Assessing the Problem Essay Assignment
1 Instructions: Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations
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- 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. Assessing the Problem Essay Assignment
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: 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.
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. Assessing the Problem Essay Assignment
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.
Capella Academic Portal
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. Assessing the Problem Essay Assignment
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. Assessing the Problem Essay Assignment
- 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.
- Apply APA style and formatting to scholarly writing. Assessing the Problem Essay Assignment
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. Assessing the Problem Essay Assignment
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 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. Assessing the Problem Essay Assignment
Leadership, Collaboration, Communication, Change Management, and Policy Considerations
Management of chronic disease in the contemporary nursing practice requires evidence-based approaches that incorporate nursing leadership, nursing communication, management of change, and incorporation of relevant policies as well as the code of ethics to plan and execute interventions in the hospital and community. Hypertension is a cardiovascular disease that presents in various patients, some with known risks while others have no identifiable risks. This paper aims to define hypertension as a health problem and assess the selected patient for this project regarding leadership, communication, change management, and policies. Assessing the Problem Essay Assignment
The Health Problem
The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) defined hypertension when systolic blood pressure (SBP) is ≥140 mmHg, and systolic blood pressure (DBP) is ≥ 90 mmHg (Flack & Adekola, 2020). This persistent elevation in blood pressure has consequences on end organs and other body systems. Therefore, hypertension accounts for significant morbidity and mortalities. Prevention and improvement in hypertension management have been given priority in the healthy people 2030 objectives. The Healthy People 2020 objectives aimed at reducing the proportion of adults, adolescents, and children with hypertension. Overall, healthy people 2030 aims at improving the cardiovascular health of the American population. This includes improving care for patients with hypertension. Patients with hypertension are at risk of stroke, cardiomyopathy, heart failure, nephropathies, liver disease making other complications. Therefore, their care requires a multidisciplinary approach justifying the need for nursing leadership, communication, change management, and policy observations.
Defining the Patient Health Problem
In this practicum project, I intend to work with Mr. KJ, a 54-year-old African American male who retired a year ago from the hotel industry due to health complications. KJ has been working in a local hotel before becoming a hotelier in the past three years. He was diagnosed with hypertension four days ago when he went for a dental checkup. During this visit, KJ is seeing his physician because he is concerned about his health lately, and he thinks his weight would impact his health soon. Otherwise, KJ has been generally in good health. He has no diabetes or heart failure. However, his maternal grandmother died of a heart attack, and his mother, 68, has heart failure. He is a Christian of the Catholic persuasion. He has no smoking history but has been taking alcohol, especially whiskey, for the past 15 years during weekends. On examination, KJ is in good general condition and is in no distress. His body mass index (BMI) is 30.7 and blood pressure today is 157/94 mmHg, heart rate is 101, and respiratory rate is 17 per minute. Assessing the Problem Essay Assignment
Presence and Relevance of the Problem
I chose this patient for my project because he has just been diagnosed with hypertension and will require intensive nursing and care coordination remotely and in the clinic to prevent the progression of his disease. This long-term disease will impact his physical and psychological health. He requires both health prevention, promotion, and maintenance to prevent disease progression and the development of complications. He is from a minority population which will determine how he views himself, others, and disease in society.
Other socioeconomic determinants of health such as housing, education, and health disparities are more likely to impact his health and journey with this chronic condition. Having acquired verbal consent from him to work with him on my practicum project, I hope that my input will positively influence his and that the interaction will be mutually productive. KJ’s health problem is relevant to my personal and professional practice because it will promote my exposure to remote care, chronic disease care, family-based care, and care in the context of ethics and policies.
Evidence from Literature
Current guidelines for the management of hypertension are derived from research and clinical trials. The Joint National Committee (JNC), American Heart Association (AHA), and American College of Cardiology (ACC) have specific guidelines for the diagnosis, prevention, and treatment of hypertension. A cohort study by Hodis et al. (2020) emphasized the need for preventive health among hypertensive patients due to the increased risk of dementia. Flack & Adekola (2020) described the need for stroke prevention by setting blood pressure goals depending on the individual’s risks. The fifth objective of healthy people 2030 under heart disease and stroke (HDS-05) aims at controlling or lowering blood pressure among hypertensive patients to reduce the risk of renal disease due to hypertension (Office of Disease Prevention and Health Promotion, n.d.). According to Ferdinand & Lavie (2020, hypotension is a potent and global risk factor for atherosclerotic cardiovascular disease, thus the need for control and prevention. Therefore, these four evidence sources emphasize the need for preventive health that requires nursing care and coordination. Prevention of stroke, dementia, kidney disease, and heart disease will require various professional checkups and health prevention strategies. Assessing the Problem Essay Assignment
The findings from the above professional sources are consistent with what I see in professional training and practice. Many hypertensive patients present with complications such as chronic kidney disease, cerebrovascular accidents, and heart failure. I, therefore, saw it fit to offer my services through this practicum project to prevent these complications through nursing interventions that I will develop later in the project after the thorough needs assessment. The sources used above are credible. This is so because they meet the CRAAP criteria for credibility tests for evidence sources. CRAAP test assesses the currency, relevance, authority, accuracy, and purpose of the sources. The sources that I used are younger than five years, relevant to my practicum health problem, used accurate information from various primary sources, including guidelines and clinical trials, published by health professionals with authority in hypertension management, and written in scholarly formats with clear proposes.
