NURS-FPX4900 Assessment 2: Assessing the Problem: Quality, Safety, and Cost Considerations

In a 5-7 page written assessment, assess the effect of the patient, family, or population problem you’ve previously defined on the quality of care, patient safety, and costs to the system and individual. Plan to spend approximately 2 direct practicum hours exploring these aspects of the problem with the patient, family, or group you’ve chosen to work with 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. Report on your experiences during your first two practicum hours.

Introduction

Organizational data, such as readmission rates, hospital-acquired infections, falls, medication errors, staff satisfaction, serious safety events, and patient experience can be used to prioritize time, resources, and finances. Health care organizations and government agencies use benchmark data to compare the quality of organizational services and report the status of patient safety. Professional nurses are key to comprehensive data collection, reporting, and monitoring of metrics to improve quality and patient safety.

Preparation

In this assessment, you’ll assess the effect of the health problem you’ve defined on the quality of care, patient safety, and costs to the system and individual. Plan to spend at least 2 direct practicum hours working with the same patient, family, or group. During this time, you may also choose to consult with subject matter and industry experts.

To prepare for the assessment:

- 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 research of the scholarly and professional literature to inform your assessment and meet scholarly expectations for supporting evidence.
- Review the Practicum Focus Sheet: Assessment 2 [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 Supportpage.

Instructions

Complete this assessment in two parts.

Part 1

Assess the effect of the patient, family, or population problem you defined in the previous assessment on the quality of care, patient safety, and costs to the system and individual. Plan to spend at least 2 practicum hours exploring these aspects of the problem with the patient, family, or group. During this time, you may also consult with subject matter and industry experts of your choice. Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form. Use the Practicum Focus Sheet: Assessment 2 [PDF] provided for this assessment to guide your work and interpersonal interactions.

Part 2

Report on your experiences during your first 2 practicum hours, including how you presented your ideas about the health problem to the patient, family, or group.

- Whom did you meet with?
  - What did you learn from them?
- Comment on the evidence-based practice (EBP) documents or websites you reviewed.
  - What did you learn from that review?
- Share the process and experience of exploring the influence of leadership, collaboration, communication, change management, and policy on the problem.
  - What barriers, if any, did you encounter when presenting the problem to the patient, family, or group?
    - Did the patient, family, or group agree with you about the presence of the problem and its significance and relevance?
    - What leadership, communication, collaboration, or change management skills did you employ during your interactions to overcome these barriers or change the patient’s, family’s, or group’s thinking about the problem (for example, creating a sense of urgency based on data or policy requirements)?
  - What changes, if any, did you make to your definition of the problem, based on your discussions?
  - What might you have done differently?

Capella Academic Portal

Update the total number of hours on the NURS-FPX4900 Volunteer Experience Form in Capella Academic Portal.

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.

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.

- Explain how the patient, family, or population problem impacts the quality of care, patient safety, and costs to the system and individual.
  - Cite evidence that supports the stated impact.
  - Note whether the supporting evidence is consistent with what you see in your nursing practice.
- Explain how state board nursing practice standards and/or organizational or governmental policies can affect the problem’s impact on the quality of care, patient safety, and costs to the system and individual.
  - Describe research that has tested the effectiveness of these standards and/or policies in addressing care quality, patient safety, and costs to the system and individual.
  - Explain how these standards and/or policies will guide your actions in addressing care quality, patient safety, and costs to the system and individual.
  - Describe the effects of local, state, and federal policies or legislation on your nursing scope of practice, within the context of care quality, patient safety, and cost to the system and individual.
- Propose strategies to improve the quality of care, enhance patient safety, and reduce costs to the system and individual.
  - Discuss research on the effectiveness of these strategies in addressing care quality, patient safety, and costs to the system and individual.
  - Identify relevant and available sources of benchmark data on care quality, patient safety, and costs to the system and individual.
  - Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form.
- Use paraphrasing and summarization to represent ideas from external sources.
- 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 5 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 3: Transform processes to improve quality, enhance patient safety, and reduce the cost of care.
  - Explain how a patient, family, or population problem impacts the quality of care, patient safety, and costs to the system and individual.
  - Propose strategies to improve the quality of care, enhance patient safety, and reduce costs to the system and individual and document the practicum hours spent with these individuals or group in the Capella Academic Portal Volunteer Experience Form.
- 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 can affect a patient, family, or population problem’s impact on the quality of care, patient safety, and costs to the system and individual.
- Competency 8: Integrate professional standards and values into practice.
  - Use paraphrasing and summarization to represent ideas from external sources.
  - Apply APA style and formatting to scholarly writing.

