Assessment 4: Patient, Family, or Population Health Problem Solution Essay

 Assessment 4: Patient, Family, or Population Health Problem Solution Essay

Capstone projects target problems in care delivery and help develop an intervention to address the problem. These interventions should be evidence-based and backed by research that shows their effectiveness. The problem of interest in this capstone project is catheter-acquired urinary tract infections (CAUTIs). The previous assignments tackled themes such as leadership communication, change, collaboration, quality, costs, and technology considerations in the issue. These have been significant in understanding the problem and its effects on care delivery. This paper will develop a solution to the problem-CAUTIs and explore the factors that influenced the development of this solution.

Part 1

The solution selected is clinician education and checklists for inserting and removing catheters. Results from the literature review (evidence-based practice) show that this intervention’s activities are superimposed and effective in preventing CAUTIs and associated complications (Hernandez et al., 2019). CAUTIs affect patient satisfaction, length of hospital stays, self-reported health experiences, and safety, essential aspects of quality care. Care coordination is significant, and electronic health records will be significant in ensuring that care providers receive adequate education and implement the learned information to improve care delivery. Clinician education will also be significant in helping develop interprofessional teams’ collaboration (Mong et al., 2022). Mong et al. (2022) note that knowledge and attitude affect other factors, such as intent and participation in CAUTI prevention and management efforts. Community resources such as reliable websites can provide information to patients to increase their collaborative efforts. This intervention will be significant to CAUTIs because it will also help ensure safe insertion and removal practices, essential areas in development and risks for CAUTIS.

Part 2

Catheter-acquired urinary tract infections cause significant health issues. They result from a microorganism (primarily bacterial) ascension in the urinary system during insertion or care of the catheter. They are a significant cause of bacteremia hence a mortality rate of about 10% (Clarke et al., 2020). Above 80% of these infections are preventable. They are the most common hospital-acquired infections, which the Medicare and Medicaid center does not reimburse, hence the selection of this problem. In critical care, about 25% of the patients are catheterized during their hospital stay, increasing the risk for CAUTIs (Clarke et al., 2020). The problem is significant to infection control nurses, whose roles are dedicated to preventing infections in facilities at all costs. Nurses majorly perform catheter insertion, care, and removal, hence the significance of problems in the catheterization process to the nursing profession. Hospital-acquired infections such as CAUTIs are often seen as professional negligence and within the scope of infection control nurses.

Role of Leadership and Change Management

Leadership and change management are significant to CAUTIs. Leadership and change management help facilitate change and reduce resistance to change management in healthcare projects. Yeruva et al. (2023) note that nurses exhibit knowledge gaps in leadership roles in CAUTI prevention. Leadership strategies significant to this proposed intervention were staff education and developing a clear vision and communication. Developing a clear vision and communicating it enhances the unity of direction and ensures all individuals work towards achieving common goals and objectives (Cortellazo et al., 2019). Timely communication and clear role communication also influenced the development of this proposed intervention. These strategies helped ensure objectivity and the development of a precise evidence-based intervention with adequate contribution from the expert group. Nursing ethics also contribute significantly to this intervention. Grace and Uveges (2022) note that nursing ethics guide decisions and practice selection to optimize resources and ensures all activities are legally and ethically abiding. The ethical principles of interest were beneficence, autonomy, and non-maleficence. The interest t was to develop an effective intervention that addresses the problem at hand and relays minimal or no harm to the patients.

Strategies for Collaborating and Communicating with the Group

The expert group encountered was the infection control nurses. Infection control nurses are vital professionals in preventing and controlling infections in the hospital. They identify gaps, patterns, and problems and develop interventions to manage them. Thus, they are crucial to hospital-acquired infections such as CAUTIs and their management. Utilizing communication technologies such as video conferencing and web-based tools can help improve communication and collaboration with the experts’ group (Aceto et al., 2019). These technologies can enhance communication by bridging geographical gaps and allowing the members flexibility. These members do not have to travel for physical meetings and can continue with their daily roles and set meetings during their free time hence better collaboration. They also allow for prompt communication; thus, these technologies are vital communication and collaboration strategies for this project.

Another strategy to improve collaboration is to clarify roles and responsibilities in communication. The strategy should go along with setting clear expectations and objectives. Role confusion is a common hindrance to collaboration. McLaney et al. (2022) note that project leaders should communicate objectives, expectations and roles early to elicit collaboration. Conflicts and hesitancy can arise due to role confusion hence the need to ensure prompt communication. The experts’ group are busy professionals, and ensuring time is not wasted when working with the group is significant. McLaney et al. (202) state that understanding roles reduces time wastage and enhances preparation, hence success in discussing problems and management.

