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

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

JJ grapples with hypertension, a chronic condition characterized by high blood pressure (systolic blood pressure ≥140mmhg and diastolic blood pressure ≥90mmHg) alongside other symptoms, including irregular heartbeats, nausea, chest pain, muscle tremors, and confusion. JJ has 20-year history of cigarette smoking and alcoholism. Further, he engages in unhealthy eating habits that have led to obesity (28 lbs. above the recommended body mass index. Based on the reported symptoms and the subsequent tests, physicians confirmed that the patient is hypertensive and is increasingly susceptible to stroke and heart disease which are burdensome chronic conditions. According to the Centers for Disease Control and Prevention [CDC] (2022), heart disease and stroke are the major causes of premature deaths, increased care costs, disability-adjusted life years (DALYs), lengthy hospitalization, and poor quality of life. In terms of the economic burden of hypertension and associated complications, the United States incurs approximately $131 billion annually for hypertension prevention, management, and treatment. Since hypertension is largely a lifestyle condition, it is essential to involve JJ in a collaborative care plan that entails effective communication, the incorporation of advanced technologies, care coordination, and the utilization of community resources.

Strategies for Communicating and Collaborating with the Patient to Improve Outcomes Associated with Hypertension

JJ’s case scenario signifies the need to implement a contingency plan for assisting the patient in addressing the modifiable factors for hypertension. In this sense, implementing non-pharmacologic interventions, such as involving the patient in regulated physical exercise, educating him on healthy diet plans, smoking and alcohol cessation programs, and establishing a plan for stress management can improve his health and intercept the disease’s progression, as well as preventing more burdensome conditions, including stroke and heart disease (Verma et al., 2021). While establishing and enacting a contingency care plan for JJ, it is vital to involve him in all steps of care delivery by strengthening communication patterns and enhancing interpersonal collaboration.

Communication and collaboration are prerequisites for patient-centered care (PCC). According to Kwame & Petrucka (2021), providing care services that are consistent with and sensitive to patients’ needs, priorities, and preferences results in positive care outcomes and improved perceptions of quality care. Effective communication is central to patient-centered care because it entails developing a meaningful relationship with the patient, and responding to the patient’s health concerns, beliefs, and contextual variables (Kwame & Petrucka, 2021). Often, a typical relationship between healthcare professionals and patients entails a scenario where care providers are superior and the primary source of information, while patients are inferior and passive recipients of services without much input on care practices. However, the widespread adoption of the patient-centered care (PCC) model seeks to debunk and challenge this normalcy by strengthening the patient’s active role in determining care trajectories and influencing decisions.

While using the patient-centered care model, it is essential to consider JJ as an active stakeholder who provides insights into care practices and has the potential for self-management. As a result, healthcare professionals should use communication as an ideal tool for sharing information, coordinating activities, and developing a meaningful relationship with the patient. Kwame & Petrucka (2021) contend that communication should be a two-way dialogue where both parties are open and free to ask questions for clarity, express their opinions, exchange information, and extract meaning from the exchanged information. In this sense, healthcare professionals should overcome institutional, communication, and environmental barriers that compromise information exchange, including language barriers, poor timing, bureaucracies, and implicit and explicit perceptions about patients. Also, when communicating with JJ, care providers should incorporate ethical and professional standards by demonstrating emotional intelligence, cultural competence, empathy, and respect. These strategies can enable the patient to effectively share his concern and openly provide information regarding his health needs, preferences, and priorities.

Besides ensuring effective communication, healthcare professionals should involve JJ in a team-based, collaborative care plan for treating and managing the condition. According to Santschi et al. (2021), a team-based care model for improving hypertension management entails regular blood pressure monitoring and measurement, motivating the patient to adhere to medications and lifestyle modification programs, such as physical activity and healthy diet plans, and improving patient’s knowledge of self-management approaches. Equally, healthcare professionals should establish clear and convenient schedules for consultation and develop a follow-up plan for assessing the progress.

The Role of Leadership and Change Management in Addressing Hypertension

Healthcare professionals would face complexities when implementing a collaborative care plan for treating and managing hypertension if the organizational leadership is not committed to supporting the concepts of effective communication and a team-based care model. According to Kwame & Petrucka (2021), communication between healthcare professionals and patients faces various institutional constraints, including shortages in nursing staff, time pressure, burnout, work overload, and the healthcare system’s emphasis on task-centered care. For instance, task-centered care focus on completing care procedures and fulfilling fixed roles instead of valuing and satisfying patients’ and caregivers’ preferences, priorities, and needs (Kwame & Petrucka, 2021). The organization should transition from a task-centered care model to patient-centered care to improve outcomes and safeguard patient safety and well-being.