Assessment 3 Instructions: Assessing the Problem: Technology, Care Coordination, and Community Resources Considerations

In a 5-7 page written assessment, determine how health care technology, coordination of care, and community resources can be applied to address the patient, family, or population problem you’ve defined. In addition, plan to spend approximately 2 direct practicum hours exploring these aspects of the problem with the patient, family, or group you’ve chosen to work with 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. Report on your experiences during the second 2 hours of your practicum.

Introduction

As a baccalaureate-prepared nurse, you’ll be positioned to maximize the use of technology to achieve positive patient outcomes and improve organizational effectiveness. Providing holistic coordination of patient care across the entire health care continuum and leveraging community resource services can lead both to positive patient outcomes and to organizational improvements.

Preparation

In this assessment, you’ll determine how health care technology, coordination of care, and community resources can be applied to address the health problem you’ve defined. Plan to spend at least 2 direct practicum hours working with the same patient, family, or group. During this time, you may also choose to consult with subject matter and industry experts.

To prepare for the assessment:

- 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 assessment and meet scholarly expectations for supporting evidence.
- Review the Practicum Focus Sheet: Assessment 3 [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

Determine how health care technology, the coordination of care, and the use of community resources can be applied to address the patient, family, or population problem you’ve defined. Plan to spend at least 2 practicum hours exploring these aspects of the problem with the patient, family, or group. During this time, you may also consult with subject matter and industry experts of your choice. Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form. Use the Practicum Focus Sheet: Assessment 3 [PDF] provided for this assessment to guide your work and interpersonal interactions.

Part 2

Report on your experiences during the second 2 hours of your practicum.

- Whom did you meet with?
  - What did you learn from them?
- Comment on the evidence-based practice (EBP) documents or websites you reviewed.
  - What did you learn from that review?
- Share the process and experience of exploring the effect of the problem on the quality of care, patient safety, and costs to the system and individual.
  - Did your plan to address the problem change, based upon your experiences?
  - What surprised you, or was of particular interest to you, and why?

Capella Academic Portal

Update the total number of hours on the NURS-FPX4900 Volunteer Experience Form in Capella Academic Portal.

Requirements

- Analyze the impact of health care technology on the patient, family, or population problem.
  - Cite evidence from the literature that addresses the advantages and disadvantages of specific technologies, including research studies that present opposing views.
  - Determine whether the evidence is consistent with technology use you see in your nursing practice.
  - Identify potential barriers and costs associated with the use of specific technologies and how those technologies are applied within the context of this problem.
- Explain how care coordination and the utilization of community resources can be used to address the patient, family, or population problem.
  - Cite evidence from the literature that addresses the benefits of care coordination and the utilization of community resources, including research studies that present opposing views.
  - Determine whether the evidence is consistent with how you see care coordination and community resources used in your nursing practice.
  - Identify barriers to the use of care coordination and community resources in the context of this problem.
- Analyze state board nursing practice standards and/or organizational or governmental policies associated with health care technology, care coordination, and community resources and document the practicum hours spent with these individuals or group in the Capella Academic Portal Volunteer Experience Form.
  - Explain how these standards or policies will guide your actions in applying technology, care coordination, and community resources to address care quality, patient safety, and costs to the system and individual.
  - Describe the effects of local, state, and federal policies or legislation on your nursing scope of practice, within the context of technology, care coordination, and community resources.
  - Explain how nursing ethics will inform your approach to addressing the problem through the use of applied technology, care coordination, and community resources.
  - Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form.
- Support main points, assertions, arguments, conclusions, or recommendations with relevant and credible evidence.
- 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 4: Apply health information and patient care technology to improve patient and systems outcomes.
  - Analyze the impact of health care technology on a patient, family, or population problem.
- Competency 5: Analyze the impact of health policy on quality and cost of care.
  - Analyze state board nursing practice standards and/or organizational or governmental policies associated with health technology, care coordination, and community resources and document the practicum hours spent with these individuals or group in the Capella Academic Portal Volunteer Experience Form.
- Competency 6: Collaborate interprofessionally to improve patient and population outcomes.
  - Explain how care coordination and the utilization of community resources can be used to address a patient, family, or population problem.
- Competency 8: Integrate professional standards and values into practice.
  - Support main points, assertions, arguments, conclusions, or recommendations with relevant and credible evidence.
  - Apply APA style and formatting to scholarly writing.

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

Assessing the Problem: Obesity Among African Americans

Obesity is a complex disorder that involves excessive body fat. Obesity is a serious health concern that increases the risk of other diseases and health problems. It increases the risk of heart disease, high blood pressure, diabetes, stroke, and some cancers. The increasing prevalence of obesity poses a significant population health burden globally. Currently, in the US alone, the adult obesity rate stands at 42.4%, the highest ever recorded. The rate of childhood obesity has also increased, with the current rate being 19.3% among children and young people aged 2-19 years. Obesity prevalence in the US varies in different health populations, socioeconomic factors, races, and ethnic backgrounds. Obesity is often ignored and may compromise healthcare service delivery and population health. Nursing interventions can, therefore, be used to address the situation at individual and population levels. This paper aims to assess the obesity health concern among African Americans from the nursing perspective and propose strategies to address the problem through leadership, collaboration, communication, change management, and policy considerations.