State Board Nursing Practice Standards/Organizational/ Government Policies

Government policies influenced the development of the intervention. The recommendations by the Institute of Medicine and the agency for healthcare research and quality in CAUTI prevention and management informed the development of the intervention for this project (IHI, n.d.). The AHRQ recommends three interventions (CAUTI care bundle) to manage CAUTIs: checklists, clinician education, and patient education programs (AHRQ, n.d.). Synder et al. (2020) note that education interventions effectively ensure adherence to these care bundle recommendations and reduce unnecessary catheterization and prevalence rates. The agency also requires healthcare institutions to keep track of CAUTIs ad their complications in the facility.

The Institute of Medicine recommends that institutions implement interventions to reduce unnecessary catheterizations and prolonged catheter use (IHI, n.d.). These recommendations are synonymous with AHRQ recommendations and guidelines. The policies developed by these government institutions are implementable in facilities and backed by organizational policies that play major roles in ensuring quality outcomes. Guidelines are significant to CAUTI prevention. These institutions provide evidence-based frameworks that institutions can adopt to improve CAUTI prevention and promote quality patient outcomes, as Shadle et al. (2021) support. These policies by these institutions were significant in developing the intervention for preventing CAUTIs.

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The CMS policy eliminating reimbursement of CAUTI management costs also motivated efforts to control CAUTIs and reduce costs to the system and individuals. The CMS CAUTI reimbursement policy ceased reimbursing CAUTI costs meaning that institutions and patients are required to contribute to their management, leading to high costs to the facility and individuals (AHRQ, n.d.). Thus, there is a need to retain costs by preventing CAUTIs.

Proposed intervention In Improving Quality, Patient Safety, and Costs

Education will increase professionals’ knowledge in areas such as the safe insertion and removal of catheters. At the same time, checklists will ensure that professionals implement the safety recommendations in caring for patients with catheters. The intervention will ensure the full participation of care providers in preventing CAUTIs. Checklists will minimize unnecessary catheterizations and ensure all catheters are removed within seven days of insertion. The interventions will eliminate the significant risk factors for CAUTIs identified as lack of staff knowledge, prolonged catheter use, ad unnecessary catheterization practices (Van Decker et al., 2021).

Hernandez et al. (2019) note that care provider education and the use of checklists reduce CAUTI prevalence, improve knowledge scores, and eliminate complications such as sepsis in hospitalized patients. CAUTIs costs are not reimbursed by CMS and most other insurance agencies; eliminating them will reduce costs to the system and individuals. Benchmark data sources include the healthcare dashboard, other facilities, and data from the agency for health research and quality (AHRQ). The facility can compare its performance to that of other facilities directly or nationally from the data released by the agency for healthcare research and quality. Data of significance include prevalence, complication, and mortality rates data.

Technology, Care Coordination, and Community resources in Addressing the Problem

Care coordination is essential to this problem, requiring the input of various professionals such as nurses and physicians. Care coordination is significant in developing interventions that encompass all professionals’ perspectives. Yeruva et al. (2023) note that care coordination is vital for developing prevention interventions such as education programs and preparing checklists for catheterization indications and removal purposes. Healthcare technology, such as electronic health records and dashboards, will significantly manage this problem. Healthcare dashboards will help show real-time data on the performance of the intervention and any deviations that could affect the quality of care. Electronic health records and dashboards will thus help communicate during the project and monitor its progress (Makic et al., 2022). Electronic health records will help professionals communicate during the implementation of the intervention. The technology will also facilitate the checklist’s implementation and can be used to enhance clinician education.

Community resources can also be significant to this problem. They are particularly significant in ensuring care continuity after patient discharge, and resources to improve communication and monitoring are thus significant to managing this problem. Online resources from reputable websites such as the center for disease control and prevention and the world health organization are also vital community resources that can be leveraged to improve outcomes in CAUTI prevention for professionals and patients. Grinstead et al. (2022) note that online education resources can be leveraged to promote patient and family collaboration and promote quality health outcomes. The recommendations from these organizations are evidenced by research and can be helpful in hospitals and at home.