Besides the need to address the underlying barriers to effective communication and other structural and organizational factors that undermine a collaborative, team-based care model, effective leadership is necessary for inspiring the incorporation of advanced technologies in all-concerted efforts to prevent, treat, manage, and control hypertension. Kario (2020) contends that wearable devices are among the advanced technologies that enable timely blood pressure monitoring, accurate detection of phenotypes with negative cardiovascular prognosis, and improved monitoring of environmental factors that lead to hypertension. Equally, the organization should support the plausibility of integrating telemedicine and m-Health technologies into strategies for preventing, treating, and managing high blood pressure. The widespread adoption of these advanced technologies prompts the organizational leadership to initiate, implement, and sustain policy changes.

Effective leadership and change management can promote patient-centered care and cultivate a culture of excellence in nursing by intercepting factors that undermine quality care delivery, including work overload, burnout, and nursing staff shortages. According to Sfantou et al. (2017), organizational leadership determines elements of workplace culture, including activities, shared norms, and practices. In the context of hypertension prevention, treatment, and management, hospital leaders should adopt various elements of transformative leadership to promote creative interventions and support evidence-based practices. These elements include intellectual stimulation, inspirational motivation, individualized consideration, and idealized influence. Finally, the organizational leadership should support patient-centered communication, encourage innovation, and implement quality improvement initiatives to improve care quality.

How the Proposed Intervention will Improve the Quality of Care, Enhance Patient Safety, and Reduce Costs to the Systems and Individual

The proposed intervention encompasses various themes of pharmacological and non-pharmacologic strategies for managing and controlling hypertension, including involving the patient in cigarette and alcohol cessation programs, increasing access to physical exercise opportunities, and educating the patient on regular vital sign monitoring, healthy diets, and self-management. These approaches are consistent with the need to reduce the costs associated with hypertension and related burdensome conditions like heart disease and stroke. Also, the proposed care plan seeks to improve the quality of care and enhance patient safety. Other essential components of the proposed intervention are care coordination, incorporating advanced technologies, and utilizing community resources.

Hypertension and its sequelae, including stroke and heart disease inflict a massive economic burden on healthcare systems, considering the ever-upsurging costs of preventing, treating, and managing the condition. As a result, implementing non-pharmacologic strategies and encouraging technology-aided interventions can reduce the cost of care by intercepting the disease’s progression and averting complications. Further, utilizing technologies like telemedicine and m-Health applications can reduce the costs associated with in-office visits and in-person consultations (Snoswell et al., 2020). Finally, coordinating care through effective communication can improve adherence to the proposed care interventions and enhance outcomes.

Finally, the proposed intervention promotes care quality and patient safety by endeavoring to address symptoms of hypertension and prevent complications. Verma et al. (2021) contend that lifestyle modification approaches like physical activity, weight loss, mindfulness-based stress management, and limited alcohol consumption effectively lower blood pressure and reduce the likelihood of adverse cardiovascular events, such as stroke, heart failure, and myocardial infarction. Pharmacological methods like administering diuretics and angiotensin-converting enzyme inhibitors drugs should complement these non-pharmacologic strategies to improve hypertension symptoms and prevent complications that can compromise the patient’s quality of life, safety, and well-being.

How State Board of Nursing Practice Standards and Organizational or Governmental Policies Guided the Development of the Proposed Intervention

When implementing a contingency care plan for a hypertensive patient, it is vital to consider the inputs from nursing practice standards, and organizational, and governmental health policies that provide directions on care delivery thresholds and expectations. For instance, the American Nurses Association (ANA) ethical codes for nurses requires nurse practitioners to; collaborate with other professionals and the public in establishing, maintaining, and improving the ethical environment to provide safe and quality care, participate in interdisciplinary teams to protect human rights, promote health diplomacy, and reduce health disparities and demonstrate compassion and respect for inherent dignity (Haddad & Geiger, 2022). These provisions form the basis of ethical practices in nursing and underpin team-based, collaborative care plans.

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Similarly, the Medicaid Incentives for Prevention of Chronic Diseases (MIPCD) influence interventions for preventing, treating, and managing hypertension by supporting smoking cessation programs, weight management interventions, diabetes management, and cholesterol regulation (Witman et al., 2018). The MIPCD program is a provision of the Affordable Care Act (ACA) that supports state and organization-level interventions for preventing chronic conditions, such as cardiovascular diseases and diabetes.

Finally, the Health Insurance Portability and Accountability Act (HIPAA) of 1996 influenced the development of the purposed intervention by regulating the use of telemedicine technology in hypertension management. According to Edemekong et al. (2022), HIPAA requires healthcare organizations to implement physical, administrative, and technical safeguards, such as data protection, employee training, disaster recovery plans, and securing hardware to protect personally identifiable information (PHI). Further, this policy prompts care providers to obtain written consent from patients before sharing information with the covered institutions and healthcare professionals, including billing companies, clearinghouses, and non-patient care employees. This policy is essential in strengthening patients’ autonomy and control over information interoperability and utilization.

