Practicum Project: Suggesting Interventional Solution To The Problem Essay

Practicum Project: Suggesting Interventional Solution To The Problem Essay

 

Patient Health Problem Solution

This practicum project was about a health issue involving a 12-year-old female who was admitted with acute asthmatic exacerbation. The patient also had childhood obesity and chronic GERD. The last session with the patient and the mother evaluated how technology would impact their healthcare. An intervention of choice to improve their health promotion and maintenance was a health educational brochure. The purpose of this paper is to summarize and substantiate this patient’s health problem; elaborate on the impact of nursing leadership and change management on the problem; explain how the quality of care, cost, and patient safety impacted the intervention; explain the role of the state board of nursing standards in improving the management of the problem; and explain the potential role of technology, utilization of community resources, and care coordination in developing the educational brochure.

Problem Summary and Justification

The patient was Annie (not her actual name), a 12-year-old black female patient accompanied by her mother on a brief inpatient hospital admission due to acute asthmatic exacerbation. However, during this admission, she was diagnosed with chronic GERD and childhood obesity. Annie has been using her Ventolin inhaler whenever needed for asthma attacks. However, this time, the inhaler did not control her symptoms even after half an hour of treatment. This was her second admission due to asthma. The first admission was four years ago when she was being evaluated for symptoms of GERD.  Recently, asthma attacks have increased in frequency and are triggered not only by cold weather but also by certain body sprays and strong smells from foods and fresh paints. Annie lives with her parents and is the only child in her family. I selected this patient because her case represents a patient health problem with various socioeconomic determinants, a need for care coordination, and nursing care and patient exudation. At the first point of our interaction, I desired to learn more in-depth about the reasons for her recent increase in attacks and offer care where possible and necessary. Therefore, her care would offer me the opportunity to exercise my quality improvement skills and nursing care coordination skills.

Role of Leadership and Change Management in Addressing the Health Problem

Good nursing leadership qualities and skills enable a nurse leader to inspire, influence, and motivate patients, care stakeholders, and other healthcare professionals in the nursing process. Nursing leadership helped inspire the patient and her family to take the initiatives to prevent future attacks through knowledge empowerment by using the educational brochure. The educational brochure contained self-explanatory information that informed the patient’s caregiver about emergency awareness and prevention strategies for future attacks. According to van Diggele et al. (2020), effective nursing leadership influences patient education through attitude and behavior change. Nursing leadership ensured that the resource was influential by keeping it simple, direct to the point, and only including the need-to-know elements that would enhance understanding and health literacy.

Change management concepts learned from undergraduate education influenced the development of the intervention. This patient’s health problem was not an ordinary case of pediatric asthma. It was complicated by comorbidities and socioeconomic issues. One key change management concept applied in this intervention’s development was stakeholder involvement (Harrison et al., 2021). Key stakeholders in this patient health problem were family caregivers, doctors, and community resource managers. This intervention aimed at engaging these stakeholders by promoting awareness in the patient and her family caregiver (the mother) in seeking these services by providing necessary contacts and links to essential community resources

The role of nursing ethics was not overlooked in the development of this intervention. Patient privacy, confidentiality, and data security ethics ensured that no direct patient identifiers were included in the interventions. The need to promote justice and equity in resource allocation, utilization, and access ensured that sample community resources for social and material support were included in the intervention. This intervention also attempted to ensure that the patient’s caregiver makes informed decisions in future health-related endeavors regarding the child’s health. Therefore, the information included in the brochure was evidence-based and adapted from current guidelines and reputable sources.

Strategies for Communicating and Collaborating with The Patient and the Family

Patient collaboration and communication improved collaboration. To enhance collaboration with this patient and her family, patient and family-centered communication is an evidence-based strategy that ensures their engagement and quality outcomes (Park et al., 2018). Patient- and family-centered communication will include a discussion of factors specific to this patient and their relevant determinants of health, such as income and health insurance in healthcare resource utilization. Communicating strategies that promote self-management and behavior improvement will improve their engagement and self-care. Change communication is another strategy that enhances cooperation and engagement of the patient’s family and their effective self-planning in the process of enhancing self-management.

