inpatients are prescribed high-alert drugs, including insulin, chemotherapeutic agents, and heparin. This trend is attributed to increase in the number of inpatients seeking treatment for chronic/terminal illnesses, including cancer, diabetes Mellitus (DM), and cardiovascular disorders (CVDs). High-alert drugs are attributed to heightened risk of predisposing patients to significant harm or death when used incorrectly (van Stralen et al., 2024). However, potential ADRs can be reduced significantly if medication errors are detected early stages of drug administration process. Therefore, the proposed policy aims to ensure approximately 97% of medication errors are detected before they get to the patient.

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The desired medication errors score will be achieved by ensuring double verification in highly critical clinical practices, including pediatric dosing and chemotherapy administration. Other areas that require double verification of the patient’s drug are intensive care units and insulin infusion. According to “The Institute for Safe Medication Practices” (ISMP) two clinicians should very patient’s medication independently to ensure its safety (Bertagnoli et al., 2025). Additionally, medication errors will be reduced through correct calculation of the patient’s dosage, thereby preventing ADRs that might be caused by administering high dosages. Medication errors will also be reduced by ensuring that the patient’s, drug, route, dose, formulation, and time are correct before administering drug. Strengthen accountability within the healthcare system will also play a significant role in reducing medication errors. Lastly, promote a culture of safety will lower medication errors and potential undesired treatment outcomes High-Alert Medications Independent double checks.

Factors Influencing Policy

Multiple factors have contributed to the introduction of the recommended policy, involving double verification of HAMs. The first factor is dramatic increase in number of patients using HAMs in various areas of acute care settings, including neonatal units, intensive care units (ICU), and emergency departments. For instance, insulin therapy and neuromuscular blockers are commonly prescribed to patients admitted in the ICU, emergency department, or NICU (Rochester-Eyeguokan, & Pincus, 2025). HAMs predispose these patients to significantly high risk when they are used incorrectly. Thus, these drugs must be verified by two clinicians before administering them to patients, thereby eliminating potential harm or death. Additionally, complexity of medication regimens influences introduction of double verification policy. Treatment of patients diagnosed with multiple chronic comorbidities involves complex titration protocols. These cases require double verification of the patient’s medication to ensure safe administration, thereby preventing potential safety issues.

Other influencing factors are staff’s high workload, prolonged work schedule, and pressure to provide timely patient care. Increase in number of patients seeking treatment services from the hospital acute care settings exposes staff to high workload. In some cases, clinicians work overtime to meet high demand for quality, timely, and effective patient care. As a result, healthcare providers are exposed to burnout and fatigue, making them skip the second check, which increases risk of medication error (Mert & Kersu, 2025). Therefore, double-checking policy would ensure that the patient’s medication is verified by a second clinician despite the high workload, thereby preventing potential error and related ADRs. Additionally, staff’s overconfidence necessitates implementation of the double-verification policy. In most cases, more experienced nurses feel confident; hence checking the patient’s medication once, increasing risk of medication errors. Thus, the new policy would ensure that highly-experienced nurses confirm the medication with another clinician before administering it, which would prevent potential errors and promote patient safety.

Organizational culture emphasizing on patient safety has also contributed to the adoption of double-verification policy. Contemporary healthcare systems are committed to prioritizing patient safety in various clinical practices (Alrawili et al., 2024). Therefore, double-verification process is recommended since it would ensure compliance with safety standards during drug administration despite pressure associated with high workload. High-Alert Medications Independent double checks Consequently, preventable medication errors will reduce, preventing potential adverse treatment outcomes or deaths.

The last factor is the need to comply with legal and regulatory requirements. State board of nursing standards requires healthcare institutions to comply with safety measures. The Nurse Practice Act (NPA) enforced standardized practice measures and patient safety guidelines to support high-quality care and protect the public from potential harm (Markowitz & Smith, 2024). For this reason, double verification process was adopted to protect patients from harm caused by medication errors. Moreover, this policy provides legal defensibility if medication error occurs within healthcare institutions despite compliance with all reasonable precautions, thereby preventing potential malpractice liability. Protecting patients from potential safety issues/harm through double-verification indicates compliance with accreditation requirements.

Policy Impact and Implications

The implementation of double-verification policy has positive and negative impacts. This policy would ensure compliance with patient safety standards and accreditation requirements, thereby preventing potential malpractice liabilities in the event of drug errors. This policy would also reduce healthcare system’s medication errors by ensuring a pharmaceutical regimen is double-checked by two competent clinicians before being administered to a patient. Another positive impact involves enhancing professional accountability. All healthcare providers involved in drug administration, including physicians and nurses will double check the patient’s drug to ensure correct administration route and appropriate dosage. This process will prevent potential harm/ADRs that might occur if incorrect medication or a higher dosage is administered to the patient. Lastly, double-checking patient’s medication would improve patient/family’s trust, making them satisfied with quality and safety of patient care.

However, double-checking process has some negative effects. First, this policy would result in inefficient workflow in healthcare organizations facing staff shortages since double-checking patient’s medication is time consuming. This process would also delay patient care, increasing likelihood of potential adverse treatment outcomes, particularly in critically ill emergency department patients. Lastly, inconsistent results would be reported across a healthcare organization due to variability in implementation of double-checking policy. Consequently, the new policy would be ineffective in reducing medication errors and related ADRs.

Implementing the new double-checking policy will reflect compliance with ethical standards that advocate for patient safety. This policy further implies that healthcare organizations should focus on continuous education to enhance nurses understanding of dosing and pharmacodynamics principles. Lastly, the new policy is associated with financial implications. Double-checking process aims at preventing medication errors, thereby eliminating potential litigation costs, including expenses associated with extended hospital stays.

Conclusion and Recommendations

Adopting double verification policy would improve safety among patients using HAMs by preventing potential medication errors. Consequently, additional treatment associated with ADRS would be eliminated resulting in cost-effective patient care. However, this policy would only achieve desired outcomes if it is implemented effectively across healthcare institutions. Thus, healthcare facilities should consider the possibility of getting consistent results across their departments and make necessary adjustments to ensure implementation of standardized double-check procedures High-Alert Medications Independent double checks. Additionally, the double-checking process should be monitored regularly to ensure compliance with recommended patient safety clinical practices and quality metrics.

