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

 

Assessing the Problem: Cancer Among African Americans

Healthcare providers play a significant role in identifying health problems, assessing them, and proposing interventions that can be used to address the problem. Cancer is a group of diseases characterized by the development of abnormal cells, which multiply uncontrollably and have the potential to infiltrate or destroy normal body tissue. Cancer is a major practice problem that negatively impacts individuals, families, and healthy populations. More so, cancer is a significant health burden globally, nationally, and locally due to its high prevalence, its impact on the healthcare system, and its contribution to increased mortality and morbidity rates. In the US, approximately 1.7 million new cancer cases were reported in 2019, and approximately 599,589 people died of cancer. About 439 new cancer cases out of every 100 000 people are reported, and approximately 146 out of 100 000 people die (CDC.gov, n.d.). There are existing disparities in cancer and cancer care access. Nursing interventions are instrumental in helping understand and address the cancer problem. This essay presents an assessment of the cancer health problem among the African American Population from a nursing perspective and proposes strategies to address the problem from leadership, communication, change management, communication, collaboration, and policy considerations.

Population Health Problem and its Relevance to Personal and Professional Practice

Cancer is one of the leading causes of death and poor quality of life across different health populations. DeSantis et al. (2019) state that disparities and inequalities in cancer and cancer care access are evident. The African American population bears a disproportionate burden, with the lowest cancer survival rates and highest death rates among other races and ethnic groups in the US (DeSantis et al., 2019). Being one of the minority groups in the nation, African Americans have access to vital cancer services such as screenings, prevention, early detection, and treatment is a problem, thus the high cancer prevalence rates. DeSantis et al. (2019) note that in 2019, the African American population recorded approximately 202206 new cancer cases and 73030 cancer deaths. Additionally, the cancer burden is high among the African American population due to the various risk factors such as smoking, alcohol, obesity, and family history of cancer is also high.

Research shows that the well-established cancer disparities among racial and ethnic minorities in the US are related to the interplay between behavioral, socioeconomic, structural, socio-environmental, and biological factors. The most common cancers in these populations include colon, lung, prostate, and breast cancer. Other cancers that majorly show the complexity of the disparities include leukemia, pancreas, liver, and gastric cancer (Zavala et al., 2021)

Healthcare providers must be vigilant in the research and development of interventions that will help address the issue of cancer and, most importantly, reduce the disparities in minority populations. Additionally, cancer care services are not readily accessible for minority populations, hence the need to establish evidence-based interventions to bridge the gap and address the crisis. Nurses are at the forefront of developing evidence-based interventions and advocating for policy changes affecting cancer and cancer care access. Therefore, cancer is a health concern that is important to personal and professional practice.

Evidence Analysis of Literature Related to Cancer and Nursing Actions

There are various strategies used to control cancer across different health populations. These strategies include primary prevention, early detection and secondary prevention, treatment and diagnosis, and palliative care (Young et al., 2020). According to Rock et al. (2020), interventions in primary prevention focus on reducing and eliminating exposure to cancer-causing factors. These interventions include immunizations and dietary and pharmacological interventions. Early detection and secondary prevention are done through screening programs focused on particular populations to enhance the identification of cancer at stages when curative treatment is possible. Early detection and secondary prevention help reduce cancer mortality and enhance diagnostic follow-ups and treatment interventions. Current cancer treatment and management modalities include surgeries, chemotherapy, and radiotherapy. These modalities can be used alone or in combination, depending on the type of cancer and the particular stage. Palliative care focuses on the psychological and quality of life for cancer patients, including alleviating symptoms in all stages of the disease, from diagnosis to death.

There are various barriers to implementing evidence-based practice interventions in cancer treatment and management among African Americans. A study by Mayden (2019) revealed that the primary barrier to cancer care in minority populations is the inaccessibility/limited access to treatment facilities and services. Given that most African Americans come from socioeconomically deprived and low-resource backgrounds, cancer treatment services may be out of reach due to high costs. Another barrier is inadequate information on cancers, risks, and the importance of cancer prevention through screenings and early detection.

Nurses develop initiatives and participate in interventions for cancer primary prevention, early detection, and secondary prevention, diagnosis and treatment, as well as preventive care. Additionally, nurses act as support systems for patients throughout the cancer care continuum. According to Young et al. (2020), one of the significant roles of nurses is bridging the gap to address inequalities. Nurses play an essential role in developing policies that affect cancer and cancer care among minority populations such as African Americans. They assess policies and propose changes that can be made to improve access to care. Additionally, they implement and evaluate existing policies to address inequalities and disparities in cancer care. Nurses have also been trained to develop care plans and cancer management action plans that encompass all aspects of care, including psychological, and emotional support, pain management, and coping with therapies, which help cancer patients undergo treatment easily and contribute to better health outcomes.