Effective collaboration with the patient and her family could be enhanced through shared decision-making. In this process, the patient and the nurse collaborate to make patient-specific decisions. The selection of community resources will enhance the uptake and utilization of these resources. Patient engagement is vital in promoting compliance to care interventions and adherence to treatment plans. This engagement also promotes self-management and positive behavior change. Therefore, working closely with the patient through the above communication and collaboration strategies will prevent future unplanned hospitalizations and complications of her health problem. Patient engagement in their care will also prevent ethical problems related to decision-making (Lantos, 2020). An example is a situation where the clinician requests interventions and the patient or family declines, or the patient suggests intervention, but the clinician declines it as inappropriate without communicating.

The Role Played by Practice Standards and Policies in the Intervention Development

The state boards of nursing standards regulate my scope of intervention. Therefore, it determent what I could legally perform or explain as a baccalaureate nurse. This scope included assessment, diagnosis, planning, implementation, evaluation, and coordination of care. Therefore, the contents of this intervention were limited to health problem assessment, diagnosis of complications, planning interventions, implementing prevention strategies, evaluation of outcomes, and coordinating care between different stakeholders. Therefore, the intervention was within the boundaries of the practice authority of a baccalaureate nurse.

Effective policies such as the Health Insurance Portability and Accountability Act of 1996 (HIPAA) ensured that no protected health information (PHI) of the patient was included I n this intervention. This upheld the privacy and confidentiality between the patient and the care coordinator. This intervention also borrowed concepts from another influential policy – the affordable care act (ACA). As part of mitigating the health disparities that affected this patient, the provision of ACA that allows pediatric patients to be eligible to use their parents’ insurance covers was used as the basis of influencing the patient family to use available insurance to plan for their future health activities and expenditures. According to Suri et al. (2022), ACA improved outcomes for patients from low socioeconomic status at the individual level. However, this credible research still reported the existence of cost barriers even in those individuals who used insurance.

The Quality of Care, Patient Safety, and Cost Outcomes of the Intervention

Educational brochures have been used in health care to communicate health risks and interventions and educate patients to improve health literacy (Malliarou et al., 2022). The reforms by recent policies such as ACA have shifted patient care from hospital-based care to patient and family-based care to save care costs and improve the quality of care. Using this intervention would improve the quality of care, enhance safety, and minimize the costs of care. Quality of care has six domains: safety, equity, timeliness, effectiveness, efficacy, and patient-centered care (Harrison et al., 2021). This intervention incorporated patient-centered communication, planning, and collaboration that included specific social determinants of health, such as income and health insurance, to propose specific preventive interventions. This intervention used evidence-based information from scholarly sources to recommend health prevention and monitoring. Prevention of hospitalization was a key theme discussed in this intervention. This strategy would improve patient safety. By enhancing the use of community resources and coordinated communication through technology, this intervention would ensure that the patient’s family spends less on hospitalizations due to emergencies.

Technology, Care Coordination, and The Utilization of Community in Addressing the Patient Health Problem

Potentially useful technologies impacting this patient’s health problem are smartphone application technologies, digitally-enabled technologies, phone message service technologies, and social media. These technologies would connect the patient remotely with her primary doctor and nurse, enhance remote monitoring, improve the doctor-patient relationship, improve patient satisfaction, and prevent emergency hospitalizations (Poowuttikul & Seth, 2020). Smart inhalers will enhance self-management and self-monitoring. According to a study by Homaira et al. (2022), care coordination for asthma patients integrates acute care and primary care. This coordination also enables these families with resources that have the potential to prevent emergency hospitalizations. Community resources such as community pharmacies, online support groups, and respiratory rehabilitation facilities ensure care continuity, restore health, and reduce the risk of hospitalizations.

Conclusion

The educational brochure has the potential to positively impact the quality of care, care costs, and patient safety. Nursing leadership, change management, and nursing ethics determined the scope and contents of the intervention. State board of nursing standards were applied to ensure the intervention’s scope did not go beyond the level of practice and education. National policies such as ACA and HIPAA formed the basis of patient education and outline of information in the intervention. These policies also ensured ethics of care, such as data safety, community resource utilization and equity, and patient confidentiality. Patient-centered communication, shared decision-making, and change communication is strategies to enhance patient and family communication and collaboration by promoting patient engagement and involvement in their care. The potential role of various technologies, care coordination, and community resources cannot be overlooked in this patient’s health problem.