References

Alrawili, W. G. F., Alshammari, M. H. M., Alanezi, H. S., Alrashidi, R. H. I., Al-Ruwaili, G. M. A., & Alanezi, A. L. (2024). The Importance of Patient Safety in Healthcare Institutions. 
Gland Surgery
, 
9
(2), 374-382.
https://www.diabeticstudies.org/index.php/RDS/article/view/427

Bertagnoli, S., Shastay, A., & Jew, R. K. (2025). What Does the Institute for Safe Medication Practices’ Survey Tell Us About the Impact of Shortages on Patient Safety?
The Cancer Journal
, 
31
(5), e0789.
https://journals.lww.com/journalppo/abstract/2025/09000/what_does_the_institute_for_safe_medication.12.aspx?context=latestarticles

Chalasani, S. H., Syed, J., Ramesh, M., Patil, V., & Kumar, T. P. (2023). Artificial intelligence in the field of pharmacy practice: A literature review. 
Exploratory research in clinical and social pharmacy
, 
12
, 100346.
https://www.sciencedirect.com/science/article/pii/S2667276623001270

Markowitz, S., & Smith, A. J. (2024). Nurse practitioner scope of practice and patient harm: Evidence from medical malpractice payouts and adverse action reports. 
Journal of Policy Analysis and Management
, 
43
(2), 420-445.
https://www.proquest.com/openview/3aed36787c569b5bdba81077b43a7ddc/1?pq-origsite=gscholar&cbl=18750&diss=y

Mert, S., & Kersu, Ö. (2025). Investigation of the Relationship Between Stress, Workload, Medical Error Tendency and Perceived Quality of Care in Surgical Nurses. 
Asia Pacific Journal of Health Management
, 
20
(3). 1-7.
https://journal.achsm.org.au/index.php/achsm/article/view/4641

Rochester-Eyeguokan, C. D., & Pincus, K. J. (2025). Current Recommendations for Insulin Therapy in the Hospitalized Patient. 
Critical Care Nursing Clinics
, 
37
(1), 117-131.
https://www.ccnursing.theclinics.com/article/S0899-5885(24)00039-X/abstract

van Stralen, S. A., van Eikenhorst, L., Vonk, A. S., Schutijser, B. C., & Wagner, C. (2024). Evaluating deviations and considerations in daily practice when double-checking high-risk medication administration: A qualitative study using the FRAM. 
Heliyon
, 
10
(4).
https://www.sciencedirect.com/science/article/pii/S2405844024016682
  High-Alert Medications Independent double checks

Nhs-fpx4000 developing a healthcare perspective assessment 1 – The Missing Needle Protector

Ethical Case Study Incident 9: The Missing Needle Protector

In their book on
Principlism
, Beauchamp and Childress proposed a method for guaranteeing that all clients and those under the care of others in care environments have their interests represented and cherished. They offered four bioethical principles, which have since been expanded to five with the inclusion of fidelity. Autonomy, nonmaleficence, beneficence, justice, and fidelity are the new bioethical concepts (Haswell, 2019; Melnyk & Fineout-Overholt, 2019). Autonomy refers to a client’s ability to participate in making choices that influence their management. Beneficence refers to the act of always doing what will benefit the patient. Nonmaleficence, often known as primum non nocere, refers to not causing wilful injury to the patient. Justice entails treating all patients equally and without active discrimination. Finally, fidelity sets out the ethical requirement that the healthcare staff be straightforward and honest. This paper is about an ethical situation in a clinical setting representing what would be seen as an ethical dilemma Nhs-fpx4000 developing a healthcare perspective assessment 1 – The Missing Needle Protector.

The Chosen Scenario and the Facts about the Case in the “Missing Needle Protector”

The ethical scenario chosen in this case is that referred to as “The Missing Needle Protector” (Capella University, n.d.). It is set in a hospital in which Mr E.L. Straight is the Director of Clinical Services. At the same hospital, there is a long serving surgeon by the name of Dr. Cutrite who does full scale operations but has lately been showing worrying signs of incompetence. This is by Mr Straight’s own admission. Despite his physical and mental incapacities lately, Dr Cutrite has been allowed to still perform sensitive major procedures. Mr Straight admits that the surgeon by virtue of having worked at Hopewell hospital “for longer than anyone can remember” was well connected and politically very influential in the organization. It is for this reason that he “didn’t relish crossing swords with Cutrite”.

Concerning the matter of the missing needle protector from a syringe used during a major operation, it would appear that Dr Cutrite left it in the abdomen of a patient that he closed without confirming first with the nurse carrying out instrument count as a “time-out” component. The patient’s name was Mrs. Jameson and she had undergone a major operation in her abdomen. The needle protector that was allegedly left in her abdomen by Dr Cutrite is said to be red-pink and the color of blood and therefore would be very difficult even to see on radiography. She had not yet complained about anything and had even been discharged to go home a few days earlier.

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It is the operating room supervisor that informed Mr Straight of the possible error that they had just discovered while going through instrument pack reconciliation. She told him that they had possibly left a needle protector belonging to a disposable syringe inside the belly of Mrs Jameson. When asked, the scrub nurse that was assisting Dr Cutrite during the procedure admitted to seeing the syringe but did not give much thought to the protective sheath when the final instrument count was done at the end of the procedure.

Three Components of the Ethical Decision Making Model

The above case will now be looked at through the ethical decision-making model comprising of the three steps of moral awareness, moral judgment, and ethical behavior or moral action (Lind & Wakenhut, 2016).

Moral Awareness

This stage has been described as the “I feel” stage and it is the stage in which one feels strongly that there is a moral issue in the situation. It is in this stage that one may start feeling disgusted about what has just happened (Lind & Wakenhut, 2016). Specifically, one asks themselves whether something is wrong, whether a moral principle has been violated, whether there are competing values at work, or whether the profession may lose respect and dignity from the actions of individuals.

At this first stage, one must also feel the proximity they can relate with to those that are affected by the situation and how this influences their moral awareness. Crucially, one must ask themselves if other colleagues in the profession would also detect a moral issue in the situation. Then they need to ask themselves if that will affect their moral awareness in any way. In the above case, it clear that it is the operating room supervisor that has the highest level of moral awareness of all. She discovers what had happened and approaches Mr Straight who is the Director of Clinical Services. Surprisingly, he asks that the patient (Mrs. Jameson be taken back to surgery and not told the exact reason why.

This breaches the bioethical principles of autonomy (informed consent), nonmaleficence and fidelity or honesty (Haswell, 2019; OHRP, 2018; Shah et al., 2021). This lack of ethical or moral awareness of Mr Straight is shared by Dr Cutrite who is the surgeon that left the needle protector in the abdomen of Mrs Jameson; and the Chief of Surgery who appears helpless and does nothing to protect the patient. Mr Straight fears Dr Cutrite and says that he “didn’t relish crossing swords with Cutrite”. Dr Cutrite on the other hand nonchalantly lies that the plastic needle protector was not going to hurt the patient but probably only give her “a little discomfort.”

Moral Judgment

The moral judgment stage is the second stage and is often referred to as the “I ask” stage. This is where one comes up with and assesses the potential choices and what possible outcomes could arise from them. At this stage, every possible solution must be critically assessed before any judgment is made (Lind & Wakenhut, 2016). Some of the questions here are whether the decision taken by the people in authority (Mr Straight, Dr Cutrite, and the Chief of Surgery) was just and fair. In the above case the answer would be negative since they took the matter lightly and even wanted to return the patient to surgery without revealing to her the true reason for that. The other question here would be whether the decision and behavior of those concerned reflect the organizational culture and principles of the hospital in question.