Furthermore, research shows that nurses help promote patient outcomes, prevent illness, and reduce hospital readmissions for cancer patients through health promotion and preventive care (McDonnel et al., 2019). Nurses develop health promotion programs specifically focused on minority populations to teach them about cancer prevention, encourage them to undertake cancer screenings, and promote cancer treatment adherence for cancer patients. In addition, nurses are best suited to provide patient education to cancer patients. These health promotion interventions also encourage and support family members who have cancer patients, and encourage them to seek the necessary treatment, thus improving patient outcomes, preventing illness, and reducing hospital readmissions.

Various nursing theories and frameworks guide all nursing actions. The nursing theory that will frame and guide my actions during this practicum experience is Roy’s Adaptation model. The model aims to provide holistic care by evaluating the patient’s physiologic, self-concept, function, and interdependence modes. Similarly, I aim to assess the cancer problem in the African American population from all dimensions, thus giving recommendations for interventions that will facilitate the provision of holistic care.

Based on the literature analyzed above, the current interventions and practices to manage cancer among African Americans are consistent with current nursing practice. Additionally, the literature is reliable, and current and shows evidence-based cancer prevention, treatment and management interventions. I would know if the data is unreliable if the literature provided does not come from reputable sources, provides inconsistent and incomplete information, and is not peer-reviewed. However, the literature used in the analysis above meets all the aspects of this criteria, thus reliable.

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Effects of State Board Nursing Practice Standards/Governmental and Organizational Policies on Cancer Among African Americans

State board nursing practice standards and regulations impact cancer care and its provision to African Americans. Individual state nursing boards and the Nursing Practice Act regulate the nursing professional conduct and the scope of practice. However, the state board nursing practice standards and regulations vary in different states. The scope of practice also differs in different states. For instance, in Illinois, the state board of nursing has only allowed cancer care to be offered by Licensed Practical Nurses (LNP) and Registered Nurses (RN) who are specifically trained in oncology nursing (Challinor et al., 2020). Other nurses are restricted, thus compromising care provision for cancer patients, especially in minority populations. These restrictions include prescription and diagnosis. Challinor et al. (2020) note that there is a shortage of oncology nurses, which impacts care provision for cancer patients.

Furthermore, government policies such as the Social Security Act have put legislation in place to increase cancer care access, thus improving population outcomes (National Cancer Institute, 2023). The legislations aim at providing coverage for cancer planning and coordination under the Medicare program, thus increasing care access for minority populations like African Americans.

Leadership Strategies to Improve Outcomes, Patient-Centered Care, and Patient Experience Among African Americans with Cancer

Leadership is an essential aspect of cancer care since it requires the input of various players in the medical field. Various leadership strategies can be used to improve patient outcomes, patient-centered care, and patient experience among African Americans. These strategies include collaborative leadership and continuous improvement management (Morris et al., 2022). Effective collaboration is required for the members of the interprofessional team to work together in providing cancer care. Therefore, collaborative leadership can effectively enhance patient outcomes, experiences, and patient-centered care.

Additionally, with continuous research and the increase in evidence-based interventions in cancer management, continuous improvement management is required to enhance continuous improvement in cancer care, thus effectively addressing the problem. Effective communication, collaboration, and change management are necessary to address the cancer problem in this population. Adequate communication with the interprofessional team will enhance collaboration, thus enhancing patient outcomes. It is also essential to plan for change and train the players on the effect of the change, thus encouraging their participation in implementing change interventions.

Conclusion

Cancer is a significant health concern that requires the attention of all healthcare players. Its impact is felt more in minority populations. The current evidence-based interventions for cancer control include primary prevention, early detection, treatment through current modalities, and palliative care. Various government policies and standards impact cancer care and access. Leadership strategies such as collaborative leadership and continuous change management effectively improve patient outcomes, patient-centered care, and patient experience.