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References

Harrison, R., Fischer, S., Walpola, R. L., Chauhan, A., Babalola, T., Mears, S., & Le-Dao, H. (2021). Where do models for change management, improvement, and implementation meet? A systematic review of the applications of change management models in healthcare. Journal of Healthcare Leadership, 13, 85–108. https://doi.org/10.2147/JHL.S289176

Homaira, N., Dickins, E., Hodgson, S., Chan, M., Wales, S., Gray, M., Donnelly, S., Burns, C., Owens, L., Plaister, M., Flynn, A., Andresen, J., Keane, K., Wheeler, K., Gould, B., Shaw, N., Jaffe, A., Breen, C., Altman, L., & Woolfenden, S. (2022). Impact of integrated care coordination on pediatric asthma hospital presentations. Frontiers in Pediatrics, 10, 929819. https://doi.org/10.3389/fped.2022.929819

Lantos, J. D. (2020). Ethical problems in decision making in the neonatal ICU. Obstetrical & Gynecological Survey, 75(4), 214–216. https://doi.org/10.1097/ogx.0000000000000793

Malliarou, M., Pappa, V., Papathanasiou, I., Andreanidis, I., Nikolentzos, A., Apostolakis, I., & Sarafis, P. (2022). The effect of an information brochure on patients undergoing cardiac catheterization on their anxiety, knowledge, and fear: A randomized controlled study. Health Psychology Research, 10(3), 35640. https://doi.org/10.52965/001c.35640

Park, M., Lee, M., Jeong, H., Jeong, M., & Go, Y. (2018). Patient-and family-centered care interventions for improving the quality of health care: a review of systematic reviews. International Journal of Nursing Studies, 87, 69–83. https://doi.org/10.1016/j.ijnurstu.2018.07.006

Poowuttikul, P., & Seth, D. (2020). New concepts and technological resources in patient education and asthma self-management. Clinical Reviews in Allergy & Immunology, 59(1), 19–37. https://doi.org/10.1007/s12016-020-08782-w

Suri, R., Macinko, J., Inkelas, M., & Needleman, J. (2022). The relationship between insurance status and the Affordable Care Act on asthma outcomes among low-income US adults. Chest, 161(6), 1465–1474. https://doi.org/10.1016/j.chest.2022.01.011

van Diggele, C., Burgess, A., Roberts, C., & Mellis, C. (2020). Leadership in healthcare education. BMC Medical Education, 20(Suppl 2), 456. https://doi.org/10.1186/s12909-020-02288-x

This is a two-part assignment. The first one is to develop an intervention as a solution and the second one is the analysis the intervention. I have placed an order for 9 pages total, but I think this should be split between two parts, as 5-7 pages for the second part and the rest of the pages for the first one. Would this work?

 

Develop an intervention (your capstone project), as a solution to the patient, family, or population problem you’ve defined. Submit the proposed intervention to the faculty for review and approval. This solution needs to be implemented (shared) with your patient, family, or group. You are not to share your intervention with your patient, family, or group or move on to Assessment 5 before your faculty reviews/approves the solution you submit in Assessment 4. In a separate written deliverable, write a 5-7 page analysis of your intervention.

Please submit both your solution/intervention and the 5-7 page analysis to complete Assessment 4.

Introduction
In your first three assessments, you applied new knowledge and insight gleaned from the literature, from organizational data, and from direct consultation with the patient, family, or group (and perhaps with subject matter and industry experts) to your assessment of the problem. You’ve examined the problem from the perspectives of leadership, collaboration, communication, change management, policy, quality of care, patient safety, costs to the system and individual, technology, care coordination, and community resources. Now it’s time to turn your attention to proposing an intervention (your capstone project), as a solution to the problem.