EBP Implementation and Theory
The chronic care model is an appropriate framework to improve hypertension diagnosis and management for my chosen patient’s health problem. A research study by Pilipovic-Broceta et al. (2018) explained that CCM approaches use patient, provider, and system-level interventions to organize and improve hypertension care through proactive and planned care. These interventions will require evidence-based practice to be implemented, monitored, and evaluated. However, EBP implementation faces various barriers. In a research study by Mathieson et al. (2019), EBP implementation is faced with limited use of theory. Theories provide a guiding framework for the implementation of EBP information. Its absence means the healthcare provider lacks this systematic guidance and can use non-measurable and abstract goals in the planning, implementation, and evaluation. In my practicum, I will adhere to the chronic care model to guide my nursing care and coordination for KJ and evaluate related outcomes. Assessing the Problem Essay Assignment
Nursing Roles, Standards, and Policy
Nurses play a huge role in hypertension control and care for patients with hypertension. According to a study by Hannan et al. (2022), nurses lead the efforts in hypertension control and prevention in the community, hospital, and healthcare organizations. Roles and standards of nurses in these settings include but are not limited to diagnosis and treatment, detection referral and follow-up of patients, patient education and counseling, coordination of care, care management, quality improvement, and community health management. By fulfilling these roles, Vedanthan et al. (2020) and Hannan et al. (2022) reported that nurses are the backbone of patient-centered care, and their services are vital in bridging the hypertension care quality gap.
Nurses also have an expanded role in policy-making to improve hypertension management. Public advocacy and patient advocacy through participation in policy-making and reviews are essential to enhance quality improvement and patient safety in hypotension care. Communities with abundant disparities in chronic conditions such as hypertension and disparities in resource distribution and access require nursing advocacy to improve access and enhance ethical and legal considerations regarding access to these recourses. Roils of nurses in these policies include care coordination, decision-making, and management of healthcare projects to realize the goals of the respective policies. Assessing the Problem Essay Assignment
State Board Nursing Practice StandardsAssessing the Problem Essay Assignment
Standards of professional nursing practice according to the American Nurses Association are nursing assessment, diagnosis, outcome identification, planning, and evaluation. To ensure implementation, nurses perform care coordination, health promotion, consultation, and prescription (Ferris State University, n.d.). However, these standards are not performed by all nurses everywhere. State board standards and level of nursing practice determine the nurse’s capacity and legal capacity to perform these standards. State boards license and regulate nurses’ practice, thus determining the standards for different nurse cadres (GraduateNursingEDU.org, n.d.). Consultation and prescription standards are strict regulations by state boards for patient care safety and quality reasons.
Prescribing medication and medical devices for hypertensive patients require full prescriptive authority granted by respective state boards of nursing and the state’s participation in the Nursing Compact License (NLC). National practice standards regarding hypertension management and control are regulated by various organizations and committees, including but not limited to AHA, ACC, JNC, and the International Society of Hypertension. These organizations and committees provide national guidelines for hypertension diagnosis and management but do not regulate nursing interventions. At the national level, the Call to Action Policy by National Center for Chronic Disease Prevention and Health Promotion urges various sectors and stakeholders of health such as practitioners, state departments of health, public health professionals, healthcare professionals, professional associations & societies, managed care organizations, and Academic Institutions to participate in Call-to-Action policy to control hypertension (CDC, 2022). Therefore, this policy maximizes the involvement of all stakeholders. Assessing the Problem Essay Assignment
Nursing Leadership
Nursing leadership is essential in managing personnel to promote positive outcomes regarding hypertension management. Therefore, nursing leadership can influence patient-centered care and patient care quality by promoting patient experience and patient satisfaction. I anticipate that nursing leadership should be at the core of care coordination, communication, collaboration, and change management (Potter et al., 2020). Active participation in care coordination and team building are key strategies that are important in nursing leadership to promote effective teams and collaboration. Hypertension management can benefit from interdisciplinary collaboration and multidisciplinary approaches to care. Therefore, effective the above nursing leadership strategies can help a nurse as the team captain realize the goals of effective teams. The centers for disease control and prevention (CDC, 2022) advocates for a team-based approach to achieve blood pressure control. Therefore, a multidisciplinary approach and nursing leadership through collaboration, coordination, and teambuilding can benefit patients through the promotion of health literacy, risk factor identification & reduction, and patient engagement. Assessing the Problem Essay Assignment