References

Centers for Disease Control and Prevention (n.d.). Cancer Data and Statistics. https://www.cdc.gov/cancer/dcpc/data/index.htm

Challinor, J. M., Alqudimat, M. R., Teixeira, T. O., & Oldenmenger, W. H. (2020). Oncology nursing workforce: challenges, solutions, and future strategies. The Lancet Oncology, 21(12), e564-e574. https://doi.org/10.1016/S1470-2045(20)30605-7

DeSantis, C. E., Miller, K. D., Goding Sauer, A., Jemal, A., & Siegel, R. L. (2019). Cancer statistics for African Americans, 2019. CA: A Cancer Journal For Clinicians, 69(3), 211-233. https://doi.org/10.3322/caac.21555

Mayden K. D. (2019). Evidence-Based Oncology Practice: Competencies for Improved Patient Outcomes. Journal of the Advanced Practitioner In Oncology, 10(1), 84–87. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6605702/

McDonnell, K. K., Owens, O. L., Messias, D. K. H., Heiney, S. P., Friedman, D. B., Campbell, C., & Webb, L. A. (2019). Health behavior changes in African American family members facing lung cancer: Tensions and compromises. European Journal of Oncology Nursing, 38, 57-64. https://doi.org/10.1016/j.ejon.2018.12.002

Morris, M., Seguin, M., Landon, S., McKee, M. & Nolte, E. (2022) Exploring the role of leadership in facilitating change to improve cancer survival: an analysis of experiences in seven high-income countries in the International Cancer Benchmarking Partnership (ICBP). International Journal of Health Policy Management. 11(9):1756–1766. https://doi.org/10.34172/ijhpm.2021.84

National Cancer Institute. (2023). Federal Health Legislation. https://www.cancer.gov/about-nci/legislative/current-congress/federal-health

Rock, C. L., Thomson, C., Gansler, T., Gapstur, S. M., McCullough, M. L., Patel, A. V., Andrews, K. S., Bandera, E. V., Spees, C. K., Robien, K., Hartman, S., Sullivan, K., Grant, B. L., Hamilton, K. K., Kushi, L. H., Caan, B. J., Kibbe, D., Black, J. D., Wiedt, T. L., McMahon, C.& Doyle, C. (2020). American Cancer Society guideline for diet and physical activity for cancer prevention. CA: A Cancer Journal For Clinicians, 70(4), 245–271. https://doi.org/10.3322/caac.21591

Young, A. M., Charalambous, A., Owen, R. I., Njodzeka, B., Oldenmenger, W. H., Alqudimat, M. R., & So, W. K. (2020). Essential oncology nursing care along the cancer continuum. The Lancet Oncology, 21(12), e555-e563. https://doi.org/10.1016/S1470-2045(20)30612-4

Zavala, V. A., Bracci, P. M., Carethers, J. M., Carvajal-Carmona, L., Coggins, N. B., Cruz-Correa, M. R., Davis, M., de Smith, A. J., Dutil, J., Figueiredo, J. C., Fox, R., Graves, K. D., Gomez, S. L., Llera, A., Neuhausen, S. L., Newman, L., Nguyen, T., Palmer, J. R., Palmer, N. R., Pérez-Stable, E. J. & Fejerman, L. (2021). Cancer health disparities in racial/ethnic minorities in the United States. British Journal Of Cancer, 124(2), 315–332. https://doi.org/10.1038/s41416-020-01038-6

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Seth Parker   

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

In a 5-7 page written assessment, define the patient, family, or population health problem 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 Capella Academic Portal Volunteer Experience Form.

 

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.

 

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: As you revise your writing, check out the resources listed on the Writing Center’s Writing Support page.

 

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 Capella Academic Portal Volunteer Experience Form.

 

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

The BSN Capstone Course (NURS-FPX4900 ) requires the completion and documentation of nine (9) practicum hours. All hours must be recorded in the Capella Academic Portal. Please review the BSN Practicum Campus page for more information and instructions on how to log your hours.

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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 Capella Academic Portal Volunteer Experience Form.

Organize content so ideas flow logically with smooth transitions.

AdditioAnpapl lRyeAqPuAirestmyleenatsnd formatting to scholarly writing.

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.

 

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

Competency 1: Lead people and processes to improve patient, systems, and population outcomes.

 

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

Competency 2: Make clinical and operational decisions based upon the best available evidence.

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

Competency 5: Analyze the impact of health policy on quality and cost of care.

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

Competency 7: Implement patient-centered care to improve quality of care and the patient experience.

Propose leadership strategies to improve outcomes, patient-centered care, and the patient experience related to a defined patient, family, or population problem and document the practicum hours spent with these individuals or group in the Capella Academic Portal Volunteer Experience Form.

Competency 8: Integrate professional standards and values into practice. Organize content so ideas flow logically with smooth transitions. Apply APA style and formatting to scholarly writing.

 

 

SCORING GUIDE

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

 

 

VIEW SCORING GUIDE