Population Health Problem

Obesity is one of the most prevalent chronic diseases and a leading cause of morbidity (Byrd et al., 2018). African Americans are one of the minority groups in the US. They are one of the populations that record high obesity rates. Different socioeconomic factors such as poverty and discrimination may impact people’s ability to maintain a healthy weight, thus the high prevalence of obesity in minority populations. A report by the Centers for Disease Control and Prevention (CDC) shows that African Americans have the highest obesity rates among US adults, with 49.9% age-adjusted prevalence (CDC.gov, n.d.).

Studies show that the disparities in the prevalence of obesity in racial/ethnic minorities are also associated with other factors such as diet, genetics, physical activity, psychological factors, income, stress, and discrimination, among others. Obesity is a condition that requires the input of a multidisciplinary team to address the concern. It requires lifestyle and behavioral interventions, pharmacologic therapies, and access to bariatric surgeries. Due to their high costs, health inequalities, and other societal roadblocks, it is difficult for racial and ethnic minority populations to access some of these services, such as pharmacologic therapies and bariatric surgeries. Therefore, obesity among the African American population needs particular focus, and evidence-based interventions must be applied to combat the crisis. The relevance of the problem of obesity to nursing practice is that it is an alarming global health issue that requires evidence-based interventions and research. Nurses are among the healthcare providers participating in research and development of interventions to ensure efficiency and quality of care in addressing health issues across different populations.

Obesity Among African Americans Literature Evaluation

Current practices to manage obesity majorly include obesity screening, diagnosis, and obesity counseling (Kahan, 2018). Screening and diagnosis is the first step in addressing a medical condition. Healthcare providers should screen adults for obesity at least every year and refer obese patients for multicomponent behavioral interventions to attain a healthy weight. Obesity and weight loss counseling substantially affect weight loss behaviors. These are the effective practices of obesity management. However, other practices, such as pharmacologic therapies and bariatric surgeries, are currently used to manage obesity. As mentioned earlier, the access to obesity healthcare services by minority populations such as African Americans may be compromised by health inequality and high costs (Byrd et al., 2018).

Nursing practice standards reflect nursing values that improve the quality of care delivery and patient outcomes. Literature shows that nursing practice standards and policies have significantly contributed to managing obesity across different health populations. Nurses are responsible for developing care plans and obesity management interventions for patients based on their needs. According to Schutz et al. (2019), nurses are best suited to give patient-centered obesity education, conduct motivational interviewing, and provide a report to the interprofessional team. Nurses are also trained to develop care plans that consider the psychological aspects of obesity, such as self-esteem, body image, and quality of life, thus encouraging other health benefits and reducing comorbidities in a specific population (Schutz et al., 2019). Nurses actively participate in all the stages of the policy-making process to ensure it is representative of the health needs of the total population. They provide relevant data during its formulation and pre-evaluation before implementation. Through their participation, nurses help determine areas of improvement and help produce high-quality healthcare policies. Therefore, nurses help improve patient outcomes through viable policies, prevent readmissions through good care quality and prevent illness by offering promotive and preventive health.

Obesity being a worldwide pandemic, nurses play a significant role in its management. Bucher Della Torre et al. (2018) note that individuals with obesity face stigmatization and discrimination in various settings, including healthcare settings. Obese and overweight individuals will likely suffer less educational and career access, low pay, and poor healthcare services. They are also significantly likely to be bullied, fired, teased, or even romantically rejected. Research shows that some healthcare providers, including nurses and dieticians, may have weight bias. They may also have negative stereotypes and associate obese patients with lazy, non-compliant, and undisciplined.

Weight bias is one of the barriers to implementing evidence-based practice in addressing obesity among health minority populations. Therefore, it is essential to avoid weight bias in nursing interventions towards obesity, thus preventing stigmatization and promoting obesity help-seeking behavior, especially among minority groups. Weight bias, especially from healthcare providers, may have severe psychological consequences on the patient. Individuals who encounter weight bias record poor body image, low self-esteem, stress, depression, and other psychiatric disorders.

Nursing theories provide the framework for all interventions in nursing. Younous and Quennell (2019) note that nursing theories enable nurses to evaluate and discern their roles in healthcare. The modeling and role modeling theory ensures that nurses care for and nurture patients while respecting every patient’s uniqueness. The theory will guide my actions during practicum. Since obesity is a bit of a personal condition, the theory will frame my interactions with members of the population.