Collaboration, Communication, and Change Management,
Not all the time do nurse interventions become successful in achieving nursing care goals. Change management is necessary for adjusting goals or interventions to ensure positive patient care outcomes. Collaboration through shared decision-making and patient engagement s aforementioned can improve these outcomes. Communication as a key strategy in change management is reliable when it is effective. Effective commutation involves feedback and evaluation. Therefore, the use of synchronous means such as smartphone applications for communication makes communication timely and thus effective. communication with the action and other team members will be essential in cases of anticipated change to avoid confusion
Conclusion
The selected patient for this practicum project is an adult African American male who has been newly diagnosed with hypertension. Evaluated literature emphasizes the need for preventive care to minimize the risk of stroke, dementia, heart disease, kidney disease, and atherosclerotic disease complication in the patient. Credible sources were used. After the assessment of the problem, I settled on the chronic care model to enhance patient outcomes through its guidance framework. Nursing standards and state board regulations will regulate my interventions. Nursing leadership will promote care coordination through collaboration and communication to change management and positive patient outcomes. Observations of federal policies and regulations will be vital in ensuring patient safety and quality. Assessing the Problem Essay Assignment
References
CDC. (2020, June 25). Promoting Team-Based Care to Improve High Blood Pressure Control. Centers for Disease Control and Prevention. https://www.cdc.gov/dhdsp/pubs/guides/best-practices/team-based-care.htm
CDC. (2022, March 23). Sectors and Strategies. Centers for Disease Control and Prevention. https://www.cdc.gov/bloodpressure/CTAstrategies.htm
Ferdinand, K. C., & Lavie, C. J. (2020). Hypertension 2020 update: A view from the Crescent City and beyond. Progress in Cardiovascular Diseases, 63(1), 1. https://doi.org/10.1016/j.pcad.2019.12.004
Ferris State University. (n.d.). Standards-of-Professional-Nursing-Practice. Ferris.edu. Retrieved August 23, 2022, from https://www.ferris.edu/health-professions/Nursing/Standards-of-Professional-Nursing-Practice.htm
Flack, J. M., & Adekola, B. (2020). Blood pressure and the new ACC/AHA hypertension guidelines. Trends in Cardiovascular Medicine, 30(3), 160–164. https://doi.org/10.1016/j.tcm.2019.05.003
GraduateNursingEDU.org. (n.d.). What is a State Board of Nursing? Graduatenursingedu.org. Retrieved August 23, 2022, from https://www.graduatenursingedu.org/state-board-of-nursing/
Hannan, J. A., Commodore-Mensah, Y., Tokieda, N., Smith, A. P., Gawlik, K. S., Murakami, L., Cooper, J., Koob, S., Wright, K. D., Cassarino, D., Arslanian-Engoren, C., & Melnyk, B. M. (2022). Improving hypertension control and cardiovascular health: An urgent call to action for nursing. Worldviews on Evidence-Based Nursing, 19(1), 6–15. https://doi.org/10.1111/wvn.12560
Hodis, J. D., Gottesman, R. F., Windham, B. G., Knopman, D. S., Lutsey, P. L., Walker, K. A., & Alonso, A. (2020). Association of hypertension according to new American College of Cardiology/American Heart Association blood pressure guidelines with incident dementia in the ARIC Study cohort. Journal of the American Heart Association, 9(22), e017546. https://doi.org/10.1161/JAHA.120.017546
Mathieson, A., Grande, G., & Luker, K. (2019). Strategies, facilitators, and barriers to implementation of evidence-based practice in community nursing: a systematic mixed-studies review and qualitative synthesis. Primary Health Care Research & Development, 20(e6), e6. https://doi.org/10.1017/S1463423618000488
Office of Disease Prevention and Health Promotion. (n.d.). Increase control of high blood pressure in adults — HDS‑05. Health.gov. Retrieved August 23, 2022, from https://health.gov/healthypeople/objectives-and-data/browse-objectives/heart-disease-and-stroke/increase-control-high-blood-pressure-adults-hds-05
Pilipovic-Broceta, N., Vasiljevic, N., Marinkovic, J., Todorovic, N., Jankovic, J., Ostric, I., Kalimanovska-Ostric, D., & Racic, M. (2018). Assessment of hypertension chronic care model: Pacic application in Bosnia and Herzegovina. PloS One, 13(8), e0202250. https://doi.org/10.1371/journal.pone.0202250
Potter, P. A., Perry, A. G., Stockert, P., & Hall, A. (2020). Fundamentals of nursing (10th ed.). Elsevier – Health Sciences Division.
Vedanthan, R., Kumar, A., Kamano, J. H., Chang, H., Raymond, S., Too, K., Tulienge, D., Wambui, C., Bagiella, E., Fuster, V., & Kimaiyo, S. (2020). Effect of nurse-based management of hypertension in rural western Kenya. Global Heart, 15(1), 77. https://doi.org/10.5334/gh.856 Assessing the Problem Essay Assignment