Conclusion

CAUTI is the center of this capstone project due to their significance in critical care units. CAUTIs are significant hospital-acquired infections and the most common urinary tract infections. Leadership, change management, and nursing ethics significantly affect these problems and their management. Government policies also affect the problems and efforts directed toward their management and prevention. The client education intervention and checklist (to prevent unnecessary poor prolonged catheterization) selected will help improve care quality, reduce the prevalence and mortality of CAUTIs, and reduces costs to the system and individual.

 References

Aceto, G., Persico, V., & Pescapé, A. (2019). A survey on information and communication technologies for industry 4.0: State-of-the-art, taxonomies, perspectives, and challenges. IEEE Communications Surveys & Tutorials, 21(4), 3467-3501. https://doi.org/10.1109/COMST.2019.2938259

Cortellazo, L., Bruni, E., & Zampieri, R. (2019). The role of leadership in a digitalized world: A review. Frontiers in Psychology, 10, 1938. https://doi.org/10.3389/fpsyg.2019.01938

Grace, P. J., & Uveges, M. K. (2022). Nursing ethics and professional responsibility in advanced practice. (4^th Ed.). Jones & Bartlett Learning.

Grinstead, C., Sumner, S., & Inofuentes-Likins, M. (2022). Nurses’ Experiences and Perceptions of Using Online Resources for Patient and Family Education. Journal of Consumer Health on the Internet, 26(2), 199-206. https://doi.org/10.1080/15398285.2022.2067715

Hernandez, M., King, A., & Stewart, L. (2019). Catheter-associated urinary tract infection (CAUTI) prevention and nurses’ checklist documentation of their indwelling catheter management practices. Nursing Praxis in New Zealand, 35(1). http://dx.doi.org/10.36951/NgPxNZ.2019.004

Institute for Healthcare Improvement (IHI), (n.d.). Catheter-Associated Urinary Tract Infections: IHI How-to Guide: Prevent Catheter-Associated Urinary Tract Infection. https://www.ihi.org/resources/Pages/Tools/HowtoGuidePreventCatheterAssociatedUrinaryTractInfection.aspx

Makic, M. B. F., Stevens, K. R., Gritz, R. M., Wald, H., Ouellet, J., Morrow, C. D., Rodrick, D., & Reeder, B. (2022). Dashboard design to identify and balance the competing risk of multiple hospital-acquired conditions. Applied Clinical Informatics, 13(03), 621-631. 10.1055/s-0042-1749598

McLaney, E., Morassaei, S., Hughes, L., Davies, R., Campbell, M., & Di Prospero, L. (2022, March). A framework for interprofessional team collaboration in a hospital setting: Advancing team competencies and behaviors. In Healthcare Management Forum (Vol. 35, No. 2, pp. 112-117). Sage CA: Los Angeles, CA: SAGE Publications. https://doi.org/10.1177/08404704211063584

Mong, I., Ramoo, V., Ponnampalavanar, S., Chong, M. C., & Wan Nawawi, W. N. F. (2022). Knowledge, attitude and practice in relation to catheter‐associated urinary tract infection (CAUTI) prevention: A cross‐sectional study. Journal of Clinical Nursing, 31(1-2), 209-219. https://doi.org/10.1111/jocn.15899

Shadle, H. N., Sabol, V., Smith, A., Stafford, H., Thompson, J. A., & Bowers, M. (2021). A bundle-based approach to prevent catheter-associated urinary tract infections in the intensive care unit. Critical Care Nurse, 41(2), 62-71. https://doi.org/10.4037/ccn2021934

Snyder, M. D., Priestley, M. A., Weiss, M., Hoegg, C. L., Plachter, N., Ardire, S., & Thompson, A. (2020). Preventing catheter-associated urinary tract infections in the pediatric intensive care unit. Critical Care Nurse, 40(1), e12-e17. https://doi.org/10.4037/ccn2020438

Van Decker, S. G., Bosch, N., & Murphy, J. (2021). Catheter-associated urinary tract infection reduction in critical care units: a bundled care model. BMJ Open Quality, 10(4), e001534. http://dx.doi.org/10.1136/bmjoq-2021-001534

Yeruva, K., West, N., & Powell, W. (2023). An Eye on CAUTI Prevention: Bridging the Gap in the Prevention of Catheter-Associated Urinary Tract Infections. medRxiv, 2023-01. https://doi.org/10.1101/2023.01.21.23284862

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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.

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.

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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.