Assessment 1 Instructions: Communication, Change Management, and Policy Considerations

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 Core Elms Volunteer Experience Form.

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: Remember that you can submit all, or a portion of, your draft assessment to Smarthinking Tutoring for feedback, before you submit the final version for this assessment. If you plan on using this free service, be mindful of the turnaround time of 24-48 hours for receiving feedback.

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.

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 Core Elms Volunteer Experience Form.

CORE ELMS
Complete the NURS-FPX4900 Volunteer Experience Form in CORE ELMS. Include a descriiption of your relationship to the patient, family, or group in the Volunteer Experience comments field.

Requirements
The assessment requirements, outlined below, correspond to the scoring guide criteria, so be sure to address each main point. Read the performance-level descriiptions 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.
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 Core Elms Volunteer Experience Form.
Organize content so ideas flow logically with smooth transitions.
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 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 Core Elms 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.

Present Your PowerPoint Presentation to Your Community Members

Practicum: Present Your PowerPoint Presentation to Your Community Members
This week, you will be presenting your practicum project to community members, community professionals, or mentors to elicit their opinions about your project and to gather their suggestions for improvement, which you can then incorporate into the document before it is due by Day 3 of Week 6.

By Day 4
Post the contact information of the individual(s) to whom you plan to present this week. You will want to include the first name of the individual, their position, and the agency that employs them.

By Day 7
Summarize the feedback that you received and describe how you plan to incorporate it into your final presentation.

You will be required to submit the PowerPoint you presented or changed after comments were received. Your PowerPoint must be posted by Day 3 of Week 6 (refer to the Practicum Guide in the Course Information area).

I will need more clarification from my professor in this section and will update you. (Post the contact information of the individual(s) to whom you plan to present this week. You will want to include the first name of the individual, their position, and the agency that employs them.) Thank you

Medical Applications

** Mobile app is Medscape–See attached I filled out all the info on Medscape and what it is. You are just doing the next part of this which is the example…see below..

Provide one example of an appropriate patient or clinical scenario for this app (Medscape) The example should include the following details:
Patient Age-population (Pediatric, Adult, Geriatric)
Clinical Setting (Hospital, Private Practice, Extended Living Facility)
History of Present Illness and Diagnosis or Condition
Provide a detailed descriiption of the app in your example. When will the app be implemented (at the Point-of-care or elsewhere)? Who will use the app? What potential impact will it have on the scenario? Incorporate the critical appraisal information from Part

2. Provide one evidence-based scholarly article as a reference to support clinical decision making.
This assignment will be graded on the quality of the information, inclusion of one evidence-based scholarly resource, use of citations, use of Standard English grammar, and organization based on the required components (see the paper headings and content details in Part 1)…see attached.

The length of the paper is to be between 1,000 and 1,500 words, excluding title page and reference list.
Create this assignment using Microsoft (MS) Word. You can tell that the document is saved as a MS Word document because it will end in “.docx.”
APA format is required in this assignment, explicitly for in-text citations and the reference list. Use 12-point Times New Roman font with 1-inch margins and double spacing. See the APA manual for details regarding proper citation. See resources under Course Resources, “Guidelines for Writing Professional Papers” for further clarification.
* Scholarly Sources: Only scholarly sources are acceptable for citation and reference in this course. These include peer-reviewed publications, government reports, or sources written by a professional or scholar in the field. The textbooks and lessons are NOT considered to be outside scholarly sources. For the threaded discussions and reflection posts, reputable internet sources such as websites by government agencies (URL ends in .gov) and respected organizations (often ends in .org) can be counted as scholarly sources. The best outside scholarly source to use is a peer-reviewed nursing journal. The following sources should not be used: Wikipedia, Wikis, or blogs. These websites are not considered scholarly as anyone can add to these. Please be aware that .com websites can vary in scholarship and quality. For example, the American Heart Association is a .com site with scholarship and quality. It is the responsibility of the student to determine the scholarship and quality of any .com site. Ask your instructor before using any site if you are unsure. Points will be deducted from the rubric if the site does not demonstrate scholarship or quality. Current outside scholarly sources must be published with the last 5 years. Instructor permission must be obtained BEFORE the assignment is due if using a source that is older than 5 years.

Acute Stress

Your post must include for each disorder assigned:

Presentation (Clinical Picture – Signs/Symptoms)
Nursing Interventions
Medications (include any important patient teaching)
Therapy/Alternate Treatment options for each disorder.

This is a discussion question that I do not completely understand. It does not have to be long just make sure all the questions are answered.

Week 8: Discussion: Ms. X

he initial post must include responses to all the questions in both case studies.

Ms. X, a 32-year-old Hispanic woman, has had a history of intermittent pleuritic chest pain and joint pain for the past several years. Recently, she went to her physician because she noticed that an erythematous, butterfly-shaped rash had appeared on her face. Further lab tests indicated protein in her urine. Her blood test indicated the presence of numerous antinuclear antibodies, especially anti-DNA, and mature neutrophils containing nuclear material. A diagnosis of systemic lupus erythematosus (SLE) was made. (Refer to Chapter 7, Immunity)

Discuss possible reasons why SLE was not diagnosed earlier.
Discuss how the presence of antibodies can cause such widespread damage in organ systems.
Discuss treatments for SLE and a prognosis for the patient in this case.
Mr. F, age 46 years, has had a persistent unproductive cough for several months that did not respond to cough medications. Recently, he has developed a productive cough accompanied by fatigue, anorexia, and night sweats.

Examination indicated abnormal chest sounds and weight loss. A chest radiograph showed a small cavity and infiltrate, the tuberculin test was positive, and the sputum sample contained a small amount of blood and numerous acid-fast bacilli, confirming the diagnosis of active tuberculosis. (Refer to Chapter 13, Respiratory Disorders)

Discuss the pathologic changes occurring during the development of active tuberculosis.
Discuss the transmission of TB and the conditions predisposing to the development of TB.
Discuss the treatment of tuberculosis and the precautions involved for health care personnel coming into contact with the patient.
Suggest how family members or co-workers can protect themselves.

Week 6: Discussion: Mrs. A.

The initial post must include responses to all the questions in both case studies.

Mrs. A has been taking high doses of glucocorticoids for much of the past 2 years to control severe rheumatoid arthritis. She has now developed hypertension and type 2 diabetes and would like to stop taking the cortisone because of the unwanted changes in her appearance.

Discussion Questions

How does Cushing’s syndrome affect the individual?
Discuss how hypertension and diabetes have developed and the potential complications of these conditions.
Discuss other potential problems that Mrs. A may experience resulting from long-term use of glucocorticoids.
Mrs. L is a 63-year-old woman who reports constant back pain. Further inquiry into her medical history revealed that over the past 3 years, she has suffered fractures of her femur and wrist after minor falls. She experienced menopause at age 49. Mrs. L has a secretarial job, drives to work, and she “does not have time for exercise.” She reports that she consumes 8 to 10 cups of coffee a day and has been a smoker most of her adult life. She has not seen her physician recently nor had a recommended bone density test because of the time and cost involved.

Discussion Questions

Relate Mrs. L’s history to the diagnosis of osteoporosis. What risk factors are present, and how does each predispose to decreased bone density?
Explain the cause of pathological fractures in this patient.
How could osteoporosis have been prevented in Mrs. L?
Discuss the treatments available to the patient.