Hospitals operate under strict regulations and policies and therefore it would beat logic to assume that the hospital’s policies condone the kind of moral and ethical breaches that the above three were engaging in. Last but not least, one must ask whether the decision of the three above to not tell the patient the truth and possibly take her back to theatre without informed consent violates the Hippocratic Oath taken by Dr Cutrite. Indeed, it goes without question that it does. The best solution after critical assessment in the above case would have been to recall the patient to the hospital as soon as possible and explain t her truthfully what happened. a formal apology should be offered and the patient asked to give consent for the plastic needle protector to be removed. This “never event” should also be reported to the regulatory bodies such as the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and the National Committee for Quality Assurance or NCQA Nhs-fpx4000 developing a healthcare perspective assessment 1 – The Missing Needle Protector.

Ethical Behavior

This is the “I think I will” and “I act” stage and involves the professional (in this case the operating room supervisor) deciding on her intention to act. It is at this stage that she will decide on what to do and exactly how she would act (Lind & Wakenhut, 2016). This is keeping in mind that the patient had already been discharged and went home without knowing what happened. At this point, it is accepted also that deciding not to act may also be a valid decision. The operating room supervisor should thus think of what they should do and how they intend to act on their decision. Moral courage dictates that she should take the correct and ethical action and inform the patient of what happened. She can also alert the JCAHO and the NCQA privately to protect other patients in future.

Effectiveness of the Communication

Judging from the above engagement among the professionals involved in the above case, it is clear that effective communication is lacking at the above workplace. This is why the Chief of Surgery was not even aware of what had happened until the operating room supervisor approached them all including Dr Cutrite himself and the Director of Clinical Services Mr Straight. The staff communicated ineffectively all the time because they admitted to fearing to correct the long-serving but inept surgeon Dr Cutrite. Under the above circumstances, the organization’s laid down protocols and procedures for sentinel events should be followed to the letter. This was not done. Using effective communication helps in solving ethical dilemmas as per protocol. Not doing so leads to disorganization and harm to the patient as seen in this case.

The lessons the above case provides are that professionalism should be maintained at all times and that there should be no compromise when it comes to morality and ethics in healthcare. In the above case, the staff responsible for the patient’s safety compromised their obligations by fearing to confront Dr Cutrite just because he was “politically very powerful”. The proposed solution will foster professional collaboration in that the institutions concerned will take action against Dr Cutrite and may even revoke his licensure. This will serve as an example and make the others collaborate more effectively as professionals for the benefit of the patients.

Conclusion

The bioethical principles of autonomy, beneficence, nonmaleficence, justice, and fidelity are there to help safeguard the safety and ethical treatment of patients. In the above case, it can be seen how healthcare professionals may violate these and put the patient’s health and life at risk. When faced with such ethical dilemmas, the ethical decision making model comprising of the three steps of moral awareness, moral judgment, and ethical behavior come in handy Nhs-fpx4000 developing a healthcare perspective assessment 1 – The Missing Needle Protector.

References

Capella University (n.d.).
Incident 9: The missing needle protector
.
https://www.capella.edu/

Haswell, N. (2019). The four ethical principles and their application in aesthetic practice.
Journal of Aesthetic Nursing, 8
(4), 177-179.
https://doi.org/10.12968/joan.2019.8.4.177

Lind, G., & Wakenhut, R. (2016). Testing for moral judgment competence. In Lind, G., Hartmann, H.A., & Wakenhut, R. (Eds).
Moral judgments and social education
(pp. 9-12). Routledge.

Melnyk, B.M., & Fineout-Overholt, E. (2019).
Evidence-based practice in nursing & healthcare: A guide to best practice, 4
th
ed
. Wolters Kluwer.

Office for Human Research Protections [OHRP] (January 15, 2018).
The Belmont Report: Ethical principles and guidelines for the protection of human subjects of research
.
https://www.hhs.gov/ohrp/regulations-and-policy/belmont-report/read-the-belmont-report/index.html

Shah, P., Thornton, I., Turrin, D., & Hipskind, J.E. (June 14, 2021). Informed consent.
StatPearls
.
https://www.ncbi.nlm.nih.gov/books/NBK430827/#:~:text=Valid%20informed%20consent%20for%20research,study%20and%20its%20potential%20risks
  Nhs-fpx4000 developing a healthcare perspective assessment 1 – The Missing Needle Protector

NHS-FPX4000 Developing a Health Care Perspective Assessment 2 Instructions: Applying Research Skills – Annotated Bibliography

NR520 APPLIED THEORETICAL FOUNDATIONS, SCIENTIFIC INQUIRY, AND DECISION-MAKING Module 3 Assessment: Project Area of Interest Form Professional Practice Issue

Module 3 Assessment: Project Area of Interest Form Professional Practice Issue

 

Consider your practicum work setting and environment. Complete the following:  

(1)

What issues or problems are you working on or want to work on for your MSN evidence-based practice quality improvement project?
How would the Johns Hopkins model be used to support this project process?
(This is brainstorming.)

Answer

 

 

 

(2)

Thinking about these issues or problems, what internal organization data is currently available, tracked, or reviewed? (What is it that indicated to you that this was an issue or problem? Do not drill down to the details; keep it broad. Do you see patterns developing? Such as between 2-4 am most patients between the ages of 65-85 fall.)

Answer

 

 

(3)

Based on the data that is available, what is done with it? (Are process improvement plans generated? Are there groups of people that work on this? Such as a Root Cause Analysis group? Clinical nurse specialists?  Nurse managers?)

Answer

 

 

(4)

When this issue or problem is improved / positive change occurs, how will you know you have been successful? (What measures? Can be patient-centered, financial, clinical-based?)

Answer

 

 

(5)

Identify why this issue or problem is important to nursing and healthcare. (You should include at least 2 scholarly sources here which include 1 quantitative and 1 qualitative design)

Answer

 

 

(6)

What are the real or potential barriers to you implementing your intervention to the problem? (Identify at least (4) potential barriers.)

Answer

 

 

(7)

Who (inside and outside) can you connect with to refine & develop this work?

Answer

 

 

 

(8)

State your PICO(T) Elements

Answer

P
– (Patient, population, or problem)

I
– (Intervention)

C
– (Comparison with other interventions, if foreground question)

O
– (Outcomes are qualitative or quantitative measures to determine the success of change)

T-
(Time frame)

NR520 APPLIED THEORETICAL FOUNDATIONS, SCIENTIFIC INQUIRY, AND DECISION-MAKING Module 3 Assessment:
Project Area of Interest Form Professional Practice Issue

(9)

From you PICOT elements, state your clinical practice or EBP question.