Based on the literature discussed above, I have noted consistency between research and actual nursing practice. I would know if the data was unreliable, if the literature has insufficient or incomplete information, is not peer-reviewed and if the research measures what it claims to measure. The information in this literature review is reliable since I used peer-reviewed scholarly sources, which fulfill their purpose.

Impact of State Board Nursing Practice Standards and or Organizational/Governmental Policies on Obesity

Health policies may help create various strategies and build environments that promote healthy lifestyles, thus preventing obesity. Care providers can also encourage policy change and environments supporting obesity reduction (Bowen et al., 2018). Various government policies may affect the nursing scope of practice, thus influencing the management of obesity among African Americans. Obesity management requires the attention of RNs and APRNs. State government bodies produce the nursing practice act (NPA), which regulates nurses’ professional conduct and the scope of practice. Specific government policies also regulate the nurses’ curriculum, affecting the nurses’ scope of practice. However, in some states, the nursing scope of practice restricts the nurses from prescribing anti-obesity medications. However, some states exercise full practice, whereby nurses can evaluate patients, diagnose illnesses, order and interpret diagnostic tests, and prescribe medications. In such states, nurses are even allowed to open clinics, thus increasing healthcare access, especially for healthcare populations.

Leadership Strategies

Leadership is vital in healthcare since it influences care and care activities. Obesity management requires a multidisciplinary approach to ensure good patient outcomes. Obesity management requires the collaboration of the patients, their families, nutritionists, therapists, nurses, physicians, dieticians, and counselors. A participative leadership strategy ensures that all the stakeholders of obesity management are involved in decision-making and setting common goals based on the patient’s needs (Asif et al., 2019). Therefore, patient outcomes are better due to targeting individual patient needs. Patient-centered care through participation enhances patient satisfaction and adherence to behavioral change, thus significantly contributing to the overall outcome.

Participative leadership requires effective coordination and communication. The team leader should communicate the best care plan and interventions based on patient needs to the other team members (Asif et al., 2019). Planning and communication of change will be the best change management strategy to improve care outcomes. Therefore, communication, collaboration, coordination, and an active, participative approach are essential leadership strategies to ensure high-quality patient-centered care.

Conclusion

Obesity is a global health issue that requires consideration at all levels. Current interventions include bariatric surgeries, pharmacologic therapies, and behavioral interventions. Nurses have a role in collecting data for policy-making and evaluating policies to accommodate diverse and complex population needs. The local and national governments greatly influence the nursing scope of practice through the Nursing Practice Act and other acts and regulations. Nurses must be aware of these regulations to ensure interventions in healthcare conform to their stipulations. Nurse leaders should also be aware of leadership strategies to carry out leadership roles, ensuring healthcare institutions’ success in managing obesity.

References

Asif, M., Jameel, A., Sahito, N., Hwang, J., Hussain, A., & Manzoor, F. (2019). Can leadership enhance patient satisfaction? Assessing the role of administrative and medical quality. International Journal Of Environmental Research And Public Health, 16(17), 3212. https://doi.org/10.3390/ijerph16183318

Bowen, P. G., Lee, L. T., McCaskill, G. M., Bryant, P. H., Hess, M. A., & Ivey, J. B. (2018). Understanding health policy to improve primary care management of obesity. The Nurse Practitioner, 43(4), 46–52. https://doi.org/10.1097/01.NPR.0000531069.11559.96

Bucher Della Torre, S., Courvoisier, D. S., Saldarriaga, A., Martin, X. E., & Farpour‐Lambert, N. J. (2018). Knowledge, attitudes, representations, and declared practices of nurses and physicians about obesity in a university hospital: training is essential. Clinical Obesity, 8(2), 122-130. https://doi.org/10.1111/cob.12238

Byrd, A. S., Toth, A. T., & Stanford, F. C. (2018). Racial Disparities in Obesity Treatment. Current Obesity Reports, 7(2), 130–138. https://doi.org/10.1007/s13679-018-0301-3

Kahan, S. I. (2018, March). Practical strategies for engaging individuals with obesity in primary care. In Mayo Clinic Proceedings (Vol. 93, No. 3, pp. 351-359). Elsevier. https://doi.org/10.1016/j.mayocp.2018.01.006

Schutz, D. D., Busetto, L., Dicker, D., Farpour-Lambert, N., Pryke, R., Toplak, H., Widmer, D, Yumuk, V. & Schutz, Y. (2019). European practical and patient-centered guidelines for adult obesity management in primary care. Obesity facts, 12(1), 40-66. https://doi.org/10.1159/000496183

The Center for Disease Control and Prevention (n.d.). Adult Obesity Facts. https://www.cdc.gov/obesity/index.html

Younas, A., & Quennell, S. (2019). Usefulness of nursing theory‐guided practice: an integrative review. Scandinavian Journal Of Caring Sciences, 33(3), 540-555. https://doi.org/10.1111/scs.12670