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

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

Wei et al. (2021) indicate that collaboration among healthcare providers has increased patient outcomes such as adverse drug reactions, decreased mortality and morbidity, and improved medication dosage. One of the main issues impacting healthcare provision among patients is poor communication. Poor communication among nurses and physicians increased patient dissatisfaction and adverse patient outcomes. Studies indicate that hypertension puts patients at a high risk of developing cardiovascular disease. The mortality rate for hypertension remains high, and the condition remains undertreated, under detected, and uncontrolled. Team-based care is coordinated care which involves various healthcare providers working together collaboratively to help patients manage Hypertension (Linthicum et al., 2021). Team-based care has received attention since it allows patients to access high-quality care from various healthcare providers. Hospitals that lack proper communication and collaboration among the healthcare provider also experience higher rates of readmission and increased hospital stays among patients. This paper will assess a patient with hypertension from a leadership, communication, collaboration, change management, and policy perspective.

Patient Health Problem and Relevance to Nursing Practice

In this assessment, we will consider the case of Tina Jones, a 38-year-old African American with no history of substance abuse but admits to turning to food as a way of coping with stress and anxiety. She states that she lives in the ‘hood’ and is constantly worrying about the safety of her husband and her son. She is also 30lbs past her recommended BMI. She has issues sticking to a healthy diet because she frequently visits her parents (3-4 times a week) and her father enjoys spoiling her with barbecues and other fried foods. She does not find eating vegetables appealing and generally avoids them. Her mother has a history of diabetes and high blood pressure, while her father was recently diagnosed with hyperlipidemia. Her father, unlike her, maintains a highly active lifestyle and exercises four days a week. The combination of the poor lifestyle choices and the high blood pressure issue increase Mrs. Jones’ adverse outcomes.

This issue is a significant problem for the patient because it increases her risk of developing cardiovascular conditions. Her poor lifestyle choices also increase her chances of developing diabetes, among other lifestyle-related diseases. Carey et al. (2018) indicate that African Americans are twice more likely to develop hypertension than other populations. Blacks have a higher incidence of hypertension-related cardiovascular disease and end-stage renal failure than other populations in the United States. The CDC suggests that a heightened response is necessary due to the disparities in high blood pressure control in African American individuals (Wei et al., 2021). Poor management of hypertension causes patients to develop treatment-resistant hypertension.

Carthon et al. (2019) indicate that African Americans are more sensitive to salt than other patient populations. They also respond differently to high blood pressure medication than other patient groups. As a baccalaureate-prepared nurse, this information is essential because it indicates that while hypertension is mainly a lifestyle-related condition, certain populations are more prone to developing the problem than others (Linthicum et al., 2021). Therefore, it is vital to constantly advise and educate African American patients about their risk of developing the condition and salt sensitivity. It also demonstrates that specific treatment should be considered for this patient population.

Evidence from Peer-Reviewed Literature Describing and Guiding Nursing Actions Related To the Issue

Research agrees with observations made when treating patients with hypertension. A person’s lifestyle, pharmaceutical regimen, underlying health issues, genetic background, or a combination of these elements can cause hypertension. Age, race, a family medical history of hypertension or premature cardiovascular disease, and other concomitant health issues are all nonmodifiable health issues (Carthon et al., 2019). Therefore changing a patient’s lifestyle through healthy eating and exercise will achieve a healthy weight and reverse their hypertension diagnosis. Integrated therapy also involves various psychotherapy treatments, including changing the patient’s lifestyle (Wei et al., 2021). The success of a treatment course is measured by the patient’s acceptance and adherence to the treatment regimen. The reliability of research data is measured by comparing various versions of the same measurement. Its validity is found by comparing other relevant data and theories.

Modey Amoah et al. (2020) suggests that despite efforts to combat hypertension through pharmacotherapy, the control of the condition remains low. Lifestyle modifications of patients with hypertension allow them to enjoy better health outcomes. The study assessed the impact of modifiable lifestyle factors on blood pressure among patients in Ghana. The study used 360 individuals diagnosed with hypertension. The study used a diet and exercise assessment, and the blood pressure was measured frequently. The study concluded that increased physical activity, increased fruit intake, and reduced meat, carbohydrates, and fat positively impacted blood pressure control among patients. The lifestyle modified factors play a significant role in complementing pharmacotherapy in blood pressure control.

Nurses play a significant role in improving patient outcomes. Since they are at the forefront of patient care, nurses are responsible for educating patients on the importance of eating healthily and maintaining an active lifestyle (Linthicum et al., 2021). Nurses also have the role of continuing their education and finding ways of implementing evidence-based research into their treatment plans. Orem’s self-care framework was most suitable for this issue (Wei et al., 2021). The theory suggests that individuals should deliberately and freely initiate and perform on their behalf in maintaining life, health, and well-being. Nurses’ actions should be directed toward assisting the patient in assuming responsibility for self-care (Nasresabetghadam et al., 2021). Therefore, with proper education on the best lifestyle changes, Mrs. Jones can enjoy a healthy life and significantly reduce her blood pressure and weight.