Answers

 

P
– (Patient, population, or problem)

I
– (Intervention)

C
– (Comparison with other interventions, if foreground question)

O
– (Outcomes are qualitative or quantitative measures to determine the success of change)

T-
(Time frame)

 

(10)

Quantitative Research

 

Reflect upon the nursing professional practice issue of interest that you identified. In addition, consider the intervention that you proposed to improve the issue. Be sure to reference and cite the quantitative scholarly source you identified in item 5 from above. Include the full reference for article (APA Format) and hyperlink to article.

 

With both the issue and the intervention in mind, respond to the following:

 

·        What type of evidence produced through quantitative research would be helpful to better understand the selected practice issue?

·        How might quantitative research findings shape your efforts to improve the issue?

·        Describe an example (real or hypothetical) of a quantitative research design that would provide valuable evidence regarding this issue (may refer to source above related to question 5).

Answers

 

 

 

(11)

Qualitative Research

 

Reflect upon the nursing professional practice issue of interest that you identified. In addition, consider the intervention that you proposed to improve the issue. Be sure to reference and cite the qualitative scholarly source you identified in item 5 from above. Include the full reference for article (APA Format) and hyperlink to article.

 

With both the issue and the proposed practice change in mind, respond to the following:

 

·        What type of evidence produced through qualitative research would be helpful to better understand the selected practice issue?

·        How might qualitative research findings shape your efforts to improve the issue?

·        Describe an example (real or hypothetical) of a qualitative research design that would provide valuable evidence regarding this issue (may refer to source above related to question 5).

Answers

 

 

NR520 APPLIED THEORETICAL FOUNDATIONS, SCIENTIFIC INQUIRY, AND DECISION-MAKING Module 3 Assessment: Project Area of Interest Form Professional Practice Issue

NR520 Module 3 Assessment: Project Area of Interest Form Professional Practice Issue

NR520 Applied Theoretical Foundations, Scientific Inquiry, and Decision-Making

Module 3 Assessment: Project Area of Interest Form Professional Practice Issue

There are two parts to this assessment. In the first (Part I), students will consider a professional practice issue or problem, and develop a clinical/practice question to guide an evidence-based practice process improvement project. Second (Part II), students will select a qualitative and quantitative article related to the professional practice issue. Students will answer the questions related to quantitative and qualitative research within the Professional Practice Issue form. Consider different professional practice issues related to future professional practice in the master’s-

prepared advanced practice role. Think about your practicum project and where this will take place. What issues or problems, have you identified in the practicum practice setting? (Other suggested issues or problems might include unit nurse staffing, supply access, patient falls, or staff to patient/family communication.) How might you resolve the issues or problems with an evidence-based practice quality improvement project?

1. Complete the Project Professional Practice Issue form.

2. Choose one quantitative and one qualitative scholarly source which will help you identify why this issue or problem is important to nursing and healthcare. Answer the questions related to

quantitative and qualitative research within the Professional Practice Issue form.

NR520 Module 3 Assessment: Project Area of Interest Form Professional Practice Issue

Consider your practicum work setting and environment. Complete the following:  

(1)

What issues or problems are you working on or want to work on for your MSN evidence-based practice quality improvement project?
How would the Johns Hopkins model be used to support this project process?
(This is brainstorming.)

Answer

The professional practice issue in my practicum setting is patient falls among adults older than 65 years on a medical-surgical unit. Falls increase injuries, length of stay, and healthcare costs. For my MSN evidence-based practice quality improvement project, I plan to implement structured hourly rounding and improved patient fall education. The Johns Hopkins Nursing Evidence-Based Practice Model will guide this project using the PET process. First, I will define the practice question about fall prevention. Second, I will review current research evidence. Third, I will translate the evidence into practice by implementing the intervention and evaluating results.

 

GET WRITING HELP HERE

(2)

Thinking about these issues or problems, what internal organization data is currently available, tracked, or reviewed? (What is it that indicated to you that this was an issue or problem? Do not drill down to the details; keep it broad. Do you see patterns developing? Such as between 2-4 am most patients between the ages of 65-85 fall.)

Answer

The organization tracks fall rates per 1,000 patient days, falls with injury, patient age, time of fall, and unit location. Incident reports show that most falls happen at night and involve older adults trying to go to the bathroom without help. There is also data on staffing levels and call light response times. The pattern shows that lower staffing and delayed response times may increase fall risk.

 

(3)

Based on the data that is available, what is done with it? (Are process improvement plans generated? Are there groups of people that work on this? Such as a Root Cause Analysis group? Clinical nurse specialists?  Nurse managers?)

Answer

The Quality Improvement Committee and nurse managers review fall data monthly. Root Cause Analysis is completed for serious falls. Education sessions are sometimes provided, and reminders are posted. However, fall rates remain a concern, and current strategies are not always consistent.

 

(4)

When this issue or problem is improved / positive change occurs, how will you know you have been successful? (What measures? Can be patient-centered, financial, clinical-based?)

Answer

Success will be measured by a reduction in total fall rates and falls with injury within six months. Data will be compared before and after the intervention. Other measures include improved staff compliance with hourly rounding and improved patient satisfaction scores related to safety.

 

(5)

Identify why this issue or problem is important to nursing and healthcare. (You should include at least 2 scholarly sources here which include 1 quantitative and 1 qualitative design)

Answer

Patient falls are important to nursing and healthcare because they affect patient safety and quality of care. A recent quantitative study by Morris et al. (2024) examined a hospital fall prevention education program and measured falls per 1,000 bed days. The study showed that structured education programs can reduce falls in acute care hospitals. A qualitative study by McLennan et al. (2024) explored views of nurses, patients, and families about fall prevention. The study found that teamwork, communication, and leadership support are key factors in successful fall prevention programs. Together, these studies show that both measurable outcomes and staff experiences are important in improving safety.

 

(6)

What are the real or potential barriers to you implementing your intervention to the problem? (Identify at least (4) potential barriers.)

Answer

Potential barriers include staff resistance to change, limited staffing, time constraints, and inconsistent documentation. Other barriers may include poor communication between shifts and lack of leadership support.

NR520 Applied Theoretical Foundations, Scientific Inquiry, and Decision-Making

(7)

Who (inside and outside) can you connect with to refine & develop this work? NR520 Module 3 Assessment: Project Area of Interest Form Professional Practice Issue

Answer

I can collaborate with nurse managers, bedside nurses, clinical nurse specialists, and the quality improvement team.

I can consult faculty mentors and patient safety experts outside the organization.

 

(8)

State your PICO(T) Elements

Answer

P
– Hospitalized adults over 65 years on a medical-surgical unit

I –
Structured hourly rounding and enhanced fall education

C –
Usual care without structured rounding

O –
Reduced fall rates and fall-related injuries

T –
Six months

 

(9)

From you PICOT elements, state your clinical practice or EBP question.