How Technology, Care Coordination, and the Utilization of Community Resources Apply in Addressing Hypertension

Telemedicine technology and its components, such as wearable devices and m-Health applications can improve hypertension management interventions by improving communication and supporting interactive care plans. According to Omboni et al. (2021), telemedicine facilities e-learning, medical imaging and diagnostic, remote consultation, progress tracking, and drug management. Further, the technology provides opportunities for accurate and timely vital signs monitoring and communication (Omboni et al., 2021). The entry of telemedicine technology in hypertension management can lower the costs associated with in-office visits, strengthen patients’ participation in care plans, and improve care coordination and collaboration between healthcare professionals and patients.

Similarly, care coordination and utilization of community resources are fundamental in promoting hypertension prevention, treatment, and management approaches. Care coordination entails teamwork, the creation of proactive care plans, approaches for supporting the patient’s self-management goals, and aligning community resources with patients’ health needs and goals (Agency for Healthcare Research and Quality, 2018). On the other hand, community resources are physical and virtual assets that can improve patient health and wellness. They include expert offices, gymnasia, community-based organizations, health education centers, and online websites like the American Heart Association (AHA) and the National Institute of Neurological Disorders. These resources provide timely information and recommendations for lowering blood pressure, as well as suggestions for lifestyle modification and hypertension management.

Conclusion

Hypertension is a primary cause of burdensome conditions, including stroke and heart disease. Patients grappling with high blood pressure require individualized care plans that emphasize pharmacologic and non-pharmacologic approaches, such as weight management, healthy diet education, physical activity, smoking and alcoholism cessation, and medication adherence. Care coordination and the subsequent incorporation of advanced technologies like telemedicine can facilitate the implementation of interactive, team-based care plans. Coordinated practices underpin effective communication and the norm of linking hypertensive and at-risk populations with community resources. It is essential for healthcare professionals to comply with ethical standards of nursing practice and align their activities with the provisions of landmark governmental policies, including the Affordable Care Act (ACA) and the Health Insurance Portability and Accountability Act (HIPAA) when caring for hypertensive patients.

 

References

Agency for Healthcare Research and Quality. (2018). Care coordination. https://www.ahrq.gov/ncepcr/care/coordination.html

Centers for Disease Control and Prevention. (2022). High blood pressure facts. https://www.cdc.gov/bloodpressure/facts.htm

Edemekong, P. F., Haydel, M. J., & Annamaraju, P. (2022). Health insurance portability and accountability act (HIPAA). StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK500019/

Haddad, L. M., & Geiger, R. A. (2022, August 22). Nursing ethical considerations. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK526054/

Kario, K. (2020). Management of hypertension in the digital era. Hypertension, 76(3), 640–650. https://doi.org/10.1161/hypertensionaha.120.14742

Kwame, A., & Petrucka, P. M. (2021). A literature-based study of patient-centered care and communication in nurse-patient interactions: Barriers, facilitators, and the way forward. BMC Nursing, 20(1). https://doi.org/10.1186/s12912-021-00684-2

Omboni, S., McManus, R. J., Bosworth, H. B., Chappell, L. C., Green, B. B., Kario, K., Logan, A. G., Magid, D. J., Mckinstry, B., Margolis, K. L., Parati, G., & Wakefield, B. J. (2020). Evidence and recommendations on the use of telemedicine for the management of arterial hypertension. Hypertension, 76(5), 1368–1383. https://doi.org/10.1161/hypertensionaha.120.15873

Santschi, V., Wuerzner, G., Pais, B., Chiolero, A., Schaller, P., Cloutier, L., Paradis, G., & Burnier, M. (2021). Team-based care for improving hypertension management: A pragmatic randomized controlled trial. Frontiers in Cardiovascular Medicine, 8. https://doi.org/10.3389/fcvm.2021.760662

Sfantou, D., Laliotis, A., Patelarou, A., Sifaki- Pistolla, D., Matalliotakis, M., & Patelarou, E. (2017). Importance of leadership style towards the quality-of-care measures in healthcare settings: A systematic review. Healthcare, 5(4), 73. NCBI. https://doi.org/10.3390/healthcare5040073

Snoswell, C. L., Taylor, M. L., Comans, T. A., Smith, A. C., Gray, L. C., & Caffery, L. J. (2020). Determining if telehealth can reduce health system costs: Scoping review. Journal of Medical Internet Research, 22(10), e17298. https://doi.org/10.2196/17298

Verma, N., Rastogi, S., Chia, Y., Siddique, S., Turana, Y., Cheng, H., Sogunuru, G. P., Tay, J. C., Teo, B. W., Wang, T., TSOI, K. K. F., & Kario, K. (2021). Non‐pharmacological management of hypertension. The Journal of Clinical Hypertension, 23(7). https://doi.org/10.1111/jch.14236

Witman, A., Acquah, J., Alva, M., Hoerger, T., & Romaire, M. (2018). Medicaid incentives for preventing chronic disease: Effects of financial incentives for smoking cessation. Health Services Research, 53(6), 5016–5034. https://doi.org/10.1111/1475-6773.12994

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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.
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.

 

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