How the State Board Nursing Practice Standards and Organization Policies Could Impact the Population with Hypertension

According to the Nursing Practice Act (NPA), nurses must provide safe, appropriate, and responsive quality nursing practice and develop a plan for nursing practice. To achieve these objectives, nurses have to implement and recognize the nursing practices and act to improve the treatment and comply with practice requirements (Carthon et al., 2019). Nurses should advocate for better care for the patients ensure they have the information to with the information they need. Nurses should educate patients on the impact of salty and fried foods on their health. They should also advocate for the creation of public policies which prevent and ensure appropriate treatment for hypertension. The organizational culture significantly impacts patient care (Wei et al., 2021). A healthier organizational culture will ensure positive patient outcomes such as reduced mortality and length of stay. It will also improve the patients’ quality of life and decrease pain levels. The organization culture should support nurses’ efforts of educating patients and providing evidence-based treatment.

Proper Leadership Strategies to Improve Patient Outcomes Related To Hypertension

Organizational success and leadership have a direct cause-and-effect relationship. Ideology, culture, change adaptability, and employee empowerment are all determined by leaders (Wei et al., 2021). They influence institutional strategies, as well as their implementation and efficacy. Leaders in healthcare institutions have a critical impact on the care provided to patients. They encourage personnel to increase their knowledge, skills, and talents to enhance health care quality, safety, empathy, and patient outcomes (Akbiyik et al., 2020). They continually encourage, motivate, and reward innovation and introduce new and better working methods. Nasresabetghadam et al. (2021) indicate that when nurses have proper leadership, medical facilities exhibit improvements in patient satisfaction, patient safety outcomes, and fewer medical complications. Nurse leaders are increasingly being asked to provide patients with better healthcare encounters. Effective leadership, communication, and collaboration can increase, leading to better patient outcomes.

Conclusion

Hypertension is a condition that can greatly impact a patient’s outcomes and quality of life. However, since it is a lifestyle-related health problem, it can be managed and reversed when the patients engage in regular exercises and have a better diet. Nurses play a critical role in patient care and educate patients on the best practices to ensure better patient outcomes. Effective organizational leadership can improve patient outcomes, and nurses are encouraged to practice evidence-based patient-centered care. Nurses should also be actively involved in the development of policies and legislation that can help the country and communities reduce the number of patients suffering from hypertension and other lifestyle-related illnesses.

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References

Akbiyik, A., Korhan, E. A., Kiray, S., & Kirsan, M. (2020). The effect of nurses’ leadership behavior on the quality of nursing care and patient outcomes. Creative nursing, 26(1), e8-e18. DOI:10.1891/1078-4535.26.1.e8

Carey, R. M., Muntner, P., Bosworth, H. B., & Whelton, P. K. (2018). Prevention and control of Hypertension: JACC health promotion series. Journal of the American College of Cardiology, 72(11), 1278-1293.

Carthon, J. M. B., Davis, L., Dierkes, A., Hatfield, L., Hedgeland, T., Holland, S., … & Aiken, L. H. (2019). Association of nurse engagement and nurse staffing on patient safety. Journal of nursing care quality, 34(1), 40. doi: 10.1097/NCQ.0000000000000334

Linthicum, M. T., dosReis, S., Slejko, J. F., Mattingly, T. J., & Bright, J. L. (2021). The importance of collaboration in pursuit of patient-centered value assessment. The Patient-Patient-Centered Outcomes Research, 14(4), 381-384.

Modey Amoah, E., Esinam Okai, D., Manu, A., Laar, A., Akamah, J., & Torpey, K. (2020). The role of lifestyle factors in controlling blood pressure among hypertensive patients in two health facilities in Urban Ghana: a cross-sectional Study. International Journal of Hypertension, 2020. https://doi.org/10.1155/2020/9379128

Nasresabetghadam, S., Jahanshahi, M., Fotokian, Z., Nasiri, M., & Hajiahmadi, M. (2021). The effects of Orem’s self-care theory on self-care behaviors among older women with Hypertension: A randomized controlled trial. Nursing and Midwifery Studies, 10(2), 99-108.

Wei, H., Corbett, R. W., Ray, J., & Wei, T. L. (2020). A culture of caring: the essence of healthcare interprofessional collaboration. Journal of interprofessional care, 34(3), 324-331.

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

Introduction

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

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

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

Develop a problem statement for a patient, family, or population that’s relevant to your practice.
Begin building a body of evidence that will inform your approach to your practicum.
Focus on the influence of leadership, collaboration, communication, change management, and policy on the problem.
Preparation

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

To prepare for the assessment, complete the following:

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

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

Instructions

Complete this assessment in two parts.

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

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

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CORE ELMS

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

Requirements

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

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

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

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