Answers

 

In hospitalized adults over 65 years on a medical-surgical unit (P), how does structured hourly rounding and enhanced fall education (I), compared to usual care (C), affect fall rates and fall-related injuries (O) over six months (T)?

 

 

(10)

Quantitative Research

 

Reflect upon the nursing professional practice issue of interest that you identified. In addition, consider the intervention that you proposed to improve the issue. Be sure to reference and cite the quantitative scholarly source you identified in item 5 from above. Include the full reference for article (APA Format) and hyperlink to article.

 

With both the issue and the intervention in mind, respond to the following:

 

·        What type of evidence produced through quantitative research would be helpful to better understand the selected practice issue?

·        How might quantitative research findings shape your efforts to improve the issue?

·        Describe an example (real or hypothetical) of a quantitative research design that would provide valuable evidence regarding this issue (may refer to source above related to question 5).

Answers

 

 Quantitative research provides numerical data such as fall rates and injury rates. This type of evidence helps determine if the intervention works. The study by Morris et al. (2024) used measurable outcomes to compare fall rates before and after an intervention. These findings support the use of structured education and rounding to reduce falls. A randomized controlled trial or quasi-experimental design would provide strong evidence by comparing two groups and measuring statistical differences. NR520 Module 3 Assessment: Project Area of Interest Form Professional Practice Issue

Reference:

Morris, M. E., Thwaites, C., Lui, R., McPhail, S. M., Haines, T., Kiegaldie, D., Heng, H., Shaw, L., Hammond, S., McKercher, J. P., Knight, M., Carey, L. M., Gray, R., Shorr, R., & Hill, A. (2024). Preventing hospital falls: Feasibility of care workforce redesign to optimise patient falls education. 
Age and Ageing
, 
53
(1). 
https://doi.org/10.1093/ageing/afad250

 

(11)

Qualitative Research

 

Reflect upon the nursing professional practice issue of interest that you identified. In addition, consider the intervention that you proposed to improve the issue. Be sure to reference and cite the qualitative scholarly source you identified in item 5 from above. Include the full reference for article (APA Format) and hyperlink to article.

 

With both the issue and the proposed practice change in mind, respond to the following:

 

·        What type of evidence produced through qualitative research would be helpful to better understand the selected practice issue?

·        How might qualitative research findings shape your efforts to improve the issue?

·        Describe an example (real or hypothetical) of a qualitative research design that would provide valuable evidence regarding this issue (may refer to source above related to question 5).

Answers

 

Qualitative research provides information about experiences and perceptions. The study by McLennan et al. (2024) used interviews to explore barriers and facilitators of fall prevention. This type of evidence helps understand staff attitudes and patient concerns. A phenomenological or interview-based study would help identify challenges in workflow and communication. These insights can guide better implementation of the fall prevention program and improve long-term success.

Reference:

McLennan, C., Sherrington, C., Tilden, W., Jennings, M., Richards, B., Hill, A. M., … & Haynes, A. (2024). Considerations across multiple stakeholder groups when implementing fall prevention programs in the acute hospital setting: a qualitative study. 
Age and Ageing
, 
53
(10), afae208.
https://doi.org/10.1093/ageing/afae208

NR520 Module 3 Assessment: Project Area of Interest Form Professional Practice Issue

KTIP lesson plan

Please create a KTIP lesson plan in PE on the game Ultimate Frisbee for a seventh grade PE class

Lesson Plan Rubric

ARTIFACT

Exemplary

4

Accomplished

3

Developing

2

 Ineffective

1

SCORE

Lesson Plans (4)

 

CAEP:
1.1, 1.3, 1.4, 1.5

InTASC:
1,2,4, 5, 7, 8

 

 

 

 

Includes a comprehensive plan with:

§  learning targets clearly aligned to Kentucky Academic Standards

§  lesson procedures clearly defined

§  a variety of appropriate  instructional strategies

§  multiple examples of differentiation within the lesson

§  effective formative and summative assessments

Includes an adequate plan with:

 

§  learning targets aligned to Kentucky Academic Standards

§  lesson procedures defined

§  appropriate instructional strategies

§  sufficient evidence of differentiation within the lesson

§  effective formative or summative assessments

 

Includes a limited plan with:

 

§  learning targets

§  lesson procedures somewhat defined

§  instructional strategies

§  some evidence of differentiation within the lesson

§  formative and / or summative assessments KTIP lesson plan

Includes a plan with:

 

§  unrelated learning targets

§  partial / incomplete lesson procedures

§  ineffective instructional strategies

§  ineffective differentiation within the lesson

§  ineffective formative and / or summative assessments

 

 

KTIP lesson plan

Source of Evidence:  Lesson

Plan

 

 

Name:

Date of Observation:

Cycle:
Spring 26

Grades/Ages of Students:
7th Grade / Ages 12-14

Number of Students:
12

Number of Students with IEP/504:

Number of Gifted Students
: 0

Number of Students with LEP
: 0

Lesson Title:
Introduction to Ultimate Frisbee: Passing, Movement, and Team Play

 

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1. Context: Description of Students (IB)

This is a seventh-grade physical education class with 12 students who have different levels of athletic skills and experience with team sports. There are two students with IEPs for attention deficit and motor coordination. These two students require clear instructions, visual modeling, and more practice. The students are very engaged with cooperative learning and games. The students respond well to routines and positive reinforcement. The students require small group instruction, feedback, and physical learning. All the students are English fluent. There are no gifted or LEP students.

2.  
Lesson Learning Targets/Objectives
(lA) (lC)

Learning Targets:

• Students will demonstrate correct forehand and backhand Frisbee passing techniques.

• Students will apply basic Ultimate Frisbee rules where no running with the disc, self-officiating and inclusion of fair play during modified gameplay.

•Students will work cooperatively with teammates to maintain possession and score points.

Connection to Standards:

• SHAPE America Standard 1: Demonstrates competency in motor skills and movement patterns.

• SHAPE America Standard 4: Exhibits responsible personal and social behavior that respects self and others.

3. Students’ Baseline Knowledge
and Skills (lB) (lF)

The students’ knowledge was determined by observing the students and asking them questions during the warm-up activities at the beginning of the unit. Half of the students had some knowledge of throwing a Frisbee, however, the students were having difficulties with gripping and throwing the Frisbee. The students were not familiar with the rules of Ultimate Frisbee, such as not running with the disc; this is a big part of the game. (Appendix A) KTIP lesson plan.

4. 
Formative Assessment (lF)

Formative Assessment Methods:

·        Teacher observation during partner passing drills to assess grip, stance, and accuracy

·        Questioning during instruction to check understanding of rules and strategies

·        Observation of student engagement, teamwork, and rule adherence during small-sided games

Use of Data:

·        Immediate feedback and corrective cues provided during drills

·        Students demonstrating proficiency are encouraged to model skills

·        Students needing support receive additional practice and simplified tasks (Appendix B)

 

5.  Resources (lD)

 

6-8 Ultimate Frisbees.