Preparation
In this assessment, you’ll develop an intervention as a solution to the health problem you’ve defined. To prepare for the assessment, think about an appropriate intervention, based on your work in the preceding assessments, that will produce tangible, measurable results for the patient, family, or group. In addition, you might consider using a root cause analysis to explore the underlying reasons for a problem and as the basis for developing and implementing an action plan to address the problem. Some appropriate interventions include the following:

Creating an educational brochure.
Producing an educational voice-over PowerPoint presentation or video focusing on your topic.
Creating a teaching plan for your patient, family, or group.
Recommending work process or workflow changes addressing your topic.
Plan to spend at least 3 direct practicum hours working with the same patient, family, or group.

In addition, you may wish to complete the following:

Review the assessment instructions and scoring guide to ensure that you understand the work you will be asked to complete and how it will be assessed.
Conduct sufficient research of the scholarly and professional literature to inform your work and meet scholarly expectations for supporting evidence.
Note: As you revise your writing, check out the resources listed on the Writing Center’s Writing Support page.

Instructions
Complete this assessment in two parts: (a) develop an intervention as a solution to the problem and (b) submit your proposed intervention, with a written analysis, to your faculty for review and approval.

Part 1
Develop an intervention, as a solution to the problem, based on your assessment and supported by data and scholarly, evidence-based sources.

Incorporate relevant aspects of the following considerations that shaped your understanding of the problem:

Leadership.
Collaboration.
Communication.
Change management.
Policy.
Quality of care.
Patient safety.
Costs to the system and individual.
Technology.
Care coordination.
Community resources.

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Part 2
Submit your proposed intervention to your faculty for review and approval.

In a separate written deliverable, write a 5–7 page analysis of your intervention.

Summarize the patient, family, or population problem.
Explain why you selected this problem as the focus of your project.
Explain why the problem is relevant to your professional practice and to the patient, family, or group.
In addition, address the requirements outlined below. These requirements correspond to the scoring guide criteria for this assessment, 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 the role of leadership and change management in addressing the problem.
Explain how leadership and change management strategies influenced the development of your proposed intervention.
Explain how nursing ethics informed the development of your proposed intervention.
Include a copy of the intervention/solution/professional product.
Propose strategies for communicating and collaborating with the patient, family, or group to improve outcomes associated with the problem.
Identify the patient, family, or group.
Discuss the benefits of gathering their input to improve care associated with the problem.
Identify best-practice strategies from the literature for effective communication and collaboration to improve outcomes.
Explain how state board nursing practice standards and/or organizational or governmental policies guided the development of your proposed intervention.
Cite the standards and/or policies that guided your work.
Describe research that has tested the effectiveness of these standards and/or policies in improving outcomes for this problem.
Explain how your proposed intervention will improve the quality of care, enhance patient safety, and reduce costs to the system and individual.
Cite evidence from the literature that supports your conclusions.
Identify relevant and available sources of benchmark data on care quality, patient safety, and costs to the system and individual.
Explain how technology, care coordination, and the utilization of community resources can be applied in addressing the problem.
Cite evidence from the literature that supports your conclusions.
Write concisely and directly, using active voice.
Apply APA formatting to in-text citations and references.
Additional Requirements
Format: Format the written analysis of your intervention 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.
Portfolio Prompt: Save your intervention to your ePortfolio. After you complete your program, you may want to consider leveraging your portfolio as part of a job search or other demonstration of your academic and professional competencies.

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 the role of leadership and change management in addressing a patient, family, or population health problem.
Competency 3: Transform processes to improve quality, enhance patient safety, and reduce the cost of care.
Explain how a proposed intervention to address a patient, family, or population health problem will improve the quality of care, enhance patient safety, and reduce costs to the system and individual.
Competency 4: Apply health information and patient care technology to improve patient and systems outcomes.
Explain how technology, care coordination, and the utilization of community resources can be applied in addressing a patient, family, or population health 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 guided the development of a proposed intervention.
Competency 6: Collaborate interprofessionally to improve patient and population outcomes.
Propose strategies for communicating and collaborating with a patient, family, or group to improve outcomes associated with a patient, family, or population health problem.
Competency 8: Integrate professional standards and values into practice.
Write concisely and directly, using active voice.
Apply APA formatting to in-text citations and references.