Cones to mark boundaries and end zones.

Whistle.

Visual cue cards showing throwing techniques.

Outdoor field or gym space.

6.Lesson Procedures (lE)

Opening / Warm-Up (5 minutes)

·        Light jog and dynamic stretching

·        Review of safety expectations and lesson objectives

Activity #1: Frisbee Passing Skills (10 minutes)

·        Teacher models forehand and backhand throws

·        Students practice passing with partners at short distances

Differentiation:

·       
Extension:
Increase distance or add moving targets

·       
Remediation:
Shorter distance, slower pace, additional modeling

Assessment:

·        Teacher observation using a skills checklist

Activity #2: Movement and Catching Drill (10 minutes)

·        Students practice cutting and changing direction and catching while stationary throwers pass

·        Emphasis on communication and spacing

Differentiation:

·       
Extension:
Add defenders

·       
Remediation:
Walk-through pace with fewer players

Assessment:

·        Observation of movement patterns and teamwork

Activity #3: Modified Ultimate Frisbee Game (10 minutes)

·        4v4 or 5v5 small-sided games

·        Focus on passing, teamwork, and rule application

Differentiation:

·       
Extension:
Limit number of passes before scoring

·       
Remediation:
Allow additional time or modified rules

Assessment:

·        Teacher notes on skill application, cooperation, and rule adherence.

 

 

Closing of the Lesson

Cool-down stretches

Group discussion:

“What skill helped your team the most today?”

“How did teamwork affect your success?”

Preview of next lesson: offensive and defensive strategies

KTIP lesson plan

 

 

 

 

 

 

Appendices

Appendix A: Pre-Assessment Data Summary Table

Skill/Knowledge Area Assessed

Assessment Method

Number of Students Demonstrating Proficiency (out of 12)

Percentage

What the Data Indicates

Basic Frisbee Throwing (grip & release)

Teacher observation during warm-up toss

6

50%

Half of the class can throw with basic accuracy;

Others need explicit modeling and practice.

Catching Skills

Observation during partner toss

7

58%

Most students can catch stationary throws but struggle with movement and timing.

Knowledge of Ultimate Frisbee Rules

Oral questioning

4

33%

Majority of students are unfamiliar with rules such as no running with the disc and self-officiating KTIP lesson plan.

Teamwork and Communication

Observation during small-group activity

8

67%

Students are generally cooperative but need guidance on strategic movement and spacing.

Overall Readiness for Gameplay

Teacher judgment based on all indicators

5

42%

Class requires skill instruction and modified games before full gameplay.

 

 

 

Appendix B: Ultimate Frisbee Performance Rubric

Student Name: ________________________ Date: ____________ Class: ____________

Lesson Focus:
Passing, movement, teamwork, and rule application in Ultimate Frisbee

Performance Levels

4 – Exceeds Expectations

3 – Meets Expectations

2 – Approaching Expectations

1 – Needs Improvement

Criteria

4- Exceeds Expectations

3 – Meets Expectations

2 – Approaching Expectations

1-Needs Improvement

Throwing Skills (Forehand/Backhand)

Consistently throws with correct grip, form, and accuracy to moving teammates

Usually throws with correct form and accuracy

-Inconsistent form or accuracy;

– Needs reminders

Unable to demonstrate correct throwing technique

Catching Skills

Consistently catches passes while moving and under light pressure

Catches most passes when stationary or lightly moving

Catches some passes but struggles with timing

Rarely catches passes

Movement & Positioning

Moves effectively to create space; demonstrates strong cutting and awareness

Moves appropriately to support teammates

Limited movement; often stands still

Does not move to support play

Knowledge & Application of Rules

Consistently follows all rules and self-officiates respectfully

Follows most rules with minimal reminders

Needs frequent reminders about rules

Does not follow rules

Teamwork & Sportsmanship

Demonstrates excellent cooperation, communication, and fair play

Works well with teammates and shows respect

Limited communication or cooperation

Poor teamwork or unsportsmanlike behavior

Effort & Participation

Fully engaged and gives best effort throughout lesson

Participates actively most of the time

Inconsistent effort or engagement

Minimal participation

Throwing Skills (Forehand/Backhand)

Consistently throws with correct grip, form, and accuracy to moving teammates

Usually throws with correct form and accuracy KTIP lesson plan

Inconsistent form or accuracy; needs reminders

Unable to demonstrate correct throwing technique

 

Scoring Guide

21-24 points:
Advanced

15-20 points:
Proficient

9-14 points:
Developing

6-8 points:
Beginning

KTIP lesson plan

Confidentiality vs. Duty to Warn Scenario Essay

Discussion: Confidentiality vs. Duty to Warn

Balancing Confidentiality and the Duty to Warn

The aspect of confidentiality is a foundation of psychiatric-mental health nursing and is important in creating therapeutic trust. However, this duty is not absolute in some specific circumstances (Ismayilova, 2024). In the case under consideration, a patient poses a realistic risk of inflicting harm on a specific colleague upon discharge and demands confidentiality. The nurse in this case will need to balance confidentiality with ethical and legal duty to avoid preventable harm to others. In a scenario where there is a clear and recognizable danger to an individual, then confidentiality would put other individuals at a significant risk and would be morally unjustifiable.

Ethical Principles Guiding the Decision

A number of ethical principles guide the response of the nurse. In the instances of plausible threat, strict confidentiality is secondary to nonmaleficence (the obligation to do no harm) and beneficence (the obligation to promote safety and well-being). Justice would assist in protecting the potential victims against unnecessary harm, and fidelity would require the nurse to be honest with the patient about the limits of confidentiality. Ethical behavior of nurses, as defined in the American Nurses Association (ANA) Code of Ethics, presupposes that the nurse in question should act accordingly in case a patient endangers other individuals in a significant way, whether this means breaking the principle of confidentiality or not (American Nurses Association [ANA], 2025).

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Legal Considerations and Duty to Warn

Legally, this scenario is guided by the Tarasoff v. Regents of the University of California ruling, which established the clinician’s duty to warn or protect identifiable victims when a patient makes a credible threat (Gorshkalova & Munakomi, 2025). Most of the states in the United States support this duty through statutes or case laws. In addition, the Health Insurance Portability and Accountability Act (HIPAA) permits the release of the protected health data to prevent or reduce a critical and imminent risk to wellbeing or security (Edemekong et al., 2024). The nurse should report the threat and direct the treatment team to ensure the protection measures required, such as informing supervisors, the police, or the potential victims, are established Confidentiality vs. Duty to Warn Scenario Essay.

Application to Psychiatric Nursing Practice

In practice, the nurse must initially determine the urgency and reliability of the threat, note down the disclosure in an objective manner, and educate the patient about the lawful boundaries of confidentiality. It is important to collaborate with interdisciplinary team members to make ethical decisions, ensure patient safety, and adhere to the law Confidentiality vs. Duty to Warn Scenario Essay. This is a viable alternative to maintain professionalism and ensure the safety of the patient and the community .

References

American Nurses Association (ANA). (2025). Code of ethics for nurses.
American Nurses Association
.
https://codeofethics.ana.org/home

Edemekong, P., Haydel, M., & Annamaraju, P. (2024).
Health Insurance Portability and Accountability Act (HIPAA)
. National Library of Medicine.
https://www.ncbi.nlm.nih.gov/books/NBK500019/

Gorshkalova, O., & Munakomi, S. (2025, February 15).
Duty to warn
. PubMed; StatPearls Publishing.
https://www.ncbi.nlm.nih.gov/books/NBK542236/

Ismayilova, P. F. (2024). Key characteristics of autonomy, confidentiality, beneficence, non-maleficence, justice, and privacy principles in medical law within the context of human rights.
Analytical and Comparative Jurisprudence
,
3
(3), 663–674.
https://doi.org/10.24144/2788-6018.2024.03.112 
 Confidentiality vs. Duty to Warn Scenario Essay

Concept Map: The 3 P’s and Mental Health Care – Mind Map Concept: Post-Traumatic Stress Disorder (PTSD)

 

References

Forkus, S. R., Raudales, A. M., Rafiuddin, H. S., Weiss, N. H., Messman, B. A., & Contractor, A. A. (2022). The posttraumatic stress disorder (PTSD) checklist for DSM–5: A systematic review of existing psychometric evidence.
Clinical Psychology: Science and Practice
,
30
(1), 110–121.
https://doi.org/10.1037/cps0000111

Hoskins, M. D., Bridges, J., Sinnerton, R., Nakamura, A., Underwood, J. F. G., Slater, A., Lee, M. R. D., Clarke, L., Lewis, C., Roberts, N. P., & Bisson, J. I. (2021). Pharmacological therapy for post-traumatic stress disorder: A systematic review and meta-analysis of monotherapy, augmentation and head-to-head approaches.
European Journal of Psychotraumatology
,
12
(1), 1802920.
https://doi.org/10.1080/20008198.2020.1802920

Jones, K., Boschen, M., Devilly, G., Vogler, J., Flowers, H., Winkleman, C., & Wullschleger, M. (2024). Risk and protective factors that predict posttraumatic stress disorder after traumatic injury: A systematic review.
Health Sciences Review
,
10
, 100147.
https://doi.org/10.1016/j.hsr.2023.100147

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/

 

Concept Map: The 3 P’s and Mental Health Care – Mind Map Concept: Post-Traumatic Stress Disorder (PTSD)

Pathophysiology and Etiology

Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis

Increased sympathetic nervous system activity

Altered neurotransmitters (↓ serotonin, ↑ norepinephrine, altered dopamine)

Hyperactivity of the amygdala with reduced prefrontal cortex inhibition (Mann et al., 2024)

Impaired hippocampal function affecting memory processing and fear extinction.

Concept Map: The 3 P’s and Mental Health Care – Mind Map Concept: Post-Traumatic Stress Disorder (PTSD)

Pharmacology

SSRIs
(e.g., citalopram, sertraline, paroxetine): first-line for mood, anxiety, and intrusive symptoms

SNRIs
(e.g., venlafaxine): alternative first-line agents

Prazosin
: alpha-1 blocker used off-label to reduce nightmares and sleep disturbances

Adjuncts (if needed)
: mood stabilizers or atypical antipsychotics for severe symptoms

Avoid benzodiazepines
due to dependency risk and limited PTSD benefit (Hoskins et al., 2021)

Physical Assessment Signs and Symptoms

Recurrent nightmares and intrusive flashbacks

Sleep disturbance and insomnia

Hypervigilance and exaggerated startle response

Anxiety, irritability, restlessness

Avoidance of trauma-related stimuli

Emotional numbness or guilt

Difficulty concentrating (Mann et al., 2024).

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Risk Factors

Exposure to severe or repeated trauma (combat, war journalism, violence)

Chronic occupational trauma exposure

Personal history of depression or anxiety

Family history of anxiety disorders

Poor coping mechanisms, or limited social support.

Diagnostic Procedures

Clinical assessment using DSM-5-TR criteria, PTSD screening tools (e.g., PCL-5, CAPS-5), Suicide risk assessment (Forkus et al., 2022)

CBC and CMP to rule out medical contributors and establish medication baselines

Blood pressure monitoring (especially with prazosin and antihypertensives)

Complications

Major depressive disorder, Suicidal ideation or behavior

Substance use disorders, Chronic insomnia

Impaired occupational and interpersonal functioning

Cardiovascular complications related to chronic stress

Nursing Diagnoses

Disturbed Sleep Pattern related to recurrent nightmares and hyperarousal as evidenced by difficulty falling and staying asleep and reports of frequent trauma-related nightmares.

Anxiety related to traumatic experiences and dysregulation of stress response as evidenced by hypervigilance, restlessness, intrusive thoughts, and reported fear when exposed to triggers.

Ineffective Coping related to persistent trauma exposure and maladaptive stress responses as evidenced by avoidance behaviors, social withdrawal, and difficulty managing emotional responses Concept Map: The 3 P’s and Mental Health Care – Mind Map Concept: Post-Traumatic Stress Disorder (PTSD).

Risk for Self-Directed Violence related to history of trauma, depression, and escalating PTSD symptoms as evidenced by sleep disturbance, guilt, and emotional distress.

Impaired Social Interaction related to emotional numbing and avoidance of reminders as evidenced by isolation, decreased participation in activities, and preference to be alone.

Chronic Low Self-Esteem related to trauma-related guilt and negative self-perception as evidenced by self-blame and feelings of responsibility for traumatic events.

Nursing Interventions

Establish a therapeutic, trauma-informed relationship

Assess sleep patterns, anxiety levels, and suicide risk regularly

Administer and monitor medications (SSRIs, prazosin) and observe for side effects

Educate on PTSD, medication adherence, and orthostatic precautions

Teach relaxation and grounding techniques

Encourage engagement in psychotherapy (CPT, PE, EMDR)

Promote sleep hygiene and stress-reduction strategies

Coordinate interdisciplinary mental health care

 

Concept Map: The 3 P’s and Mental Health Care – Mind Map Concept: Post-Traumatic Stress Disorder (PTSD)

Create a concept map of a mental health diagnosis using one of the mental health scenario case studies presented in this section of the course.

Introduction

Concept maps are useful tools to help care providers and patients visualize the big picture of a condition. By being able to present a snapshot of symptoms, impacts, treatments, as well as contributing and risk factors, concept maps can improve communication, treatment planning, and health outcomes. Understanding how to create accurate, well-organized, and easy to understand concept maps will help you improve your efficacy as a healthcare practitioner and the outcomes of the patients you work with.

Instructions

Before beginning this assessment, make sure that you have completed the three Sentinel U case study activities included in the assessment. These will form the basis of your assessment.

For this assessment you will select one of the mental health Sentinel U case study activities and create a concept map that outlines the pathophysiology, pharmacology, and physical assessment of the mental health diagnosis from your chosen case study.

The key components of a mental health diagnosis concept map include the pathophysiology, pharmacology, and physical assessment of the diagnosis. The concept map should outline the key concepts related to the diagnosis, including risk factors, signs and symptoms, diagnostic procedures, medications, complications, nursing diagnoses, and nursing interventions. The map should be organized using a nursing concept map template, such as spider maps, hierarchical maps, or flow charts, to organize the information. The concept map should be accurate, complete, well-organized, and use appropriate nursing concepts and terminology.

To complete your concept map, you may wish to follow these steps:

Select one of the mental health Sentinel U scenarios:

Ivy Jackson, 61 YO, Female, African American.

Marco Mancini, 43 YO, Male, Mediterranean.

Wesley Blanco, 13 YO, Non-Binary, Filipino, White.

Research the pathophysiology, pharmacology, and physical assessment of the chosen mental health diagnosis within the Sentinel-U case study.

Complete the case study simulation and download the simulation report showing the patient you selected and showing 100% complete.

Create a concept map that outlines the key concepts related to the chosen diagnosis, including risk factors, signs and symptoms, diagnostic procedures, medications, complications, nursing diagnoses, and nursing interventions.

You may wish to use the 
Concept Map Template [DOCX]
, but are also free to create your own.

Organize content with clear purpose/goals and with relevant and evidence-based sources (published within 5 years).

Your assessment submission will be assessed on the following criteria.

Diagnosis:
Describe a mental health diagnosis. The diagnosis should be accurate and supported by relevant and evidence-based sources.

Make sure that the diagnosis is accurate and includes specific symptoms or criteria that support the diagnosis.

Ensure you have downloaded the completed Sentinel-U simulation report showing the patient you selected.

Concept Map:
Create a concept map that outlines the key concepts related to the chosen diagnosis, including risk factors, signs and symptoms, diagnostic procedures, medications, complications, nursing diagnoses, and nursing interventions.

Make sure that your use of evidence to support the concept map is explicit and relevant, and that the relationships between the concepts are clearly defined.

Organization:
The concept map should be well-organized and easy to follow. The content should be presented in a logical and clear manner, with a clear purpose and goals.

Also, you should make sure that your map is visually appealing and easy to read, incorporating appropriate use of colors, shapes, and symbols.

Professional Communication:
The concept map should demonstrate professionalism and effective communication. The map should be free of errors and typos and should use appropriate terminology and language. The map should effectively communicate the key concepts related to the diagnosis to a professional audience.

APA format and style:
The reference list should be formatted in APA style. All sources used should be relevant to the topic and evidence-based, published within the last 5 years.

Additional Requirements

Concept Map:
1-page concept map that clearly organizes the 3Ps related to a mental health diagnosis, risk factors, diagnostics, complications, nursing diagnosis, and nursing interventions.

SIM Report: 
Ensure you download the completed SIM report showing the patient selected.

Reference List: 
Create an APA style reference list for all sources that you used to help build and support the information in your concept map. Include this in the same document as your concept map, but on its own page.

APA Style: 
Use current APA style for all in-text citations and any current APA-approved font.

Competencies Measured

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

Competency 2: Create evidence based interventions to address the health needs, risks, and resources of individuals from diverse backgrounds and cultures.

Describe a mental health diagnosis that is supported by relevant and evidence-based sources.

Create a concept map that outlines the key concepts related to the chosen diagnosis, including risk factors, signs and symptoms, diagnostic procedures, medications, complications, nursing diagnoses, and nursing interventions.

The concept map is well-organized and easy to follow, with a clear purpose and goals.

Competency 4: Perform comprehensive and focused physical assessments using appropriate techniques and tools.

Upload the Sentinel-U case study showing the Simulation name OR showing 100% complete.

Competency 5: Apply scholarly writing standards to communicate evidence based strategies that support safe and effective patient care.

The concept map should demonstrate professionalism and effective communication, use appropriate terminology and language. The map should effectively communicate the key concepts related to the diagnosis.

The reference list is formatted in APA style. All sources used should be relevant to the topic, evidence-based, and published within the last 5 years.

Concept Map: The 3 P’s and Mental Health Care – Mind Map Concept: Post-Traumatic Stress Disorder (PTSD)

Scoring Guide

Use the scoring guide to understand how your assessment will be evaluated.

 

Criterion 1

Describe a mental health diagnosis that is supported by relevant and evidence-based sources.

Distinguished

Describes a mental health diagnosis that is supported by relevant and evidence-based sources. The diagnosis is accurate and includes specific symptoms or criteria that support the diagnosis.

 

Criterion 2

Create a concept map that outlines the key concepts related to the chosen diagnosis, including risk factors, signs and symptoms, diagnostic procedures, medications, complications, nursing diagnoses, and nursing interventions.

Distinguished

Creates a concept map that outlines the key concepts related to the chosen diagnosis, including risk factors, signs and symptoms, diagnostic procedures, medications, complications, nursing diagnoses, and nursing interventions. The use of evidence to support the concept map is explicit and relevant. The relationships between the concepts are clearly defined.

 

Criterion 3

Upload the Sentinel-U case study showing the Simulation name OR showing 100% complete.

Distinguished

Uploads the Sentinel-U case study showing the Simulation name AND showing 100% complete.

 

Criterion 4

The concept map is well-organized and easy to follow, with a clear purpose and goals.

Distinguished

The concept map is well-organized and easy to follow, with a clear purpose and goals. It is visually appealing and easy to read, incorporating appropriate use of colors, shapes, and symbols.

 

 

 

Criterion 5

The concept map should demonstrate professionalism and effective communication, use appropriate terminology and language. The map should effectively communicate the key concepts related to the diagnosis.

Distinguished

The concept map showcases excellent professionalism and effective communication, is free of errors and typos, utilizes appropriate terminology and language, and effectively communicates the key concepts related to the diagnosis Concept Map: The 3 P’s and Mental Health Care – Mind Map Concept: Post-Traumatic Stress Disorder (PTSD).

 

Criterion 6

The reference list is formatted in APA style. All sources used should be relevant to the topic, evidence-based, and published within the last 5 years.

Distinguished

The reference list is in APA format, exceptionally well-organized and provides comprehensive evidence-based support for the topic, utilizing highly relevant and credible sources.

Concept Map: The 3 P’s and Mental Health Care – Mind Map Concept: Post-Traumatic Stress Disorder (PTSD)